by Bill Clem
With his oxford shirts, khaki pants, and the ever-present white lab coat, complete with drug and diagnosis book that stuck out from the side pocket; he looked like a young intern. The only thing that hinted of his age was his bald scalp. Leah, an excellent diagnostician, and well qualified to handle any problems of Jack McDermott, hurried to see his patient--who should be dead.
Jack McDermott sat up in bed when Dr. Leah walked in his room. The nurse turned and regarded Leah with a smile as he stood at the foot of Jack's bed.
Leah flipped through McDermott's chart then looked up. "Mr. McDermott, I'm Dr. Leah. How do you feel?"
Jack blinked, staring. "Dazed."
"You've been in a coma for a little over a week."
"So I hear."
The nurse looked up from the chart. "I was telling him what happened."
"So what now?" Jack asked.
Leah studied McDermott for a long moment. "First and foremost, you need to get some rest. We'll get another MRI of your head and depending on the results, we may move you to another unit."
"What's an MRI?"
"It's basically a fancy X-ray, just a little more thorough."
Jack nodded. "Any chance I can get something to eat? I'm starved."
"Sure, we can fix that."
Leah could relate to it. He still smelled his soup he'd left on the cafeteria table. He turned to the nurse. "Let's start him off with some clear liquids and see how he tolerates those. If he does all right, we'll get him something solid for lunch." He turned back to Jack. "All right, Mr. McDermott, I'm going to write some orders for you. Later on I'll run some tests, and see you then."
"OK thanks, doc... Dr. Leah, is it?"
"That's right, L-E-A-H."
"Good I remembered," he said, as Leah went out the door.
Chapter Four
Aboard Air Force One, the first steward, a Technical Sergeant, appeared in the cabin and announced their final approach to Zurich International Airport. He advised everyone to return to his or her assigned seat and put their seat belt on.
President Lloyd excused himself from the reporter and made his way back to his seat. He nudged the steward as he went past. "Could you get me a couple antacids? I'm a little nauseated from the flight."
"Pre summit jitters, no doubt. I'll get them right away, sir."
Lloyd nodded. "No doubt." He had held four summits in his two years as President. Although used to them, they still gave him butterflies. The sheer power he possessed sometimes frightened even him. Enough to make anyone's stomach upset.
The First Lady and daughter sat across from the President discussing the latest ski attire when the plane's engines slowed and the intercom announced it was time to land.
"Finally," Sara Lloyd said. She leaned across her mother and looked at the Swiss countryside getting larger in the window.
"It's breathtaking," Gwen Lloyd said.
Sara squeezed her mother's arm. "Breathtaking and scary."
The President smiled despite his nausea.
A minute later the landing gear hit the runway with a dull thump, and the reverse thrusters reverberated through the cabin as the plane slowed.
Air Force One reached idle speed and lumbered to the taxiway. Lloyd looked out his window. A row of black Mercedes limousines lined the tarmac. The red carpet had already been rolled out, a podium with a dozen microphones was in place, and a wide staircase was being towed toward the exact spot where the aircraft would taxi to a standstill. After Air Force One was secured, the stairs rolled into place and cabin lights flickered on. As the door of the plane opened, the Secret Service exited first. Lloyd followed then the Vice President and the remaining entourage.
At the bottom of the stairs, a Swiss envoy extended his hand. "Welcome, President Lloyd. Comfortable trip I trust."
"Very," Lloyd said, although the knots in his stomach had not abated.
Jesus, what's wrong with me?
The U.S. chief of protocol stepped forward to introduce the President, and after a brief welcome ceremony, security escorted Lloyd to his limousine. He plopped down next to Charlie Lathbury, the Secretary of State. Beads of perspiration dripped off Lloyd.
"You all right, Tom?" Lathbury asked.
Lloyd unbuttoned the top of his shirt and loosened his tie.
"Just a case of nerves," Lloyd assured him.
Lloyd had selected Breckgarten as the meeting place for the summit. A seventeenth-century castle set below the highest peak in the Swiss Alps, its beauty was unsurpassed. Popular with heads of state, it had been the backdrop of many world summits in the past.
