Oath of Office

by Michael Palmer

  Missing from the emergency, except in himself, was any sense of tension and urgency. Lou wondered if anyone in the room really cared whether John Meacham made it or not. It would not be hard to understand if they didn’t, even though, as Sara had said, it should never be a caregiver’s role to pass judgment on any patient.

  This was as bad as it could get.… Poor bastard.… Poor victims.

  What in the hell happened?

  A large-bore needle with a plastic catheter running through it was brought on an instrument tray, along with latex gloves, a large syringe, surgical sponges, some surgical snaps, and several culture tubes.

  Blood pressure, seventy over thirty. Oxygen saturation, 60 percent. Color worsening.

  Moving rapidly, Lou gloved and swabbed some Betadine antiseptic below Meacham’s collarbone on the right side. Then he set the plastic catheter aside and attached the needle to a 20 cc syringe. His movements were careful and considered, but almost automatic, like a boxer throwing a right-left-right combination.

  To Lou’s left, behind the crowd, he could see the neurosurgeon, Prichap, gazing almost placidly out the glass wall of the cubicle. No apparent concern, no offer to help out.

  The needle thrust was where the right second rib space was intersected by an imaginary line between the middle of the collarbone and the nipple. Gripping the syringe tightly, Lou forced the needle against the top of the third rib, and then drove it to the hilt, over the bone and into Meacham’s chest. The jet of air, under great force, actually blew the plunger out of the syringe. Lou twisted the syringe from the hub of the needle, set it on the tray, slid the catheter into Meacham’s chest, then quickly sutured it to the skin. Air continued to hiss out as the collapsed lung struggled to reexpand.

  Blood pressure, eighty over fifty. Color slightly improved. O2 sat, seventy-two.

  “Chest tube kit, please,” Lou said firmly.

  “Here you go, Doctor,” Turnbull said, replacing the used steel tray with a fresh one and opening the setup used to insert a much larger tube.

  Lou glanced over and realized that the blown IV had been replaced by one that was running smoothly. The emergency was beginning to feel more normal. Despite some improvement, however, Meacham was still in big trouble. In case he was not in a coma, Lou anesthetized an area of skin over the fifth rib, two inches below the catheter. Then, using a scalpel, he opened a slit through skin and muscle, grasped the end of the chest tube with a heavy clamp, and drove it into the space between the still-deflated lung and the inside of the chest wall. Given the relatively minor trauma of most of the patients in the Eisenhower Memorial Annex, this was, he realized, the first time he had inserted a chest tube since before he was sent away.

  Just like riding a bike.

  A suture to hold the tube in place, connection to a water-seal container to keep air from being sucked back into the chest cavity, and the deal was done.

  Pressure, still eighty over fifty. O2 sat, seventy-nine. Not good.

  Lou knew that all he had accomplished was bringing John Meacham back to a man with a bullet hole in his head.

  “Nice job,” Turnbull whispered, squeezing Lou’s elbow.

  “Thanks, although I suspect the barn door might be closed shut by now. I don’t know who I should go ballistic at first—the respiratory tech, the IV nurse, or that Prichap guy.”

  “I haven’t had much experience with him, but like I said, I’ve never heard anything bad.”

  “Well, you have now. How about I take a few deep breaths in the interest of reestablishing my serenity, and speak to him.”

  “There’s a small nurses’ lounge out there to the right. Tell me when, and I’ll bring him there for you.”

  “Provided you can get his attention away from the painting on that wall out there.”

  Lou checked Meacham over again. Not much change. He tried to imagine what it was like to pull out a gun and shoot to kill someone. It just didn’t register. The usual motives—greed, hatred, anger—simply didn’t apply. Only crazy.

  He headed down the hallway to the nurses’ lounge. Two minutes later, Dr. Prichap entered. Once again, he didn’t bother shaking Lou’s hand. The neurosurgeon, like others in his specialty Lou had dealt with over the years, exuded arrogance. Lou flashed on his four-week rotation holding instruments on the neurosurgery service in medical school.

  “Never forget, son,” the chief had told him during one seemingly endless procedure, “that’s brain you’re sucking on.”

