Patient One: A Novel Page 2

  The Russian concept of diplomacy, Merrill thought darkly. To them, treaties are meant to be used, not adhered to. So I’ll watch him. And I’ll keep in mind that America is racing ahead with a new internal combustion–based technology that could release the one and a half trillion barrels of oil trapped in the massive shale beds of Wyoming, Montana, and Utah.

  Currently, the oil in shale was being extracted by a process called fracking, which consisted of blasting water, sand, and chemicals into the oil-soaked rock. But fracking was far more expensive and considerably less effective than the newly discovered process. Once the internal-combustion method was perfected, it was estimated that oil could be produced from shale at a cost of $75 a barrel. Just imagine that! Over a trillion barrels of oil, all belonging to America! We would be energy independent for hundreds of years, and with oil at $75 a barrel our nation’s economy would boom. But perfection and implementation of the new technique was thought to be at least eight to ten years away. Until then, America needed Russia. But Russia also desperately needed American investment and know-how to rebuild its massive infrastructure. And that, Merrill thought, would keep Suslev partially honest. For now.

  The toast went on and on.

  Merrill held up his glass of water and wished Suslev’s long-windedness would come to a close. But the Russian president rambled on, now saluting the American Secretary of State and his wife, who were seated beside him. Suslev paused, then began extolling the natural beauty of California. Goddamn it! Wrap it up! Merrill growled under his breath.

  Another wave of nausea traveled up Merrill’s esophagus and he swallowed it back. But it left a sour, bilious taste in his mouth. Again he considered reaching for an antacid pill but resisted the urge. He pasted a smile on his face and gazed down at those assembled, many of whom had their glasses raised. But something was wrong. Some of the people appeared to be hurrying out. A dozen or so. Mostly women, with their hands covering their mouths. One of the seated movie stars was bent over, with her head between her knees. The man next to her appeared to be retching.

  An intense surge of nausea caused Merrill to gag. He tasted vomit coming up. Quickly he turned to Wells, stood, and said, “Get me to the john. Now!”

  “Liberty is on the move!” Wells barked into his microphone. “Clear the head!”

  He took the President’s arm and led him past the startled guests on the dais. They raced out the side door and down a long corridor, now joined by four more Secret Service agents, two to each side of the President. A maid standing beside a laundry cart was roughly shoved into a linen closet. A nearby elevator door opened, and an agent peeled off to stop the passengers from exiting.

  “Secure the entire hall!” Wells shouted. “Nobody in or out!”

  Merrill dashed into the men’s room and entered a stall just in time. Kneeling down, he put his face over the toilet bowl and brought up a torrent of vomit. Then another mouthful, then another, until his stomach was empty. Finally he opened his eyes and took a deep breath. Perspiration was pouring off his forehead in big droplets. A wave of dizziness came and went. He tried to stand but felt lightheaded, and sank back to his knees. Then he vomited again. Now the vomit tasted peculiar, more sweet than bitter. Once more he attempted to get to his feet and, as he did, he stared down into the toilet bowl. It was filled with blood. Bright red blood!

  Merrill felt as if he was about to pass out. Desperately gathering his strength, he reached up for the handle to the stall door and slowly pulled his body to a standing position. He paused a moment and steadied himself before staggering toward the door of the men’s room. Again he threw up bright red blood, with most of it splattering over his shirt and coat. He reached for the door and opened it, then collapsed into the arms of Aaron Wells.

  “Liberty is down!” Wells cried out into his microphone. “Liberty is down!”

  The corridor suddenly seemed filled by men in suits, with wires from earphones snaking down their collars. The President was lifted by four agents. Two had his legs, two his upper torso. Wells grabbed a large towel from the laundry cart and draped it over the President’s blood-soaked shirt and coat. The group ran down the corridor with four more agents joining in, their weapons drawn. They formed a phalanx as they entered the lobby and rushed for the rear entrance, knocking over everybody and everything in their way. A man in a wheelchair was pushed into a sofa, a large potted plant alongside him sent flying. Two chatting women were bowled over. A bellman at the door was slammed into the ground. In the driveway the presidential limousine was waiting, motor running.

