Presidential Donor (3 page)

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.

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.

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."

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 paramedic 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.

"How is it going?" he asked.

"Not well, I'm afraid. His wedge pressure continues to go up, and his urine output is not what I expected with all the diuretics."

"Sounds like he's getting into some congestive heart failure."

She adjusted the IV monitor. "I think so."

After he completed his exam, Gregg pulled the stethoscope of his neck and slipped it into his back pocket. He looked up again at the monitor above the President's bed, then heaved a long sigh as he walked out of the room.

The Secretary of State grabbed him outside the door.

"Dr. Gregg, I'm Charles Lathbury, the President's Secretary of State."

"Glad to meet you, Mr. Lathbury. I only wish it were under different circumstances."

"Dr. Gregg, the First Lady is anxious to talk to you."

Gregg gave a comforting smile. "Yes, of course, I can talk to her now."

"She's down the hall, if you want to come with me. I'll introduce you."

Lathbury praised Gregg for the professionalism his staff had shown.
True.

President Thomas Lloyd could not have picked a better place for a heart attack, Gregg thought. Brighton Heart Center held the distinction of being the world's most sophisticated cardiac hospital. To watch the technology in action, bordered on magnificent. With a staff of twelve hundred, and the best cardiologists and heart surgeons in the world, it rivaled none. Indeed, Lloyd could consider himself lucky in one regard. Given the scope of his cardiac injury--if he was anywhere else
--he would already be in cold storage.

Gwen Lloyd sat in a secure room the Secret Service and hospital security had set up for her. Agents stood guard inside and out to protect her person, as well as her privacy.

They cleared Gregg and Lathbury at the door. The two entered the room and Gwen Lloyd jumped to her feet. Gregg could see a look of grave concern on her face: a look reserved for families of critically ill patients. That kind of Marcus Welby, anticipation of good news look that a surgeon gets when he comes in to tell the family the outcome of an operation. Unfortunately for Gwen Lloyd, the news was
not
good.

* * *

"Dr. Gregg," Lathbury said, "I would like you to meet First Lady Gwen Lloyd."

Gregg extended his hand. "Mrs. Lloyd, I'm sorry we have to meet this way, still it's a pleasure."

"I've heard wonderful things about you, Dr. Gregg." Her smile didn't match her words.

"That's very kind." Gregg took a deep breath. "Mrs. Lloyd, I've examined your husband, and I'm afraid I don't have any good news. Your husband has suffered a massive heart attack."

She nodded, ostensibly without emotion. She had expected as much and had tried to prepare herself. What she wasn't prepared for was what Dr. Gregg said next.

"I'm afraid he's going to need a transplant. He's lost eighty-percent of his heart muscle." Gregg paused while the PA system announced a code-blue.

"The only thing keeping him alive right now is the many medications we're using. That will only buy him so much time."

Gwen Lloyd looked away. "How long?" she asked.

"My guess is forty-eight hours."

She felt a sudden chill. "But can you find a donor so quickly?"

"Difficult, but not impossible. I've put the transplant team on standby, and I've notified procurement to begin a donor search. Every available donor center in Europe will try to find a heart for your husband."