This was his first direct contact with this agency, although he’d heard about it since medical school. Josh hoped he would be able to navigate the labyrinth of departments without too much difficulty. Then again, it was a government agency.
After his call was transferred several times, Josh was finally connected with the appropriate duty officer. He identified himself and said, “I need enough diphtheria antitoxin to treat two patients.”
“We don’t get much call for that,” the doctor on the other end said. “Let’s talk about the indications for DAT treatment of patients.”
Josh patiently provided information until at last he said, “Look! I’m a board-certified internal medicine specialist. I’ve examined the patient. I’ve looked at the slides. These people have airways that are at risk. Now, how soon can I get the DAT?”
“I’ll have to check the database to locate it,” the duty officer said. “Let me get back to you shortly.”
Josh was caught on the horns of a dilemma. If he hid the identity of his patient, it might take a day, even a couple of days to get the antitoxin. On the other hand, he was certain David Madison wasn’t anxious for the whole world to know the details of his illness. “Let me emphasize that this is a genuine medical emergency,” Josh finally said. “I need that antitoxin today. ASAP. Stat. If necessary, I’m prepared to send a private jet to pick up the antitoxin and fly it back here.”
“Sounds like either you or your patient have resources most of us don’t.”
Please don’t let this guy throw a monkey wrench into the works just because he’s envious. “I’m not at liberty to disclose the identity of the patients involved,” Josh said. He hardened his voice. “I’m going to say this once more. This is a medical emergency. Give me your name and your direct number. I’m going to call you back in thirty minutes, and I want you to get me sufficient diphtheria antitoxin for two patients. Do you understand?”
After Josh hung up, he wondered if he’d handled the situation the right way. Should he have used Madison’s name and invoked his influence? Maybe he should have checked with Jerry Lang before making the call. Josh reached for his cell phone, where he’d entered Lang’s number. If Ben Lambert weren’t dead . . . but he was, and Josh was on his own. I guess I have a lot to learn about caring for an ex-president.
***
Karen Marks exited the limousine as soon as the driver opened the door for her. “Wait here. I shouldn’t be long,” she said.
The neighborhood where they were wasn’t in the same league as the estate where David and Mildred Madison lived, but it certainly wasn’t a poor one, either.
The home was a rambling, one-story house in a nice neighborhood—not pretentious, not opulent. Probably bought it as soon as they could after Ben graduated from med school. If there were children, they were long since gone.
She squared her shoulders and rang the doorbell. Karen had done lots of difficult tasks for David Madison at all his stops in government service. It never got easier, but she’d learned that a direct approach was best. It was sort of like ripping off a bandage. Get it done and move on.
The woman who answered the door was probably in her mid-sixties. Her black hair was neatly combed and styled. She’d made no effort to hide the streaks of gray that ran randomly through it. The woman wore a simple black dress, and reading glasses with red horn-rimmed frames dangled from a chain around her neck.
“Yes?” the woman said.
“Mrs. Lambert?”
“Yes.”
“I’m Karen Marks. I’m David Madison’s administrative aide—sort of a chief of staff, I guess you’d say. May I come in? I need to give you some news about your husband.”
The woman stepped back and gestured Karen into the house. “I don’t know how much worse any news could be than that my husband is dead,” she said. There was neither rancor nor self-pity in her voice. This was a woman who’d already shed her tears in private. Perhaps her husband’s relationship with the ex-president had schooled her in facing the world in good times and bad.
“Is there somewhere we can sit and talk?” Karen asked.
Mrs. Lambert nodded and escorted Karen into a living room, where she took a side chair and Karen perched on the couch. “What have you come to tell me?” Mrs. Lambert asked.
“One of our party—a nurse who participated in the attempts to revive your husband—escorted his body home. After Mr. Lang, the head of the Secret Service detail, talked with you, he contacted Sparkman Hillcrest and arranged for a funeral director to meet the chartered aircraft and take charge of the body. But another hearse got there first.”
