“Can you come up with some evasive maneuvers?” Halloway asked the former naval aviator.
“We can try,” Sanders said and swiftly pointed to the four Mexican jets closing in on their target. “Madam Vice President, it’s now or never. If we’re to have any chance of getting that plane home safe, we have to act.”
Without hesitating, Halloway gave the order. “Get those Hornets in the air!”
Twenty-two
David quickly began the fifth mini-transfusion, injecting another 50 ccs of whole blood into the President’s IV line. Merrill was groaning and muttering through his stuporous condition. David’s gaze went to the transparent nasogastric tube and to the cardiac monitor beyond it. The gastric juice coming up remained bright red. And the President was still in shock, despite having received over 200 ccs of David’s blood. His blood pressure was 70/40, his pulse 140 beats per minute and thready.
“We’re not making much headway,” David said.
“At least he’s got some blood pressure,” Carolyn noted, filling the last of the syringes. “And he hasn’t shown signs of a transfusion reaction.”
“Which only means there’s no ABO incompatibility,” David told her, pushing blood in faster.
“Are you saying he could still have a bad reaction?” Carolyn asked.
“A really bad one,” David replied. “Remember, they had a lot of problems cross-matching him earlier, and that tells us there’s something in his plasma that doesn’t like other people’s blood.”
“Jesus! This poor man doesn’t seem to have anything going for him.”
“Except a pretty good nurse and doctor looking after him,” David said, checking the monitor again. The systolic pressure was still at seventy. “Pass me another syringe of blood.”
Carolyn handed him the syringe. She was thinking that Merrill’s survival was due far more to a good doctor than to a good nurse. How do you make a physician this good? Most doctors had difficulty dealing with a massive gastrointestinal hemorrhage, even when all the hospital’s facilities were available. And David was keeping the President alive with virtually none of the medical center’s resources. No blood bank. No endoscopist. No coagulation specialist. Every step, every treatment had to be improvised. Yet he never faltered, never lost his cool. She wondered if he had been a military doctor in combat. That would explain his nerve and quick wits under fire.
The President started mumbling again, the words indecipherable and jumbled.
Carolyn turned to David and asked, “Do you think the President suffered brain damage while he had no blood pressure?”
“Let’s hope not,” David said flatly. “Hand me another syringe.”
As she passed the seventh syringe, her eyes drifted over to the President, who was moving his arms and legs. Well, at least his motor function is intact, she told herself. But he could still be mentally impaired. Carolyn had seen that happen before. A brilliant professor of archaeology at the university was admitted to the hospital in severe shock. When he left he was wearing diapers and babbling nonsense. But he could still move his arms and legs.
“The fluid in his nasogastric tube is turning a lighter red,” David remarked, breaking into her thoughts.
Carolyn quickly looked over to the cardiac monitor. “And his pressure is up to 88 over 60.”
“Good,” David said and reached for the last two syringes of blood. “Now if we only had another half unit of blood, we could really get the President out of the woods.”
“That’s not going to happen,” Carolyn said.
“Tell me about it,” David pointed to a large syringe filled with water. “Would you connect that to his nasogastric tube and start lavaging his stomach again?”
Carolyn felt the syringe and commented, “It’s lukewarm now.”
“Make another ice slurry,” David directed. “Keep stirring it until it’s frigid enough to burn your fingertips. The colder the better.”
Carolyn prepared the fresh ice slurry and hastily lavaged the President’s stomach over and over. The gastric juice remained light red initially, then gradually turned pink, then yellowish brown. “I think the bleeding has stopped! The ice water must have done it.”
“That and the Factor VIII in the blood he received,” David said, showing little emotion. “But neither is going to last very long.”
“Maybe it’ll last until we get out of here.”
“Don’t bet on it.”
The President moaned loudly, then twisted and turned in his bed and moaned again.
The terrorist standing by the door stepped inside to check out the origin of the sudden sounds. David pointed to the President, then to his mouth. The guard nodded and went back into the corridor.
“David,” Carolyn said, motioning to the monitor, “his blood pressure is 96 over 70 and climbing.”
“Excellent!” David said and placed the final syringe aside. Suddenly the weakness in his legs returned. The room began to sway. Hurriedly he reached for the night table and waited for his unsteadiness to pass. “It’s doubly excellent, because we just ran out of blood.”
Carolyn saw him holding on to the edge of the table and asked, “Are you all right?”
“Just my leg,” David lied. “It’s throbbing a little.”
“Then go lie down on the couch for a few minutes,” Carolyn urged.
“It’s better,” David said, knowing if he lay down his leg would stiffen and he’d have to drag it around like a limp appendage. As it was, he stood little chance against the terrorists. With a dead leg, he stood none.
“Let’s try to awaken the President,” he went on, changing the subject. “Pat his cheek a few times and see if you can get a response.”
Carolyn gently struck Merrill’s cheek and called out, “Mr. President! Mr. President! Can you hear me?”
Merrill groaned and moved his head away from the noise.
“Again,” David directed.
