Patient One (4 page)

Keeping his expression even, Warren said, “We should send a sample of the gastric juice to the FBI laboratory for stat analysis.”

“Better that we do it here,” David advised. “We’ll have the answer while the FBI is still filling out paperwork.”

“And you’ll check for corrosive toxins too, eh?” Warren asked in a low voice.

David nodded. “We’ll do a comprehensive drug and toxin screen on his blood and gastric juice.”

“How sensitive is this screen?” Warren asked. He wanted to be certain nothing was missed. “What type of test is it?”

“They use gas chromatography and mass spectrometry that can detect a few parts per million, and you can’t get much more sensitive than that. The screen can clue us in to the presence of hundreds of different drugs and poisons.”

Merrill’s eyes darted back and forth between the two doctors. The phrases
gas chromatography
and
mass spectrometry
didn’t bother him, but the mention of toxins and poisons did.

“What is this about poison? Has someone tried to poison me?”

“We have to check out all possibilities, Mr. President,” Warren explained.

“But I wasn’t the only one who became ill.”

“They may have poisoned everyone just to get to you,” Warren theorized. “Now, Mr. President, I don’t want you to worry. This is probably going to turn out to be good old-fashioned food poisoning. But we have to cover all the bases.”

Merrill felt a streak of fear go up his spine, but he kept his expression even. He remembered back to the last time he had food poisoning, and it was nothing like this. Quickly he turned to David and asked, “What do you think?”

“I’m thinking along the same lines as Dr. Warren,” David hedged. “We’re somewhat concerned because you’ve vomited blood, and that’s not usually seen in people with food poisoning.”

“Are the others throwing up blood?” Merrill asked.

“No, sir, they’re not.”

“So my diagnosis may not be the same as the others.”

“It may not,” David had to admit.

Merrill nodded slowly, the concern now showing on his face. The possibility of being poisoned gnawed at him. “Dr. Ballineau, I take it this hospital has some very fine specialists.”

“They’re among the best in the world, Mr. President,” David said.

“I think we should call them in.”

“I do, too,” David agreed. “If it’s all right with you, I’ll clear the ward upstairs and get you situated. Then we can have our specialists evaluate you.”

“Good.”

David reached for his cell phone and called the Beaumont Pavilion. As the head nurse answered, David’s gaze went back to the President’s nasogastric tube. Red blood was beginning to flow through it.

_____

Carolyn Ross reached for a pen in her nurse’s uniform and began writing down David Ballineau’s instructions. Eleven patients would have to be transferred. Six would go to the Intermediate Care Facility, the remaining five to private rooms on the general medicine ward. All rooms had to be thoroughly cleaned. All would be scrupulously searched by the Secret Service. The nurses on duty would remain on an extended shift. The interns were to be summoned to the Pavilion, where they would stay until further notice. All visitors would be asked to leave immediately.

Carolyn placed the phone down and promptly remembered something she should have asked.
What about the diet orders?
She realized that the patients coming up were suffering with gastroenteritis, but their symptoms would in all likelihood be short-lived. And not all would be on IVs.

She called David Ballineau’s number and got his message service. “Shit!” Carolyn grumbled. She did not want to waste any more time. There were too many things to do. The diet orders would be put on hold.

Carolyn dialed the number of the Beaumont Pavilion’s kitchen, which was located one floor down. It had its own crew of chefs who prepared meals that the patients ordered from menus. Its dishes were considered by some to be equal to those found in the better restaurants in Los Angeles.

The chef answered, “Yes?”

“This is Carolyn Ross, upstairs. You’ll have to stay late,” Carolyn directed. “We have some very distinguished patients being admitted, and they will require special diets.”

“No problem,” said the man pretending to be the chef. “I’ll await your orders.”

Kuri Aliev hung up and nodded to a heavyset man standing guard over two bound, blindfolded chefs. The man quickly tightened the silencer on the end of his pistol, and fired single shots into the eye sockets of the chefs, killing them instantly.

