Patient One (11 page)

Alderman searched his mind, with its near-encyclopedic memory, for an answer. A highly trained team, he thought. One that could go anywhere any time and do pinpoint kills. One that could get in and out with clockwork precision. Alderman’s brain suddenly clicked. He now recalled a plan he’d been recently briefed on in which a special team was to be sent into Mexico to settle a score with a heavily guarded drug lord who had captured and mutilated two DEA agents.

Alderman shifted his considerable frame in his seat. At two hundred and fifty pounds, his weight caused the chair to squeak. He rubbed his double chin thoughtfully, then ran a hand through his thinning hair. It was an involuntary ritual he performed every time he came up with an answer to a difficult problem. “Madam Vice President, there is a Secret Service Special Operations team that is used in sensitive presidential-threat cases. This team was recently called on to deal with a vicious drug lord.”

Toliver looked at him quizzically. “What does a drug lord have to do with protecting the President?”

“On the surface, not much,” Alderman explained. “But when the drug lord executes two DEA agents and then threatens to kill the President of the United States, it becomes a threat to national security. As you know, after 9/11 Congress passed an anti-terrorism statute that empowers the Secret Service to assume control over any felony involving possible terrorism. When it comes to fighting terrorism, this team is authorized to go anywhere in the world.”

“Are they good?” Halloway asked. “I mean, as good as our military Special Ops teams?”

“Oh, yes,” Alderman assured her. “And every bit as experienced, too. They know how to grab and kill, and improvise if necessary. They were the ones who brought the Bali incident to a successful conclusion.”

“I thought that was done by military Special Ops,” Toliver interjected.

Alderman shook his head. “It was the Secret Service team.”

Halloway remembered back to the near-tragic event that took place on the island of Bali. Months earlier, two Under Secretaries of State, Jack and Valerie Traynor, had traveled to Indonesia to do the groundwork for an upcoming presidential visit. After completing the preparations, the couple decided to vacation at a posh resort on Bali, where they were taken hostage by terrorists who threatened to kill them if the President didn’t cancel his trip. The terrorists also threatened to assassinate the President if he insisted on visiting. Within days, the Secret Service team entered the resort on stealth helicopters, rescued the hostages, and killed five terrorists. And they did it without so much as breaking a window.

“Where is the team located?” Halloway asked at length.

“Beltsville, Maryland. But they may not be there,” Alderman said. “They travel all over the globe. Their last mission was scheduled in Mexico. I recently signed off on the plan.”

Halloway perked up. “How far from the California border?”

“That’s what we have to determine.” Alderman turned to an aide and snapped his fingers rapidly. “Find out where they are!”

The aide placed a call on his cell phone and spoke in staccato sentences. Then he waited, anxiously tapping his foot against the floor. Abruptly he pressed the phone to his ear and listened intently before firing off a string of questions. He turned back to Alderman and reported. “Sir, the Secret Service Special Ops team is just outside Manzanillo, Mexico.”

“Get Manzanillo up on the screen,” Alderman ordered.

The directive was issued. Almost instantly a map of Mexico appeared on the video screen. A red arrow zeroed in on Manzanillo, a city on the western coast north of Acapulco.

“What’s the flying time to Los Angeles?” Alderman asked at once.

“Three hours and twenty minutes,” the aide replied.

“Get them out!”

“Sir, they’re in the middle of a firefight.”

“Get them out and airborne now!” Alderman demanded.

The aide hurriedly passed on the order.

Halloway strummed her fingers on the conference table, calculating how much time the team would have to rescue the President. She checked the digital clock on the wall that was set to Los Angeles time. They had three hours and forty minutes until the deadline. “It’s going to be close. They’ll have barely twenty minutes to land and execute a rescue.”

“I think even less than that,” Alderman estimated. “It all depends on how fast they can fight their way out and get to the airstrip.”

Halloway stopped strumming the tabletop. “Are you saying they won’t make it back in time?”

“That’s what I’m saying,” Alderman answered gloomily. “We must come up with other options.”

