A panel in the ceiling slid open and David’s face and hand appeared. He formed a circle with his thumb and index finger and gave her a you’re doing fine sign. Next he pointed to the EKG, then over to the IV pole, and made a wraparound gesture.
Carolyn spread her hands apart, gesturing back. What does that mean?
David took a prescription slip and wrapped it around his finger, and again pointed to the IV pole. Then he signaled upward.
Carolyn nodded quickly and glanced over to the guard once more. He still had his back to her. She hurriedly wrapped the EKG strip around the top of the pole and lifted it toward the opening in the ceiling.
Just as David grabbed the strip, Warren opened his eyes and saw Carolyn holding the IV pole up. He didn’t notice the opened panel behind his bed. “Is something wrong with my IV?”
“No,” Carolyn lied easily. “I’m repositioning it so I can see the flow rate more clearly.”
Warren suddenly felt his heartbeat becoming more erratic, the tightness in his chest more noticeable. “I … I think I’d better take a nitroglycerine tablet.”
Carolyn looked up, as David nodded his approval. She searched for a nitroglycerine tablet from the crash cart and placed it under Warren’s tongue. Warren’s complexion was taking on a grayish hue. A bad sign, Carolyn thought. Death was coming.
David rapidly read the EKG. It showed an evolving myocardial infarction with a grossly abnormal rhythm. There were multifocal PVCs, which were occurring so frequently that in places the rhythm resembled a deadly ventricular tachycardia.
“I’m having trouble catching my breath,” Warren gasped.
Carolyn glanced over to the cardiac monitor. Warren’s blood pressure was bouncing around, the number changing by the moment. She wondered if the monitor was malfunctioning. Quickly, Carolyn reached for a stethoscope and placed a blood pressure cuff on Warren’s arm, then took a manual reading. 92/64. Warren was straining to fill his lungs, and his skin color was turning ashen. Again Carolyn hurriedly inflated the blood pressure cuff. Whiff ! Whiff ! Whiff ! Then she slowly let the air out. The reading was 84/50 and barely audible. He was going into shock.
A gurgling noise came from Warren’s throat. It sounded agonal. Now his lips were blue.
A prescription blank floated down onto the bed.
Carolyn snatched it up and quickly read David’s orders.
• Give IV bolus of lidocaine 80 mg, followed if necess. by 40 mg bolus every 8–10 mins. to total dose of 200 mg
• Maintenance dose 2 mg/min.
• If it doesn’t work, use defibrillator set at 200 joules
Carolyn reached for a needle and syringe and drew up 80 milligrams from a vial of lidocaine. She injected it directly into Warren’s IV line. Then she waited. Seconds ticked off. Warren’s color was still poor, his breathing shallow.
Carolyn looked up at the ceiling and silently mouthed the question: Should I give another bolus?
David held up an index finger, signaling her to wait.
Carolyn mouthed up, defibrillator?
David shook his head, then pointed to the EKG and made a turn it on gesture.
Carolyn switched the EKG machine back on. And waited again. The strip started moving. It still showed bizarre complexes, but not as many as before. Then the R waves narrowed into slender triangles and became more normal-appearing. Carolyn could now clearly see the heart rate slowing. Warren was reverting to a normal sinus rhythm. Carolyn hurriedly took his blood pressure again. It was 100/70. Then again. 108/74.
She let out a sigh of relief and asked, “How are you doing, Dr. Warren?”
“Better,” Warren said softly. “I’m breathing much easier.”
“Good,” Carolyn told him, noticing that his facial complexion was turning pink. “You’re back to a sinus rhythm, thanks to a big bolus of lidocaine.”
“It’s you I should thank,” Warren said gratefully. “And I do.”
“You’re welcome,” Carolyn replied and glanced up at the ceiling. David gave her a thumbs up signal and moved the panel back into place.
He squirmed his way around a metal partition and headed for the corridor. Warren needed to be in a CCU where he could be constantly monitored and anticoagulated, and perhaps receive a thrombolytic agent that could dissolve away the clot blocking one of his coronary arteries. But the terrorists would never let that happen. Nobody was going to leave the Pavilion, regardless of the gravity of their illness. It sounded heartless, but it was the smart move. The terrorists realized that in order to secure an area, it had to be done absolutely and completely. One breach, one small opening, and all could be lost. They knew that a few could hold off many in a given area as long as all the entrances and exits were sealed. It was a basic tenet of guerrilla warfare.
Below David heard the voices of the terrorists. They were speaking in Chechen, and sounded as if they were arguing. He peered down through a ventilation duct in the ceiling and studied the men in black. There were three of them—the leader; the balding, stocky one; and the wounded one. The leader was yelling at the wounded terrorist, shoving him into the room with the dumbwaiter and hollering out, “Leela!”
David didn’t understand the word leela, but quickly figured out what the argument was about. Earlier he had seen the wounded terrorist standing in the room with the dumbwaiter and watching the others as they booby-trapped it. Now the man was wondering why he had to continue guarding the dumbwaiter. Because it represents a way in, David thought strategically. A possible passageway that, although mined, might still be circumvented. The leader knew it, the terrorist with the wounded arm didn’t.