Lloyd laid his head back on the seat. "How far is it, Charlie?"
"About a half hour."
Lloyd closed his eyes. "Good, I'll take a nap."
"You sure you're all right?"
Lloyd nodded. "Yea, just nerves."
Chapter Five
Denton Cogswell and Frank Bahr had arrived in Zurich a day earlier to set up security for the President. The two were a study in contrast. Although both men wore identical outfits, dark topcoats, charcoal gray suits, dark ties, white shirt, and black oxfords: the similarities ended there.
Bahr, a solid mesomorph, a shade under five-eight, cast a stunted shadow across the much taller Cogswell, an Icabod Crane look-alike with sinister features.
Cogswell could not believe the CIA now did what amounted to security detail. "That's what the fucking Secret Service is for," he told Bahr every day.
Here he was, though, along with the Secret Service and the Swiss police, coordinating the efforts to guard Thomas Lloyd--a President he didn't even vote for.
Cogswell's official title: Security Enforcement Officer, a new division of the CIA, was created after the Cold War ended. Previously stationed in Moscow, and familiar with high level contacts, his experience proved invaluable. He protested when his boss picked him for the job, he sorely hated the Russians, but his orders stood. They needed him in Zurich, period.
Cogswell kicked at a patch of snow as one of the Swiss police walked up.
"How will we handle this?" the officer asked in his thick accent.
"You'll be briefed in a minute." Cogswell walked away.
"Take it easy," Bahr said to Cogswell. He shifted his weight from one foot to the other. "They're on our side."
Cogswell briefed all the security detail on their duties, as well as what to expect from the Russians who insisted on no interference with security for their president, Viktor Chermonovik. The Russian routine proved simple.
They surrounded their president with thugs, ten strong and all in the three hundred pound range. If anyone tried to get close to Chermonovik, with malice, the thugs shot them.
Russian democracy, Bahr told them.
The American security plan, much more sophisticated, yet no less deadly, required a group effort. Along with the usual Secret Service agents assigned to the President, the CIA and Swiss Police had snipers on the roof of Breckgarten and plainclothes officers throughout the crowd.
The Russian President stood in a semi-circle to await the arrival of Lloyd and his group. The goons alongside him looked as if any one of them could crush a small car with his bare hands. Chermonovik stood a shade over five-feet tall and nearly as wide. With a pit bull's face and thick silver hair, he resembled a compacted version of The Man from Glad. He oozed charisma, though. In his three short years as Russia's President, he had finagled more deals and secured more financing for his country than all his predecessors combined. Standing in front of Breckgarten, he looked every bit the exuberant politician.
Cogswell ratcheted his jaw as he watched Chermonovik. His blood boiled to see all these Russian bastards, most who were former KGB henchmen, now supposed diplomats. Cogswell could see their breath form clouds in the cold air. How much he would love to squeeze that breath right out of them.
It never changed. He had spent enough time there to know. No matter how much you give them it's never enough. This latest deal proved just another ploy. In
fact, he had intelligence reports from contacts in Moscow that said the money would be used for military purposes. The Vice President confirmed the reports, and tried to tell Lloyd he was making a mistake. Lloyd didn't want to hear it. His oil deal would save the Russian economy and make the world a safer place to live. Bullshit.
The motorcade approached and Cogswell let the thought pass. He keyed his mike. "This is team leader, all units stand by."
* * *
President Thomas Lloyd's motorcade pulled to a stop in front of the Swiss Consulate Mansion. The ride had not been long enough for Lloyd. When his limo pulled into the circular drive, his enthusiasm to meet anyone had dwindled. The initial nausea he'd felt on his arrival at the airport, now overwhelmed him.
He needed to vomit.
Lloyd looked at his wife in the seat beside him. "Maybe I ate something bad at breakfast." His elation about the summit had turned to feelings of doom.
The reception party was lined up in front of the mansion as Lloyd stepped out.