“What are you saying?”
“Someone took your husband’s body.”
Other than a sharp intake of breath, Mrs. Lambert showed no emotion. “I called Sparkman Hillcrest this morning,” she said. “They told me Ben’s body wasn’t ready for viewing and I should call tomorrow. I guess that’s why.”
“There’s more,” Karen said. “This morning, cremated remains were left on the doorstep of the funeral home, along with your husband’s watch, wallet, and wedding ring.”
Mrs. Lambert slowly shook her head. “Why would anyone—”
“My guess is there was a terrible error. For instance, the body these people expected to receive might have been someone who died of a highly communicable disease. Immediate cremation was called for and carried out. In the meantime, the police had been in contact with every funeral director in town, looking for your husband’s body. When these people went through the personal effects that accompanied the body, they realized their error. It was too late to stop, so they did what they could. They delivered the cremains to the right funeral home with the personal effects and a note that said they were sorry.”
Mrs. Lambert sat silent, shaking her head, her lips pursed. Then she said, “You said the personal effects were a wallet, a watch, and a wedding ring?”
“Yes. The wallet was your husband’s, with identifying material inside. The watch had his name engraved on the back, apparently a gift of some kind. And the wedding ring bore his initials and yours inside it.”
“What about his class ring?”
Karen shook her head. “All we have is what I’ve described.”
Mrs. Lambert looked away. “Ben did his pre-med at Texas A&M. That senior ring was more precious to him than his wedding band. He never took it off.” She fixed Karen with a steady gaze. “If there was no A&M senior ring with the personal effects, I can’t believe that those cremated remains are those of my husband.”
5
Karen climbed into the backseat of the limo and said, “Prestonwood Hospital. And close the partition, please.”
She dialed Jerry Lang. “Okay, I broke the news to Mrs. Lambert.”
“How did she take it?”
“We may have a problem. She insisted that if there was no Texas A&M class ring with the personal effects, she couldn’t be certain the remains were those of her husband.”
“So . . .”
“I told her the police would investigate further and get back to her. Can you take care of talking with them?”
“Sure,” Lang said. “The detective in charge is a guy named Warren. I’ll ask him to keep a lid on it for a few days.”
“Have him contact the funeral director who has the cremains we think are Lambert’s, and tell him to keep his mouth shut until he hears from us.”
“Already did that when he called me,” Lang said.
“Now what else?”
Lang’s sigh came over the phone clearly. “I’ve got a situation here.”
“Tell me about it.” I’ve been back in the U.S. for less than three hours and I’m already solving problems. Maybe one day David will realize how much I do for him.
“President Madison’s doctor needs diphtheria antitoxin to administer to both his patients. He’s talked with the duty officer at the CDC and is due to call him back in a few minutes. Frankly, he’s not sure whether to reveal Madison’s identity
. If he does, it may start a rumor about Madison’s health. On the other hand, if he doesn’t, he thinks he risks getting a runaround for what I understand is a vital treatment. He was about to ask Madison, but I suggested he wait until I talked with you.”
“Do you have the name and number of the person he talked with?”
Karen jotted the information down on a small notebook she pulled from her purse. “Tell the doctor I’ll call and straighten this out. And I should be at the hospital soon. Be certain I’m cleared for immediate access to the boss.”
She leaned forward and tapped on the glass partition until the driver opened it. “If I’m still talking when we get to Prestonwood, stop in the emergency room area and keep the motor running so the air conditioner keeps it cool back here.”
“But if the guard asks me to move—”
“If he does, I’ll handle him. Now I have to make a call.” As soon as the glass was closed, Karen dialed the number Lang had given her. Actually, she didn’t mind doing battle like this. She’d had very little of it since leaving DC. It was good to get back into action.
“Dr. James,” came a voice in her ear.
