Patient One

Copyright Information

Patient One: A Novel
© 2012 Leonard Goldberg

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This is a work of fiction. Names, characters, places, and incidents are either the product of the author’s imagination or are used fictitiously, and any resemblance to actual persons, living or dead, business establishments, events, or locales is entirely coincidental.

First e-book edition © 2012

E-book ISBN: 978-0-7387-3169-8

Book design by Donna Burch

Cover design
by Ellen Lawson

Cover art © Blood: iStockphoto.com/Renee Keith; Caduceus medical symbol: iStockphoto.com/jgroup

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Manufactured in the United States of America

Dedication

For Mia and Jackson

Attack him where he is unprepared,

appear where you are not expected.

—Sun Tzu,
The Art of War

Prologue

They had no idea
they were being poisoned.

The elegantly dressed guests swallowed the concealed toxin without tasting it and washed it down with expensive wine and champagne. The toxin traveled past the pharynx, through the esophagus, and into the stomach, causing no ill effects or damage because it was encased in a thick, lipid coat. But once it entered the small intestines, the protective coat dissolved away and slowly released its contents. The toxin, floating freely at first, was unaffected by the alkaline pH and proteolytic enzymes of the intestinal juice. But gradually individual molecules of the toxin found their way to receptors lining the intestinal wall. There they attached themselves firmly, then swept into the intestinal cells and quickly overwhelmed their defense mechanisms. From that moment on, the outcome was inevitable. With pinpoint accuracy, the toxic molecules began disrupting metabolic pathways that were crucial for the cells’ survival. The killing process was underway.

The two hundred and fifty distinguished guests, having no symptoms yet, continued to ingest the hidden toxin. Some went back for second and even third helpings of the delicious delicacy. They would suffer the most.

One

The morgue attendant pulled
back the sheet covering the body on the gurney. “Extra crispy, huh?”

José Hernandez nodded and averted his eyes from the charred remains of a firefighter sent down from the hospital’s ICU.
Holy Mother of Mercy!
What a terrible way to die!
He winced at the thought of the pain this man must have endured, and felt nauseous from the sweet, greasy smell that rose from underneath the sheet.

“You okay?” the attendant asked as he transferred the corpse to a refrigerated unit in the wall.

“Just tired,” José replied. “They have me working a double shift.”

“That’ll wear you out,” the attendant said, then rapped on the railing of the gurney. “We’re all done here.”

José guided the empty gurney out of the morgue and into the basement of University Hospital. He paused briefly to gather himself, then stretched his weary legs and tried to bring life back into them. The stretching helped, but only a little. José continued down the dim corridor, leaning heavily on his gurney. It had been a very busy night, with a seemingly endless line of patients that needed to be rushed to radiology and the ICU and the OR. He hadn’t stopped—not even for a moment—since the beginning of his first shift. But the hectic activity was slowing at last, and he would shortly take a break in the room where orderlies could relax and refresh themselves.

As he passed a bank of elevators, his cell phone chirped loudly in the stillness. The caller ID said that it was his pregnant wife. Instantly, he sensed bad news. She never phoned him at work, except for emergencies. He quickly answered. “
¿Ana, está todo bien
?”—Ana, is everything all right?

“I’m fine,” she replied in English. “I’m just calling to tell you that the dizziness I had earlier is gone. So now you do not need to keep worrying about me.” Ana always spoke in English to him when she talked about “serious matters,” a legacy of her more assimilated second-generation Angeleno family.

“You should still rest,” José said, breathing a sigh of relief. “The baby will need all of your strength.”

“I’ll rest more,” she promised.

“And I’ll see you tomorrow morning, after I get off. I will stop at the market, and make a special breakfast for us.”

“You spoil me.”

“It is easy to spoil a beautiful woman.”

His wife laughed that sweet little-girl laugh he loved. “Stop your nonsense, and go back to work.”

“Sleep well,
ángelita
.”

José put his cell phone away and pushed the gurney along the vacant corridor. Now he had a bounce to his step. His wife’s voice had reinvigorated him.
Nothing could go wrong today
, he thought contentedly. The past two weeks had been the best in his life. The very best. It started with his wife informing him that she was pregnant with their first child. She was certain it would be a girl, and they would name her Maria. What a blessing! A gift from God, after years of trying. Then came the second major event, the one he’d awaited even longer: just the previous week, he had finally been sworn in as a citizen of the United States at a public ceremony at the Convention Center on Figueroa Street. Finally he had become an American. His unborn daughter would automatically become one, anyway, but now she would have two American parents—and that would assure her a good life. And to top everything off, he had been elevated to his new position as an orderly at the medical center. He was no longer just part of a cleaning crew that mopped floors and scrubbed bathrooms. And his modest salary would be almost doubled.

