David smiled down at Marci, whom he had grown to really like. She was pretty and smart and full of life, despite her illness. She was a fighter. His gaze went to her face and as usual focused in on her doe-like eyes. He had seen those same eyes way back in the past. They reminded him of his wife, Marianne.
A hacking cough came from the doorway.
David glanced over and saw the balding terrorist looking in at them. He still seemed befuddled, just as he had been when David and Carolyn ran by him in the corridor earlier. And rather than shoot or shout at the pair, he simply followed them into Marci’s room. He wasn’t too bright, David decided. But that didn’t make him any less deadly. On Aliev’s command, he would happily kill a nurse and a doctor. And a President.
Marci began choking, her hands desperately clutching for her throat. Her lips were turning a deep blue.
It’s the end, David thought sadly.
Carolyn dashed into the room, holding a cloth-bound tray. “Got it!”
A second terrorist suddenly appeared in the doorway. He yelled angrily in Chechen at the guard and shoved him down the corridor. Then he came back to David and Carolyn and motioned them to the door with his Uzi. “Out!”
“But this patient desperately needs our help,” Carolyn pleaded, turning toward Marci. “Without us she’ll—”
“Out!” The terrorist backhanded Carolyn across her forehead, and sent her flying into David’s arms.
David was knocked off balance, but somehow managed to steady himself and hold onto Carolyn. Quickly, he asked her, “Are you all right?”
“More scared than hurt,” she breathed, although a red welt was forming over her temple area.
“I will not say a third time,” the terrorist threatened, now pointing his Uzi directly at them.
Supporting Carolyn, David headed for the door and asked the terrorist, “Where do you want us to go?”
“To roof, to see Aliev.”
“For what?”
The terrorist smiled malevolently, then held his hand up high, cupped it, and slowly let it drop.
“Oh Jesus!” Carolyn whimpered. “I think he plans to throw us off the roof !”
“Yeah,” David said tonelessly, knowing it was Carolyn who would most likely be killed. To Aliev, a doctor was all that was required to keep the President alive. The nurse was expendable.
“M … maybe we can reason him out of it,” Carolyn hoped in a weak voice.
“Terrorists don’t reason, they kill.”
They walked across the corridor, which was silent and vacant, and entered the stairwell for the fire stairs. The terrorist nudged them toward the stairs with the barrel of his Uzi. “Nurse first,” he ordered.
David hesitated and tried to think of a way to disarm the terrorist. And he had to do it before they started up the stairs. With his back to the terrorist he stood no chance.
“Go!” The terrorist demanded.
Suddenly, a flashback from a similar situation long ago came to David. But he needed a distraction for it to work again. A big distraction.
Moving slowly, David helped Carolyn up the first step and said under his breath, “Pretend you’re going to throw up when your foot touches the next step.”
On cue, Carolyn forced herself to gag, then abruptly leaned over the railing and began retching.
For a moment the terrorist’s eyes went to Carolyn. When he brought his gaze back to David it was a second too late. David’s kick was already in midair, heading directly for the terrorist’s testicles. The man let out a muffled cry, then groped at his groin and fell onto the floor face first. David quickly pounced upon the terrorist. He held the man’s head up by its hair and delivered a powerful, precise blow to the upper neck, crushing the second and third cervical vertebrae and severing the spinal cord beneath them. The terrorist’s body convulsed, then went flaccid.
Carolyn stared at David, wide-eyed. “Did you kill … ?”
David waved his hand, quieting her. “We’ve got to get rid of the body, or we’ll both be dead.”
Swallowing back her fear, Carolyn hurriedly collected herself and looked over to the staircase. “Let’s throw him down the steps.”
David peered down the stairs and saw the multiple tripwires and photoelectric sensors that were connected to explosives taped to the walls. “It’s booby-trapped. The body will set off an explosion that will blow us to hell and back.”
“So what should we do?” Carolyn asked anxiously.
David glanced around the stairwell, with its thick plaster walls that had neither ducts nor crawlspaces. There weren’t any places to hide the dead terrorist, and it made no sense to drag the body across the corridor where it would surely be found. Shit! David grumbled silently, thinking they were trapped and bound to be discovered any moment now. Again, he surveyed the fire stairs, searching for a way out of the dilemma. Abruptly, his gaze stopped at the space between the staircases. He rapidly turned to Carolyn and said, “Help me pick him up.”
“What are we going to do?” Carolyn asked.
“You’ll see,” David replied. “Grab his legs.”
They lifted the body and moved it over to the railing, then rolled it over into the space between the staircases. The body fell straight down, then glanced off a rail and slammed into the landing on the floor below. It bounced up once and stayed within sight.
Carolyn asked, “Won’t the terrorists see the body when they start searching for their missing man?”
David shook his head. “The Secret Service has the floor beneath us covered. Chances are they’ll find the body and remove it.”
“And if they don’t?”
“Then we’re in big trouble.”
Carolyn pointed to the Uzi on the floor near the stairs. “Should we take his weapon?”
“No.” David picked up the Uzi and tossed it over the railing. “If they find us anywhere near the weapon, they’ll figure out what happened and we’ll both be dead.”