  Just in case, Lou introduced himself again.

  Prichap looked as if he could not care less. “The nurse said you wanted to see me,” he said.

  “I’ve known Dr. Meacham for a number of years. Just wanted to get your take on what might have happened to him.”

  “He lost his mind. That is what happened. He lost his mind and killed seven people.”

  “I suppose.… Is this the only hospital you’re on the staff of?”

  “I am in a five-person group. We cover six or seven hospitals.”

  “And you’ve not encountered behavior like Dr. Meacham’s in any of those hospitals?”

  “Not that I’m aware of. What specialty are you?”

  “ER. I work in the ER at Eisenhower.”

  “I see.”

  Feeling the surgeon losing interest, Lou decided on a frontal assault. “Tell me, Dr. Prichap, what were you hoping to accomplish by fishing out that bullet?”

  Lou fully expected the man to erupt, or at least to storm out of the lounge. Instead, Prichap turned his head and gazed out the window, much as he had in the ICU.

  “I … do not … suppose it … would … have accomplished … anything,” he said distantly.

  “But if it—”

  The surgeon snapped out of his reverie as if he had been jabbed by a cattle prod. “Well, good to meet you, Doctor,” he said, turning toward the door.

  As he did so, he nearly collided with Sara Turnbull.

  “Dr. Prichap, Dr. Welcome,” she said breathlessly, “come quickly, please, Dr. Meacham’s arrested.”

  Lou bolted past the neurosurgeon and out the door. DeLand Regional had community support and a reputation for giving good care. Yet the respiratory tech had overinflated Meacham’s lungs, the infusion nurse had badly blown a line, and the neurosurgeon was acting like the doctor/barber in a Saturday Western. Even usually reliable Sara Turnbull had failed to notice a malfunctioning IV.

  What in the hell was going on?

  CHAPTER 6

  Bar None was three blocks from the Capitol. The upscale lounge served unusual cocktails that seemed to appeal to congressional aides more than to their stodgier, older bosses. At this hour, it was as safe a place as any for Darlene and Kim to escape to for a drink. They waited outside under an awning while a team of Secret Service agents checked out the interior.

  With them on the sidewalk was Victor Ochoa, a tall veteran agent with salt-and-pepper hair and dark, narrow eyes that appeared to be on constant alert. He stood a respectful distance from the two women until sudden static from his radio announced a transmission.

  “Cobra here,” he said.

  “All clear for Buttercup and Wildcat, Cobra,” a woman’s voice replied.

  “Buttercup and Wildcat,” Ochoa echoed.

  By tradition, the three members of the First Family each carried a radio code name beginning with the same letter. The president, Bronco, had chosen B for them. Darlene had adopted the name of her heroine from the novel and movie The Princess Bride, and Lisa, now twenty-one and a totally independent sophomore at Yale, chose Bullfighter. Kim, to no one’s surprise, had gone with the Kansas State mascot.

  “Safe in there for a drink, Victor?” Darlene asked.

  “So long as you keep away from the Fireball Gimlets, you’ll be fine.”

  The agent escorted them. The space was dimly lit and modestly filled. A jukebox in one corner of the bar played alternative rock songs at a volume that permitted conversation without shouting.

  Dar
lene smiled up at Ochoa and patted him on the arm. “I’m guessing you’d like us to sit over there,” she said, pointing to an empty booth that was closest to the emergency exit.

  “I knew you’d eventually get the hang of this, Madam First Lady,” Ochoa said.

  “Victor, it’s Darlene. Please. I’d rather you call me Princess Buttercup than Madam First Lady, and you’re wrong. I don’t think I’ll ever fully get the hang of this role.”

  Ochoa laughed warmly. “Our guide to protocol is thicker than the D.C. phone book. No excessive familiarity, including no first names, even though you’re about the most down-to-earth, approachable First Lady I’ve worked with. Tell you what—I’ll be saying ma’am and thinking Darlene. How’s that?”

  “That’ll be fine. What does your protocol guide say about my going grocery shopping without an advance team clearing the cereal aisle first?”

  “It says that isn’t going to happen … ma’am.”