  The President was quickly placed in the back seat, with Aaron Wells at his side. Another agent was in front on the right, a third in the driver’s seat. A black Chevy Suburban pulled up in the rear, carrying another team of heavily armed Secret Service agents.

  “Go! Go!” Wells yelled.

  The LAPD motorcycle escorts gunned their engines, and with lights flashing led the way out of the drive.

  The presidential motorcade sped out onto Wilshire Boulevard, sirens blaring.

  Three

  In a light drizzle, Dr. David Ballineau hurried up the lawn to his West Los Angeles home, a step behind his eleven-year-old daughter who was still wearing her Harry Potter costume.

  “Did you really like the play, Dad?” Kit asked, her wizard’s hat tilted to one side.

  “It was wonderful,” David enthused. “And you were great.”

  “I think I messed up one of my lines.”

  “I didn’t notice, and I doubt that anyone else did either.”

  “Good,” Kit said, and smiled. “I didn’t want to embarrass myself in front of a lot of people.”

  As he opened the front door, David glanced back at the dark, misty night and sampled the air. The humidity was heavy, a consequence of the big winter storm that was lingering off the Southern California coast. It would bring plenty of rain, David thought. That would make the freeways slick and cause cars to hydroplane, setting the stage for gruesome accidents, similar to the one he’d seen earlier that day. For emergency room physicians like David Ballineau, rain was unwelcome, particularly when accompanied by thick mist.

  “Dad, is that woman in the audience who got sick going to be all right?” Kit asked, wiping her feet on the doormat.

  “She’ll be fine, honey,” David assured her.

  “She’s lucky you were there.”

  “Yeah. Very lucky.” He watched Kit scamper up the stairs and called after her, “Don’t forget our agreement, Kitten. No late night phone calls. Right?”

  “Just one to Susie,” she said over her shoulder. “And it’ll be a quickie.”

  “How quick?”

  “B-Y-K-I.”

  It took him a moment to decipher her spoken text message. BYKI stood for Before You Know It. She’s growing up so fast, David mused with that combination of pleasure and terror peculiar to fathers of daughters. One day she was a toddler, the next a beautiful, spirited young girl who could steal his heart without even trying.

  “Okay, Dad?” she yelled down to him.

  “Okay.”

  Kicking off his loafers, David stopped in the kitchen for a cold beer, then strode into the small library and, propping his feet up on his desk, began to relax for the first time in fourteen hours. Christ! What a monster of a day! he murmured wearily to himself, thinking back to the events that began at 7 a.m. and never ceased. From the moment he stepped into the emergency room at University Hospital, all hell seemed to have broken loose. It started with the burned firefighters who had gotten trapped in a windblown inferno just north of Los Angeles. Most were suffering from smoke inhalation and second-degree burns. But a few had been charred beyond recognition and were now fighting for their lives in the hospital’s ICU. Then came the victims from a high-speed, multi-car accident on the San Diego Freeway that left two dead and a dozen seriously injured. The
injuries were horrific. Amputated limbs. Open tibial fractures. Ruptured spleens. Torn aortas. A museum of bloody horrors.

  David rocked back absently in his swivel chair, still seeing the charred and severely injured patients in his mind’s eye and knowing most wouldn’t survive.

  There was one life he was certain he’d saved. But that came later on, when his twelve-hour shift in the ER was over.

  After giving a report to the incoming physician, David had dashed out of the hospital and hurried over to Kit’s private school, where she had one of the leading roles in a play based on a Harry Potter book. Arriving late, David had been in his seat only a few minutes when the woman behind him sucked too hard on a breath mint and aspirated it deep into her posterior pharynx. Despite numerous Heimlich maneuvers, the mint remained lodged in place and compromised the woman’s air supply. She started to panic and dashed out of the auditorium, which only made matters worse. When David caught up with her, she was gasping for air and beginning to turn cyanotic. He was forced to do a tracheotomy, using a knife from the school cafeteria. By the time the paramedics arrived and David returned to his seat, the play was nearly over. He never got to see his daughter on stage.