Five

Marci Matthews was frightened
by the commotion going on around her. The head nurse was disconnecting all of her cardiac monitors, while a trio of housekeepers was rapidly cleaning her room on the Beaumont Pavilion. One was mopping the floor, a second scrubbed the bathroom, and a third was collecting all the cards and toys Marci’s classmates had sent her. Nobody in the room was talking and they all had grim expressions, Marci noticed.
And it was night. Nine o’clock at night. Something bad was happening.

“Can you tell me why I’m being moved?” Marci asked nervously.

“A patient with special needs has to come into your room,” Carolyn Ross explained, then added a lie. “He has to be close to the nurses’ station, in case of an emergency.”

“He’s real sick?” Marci inquired.

“Very sick.”

“Sicker than me?”

“Yes.”

Nobody can be sicker than I am
, Marci thought miserably.
Nobody.
And for the hundredth time she asked silently,
Why me? Why me, dear God? What have I done to deserve this?
And again God didn’t answer. Marci sighed sadly, wishing it was all a nightmare from which she’d awaken healthy, like she was six months ago. Her mind drifted back to the day her illness started and turned her life upside down. She was a junior at UCLA, a cheerleader, secretary of her sorority, and in love with the best-looking guy on campus, who loved her back even more. Then the rash started on her face and arms, and grew worse in the sunlight. Then came the joint aches and chest pain, and the diagnosis of systemic lupus erythematosus. And the final blow was a pericardial effusion—a collection of fluid around her heart—which made her feel weak and short of breath.

After treatment with cortisone and immunosuppressive drugs, her symptoms improved. But the effusion persisted. She was warned that if her symptoms worsened again, the doctors would have to remove the fluid from her heart with a needle. Marci shivered to herself, not wanting even to imagine what that would be like. They said it wouldn’t hurt. But that’s what they told her when they took fluid off her lungs. And it had hurt like hell.

“You’re not taking me to remove the fluid from my heart, are you?” Marci asked at length.

“No,” Carolyn assured her. “There’s no need for that, not with your symptoms getting better.”

“The drugs are really helping,” Marci said, but she was being less than honest. The drugs had been working, making her feel stronger and stronger, until just after lunch. Then her symptoms of weakness and shortness of breath began to return. It wasn’t as bad as before, and Marci kept hoping the beneficial effects of the drugs would kick in again. “Dr. Ballineau says that sometimes the drugs work even better with time.”

“Dr. Ballineau is a straight shooter,” Carolyn told her. “If he says it’s so, it’s so.”

“And he said we could even increase the dose of my medicines if we need to,” Marci went on, wondering if she should tell the nurse about her worsening symptoms.

“Let’s hope that won’t be necessary.” Carolyn reached for a hand mirror on the night table and asked, “Do you want to carry this?”

“Yes.”

Marci took the mirror and carefully studied her face. She still considered herself pretty, with her soft features, doe-like brown eyes, and blond ponytail. But the cortisone was making her cheeks puffy, and the red rash on her forehead was more obvious. And she knew deep down that it was just a matter of time before her illness caused her beauty to disappear altogether. Then people would stare at her rash and her bloated face, and feel sorry for her. And she would be ugly and never have another date or get married and have children. Tears welled up in her eyes, and she looked away to hide them.

“Do you have anything hidden away we should take with us?” Carolyn broke into Marci’s thoughts.

“My Mickey Mouse slippers under the bed,” Marci said, still looking away.

Carolyn reached for the slippers adorned with the Disney character and placed them on the bed. “Anything in the bathroom?”

“My curling iron and hair dryer are in the cabinet drawer.”

Carolyn hurried into the oversized bathroom, with its marble fixtures and glass-enclosed shower, and fetched Marci’s personal items. She gave the bath and bidet a final glance before returning to the sitting area, where a housekeeper was dusting off a 42-inch plasma television screen that was set into the wall. Another housekeeper was carefully arranging leather-upholstered chairs around a polished coffee table.

Although Carolyn had worked on the Beaumont Pavilion for over a year, she was still impressed by how luxurious the individual suites were. They looked like rooms you would expect to find in a Ritz-Carlton hotel. And that was the intent when the Pavilion was designed. The rooms were reserved for the privileged and wealthy, and particularly for those benefactors who contributed generously to the hospital. The house staff had aptly nicknamed the floor the Gold Coast. Tonight, Carolyn thought somberly, it would be called by another name—the Western White House.

