Miracle Drug

by Richard L. Mabry M. D.

  “I’ll gown up in a minute,” Lang said. “First, I want to be sure that man is dead.”

  “What’s going on here?” Dr. Josh Pearson, an untied gown covering his white coat, a mask loosely in place, grabbed Lang by the shoulder and spun him around. “I heard gunshots and shouting.”

  Lang inclined his head toward the corpse on the floor. “Even after that man showed Agent Rutledge a hospital badge at the door, I had a feeling there was something not quite right with him. He went into the room, and when I opened the door for a closer look, I saw him pull a gun and fire at Mr. Madison.” He used his pistol to point at the gowned and masked figure on the floor. A pool of blood was slowly spreading around the assassin. “That’s when I shot him.”

  Pearson jerked his head toward the stack of isolation gowns and masks in the hallway. “Get one of those on. Put on some gloves.”

  “I will,” Lang said. “But until I get back, watch that man. If he moves, yell.”

  There was more commotion in the hallway as Lang backed out of the room. “Stay back,” he said to the group that was gathering. He hurried to don the required garb.

  “I’ll call 911,” an older woman, a nurse, said.

  Lang stopped her before she could turn away. “No. Call the Dallas Police.” He finished tying his gown and picked up a mask. “Give them this message: Agent Lang needs Detective Warren at the hospital as soon as possible. He should bring one police officer and probably the coroner, but other than that we need to keep this to ourselves.”

  Once he was gowned, gloved, and masked, Lang stepped back into the room and closed the door. He motioned for Madison to stay where he was in the bed. He directed Dr. Pearson to a corner of the room where he’d be out of the way. Then, his pistol pointed toward the man lying on the floor, Lang crept forward. He’d seen enough dead bodies to know his bullets had found their mark. This man was no longer a threat. But he’d handle this by the manual. That was the only way—the only safe way—to deal with the situation.

  When he reached the side of the would-be assassin, Lang searched with his gloved left hand for a carotid pulse in the neck and found none. He gently moved the pistol well away from the dead man’s outstretched hand. Then Lang stood up and announced, “He’s dead.”

  “Who is he? Why did he try to do this?” Madison said.

  “Dr. Pearson,” Lang said, ignoring the ex-president’s questions, “check Mr. Madison and make sure he’s okay. Don’t come near the body, though. We leave everything as it is until Warren gets here.”

  Lang opened the door of the room wide enough to hold a brief whispered conversation with Agent Rutledge, who stood guard outside. In hushed tones, he told the man what had happened and asked him to call a couple of agents to beef up the security around the ex-president. Someone had tried to shoot Madison. The shooter was dead, but they couldn’t relax. The danger wasn’t over.

  ***

  Rachel stirred and slowly came awake. It took a few moments for her to realize where she was . . . and why. Her dreams had been a troubled mishmash of sights and sounds, and when she tried to recall their content, it was like trying to catch a butterfly with her bare hands—it danced just outside the reach of her mind. It seemed that she’d heard shouting and loud noises. Did they represent gunshots? She blamed it all on the fever.

  She knew she still had fever. Actually, although her time perception seemed to be skewed, she thought her fever was worse than when she was admitted. How long had she been here? Her watch was on the bedside table, and by carefully rolling over she was able to reach it. She had to squint a couple of times before she could see the tiny numbers and letters in the date window at the edge of the dial.

  The watch told her it was Friday noon. Surely that couldn’t be right. If it were, she’d been in the hospital for only about twenty-four hours. She looked at the IV pole above her head. Yes, the empty bag that had held the diluted diphtheria antitoxin was still hanging there, although the piggyback line that had been plugged into her IV dangled free. So maybe the fever she felt was due to the effects of the DAT, the antibodies doing their job. When she’d received immunizations in the past, she’d sometimes had low-grade fever along with arm soreness. That, in turn, made her wonder why she hadn’t experienced any of those symptoms when Dr. Lambert administered her recent immunizations.