  David swallowed a sip of cold beer and thought about how many more special moments he might miss in Kit’s life because of his profession. I have to plan better, he vowed determinedly. Yeah. Better planning. Right! he scoffed at himself, now recalling the age-old adage—If you want to make God laugh, tell Him your plans. David had learned the wisdom in that proverb the hard way, a long time ago.

  “Wooooo!” Kit said, prancing into the room. She had a wool blanket draped over herself from head to toe.

  “Why the blanket?” David asked, smiling at his daughter and loving her more than anybody could love anyone.

  Kit pulled the quilt away from her face and looked at him quizzically. “Don’t you remember that part in the play, Dad? When Harry Potter wore his special blanket, no one could see him.”

  “Oh yeah,” David said, reacting quickly because he’d missed that section of the play. “But I thought the blanket worked only for Harry.”

  “Uh-uh,” Kit corrected him. “It does magic on anyone who wears it.”

  “Got it,” David told her, nodding. “So I can’t see you, but I can still hear you. Correct?”

  “Of course you can hear me,” Kit replied, placing the blanket back over her head. “We’re having a conversation, aren’t we?”

  David grinned broadly. “Good point.”

  “You’ve got to put a lot of feeling into your voice, Dad,” Kit urged. “You have to make people believe you really can’t see me.”

  David had to bite his lip to keep himself from laughing. “Okay.”

  “And you have to sound like something is spooky.”

  “I can do that.”

  “Excellent,” Kit approved. “Now we’ll start again.”

  Just then Juanita Cruz, their live-in housekeeper, entered the library and said, “Tomorrow you will start again.” She removed the blanket from Kit’s head and gently stroked the child’s raven hair back into place. “That is enough play-acting for tonight, Little One. Now you must do your homework.”

  “Can’t I do it later?” Kit tried to beg off.

  “Now!” Juanita insisted.

  “Dad!” Kit pleaded, looking to her father for support.

  David shrugged. “Homework is important.”

  “Five more minutes,” Kit bargained with Juanita.

  Juanita ignored the girl’s plea and pointed to the door of the library with her index finger. “Are you going to embarrass us by making me say it a third time?”

  “Phooey!” Kit protested, and headed out of the room.

  Juanita followed her to the door, then turned back to David. “Have you had your dinner yet, Dr. Ballineau?”

  David shook his head. “I’m not very hungry. Maybe I’ll have something later.”

  “There is cold chicken and pasta in the refrigerator.”

  David watched her leave, grateful as always that he had such a wonderful housekeeper to help him raise Kit. What in the world would I do without her? he wondered, but he already knew the answer. Somehow I’d manage. I’d muddle through, just as I did when Marianne died. His gaze drifted over to the picture on his desk of his wife, dead just over eight years. Sometimes it seemed like the tragedy happened only yesterday, other times like it occurred an eon ago. He sighed deeply, recalling that the pain had slowly and finally subsided. But the emptiness was still there, and all the joy in the world couldn’t remove it. He could forget about the emptiness for a while, but it never really left him. And never would.

  His eyes went to the calendar on his desk. Kit had circled Sunday’s date with a thick red crayon. It marked the anniversary of Marianne’s death. On that day Juanita would take Kit to her church and light candles in memory of Marianne. And David would tag along. But he would refuse to sing and recite prayers about a good and merciful God, again asking himself the same questions in church. Where was this good and merciful God when Marianne was dying a slow and painful death from leukemia? And where was God when a three-year-old child cried every night for her mommy?

  David shook his head at the sad memories, still wondering how a merciful God could let all that happen. A young minister once told David that God sometimes tested people in harsh ways. Well, David thought somberly, he had no use or belief for that kind of God. Not then. Not now. Not—

  The phone beside the calendar rang. It was his private line, which meant it had to be the hospital. No one else called this late at night.