“Including the military,” Toliver insisted.

“Including the military,” Alderman conceded, thinking what a disaster it would be to have Toliver in command. He puffed on his pipe and again concentrated on the problem at hand. But now his mind kept drawing blanks.

_____

Kuri Aliev hurried up the steps of the fire stairs and onto the roof of the hospital. The night was very dark and misty, with a dense fog rolling in from the sea. Good, he thought, knowing that the poor visibility would render a rescue attempt by helicopter difficult. Aliev made sure the door to the roof was closed and then, with his satellite phone, placed a call to a cargo plane sitting on the tarmac at Guadalajara International Airport. His second-in-command, Akhmad Basagev, answered on the first ring.

“
Mar-shal du hög
”—Greetings to you, Aliev said.

“
Mar-shal du hög
,” Basagev replied.

After greeting each other, they began as planned, speaking in an unusual Middle Eastern dialect of Chechen that they learned while training with Hezbollah along the Syrian-Lebanese border. It contained so many Arabic words that even a native Chechen had difficulty understanding it. Aliev was using this strange dialect in case the Secret Service and their translators were listening in on the call.

“I have good news,” Aliev informed him. “Our plan has been set in motion. We have the hostages, and our demands are known to both governments.”

“Do we have any indication they will comply?”

“I can tell you the Russians won’t,” Aliev predicted confidently. “But the Americans will. They have no stomach for this kind of thing.”

“But what if the Americans refuse to negotiate? What if they do not allow us to fly on to Chechnya with our hostages?”

“Then we will detonate our nuclear bomb over Los Angeles rather than over the oil fields of Siberia,” Aliev said, now thinking about the special nuclear device that had been heavily salted with cobalt. In addition to a massive blast wave, the bomb was designed to spew out a huge cloud of radioactive cobalt that would contaminate a vast area and make it uninhabitable for decades and decades to come. The detonation would turn Russia’s oil fields into a worthless desert of death. It would do the same to America’s second-largest city.

Basagev broke the silence, saying, “Destroying Los Angeles would not be nearly as meaningful to our cause.”

“True,” Aliev admitted. “But it would kill two presidents and their foreign ministers, and bring the Great Satan to its knees.”

“And send millions of infidels to hell.”

“That too,” Aliev went on. “Now tell me, is your cargo plane ready?”

“All is in order,” Basagev said. “The bomb is aboard—ready to be armed. Our flight plan and manifest have been approved. And the appropriate officials have been bribed.”

“Well done,” Aliev praised. “You are to request permission to take off immediately.”

There was a long pause before Basagev asked, “My brother, forgive me for bringing up this evil thought. But what if the Americans mount a successful rescue operation and you are killed?”

“Then, with my last breath, I will activate the homing device on my satellite phone, which will pinpoint the exact location for you to detonate the bomb over Los Angeles.”

“In that event, I should fly in low to maximize the blast effect.”

“Exactly.”

“Peace be unto you, Aliev.”

“
Miyarsh Noxchi Che
”—Long live free Chechnya, Aliev replied, reverting back to the common form of the Chechen language. “
Miyarsh Noxchi Che
.”

Moments later the large cargo plane taxied out onto the runway. Basagev quickly ordered his crew to arm the nuclear bomb once they were in flight—in case Los Angeles was the chosen site. Not a bad second choice, Basagev thought on, now envisioning a giant ball of fire engulfing the entire metropolitan area and turning it into ashes. Of course the blast would also kill him and his crew. But he was unafraid, because he knew there was no higher honor in this world or in the world to come than to die in a glorious jihad.

“You are cleared for takeoff,” the control tower notified him.

With a roar of its engines, the cargo plane sped down the runway and lifted off into the pitch-black Mexican night.