  The process of her selection to join the group was a bit hazy in her fever-ridden mind. She’d received a call from President Madison’s administrative aide, asking if she’d come to Preston Medical Clinic after her shift ended in the ICU at University Hospital. A nurse had dropped out of the group scheduled to leave in a few days for South America. Rachel’s colleague at the medical center, Linda Gaston, was going on the trip and recommended her as a replacement.

  Rachel wondered if she should have talked it over with Josh Pearson before saying yes. But she’d had to make a decision right then. Of course, afterward, they’d discussed it, and Josh told her it sounded like a great opportunity. In retrospect, Rachel wondered if she’d made a wise decision.

  She rolled back onto her side and closed her eyes. Maybe the fever would be gone when she woke this time. Maybe if she prayed hard enough . . . she was still praying silently when sleep overtook her.

  ***

  “Are you okay?” Josh said in a low voice, bending over David Madison’s bed. He noticed two bullet holes in the pillow where the ex-president’s head would have been had he not sat up and leaned to the side.

  “I’m shaken,” Madison replied, “but other than that I’m okay.”

  Josh assured himself that the ex-president hadn’t been harmed before he straightened up and conveyed the message to Lang.

  The agent nodded. “Good. Now we need to preserve this room as a crime scene, so I think it’s best to move Mr. Madison, if you can arrange it.”

  Josh considered that for a moment. “We’ll still need to maintain isolation precautions.”

  “For how long?”

  Until I can figure out what else is infecting Madison and Rachel and get it under control. “I don’t know yet,” Josh said. “Let me see if we can do some shuffling and move Mr. Madison to a room across the hall, next to Rachel.”

  “And the assumed name?” Lang asked.

  “Despite our best efforts, gossip spreads here, the same as it does any other place. You saw the crowd that gathered outside this room when they heard shots in here. I think that ship of anonymity has sailed, don’t you?”

  “Okay, but I think we should keep trying. I’ll ask Warren to keep the number of police personnel in here to a minimum. If we restrict access to this area of the hospital, I think we can maintain security and a degree of secrecy. That is, unless you’d rather transfer Mr. Madison to another medical facility.”

  Josh had already considered this. That would entail giving up control of his patient to another doctor, not to mention the effort of bringing another medical team up to speed and the possibility that information would fall through the cracks. And what about Rachel’s treatment? For better or worse, the care of the two patients was linked, and Josh felt it was his responsibility to bring it to a successful end. When he was honest with himself, he realized he didn’t want to let go of the case. Despite the bleak outlook, he thought he could handle it.

  “If you’re suggesting we airlift Mr. Madison to Bethesda, I don’t like the idea,” Josh said. “The same goes for the special isolation unit the CDC supports at Emory Hospital in Atlanta.”

  “How about the university medical center here in town?”

  “Again, I think it’s best we continue the care started here,” he told Lang.

  “Okay. Step outside and set the wheels in motion for the move to another room. Keep this as a ‘need to know’ situation.”

  Josh had taken a step toward the door before he stopped. Should he leave Lang here alone with Madison? When he’d come into the room, Lang had just shot the gunman. Had that taken place before or after shots were fired at Madison? Was Lang part of a
conspiracy, or part of the solution to it? Josh knew the idea was crazy—after all, Lang was there to protect Madison. If he couldn’t be trusted, who could? Nevertheless, for whatever reason, Josh couldn’t bring himself to leave the agent alone with the ex-president right now.

  “I’ll do it this way,” Josh said. He pulled out his cell phone and punched in a number. “This is Dr. Pearson. I need to speak to the head nurse on two south.”

  In a few moments, there was a tap on the door and a masked and gowned nurse entered, followed by a similarly garbed orderly pushing a wheelchair. “Mr. Madison,” the nurse said, “I’m Mary Wynn, the head nurse on this floor. Let’s get you into this chair and take you across the hall. After the police are through in here, we’ll get your belongings and move them.”

  A few moments after Madison was wheeled out the door, a stocky man in isolation gear entered the room. Josh didn’t recognize him behind the mask. Then he heard the man’s voice and recognized it as the one he’d heard at Love Field when he first met Detective Stan Warren.

  “Okay,” the detective said, swiveling his head between Josh and Lang. “What do we have here?”

