The First Patient

by Michael Palmer

  "Magnus, this man"—Gabe gestured down at Stoddard, who had yet to move except for the rise and fall of his chest—"has the authority and the power to destroy everything. Everything! And he may be losing his mind."

  "There's got to be something causing this besides stress," Carol said. "I'm certain of it. You heard him answer your questions. He's absolutely brilliant. You had barely asked the questions before he produced the answers. Gabe, you're worried that Drew has the power to destroy everything, but he also has the power and the vision to change the world for the better as no president—no person—ever has."

  "This upcoming election is by no means a lock," Lattimore added. "Dunleavy still has a lead in most of the red states, and the religious right is starting to get mobilized and organized again. Their political machine weakened when Dunleavy lost the last election, but there's strong evidence they're regrouping. Do you remember Thomas Eagleton?"

  "No. . . . Wait, maybe. Yes, yes, I do. He was McGovern's vice presidential nominee in, what, seventy?"

  "Seventy-two. McGovern wasn't going to beat Nixon no matter what, so none of the Democratic biggies would run with him. So he picked Eagleton, a nice enough senator from Missouri. Only McGovern's half-baked research didn't uncover that the man had several psychiatric hospitalizations for depression, which included electroshock therapy. The negative press made McGovern seem like anything but fit to lead this country, and forced Eagleton to quit."

  "He was replaced by Sargent Shriver, the Peace Corps guy. I remember now."

  "It was even worse with Dukakis. He was ahead in the polls when all of a sudden word started to circulate that he had been treated for depression. Rumor. Pure unsubstantiated rumor. But the result was a dramatic shift in the polls, and that scene in the tank notwithstanding, he could never catch up."

  "I understand what you're saying."

  "If word gets out about these episodes of the president's, all the king's horses and all the king's men aren't going to be able to help us. And the most important thing, as Carol said, is that in between episodes, he's as sharp and in command as ever."

  At that instant, as if on cue, Andrew Stoddard's eyes fluttered open. He looked to his left at his wife and chief of staff, then to his right at Gabe.

  "Dr. Singleton, I presume," he said, sweeping his tongue across his parched lips.

  "Hey there. Welcome to our world."

  "This doesn't look good. Another episode?"

  Gabe nodded.

  "Honey," Carol said, "are you okay?"

  "Doin' fine. Doin' fine. A little bit of a throbbing up here in my temples, but otherwise I feel great. I confess, though, that seeing the doc here like this is a little disconcerting—especially when he's supposed to be having dinner and Botswana flag cake with Calvyn Berriman."

  "Do you remember anything about what happened?" Gabe asked.

  "Not really. I vaguely remember not feeling well. Mostly in my stomach. Why? Did I insult someone we're supposed to be friends with?"

  "No, nothing like that," Carol said. "We're just glad you're okay. Honey, Gabe's really upset that we didn't—"

  "Carol, I can do this myself," Gabe said, with more snap to his voice than he had intended.

  He looked from Carol to Lattimore and back, and considered whether or not to send the two of them out of the room so he could speak to his patient in private. Finally, though, he pulled a brocade chair over next to Stoddard, who had pushed himself up on one elbow.

  "Drew, have you been totally aware of these episodes all along?"

  "I have . . . except when I'm having them, of course."

  "But you chose not to tell me about them before I agreed to come to Washington to care for you."

  "That may have been a mistake."

  "Drew, I appreciate your owning this, and not deluging me—at least not up front—with rationalizations for why you chose to keep me in the dark. And I understand why you and Carol and Magnus might have chosen that course. But it was a mistake. It was a lie. I know, I know, omission of something isn't technically a lie. But where I come from we don't draw that line."

  "I'm sorry, Gabe. I truly am. There was so much going on, and so much pressure to stabilize the situation surrounding Jim's disappearance, and I so desperately needed you with me. Jim told me the episodes were probably some form of atypical migraines. He started me on Imitrex and told me they might never happen again. Meanwhile, he did all the tests and called in consultants."