Suddenly, numbness shot from his left jaw down through his left arm. He had never experienced anything like it. Numbness turned to pain. A crushing pressure squeezed Lloyd's chest as if he were in some medieval torture device. Mortal fear gripped him as he gasp and his eyes bulged in their sockets. His hands clawed at his shirt.
Something was definitely wrong. Please, get this elephant off my chest!
* * *
When Lloyd fell, the Secret Service agent closest to him grabbed him at the elbow and lowered him to the pavement. He'd stopped breathing and was ashen.
Lloyd's personal physician, Dr. Jim Bullock, grabbed his medical bag and bolted from the limousine he'd followed in. He yanked open the bag and knelt beside the President.
"Get me some oxygen over here," he yelled to no one in particular, "he's having a heart attack!"
Two paramedics sprinted from an ambulance parked nearby. Each carried heavy canvas duffel bags full of medical supplies. Bullock, already inserting an airway when they got there, looked up.
"I'll start an IV," one of them said.
"Give me two amps Bicarb as soon as it's in," Bullock ordered.
With the airway in, the other paramedic hooked up an ambu bag and connected it to a small oxygen tank and began respirations on Lloyd.
Bullock unbuttoned Lloyd's shirt and placed his stethoscope over the chest. Fear gripped him. He heard only a crispation.
"Defibrillator! He's in V fib," he yelled to the paramedic on his right.
The paramedic yanked the defibrillator from inside the ambulance. He handed it to Bullock, then stepped back, anticipating the next move. Bullock turned the defibrillator dial to three hundred joules.
"Stand clear," he said, pressing the paddles to the President's chest. He jammed the buttons on the paddles. Lloyd's body jumped off the ground as the current surged through it.
"Damn it," Bullock said, as no heart rhythm appeared on the small defibrillator screen, only a squiggly line that indicated ventricular fibrillation.
Desperate, he turned the dial to three hundred fifty joules and placed the paddles back on Lloyd's chest. "Recharging, stand clear."
Again the current coursed through Lloyd's body as it jumped off the pavement. Bullock checked the monitor. A small blip appeared, then a slow steady spike traced across the screen. He heaved a sigh. "I've got a rhythm. It's shaky, but it's a rhythm. We need to get him to the nearest hospital as fast as possible."
The President's security team made a small fortress around him as the doctor secured his IV lines. Finally, packed in the ambulance with Bullock next to him, and two Secret Service agents on either side, the driver looked over his shoulder. "We're going to Brighton Heart Center," he said.
Bullock saw a strange look on the other paramedic's face when the driver said that.
Chapter Six
The decision had been controversial Jorge Sacov knew. The ethics committee of the Organ Procurement Network had been in a catch twenty-two. Yes, they wanted to increase the number of donor organs available.
However, to place dying patients on a donor list, then match them to the recipient before the donor even died, was not what they'd intended. As often goes in the medical community, though, after much controversy, including outrage from some citizen groups, the Swiss government approved the bill.
Soon, Germany, Italy, France, and the rest of Europe, endorsed the newly created program to assure more organ donors. Most were trauma patients in centers around the continent. Each hospital entered its own potential donors into the donor bank. The donor could have no chance of recovery, with clinical death expected in seventy-two hours or less. Once accepted, their name went into the computer of the Procurement Network, along with all compatibility reports, lab studies, and any medical anomaly or unusual characteristics.
When a recipient became ready for transplant, the procurement team of his hospital accessed the donor bank. If no "clinically dead" donor was found, the computer automatically switched to a, "potential donors" list, which matched him or her to the recipient, effectively providing that patient's donor.
The United States had rejected a similar plan as unethical; some organizations were afraid it would be incentive to treat trauma patients less aggressively, hoping to harvest their organs. The European medical community, though, viewed it as a way to solve the shortage of viable organs for transplant.
Jorge Sacov considered all the ramifications. Just a job. He dismissed any feelings of guilt. He picked up the folder for the patient who would become the next potential donor for Zurich Trauma Center. He typed in the name: JACK McDERMOTT.
