The Patient

by Michael Palmer

  “Hang in there, Michelle,” she said. “I’ll explain everything to you when I can.”

  “You mean when we allow you to,” Malloche corrected.

  “You just treat this woman well,” Booker said boldly. “She just performed an operation on you that maybe no neurosurgeon anyplace could have done better.”

  “I was counting on that.”

  Arlette was there when the elevator arrived. She took her husband’s hand and kissed him on the lips. Then she looked up at Jessie.

  “He looks quite good. I understand the surgery went well.”

  “As of this moment, it has. But post-op, much can happen. My patient Sara Devereau is a perfect example. How is she doing?”

  “What do we do for my husband now?” Arlette responded, pointedly ignoring the question.

  The battle of wills between the two of them had begun anew. After nearly seven hours in the operating room, Jessie was in no mood to back down.

  “I asked you a simple question,” she said.

  “And I—”

  “Tell her, Arlette,” Malloche said with a weak wave. “Tell her what she wants to know.”

  “Very well. Dr. Gilbride has been in with your patient since you left. She is awake and seems to be responding to commands, and the doctor seems quite pleased with himself.”

  “Oh, thank God! I want to see her.”

  “My husband …,” Arlette said stonily.

  “Okay. The surgery was, I would have to say, an unqualified success. We were able to remove about ninety-five percent of the tumor.”

  “You left some in?”

  Jessie hesitated, wondering what the immediate fallout would be of explaining that the reason she couldn’t get all the growth out was that Arlette’s man Derrick had murdered the computer expert and destroyed his equipment. She decided now was not the time.

  “The little I left in will probably never cause a problem. In fact, the blood supply to that fragment may have been disrupted enough to kill what cells remain.”

  “Go on. What can we expect now?”

  “Well, seizures may be a problem. We’ve medicated him for that with a drug he has taken before. My nurse practitioner, the one your people kidnapped, should stay with him continuously for a while to administer medications and monitor his vital signs. Infection is always a concern post-op. There is also the chance of a pressure buildup like the one that happened to my patient.”

  “That could happen this soon?”

  “Oh, yes, or up to several days after surgery. There’s no way to predict whether this particular complication is going to happen, or when. Now, may I go in and see Sara Devereau?”

  “First, get Claude settled in with his nurse. Then you may go and check on the Devereau woman. After that, Doctor, you and I have some very serious matters to discuss.”

  “What matters?” Malloche asked dreamily.

  Arlette kissed him on the forehead and spoke reassuringly to him in German. Apparently satisfied with whatever she said, Claude smiled feebly and closed his eyes, obviously exhausted.

  Under Arlette’s watchful gaze, Jessie and Booker wheeled Malloche into the deserted ICU. Then, while he was being transferred to a bed and hooked up to a monitor, Arlette and Grace huddled in the hallway. Jessie had no doubt whatsoever about the subject of their conversation. She was running out of time to prepare some believable explanation.

  A fairly extensive neurologic exam on Malloche verified what Jessie already suspected—that ARTIE had excised nearly all of a very extensive, hard-to-reach meningioma without causing any gross neurologic damage. Sadly, ironically, she acknowledged that the tiny robot and the MRI guidance system may have come of age working within the skull of a demon. She was just finishing when Emily came in.

  “Sara’s wide awake,” she said excitedly.

  “Talking?”

  “She’s not ready for the debating society, but she’s certainly making her needs understood. You’re on a helluva roll today, Jess.”

  “Carl’s still there with her?”

  “A man on a mission.”

  “Maybe someone should have smashed him across the face with a gun a long time ago.”

  “Amen to that,” Emily said.

  Jessie went over Malloche’s up-to-the-minute condition and medications.

  “Between you, me, Michelle, and the nurses, we should be able to provide him with continuous coverage.”

  Arlette and Grace reentered the room. Neither looked too pleased. Until that moment, Michelle Booker had remained silent. But now her exasperation broke through.

  “Would somebody please tell me what in the hell is going on?” she pleaded. “I went off coverage half an hour ago, and my kids are expecting me home. I need to get out of here.”

  “I don’t believe that’s going to happen,” Jessie said.

  She received an assenting nod from Arlette and gave a capsule summary of their predicament. Michelle’s expression—increasingly astonished and fearful—suggested that the reality of the situation on Surgical Seven was far more bizarre and dangerous than whatever her imagination had conjured up.

  A muttered “Dear God” was all she could manage when Jessie had finished.

  Arlette motioned the two of them out into the hall, then down to the small conference room. She was wearing her machine gun over her shoulder and had a thick-barreled pistol stuck in her belt. For the first time Jessie could remember, the woman wore no makeup. Her porcelain skin was unlined, but her lips looked bloodless, and her eyes had an unsettling hollowness about them.

  Exhaustion? Tension? Anger? Jessie wondered. All three, perhaps. It certainly seemed as if the strain of running such a show by herself was beginning to take its toll.

  “Dr. Booker,” Arlette asked when they reached the conference room, “do you have any knowledge of what transpired downstairs in the operating room?”

  “Nothing other than what I saw,” Booker replied.

