Patient One (7 page)

“Have him come in,” David said.

“
Her
,” Jarrin corrected and stepped aside.

Karen Kellerman, wearing a stethoscope and a string of pearls around her neck, entered the room. She was strikingly attractive, in her late thirties, with ash-blond hair and eyes so blue they were almost violet. Her long, white laboratory coat was opened wide enough to reveal a curvaceous figure.

“Hello, David,” she greeted him with a smile. “How have you been?”

“Good,” David said icily. He stared at her for a long moment before continuing. “Are you aware the endoscopy will be done in here?”

“Yes.”

“Good,” David said again, then lowered his voice. “What you’re not aware of is that the President is a bleeder.”

Karen’s brow went up. “What!”

David nodded. “He’s got von Willebrand’s disease, which we’re in the process of bringing under control.”

“How much—”

“That’s all you need to know for now,” David cut her off. He turned his back to her and spoke to Carolyn. “Once you get this room cleaned up, it might be worthwhile to spray the air with some disinfectant.”

“And we should wipe down everything with an antiseptic,” Carolyn added as she finished drying her hands. “Including the filthy ventilation duct.”

David came back to Karen and said, “You can sit anywhere you like. Just don’t get in the way of things.”

“Perhaps I can help,” Karen offered.

“Just stay the hell out of the way,” David growled.

Karen looked down, stung by David’s brusqueness. After an awkward pause, she asked quietly, “Can we talk in private for a moment, David?”

“About what?”

“The misunderstanding you and I had.”

“There wasn’t any misunderstanding,” David snapped. “It was straightforward. I had a great idea, and you took it and profited from it. That’s called stealing.”

Karen’s face closed. “You’re oversimplifying what happened. You never gave me a chance to explain.”

“Stealing is stealing, any way you cut it.”

Carolyn cleared her throat loudly, not wanting to be caught in the middle of the hostile exchange. “I’ll fetch Jarrin so we can get this room spic and span.”

She hurried out into the corridor and quickly looked around the Pavilion. Everything was running smoothly. Patients were being placed in their rooms in an orderly fashion, with Kate directing traffic. Secret Service agents were scurrying about to make certain the President was secure. And Jarrin was on the phone, busily reading off a list as he ordered up more supplies. She gestured to him with her hand, signaling him to speed the conversation up.

Behind her Carolyn could hear the two doctors arguing. From what she could piece together, David had come up with an idea for a portable cooling blanket. It could rapidly decrease the body’s temperature and be particularly valuable in patients with sky-high fever and those suffering from spinal cord injuries and cerebral anoxia. A portable cooling blanket was ideal for use in ambulances and MedEvac helicopters.

“You can’t sugarcoat it,” David was saying. “You stole my idea and sold it to the highest bidder.”

“You didn’t seem that interested in the blanket,” Karen countered. “You made it sound like it was just a passing theory you had.”

“That’s bullshit!” David shot back. “I even drew sketches of the design and showed them to you.”

“Those were crude outlines that didn’t begin to resemble the final product,” Karen argued.

“More BS!” David said, then asked, “Why did you do it? For the money?”

“Goodness, no! I make more money now than I know what to do with.”

“Then why?”

“Because it was a notable achievement that would further my academic career,” Karen explained. “That may not seem important to you because you’re already at the top of academia and secure. But I was still a step away from a tenured professorship, and this invention got me promoted. Believe me, David, it wasn’t for the money.”

“Then why did you license it to a big medical supply corporation?” David demanded. “Those royalty checks come to you, don’t they?”

“No,” Karen answered at once. “They go to Doctors Without Borders, a group I’ve worked with closely since I was a resident.”

There was a long pause before Karen spoke again. “Had I known I was going to lose you over this, I would have never done it—never in a million years.”

“It’s too late for words,” David said with finality. His mind went back three years to a winter vacation they’d taken in Cancun. It was so good then. Now it was a sour memory. “What we had once together is long gone and never coming back.”

“Don’t be so sure,” Karen said in a smug tone. “Time has a way of healing spats between lovers.”

Carolyn groaned inwardly and cursed at the turn of events. She and David were just starting to get close. And suddenly an old flame shows up. A gorgeous old flame. Carolyn cursed again at her bad luck. She wondered if fate was going to screw her life up once more.

Off to her right Carolyn heard a sudden commotion. She glanced over to the elevators and saw gurneys and wheelchairs being moved out of the way. A male voice cried loudly, “The Russian Foreign Minister is on his way up!”

Carolyn raced over to the door of the treatment room and called in, “David, I have to help get the Foreign Minister set up. You might want to start moving the medicine cabinets into the hall.”