  "What kind of consultants?"

  "Neurologists, I guess."

  "Any psychologists? Psychiatrists?"

  Stoddard shook his head.

  "I . . . I don't think so. Gabe, if word gets out about these things, I'm finished."

  "Drew, as things stand, I feel as if I only have two choices: to call in that military aide who's out there so that you and I can turn over the government to Vice President Cooper, or to quit and jump on the next flight back to Wyoming."

  Lattimore leaned forward and seemed as if he were about to enter the discussion, but Stoddard, whose back was turned directly toward him, stopped him with a raised hand and then sat up in bed, still facing toward Gabe and away from the chief of staff. In that instant, every vestige of Drew Stoddard had vanished and was completely replaced by the President of the United States.

  "Gabe," he said, "Jim Ferendelli had to deal with the same crisis of conscience as you are right now. I ached for him then just as I ache for you now. Ultimately, he rejected both possibilities you suggest. He didn't quit and he didn't insist I turn over the government of this country to Tom Cooper. He put me on medication for what he felt was causing my problem, and he promised not to rest until he knew what was the matter with me and what we should do about it. Please believe that."

  "I do."

  "Gabe, working with a Republican Congress, my jobs programs have taken more than six hundred thousand workers off unemployment. Communities have joined with me and private business to add two hundred thousand computers to our schools. Drug use in the inner cities has begun a serious decline. A decline, Gabe. The polls say that if I win, I'll likely have a friendly Congress next term. Give me that and there's no limit to what we can accomplish for the people of this country. I'm begging you, Gabe. Stay close to me. Find out what's the matter with me. Treat me with any medication you want. Bring any specialists in to evaluate me. But please, for God's sake please don't pull the plug on me. Not now. Not when we're so close."

  In the silence that followed, Gabe felt much of his anger at being deceived and much of his zeal to take immediate action deflate. He didn't have the statistics that Lattimore and the president had cited, but he did know that there was a spirit of hope and optimism in the country that hadn't existed for a generation or more. And best of all, there were no American soldiers losing their lives on foreign soil. Drew Stoddard, scholar, intellectual, war hero, humanist, populist, was the real deal.

  "I need some time," Gabe heard himself say. "I need some time to sort things out. That was a very frightening scene in here."

  "I'm sure it was, Gabe. Take all the time you need."

  "And I need Jim Ferendelli's records about his findings and his conclusions so far."

  "Wherever they are," Lattimore said, "we can't find them, except for some very thin records at Bethesda Naval. The FBI and the investigative arm of the Secret Service have gone over every inch of the medical office, Jim's house in Georgetown, and his home in North Carolina. Dozens of agents are still on the job. Maybe a couple of hundred."

  "Well, I want access to his place."

  "No problem."

  "And if I decide to go along with what you're asking, I need at least one other doctor to be my assistant in this case and to be close to you when I can't be."

  "Do we have to tell him everything?" Carol asked.

  "I need to decide that. First, though, I have to feel more certain that this is a secret I want to keep."

  "Just tell me what you need," Stoddard said. "Tell me what you want me t
o do."

  "Stay close to home. Here or Camp David. I want to know precisely where you are every minute until I've made my decision."

  "What about Texas?" Lattimore asked the president.

  "Cancel it," Stoddard ordered brusquely.

  "Finally, I want your word, Drew, and yours, too, Carol and Magnus, that if I opt to bail on this whole deal and involve Vice President Cooper, you won't try anymore to convince me otherwise."

  "You have our word," the president said.

  The other two hesitated, then reluctantly nodded in assent.

  "In that case," Gabe said, "get ready for bed and then crawl back under the covers. I'm going to be here tonight for as long as it takes to convince myself you're stable."

  "Fine. The Lincoln Bedroom is right down the hall if you want to rest there," Carol said. "I can get you a robe and pajamas. Griz will arrange for some food if you're hungry."