As David turned his body in the direction of the President’s room, his knee banged against a metal duct. It made a metallic, ringing noise. David froze in place and held his breath. The terrorists went quiet, then began speaking in urgent tones. Goddamn it! They know I’m here! David’s brain screamed. I’m a dead man!
Suddenly the air conditioning system clicked on and cool air blew down into the corridor. There was another pause. Then one of the terrorists laughed and spoke in a lighter tone. David pricked his ears, listening intently, and waited. The men continued talking, but now their voices seemed more distant. The terrorists were walking away.
David breathed a deep sigh of relief. They must have believed that the metallic sound they had heard was made by the air conditioning switching on. But David still didn’t move. He remained absolutely motionless, wondering if two of the terrorists had walked away and left one behind to listen and see if the noise would recur. He let a full five minutes pass before he peered down through the duct again. The corridor was clear.
Carefully David started off again, moving slowly and staying well clear of the metal ducts. You’re rusty! he berated himself. You would have never made that mistake when you were in Special Forces! But that was a lot of years ago, and you’re not the same person you once were. So be careful, and don’t do anything stupid.
He pushed on, now picking up the scent of death. Not just plain, ordinary death, but violent death that had its own peculiar odor. Maybe it was caused by gunfire mixed in with blood and fear and decay. But whatever caused it, the smell was distinctive to David and made his mind flash back to Somalia, and to the firefight, and to the dead piled up in heaps. So many dead. Forty or more. Mostly Somalis, a few of ours. And for what? Nothing had changed there. All that death, and it hadn’t mattered a damn.
David came to another ventilation duct and looked down through it. He was over the chart room that was filled with dead bodies. Arms and legs were entangled into a bizarre patchwork. Heads were blown open, their brains oozing out and mixing with pools of blood. And now the smell of death became more intense. Then David saw a corpse with no head. It was gone. It was totally gone, leaving only the stump of a neck behind. David flinched as a gruesome flashback came into his mind. It wa
s the horrifying image of his best friend in the Special Forces, a sharpshooter from Tennessee who hadn’t returned with his comrades from the field of battle. They went back for him and found him outside a Somali village. Beheaded! The bastards had sawed his head off ! The image grew sharper and sharper and now David could see the carotid arteries dangling down from his best friend’s severed head.
Perspiration poured off David’s brow as the full-blown panic attack began. The head, the severed head with its eyes gouged out! David’s hands started to shake so violently he had to grab a nearby metal beam to steady them. Then the shortness of breath came. He strained frantically, gasping for air and feeling as if he was about to suffocate. With effort he forced himself to expand his lungs. He did this over and over until his respirations gradually returned to normal. But it took another full minute for the trembling to stop.
He lay back, drenched in sweat, and cursed at his post-traumatic stress disorder. Goddamn it! When will it end? When? The clinical psychologist at Walter Reed had told him the attacks would diminish with time, and they had. But they were always lurking near the surface, waiting for the right trigger to set them off. A trigger that reminded him of warfare. Like a missing head.
He took a deep breath, turned onto his stomach, and gazed down at the dead bodies again, avoiding the one that had been beheaded. Atop the stack was Aaron Wells, who was staring up at him with lifeless eyes. David was about to continue when he abruptly stopped.
Goddamn it! I’m going in the wrong direction! Think what you’re doing or you’ll get yourself caught and maybe killed!
He turned and headed back to the President’s room at the far end of the corridor. He moved cautiously, brushing up against bundles of wires and staying clear of the metal ducts. Just ahead he heard a conversation going on in one of the rooms. He slowed even more, now inching his way toward the sound. It was a man’s voice speaking English. There was no accent. Not a terrorist, David decided. He reached a ventilation duct and gazed down. He was over the First Daughter’s room. She was watching a news program on television. The reporter was describing the illness that had befallen the President and all the guests at the official dinner. He said that President Merrill was now a patient at University Hospital, and was resting comfortably. There was no mention of a hostage situation. They’ll find out soon enough, David through grimly, and moved on.
He approached the President’s suite and stared down at the guard outside the door. David inched his way forward, pulling his body along rather than wriggling and squirming. Once over the room, he noiselessly removed a panel from the ceiling and looked down at the sleeping President. There was blood caked around his mouth, with no evidence of fresh bleeding. But Merrill’s color was pale, very pale.
David’s eyes darted over to the cardiac monitor. The monitor was adjacent to the bed over five feet away, but its large illuminated numbers made it easy to read. The President still had a tachycardia of 120/minute, and was borderline hypotensive with a blood pressure of 94/60. That was a high enough pressure to perfuse his brain and kidneys. But one more big bleed and the bottom would drop out, and the President would die.
David’s gaze went to the bag of fresh plasma that was dripping into Merrill’s arm. The bag was half empty. Maybe that would be enough plasma to stem the hemorrhaging, David hoped. At least for a while. But for how long?
Merrill coughed and gagged and was suddenly awake. He retched and blood gushed out of his mouth and onto the sheet covering him.
