The Patient

by Michael Palmer

  “Bastard,” he muttered.

  “There, that’s much better,” Malloche said. “The gas whose power you just witnessed is called soman. You may have heard of it as GD, currently the most virulent neurotoxin known to man—far more potent than sarin. Some friends of ours in Baghdad have made a generous supply available to us. But I assure you that, depending on placement, population density, and the prevailing wind, a generous supply of soman is not needed to cause a massive amount of damage. We have placed radio-detonated vials, much larger than the one whose effects you just witnessed, in well-camouflaged spots in heavily trafficked areas throughout the city. If anything should happen to prevent my surgery, or if I should not wake up promptly after leaving the operating room, not only will all those on Surgical Seven pay the price, but a significant proportion of the city as well. Is that clear? … Dr. Marcus?”

  “Oh, God. Yes, it’s clear, it’s clear.”

  “I will be cured of this tumor in my head, and I will make it safely out of the hospital. Is that clear, Dr. Copeland?”

  Jessie sighed.

  “Clear,” she said.

  “Okay. I’m glad we’re on the same page. Now, Dr. Marcus, you have about two days to keep the public at bay, maybe three, depending on my recovery time. In the process of so doing, you will save the lives of a great many people. First, I want you to empty the pathology department and seal it off. Then announce to the media that there has been a biological disaster here at the hospital—a deadly viral exposure of some as yet unknown sort, requiring that the microbiology lab and the neurosurgical service on Surgical Seven be sealed off. Inform the public that the rest of the hospital is perfectly safe, but as a precaution it is being closed to all but essential personnel. All other hospital employees should be told to stay away until the crisis has passed. Go to minimal staffing. Double or triple all pay for those who come in. Discharge as many patients as possible at once. Chain off all entryways except through the main lobby. Divert all emergencies to other hospitals. Clear?”

  “Yes, but—”

  “Then you are to do whatever is necessary to muddle efforts to get to the bottom of the problem. If one agency wants to investigate, tell them another already is. Create as much confusion and dissension as you can. Whatever you need to do to buy time you must do. Derrick, here, or one of my other people, will be with you at all times seeing to it that you perform the way I know you’re capable of. Another of my people will be out in the city, connected to us by radio, and never far from the vials of soman. Please do not do anything that will force me to conduct another, more extensive demonstration of its virulence.”

  “I—I’ll try my best,” Marcus replied.

  Malloche threw the switch and returned Marcus and Derrick to the basement. Then he took Jessie back up to Surgical Seven.

  “Dr. Copeland, I have decided that my surgery will take place tomorrow afternoon no matter what. Offer whatever assurances and financial inducements necessary to assemble the essential operating room personnel. Fail in this regard, and I promise you a quite sizable group of people will suddenly be on intimate terms with soman.”

  “I don’t see how—”

  “Dr. Copeland, my patience is thin, and my demands are not up for debate. Now mobilize whomever you have to and get this goddamn tumor out of my brain.”

  CHAPTER 29

  OVER THE SEVENTEEN YEARS SINCE THE CIA HAD recruited him, Alex Bishop had become used to dealing with informants. Most were no less criminal than those on whom they were informing. Jorge Cardoza was no different. A scarred, rodent-faced little man, he had made it up the ranks in Claude Malloche’s organization simply because he was quite proficient at the one skill Malloche demanded—killing.

  As Alex inched back from the airport into Boston through the Sumner Tunnel, he assessed the man who he knew was responsible for the deaths of many. Cardoza, dressed in worn jeans and a stained polo shirt, sat slumped in the passenger seat, head pressed against the side window, staring out at the exhaust-stained concrete and tile. He had traded information on Malloche for his own freedom and had paid dearly for that decision. Now, with his wife and child dead, and a hefty price on his head throughout Malloche’s organization, information was all that was keeping him from being thrown to the wolves. With no money and no support whatsoever as far as Alex could tell, he was attempting to start his life over again in Uruguay—the one place outside of Europe where he had relatives.