“Will my parents be notified that I’m changing rooms?” Marci asked.

“We’ll see to it,” Carolyn replied.

“Maybe I should call my dad,” Marci suggested.

“Let us take care of it,” Carolyn said. Marci’s father was a powerful entertainment lawyer who made demands every time he came onto the floor and, on a few occasions, when he was unhappy, ended up calling the dean’s office. The last thing Carolyn needed this evening was an angry phone call from a pain in the ass like Bert Matthews.

“Done!” the head housekeeper called out.

“Grab the foot of the bed,” Carolyn instructed, glancing around to make certain all the wires and monitors were disconnected. Then she quickly put the side rails up.

With care they guided the bed, Marci still in it, out the door and down the hall. Just past the nurses’ station they stopped and waited while another bed was being wheeled out of a nearby room. It carried Diana Dunn, a movie actress in her early sixties who had once starred alongside some of Hollywood’s most handsome leading men. But her beautiful face and body were now withered and wasted by progressive liver failure. As usual, her skin color was yellow, her breathing labored, and she was asleep. And she would sleep forever, Carolyn thought grimly, unless a donor for a liver transplant was found soon. Very, very soon.

Carolyn shouted over to Kate Blanchard, the junior nurse on the Pavilion who was pushing Diana Dunn’s bed, “Kate, would you take Marci down to fourteen and get her set up?”

“I’ve got to connect Diana to her monitors,” Kate shouted back as she repositioned an IV line. She was tall and young, with sharp features and jet-black hair. “It’ll take a few minutes.”

“Have one of the interns do it,” Carolyn directed.

“Gotcha.”

“Did you put Sol in his new room?” Carolyn asked.

Kate shook her head. “He won’t move until he talks to you.”

“Christ!” Carolyn grumbled under her breath. She put a confident smile on her face and squeezed Marci’s hand. “Kate will take good care of you. You’re going to do fine, kiddo.”

“You promise?” Marci asked, trying to read the nurse’s expression.

“Carolyn doesn’t lie.”

Marci waved with her fingers as her bed was wheeled away. She grinned almost enough to cover her fear.

Carolyn raced down the corridor and checked her wristwatch. She was already behind. The rooms should have been cleared out ten minutes earlier for the President. And it would take at least another ten minutes to get everything in order. But Carolyn loved the adrenaline surge and excitement of an emergent situation, where things had to be done quickly and correctly under pressure. That was what had attracted her to being a flight nurse for MedEvac, hopping into helicopters and flying to crash scenes, where life-and-death predicaments awaited her. And often she was the only trained medical person aboard, so she served more as a doctor than a nurse, starting IVs, administering drugs, and opening airways. Her schedule was hectic, twelve hours on and twelve hours off, with frequent double shifts.

But how she loved it, and she would still be doing it if her mother hadn’t become ill. A couple of years earlier, her mother started becoming forgetful, and a few times wandered off and got lost. With her mom’s diagnosis of Alzheimer’s disease, Carolyn could no longer be away erratically and for prolonged periods of time. So a year and a half earlier, she gave up flight nursing and took the position of head nurse on the Beaumont Pavilion.

In this luxurious ward, which often felt to her like a boring prison, she worked a tedious eight hours a day, five days a week, on a regular schedule. The only good part was the generous salary that allowed her to hire a sitter to care for her mother during the time she was on duty at the hospital. That damned disease takes away so much from the patient and the patient’s family. It changed everything for everybody, destroying hopes and dreams and lives. A wave of sadness came over Carolyn as she thought about her mother withering away, now only a shell of the person she used to be.

An alarm suddenly sounded behind Carolyn.

She spun around and saw an intern trying to reattach a monitor wire to Diana Dunn’s chest. He was having a difficult time with it.

“Do that when you get her into a room,” Carolyn called out. “Let’s keep this corridor clear.”

“Mrs. Dunn won’t stop twisting and turning,” the intern called back. “I don’t think the wire will stay on.”

“Then tape it down with double strips.”