  David reached for the phone. “Yes?”

  “Dr. Ballineau, this is Betsy in the ER. We’ve got a big problem on our hands.”

  “What?”

  “A hundred cases of severe gastroenteritis, and even more coming in. We’re overflowing and way understaffed.”

  “Get all the interns and residents to come down to the ER,” David instructed. “They should be able to handle straightforward gastroenteritis.”

  “They’re already here, but it may not be straightforward gastroenteritis,” the nurse went on. “And we’re dealing with some very, very important people.”

  “Such as?”

  “The President of the United States.”

  “I’m on my way in,” David said, hanging up.

  _____

  It was like talking to a statue, and hoping it would respond.

  Carolyn Ross sat across from her mother in the living room of their Santa Monica home and tried to make conversation. But her mother just stared into space, lost in the deep haze that came with Alzheimer’s disease.

  “Mom,” Carolyn asked softly, “Can I get you something to drink?”

  The woman stayed silent.

  “Are you thirsty?”

  Again, nothing. Saliva drooled out of the woman’s mouth and down onto her chin.

  Carolyn reached over for a Kleenex and dabbed it away. Her mother didn’t seem to notice as more saliva dripped out, now spilling onto the woman’s bib.

  Carolyn continued to clean the drool, remembering back to a time when her mother was so neat and tidy she wouldn’t tolerate even a speck of dirt or dust. And she’d been so independent, never wanting to need anyone for anything. But now the poor woman was totally dependent, Carolyn thought sadly. Her mother had to be fed and bathed like a baby, and had to wear diaper-panties that required changing every few hours. It was a living nightmare.

  At least I know how to care for Mother and keep her comfortable, Carolyn told herself. And my salary as a nurse means I can afford to hire a sitter to look after Mother during the day while I’m away. Thank goodness for that.

  Carolyn discarded the saliva-laden Kleenex into a nearby trash can, now wondering how the poor and those with modest
incomes managed to care for family members afflicted with Alzheimer’s disease. How do they afford it? How? Between the sitters and medicines and doctor visits, the expenses never stopped mounting. For these families, Alzheimer’s must be an overwhelming burden. A double living nightmare.

  Carolyn’s cell phone chirped. She stared at the phone, then at her mother, hoping the high-pitched sound would register in the woman’s mind. It didn’t. The costly drugs her mother was taking weren’t helping at all.

  Sighing resignedly, Carolyn reached for the phone. “Hello.”

  “Carolyn, this is Kate Blanchard on the Pavilion,” said the junior nurse. “The head nurse had to leave for a family emergency and we’ve going to be really shorthanded. According to the doctors in the ER, we’re about to be swamped up here with acutely ill patients that have severe gastroenteritis. Apparently they’ll be coming in droves.”

  “To the Beaumont Pavilion?” Carolyn asked. The Pavilion’s plush suites were always reserved for the rich and famous. “When I left this evening, all fourteen rooms were occupied.”

  “They still are. But since most of our patients are here for diagnostic workups, they can temporarily be transferred to the Intermediate Care Facility. That will make room for some of the terribly ill patients who also happen to be dignitaries.” The junior nurse paused as if to catch her breath. “It’s bad, Carolyn. It sounds like they’ll be needing every bed they can free up.”

  Carolyn groaned inwardly. She had no choice but to go in. It would be impossible for one nurse to handle a ward overflowing with really sick patients.

  “I’ll be there in fifteen minutes.”

  “Don’t come through the ER,” Kate warned. “It’s a madhouse down there.”

  Carolyn clicked the cell phone off and quickly thought of the essential things she had to do. First, she had to call the sitter and hope the neighbor could come and spend the night. Hastily, she punched in a phone number. The sitter answered on the second ring. “Dolly, I’ve got an emergency at the hospital. I need you to look after my mother tonight.” She listened for a response, then said, “Of course you can bring your dog. But you must come now.”