  “You promise I can have my money and my plane tickets out of here as soon as I have done what you want?” Cardoza asked in Spanish.

  “You identify this body and I will keep my side of the bargain,” Alex replied, his Castilian Spanish fluent and with little accent.

  “What if the man you have is not Malloche?”

  “Then I will have made a very serious misjudgment, and you will still be free to go.”

  “With the money.”

  “Yes.”

  “And the tickets.”

  “Yes. But I am certain the man I have is Malloche.”

  Alex used his cell phone to call the FBI answering service that was functioning essentially as his office. No word from Jessie, no word from Lisa Brandon. Both were good signs. Arlette Malloche was still at Eastern Mass Medical, apparently willing to accept as necessary the delays in allowing her to claim her husband’s body. It would not be long now. Once Malloche was positively identified, he was sure the Boston FBI would cooperate fully and move in on Arlette and her people.

  “It has been hard on me,” Cardoza said.

  “I know, I know.”

  Ratting on your cohorts often is.

  “Malloche has forced me to do this.”

  “Yes, he has.”

  “You are a good man, Bishop.”

  “That means a lot coming from you, Jorge.”

  The Bowker and Hammersmith Funeral Parlor, in the city’s Dorchester section, was straight out of The Twilight Zone—weathered sign, gray, peeling clapboard siding, front steps that creaked and groaned on the way up to a porch that couldn’t possibly have supported an oak casket and full complement of pallbearers.

  “I need a funeral parlor that will rent me a hearse and store a body, and not ask any questions,” Alex had asked his FBI contact.

  Bowker and Hammersmith’s number was given to him without hesitation.

  Alex pulled the rental car into the driveway on the side and motioned Cardoza to bring along his luggage—a single black nylon gym bag, small enough to carry onto the plane. They entered the funeral parlor through a service door and went directly to the basement room that held the refrigerated walk-in storage unit.

  The man Alex had dealt with at the funeral home had identified himself as Richard Jones. He had gladly taken five hundred dollars, along with another thousand that would be returned when the hearse was. Now, as Jones put it, he was out of the loop and would be gone until the body had been identified and someone from the coroner’s office had come by to pick it up.

  Alex flipped on the light and directed Cardoza to wait while he went to get Malloche.

  This is it, he was thinking. Five years.

  He wheeled out the body and pulled the sheet down to the nipples. The lips had pulled back in a gaping, toothy rictus so that it looked as if Malloche were grinning at him. Unsettling.

  Jorge Cardoza approached the corpse cautiously, then bent over and studied the face.

  “You have my money and my ticket?” he asked.

  “Right here.” Alex patted his pocket.

  “And I get them no matter what?”

  “No matter what.” Alex felt suddenly cold. There was no reason for Cardoza to be stalling like this unless—

  “It’s not him.”

  “What?”

  “I don’t know who this is, but it is not Claude Malloche.”

  Alex braced himself on the stretcher and stared down at the corpse.

  “Could he have had plastic surgery?”

  “I saw him just three or four month
s ago,” Cardoza replied. “There is no resemblance.”

  Alex grabbed the man by his shirt and pulled him up onto his tiptoes.

  “Look at me, Jorge! Look me in the eyes and say this isn’t Malloche!”

  “Bishop, I want the man to be dead as much as you do. He killed my wife and child, and he wants to kill me! But this is not Malloche.”

  Slowly, Alex released his grip.

  “I don’t believe this,” he said. “I … I was so certain. What about Arlette? Have you ever seen her?”

  Cardoza shook his head.

  “I only know that she is said to be a very beautiful woman,” he said. “Now, please.…”

  Bishop replaced the sheet, wheeled Rolf Hermann’s body back into the refrigerator, and closed the door. There was no sense trying to keep Cardoza around to identify a man who might already be back in Europe after having been operated on at some other medical center. He had lost, and that was that. With luck, Malloche would die from his goddamn tumor. But it was doubtful Alex Bishop would ever hear about it.

