Patient One: A Novel

by Leonard Goldberg

  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.

  They entered Sol Simcha’s room and found the elderly man sitting in his wheelchair reading from a Hebrew prayer book. He slowly raised his head.

  “Sol,” Carolyn said softly, “these people have taken over—”

  “I heard the shots and screams,” Simcha broke in with a nod. “And I knew exactly what it was. I heard those same sounds a long time ago,” he said, looking Aliev in the eye, “at a place called Auschwitz.”

  Aliev stared down at Simcha and focused in on the faded numbers tattooed across his arm. “You are a Jew?”

  “Yes,” Simcha said, closing his prayer book and kissing it.

  “The Holocaust was a hoax,” Aliev jeered.

  “It happened,” Simcha said flatly.

  “A myth,” Aliev insisted.

  “It happened,” Simcha said again.

  “It was an invention made up by the Jews so they could take Palestine away from the Arabs.”

  Simcha shrugged.

  Aliev grinned widely. “So you agree, Jew?”

  “I’m old and tired,” Simcha said in a quiet voice. “I barely have enough strength to call you a Nazi piece of dreck.”

  “Dreck?” Aliev asked. “What is dreck?”

  “It’s a Yiddish word for shit.”

  Aliev’s grin abruptly disappeared. He raised his weapon up to Simcha’s head.

  Carolyn quickly interceded. “He has a severe muscle disease. He can barely walk. And he is taking medications that make him say things he ordinarily wouldn’t.”

  Aliev continued to point his weapon at Simcha, his finger tightening on the trigger.

  “It’s the medicine talking, not him,” Carolyn pleaded. “Sometimes he just babbles on, not even knowing what he’s saying.”

  “He knows,” Aliev growled.

  “Please!” Carolyn begged.

  Aliev slowly lowered his submachine gun and gave Simcha a long, stern look. “I will make time for you later, old man.”

  “I’ll be here,” Simcha said with equanimity.

  They walked out of the room and down the corridor. The smells of stale vomit and blood were everywhere. Two terrorists were rapidly moving in and out of suites, with handkerchiefs held up against their noses. A third terrorist was guarding the three other survivors. Vladimir Yudenko, Jarrin Smith, and Jamie Merrill were seated on the floor across from the nurses’ station. The terrorist standing over them had taken off his chef’s uniform and now was dressed in black pants and a black turtleneck sweater.

  As Aliev approached the group, he spoke to Carolyn. “Place the President’s daughter in a separate room. She is no
t to see the President, and her door is to be kept closed. Do you understand?”

  “Yes,” Carolyn said and helped the badly frightened girl to her feet.

  “You are to rejoin us in two minutes,” Aliev ordered. “Don’t make me send someone to find you.”

  “I won’t,” Carolyn said, wishing that a rescue team of special agents would suddenly appear and engage the terrorists in a fierce gun battle. Yeah. Right. And in the process we’d all be killed. Which is probably going to happen, regardless of what we do or don’t do, Carolyn thought dismally. Sol Simcha, who was an expert on facing terror, believed that too. That’s why he unblinkingly called the lead terrorist a piece of shit.

  Her gaze went into the chart room, where dead bodies were stacked one on top of the other. Noisy flies were already beginning to gather, attracted by the fresh blood. Carolyn knew they would soon find their way into the vomit-laden suites and become really bothersome to the patients. Somehow she’d have to get the chart room sprayed with an insecticide. But that wasn’t high on her list of priorities at the moment. Staying alive was.

  “What’s the problem?” Aliev asked impatiently.

  “The President’s daughter is a little unsteady on her feet,” Carolyn lied. “We don’t want her to fall and hurt herself.”

  Aliev shrugged. “I have one more question. You said the old man was taking some type of medicine that made him brave. What is it?”

  “High doses of prednisone,” Carolyn answered. “It can make people very aggressive.”

  “And very dead if they don’t watch what they say,” Aliev said, then came back to Warren. “Let us go see the high and mighty President of the United States.”

  They continued down the corridor, passing the rooms of the Russian president and his wife. The door to the suite of the Secretary of State was cracked open, letting the strong odor of vomit seep out. From within came the sound of a man retching. Aliev closed the door tightly. The retching noise disappeared. The odor did not.

  The way into the President’s suite was blocked by Aaron Wells. The agent was sprawled out on the floor, eyes wide open, the bullet holes in his chest bubbling up frothy blood with each shallow breath. As Aliev stepped over him, Wells brought up a hand and feebly grabbed the terrorist’s ankle. He strained to hold on, but the effort caused even more blood to spurt from his chest. Aliev glanced down and fired a round point blank into Wells’s mouth. The back of the agent’s head exploded, bone and brain flying out.

  Warren looked away in disgust, detesting the terrorist and his savagery but helpless to do anything. And now he feared what the terrorist had in store for the President. The tightness in Warren’s chest suddenly returned. He took another deep breath, but this time the pain didn’t subside.

  They entered the President’s room without knocking. Merrill turned his head and looked over to them. His jaw dropped, his pulse abruptly racing at the sight of the heavily armed terrorist. For a moment his reasoning was a blur. But he quickly gathered himself. He realized that if they just wanted to kill him he would have been dead minutes ago. No, he thought darkly, they have something else in mind. Merrill’s gaze went to William Warren and the bloody handkerchief he was holding against his side.

  “Are you badly hurt, Will?” Merrill asked.

  “I’m fine. It’s only a superficial wound,” Warren replied as he leaned against the wall to take his weight off his feet. “Mr. President, I’m afraid these men have taken over the Pavilion.”

  Merrill nodded knowingly. “So I figured, when I heard the shouts and screams. How are my wife and daughter?”

  “They’re unharmed, Mr. President.”