David nodded and reached for the phone. “As soon as I find out what’s holding up the blood I ordered for the President.”

Carolyn dashed back out into the corridor just as the elevator door opened, and the Foreign Minister was wheeled out on a gurney. Only the man’s head was visible above the white sheet covering him. There was caked vomit around his nose and mouth. His wife was brought out of the elevator behind him. At the rear was a barrel-chested Russian security agent, hand inside his coat, his eyes quickly surveying the surroundings.

Carolyn pointed down the hall past the treatment room. “They go in suites ten and eleven.”

As the gurneys were turned around, Carolyn touched the arm of the security agent. “Do you understand English?”

“Yes,” the agent said.

“After you’ve checked the rooms, please stand outside in the corridor while we get the patients squared away,” Carolyn requested. “It will only take a few minutes.”

“Understood.”

Vladimir Yudenko darted ahead and made certain the rooms were safe and secure. He paused briefly to marvel at the size of the suites, which were as large as some apartments in Moscow. Then he moved into the corridor and waited for the patients to be wheeled in and the doors closed behind them.

Yudenko glanced down to the far end of the hall, where most of the activity was. And where the presidents of Russia and the United States were no doubt located. He spat in the direction of both before making his way to the other end of the corridor. Glancing over his shoulder once more, he knocked on the door to the kitchen and entered. A Secret Service agent was standing by the open dumbwaiter.

“All clear?” Yudenko asked.

“All clear,” the agent said.

“Good.” Yudenko reached for the door, then suddenly spun around and drew his silenced revolver. He fired two shots into the Secret Service agent’s chest, one ripping into the heart, the other into the aorta. The agent bled to death in seconds.

Yudenko moved quickly over to the dumbwaiter and pushed a switch. The green light beside it turned red. The dumbwaiter started on its way down.

Yudenko holstered his weapon and sprinted back to his post outside the Foreign Minister’s room. Out of the corner of his eye he gazed down the corridor to see if anyone had noticed his brief absence. No one had. Everybody seemed to have their backs to him. Good, he thought, pleased that things had gone so smoothly and easily so far. Yudenko checked his watch. Now all they needed was another eighty seconds.

A young nurse came out of the room of the Foreign Minister’s wife and paused to write herself a note. Then she turned, as if heading for the kitchen area. Yudenko reached for his revolver, but the nurse abruptly whirled around and raced off in the opposite direction. She barked out orders to someone before disappearing into a side room. Yudenko checked his watch again. Fifty seconds to go.

Yudenko’s pulse quickened in anticipation.
So close to success! So very close!
Kuri Aliev’s plan was working to perfection. Soon his name would be shouted from every rooftop and praised in every mosque, and forever enshrined in the hearts and minds of his countrymen.

“The President’s daughter is coming up!” someone yelled out.

The door to the Foreign Minister’s room flew open. Carolyn Ross rushed by Yudenko and ran for the nurses’ station.

“Put the daughter in room three, across from the President,” Carolyn ordered loudly. “And call down to the pharmacy. We’re going to need more five-percent glucose in saline.”

“How many bags?” the ward clerk asked.

“Twenty,” Carolyn replied. “And get a dozen vials of potassium chloride.”

Carolyn hurried on and reached the bank of elevators a second before the President’s daughter was wheeled out. Anyone could tell that the new patient was the First Lady’s daughter. Their resemblance was striking. Both had narrow faces, high-set cheekbones, and sandy blond hair. They could have passed for sisters. Next, the daughter’s date came out of an adjacent elevator. It was impossible to tell what he looked like, because he was retching and his face was buried in a small basin.

As Carolyn backed away to give the gurneys more room, she spotted a group of chefs coming down the corridor. There were four of them, all dressed in white, with their chef’s hats cocked off to one side. Carolyn stared at them, wondering what they were doing up on the Beaumont Pavilion.
They never came to the floor. Never. Not even to
… Then she saw the oversized weapons they were pointing at everyone. For a moment she was paralyzed by fear. But then she somehow managed to find her voice.

“Look out!” Carolyn yelled. But it was too late.

The sound of automatic gunfire filled the air, followed by screams and shrieks and cries for help. People tried to run, but stumbled and tripped over themselves in the mayhem and panic. Carolyn found herself on the floor, with heavy bodies atop her. There was more rapid fire.
Pop! Pop! Pop! Pop!
Pop! Pop!
More people fell, screaming out in agony.

