Josh shook his head. “Not only in other countries.”
Rachel thought about that. “You mean—”
“Yes, there are people in the U.S., as well as throughout the world, who’d like to see David Madison out of the picture . . . totally.”
“That’s probably true of all former presidents,” Rachel said.
“I gather it’s truer of Mr. Madison than most of the previous ones,” Josh replied.
He went on to explain that Madison had learned of a couple of projected attempts on his life that had never come to fruition. “The latest was a plan to assassinate him while he was making a public appearance. The local police nipped that in the bud. There have also been rumored attempts to infect him with anthrax or something equally deadly. I think that’s why he feels so dependent on his personal physician.”
Rachel paused to cough again and clear her throat. “And since Dr. Lambert is dead, now that responsibility is yours.”
“I guess,” Josh said. “One more thing I probably should share with you. Madison thinks someone may have killed Dr. Lambert.”
“Josh, that man had a heart attack. He was in the bathroom just off the room at the church where we were eating lunch. We heard him fall. I helped give him CPR.”
“I’m going to have to do some research, but as I recall, there are drugs that can cause a death that’s clinically indistinguishable from a heart attack. And remember, Ben’s body disappeared from the airport.”
“What—”
“Normally an autopsy would confirm whether Ben died of natural causes,” Josh said. “But now, there’s no body. That means no autopsy.”
***
The waiter moved silently away, leaving Josh and Rachel alone in a quiet corner of the restaurant. Josh reached across the table and put his hand atop Rachel’s. He’d planned this evening since the time Rachel left. Now it was finally here.
After the limo had delivered Josh and Madison to the former president’s home, Lang asked another agent to drive the doctor back to Love Field for his car. By the time he’d made it to Rachel’s apartment and told her about his meeting with the former president, it was getting late. She’d offered—almost insisted—that she could make dinner for them, but Josh wouldn’t hear of it. “I want to take you out.” So now, they were sitting here in the back of the almost deserted restaurant.
“Your hand is shaking,” Josh said. “Is something wrong?”
“I . . . I need to tell you about something that happened on the trip.” Rachel coughed, then took a sip of water. “And it may fit in with what President Madison told you earlier this evening.”
Josh felt as though things were coming at him faster than he could process them, but he composed his features as best he could and said, “Sure, let’s hear it.”
Rachel picked up her water glass but put it down without drinking. “It was quite a thrill accompanying Mr. Madison on a trip like this. More than that, he actually seemed to value my opinion and that of the other medical people in the group. We talked about the location for the clinic he wanted to build—about the size of facilities, staffing, all the things you’d expect.”
“Was this in a primitive area?” Josh asked.
“Yes and no,” Rachel said. “It was a small town with perhaps seven hundred people in it and another two hundred or so living in the countryside around it, but the nearest medical facility was about fifty kilometers away.”
Josh automatically translated the distance: approximately thirty miles. “I’m assuming the Madison Foundation was going to fund this. Was there opposition?”
“No overt signs of any. But President Madison told us he’d heard rumblings. I asked him about details, but he didn’t want to go into them.”
“But the trip was going along okay—”
“I’ll give you an example. We were quartered in the homes of members of a local church. The women cooked our meals, and we ate them together at the church. One day Mr. Madison complained of stomach pains after a couple of bites. He left the table, and Dr. Lambert gave him some medication for his symptoms. At the time I figured it was just a bug, although no one else had any trouble.”
“That doesn’t mean much,” Josh said.
“One of the women serving us scraped the remains off all our plates into a bowl she left outside the kitchen door to feed some of the dogs that hung around the church.” She stifled a cough. “The next morning, someone in our group found one of the dogs about sixty yards away from the church . . . dead.”
“Okay, that’s troubling. What did Lang do?”
“Lang was concerned, but Mr. Madison dismissed it as coincidence, and I guess it could have been. The dogs were wild, and I take it they had a sketchy existence. Anyway, Madison didn’t want to make a fuss. But two days later, Dr. Lambert, Mr. Madison, and I were looking at a proposed site for the new clinic when a woman in a long dress with a scarf over her head and a cloth covering the lower half of her face ran into the room where we were. Mr. Madison asked her in Spanish if he could help her. Without a word, she drew what looked like a flask full of yellow liquid from the folds of her dress and showered us with the contents. Then, still without a word, she ran out.”
“Strange, but—”
“No, it doesn’t end there,” Rachel said. “The next day each of us had a raw throat and mild cough. At first, we attributed that to irritation from the environment we were in.”
“When was this?”
“The exposure—and I think that’s what it was—took place five days ago. Two days ago Ben Lambert died of what we thought was a heart attack. That’s pretty well occupied our thoughts and actions since. Did Mr. Madison say anything to you tonight about coming back with respiratory symptoms?”
“He asked me to see him in my office tomorrow, but he led me to believe it would only be a routine, get-acquainted visit.”
Rachel held her napkin to her mouth to smother a violent cough. When she stopped, she said to Josh, “I think you’d better check him over pretty carefully.” She coughed again. “And maybe someone should have a look at me as well.”