  “Well, I’d like you to tell me exactly what that was. But first, Dr. Copeland, why don’t you go on down the hall and see how your patient is doing. I’ll send for you when I’m ready. It won’t be long.”

  Jessie knew that Arlette would have Booker go through the surgery on her husband step by step until she reached the part when Mark Naehring entered the OR. Then the questions would become more and more detailed until Arlette had a crystal-clear image of what the anesthesiologist had seen. And later, the details of Booker’s story would be used to check off on Jessie’s account.

  Just don’t lie, Michelle, Jessie begged silently. Don’t take any chances with this woman. Tell her what you saw.

  “I’ll be down the hall,” she said, her eyes urging Booker to be strong.

  With Armand in tow, Jessie hurried to Sara’s room. Her friend and patient was indeed awake and alert, sitting up and sipping some juice. The shunt Jessie had placed through the twist-drill hole had been carefully sutured down and hooked up to a drainage system. Carl Gilbride was adjusting the valve that controlled the flow rate.

  “Hey,” Jessie said, “an island of sanity in the sea of madness. How’re you doing, Sar?”

  “Nah … sobad. Tube … inma … head.”

  “I know. I know.” Jessie hugged her. “Don’t worry about it. If the tube needs to stay in to keep the pressure down, we’ll hide it beneath your skin. Understand?”

  “Yes.”

  “The drainage was dropping off, so I repositioned the tube,” Gilbride said, sounding to Jessie like a four-year-old announcing he had picked up all his toys.

  “You did great, Carl,” Jessie replied. “She would have never made it without you.”

  “How’d the case go?”

  “ARTIE did well. Malloche is awake with no apparent residual neurologic problems.”

  “Does that mean we’re going to make it out of this?”

  “You’re asking the wrong person, Carl,” she said. She lowered her voice, making it difficult, if not impossible, for Armand to hear. “Somethin
g happened during the operation that Arlette isn’t too pleased about. One of their people—the big guy with the blond crew cut—took off after someone and hasn’t returned.”

  “Took off after who?”

  “I don’t know. I’ll speak to you about it all later. Meanwhile, please just keep on doing what you can for Sara. How’s everyone else on the floor?”

  “I … um … haven’t been around to see them. It seemed like this is what you wanted me to do.”

  With the power to dictate all the rules in effect stripped from him, Gilbride seemed almost helpless.

  “It was, Carl,” she said.

  “Dr. Copeland?”

  Arlette Malloche stood by the doorway. Red smudges of anger colored her cheeks.

  “Yes?”

  “Come with me now.”

  “I’d like to make rounds on the other patients.”

  Arlette grabbed the pistol in her belt, but didn’t pull it out.

  “Now!” she demanded.

  Jessie took a calming breath. This was the moment she had been dreading since she realized that Derrick hadn’t returned to the floor. She had never been much of an actress or much of a liar. But she knew she was going to have to be both now. She had to believe that Alex had somehow managed to get away from Derrick; he would need time to locate the soman vials and disarm them. The moment that Arlette suspected they had learned the locations, it seemed certain one or more of the setups would be detonated. No matter what pressure Arlette brought to bear, that was the one piece of information that had to be kept from her.

  “Hang in there, Sar,” Jessie said. “You, too, Carl. Keep up the great work.”

  Arlette motioned her to the conference room and into a chair, and closed the door.

  “I assume you know what I wish to learn about,” she said.

  “The man who came into the OR.”

  “Precisely. I warn you in advance, Doctor, that I have a version of this story from your anesthesiologist friend. If your account differs in the slightest from hers, I’m going to let you watch while I kill her.”

  Jessie sucked in a jet of air, then moistened her lips.

  This had better be damn good, Copeland, she was thinking. She had come up with the rough outline of a story that would jibe with anything Booker might have told Arlette. But there would be a major problem if Arlette went to Gilbride for confirmation. Somehow, he had to be kept out of the loop. Just as Jessie was preparing to ramble through the version she had created, something Alex had said about Gilbride gave her the answer she needed.

  “I don’t know as much as you might think,” she began.

  “I don’t believe that.”

  “Well, you’ve got to. I don’t want anyone to get hurt.”

  “Go on.”

  “The whole thing was set up some time ago by that woman Lisa from the FBI—the one that your husband shot. I don’t know how, but somehow they knew Claude was in the States looking for a neurosurgeon. Eastern Mass Medical Center was just one of the hospitals they targeted. I don’t know how many others there were. Lisa was the agent assigned here, and she was around almost all the time. She was certain Rolf Hermann was Claude, but she didn’t trust Dr. Gilbride enough to tell him that. She said they had done some research on Carl, and felt there was a good possibility he had been paid off by you. So she spoke exclusively with me. When it was clear Hermann was going to die, she had people from the FBI lined up to storm the floor and capture you and the Count’s so-called children.”

  “But then your Dr. Gilbride made a mess of things by losing his temper at the agent and forcing her to identify herself before she wanted to.”

  “Exactly. She had given me a number to call if there was trouble, but I never had a chance to use it until Dave Scolari, the man in seven-seventeen with the broken neck, had his seizure. During the commotion, I took a chance and slipped into the conference room to use the only phone you had left hooked up. The conversation with the FBI people who answered only lasted maybe a minute before I had to hang up. I was told to prepare the way for one of their people to come into the operating room. I said whoever it was should use the name Dr. Mark Naehring.”