Carolyn pushed herself up and scurried on her hands and knees for the safety of the nurses’ station. She banged into a female body lying spread-eagled, with its chest ripped open and gushing blood as its lungs and heart emptied onto the floor.

Carolyn heard more shots whizzing by overhead and moved faster. She reached the nurses’ station and tried to wriggle under the desk. But the space was already taken by Jarrin Smith, who was grimacing and holding onto his arm. Blood was oozing between his fingers. Carolyn curled herself into a ball and, shaking with terror, started praying.
Oh, God! Don’t let me die! Please don’t let me die!

There were more yells and shrieks, and more gunfire. Some of the bullets ricocheted into the medicine room and shattered glass and bottles. Two interns dashed from the chart room, blindly running for a way out. Carolyn saw the pair, but there wasn’t enough time to warn them. A stream of bullets tore into their heads and necks. The interns were dead before they hit the floor.

Then there was quiet. Total quiet, except for the occasional weak groan. Someone yelled out something in a foreign language that Carolyn didn’t recognize. Nearby another shot rang out, followed by another scream of pain.
Oh, God! Oh, God!
Carolyn cringed and pressed herself against the carpet, and prayed she wouldn’t be the next to die.

Seven

The terrorists began dragging
bodies into the chart room, stacking them up like firewood. First in were the interns who were barely recognizable, with half their heads blown off. Then a pair of Russian security guards were piled on, one still gripping an ammunition clip. Carolyn Ross had to look away when the terrorists lifted the next corpse. It was Kate Blanchard, her chest torn open and dripping blood. Carolyn still couldn’t believe this was really happening, not here, not in a prestigious teaching hospital. And she kept wondering through her fear who the gunmen were and why they were killing innocent people.

“
Sikha! Sikha!
”
—
Quickly! Quickly! Kuri Aliev urged his Chechens to rapidly remove all the bodies from the hallway.

Carolyn’s eyes came back to the dead on the floor. Most were Secret Service agents, with the wires to their earphones visible on the backs of their necks. Just beyond them was a young messenger from the blood bank. The box-like container beside him, which usually held bags of blood and plasma, had bullet holes in it. Carolyn couldn’t tell if its contents were intact.

Aliev yelled another set of orders down the corridor, still speaking Chechen. Carolyn had no idea what he was saying, but she could sense a change in his posture and voice. Now he looked even more menacing and cold-blooded. After a pause, Aliev shouted a spate of commands that included a few words Carolyn thought she could understand.
Telefon. Cell fon. Ifon.
Then he spun around and turned his attention to the remaining corpses. He barked out more orders and his men hurriedly cleared away the last of the dead. They quickly picked up the semiautomatic weapons lying in bloody pools on the floor, removed their ammunition, and threw them into a nearby linen closet. The door to the closet was then jammed shut using metal spikes.

Moments later a young, stocky gunman ran up to the group and deposited a large sack at Aliev’s feet. It contained all the phone devices collected from the patients. It also held the room telephones that had been ripped from their wall sockets.

“
Dika
”—Good, Aliev said, then came back to the survivors and spoke in English. “All right. Who is the doctor in charge?” There were five people lined up against the wall next to the nurses’ station: Carolyn Ross, with blood splattered across the front of her uniform; Jarrin Smith, pressing a towel on the wound in his arm; William Warren, holding his side where a bullet had torn through a muscle but had not entered the peritoneal cavity; Vladimir Yudenko, who had a split lip and a nasty bruise across his forehead; and the President’s daughter, Jamie, badly shaken but unharmed.

“Who is the doctor in charge?” Aliev asked again. He was a short man at five and a half feet, with dark piercing eyes, black hair, and hollowed-out cheeks. When no one answered his question, he brought his submachine gun up and pointed it at Jarrin Smith’s head. “You have five seconds to reply. One … two … three …”

Carolyn quickly stepped forward. “There is no doctor in charge now,” she said. “The interns are dead, and the resident is out sick.” She glanced in the chart room at the mound of corpses and tried to locate David Ballineau’s body. Her heart dropped as she thought she saw his salt-and-pepper hair in the tangle of arms and legs. “And … and you’ve killed the only staff physician who was here.”

Aliev gazed down the line of survivors, then came back to William Warren. He briefly studied the bespectacled, slender man with silver-gray hair. “Who are you?”

“I’m the President’s personal physician,” Warren answered, still holding his side where a bullet had ripped through the outer edge of his latissimus dorsi. It hurt more than it bled.

“You will do,” Aliev said. “My men are checking all the rooms. So far, we know where the presidents and the foreign ministers and their wives are located. But three of the rooms are occupied by civilians. I need to know who they are.”

