And with that, Susie finally appeared to be resting comfortably. All it took was giving her ketamine, getting her anesthetized, and then putting on a ventilator.
Lee noted Susie’s temp was still high, at 101.6. Her blood pressure was also elevated at 160 over 110, and her heart rate still too fast, at 140 beats per minute, with frequent ectopic premature beats.
“Let’s increase the labetalol,” Lee said. “Start her on a drip, fifty milligrams per min. Dr. Rajit, you concur?”
The young resident looked as though he had just leapt from a moving train.
“Yes, yes, of course,” he said.
Blood still had to be cleaned off the floor. The nurses would have to change their clothes, their sneakers, too.
The room was a total mess.
At least Susie’s ECG showed normalization of those inverted T-waves.
“CK-MB and troponin levels normal, Dr. Blackwell.”
“Let’s get another serum creatinine test,” Lee said. A normal jump might be one point per day for someone in kidney distress. Susie’s had gone up more than that in under an hour. Lee had never heard of a patient whose levels had risen so rapidly.
A nurse administered the serum test while Lee kept close watch. A shocked expression came to her face as she read the results.
“Her creatinine level is nine point oh.”
Lee’s mouth fell open.
Impossible.
“We’ve got to get her to the ICU, get her on dialysis STAT! Now! Now!”
Orderlies, nurses, gathered around and rushed Susie out of the room, headed for the elevator to take them to the ICU one floor above. The critical care physicians, with the help of the radiologist, would get her started on dialysis before her creatinine levels shot up to the point of no return.
Lee watched Susie get wheeled away, wondering if her kidney failure could be related to her other symptoms—the ones she and Cam had in common. He desperately wanted those tox screen results. It was certainly a possibility the repairman had injected Susie with something to manifest her delusions; exactly what, he could not say. But he doubted the tox report would explain the sudden and alarming rise of Susie’s creatinine levels.
Nothing in medicine Lee knew of could do that.
CHAPTER 29
Lee visited the ICU to instruct Susie’s doctors and nurses not to allow her any visitors. While he doubted the repairman would return, Lee knew there was a chance he could. It was a risk trusting the staff to keep a vigilant watch, given how patients on this floor were in constant crisis. A discomforting image of the repairman slipping into Susie’s ICU cubicle with the stealth of a serpent made him shiver. Maybe he’d return as an orderly, or a doctor, or even a hospital security guard. Lee believed anything was possible.
When he returned to the medical unit, Lee counted six members of the MDC security team roaming the floor. These were not rent-a-cops. They wore light blue shirts with shiny badges pinned to their breast pockets, dark neckties, and dark slacks. Most were armed like patrol officers.
Joining the investigation were two police officers from the MPD—D.C.’s Metropolitan Police Department. They were fit-looking young guys, early thirties, who were treating this as a straightforward case of assault and battery. Depending on what the tox screen revealed, the police might have to upgrade the alleged crime to attempted murder.
As it was, these two cops were taking statements and making every effort to gather evidence. Forensics was coming to get fingerprints, even though Lee told the police the man had been wearing gloves. In the description Lee gave, he made sure to call out the tattoo of a skull wearing a spiked helmet on the man’s forearm. He offered to work with a sketch artist, and was told it might be arranged.
“What about security cameras?” Lee asked.
“We’re looking into it,” the shorter of the MPD cops said.
Lee understood. It was going to take time to scrutinize the security footage, speak to all potential witnesses, and do whatever was required to track down the repairman. All the while, Lee believed Susie’s mystery illness would continue to confound her doctors.
The more Lee pondered, the more Susie’s rapid spike in creatinine levels puzzled him. A jump like hers should have taken days, weeks, or even months, not hours. These MPD officers were not the ones to confide in regarding a possible connection to the Stewart twins’ suspicious car accident, Susie’s equally suspicious CO exposure, and potential links to the TPI and Cam Hilliard. They were too low-level and it was all too nebulous, too much conjecture.