3
Jerry Lang spoke softly, but the state-of-the-art two-way radio picked up his voice loud and clear. “Cowboy is leaving his house now. ETA to Preston Medical Clinic is 0930.”
“Roger that.”
“Do we always have to go through that Dick Tracy wrist radio stuff?” David Madison asked from the backseat of the town car. The question was the same one he always asked, and his grin took any possible sting out of the words.
Lang turned from his position in the front seat. “Sir, you’re at liberty to cancel your Secret Service protection at any time, but if I were you, I’d speak with Mrs. Madison before doing anything that rash.”
“I know, I know,” Madison said. He coughed and cleared his throat. “But you’d think, after a couple of years out of office, I wouldn’t be worth much to any terrorist who’s out to kidnap me.”
Lang didn’t answer. He kept his eyes moving, quartering the area as the car rolled through the streets of Dallas. This assignment to guard the former President might not be as glamorous as his former post at the White House, but he was determined to carry it out to the best of his ability.
His wife—actually, his ex-wife—had told him repeatedly he had to stop making the Secret Service his life, but it was hard to do, especially after that incident at 1600 Pennsylvania Avenue. Shortly after that, he got this assignment to follow Madison into retirement. Say what you will, despite his boss’s calling it a lateral transfer, in Lang’s mind it had been a demotion. Now he was determined to prove to everyone he was still at the top of his game.
The car pulled to a stop in the circular drive of the four-story white stone building that housed the cadre of doctors—both generalists and specialists—that made up the Preston Medical Clinic. An agent hurried from the area of the front door and assisted Madison from the car.
“I think I’ll be safe in here, fellows,” Madison said as he st
rode through the sliding glass doors.
Lang fell in beside him. “Agent Gilmore there has already done the sweep of the clinic building. I spent the morning checking out Dr. Pearson. I’ll hang out in the waiting room while you’re in there with him. Give me a heads-up when you’re ready to leave, and I’ll have the car pulled around.”
***
Dr. Josh Pearson shrugged into a crisply starched white coat. He wasn’t sure why he’d changed before seeing this patient. After all, David Madison put on his pants one leg at a time. Maybe the difference was that the pants were part of a suit worn by a man who was the immediate past president of the United States.
Josh tapped on the exam room door before opening it. “Good morning, Mr. President.”
Madison was perched on the edge of the examining table, a faint smile on his face. He’d shed his suit coat, which hung on the back of the exam room door, a tie peeking out of one pocket. The collar of his dress shirt was open.
“I’ve reviewed your chart, so let’s get right to your present status. Last night you said some things were bothering you. I’d like to hear more about them.” Josh pulled out a rolling stool and sat. “While you’re telling me, would you please slip out of your shirt?”
Madison unbuttoned his shirt and shrugged out of it. “Let’s drop that ‘Mr. President’ stuff at the door if we can. In here, I’m David . . . or, if you prefer, Mr. Madison. Treat me like any other patient. Okay?”
Josh knew that, despite Madison’s attempts to put him at ease, he’d always be aware of this man’s status, of what he’d been, and what he’d done. But he appreciated the gesture. “I’m flattered, Mr. . . . Madison. Now, how can I help you?”
Madison coughed. “This has to stay between us.”
“Everything you tell me is in confidence. Your records are doubly encrypted, and I’m the only one with access to them.”
Madison went on to relate the scene Rachel had described to Josh the night before. “Rachel’s pretty good at hiding things, but I had a hunch she was getting sick about the time they were loading Ben Lambert’s coffin on the private jet for the return to Dallas.”
“I can tell you that Rachel related this same story to me last night. One of the other clinic doctors is examining her this morning. And, before you ask, I’m sure we can trust Dr. Neeves to be discreet.” Josh rolled his stool forward a bit. “Now let’s talk about you. After that incident, what kind of symptoms have you developed?”
“I didn’t say I had symptoms,” Madison said. He coughed again. “Well, I might have picked up a little respiratory infection while I was gone.”
“I noticed that. You have to be honest with me.”
“Even if it’s nothing serious?” Madison asked.
“Yes. Because you’re used to being invulnerable. I suspect chiefs of state, even those no longer in the limelight, feel that way.” When Madison started to speak, Josh stopped him with an upraised hand. “Don’t worry. It’s the same with doctors.”
Madison gave a wry grin. “You got me. All right. I had a raw throat a few days ago—probably two days after the incident with the native woman. A day or two later I developed a mild cough. I still have it. And I might have a bit of a fever.”
Josh nodded. “Well, let’s have a look at you.” When he’d finished, he stowed his stethoscope in the pocket of his lab coat. “I’m going to take a swab from your throat and ask our lab to culture the material and also to make a slide, stain it, and look for bacteria. I want to get a chest X-ray and some blood work. The nurse will assist you and bring you back here when you’re done.”
“What do you think?”
“It may be nothing more than a routine viral or bacterial respiratory infection, but I want to be certain.” He smiled.
“Sounds like you’re being extra thorough, but you’re the doctor,” Madison said. “I can see why Ben Lambert thought so highly of you.”