Warren shrugged. “I’m not familiar with them. I only look after the President.”

Aliev stared at Warren dubiously. “But you will know what is wrong with them, and whether they are legitimate patients.”

“Perhaps I’m not making myself clear,” Warren said. “Without having seen and examined them, I can’t—”

Aliev cut him off with a wave of his hand, then turned to Carolyn. “You are the major nurse here. Correct?”

“Right,” Carolyn replied, trying not to look at his menacing weapon. She gazed away but could still feel the heat from its barrel. “I’m the head nurse.”

“Which means you have a lot of contact with the patients. Yes?”

“Yes.”

“Then you will tell me all about them,” Aliev said, nudging her down the corridor with his submachine gun. “And you will come too, doctor. You will explain to me things the nurse cannot.”

They walked down the corridor, which was now eerily quiet. All the doors were closed except for the one to the kitchen area. A fifth terrorist, with his arm in a bloody sling, stuck his head out and uttered a long sentence in Chechen.

Aliev turned and glared at him, then growled an order. The terrorist disappeared back into the room that held the dumbwaiter.

From a nearby suite came the sound of someone throwing up violently. Then there was a loud groan and more vomiting, followed by the noise of liquid splashing onto the floor.

Aliev ignored the sounds and looked over to Carolyn. “I will require a large room. Which is the largest room on this pavilion?”

Carolyn thought for a moment. “I guess the nurses’ lounge. It’s a little bigger than the suites.”

“Good,” Aliev said. “We can put all the hostages in there. That will make it easier to control their activities.”

Carolyn looked at him incredulously and blurted out, “You can’t! They’ll never sit still for that.”

Aliev’s eyes narrowed into angry slits. “We will shoot those who resist and leave their bodies in the room as a warning to the others. Or perhaps we should begin by killing one of the hostages. That would remove all resistance, eh?”

Carolyn realized she had gone too far and softened the tone of her voice. “Sir,” she said deferentially, “I didn’t mean to imply that they would fight you. I was just trying to tell you that their physical condition would make it impossible to crowd them all into the lounge. Please keep in mind that these patients have terrible nausea and vomiting, and some have severe diarrhea as well. I don’t think they could stand to stay in one room with only a single bathroom.”

Aliev considered shoving all the hostages into a cramped lounge despite the vomit and fecal stench they’d be exposed to. He couldn’t care less about their discomfort. But if the conditions became unbearable, the hostages might riot and try to break out. Then he’d have no choice but to shoot them. And for now he wanted them alive because they might be useful as bargaining tools later on. They could also serve as human shields. Finally Aliev nodded and said, “They may remain where they are. But they are to stay in their rooms, and if they so much as step into the corridor they will be shot. There will be no exceptions. Understood?”

“Understood,” Carolyn said.

“And you and the doctor will limit yourselves to going only into the President’s room,” Aliev went on. “I want him kept alive. What happens to the other hostages is of no concern to me.”

“But the President will ask about his wife and daughter,” Warren interjected. “He’ll insist on knowing that they’re all right.”

Aliev’s face hardened. “He is in no position to insist on anything. Nor are you.”

Warren held up a hand defensively. “I’m only trying to tell you that I know the President very well and—whatever your demands—he won’t budge an inch unless he knows his family is being looked after.”

“And the President’s wife takes a diuretic medicine for her hypertension,” Carolyn inserted. “Fluid loss in these instances can be life-threatening.”

Aliev narrowed his eyes. “How do you know what medications the President’s wife takes?”

“Because I asked when I checked her into her room and took her vital signs,” Carolyn answered at once.

Aliev hesitated, then slowly nodded. He wanted the President’s family alive. They could be used to manipulate John Merrill at a crucial moment. “You will be allowed to care for the President and his family, but no one else.”

Carolyn gathered up her courage for a final request. “Sir, there’s also a desperately ill—”

“No one else,” Aliev snapped harshly. “Now let us move on.”

As the trio approached Marci Matthews’s room, Carolyn said to Aliev, “These patients are very sick. Is it really necessary to put them through this?”

“Yes,” Aliev said and pushed the door open. “Now stop asking questions, and do as you’re told.”

Marci watched the group enter, her doe-like eyes darting back and forth between Carolyn and the large weapon Aliev was holding. She hurriedly pulled the sheet up to her chin and tried to push herself away. The pulse rate on her cardiac monitor suddenly jumped to 100 per minute. “What … what’s going on?”

Carolyn walked over and took Marci’s hand, then squeezed it gently. “Listen carefully to me, Marci. Some men with guns have taken over the floor and we’re all now their prisoners. We have to follow their instructions. Do you understand?”