What Lee needed was hard evidence. Looking in Cam’s eyes using an ophthalmoscope was the new priority. Cam’s body could be a ticking bomb as well.
Having found an empty chair behind the nurses’ station, a respite from all the commotion, Lee sipped at a ginger ale on ice while awaiting Karen’s arrival. With his adrenaline rush subsiding, he became acutely aware of how much his body ached. His chest where he took the punch, legs, lungs, everything hurt.
Lee called the ICU, forgetting his last check-in was fifteen minutes ago. With luck the IVs would flush out most of the toxin, allowing Susie to come off the ventilator. He was eager to find out what had made her see spiders, naturally, and footsteps down the hall told him the answer was on the way.
Dr. Rajit approached in lockstep with the intensivist, Dr. Sears, a woman Lee had met only recently. Her sallow skin tone and tangle of hair escaping a loosely held bun hinted at too many hours spent in the hospital. Lee rose from his seat and greeted them in the hallway.
“We got the results from the tox screen,” Dr. Rajit said.
“And?”
“And Susie Banks suffered from massive methamphetamine toxicity. It certainly would explain her hallucinations. There was enough drug in her system to kill a horse. I have no idea how you managed to save that girl.”
Lee had no idea either. All he did was follow established procedures, nothing special. He wondered if the unexplainable spike in Susie’s creatinine levels had somehow acted as a buffer against the narcotic. Did it also help her to survive the CO exposure that killed her parents?
“Has security made any progress tracking down this mysterious repairman?” Dr. Sears asked.
“No, but I suspect detectives will be brought in now,” Lee said. “Please, make sure you get this report to them ASAP. And Dr. Rajit—”
“Yes?”
“I want to thank you for letting me help with Susie Banks. Dr. Sears, you should know it was a most unusual situation and Dr. Rajit handled himself admirably and professionally. I’m sure the police will be eager to talk with you both. If you’ll excuse me, I have to go.”
Lee shook their hands, making a fast exit, because behind them he saw Karen, still in her wall jumper outfit, flashing a badge to the security team guarding the entrance to the medical floor. Tension seared her face.
Lee led Karen to the waiting room, where they could speak in private. He went into details about his confrontation with the repairman and Susie’s crazed hallucinations.
“She was injected with what should have been a fatal dose of methamphetamine,” Lee said. “This repairman tried to kill her. No doubt about it.”
“How’s she doing now?” Karen asked.
“Stable,” said Lee. “They moved her to the ICU. I’ve told the staff no other visitors.”
“Good call,” Karen said.
“I’m just glad my emergency medicine training came back to me. Otherwise I might not have been able to save her.”
Karen’s expression became strained. “You’re sure there’s a connection between Susie and Cam?”
“I think a lot of evidence points that way.”
“And these Stewart twins, their deaths no longer seem accidental to you, do they?”
“No, they don’t,” Lee said. “Where are you going with this?”
“If Cam’s connected to Susie, and Susie to the twins, doesn’t it stand to reason that Cam could be a target, as well?”
Lee retur
ned a grim nod of agreement. “You have those brain pills?” he asked.
“Getting them wasn’t the best moment of my day, but yes, I’ve got them.”
“Good. Let’s get to the White House. Now.”
“Why?”
“Because I want to shine a light into Cam’s eyes. If there’s a red spot on his macula, like there is on Susie’s, it might as well be a laser pointer from a sniper rifle.”
CHAPTER 30
Lee and Karen shared an Uber to the White House, which they exited nine dollars poorer. Lee was actually two hundred and nine dollars poorer, because he had slipped a security guard all he had in his wallet in exchange for a promise to keep an extra-close eye on Susie.
“You realize someone could pay a lot more money than two hundred bucks to do something other than keep a close watch,” Karen said.
“Don’t remind me,” Lee answered glumly.
At the Pennsylvania Avenue security checkpoint, Lee was asked for identification. Phone calls had already been made, chains of events set in motion, which allowed Lee to enter the White House compound with little hassle.