Ten

David peered down at
the cardiac monitor behind the President’s bed. Merrill’s blood pressure had stabilized at 104/80, but his pulse continued to race at 122 beats per minute.
Not good
, David thought, now envisioning the pathophysiology going on inside the President’s vascular system. The transfusion of plasma had expanded Merrill’s depleted intravascular volume, allowing his blood pressure to return to near normal. But it hadn’t replaced the red blood cells he’d lost, so his hemoglobin remained low and unable to carry adequate amounts of oxygen. To make up for this deficit, his heart had to pump faster and faster to send out more and more oxygen-poor blood to his peripheral tissues.
Not good
, David thought again. A continuously overworked heart could lead to arrhythmias and even cardiac failure.

His attention went to the plastic bag of plasma dripping rapidly into Merrill’s arm. There was only a small amount remaining, not more than 25 ccs. David lowered his head through the ceiling and carefully studied the sleeping President’s face. Merrill was even paler than before, with caked blood around his nose and mouth. The basin on the nightstand was half filled with blood, but David couldn’t tell if it was old or new.

His eyes drifted over to the suction bottle containing Merrill’s gastric juice. It was colored light brown. Maybe there was still a little bleeding, David surmised. Maybe the plasma transfusion had partially corrected the coagulation defect. And maybe it hadn’t. Maybe the President was still bleeding internally and the blood was traveling down through his colon rather than up through his gastric tube. That would cause a black, tarry diarrhea that gave off an awful smell. David lowered his head farther to sniff at the air above the President’s bed.

Suddenly the door opened and the guard peeked in. David jerked his head back through the opening in the ceiling, but didn’t have enough time to replace the panel. He stayed motionless, holding his breath. For some reason the guard walked over to the President’s bed and stared down at him for a long moment. The guard was so close to the opened panel that David could see the early bald spot on the crown of his head. If the terrorist looked up, David knew he was a goner. The guard continued to stare down, as if contemplating some action. Then he abruptly spun around and left the room, closing the door behind him.

David started breathing again. He wiped the perspiration from his brow and, steadying his nerves, gazed down at the President. Once more he was struck by how pale Merrill appeared. The President’s complexion was more white than pink.
He desperately needs a blood transfusion
, David thought, as his eyes went to the bag of plasma that was nearly empty now. It had to be replaced by the bag of blood or the IV line would become dry and clogged.
Where’s Carolyn? Where the hell is she?
Then, with a sigh, he answered his own question.
She’s busy being doctor and nurse to a dozen patients, some so ill they belong in an ICU. And she’s holding up like a real trooper. She is some woman.

David put the panel back in place and crawled away on the metal grid, heading for the large bathroom that adjoined the suite. He stayed well clear of the metal piping and moved noiselessly past bundles of wires. On reaching the bathroom, he made sure he was over the marble countertop and then, grasping a bar of the grid, lowered himself six feet down. He paused on the countertop, listening for any sound, then climbed off and tiptoed into the President’s suite. Again he hesitated, his eyes now on the door that was cracked open. He took a deep breath and made himself wait while listening for motion in the corridor. The only noise he heard was the thumping of his own heart.

Quickly he went to the bedside and took down the empty plasma bag, then replaced it with a bag of packed red blood cells. After adjusting the flow rate to two ccs per minute, David hurriedly examined the President without touching him. Most of the blood on and around Merrill was old, and David didn’t detect the awful odor of a tarry stool, which would have indicated ongoing gastrointestinal bleeding.
So maybe I bought some time. But how much? Not a lot
, David guessed.
Not with just one bag of plasma.

Abruptly David pricked up his ears. There were approaching footsteps in the corridor. The guard began to open the door. In an instant David dashed across the suite and into the bathroom. He heard the door open wide and someone walking in. With a single bound he was on the marble countertop. But the footsteps were closer now. Much closer. He didn’t have time to climb up into the crawlspace. Silently he eased himself down from the countertop and moved behind the door to the bathroom. He crouched low and scanned the room for a weapon. Any weapon. He didn’t see any. There was a roll of toilet tissue, a big plastic cup, and a box of Kleenex. His eyes came back to the plastic cup.
Maybe the cup
, David thought. Yes, maybe the cup would do. He crept over to it.