Marci nodded rapidly. She wanted to ask another question, but the words caught in her throat and wouldn’t come out, so she just kept nodding.

Aliev asked, “What is wrong with her?”

“She has a disease called lupus,” Carolyn answered.

Aliev looked over to Warren. “What is this lupus?”

“It’s an inflammatory disease of the skin, muscles, and joints.”

“And in her case it also involves the heart,” Carolyn added.

Aliev studied the girl with the red rash on her face and asked, “Can you walk?”

“Only to the bathroom,” Marci muttered in a weak voice. “And then I become really short of breath.”

Carolyn said quickly, “I thought that was getting a lot better.”

Marci shook her head. “It’s coming back, just as bad as before.”

“When did this start?”

“A little while ago.”

Carolyn groaned silently. The Beaumont Pavilion was totally unprepared to deal with a rapidly developing pericardial effusion. She turned to Aliev and said, “If Marci gets worse, we’ll have to send her down to a special ward.”

Aliev waved away the idea with his weapon. “Nobody leaves or comes to this floor.”

“But she—”

“Nobody!” Aliev said resolutely, and jerked Carolyn away from the bedside. “Let us go to the next patient.”

As they were leaving, Aliev glanced back at Marci and warned, “You keep this door closed, and under no circumstances open it. If you try to leave, you will be shot.”

Marci looked away and started sobbing.

In the corridor, Carolyn stepped in front of Aliev and said urgently, “You don’t seem to understand how sick that girl is. If she develops more fluid around her heart she will die. The only way to save—”

“You are the one who doesn’t understand,” Aliev interrupted. “I don’t care whether she lives or dies. She is irrelevant. Now let us proceed to the next patient.”

Carolyn glared at the man, incredulous at his lack of humanity. But then she remembered he was a cold-blooded killer. One more death wasn’t going to bother him.

Aliev shoved her across the hall and into the room of Diana Dunn. The first thing that struck them was a strong, pungent odor. It had a sour and metallic quality.

“What is that smell?” Aliev asked, wrinkling his nose.

“It’s the odor given off by patients in liver failure,” Carolyn told him. “It’s called fetor hepaticus. I don’t know what causes it.”

Warren explained, “It’s the result of backup of sulfur-containing compounds that the failing liver can no longer metabolize.”

“Oh,” Aliev said, as if he understood.

To Carolyn the question-and-answer drill now seemed similar to the teaching rounds that the house staff made every day.
Except this isn’t an academic exercise
, she thought darkly. The leader of the terrorists was making certain that none of the patients posed a threat to him or his men.

Aliev was bending over the bed, studying the patient’s face carefully.

“I have the feeling I have seen her before.”

“She’s Diana Dunn, the movie actress,” Carolyn said.

Aliev was taken aback. He leaned closer and examined her face once more. “But she was beautiful. This is an old hag.”

“Liver failure does that to a person,” Carolyn said.

“Is she conscious?”

“Sometimes.”

Aliev poked the actress’s ribs with his weapon.

“Ohhh!” Diana moaned softly.

He poked her again. Harder this time.

Diana Dunn slowly opened her eyes and stared out into space.

“Ah!” Aliev said, pleased with himself. “So you are awake.”

With effort Diana sat up and turned her eyes to Aliev. Her face took on a pained expression. Then she waved a hand theatrically and began acting. “I can’t do that, Roger! I won’t do that! I won’t come to Paris and wait around like some toy to be used at your convenience.”

“What?” Aliev asked, caught off balance.

“My God!” Diana went on. “At least leave me some dignity.”

Aliev asked Carolyn, “What is this nonsense?”

“She’s confused and disoriented,” Carolyn explained. “She’s reciting lines from a movie she made years ago. She does that a lot.”

“Can she get out of bed?”

Carolyn nodded. “Sometimes she wanders around, but she’s harmless.”

“If she wanders into the hall, it will be her final performance,” Aliev threatened, motioning Carolyn and Warren to the door with his weapon.

Back in the corridor Warren leaned against the wall and pressed a handkerchief to his wound, which was bleeding more heavily now. “I need to rest for a minute.”

Aliev pushed him forward. “You can rest later.”

Warren moved on, bothered more by the tightness he felt in his chest than by the wound in his side. He hoped it was musculoskeletal pain and not a return of his angina, which had been diagnosed a year earlier and was controlled so well with medication. Warren stretched his spine and took a deep breath, and the pain seemed to ease. But he was still worried about it being angina.
Christ! Not here. Not now.