  Arlette motioned for Jessie to stop so that she could mentally pick through the story for inconsistencies.

  “All right,” she said finally, “what happened next?”

  Jessie released the death grip she had on the arm of her chair. She was improvising—flying almost blind. But so far at least, her account seemed to be holding up.

  “I made up the story that Dr. Naehring might be coming into the OR to help me with part of the case. He’s a psychopharmacologist—someone who works with the sort of medications we use when patients are kept awake during brain surgery—so I thought if you checked up on him, his helping me would make some sense, at least as long as you didn’t try to call him.”

  “That was very clever. Go on.”

  “The night before the operation, I made it a point to say something to Dr. Booker about it when she was doing your husband’s pre-op physical.”

  “I remember.”

  “I wasn’t sure anyone was going to show up, but right in the middle of the case, someone from the FBI did. We were able to speak to one another by turning off our microphones and whispering. Because of the way the MRI magnets are set up, both Grace and Derrick were shielded by our backs.”

  “What did this agent want?”

  “He wanted to kill your husband, and then kill both of your people, and then go up to Surgical Seven and kill you.”

  “And—”

  “I had to tell him about the soman—that it was out there in the city someplace, and that you would have it released in a crowded area if anything happened to Claude. I also told him I had seen the way it killed the microbiology people.”

  “That was good. What did he do then?”

  Jessie regripped the chair. This chapter, the most farfetched of the fish tale, had to be totally believable—and diverting.

  “He said he had a tiny transmitter in the locker room that he wanted me to insert into your husband’s head.”

  “My, my,” she said.

  “I told him the transmitter couldn’t be brought into the MRI room because of the magnets. They would destroy it and it might damage the machine. He argued with me that there must be a way to do it, but I assured him there wasn’t.”

  “Then he left?”

  “He did. He asked me how many people were being held on Surgical Seven and if anyone had been harmed. He said the FBI would work something out, but that no one would be placed in any more danger than they were in right now. Then he left. A few seconds later, I heard Derrick demand that he pull down his mask. Next thing I heard was shooting. I saw them take off, so I just finished the operation.”

  For a full minute, Arlette studied her face, probing. Jessie forced herself to maintain eye contact.

  “You’re certain they know about the soman,” Arlette said finally.

  “I … I’m sorry. I couldn’t think of anything else to tell them but the truth.”

  “You did right. I want them to know. In fact, I’m thinking about giving them a demonstration.”

  “No! … I mean, please don’t. As long as it’s only a threat, I think the FBI will keep their distance. Once the gas is used, I think they’ll just do whatever is necessary to get at you. Ask your husband if you don’t believe me. There’s no need for a demonstration.”

  “We’ll see,” Arlette said.

  But Jessie could tell she understood the point. Once again, her hands stopped compressing the oak armrests.

  “Could I please go and check on the other patients now?” she asked.

  Arlette brought her hand across and rested it on the gun.

  “I don’t believe you,” she said.

  A knot formed and tightened in Jessie’s gut.

  “Well, everything I said is just the way it happened.”

  “We shall see.”

  Please. Please don’t hurt anyo
ne.

  “That woman Grace brought up from the operating room is an X-ray technician, is she not?” Arlette asked.

  “She is,” Jessie replied, suddenly terrified for Holly. “Why?”

  “I’m going to send her off the floor with Grace to bring back a portable X-ray machine.”

  “For what?”

  “I want a picture done of Claude’s head, that’s what. You knew that one of the first things I’d think of was that the FBI man wanted you to insert a tracer into Claude’s head. That’s just the sort of thing they do. So you thought that by telling me they had asked you to do it, I’d believe that you hadn’t. Well, I think you underestimate me. You did it, didn’t you?”

  The knot loosened. Jessie actually had to keep her lips pressed tightly together to prevent a smile. She had almost rejected using the idea of the implanted transmitter because it sounded so far-out.

  “Believe me,” she said with genuine conviction, “I did nothing but remove his tumor.”

  “We’ll see. I think between Grace, Claude, and me, we should be able to spot the device on an X ray. As things stand, I owe you some distress for calling the FBI the way you did. But you did a good job in the operating room, so I’m going to let that go—as long as I don’t find out you are lying.”

  “I’m not,” Jessie said, perhaps too quickly.

  Again, Arlette searched her face for signs of deceit.

  “When do you think Claude will be ready to travel?” she asked.

  “Do you mean travel without risk?”

  “No. I mean the soonest he could travel at all. He won’t have to sit up. We can keep him on a stretcher.”

  “It’s hard to say, because I’ve never done an operation with the robot before. I guess a day. Two or three would probably be better. As you saw with Sara Devereau, things can happen.”

  “That’s why you’re coming with us.”

  “What?”

  “Armand will give you a large canvas bag. I want you to fill it with whatever medical supplies you are likely to need in any situation or emergency that might arise with my husband.”

  “When are we leaving?”

  “When we leave, you’ll know,” Arlette said.