Suddenly the loud, pinging alarm of the monitor sounded. David froze in place, thinking the President had gone into shock.
He’s bleeding out. The plasma didn’t hold. I’ve got to get back to him. But what about the guard?
David hurriedly reached for the plastic cup, put it on the floor, and crushed it with his shoe. The cup split into pieces, one of which was long and slender with a sharp point. David knew exactly how to use it on the terrorist.

The guard was yelling in rudimentary English above the loud pinging noise. “What wrong?”

“It’s nothing,” Carolyn yelled back, shutting off the alarm. “One of the attachments dropped off the President.”

Carolyn! It was Carolyn.
David lowered his makeshift dagger and gathered himself, not daring to peek out. The guard was either with her or watching her through an open door. Better to stay put, he thought. David pressed up against the wall and waited.

“Well, Mr. President, I see you’re awake,” Carolyn was saying. “It’s time to start your blood transfusion.”

“Do I need another needle stick?” Merrill asked weakly.

“Oh, no. We’ll use the IV line that is already—” Carolyn stopped in mid-sentence. She saw the bag of blood running into the President.
David
, she realized immediately. She quickly looked up at the ceiling, then into the empty bathroom. He’d come and gone with a guard at the door. How did he manage that? How … ?

The guard blurted out something in Chechen, breaking into her train of thought.

“Goddamn it! If you want to speak to me, do it in English!” Carolyn said sharply. She wasn’t being overly brave. She knew they weren’t going to shoot her, at least not now. They needed her to keep the President alive—or so they believed.

Out of habit she checked the label on the bag of blood to make certain it had the President’s name on it. It did. He was AB negative, a rare blood type that was hard to come by, even under normal circumstances. Bringing her hands down, she noticed blood on them. A shiver went through her as she wondered if the bag had been damaged by the terrorists’ bullets that had shot up the messenger’s box. She quickly examined the plastic bag and found it intact. The blood was old and had probably come from the bags in the box that had ruptured. Thank goodness!

She headed for the bathroom to wash her hands. At the basin she gazed in the mirror and studied her face. Her lipstick was gone, her hair a mess, and there was a blood smear on her cheek.
I look like hell—
Suddenly her eyes bulged. David was standing beside the door behind her. He had his index finger on his lips. He signaled for her to turn on the faucets.

Peering around the doorway, he made certain the way was clear, then rushed over and pressed himself against the wall.

“Where’s the guard?” David asked quickly.

“By the door,” Carolyn replied.

“Facing in or out?”

“Out.”

“Good,” David said. “Now run the water faster.”

Carolyn turned the faucets up to full force, then looked over to him. Her lower lip began to quiver and she had to bite down to calm it. Then she flew into his arms. “Oh, David! I’m so frightened!”

“You’re doing fine,” he whispered, holding her close. “You’re saving lives, left and right.”

“But for how long?” Carolyn asked, her voice trembling. “We’re all going to end up dead. None of us will leave this floor alive.”

“Don’t be so sure.”

She stared up at his face. “Are you saying there’s a way out?”

“We’ll see,” David said, although he knew their chances for escape were slim. “But we’ve got to play it very smart.”

Carolyn nodded, trying to read his face and decide if there really was a glimmer of hope. “What do you want me to do?”

“Leave everything to me,” David said, keeping his voice low. “First off, you should know that Karen Kellerman also got out alive. She’s in the ceiling crawlspace with me.”

“Is she wounded?” Carolyn asked at once.

“No, but she has asthma and doesn’t have an inhaler with her,” David said rapidly. “Do you have any inhalers in the Pavilion?”

Carolyn shook her head. “Not that I know of.”

“Check and see,” David went on. “If not, I want you to prepare some small syringes with a cc of 1:1000 epinephrine in them.”

“That won’t help much in a bad asthma attack.”

“It’s better than nothing,” David said. “Now tell me about our patients.”