José made the sign of the cross and thanked God and his patron saint for the good fortune that had come his way.

Ahead he saw two fellow orderlies who, like himself, were dressed in white. One was thin and pale, the other stocky and balding. Both were Anglos. José wondered how he should address them. Certainly not with too much respect, now that they were equals.
You are no longer a cleaner,
he reminded himself, pulling his shoulders back slightly.
You are a hospital orderly.

The thin man waved cordially.

José waved back and greeted them, “Good evening. I am José Hernandez.”

“I am Aliev,” the thin man said, not bothering to introduce his co-worker. “Very busy tonight, eh?”

“Yes. It’s been nonstop.”

“Too bad these new gurneys are not functioning well.”

“What do you mean?” José asked.

“Some of the wheels have been breaking. Two patients have fallen off their gurneys already today,” Aliev informed him.

“My wheels are working fine,” José said.

“You had better check them,” Aliev advised. “You don’t want yours to malfunction with a patient on it.”

“Yes, I’ll take a look,” José agreed, and leaned over to examine the wheels.

He never saw the blow coming.

The balding man slammed the back of his clenched fist into José’s neck, with the force of a sledgehammer. The Hispanic orderly dropped to the floor, stunned and unaware of what had happened. Before José could regain his senses, the balding man looped a string of piano wire around his throat. Betraying no emotion at all, he tightened the garrote and shut off the orderly’s air supply. Once his legs stopped kicking, it took José Hernandez less than a minute to die.

“Hurry,” the man who called himself Aliev urged.

The balding man dragged the body into a nearby room, then forcefully stuffed it into a narrow metal locker. Before closing the door, he ripped off the orderly’s ID card and tossed it to Aliev.

“You want other ID, like wallet?” the balding man asked in broken English.

“No, just the card.”

Aliev studied the plastic card briefly. The photograph on it bore no resemblance to him, but that was of little concern. No one closely checked ID cards on orderlies late at night. He pinned it onto his shirt.

Stepping out into the corridor, Aliev said, “Now, quickly, get onto the gurney beneath the sheet.”

The balding man stared back at him uncomprehendingly. The word
sheet
was unfamiliar to him. “
Soh tsa khaet
”—I don’t understand, he said in Chechen.

Aliev repeated the order in his native Chechen, then switched back to English. “While we are in the halls of the hospital, speak only as the Americans do. Understand?”

“Y-yes,” the balding man said haltingly and climbed onto the gurney. “Only American.”

“Good.” Aliev nodded his approval. He had demanded that his Chechens speak proficient Russian and rudimentary English. Some understanding of the latter two languages could prove to be critical for the success of their mission. “Your shoes are showing. Draw them back.”

Again the balding man did as he was ordered. “Can you see them now?”

“No.”

Aliev pushed the gurney down the deserted corridor, peering into each room he passed. All were quiet and empty, except one. Its door was closed, with music playing behind it. Aliev ignored the sound and glanced at his watch. It was 9:10 p.m. The security guard would begin making his rounds soon. The guard was old, with a noticeable limp. But he carried a two-way radio, and that could cause trouble. Aliev moved on, picking up the pace.

As he turned the gurney into a waiting elevator, Aliev asked, “Is your silencer attached?”

Under the sheet the balding man fingered the silencer on his 9mm Glock, then answered, “Yes.”

“Be ready,” Aliev said, and punched the button for the ninth floor of the medical center.

Two

The President’s pain started
halfway through the official dinner. It was a deep, burning sensation in his upper abdomen that radiated into his chest. He reached for a glass of water and took a sip. The burning eased.

“What a lovely banquet, Mr. President,” said Ivana Suslev. “So
many
movie stars.”

“Well, this is where they all live,” the President said to the wife of the visiting Russian leader.

“I see Tom and Jennifer and Nicole,” she stargazed at the tables below. “Do you think I might meet them?”

“I think we can arrange that.” The President smiled to himself. He’d been briefed that Ivana Suslev was fascinated with American film stars, and the protocol officers had seen to it that several major stars sat in her line of sight, directly in front of her.

They were seated on the dais in a large banquet hall at the Beverly Hills Wilshire Hotel. In attendance were two hundred and fifty members of Los Angeles’ wealthy elite. Mostly bankers and builders and financiers, with just enough Hollywood stars and entertainment moguls. They were invited to the gala to honor the President of the United States and the President of Russia, who would soon sign a friendship pact that had heavy economic overtones. Although the pact made no mention of petroleum, every sentence was dripping with it. Russia now controlled the largest of the world’s untapped oil reserves, and had promised to supply the United States with every gallon it needed. America’s dependency on Middle Eastern oil was about to end.