David groaned silently and quickly replaced the panel in the ceiling. Maybe the President had no time left at all! He hurriedly reached for his cell phone and dialed 411. Then, in a voice barely above a whisper, he asked the directory-assistance operator to connect him with the Secret Service office in Los Angeles.
Nine
The National Security Council listened in stunned silence to the demands of Kuri Aliev coming over the speakerphone.
“The prisoners are to be dressed in civilian clothes and placed on military transport planes, with a crew of only pilot and co-pilot. Once they are airborne, you will be given instructions on their final destinations. The list of prisoners will be faxed to you and to your counterparts in Moscow. There are two hundred and eighty-six names in all. Everything must be done within four hours. If the deadline is not met, we will kill a hostage every half-hour until it is.”
The council could discern Aliev’s voice resonating in the background. He was speaking on a phone connected to a PA system, so that all the hostages on the pavilion could hear his threats. “You have exactly four hours.”
Ellen Halloway, the first female Vice President of the United States, leaned toward the speakerphone and said, “Even if we wished to comply, that’s not enough time.”
“Ha!” Aliev scoffed. “You could mobilize your entire fleet of stealth bombers and have them halfway to Iraq in four hours. So stop talking foolishness.”
“But those aircraft are on standby and ready to—”
“If you want to waste time arguing, that is your business,” Aliev cut in. “But the clock is running. You now have three hours and fifty-nine minutes.”
Ellen Halloway ran a hand through her sandy blond hair, which was pulled back and held severely in place by a silver clip. In her mid-fifties, she was tall and attractive, with high cheek bones and deep brown eyes. “I need to talk to the President.”
“Why?”
“To make certain he’s still alive.”
There was a long pause before Aliev said, “Hold.”
Halloway leaned over to Arthur Alderman, the Director of National Intelligence, and asked in a barely audible voice, “Any ideas?”
“Keep the conversation going,” Alderman whispered back. “Perhaps that will give the President a chance to send us some sort of message.”
Martin Toliver, the Secretary of Defense, was seated to the Vice President’s left. He moved his chair in closer, and hissed, “Tell that Chechen bastard we don’t negotiate with terrorists!”
“That’s up to the President, not us,” Halloway said, keeping her voice low.
“But he’s got a gun pointed at his head,” Toliver argued.
“He’s still the Commander in Chief,” Halloway said.
An Air Force colonel with a small suitcase handcuffed to his wrist entered the Situation Room in the White House and saluted sharply. “Madam Vice President, the nuclear codes have been changed. New launch codes have been activated.”
Halloway nodded. That was one less thing to worry about. They had to assume that the military officer, who carried the nuclear football and followed the President wherever he went, had also been taken hostage or killed. “Thank you, Colonel.”
The Air Force officer stepped off to the side.
“What the hell is taking him so long?” Toliver growled.
Halloway held her palm out, urging patience, as she tried to think through the nightmarish dilemma they were facing. Not only was the President being held hostage by the terrorists, but so were his family and the Secretary of—
“Ellen?” John Merrill’s voice came over the speakerphone. There was some static as the call was being transmitted to Washington from the Beaumont Pavilion via a Secret Service line. “Ellen?”
“Yes, Mr. President,” Halloway replied. “I’m here with the Security Council.”
“Good,” the President went on. “I want all of you to know that I have complete confidence in Vice President Halloway. I’m sure that she, together with the Council, will find a way to resolve this matter.”
“Thank you, Mr. President,” Halloway said, keeping her voice even and assuming the terrorists could hear her. “Now, first off, how are you feeling?”
“I’ve had better days,” Merrill answered.
The council members gathered around the oval conference table nodded to one another. The Presi
dent sounded strong and in control of himself.
“You of course know that we’ve been taken hostage by these terrorists,” Merrill told her.
“We know.”
“And you should also know any rescue attempt would be very dangerous, even if carried out by a highly specialized team,” Merrill went on. “Very dangerous and very difficult.”
“We’re aware of that, Mr. President.”
“A lot of people would die,” Merrill warned, but not too strongly. “Your military advisors will tell you how much damage three submachine guns can—”
There was a sudden rustling noise, then a grunt. The line went quiet.
The council members stared at the speakerphone and waited anxiously. Seconds ticked off.
“Very clever, Mr. President,” Aliev came back on. “You were trying to tell your people that you saw three terrorists outside your door, so that is how many there must be. Well, I hope you govern better than you count.”
“I was simply warning them not to do anything foolish,” Merrill said evenly.
“If they do try, Mr. President, I can assure you that you and your family will be the first to die,” Aliev threatened, then paused a long moment before speaking to the council again. “Lady Vice President, you now have three hours and fifty-four minutes to release the prisoners.”
“We need more time,” Halloway said urgently. “We’re asking you to reconsider and give us an additional hour.”
There was no reply.
The Situation Room remained silent. No one uttered a sound. The staff and military aides standing behind the council stayed motionless, their ears pricked. Everyone waited for Aliev’s voice to come back on the line. Half a minute passed. Still there was no response.
Patient One: A Novel Page 11