Karen led Lee through the West Wing entrance to the clinic where the Hilliards, Cam, and Gleason all were waiting. Agent Duffy stood nearby, along with other members of the Secret Service. With the president downstairs, they needed to be a presence.
Everyone was dressed casually, including the president, who had on a navy polo shirt, dark jeans, and loafers. This was a side of the White House few ever saw. These were normal people, Lee realized, leading a truly extraordinary life. They may have been the first family, but right now it was family first.
Karen took Cam into the waiting room, so Lee could get everyone up to speed without alarming him. He started off explaining the possible medical connections between Susie and Cam—seizure activity, enlarged organs, abnormal liver function tests—and concluded with the cherry-red spot in Susie’s eye, the big mystery.
“That can be a symptom of CO exposure, or were you not aware?” Dr. Gleason’s tone carried some bite.
“I am well aware, thank you,” Lee said. “But it is also a rare symptom. Which is why this eye exam is so important. If Cam has a red spot, it may suggest that the origin of Susie’s spot is something other than carbon monoxide.”
“Such as?” Dr. Gleason’s arms refused to uncross.
“Such as whatever enlarged Cam’s spleen and made him susceptible to splenic rupture, or caused his nocturnal seizures, or gave him abnormal liver function.” Lee’s voice was steady. “It’s everything I just talked about. I don’t know what exactly is causing these symptoms, and until I do, I suggest Cam stop taking any medication, supplements—anything other than what we’ve prescribed for his seizures. We need to be extremely cautious.”
Lee also needed to tread lightly, at least until he got those nootropics tested. If that red spot was there, as Lee believed it would be, talk could turn to protecting Susie and Cam from outside threats. But how do you protect a patient from his doctor?
For now, Gleason was untouchable. Outlandish accusations might lead to Karen’s dismissal, and that could put Cam in grave danger. She needed to stay near him, continue to serve as his protector.
“Now there’s something more you need to know,” Lee said to the group.
He told them about the repairman, his fight in the stairwell, and Susie’s close call with death.
“Somebody tried to kill this girl?” Ellen sounded horrified.
“I believe this repairman tried to kill Susie at her home, and when that didn’t go as planned, he struck again at the hospital.”
Ellen shook her head in shock and disbelief.
“That poor, poor girl,” she said, her voice brimming with emotion. “And nobody knows who assaulted her, or why?”
“No,” Lee said. “There are a lot of police at the hospital right now, but it’s a short-term measure. They’re watching over the entire facility, not just Susie.”
“Why on earth are they doing that? The attack was on Susie.”
Ellen sounded incredulous and more than a little angry. Lee explained what the police had told him: Susie had never taken out a restraining order against a violent boyfriend; no one in the Banks family had ever reported receiving threats of any kind. Susie was the victim of a crime, but the motive and suspect were both unknowns. Since there was nobody for the authorities to detain, the heightened police presence was meant to deter the attacker from making a brazen return for a second strike against another random target.
“It hardly seems random to me,” said Ellen, who seemed to share Lee’s frustration. “If there’s anything I can do for her, please, please let me know.”
“There’s actually more to the story,” Lee said. He told them about the Stewart twins.
“And these twin boys had seizures similar to the ones Susie Banks suffered?” President Hilliard’s paternal instincts came through clearly.
“And they died in an accidental way, which might have happened to Susie if she hadn’t escaped from her house,” Lee added. “Honestly, I can’t explain how she survived either attack. It could have something to do with what’s happening inside her body. We just don’t know.”
“Is Cam in any danger?” The president’s stare was harder than stone.
“Sir, I can’t say for sure,” Lee said. “I’m only telling you the facts as I know them.”
Almost all of the facts, he thought, eyeing Gleason.
Ellen’s concern and worry were palpable.