Carolyn slapped Merrill’s face with more force and cried into his ear, “Mr. President! Mr. President!”
Merrill’s eyelids fluttered before they gradually opened. He blinked against the bright light. “Wh … where am I?”
“At University Hospital, Mr. President,” Carolyn told him.
Merrill slowly nodded and said groggily, “Oh, yes. Yes. The hemorrhage. Did I pass out?”
“You just drifted off,” Carolyn answered.
“Am I still bleeding?” Merrill asked through parched lips.
“No, sir. We’ve stopped it,” Carolyn replied, relieved that the President was oriented and had suffered no apparent brain damage. “We had to give you another transfusion.”
Merrill’s eyelids began to close. “I’m so tired. I feel like I could sleep for a month.”
“Go ahead and rest, Mr. President,” Carolyn said soothingly. “We’ll be nearby.”
Merrill closed his eyes and drifted off.
Carolyn moved over to David and whispered, “I thought it best not to tell him he passed out.”
“That wouldn’t have helped anything,” David agreed.
“Do you have any idea how long the blood transfusions will hold him in check?” Carolyn asked, keeping her voice low.
David shrugged. “I’d just be guessing.”
“Then guess,” Carolyn pressed.
“As soon as he’s used up the Factor VIII in my blood, all hell is going to break loose.”
“And how long will that take?”
“Not long at all, I’m afraid.”
Aliev stomped into the suite and came to the bedside. He stared down at the sleeping President and studied him before asking, “Why is your President making those loud sounds?”
“He was bleeding again,” David explained. “The blood was caught in his throat.”
Aliev looked down at Merrill once more. “He seems to be all right now.”
“That won’t last,” David said. “He could start hemorrhaging again in a matter of minutes.”
“Then you can stop it again,” Aliev responded, showing no concern.
“But we need more blood and plasma sent up to the Pavilion,” David implored. “Without them the President will die.”
“He looks fine to me,” Aliev said, unimpressed.
“Don’t you understand? He damn near died!”
“But he didn’t. So just continue doing the same things you are doing.”
“He desperately needs blood and plasma,” David pleaded. “And we have no more to give him.”
“Use your own, like you did before,” Aliev said tonelessly, and walked out.
Carolyn watched him leave and hissed through her teeth, “What a cold bastard!”
And smart, David thought. The terrorists were so close to success. They weren’t going to take any chances now. They would keep the area absolutely secure. Nobody in, nobody out, until their demands were met.
Aliev stuck his head back into the suite. “Doctor, you may receive the blood for your President sooner than you think. To be precise, in thirty-six minutes.”
“Why thirty-six minutes?” David asked promptly.
“Because that is when the deadline comes to an end,” Aliev explained. “If our Chechen fighters are released, the President will receive his blood. If the prisoners are not freed, your President can hemorrhage all day and all night. It won’t bother us. You see, we will be busy killing hostages.”
Aliev walked away, humming under his breath.
Carolyn shuddered at the terrorist’s ruthlessness, and wondered who he would choose to kill first. Probably Sol Simcha, she guessed sadly. Not because the nice old man was of any value to them or to the outside world as a hostage. But because he was Jewish. And they would probably make him suffer, too. The bastards! She moved in close to David and asked in a barely audible voice, “Where is that rescue team?”
David shrugged. “I don’t know.”
“But they will come, won’t they?
“Eventually.”
“To hell with eventually!” Carolyn blurted out. “I don’t want to sit here like a lamb about to be slaughtered.”
David took her hand and squeezed it gently. “We’ve got to play it smart and wait for our chance.”
“Are you planning to grab one of their weapons?” Carolyn asked quickly.
David shook his head. “They’ve got us outnumbered and outgunned. And even if we managed to bring down a few, the others would start shooting hostages until we surrendered. Grabbing a weapon won’t get it done.”
“How will you do it then?”
“It’ll just happen,” David said without inflection. “There’ll be an opening, and they’ll die without being aware of what hit them.”
“How do you know so much about these things?”
“I read a lot.”
“Ah-huh,” Carolyn said, certain he was hiding something from his past. “Let’s get back to the opening you spoke about. Can you really get to someone pointing a gun at you without them knowing it?”
“There are ways,” David said vaguely.
Carolyn thought for a moment, then a mischievous glint came to her eyes. “You mean, like zapping them with defibrillator paddles?”
David smiled thinly. “You think you could take out all five of the bastards that way?”
“Just fantasizing,” Carolyn said. “But you never—”
John Merrill suddenly wheezed, with a loud rattle in his throat. He coughed hard to clear his airway and brought up bloody sputum that stuck to his lips before dripping off. Then more maroon-colored sputum came up.
Carolyn moaned. “Don’t tell me he’s bleeding into his lungs now.”
“It looks like it,” David said, lowering his voice to a whisper. “And if he really starts to hemorrhage into his bronchial tubes, he’ll drown in his own blood.”
“Can you do anything to stop it?”
“Not without more fresh plasma.”
“But he’ll suffocate to death, and he’ll be awake and know it’s happening.”