  Josh decided he had nothing to contribute to this conversation, so he edged into a far corner and listened as the Secret Service agent described the attempt to shoot ex-president Madison. “I saw the shooter go into the room. Of course, with that isolation garb, I couldn’t tell who it was, but somehow I had a feeling things weren’t right. I opened the door and peeked in, and I’m glad I did.”

  “Did you call out to him? Tell him to stop? Say something like, ‘Police, freeze’?”

  “There was no time,” Lang said. “He had his gun aimed at Mr. Madison. I think I may have fired just a fraction of a second after the shooter did.”

  Warren nodded. “I see.” He looked at Josh. “You got anything to add, Doc?”

  “No,” Josh said. “I got here after it all happened.”

  “Okay. We’ll get your statement later, then,” Warren said.

  “We have Mr. Madison in a new room, right across the hall. I suppose you’ll want to talk with him, since he was the only other eyewitness,” Lang said.

  Josh’s cell phone vibrated in his pocket. He eased it out and looked at the caller ID. The call came from inside the hospital. Well, whatever it was, it would have to wait a bit.

  Warren nodded once as he knelt beside the body. “We’ll get Mr. Madison’s statement in good time.” He fixed his gaze on Lang. “I realize this is really a Secret Service situation, but if you want to keep a lid on this information getting around, I suggest you let me try to backtrack the shooter. I can use Dallas Police Department resources to do that.”

  “Fine. We’ll coordinate and share information.” Lang pulled his pistol from its holster beneath his isolation gown. He grasped the barrel and held the weapon out butt-first to Warren. “Will you need this?”

  “I’m supposed to take it, but it seems to me you might need it again before you can pick up a replacement. Keep it for now.”

  “Thanks,” Lang said softly. “I did what I swore to do—protect the ex-president, even if it meant risking my own life.”

  Warren edged closer to the pistol the gunman had dropped, but didn’t touch it. “Looks like a Type 64 silenced pistol. It’s a one-piece handgun, with the silencer built in.”

  “That’s why I only heard two shots,” Josh said. “The ones fired at Mr. Madison were from a silenced weapon.”

  “Probably no more than a loud fftt,” Warren said.

  “Does the type of pistol tell you anything?” Josh asked.

  This time Lang answered. “Unfortunately, no. The Chinese military used this pistol a lot for clandestine operations, but that was maybe fifty years or more ago. Now, assassins of all nationalities seem to like it. Sort of an equal opportunity piece.”

  “Are you going to check his identity?” Josh asked, pointing to the fallen gunman.

  “They’ll take the shooter’s prints at the morgue, and we’ll see if we can get a hit on them,” Warren said.

  “What about his ID badge?” Josh asked.

  Warren reached under the prone gunman and pulled out the badge clipped to his isolation gown. “Terry Forester. Ring a bell?”

  “I’d have to check with the personnel office, but I think that’s the guy who was fired recently for stealing supplies,” Josh said.

  “Well, let’s see if the identity matches his face.” Warren slipped his gloved hand under the gunman’s head and turned it slightly, then used his other hand to pull down the mask.

  Despite himself, Josh took in a sharp breath.

  “What about it, Doc?” Warren asked. “Recognize this guy?”

  Josh nodded slowly, wondering if this new information made things clearer or muddied them even more.

  ***

  Jerry Lang turned his head with a jerk when the door to the room opened a crack. He still held his service pistol, but let his arm drop when he heard the words from the hall outside. “Mrs. Madison, that’s a crime scene. You can’t go in there.”

  “That room is my husband’s.” The voice was a quiet but intense contralto. “Is David all right? If it’s a crime scene, I need to know what happened.”

  Lang immediately recognized the situation. He held up one finger in a “just a second” gesture and moved toward the door. In the hall, Mrs. Mildred Madison tried to free herself from the gentle restraint applied by the uniformed Dallas police officer stationed there, while two men in dark suits tried to interpose themselves between her and the hospital room.