“I’ll speak with Karen,” the president said to his wife. “We’ll increase the size of Cam’s Secret Service detail. Nothing is going to happen to him. He’s the most protected child in the country. But this theory of yours, Lee, if I understand correctly, is predicated on Cam having the same red spots in his eyes as this girl does? Otherwise, their issues might not be connected after all.”
The president impressed Lee with his quick understanding.
“If the red spot is in Susie and not in Cam, I’ll have to assume her spots are the result of carbon monoxide exposure.”
Gleason uncrossed his arms and approached Lee. “And what if Cam doesn’t have this spot, Dr. Blackwood? What then? Can we agree at this point to stop worrying the president and first lady? Because that’s what you’re doing here.”
“No, we cannot,” Lee said firmly. “Because regardless there’s something wrong with Cam. His moodiness isn’t what made his internal organs larger.”
“Back to the girl,” Gleason said. “Susie Banks. If there’s no red spot, does that mean there’s no connection between them?”
“I can’t say that for certain. There are symptomatic similarities in the four children who have a shared connection to the TPI,” Lee said.
“How similar, Lee?” Gleason said. “Cam doesn’t have myoclonus jerks like these other three.”
“We don’t know if that’s actually true,” Lee said. “They could be happening while he’s asleep.”
“Right. Those seizures of his that we’ve yet to prove he has.” Gleason’s voice was sharp. “Keep stretching, Lee, and eventually you’ll figure out a way to make it all fit. Isn’t that what people say about statistics? You can make them say anything, including the truth. The bottom line is that Cam isn’t on dialysis. His creatinine levels are perfectly normal. Slight enlargement of the organs could be something viral or bacterial, something we can treat. But when we reviewed the EEG, it’s inconclusive, and you put him on a medication with a host of side effects to treat his excessive tiredness in the morning—which by the way, is symptomatic of depression.
“Now, I’ll grant you that we need to get to the bottom of his liver function and slight organ enlargement, but nothing you’ve said has steered me away from my original diagnosis of some form of depression. Perhaps there’s something viral we haven’t found in the blood work taking a toll on his mood. Perhaps. But in no way will I embrace the notion of some sort of murder conspiracy involving Cam and his TPI associates. Y
our imagination is truly a wondrous thing, but just because someone wanted to do away with Susie Banks doesn’t mean there’s any connection to a tragic car accident or to Cam.”
“The clustering around the TPI is more than a little unusual,” said Lee.
“Why do you say that? Did the twins have this red spot in their eyes? Enlarged organs?”
“No, only the severe myoclonus as far as I know,” Lee admitted. “They weren’t tested for any of the other symptoms.”
Gleason shook his head in disgust. “What you’re doing, Lee, is making it difficult for me to properly treat the boy, and that—that is my greatest concern, and the reason I have been vocally opposed to your involvement from the very start.”
President Hilliard cleared his throat, and that got everyone’s attention.
“Lee, I appreciate what you’re trying to do for us,” the president said, taking Ellen’s hand. “But Dr. Gleason is right. What you’ve stated is quite outlandish. I’m worried we’re missing the bigger point here, which is what to do for Cam. If there’s no red spot in his eye, some definitive way to tie him to this girl—well, I’m honestly more inclined to focus on what Dr. Gleason has told us from the get-go.
“Ellen wants Cam on the new medication you’ve prescribed, and I’m fine with that, for now, but as for the rest, well, murders and whatnot, until there is proof, I’ll have a hard time seeing how any of it is related to my son.”
“I believe wholeheartedly that Susie Banks’s life is in grave danger,” Lee said. “I was physically assaulted by the man who injected her with methamphetamine.”
“I’ve no doubt that it happened, Lee,” the president responded. “But I’m responsible for the country and for my family, not for one girl who is being stalked. I feel for her, I honestly do. But without some direct, irrefutable connection to Cam, her situation is a matter for the local authorities, not the federal government, and certainly not the president.
“For Cam’s sake, I want to keep his life as normal as possible. The World Junior Chess Championships are three months away, and Cam needs to train diligently if he has any shot of winning.”
The First Family Page 17