“Couldn’t you have used it to shoot …”
David shook his head again, interrupting her. “There are too many of them. If just one of the terrorists is left standing, the President and his family will be carried out of here in body bags.”
Hurriedly turning for the door, neither of them noticed the smear of blood on the floor that had come from the dead terrorist’s mouth.
At the doorway, David peeked out into the corridor and saw a terrorist about to enter the nurses’ lounge. He quickly jerked his head back in and waited several seconds before peeking out again. The corridor was now clear. Taking Carolyn’s hand, he dashed across to Marci’s room.
Marci was grasping for air with shallow, rapid respirations. Her entire face was now deeply cyanotic.
“Lower the bed!” David directed. “And pull her gown up well away from her abdomen!”
David hastily opened the lumbar puncture tray and painted Marci’s abdomen and lower rib cage with an orange antiseptic. After slipping on latex gloves, he palpated the xiphoid process, the small cartilaginous structure at the very end of the sternum. Then he took a long needle and stuck it through the skin and muscle beneath the xiphoid process. Slowly he advanced it upward toward the heart, staying as close to the chest wall as possible. Be careful, he warned himself, trying to be even more deliberate. He didn’t want to puncture the heart or tear a hole in it. Goddamn it! I need an echocardiogram to guide me! I’m blind without it, and I don’t know where I am anatomically. He felt like he was practicing medicine in the Middle Ages.
Marci was gagging and choking, now unable to clear her airway. Her respirations sounded like squeals.
“David,” Carolyn warned, “she’s going out.”
“I know. I know.”
David pushed the needle up farther and felt the resistance of the diaphragm that separated t
he thoracic contents from the abdomen. He gave the long needle another thrust. The resistance vanished. But no fluid came out of the needle. Oh, shit! I missed it! Am I inside the lung, or what? The needle was in almost to the hub. Out of desperation he gave the needle a final push.
Clear fluid suddenly spurted from the end of the needle, gushing out in a steady stream. It slowed for a moment. Then the flow continued, pouring onto Marci’s abdomen and sheet. David stared in awe at the volume of pericardial fluid being extracted. It had to be 200 ccs, or more. My God! How did she stay alive with an effusion that size?
The flow gradually diminished, until it was coming out in drops. David attached a large syringe to the needle and aspirated another 20 ccs.
“David! David!” Carolyn said excitedly. “You’ve got to see this!”
David looked over at Carolyn, who was motioning to Marci’s face. The girl’s cyanosis was disappearing right before their eyes, her lips and cheeks turning a rosy pink. And her neck veins were flattening to the point they were barely noticeable.
“Unbelievable!” Carolyn marveled.
“Oh,” David swooned softly, enjoying the moment. A life almost gone. A life brought back. It was one of medicine’s magic moments. With a nod of satisfaction, he removed the needle and bandaged the puncture site. I was lucky, he had to admit. Just plain lucky. Blind man’s luck on the first try. He put a smile on his face and gazed down at Marci, who was taking long, even breaths. “How are you doing, kiddo?”
“Better,” Marci replied, taking another deep breath and savoring the air. “A lot better.”
“So I can see.”
“Thank you for helping me, Dr. Ballineau.”
“You’re welcome.” David patted her shoulder and glanced up at her IV line. The plastic bag was nearly empty. He looked over to Carolyn and said, “Run a liter of saline into Marci. We’ve got to replace the fluid she’s lost.”
Carolyn hesitated. “Won’t it just go back into her pericardial sac?”
“No, it’ll stay in her intravascular space.”
David pushed himself up from the bed. He abruptly reeled as his weakness returned and the room started to sway. He grabbed Carolyn’s arm and tried to steady himself, but the wavering persisted.
“Are you okay?” Carolyn asked, alarmed.
“You’d better help me to the couch,” David said, leaning heavily on her.
Carolyn placed her arm around his waist and led him to the couch, where he plopped down. She sat beside him and said, “I think all that blood you lost is taking its toll. You’re the one who is going to need a transfusion.”
David shook his head. “It’s not anemia from blood loss. It’s volume depletion. A liter of saline will take care of it.”
Carolyn asked quickly, “Do you want me to start an IV on you?”
David nodded. “Pronto. And while you’re getting the IV set up, check on the President and see if he’s bleeding again.”
“Okay,” Carolyn said, rising to her feet. “But you stay put! Don’t you move off of this couch, and I mean it. I can’t get through this mess without you.”
“I’m not going anywhere,” David assured her.
“You stay put!” Carolyn ordered again, and hurried out of the room.
David leaned back, weak and now bone-weary as well. He felt his eyes closing and had to fight to keep them open. Don’t sleep, he commanded himself. Because if you do, you’ll sleep deeply and lose valuable time, and your leg will stiffen and you’ll be worthless in combat. And people will die because your brain was muddled by a little sleep, but not nearly enough. So stay awake! He stretched out his leg and the throbbing pain came back. Good! That would keep his mind occupied on something other than sleep.