  Darlene followed Ochoa, Kim, and another agent beyond the bar, smiling and shaking hands with surprised patrons as she passed by. Then she asked Ochoa for two vodka tonics and settled into the booth, sitting directly across from her friend.

  “I’ll be the second to admit the constant attention gets tiresome,” Kim said. “But at least after shopping, we won’t have to lug any of our purchases back home.”

  “That is a plus. Alas, it was one thing when Martin had an approval rating of sixty percent. Now we’re in free fall. The depression or recession, or whatever it is, has seen to it that even shopping is unpleasant for me. Imagine what it must be like for those poor folks who suddenly don’t have a job.”

  Moments later, Ochoa materialized from within the crowd, carrying two tall vodka tonics, each garnished with a crescent of lemon. The women clinked glasses more out of habit than over anything to celebrate.

  “I wonder if Victor had to sample our drinks before he brought them over,” Kim said.

  Darlene took a sip of hers, which she quickly followed with a much longer swallow. The sting of Martin’s behavior abated some.

  “How did you know this is what I needed?” Darlene asked.

  “Honey, it doesn’t take Sigmund Freud to figure out that you’re stressed out. Look at those circles under your eyes. You’ve got a social schedule that would exhaust a rhinoceros. On top of that, you’re working every spare moment trying to change the eating habits of three hundred million Americans, while keeping the fragile ego of their president appropriately stroked. Sometimes, I don’t think you realize just how much you’ve taken on.”

  “Well, maybe it’s time I put my agenda on a diet.”

  Kim took a healthy swallow and set her glass firmly on the table. “Nonsense,” she said. “Just because the president of the United States acts like your work is irrelevant doesn’t make it so. You just have to pace yourself better, that’s all—a little more shopping, a little more spa time, a few more vacations, an extra hour at the gym. Sweetheart, you’re changing things out there. You’ve read the reports. You’re like the pediatrician to the nation, and people are starting to pay attention to your message.”

  “Sure, they’re starting to listen, but change is coming very slowly. And if we don’t get reelected, any chance of making much of a difference will be gone.”

  “Meal by meal, isn’t that your war cry? Keep pushing, Dar. Just don’t push yourself over a cliff. Blow off steam when the pressure gets too intense, and for God’s sake, don’t let that galoot you’re married to get away with not giving you or your cause the respect you deserve.”

  Darlene clinked Kim’s glass with more enthusiasm. “You know, Hajjar, I think you’d make someone a great chief of staff. Are you looking for a job?”

  “Depends,” Kim answered, her rich brown eyes gleaming playfully. “Will I have to keep reminding you how terrific you are?”

  “Absolutely,” Darlene said.

  “Well, then, count me in.”

  Just then, Ochoa came over to their table, leaned down, and spoke softly in Darlene’s ear. “Madam First Lady, Russell Evans is upstairs in the private party room. He asked if you two would be willing to join him for a drink.”

  Darlene took a hard swallow of her V&T against the tightness that had developed in her chest. She flashed Kim a surprised look.

  Evans, former Secretary of Agriculture, had been one of her husband’s first cabinet appointments. His resignation, in disgrace, had been responsible for at least some of the drop in Martin’s numbers. The scandal had been especially hard on Darlene. She and Evans went back to their childhood years in the Kansas plains town of Dubuque, where their farming families were neighbors even though they lived several miles apart. In fact, Martin had first met Evans through her, not long after the three of them started at Kansas State, and often used him as an adviser during his climb up the political mountain.

  “Russ Evans is upstairs,” Darlene whispered.

  “Goodness.”

  “He wants to speak with us.”

  “You okay with that?”

  “Are you?”

  “Part of me still thinks he was set up, if that’s what you mean.”

  “I feel the same way,” Darlene said, “but so far, the way the facts are stacking up, things look pretty bad. Still, he never was anything other than helpful to me. Victor, we’d be happy to speak with him.”

  CHAPTER 7

  Agents moved quickly to escort Darlene and Kim to the front of the bar. The tightness in Darlene’s chest refused to abate. Meeting with Evans like this would be juicy fodder for the paparazzi.