  "That's all right. A few quiet hours and I'll go home. For now, after I check you over again, Mr. President, I want to do some reading. You have a library up here, yes?"

  "Not a huge one, but yes, yes, we do. And Griz can get you into the main library in the East Wing."

  "Good."

  "Exactly what do you want to read about, Doctor?"

  Gabe reached over to again check Stoddard's pulses. Then he tested the man's eye movements and the response of his pupils to light.

  "The Twenty-fifth Amendment," Gabe said.

  CHAPTER 10

  Midnight came and went. By 2:00 A.M., when Gabe decided it was safe to leave, the president had been sleeping soundly for an hour and a half. At Lattimore's request, Gabe watched from a distance as the military aide carrying The Football was dismissed. Then Gabe gathered his things, including two books on presidential illness, succession, and the Twenty-fifth Amendment.

  He was about to notify Treat Griswold he was leaving when Carol Stoddard knocked softly on the open door. She had removed her makeup and changed into pajamas and a robe but still looked no less elegant than she had in her evening dress. Her doe's eyes were slightly reddened, leading Gabe to suspect she had been crying.

  "Ready to leave?" she asked, taking a step into the room.

  "I think it's safe. No matter what, I'm just a mile or so away."

  "He'll be all right, I think—at least for now. Do you know what you're going to do about all this?"

  "I need a little time—maybe just until later this morning."

  "Gabe, the job is taking a heavy toll on him—on us. Heavier than either of us imagined, I think. Drew's been working seven-day weeks, often as many as sixteen, even twenty hours a day. We hardly ever go to sleep at the same time and . . . and our personal life has dwindled until . . . well . . . until there just isn't much of it left."

  "I'm sorry to hear that."

  "Gabe, I'm begging you, if you think for the sake of his health Drew should drop out of the campaign and let Tom Cooper take over, please tell him. He thinks he can be all things to all people. But someone has to help him see that nobody can—not even him."

  Tears began to well in Carol's eyes. Gabe hesitated, then crossed to her and held her quietly until her composure returned.

  "Whatever I decide will be what's best for my patient," he said finally.

  "I understand. Maybe you can convince him to just cut down—take a nonworking vacation, spend more time with me and the boys, spend some time each day doing nothing, accept the fact that everyone has limits."

  "I'll try, Carol. Really I will."

  "Thank you. Thank you so much for what you're doing. I'll send Treat Griswold over to walk you out."

  Before Gabe could respond, the First Lady was gone. He flashed on the envy he had felt when he arrived in D.C. and first saw her and Drew together—the perfect, beautiful First Couple, leading the country together into a cultural, political, and social renaissance. Now he reflected on one of many wise observations by his original AA sponsor—this one dealing with the dangers inherent in going through life comparing your insides to everyone else's outsides.

  He took the elevator down to the first floor, where he identified the tubes of blood he had drawn by using his Tyler phone number in reverse and set them in the small refrigerator in the clinic.

  One fascinating vignette he had come across in his reading involved President Bill Clinton's knee injury and subsequent surgery. The president was on a golfing vacation in Florida when his knee buckled while he was walking down a short flight of stairs. His quadriceps muscle had torn in two and snapped off the patellar tendon. A White House Medical Unit physician, on duty nearby, immobilized the leg and arranged for immediate transportation to the nearest hospital. Already waiting there was Clinton's personal physician, who, as usual, was part of the medical team caring for the chief executive when he was away from the White House. From that moment until Clinton's surgery at Bethesda Naval Hospital in Maryland, and even after the muscle and tendon repair was completed, his physician had two major decisions to make—pain control and anesthesia.

  Never far from Clinton throughout the ordeal was the military aide bearing the codes for unleashing nuclear missiles as well as an agreement forged between Clinton and Vice President Al Gore regarding situations in which the reins of government would be turned over to Gore.