This sea change had taken place during the past year. Using advanced American technology, a giant oil field containing 220 billion barrels had been discovered in the Western Siberian Plain, increasing Russia’s known oil deposits to 360 billion barrels. And another smaller field to the north was being actively explored. The total reserves of Russia would soon exceed 400 billion barrels, second only to the oil reserves of all OPEC countries combined. With these new discoveries, the world had undergone a massive power shift. The economic influence of OPEC in general and the political importance of the Arab states were diminishing daily. And with their oil reserves dwindling, the situation could only worsen for them.

The two presidents had convened this formal official dinner to proclaim the increased friendship and joint economic interests that existed between America and Russia. Their more subtle motive was to let the world know that OPEC would no longer control the market and dictate the price of American oil.

Ivana Suslev was now talking about Rodeo Drive and its wonderful shops. Bally. Hermès. Bottega Veneta. The President nodded, but he really wasn’t listening. His gastric pain had returned, bringing with it a twinge of nausea. He was tempted to take one of the antacid pills he always carried in his coat pocket. But he knew he couldn’t. Not here, not with hundreds of people and a powerful head of state watching. Any pill, any sign of illness, would be interpreted as a weakness. And weaknesses could be exploited.

John Merrill, at forty-five the youngest American president since John F. Kennedy, was assumed to be in excellent health. His annual physical examination revealed a resting pulse of sixty beats per minute, a blood pressure of 110/70, and a normal stress test. His personal physician officially reported that the President had a mild case of acid reflux with esophagitis, which was well controlled with Prilosec. But in fact the esophagitis wasn’t mild and wasn’t well controlled with Prilosec, and the indigestion that came with it was bothering him more and more. The annual press release also glossed over the discomfort in his right knee, the result of an old football injury incurred while he was a star quarterback at Stanford. That too was nagging him now.

Merrill stretched out his leg under the table, and the knee joint cracked pleasantly. The ache he had been experiencing disappeared.
Too bad I can’t do the same thing for my stomach
, he thought sourly, and wondered what had set off his acid reflux this time. It was probably the lemon-cured salmon that followed the lightly seasoned soup. Or maybe the beluga caviar he’d consumed at the Russian reception earlier in the evening.
Goddamn it! I’ve got to watch what I eat.

Out of the corner of his eye Merrill saw his wife, who was four seats away, push her chair back and stand. She smiled and spoke briefly to Dimitri Suslev, then hurried off to a side door that led to a guarded corridor. A Secret Service agent followed her out.

“Excuse me,” Merrill said to Ivana Suslev, and signaled to the Secret Service agent behind him.

Aaron Wells, the President’s lead agent, quickly stepped over and leaned in close. “Yes, sir, Mr. President?”

“See if the First Lady is all right,” Merrill whispered.

Wells moved away and spoke into the microphone that was inside his sleeve next to his wrist. After a short conversation he came back to the President. “Her stomach is a little queasy, sir.”

“Goddamn lemon-cured salmon,” Merrill muttered under his breath.

“What’s that, Mr. President?” Wells asked at once.

“Nothing,” Merrill replied and glanced over to his wife’s empty chair. “Dr. Warren should take a look at her.”

“The agent assigned to the First Lady suggested that we have her seen by your personal physician, but she refused, Mr. President.”

“Have Warren check her anyway.”

“Yes, sir.”

As the agent moved back, Ivana Suslev asked Merrill, “Is there anything wrong, Mr. President?”

“Everything is fine,” Merrill assured her, wondering if the combination of lemon-cured salmon and beluga caviar had set off his wife’s stomach, too.

Lucy Merrill, like her husband, was sensitive to spicy foods and did her best to avoid them. On state occasions, however, she sometimes indulged a bit, but only after taking a double dose of Prilosec. The drug usually controlled things.
But not tonight
, Merrill thought unhappily as a second wave of burning nausea came up into his throat. He took another sip of water, but this time it didn’t help much.

Dimitri Suslev, a short, squat man with a large head and thick black eyebrows, stood and bellowed out, “Mr. President, I propose a toast to you and the people of your great country.”

Merrill got to his feet and raised his glass. He liked Suslev, but he did not trust him. Russian leaders had a long history of making alliances and pacts, only to break them later when they no longer served their purposes. And Suslev was no different. He had pledged to give exclusive drilling and distribution rights to the three American oil companies that had played a crucial role in the discovery of Russia’s new oil fields. Yet he was currently negotiating a clandestine compact with the Chinese government that included a multibillion-dollar oil and gas pipeline that ran from the Siberian Plain to northern China. Suslev had seen the opening and taken it, despite the promise he’d made months earlier.