David thought at length before saying, “The next time you’re in the medicine room, grab a couple of vials of injectable Valium and syringes.”
“What good will that do?” Carolyn asked.
“If necessary, I’ll sedate him and suppress his cough so he won’t be aware of what’s happening,” David told her, then added grimly, “And he won’t struggle.”
“But … but that’ll be like killing him.”
David shook his head. “It’ll just be making his inevitable death easier.”
Suddenly an alarm went off far down the corridor. Carolyn dashed to the door and listened carefully, then called back to David, “I think it’s coming from Dr. Warren’s room.”
“Check it out,” David called back. “I’ll stay with the President.”
As Carolyn hurried away, David leaned against the night table, his legs like heavy weights again. And his thigh wound was throbbing badly. He eased himself down on the side of the bed and rubbed at his wound. But his mind was elsewhere, now thinking about the alarm bell that continued to ring. If it was William Warren, the alarm probably signaled the return of a stubborn ventricular tachycardia that hadn’t responded to lidocaine or bretylium. Bad news. Really bad news. Maybe the defibrillator would work. The throbbing in his thigh worsened, and he looked down at the dressing over his wound. Blood was soaking through. Shit. He hoped the sutures hadn’t come apart.
Carolyn ran into the room, pausing briefly to catch her breath. “You’d better come quick! Marci is in extremis!”
David rose as quickly as he could manage, then hesitated. “Aliev is not going to let us run down that corridor again. He was mad as hell last time, and this time he might just shoot us.”
“Maybe he won’t,” Carolyn urged, thinking fast. “Remember, he still needs us to keep the President alive.”
“Aliev may figure we’ve done all we can and decide to take his chances,” David countered. “And keep in mind they’ll be making their break out of here very soon. At that point we become expendable. You and I will be like extra baggage.”
“We still have to try,” Carolyn pleaded.
David sighed resignedly. He knew Carolyn was right. He couldn’t simply look away and make believe Marci didn’t exist. And maybe they could ease her suffering a little. He moved to the door and peeked out. A guard was ten feet away, smoking a cigarette. Aliev was nowhere in sight. David came back to Carolyn and said, “Aliev is not in the corridor.”
“I saw him and another terrorist stepping into the fire stairs,” Carolyn recalled.
“Was the door left open?” David asked quickly.
Carolyn nodded. “And that chain-like device was next to it.”
David knitted his brow, wondering if Aliev had gone to the roof to post a lookout. If he had, it was bad news. That would remove the roof as a point of entry for the Secret Service team. Shit!
“Maybe this is our chance,” Carolyn prodded.
“Yeah, I guess,” David said, knowing they were about to take a terrible risk. He peeked out into the corridor once more, and saw only a single terrorist. Hurriedly he turned to Carolyn.
“Okay. Here’s what we’ll do. You scoot down the corridor. If they stop you, tell them you’re going into the treatment room for supplies. I’ll wait a little, then be right behind you.”
“They’ll come after you,” Carolyn warned.
“Not if I’m holding up a used plastic bag of blood,” David improvised. “I’ll tell them I’m coming to get you so we can refill it for the President.”
“It’s so dangerous,�
�� Carolyn breathed.
“I know,” David said. “But we really don’t have a choice, do we?”
Carolyn bit down on her lower lip and tried to steel her nerves. “Whoever thought the practice of medicine would come to this?”
“It’s not just medicine,” David growled. “It’s the whole goddamn world. Now go!”
Carolyn turned for the door, then came back and kissed David hard on the lips. Twice.
“For double good luck,” she said, and dashed out of the room.
_____
From his vantage point on the roof of the hospital, Aliev could clearly hear Basagev’s voice over the satellite cell phone. Once more they spoke in an unusual Middle Eastern dialect of Chechen.
“Everything is in order,” Basagev reported.
“And you are on schedule?” Aliev asked.
“Actually we are somewhat ahead of time,” Basagev answered. “Because of a tailwind, we should touch down in Los Angeles earlier than expected. Would you like me to slow the plane?”
“No,” Aliev said promptly. “Maintain your current speed.”
There was a loud burst of static, then the reception gradually cleared.
“And the nuclear weapon has been armed, in the event Los Angeles becomes the target for our bomb,” Basagev was saying.
“Good,” Aliev said. “But it seems we will be traveling on to Russia.”
“So the Americans are complying, eh?”
“Just as I predicted they would,” Aliev went on. “The Russians, of course, are being bull-headed.”
“Which is what you anticipated,” Basagev said. “But soon enough they will pay a heavy price for their stubbornness and for their cruelty to our people.”
“A price beyond measure,” Aliev snarled. “The oil-rich part of Siberia, which they are so proud of, is about to turn into a vast radioactive wasteland.”
“And instead of Chernobyl, the Russians will mourn over Siberia now,” Basagev prophesied.
“Now and for a thousand years to come,” Aliev added solemnly.
“And for those same thousand years, all of Chechnya will sing your praises.”
Patient One: A Novel Page 23