  Together, Clinton and his doctor decided that the only pain medication he would receive would be anti-inflammatories with no central nervous system effects. In addition, with the approval of the orthopedic surgeons at Bethesda Naval, he would receive epidural anesthesia, and so would be awake and alert throughout his surgery. The two-hour procedure and Clinton's recovery went off without a hitch.

  In print it all sounded so straightforward, so simple. Gabe wondered how Clinton's personal physician would have handled a situation like the one he was enduring now. It seemed doubtful that if Drew Stoddard had a doc other than his friend and college roommate he would still be president. Then Gabe remembered that, in fact, until just a couple of weeks ago, Stoddard did have a different doc and he was still the president. Gabe also realized that at no point had he been told the precise nature of the agreement between Stoddard and Thomas Cooper III.

  Because of the large number of dignitaries attending the state dinner, the Navy captain who was covering the medical office had elected to stay in-house. Gabe dropped off his medical bag and gave the man the line Lattimore and he had concocted and disseminated first to the dinner guests, then to the press, that the president had been seized by a combination of his asthma, migraine, and severe gastroenteritis and had specifically asked his personal physician to attend to him until the attacks were resolved.

  More lies.

  Edgy and uncertain about the decisions he had made throughout the night, medical and political, Gabe allowed Treat Griswold to accompany him down the elevator and out of the White House to the senior staff parking area on West Executive Boulevard. The Eighteen Acres, as the White House compound was known, was eerily quiet. The two of them made the trip in pensive silence, bound by the enormity of the drama in which they each had played a part.

  Bull-necked Griswold, a loyal veteran of many years in the Secret Service, had signed on to take a bullet for Andrew Stoddard if necessary. Was the man raving incomprehensibly and rocking as if trying to shake demons from his mind a person he would want to die for? Gabe wanted to ask that question of the agent but knew he never would.

  If they only knew, Gabe was thinking. The press, the cabinet, the Congress, the Chinese, the Israelis, the Arabs, the terrorists, the American people—if they only knew what had transpired this night in the presidential residence.

  He wondered about those men who had preceded Drew Stoddard into the presidency. How many secrets had been kept on their behalf? How many lies had been told?

  "You gonna be all right?" Griswold asked as they reached Gabe's car.

  "Thanks for caring, Griz. Yeah, I think I'll be okay. I'm assuming you know most of what went on in there."

  "I know as much as I
need to know," the agent said. "He's a very special man, Doctor. We should do what we can to keep him around."

  "I hear you. I'm not a hundred percent certain I agree with you, but I hear you."

  "We've all got to do what we've got to do. Take care, sir. At the moment I don't envy you."

  Gabe patted Griswold's massive shoulder. It was like patting a boulder.

  "At the moment I don't blame you. Listen, let's not forget about taking that ride in the desert someday."

  "I won't. Good luck, sir."

  Griswold retreated the way they had come, leaving Gabe alone in the quiet.

  The silver Buick Riviera Gabe was driving was, like his furnished four-room suite in the Watergate Apartments, an open-ended loan from LeMar Stoddard. The First Father wouldn't have it any other way. From the day Drew and Gabe came together at the Academy, the senior Stoddard had embraced Gabe and his parents as family, inviting them to his North Carolina estate as well as to his Virginia hunting lodge. Even though the accident and Gabe's subsequent expulsion from school and imprisonment proved more than Buzz Singleton could handle, LeMar had remained a dependable friend and supporter, providing him with a top-notch defense team and visiting him more than once at MCI. Years later, LeMar even pulled some strings to make sure Gabe's past didn't keep him from being accepted into medical school.

  Gabe started the Buick and for a few minutes simply sat behind the wheel, letting the air-conditioning get up to speed and continuing the process of sorting out his thoughts and feelings. Over the years, when faced with a medical puzzle, he tried to keep all diagnostic possibilities in play until they were weeded out by either a negative lab test, a positive lab test, or a new physical finding. But always he had an early suspicion as to where the answer lay. The trick was not to be ruled or even influenced by that suspicion until the weeding out had left little, or better still no, choice.