The Russian concept of diplomacy
, Merrill thought darkly.
To them, treaties are meant to be used, not adhered to. So I’ll watch him. And I’ll keep in mind that America is racing ahead with a new internal combustion–based technology that could release the one and a half trillion barrels of oil trapped in the massive shale beds of Wyoming, Montana, and Utah.

Currently, the oil in shale was being extracted by a process called fracking, which consisted of blasting water, sand, and chemicals into the oil-soaked rock. But fracking was far more expensive and considerably less effective than the newly discovered process. Once the internal-combustion method was perfected, it was estimated that oil could be produced from shale at a cost of $75 a barrel.
Just imagine that! Over a trillion barrels of oil, all belonging to America! We would be energy independent for hundreds of years, and with oil at $75 a barrel our nation’s economy would boom.
But perfection and implementation of the new technique was thought to be at least eight to ten years away. Until then, America needed Russia. But Russia also desperately needed American investment and know-how to rebuild its massive infrastructure.
And that
, Merrill thought,
would keep Suslev partially honest. For now.

The toast went on and on.

Merrill held up his glass of water and wished Suslev’s long-windedness would come to a close. But the Russian president rambled on, now saluting the American Secretary of State and his wife, who were seated beside him. Suslev paused, then began extolling the natural beauty of California.
Goddamn it! Wrap it up!
Merrill growled under his breath.

Another wave of nausea traveled up Merrill’s esophagus and he swallowed it back. But it left a sour, bilious taste in his mouth. Again he considered reaching for an antacid pill but resisted the urge. He pasted a smile on his face and gazed down at those assembled, many of whom had their glasses raised. But something was wrong. Some of the people appeared to be hurrying out. A dozen or so. Mostly women, with their hands covering their mouths. One of the seated movie stars was bent over, with her head between her knees. The man next to her appeared to be retching.

An intense surge of nausea caused Merrill to gag. He tasted vomit coming up. Quickly he turned to Wells, stood, and said, “Get me to the john. Now!”

“Liberty is on the move!” Wells barked into his microphone. “Clear the head!”

He took the President’s arm and led him past the startled guests on the dais. They raced out the side door and down a long corridor, now joined by four more Secret Service agents, two to each side of the President. A maid standing beside a laundry cart was roughly shoved into a linen closet. A nearby elevator door opened, and an agent peeled off to stop the passengers from exiting.

“Secure the entire hall!” Wells shouted. “Nobody in or out!”

Merrill dashed into the men’s room and entered a stall just in time. Kneeling down, he put his face over the toilet bowl and brought up a torrent of vomit. Then another mouthful, then another, until his stomach was empty. Finally he opened his eyes and took a deep breath. Perspiration was pouring off his forehead in big droplets. A wave of dizziness came and went. He tried to stand but felt lightheaded, and sank back to his knees. Then he vomited again. Now the vomit tasted peculiar, more sweet than bitter. Once more he attempted to get to his feet and, as he did, he stared down into the toilet bowl. It was filled with blood. Bright red blood!

Merrill felt as if he was about to pass out. Desperately gathering his strength, he reached up for the handle to the stall door and slowly pulled his body to a standing position. He paused a moment and steadied himself before staggering toward the door of the men’s room. Again he threw up bright red blood, with most of it splattering over his shirt and coat. He reached for the door and opened it, then collapsed into the arms of Aaron Wells.

“Liberty is down!” Wells cried out into his microphone. “Liberty is down!”

The corridor suddenly seemed filled by men in suits, with wires from earphones snaking down their collars. The President was lifted by four agents. Two had his legs, two his upper torso. Wells grabbed a large towel from the laundry cart and draped it over the President’s blood-soaked shirt and coat. The group ran down the corridor with four more agents joining in, their weapons drawn. They formed a phalanx as they entered the lobby and rushed for the rear entrance, knocking over everybody and everything in their way. A man in a wheelchair was pushed into a sofa, a large potted plant alongside him sent flying. Two chatting women were bowled over. A bellman at the door was slammed into the ground. In the driveway the presidential limousine was waiting, motor running.

The President was quickly placed in the back seat, with Aaron Wells at his side. Another agent was in front on the right, a third in the driver’s seat. A black Chevy Suburban pulled up in the rear, carrying another team of heavily armed Secret Service agents.

“Go! Go!” Wells yelled.

The LAPD motorcycle escorts gunned their engines, and with lights flashing led the way out of the drive.

The presidential motorcade sped out onto Wilshire Boulevard, sirens blaring.