“Doctor, this is Karen Marks. I’m the administrative aide for former president David Madison. I believe you spoke earlier to a doctor who needed diphtheria antitoxin for two patients. I’m calling to get that done—we need it in Dallas ASAP. How are we going to do that?”
“I . . . I was expecting Dr. Pearson to call back.”
“And instead you have a woman calling on behalf of the ex-president. I hope you understand what this means.”
“Is . . . is this for President Madison?”
“Let’s say that Mr. Madison feels it’s very important for this request to be expedited. Now, where is the material, and how do we get it here in the next few hours?”
“Uh, there’s a small supply of DAT at the CDC Quarantine Station in Houston. Their location is actually at Intercontinental Airport there. I can authorize the issuance of the vaccine as an investigational drug to Dr. Pearson.”
“Tell me what you need from this end. I’ll have a plane at Intercontinental Airport in two hours to pick it up.” She spent a few more minutes clearing up details. Her last words to the duty officer were, “Thank you for your cooperation, Dr. James. I’ll make certain your superiors know how you assisted President Madison.”
You’ve still got it, Karen. Ask how “we” are going to get this done, so the person feels they’re part of the solution. And always dangle the carrot once you’ve shown them the stick.
***
Josh sat at the desk in his hospital “office” and wished he could turn back the clock. Three days ago, he’d been like any other doctor, happy with his role in the Preston Medical Clinic’s hierarchy, looking forward to his girlfriend’s return from her travels. Then, as though someone had waved a wand to accomplish the change, he was the personal physician of one of the most important men in the world. And his patient had a real problem.
Now, although he wanted to be at Rachel’s side, to watch over her, to do everything possible to guard her from the consequences of her illness, he knew his primary duty lay with the patient in the room across the hall from Rachel’s. Never before had he so wished he could suspend the laws of physics and be in two places at one time.
Then there were his other patients. Despite Nadeel Kahn’s assurances to him that his patients would be covered, Josh couldn’t shake the obligation he felt toward them. “Just take care of President Madison,” was what Kahn said. What he really meant, of course, was “Give your best efforts to caring for the ex-president. The publicity will be good for Preston Medical Clinic.”
Josh looked at his watch: a bit after four in the afternoon. Lang had suggested he wait to call the CDC duty officer back until the agent could run the situation by Karen Marks and discuss whether to invoke Madison’s name. It seemed Karen was the “get it done” person on the ex-president’s staff. Well, Josh hoped—
His thoughts were interrupted by a brisk knock at his closed door. Josh brought his swivel chair upright and planted his feet squarely on the floor. He shrugged to ease the fit of his white coat—it had never seemed so uncomfortable—and took a deep breath. What now? “Come in,” he called.
The woman who entered was striking, to say the least. Josh’s gaze was immediately drawn to sparkling blue-green eyes accented by a just a hint of mascara. Her pale blonde hair fell to her shoulders in soft waves, framing a beautiful face. A faint amount of make-up was applied to porcelain-like skin.
At first glance, Josh decided she could have been a model or a movie star. But when he looked more closely, he saw something more. There was ice in the sparkling eyes. Her features were exquisite but displayed no emotion. Josh sensed she would be a dangerous enemy.
She stepped forward and extended her hand. “Dr. Pearson? I’m Karen Marks. Nice to meet you.”
Josh took the proffered hand. At first, he wondered if he was supposed to shake it or kiss it. He settled on the former, and she gave him what he decided was a politician’s handshake—grasp the other person’s hand as far in as possible, to avoid getting your own hand crushed; one quick squeeze, neither too strong nor too gentle; then release.
He figured that Karen Marks was probably slightly on the far side of forty, but she could easily be mistaken for thirty—that is, until you looked into her eyes. Within them he could see experience and something more. He wasn’t sure what else he saw, but it told him he didn’t want to challenge this woman.
“Please, sit down,” Josh said, indicating one of the two side chairs opposite his desk.