  Numbly, he walked the Spaniard back to the car, gave him his tickets and money, and dropped him off at a T station.

  CHAPTER 30

  THROUGH LATE AFTERNOON AND INTO THE EVENING the moans of Surgical Seven patients begging for services or explanations was constant. The beepers of Carl, Jessie, nursing supervisor Catherine Purcell, and the lab tech were sounding so persistently that Malloche finally had them confiscated and turned off. Worsening the situation, Malloche’s headache had returned with force, causing him to be increasingly irritable and uncommunicative. Finally, he ordered some painkiller from one of the nurses and returned to his bed.

  Arlette readily took over, controlling the siege with even more dispassion than had her husband. Nurses were sent to aid patients only one at a time, and never unaccompanied. One guard was constantly watching the staff seated along the nurses’ station counter, while another was positioned by the doors and elevator, wiring more explosives in place. Arlette herself spent much of the time at the doorway to her room, watching as news reports of the biological disaster at Eastern Mass Medical Center unfolded on television. At other times, she patrolled the corridors, her semiautomatic slung at loose readiness over her shoulder.

  Carl Gilbride was still in near shock. Except for the thirty minutes it took Jessie to guide him to the treatment room and sew up the gash in his face, he sat slumped in his chair, showing no particular interest in his surroundings, at times even dozing off. At five, his patient Lena Levin lapsed into a coma from the bacterial infection that was building rapidly where he had recently removed her tumor. Jessie was allowed to examine her and then confronted Arlette.

  “She needs to have a spinal tap and be moved into the unit,” she said.

  “The unit is closed. The patients and the staff have all been moved in here.”

  “I want to call an infectious disease consult to discuss her therapy and order some antibiotics.”

  “No calls. Use what medicine you already have here.”

  At that moment, one of the nurses came racing up to Arlette in a panic, with Grace a few steps behind.

  “I need to call home,” she said breathlessly.

  “No calls,” Arlette responded.

  “It’s my son. He has a seizure problem and he needs medicine I give him, that my sitter doesn’t know about.”

  “I said no calls and I mean it. We let you, and everyone will have a reason to need a phone. We have more important things to attend to.”

  “Please,” Jessie said.

  Arlette shot her a withering look and demanded, with a jerk of the muzzle of her machine gun, that the nurse get back to her seat. After the woman had settled down, Arlette motioned Jessie over to a spot away from the others.

  “My husband’s headache is worsening,” she said.

  “I’m not surprised.”

  “I want his surgery done first thing in the morning, not tomorrow afternoon.”

  “A pediatric neurosurgeon has the OR booked. There’s a very sick child who needs his tumor out.”

  “Get the case postponed.”

  “I can try, but I want you to let that nurse call home.”

  “What I’ll do instead,” Arlette said, “is to kill her.”

  Jessie sized up the threat and realized that Arlette wasn’t bluffing. She saw beyond the woman to where Tamika Bing lay propped up in bed as usual, watching and listening.

  “I’ll do what I can,” Jessie said.

  Calling from the treatment room, with Arlette monitoring, she succeeded in convincing the surgeon that with the burgeoning crisis in the hospital, it was prudent to forget about using the MRI operating room at all, and instead arrange to do his case at the Hospital for Infants and Children. Then, with Armand following her, she went to check in on some of the patients, beginning with Sara. Her friend was lying on her back, eyes closed. She looked peaceful enough, but her breathing seemed slightly rapid.

  “Hi, pal,” Jessie said “…. Sara?”

  She had expected a quick response. Instead, Sara remained as she was. Anxious, Jessie took her by the shoulders and rousted her gently. Sara’s eyes blinked open, and she forced a smile. But she seemed to be having trouble focusing.

  “Hey …,” was all she managed to say.

  “You okay?”

  “I … okay.”

  “Sara?”