  “And my agents?”

  Warren shook his head. “All dead, Mr. President.”

  Merrill sighed sadly, thinking about the Secret Service agents who were sworn to protect him and, if necessary, give their lives for him. All good, decent men who were so close to him they almost seemed like family. Merrill brought his gaze over to the terrorist, measuring him and trying to determine his ethnicity. Not Arab or Asian or Middle Eastern. The man appeared to have coarse Caucasian features. “What do you want?”

  “Oh, we want a lot of things from you,” Aliev answered.

  “Then you’re going to be disappointed,” Merrill said bluntly. “The United States does not negotiate with terrorists.”

  “You’ll negotiate,” Aliev assured him. “I promise you that.”

  Merrill felt a wave of nausea and swallowed it away. “Don’t bet on it!”

  Aliev smirked. “Nor should one bet on a small group of fighters being able to take the President of the United States prisoner, eh?”

  “Just because you have me as a hostage doesn’t mean we’ll meet your demands,” Merrill rebutted.

  “We will see.”

  Merrill tried to keep his expression even, but his jaws were tightening. How did this happen? Goddamn it! How? The Pavilion was supposedly closed off and heavily guarded by a dozen Secret Service agents. How did the terrorists get in so easily? And how did they put together a plan so rapidly?

  “Do you mind telling me how you pulled this off ?”

  Aliev shrugged. “Later, perhaps.”

  “It had to be the illness,” Merrill guessed, his mind working well now that the initial shock had worn off. “Somehow you induced the illness that caused us to come here, where we’d be vulnerable.”

  Aliev looked back, stone-faced.

  “That had to be it,” Merrill insisted.

  “And University Hospital was the medical center closest to the hotel,” Warren surmised. “You knew we’d use this facility.”

  Aliev remained silent.

  “At least tell us the poison you used,” Warren beseeched. When Aliev didn’t answer, Warren added, “If it’s something lethal, we won’t even listen to your demands. Why should we bother?”

  “It was a Russian toxin we placed in the caviar,” Aliev replied finally. “It was the same gastrointestinal poison they used on us in Chechnya. The toxin is encapsulated in tiny pellets and is slowly released hours after it is ingested. Then the nausea and vomiting start and last for about six hours. And just like you, all the Chechens who swallowed the poison in their food were rushed to the hospital for treatment.” Aliev’s expression turned into a nasty scowl. “And that is when the Russians opened up with their heavy artillery, destroying the hospital and slaughtering hundreds of men, women, and children.”

  Aliev paused to glare at his listeners, his eyes now filled with rage. “Do you know that over the past twenty years Russian soldiers have killed a hundred thousand Chechens? A hundred thousand! And the world said nothing. Then we kill three hundred and eighty-five in a school at Beslan and the world screams at us. What kind of arithmetic is that?”

  “It seems to me your grievance is with the Russians,” Merrill said, his voice neutral.

  “They will pay,” Aliev said vengefully. “They will pay a much higher price than they ever imagined. But you also have Chechen blood on your hands. A lot of Chechen blood. So these are my demands. The United States will release all Chechen fighters it now has imprisoned at Guantanamo and at Bagram prison in Afghanistan. In addition you will release all Chechen prisoners now held by your CIA in its secret prisons in Poland and Romania. This will free over a hundred Chechen fighters who will be flown to destinations of our choosing. The Russians will do the same, releasing Chechens from their Siberian work camps and from their prisons outside Moscow. They have some of our most important leaders and generals, and we want them back.”

  “What you want and what you’ll get are two different things,” Merrill said defiantly.

  “We will see what happens when the killing starts,” Aliev threatened.

  “What killing?” Merrill asked at once.

  “You will be given four hours to free the prisoners
and have them in planes on the way to safe destinations,” Aliev replied. “If this is not done, we will begin killing hostages, one every half-hour, until our demands are met. And we’ll begin with the patients.”

  From the doorway Carolyn blurted out involuntarily, “You can’t do that! You can’t just murder innocent people!”

  “Oh, yes, I can and I will,” Aliev said coldly, his eyes still fixed on Merrill. “Mr. President, we killed close to four hundred people at Beslan, over half of them children, and none of us shed a tear. So believe me when I say we will kill all the patients here and all the Russians, then your Secretary of State, then your wife and daughter, if we have to.”

  Merrill’s face hardened. He wanted to get his hands on this man, tear his heart out and grab his weapon. But he knew that was wishful thinking. In his weakened condition, Merrill could barely stand, much less tangle with an armed terrorist. With effort he calmed himself, knowing that senseless anger was the last thing he needed. But Merrill’s stomach kept churning and brought on another wave of nausea. He abruptly sat up and vomited enough red blood to half fill a small basin. Then he retched again and more blood came up.

  Aliev jumped back, wide-eyed and revolted by the bloody vomit. “What is happening?”

  “Your toxin has caused the President’s stomach to bleed,” Warren answered immediately. “This makes his condition very precarious.”

  Aliev thought for a moment before saying, “Then he will have to hurry and meet our demands, won’t he?”

  Merrill gagged and dry-heaved, then gagged again and spat out a mouthful of blood. Exhausted, he dropped back down on his pillow.

  Warren rushed over to the bucket of ice chips, but they were all melted, the water now at room temperature. He needed fresh ice to make a slurry and repeat the frigid gastric lavage that had stemmed the bleeding earlier. And he needed a gastroenterologist stat, particularly one who was an expert endoscopist. Warren quickly turned to Aliev and urged, “We have to bring in a specialist for the President.”

  “No specialist.”

  “He could die,” Warren pressed. “We’ve got to stop the hemorrhaging.”

  “You stop the hemorrhaging,” Aliev ordered. “You are a doctor.”