“Dr. Warren is starting to have PVCs again despite the increased dose of lidocaine,” she reported.

“If they become frequent, give him bretylium, ten milligrams IV, then maintain him at one milligram per minute,” David said automatically. “And keep the defibrillator at hand. What about Marci?”

“Not good,” Carolyn told him. “She’s having trouble breathing.”

“Is she leaning forward to get a full breath?”

Carolyn nodded again. “Just like before.”

“Shit!”

“Yeah.” Carolyn stared up at his pale blue eyes and studied them. “Aren’t you frightened?”

“Some,” David admitted.

“You don’t show it.”

“That’s because you’re not looking closely enough.”

“I’m looking plenty close enough,” Carolyn whispered, standing on her tiptoes and kissing him firmly on the lips.

“What was that for?”

“Good luck,” she lied.

David kissed her back, even harder. “Let’s make it double good luck.”

They heard footsteps coming toward them, the guard grumbling to himself.

David quickly disengaged and stepped away. He positioned himself against the wall beside the door and whispered. “If he starts to come in, scream at him.”

“What?” Carolyn asked, not certain she’d heard him correctly.

“Scream at him,” David instructed. “Like you would if he walked in while you were sitting on the john.”

Carolyn took a deep breath and readied herself.

David reached for his handkerchief and wrapped it around the flat end of the plastic sliver, converting it into a dagger. He held it up high and waited, his heart pounding in his chest.

Carolyn summoned up all of her courage and turned to face the approaching guard. She tried to appear surprised, then screamed at the top of her voice, “Get out of here, you perverted son of a bitch!”

The guard stopped in his tracks, caught off balance.

“Out!” Carolyn yelled and pointed to the corridor.

The terrorist gave Carolyn a long, menacing look and spat on the floor, then mumbled something in Chechen and walked away.

“And stay the hell outside!” Carolyn called after him.

David nodded to himself. She was so damn smart! She was telling him the guard was on his way out of the room. And what a performance she put on with her scream. It was perfect, just perfect.
Jesus
, he thought again,
she is some woman!

He waited another ten seconds and moved over to the marble countertop, now noticing how tightly he continued to grip the makeshift dagger. And the dagger was trembling in his hand. For a brief moment he wondered if he could have really used it. Did he still have the nerve and skill to kill? Would he have sliced into the man’s carotid artery, giving it about as much thought as opening a can of tomatoes?
Yeah. I guess so. I guess I could have done it to save Carolyn and myself
. But he knew that was just talk. And talking about killing a man was a lot different from actually doing it.

Before putting the makeshift dagger in his pocket, David rewrapped it with his handkerchief to protect himself from its pointed end. But the increased pressure caused the plastic sliver to crack and crumble. Shit! David growled at his stupid blunder. Now he was weaponless again.
Mistakes! I’m making too many mistakes!
Fuming at himself, he threw the pieces of plastic into a trash can. Quickly he mounted the countertop and reached for the metal grid, then pulled himself up through the opening in the ceiling.

David hurriedly put the panel back in place and made certain it fit snugly. His heart was still racing and skipping beats from the narrow escape. Gathering his nerves, he remained motionless and waited for his pulse to slow, all the while listening to see if the terrorist was going to return for a second look.

Karen came up alongside him and whispered in his ear, “Jesus Christ! You almost got yourself killed.”

“What the hell are you doing over here?” David whispered back harshly. “I told you to stay by the far wall.”

“It got really musty in that area and I started to wheeze,” Karen explained. “So when I saw the opening in the ceiling, I crawled over to breathe some fresh air.”

“How’s your asthma doing?”

“So-so,” Karen reported and coughed mildly. “But I’m more worried about you than me. Had that terrorist taken one more step, you would have been a dead man.”

“But Carolyn saved the day, didn’t she?” David asked with a crooked grin. “She put on quite a show, eh?”

“I guess.”

“There’s no guessing to it. She stared that terrorist in the face and didn’t back up an inch,” David said admiringly. “That takes something special.”