  Sara’s reply was slow in coming—too slow, Jessie thought. She did a rapid neuro check, including a careful examination through her ophthalmoscope. Everything seemed okay … everything except the patient. Gradually, Sara became more able to answer questions appropriately, but she still appeared marginally less aware and more sluggish than she had been. Jessie mentally scrolled through half a dozen diagnostic possibilities, including medication toxicity and simple exhaustion. But the one diagnosis that worried her most was a slow pressure buildup from a blockage to the flow of spinal fluid in and around the brain. The obstruction, if there was one, was most likely caused by scar tissue, a blood clot, or local tissue swelling. And if it became a total blockade, it would result in acute hydrocephalus—a true neurosurgical emergency. But right now, without access to the scanners in radiology, Jessie could do nothing but watch her closely.

  Damn you, she thought as Armand followed her around to Tamika Bing’s room. Damn you all.

  The thirteen-year-old appeared as she always did—stiff and motionless, gazing out at the spot in the hall where, just a few hours ago, a woman had been shot to death. Jessie wondered if there was anything at all she could say to the child that would blunt the impact of having witnessed such brutality. She pulled up a chair.

  “Hi, Tamika,” she said. “Here I am, back again.… Everyone is very upset about what happened to that poor woman. She worked for the FBI, and she was trying to help us all when she was shot.… When this is all over, I’m going to find her family and tell them how brave she was.… Tamika? … Please look at me, baby. I want so much to know how you are feeling and to help in any way I can.”

  Suddenly, almost imperceptibly, Tamika Bing’s hands moved from where they were folded in her lap up to the edge of her tray table. Her eyes remained fixed straight ahead, her posture rigid. Aside from chewing food that was placed in her mouth, it was the most purposeful movement Jessie had seen her make since the surgery. Again the girl’s hands moved. Now her fingertips were touching the edge of her laptop. The computer was always open and ready on her tray table, but as far as Jessie or Tamika’s mother knew, it had never been used.

  Jessie risked a peek at Armand, who stood at attention by the doorway, peering over to check on them from time to time, but without much interest. Mostly his focus was out in the hall. Tamika’s fingers were now on the keyboard. Jessie shifted her chair just enough to be able to read the screen. The girl struck the keys softly, with the economical movements of a skilled typist.

  Give me a phone connection and I can get outside, she wrote.

  Stunned, Jessie stared
first at the screen, then at Tamika. The girl continued looking straight ahead. But Jessie noticed the corners of her mouth were drawn up ever so slightly.

  Fooled you, the expression was saying.

  Bless you, child.

  “So, dear,” Jessie said with clarity, careful to avoid any change in tone that might alert Armand. “It’s so nice that you’re practicing your typing again. Let me see what else you can do.”

  My friend Ricky checks his e-mail all the time. I can get a message to him.

  Jessie’s pulse was racing. The phone cable lay on the floor, still connected to the wall. She checked the back of the laptop to establish where the modem port was. With luck, lots of luck, they might have a connection to Alex—a connection Arlette and her crew would know nothing about.

  “Yes, of course,” Jessie said. “I can get that for you, Tamika. I’ll be back in just a little while with that medicine you need. Meanwhile, you just rest. You’re doing terrific. Absolutely terrific.”

  With Armand not far behind, Jessie went to the nurses’ station and retrieved the red loose-leaf notebook that was Tamika Bing’s chart. Now, both Armand and Arlette were watching her, but neither of them seemed particularly interested as she opened the record and began writing a message to Alex on a progress note sheet. She said a silent prayer of thanks that she had jotted the number of his answering service in her pocket-sized clinical notebook. The book, hers since medical school, was tattered and swollen to the point where an elastic band was required to hold it closed. It was packed with normal lab values, medication doses, diagnostic tables, and other reference cards. For a decade now, when she was in the hospital and not in the OR or showering, the little black book was never out of her possession. Her message completed, she wrote Alex’s answering service number at the top of the progress report sheet, then slowly slid the paper free from the binder rings. Moments later, the weeping of the distraught nurse diverted Arlette and Armand long enough for her to fold the sheet and drop it into her pocket. Their response also gave her an idea.