She smoothed the skirt of her perfectly tailored navy business suit and lowered herself with ease. “Jerry Lang explained you needed some . . . what did he call it? Oh, yes. Diphtheria antitoxin. DAT, I think he said. Anyway, I’ve talked with the CDC. Your antitoxin is in Houston. I arranged for Agent Gilmore to fly down, pick it up, and deliver it here.” She reached into her handbag and extracted a sheaf of papers. “I had these faxed here. After you’ve signed them, give them to Jerry or me and we’ll see they’re faxed back. The last two pages are instructions for administering the DAT.”
Josh had that feeling again, the same one he had in the limo when he first met David Madison. Things were going too fast for him. On the one hand, he thought he needed to regain control of the situation. On the other, he appreciated this newfound ability to simply say, “I need something” and it was done. No question, this was a different world.
“Thank you,” Josh said. “Did you have to use President Madison’s name?”
“I used his influence, but there was never any suggestion that the drug was for him,” Marks replied. “You’ll learn how to do that, too.”
Yes, and probably to lie and cheat a bit if I’m not careful. “Look, I’m happy that you got the DAT for President Madison and Miss Moore, but let me be clear. All I want to do is practice the best medicine possible. If there’s any political maneuvering to be done, I want to know about it ahead of time.”
Marks gave him a sweet smile that was totally devoid of mirth. She rose, smoothed her skirt, and picked up her purse. “I think you’re telling me to stand aside. Well, I promise I won’t challenge your medical judgment or interfere with your treatment. But I guess I should warn you, if you haven’t already got the message. I’ll do anything for David Madison.” At the door, she turned and said over her shoulder. “Anything!”
***
Josh found Allison Neeves in her office at the clinic. She was working her way through a pile of charts, dictating from a stack of notes scattered across her desk. Allison looked up when Josh tapped on the frame of the open door.
“Come in,” Allison said. “I checked on Rachel and she seems to be holding her own. But if we’re going on a presumptive diagnosis of diphtheria, we need to get her started on some diphtheria antitoxin.” She put down the chart she was holding. “And the same for President Madison, of course.”
Josh dropp
ed into a chair across the desk from Allison. “Look,” he said, “this could get awkward, and I don’t want it to be. I’m Madison’s doctor. I didn’t lobby for the position, but I’ve got it. You know that he and Rachel probably have the same infection. I’d like to treat her too, but I agree that would present something of an ethical problem. However, you and I need to stay on the same page. Can we do that?”
“I think what you’re saying is that you’d like to call the shots for both patients, with me acting like your intern on Rachel’s case—writing the orders, reporting to you.” She leaned back in her chair and sighed. “I’ll try to cooperate, but you should realize that Rachel is my patient, not yours, and I have to make the final decisions about her treatment.”
Josh rose. “I don’t think we need to argue right now. That DAT should arrive—” He looked at his watch. “It should be at the hospital in a couple of hours. Is it okay if I write the orders for both patients to receive it?”
Allison shook her head. “Just call me when it comes in. I’ve already reviewed the protocol. I’ll check Rachel and write the orders for her; you take care of Madison.”
“If that’s the way you want it,” Josh said. He rose, turned, and headed for the door. I don’t know what I did to step on her toes, but I can’t worry about that. I’ve got to give David Madison the best possible care. And Rachel, of course.
***
“Mr. Madison,” Josh said as he entered the ex-president’s hospital room. “How are you feeling?”
“Not great,” Madison admitted. “My throat’s getting pretty sore.”
Josh noted a raspiness in his patient’s voice—something that hadn’t been there before. “Any difficulty breathing?” he asked.
“Not . . . well, maybe occasionally.”
“Okay. The diphtheria antitoxin has arrived, but before we give it to you, I have to ask you some questions, then do a skin test.” Seeing the confusion in Madison’s eyes, Josh said, “The DAT is made from horse serum, so I have to be certain you won’t have a reaction to it.”
Miracle Drug Page 5