He looked over to Marci, who now had a white washcloth covering her forehead. It accentuated her eyes and nose and cheeks, making them appear far more prominent than they really were. Part of the washcloth was draped down along the side of her face and when she turned, it moved, like the end of a turban blowing in the wind …
Oh, God! David groaned as a flashback came into his mind. Not here! Not now!
But the images sharpened and the memories flooded back. A screaming mob of African terrorists were running toward him, yelling at the top of their lungs, the ends of their white turbans flying in the air. They were old and young—some boys, some men, all filled with hate and showing no fear. Then came the gunfire and explosions. The dead were everywhere, some without arms or legs or heads. Yet more came, their numbers endless. The Special Forces unit was surrounded with no way out. The mob was howling for their necks.
David jerked his consciousness back to the present. Sweat was pouring off him, his hands shaking so badly they flapped. And he couldn’t catch his breath. With effort he clasped his hands together and forced himself to inhale. As air went into his bronchi, David heard a wheezing noise. Shit! Oh, shit! I sound like an asthmatic. He had to strain even harder to expand his lungs. Ever so slowly, his breathing eased and the other symptoms of his panic attack subsided.
David lay back heavily and gathered himself. The attacks had never come this close together. And they couldn’t have come at a worse time. Goddamn it! I’m turning into an invalid, just when I need every ounce of my strength to survive!
He stiffened suddenly, as he heard footsteps coming down the corridor. They were heavy footsteps, accompanied by a rattling sound he didn’t recognize. David hoped it wasn’t Aliev, but braced himself in case it was.
Carolyn rushed back into the suite, dragging an IV pole behind her. “The President is doing okay.”
“What’s the color of his gastric juice?” David asked.
“Light pink with no clots,” Carolyn replied, as she applied a tourniquet and rubbed alcohol over a vein in David’s forearm.
“He may still be oozing blood,” David worried.
“That beats the hell out of hemorrhaging, doesn’t it?” Carolyn expertly started an IV and taped the needle into place. “How fast do you want it to run?”
“Wide open.”
Carolyn adjusted the IV flow, then sat down next to David and sighed wearily. “This reminds me of my days as a flight nurse.”
David looked over quickly. “You rode an ER helicopter?”
“For five years, before I decided to work on the Beaumont Pavilion,” Carolyn answered, smiling weakly at the memory. “I miss it. There’s something about zooming around in a helicopter that gives you a real adrenaline rush.”
“It can be addictive,” David recalled.
“Do you miss it, too?” Carolyn asked.
“The copter rides—yeah,” David said wistfully. “But not the hell that came after.”
“Well, it looks like that hell is catching up with you again.”
“And with you.”
Carolyn stared out into space briefly, then said candidly, “I just hope I don’t fall apart when hell comes.”
“It’s already here,” David said, reaching over to gently squeeze her hand. “And you’re doing great.”
“You’re the one doing great. Only God knows how you’ve been able to hold things together up here.”
“Just dumb luck.”
“Baloney! You’re not some ordinary academician. If you were, you’d be in a corner, shaking in your boots at this moment.”
David shrugged and looked up at the IV streaming into his arm. He wished it was a unit of whole blood. That would surely set things straight.
“Right?” Carolyn persisted.
David shrugged again.
“Don’t you clam up on me,” Carolyn said bluntly. “I’ve got some important questions about you, and I want answers.”
David had to smile at her directness. “Fire away.”
“You were a doctor in the military. Right?” Carolyn asked.
David shook his head. “I became a doctor after my military service.”
“Which branch were you in?”
“Special Forces.”
“Really?” Carolyn said, taken by surprise. But then she nodded, thinking that would explain a lot. “What kind of missions did you go on?”
“You don’t want to know,” David muttered, his face tightening. He hated talking about the past. Hated it. Because it always brought back the bad memories. “Ask me about something else.”
“Okay,” Carolyn said, now seeing an opening she’d been waiting for. “How come a good-looking doctor like you isn’t married?”
“I was,” David replied, looking up at the IV bag, which was still three-quarters full. He wished the whole liter was already in so he could stand and walk out. “A long time ago.”
“And?” Carolyn pressed on.
“Marianne was a nurse at Walter Reed, where they restructured my chin after the helicopter crash that ended my military career,” David said neutrally. “She got me through a bad time. We fell in love. We married. I went back to college and got into medical school, and we planned for a wonderful future together. I graduated, did an ER residency, and was offered a faculty position at University Hospital. I rose up through the ranks and became Chief of the Service. Life was great. It couldn’t have been better. We had a big house and a beautiful baby daughter. Then one day Marianne had a sudden nosebleed that wouldn’t stop and was seen by our family physician. She was diagnosed with acute myeloblastic leukemia, and died eight months later.”
“Oh,” Carolyn said softly, and looked away. “I’m so sorry.”
“Don’t sweat it.”
Carolyn flicked her wrists, unhappy with herself. “Sometimes I talk too much.”
“You’re doing fine,” David said, pushing Marianne’s face from his mind. But the sound of her voice—that warm, wonderful voice—stayed for a moment longer. It was always the last part of the memory to leave. “What about you? I’d guess that someone as pretty as you has been married before.”
“No such luck.”
Patient One: A Novel Page 25