  Darlene had heard rumors that Evans was going to plead guilty to statutory rape charges in connection to a motel rendezvous with a teenage prostitute. When the news broke, Darlene had sent him a supportive note expressing her hope that an explanation would come clear for the episode, and urging him to put his faith in the justice system. Perhaps, she wondered, he had been unable to take her words to heart, and wanted to position himself for a presidential pardon.

  Not only had their lifelong friendship endured, but she had taken a med school elective course in farming and nutrition that he taught. Years later, she was the one to suggest that Martin consider appointing Evans—then an instructor in farming economics—as Secretary of Agriculture. Martin subsequently stood by their friend despite a fair amount of opposition in Congress.

  Darlene and Kim followed the agents through a doorway to a narrow stairwell that ascended to the balcony level. At the end of another hallway, they came to a padded vinyl door.

  “We’ve already checked the room. It’s safe to go in,” Ochoa said.

  Darlene pushed open the door and allowed Kim to enter first. Evans was alone, seated at a low table in the center of a dimly lit, cavelike room. The paneled walls were painted black, and the mood lighting cast deep shadows across Evans’s round face. During the months since Darlene had last seen him, he seemed to have aged years. He stood up somewhat clumsily as the women entered, and Darlene wondered if he might have been drinking. He was a large, usually cheery man with thinning light brown hair, and at this moment, he exuded gloom.

  “Darlene. Kim. Thanks for coming up,” he said, extending his meaty hand. “It’s good to see you.”

  “Good to see you, too, Russ,” Darlene said, giving him a quick hug in lieu of his proffered handshake. “You look as if you’re holding up okay.”

  Evans replied with his trademark deep baritone laugh. “I’ve gained fifteen pounds and am rapidly losing what little hair I had left,” he said. “But I’ll accept the compliment anyway.”

  Darlene’s apprehension was replaced with a heavy sadness at seeing the man looking so beaten. Evans had eschewed life on his family’s farm in exchange for a master’s degree and a faculty position at an agricultural college. Before the scandal hit, she had enjoyed meetings in his office, surrounded by framed photographs of America’s farmland.

  “Agent Ochoa said you wanted to speak with me. Is it about your case?”

  “P
lease. Have a seat.” Evans pushed closer to the table. “I was at your event today.”

  “You were?” Kim asked. “I didn’t see you there.”

  Again, that laugh, but this time there was an undisguised tinge of bitterness. “Well, I kept to the background,” Evans said. “Not that it matters.”

  “How so?” asked Darlene.

  “I guess I’m still surprised how little anyone recognizes the guy who, for two years, was ninth in the presidential succession order. Once you’re not a player in this town, well, you’re not a player—except, of course, to the press corps. Now, those guys still have no problem recognizing me. Scandal sells papers. This morning, though, they were too focused on you to notice me. Everyone knew the president had blown off the event. Not even an appearance by Farmer Pornpone, as the tabloids are calling me, could pull their attention away.”

  Darlene reached across the table and cupped Evans’s hands in her own. “You know you have supporters out there, Russ. Not everyone believes the charges against you.”

  Evans managed a pale smile of appreciation. “Nice of you to say, Darlene. Unfortunately, whoever paid off the girl gave her enough to keep her lies coming, to say nothing of the impact of the box of kiddie porn that investigators found in the back of my closet.”

  “Sorry if I’m out of place,” Kim said, “but what were you doing in that hotel room? We’ve heard all kinds of rumors and—”

  Evans held up his hand. “No, don’t be sorry and don’t you worry about it,” he said. “My lawyer asked me to keep my side of the story away from the press until he heard what the U.S. Attorney had against me. Now that we know they’re calling off the prosecution because they can’t find the woman who filed the complaint, I’ll tell anybody who’ll listen—not that it will help get my job back. You see, my son, Derek, has been in trouble since his teens. Drugs and such. I haven’t spoken to him in nearly three years until I got this anonymous phone call telling me he was holed up at a motel just outside of D.C., and that he was in some sort of trouble. I think you know that Derek’s mother and I have been divorced for some time. I decided not to tell her about the call until I knew what was going on.