Carolyn hurried along as she turned for an open door, now thinking about the half-dozen things she still had to do before the President arrived on the ward. There just wasn’t enough time to do everything. And only God knew what else the Secret Service would want done.

She entered Sol Simcha’s room and gave the small, thin man a stern look. “Why won’t you move?”

“Oh, I’ll move,” Simcha said pleasantly, looking up from his chair. “I just wanted to talk with you first.”

“About what?” Carolyn asked impatiently.

“Anything,” Simcha said with a shrug. “You’re the only person who talks to me. And more importantly, you’re the only one who listens.”

“And that makes me special, huh?” Carolyn asked.

“Doubly special,” Simcha replied sincerely. “And besides, it’s not often that an old man like me gets to talk to a pretty girl like you. And there’s something else you should know.”

“What?”

“Whenever I see you, I automatically feel better.”

Carolyn’s heart melted, as it always did in the presence of Sol Simcha. She wasn’t sure how he did it. Maybe it was his kind face, or maybe his gentle voice, or maybe the sweet disposition he had despite having lived through the hell of a Nazi concentration camp called Auschwitz. Her gaze drifted from his heavily lined face and thinning gray hair to his forearm, where a row of faded numbers were tattooed. “We’ll talk as we go. Now let’s get you in bed, and we’ll wheel you to—”

“No,” Simcha interrupted. “If I’m to move, I’ll walk, like a
mensch
.”

Carolyn groaned good-naturedly. Although she was in a hurry and short on time, she’d make time for Sol Simcha. She helped him up and waited while he steadied himself on legs damaged by an inflammatory muscle disease called polymyositis. “Okay, let’s go nice and easy.”

Simcha shifted his feet, barely able to lift them off the floor, but somehow he managed to get them moving forward. They made slow progress out of the room and into the hall, with Simcha holding on tightly to the nurse.

Carolyn noticed that the old man was breathing more heavily than usual. A progressive type of interstitial fibrosis was affecting his lungs. It was a rare complication seen in some patients with polymyositis. And it made the shopping mall magnate’s condition even more miserable, but he never complained about it. He figured it was minuscule compared to what he had already been through in life.

“Your arms seem stronger,” Carolyn said.

“They are,” Simcha agreed. “But my legs are still weak as a kitten.”

“Maybe the strength will come back to them soon, too.”

“From your lips to God’s ear.”

Carolyn gently patted the old man’s hand. “Somebody once told me that most Holocaust survivors had lost their faith in God.”

“That’s not true,” Simcha said at once. “We just think He was looking the other way when it happened.”

After a pause, Carolyn said, “You’re a remarkable man, Sol Simcha.”

“I like the way you say Simcha, with a hard
cha
,” Simcha praised. “You say it pretty good for being an Episcopalian.”

Carolyn smiled briefly. “Simcha sounds like an unusual name. Do you know its origin?”

“I picked it myself,” Simcha told her. “When I was rescued from the concentration camp and brought to America, it was the happiest time of my life. So I said to hell with my Ukrainian name, which was filled with bad memories, and chose the word in Hebrew and Yiddish for happiness or celebration. Simcha.”

“Nice,” Carolyn said, warmed by the story. “And I think you’re still a happy man, even with your illness.”

“I am,” Simcha told her. “And you should be happy too. You’re a wonderful nurse, and you have such a handsome doctor for a boyfriend.”

Carolyn looked at him strangely. “I don’t have a boyfriend.”

“The way you gaze at Dr. Ballineau says otherwise.”

“God! Is it that obvious?”

“Yes.”

Carolyn shrugged indifferently. “I don’t think he even notices me.”

“Then you’re blind,” Simcha said bluntly. “He looks at you the same way you look at him.”

Just ahead, the elevator door opened and Aaron Wells stepped out, followed by two other agents. He hurried over to Carolyn and asked, “Are you the head nurse?”

“I am,” Carolyn said.

“I’m Agent Wells,” he introduced himself. “Have you got this ward cleared?”

“I’ll need another ten minutes.”

Wells frowned, unhappy with the report. “How many rooms have been vacated?”

Carolyn pointed to her left. “All those from the end of the corridor up to the nurses’ station.”