  “Mrs. Madison,” Lang said, trying to keep his voice down while portraying a sense of urgency. “Your husband is in the room across the hall now.” He nodded toward one of the agents. “Gilmore, please take Mrs. Madison in to her husband.” He looked at the stack of supplies by the room’s door. “Remember that anyone going in there will have to observe isolation precautions.”

  Mildred Madison pointed to the door of what used to be her husband’s hospital room. “But if that’s a crime scene . . .”

  “I’m sure your husband will explain it all to you. As soon as I’m finished with the police here, I’ll come across the hall and answer any questions you might have.”

  He waited until the agent escorted Mrs. Madison into the ex-president’s new room, then ducked back inside. “Sorry. Now, Dr. Pearson, you were saying you recognize this man. Can you explain?”

  Josh crept forward to look more closely at the face of the dead gunman. “I’m not sure what his real name is. Maybe

  the fingerprints will help you there.” He turned away from the body, as though by doing so he could distance himself from

  the case and the associated problems that seemed to be mounting. “When I met him, he called himself Bill Smith. This is the man who drove away in a hearse from Love Field with Dr. Ben Lambert’s body.”

  8

  Josh edged his way around the would-be assassin’s body to where Warren and Lang stood talking. When he reached Warren’s side, he said, “If you don’t need me right now, there have been some new developments in the medical aspects of this case, and I have to make some calls.”

  The detective nodded. “We know where to find you, Doc.” Then he resumed his conversation with Lang.

  In the hall, Josh divested himself of his gown and mask, stripped off his gloves, and washed his hands at the sink in the hall. He was in the process of turning away when he heard someone call his name.

  “Hey, Josh.” Dr. Sixto Molina, dressed in scrubs, smiled at his friend. “I know surgery is a specialty that includes excitement, but it looks like you’ve managed to generate a bit yourself.” He inclined his head toward the two men in dark suits standing in the hall across from the room Josh had just left.

  “You might say that,” Josh replied. “Right now I’d trade specialties with you, because I’ve got a problem I need to solve, but I can’t attack it surgically.”

  “I guess I need to teach you the surgical method,
” Sixto said with a laugh. “If in doubt, cut it out. Then move on.”

  “Unfortunately, in this case that’s not possible,” Josh said. “I wish I could stay and talk, but I’ve got to make some phone calls.”

  “No problem. Let me know if I can help.”

  Promising to talk later, Josh moved down the hall. He pulled out his cell phone and checked to see what his missed call had been about. The in-hospital number meant nothing, but he saw the caller had left a message.

  “Dr. Pearson, this is Ethan in the bacteriology lab. There’s something you need to know, and it’s important.”

  What now?

  When Josh entered the bacteriology lab, he found Ethan Grant with his nose in a textbook. The tech looked up and grimaced. “I think I’ve identified the bug that’s choking out the Corynebacterium diphtheriae in the culture, but I’m not sure it’s going to help you.”

  Josh looked over Grant’s shoulder. He didn’t recognize the title, but from the appearance of the textbook, it was several years old. Whatever he’d found, Ethan had really done some digging to uncover it. The page to which the book was open was headed “Gram variable bacilli.”

  “I thought all the bacteria on the slide we saw were Gram positive,” Josh said.

  “When I couldn’t figure out what was overgrowing the diphtheria bacillus, I remembered that some organisms vary in their Gram-staining pattern,” Grant replied. “This one took up the Gram stain when I looked at it the first time, but I did another slide, and this time it’s Gram negative. That’s what sent me looking for a Gram variable bacillus.”

  “And you found it.”

  “That’s the good news,” Grant said. “The bad news is what I found about it.” He pointed to a paragraph headed Bacillus decimus.

  Josh followed Grant’s finger and read: Gram-variable bacillus, found primarily in Central and South America. When existing as Gram-positive rods, may have a club shape that makes it difficult to distinguish them from Corynebacterium diphtheriae.

  “That’s your secondary infecting organism,” Grant said.

  Josh continued to read. Infected patients display a diphtheria-like membranous pharyngitis that may result in airway obstruction. The usual course of the infection is high fever, followed by internal bleeding, convulsions, and ultimate death. This bacterium is resistant to all common antibiotics.