As Josh exited the exam room, he wondered if that confidence was misplaced. Was he overreacting? He hoped not. But the incident with the woman flinging liquid at Madison troubled him. It could be that she was just someone angry with the Americans who’d come to their small town. But perhaps there was more to it than that.
Meanwhile, he wanted to double-check something in Madison’s medical records. And maybe he could catch Allison Neeves and see what she thought about Rachel.
He’d asked Allison to see Rachel because, of the half-dozen internal medicine specialists at Preston Medical Clinic, she was probably the sharpest. Besides, she was female and something told Josh that Rachel might prefer a doctor of the same sex.
He and Allison had done their residency at different facilities, so much of what he knew about her he’d learned after she came to Preston Medical Clinic. Allison had always been hesitant to reveal details of her personal life, but Josh finally learned that she’d married during her first year in medical school. However, she and her husband had been divorced about the time of her graduation. Allison’s natural beauty plus her bare ring finger had quickly made her a target for most of the single doctors at the clinic as well as a couple of the married ones. She’d gently rebuffed these approaches, some more gently than others, but had never been anything but cordial to Josh.
Allison was closing the door to the exam room when Josh rounded the corner heading down the hall toward her. She ran her fingers through her short blonde hair and smiled at him. “Josh, I was going to see if I could find you, but you found me first.”
Josh nodded. “I’m concerned about Rachel.”
“I saw her a few minutes ago. Now she’s gone for some lab work and a chest film.”
“And . . .”
“My philosophy is to expect the common diagnoses but check for the worst-case scenarios, too. That’s what I’m doing here.”
A nurse, escorting an older woman, came down the hall toward them. Josh was itching to continue his conversation, but waited until they passed by and entered one of the several exam rooms that lined the hall. Then he said, “Rachel and President Madison were on the same trip to South America. I presume she told you about the incident—”
“With the woman who showered them with an unknown liquid? Yes. Ordinarily, I might not be too concerned, but when I look in her throat—”
“You see not just redness but a few tiny patches of exudate. Right?”
Allison nodded. “And she has cervical lymph nodes that are more prominent than you’d see with a run-of-the-mill pharyngitis. So I’m getting a throat culture and smear.”
Josh grimaced. “I’m doing the same thing. And while we wait, I’m going to go over the list of immunizations the group received again.”
As Josh walked away, he tried to ignore the ominous thought that kept popping up. Surely this wasn’t— No, it couldn’t be.
***
Josh sat before the computer in his office and scrolled through David Madison’s medical records until he came to the visit before the former president left for his South American trip. Madison had undergone a complete physical, even though his previous one had been only nine months earlier. That included a cardiac stress test, which he passed with flying colors. Josh pulled a notepad toward him and jotted down a reminder to recheck Ben Lambert’s cardiograms. Maybe there’d been something there that had been missed.
What about immunizations? Before the trip, Madison had received multiple immunizations, including a tetanus-
diphtheria booster and preventive shots against hepatitis A, typhoid, and yellow fever. That made what Josh was concerned about less likely, but then again, no immunization is 100 percent effective. And there was always the possibility of a rare type of infection, not covered in the routine spectrum of immunization. He’d double check that—another note to himself.
Dr. Ben Lambert hadn’t provided the ex-president with any prophylactic antibiotics at the time of that visit, but since Lambert was part of the group that would be traveling, he might have planned to give those out to everyone at the time of departur
e or even while on the plane. Josh would have to look into that. Rachel or Madison should be able to tell him. He scratched out another reminder.
His intercom buzzed. Josh pulled his eyes away from the screen long enough to hit the button. “Yes?”
“Doctor, Ethan Grant at the lab just called. He’s made a smear of the throat swab you took and thinks perhaps you should look at it yourself.”
“Tell him I’ll be right there,” Josh said. For reasons of security, the specimen had been sent with a code instead of a name, but he figured it wouldn’t take long for word to get around that it belonged to David Madison. Josh closed down the open medical record on his computer—he’d have to get used to the extra layers of security in place for this special patient—and headed out the door of his office.
In a few moments, he was seated before a binocular microscope in the lab with Ethan Grant, the chief lab tech in the bacteriology section, standing behind him. Grant rubbed his shaved head nervously. “I think you’ll see what I mean,” he said.
Josh focused the microscope on the glass slide prepared from a swab from David Madison’s throat. There was the usual trash: mucosal cells, white blood cells, but in among it all were dark rods. Their cell walls had absorbed the Gram stain—that is, they were Gram positive—and the organisms were elongated, with a few showing the characteristic clubbing at one end that confirmed the diagnosis Josh had feared.
“This is the best slide you have?” he asked Grant. He knew it was, but he had to ask.
“I made three, and they’re all like that.” Grant leaned closer and almost whispered. “Doctor, I know who your patient is, but don’t worry. I’ll keep it quiet. I also know that Dr. Neeves is seeing Rachel Moore this morning. We got her throat swab at almost the same time as this one came in.”
“And?”
“It shows the same thing. The morphology isn’t quite typical, but I’ve seen the real thing, and it’s my opinion that both these patients are infected with a variant of Corynebacterium.”
Josh nodded silently. The cultures would take days to grow out. Should he wait for them, or treat for something of which he wasn’t quite sure?
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