The file contained all the information the donor bank needed: Mr. McDermott had suffered severe head trauma while skiing at the Muree resort, a popular ski area in Zurich. Currently comatose, with zero brain wave activity, an ETL (estimated time left) of forty-eight to seventy-two hours.
Age: Thirty-four. Heart, lungs, kidneys, and liver: all without damage. With no prior health problems, he was a perfect donor.
Immediately the information went out via modem to the Central European Donor Bank computer headquartered in Bern. Any transplant center with a recipient now had access to it.
Sacov felt as if he'd just given someone's life away.
Chapter Seven
Dr. Roy Gregg had just finished his lecture at the local university when his pager started to beep. He reached down and pulled it up close enough to see the small numbers on its tiny screen; 5835, the number for Bob Bradley, Chief of Staff at Brighton Heart Center.
Gregg could fix hearts better than anyone else in the world. He cut his teeth doing groundbreaking heart surgeries with Dr. Christian Barnard in the early sixties. Now, at seventy-two, when most of his colleagues had either retired or died, Dr. Roy, as his friends affectionately called him, was the world's leading cardiac surgeon.
Known for his boundless energy, his wiry frame stood testament to the seventy-plus miles he ran every week. Some days, Gregg spent the day skiing in the Alps, then donned his running gear and went for a fifteen mile run. His incredible endurance carried Gregg through many sixteen-hour surgeries.
Gregg called the number on the pager. After one ring, Bradley answered.
"Hello, Roy."
"Yea, Bob, what is it? You sound upset."
"We need you over here, it's urgent. We have an extreme medical crisis on our hands," he said.
"What, what is it?"
"I can't say over the phone. Just come over to the office. I'll explain when you get here."
"Sure... sure, I'll be right over."
Chapter Eight
Jim Bullock jumped out of the ambulance carrying Thomas Lloyd as it arrived at Brighton Heart Center. He stood amid a hoard of doctors and various medical specialists who immediately descended upon it. The doors opened and the paramedics pulled out the stretcher and extended the legs. All done with such precision, it seemed like one fluid movement, rather than several calculated ones.
A paramed
ic in the ambulance handed out the intravenous bag to a nurse, who held it up high to ensure adequate flow of the clear fluid. The other paramedic holding the ambu bag to help Lloyd breathe handed it out to a respiratory therapist. All this took thirty seconds, and then Lloyd rolled through the electronic doors and into Brighton Heart Center's Emergency Room.
Bullock could see a dozen or so reporters had followed the ambulance and now set up camp outside the hospital. Spokespeople from Brighton had no answers for their questions. At this point they knew as little as the reporters, whose disappointment clearly showed.
"Can't you just tell us his status?" one reporter asked.
"The President's Press Secretary is preparing a statement. You'll be informed the minute it's ready," a hospital official said.
* * *
Inside ER room four, Dr. Myron Chilkof, staff cardiologist, assessed Lloyd first. "Let's get him on the bed."
Three nurses, along with two other doctors, each took a small section of sheet on the stretcher.
"Okay, we'll slide him over on three," Chilkof said. He tightened his grip on his piece of sheet.
"Grab the IV," one of the nurses said.
"Done," another said, a second later.
"One, two, three." They lifted Lloyd off the stretcher and onto the bed.
"Call EKG," Chilkof ordered.
"They're already here" someone said.
"Ventilator!"
"Two seconds," the respiratory therapist said.
"What's the rhythm?" Chilkof asked.
"Sinus with bi-focal PVC's," a nurse said.
"Let's get a central line in him, and start a calcium drip. We're losing ground here. He's very unstable," Chilkof said. His faced lined with worry.
After an hour, Lloyd finally stabilized and went to a specially prepared room in Intensive Care.
* * *
Dr. Roy Gregg felt a distant chill when he walked into Lloyd's room in the Intensive Care Unit. Lloyd remained unconscious, and a ventilator breathed for him. His color painted a dismal picture in Gregg's mind. He'd seen it often enough to know what it meant. Despite this, he forced a smile at Lloyd's nurse.
