by Bill Clem
"How is it going?" he asked.
"Not well, I'm afraid. His wedge pressure continues to go up, and his urine output is not what I expected with all the diuretics."
"Sounds like he's getting into some congestive heart failure."
She adjusted the IV monitor. "I think so."
After he completed his exam, Gregg pulled the stethoscope of his neck and slipped it into his back pocket. He looked up again at the monitor above the President's bed, then heaved a long sigh as he walked out of the room.
The Secretary of State grabbed him outside the door.
"Dr. Gregg, I'm Charles Lathbury, the President's Secretary of State."
"Glad to meet you, Mr. Lathbury. I only wish it were under different circumstances."
"Dr. Gregg, the First Lady is anxious to talk to you."
Gregg gave a comforting smile. "Yes, of course, I can talk to her now."
"She's down the hall, if you want to come with me. I'll introduce you."
Lathbury praised Gregg for the professionalism his staff had shown. True.
President Thomas Lloyd could not have picked a better place for a heart attack, Gregg thought. Brighton Heart Center held the distinction of being the world's most sophisticated cardiac hospital. To watch the technology in action, bordered on magnificent. With a staff of twelve hundred, and the best cardiologists and heart surgeons in the world, it rivaled none. Indeed, Lloyd could consider himself lucky in one regard. Given the scope of his cardiac injury--if he was anywhere else--he would already be in cold storage.
Gwen Lloyd sat in a secure room the Secret Service and hospital security had set up for her. Agents stood guard inside and out to protect her person, as well as her privacy.
They cleared Gregg and Lathbury at the door. The two entered the room and Gwen Lloyd jumped to her feet. Gregg could see a look of grave concern on her face: a look reserved for families of critically ill patients. That kind of Marcus Welby, anticipation of good news look that a surgeon gets when he comes in to tell the family the outcome of an operation. Unfortunately for Gwen Lloyd, the news was not good.
* * *
"Dr. Gregg," Lathbury said, "I would like you to meet First Lady Gwen Lloyd."
Gregg extended his hand. "Mrs. Lloyd, I'm sorry we have to meet this way, still it's a pleasure."
"I've heard wonderful things about you, Dr. Gregg." Her smile didn't match her words.
"That's very kind." Gregg took a deep breath. "Mrs. Lloyd, I've examined your husband, and I'm afraid I don't have any good news. Your husband has suffered a massive heart attack."
She nodded, ostensibly without emotion. She had expected as much and had tried to prepare herself. What she wasn't prepared for was what Dr. Gregg said next.
"I'm afraid he's going to need a transplant. He's lost eighty-percent of his heart muscle." Gregg paused while the PA system announced a code-blue.
"The only thing keeping him alive right now is the many medications we're using. That will only buy him so much time."
Gwen Lloyd looked away. "How long?" she asked.
"My guess is forty-eight hours."
She felt a sudden chill. "But can you find a donor so quickly?"
"Difficult, but not impossible. I've put the transplant team on standby, and I've notified procurement to begin a donor search. Every available donor center in Europe will try to find a heart for your husband."
"Thank God we were here."
"It's our saving grace. Brighton is the most sophisticated transplant center in the world. If a heart can be found, our team can find it. There is one other problem though."
"Oh?"
"I went through your husband's sonogram films. It seems he has transposition of the great vessels."
"Trans what?"
"Well to put it in simple terms, part of his heart is upside down. It means we need to find a donor with the same anomaly."
"Is that difficult?"
"It makes it harder, of course, but nothing we can't work around."
* * *
Difficult may have been the understatement of his career. Considering there are only one donor per five hundred recipients, and the anomaly in question occurred in about one in one thousand patients. Doing the math, Gregg figured it gave the President about a one in five thousand chance of finding a suitable donor. Not very good odds if you've only got forty-eight hours to live.
Gregg's eyes softened. "Actually it's more common than most people realize. It's just that most people don't find out unless they've had a sonogram of their heart. Anyway, our procurement computer has detailed medical histories of any potential donors, so any anomaly between donor and recipient will match."
Gwen Lloyd sat down. "It all sounds so complicated."
"I know it's a lot to absorb at one time. Having said that, my advice to you is to get some rest. It's going to be a long day or two."
Gregg had stretched the truth to its outer limits. The woman needed hope.
He looked at his watch as he headed back to Intensive Care.
Forty-seven hours.
Chapter Nine
Inside Zurich Trauma Center, Jack McDermott no longer needed to be in Neuro Intensive Care. His recent brain scan had shown, much to everyone's surprise, no damaged areas to any region of his brain. As the nurse prepared to transfer him, she scanned his records in amazement. His chances of survival were practically zero, 24 hours ago. Now, awake and talking, and even oriented except for some slight amnesia, she found it remarkable. To send someone out breathing for a change thrilled her.
Going through his records, she noticed the Authorization for Organ Donation form that the Emergency Room nurse had filled out on his admission. An Organ Donor card in his wallet gave permission to any medical facility to use his organs should he be deemed brain dead. On his admission to Zurich Trauma, and because his diagnosis was grave, the procurement liaison entered him into the computers of the Organ Procurement Network.
With his recovery imminent, she needed to call and tell them the good news, or in their case, the bad news. That depended on which side of the fence you stood. She picked up the phone and called the procurement liaison on duty.
"Hello, procurement," a voice answered.
"Yes, this is Neuro ICU at Zurich Trauma. I sent you a potential yesterday, Jack McDermott."
"Yea, I just entered him in the computer."
"Well I'm sorry, but he just came back to life."
"You're kidding, right."
"Nope, he woke up and he's alert and oriented. So I need you to take him out of the system."
"All right. It is unusual, but I'll take care of it."
* * *
When he hung up the phone, he realized he had never received a call to take a donor off the list. He'd heard of it happening to a near drowning victim on occasion, after being submerged in freezing water for an hour or so. Then, when rescued and warmed to normal body temperature, they suddenly regained consciousness. Those cases were rare, though, and the potential donor list remained reserved for the "breathing dead." Anyway, he would give the task to the next shift. He was too tired to fool with it this morning.
Chapter Ten
After his breakfast, Jack McDermott was starting to feel human again. He got up on slightly unsteady legs and walked to the sink. His mouth had a taste like a bad hangover. He closed his eyes and tried to gather his thoughts. It had been one hell of a morning. Suddenly a wave of dizziness washed over him.
He stood motionless, grabbing onto the sink for support, grabbing on as though the floor had tilted sharply underneath him. After a minute, the feeling passed, and he looked up. He stood as straight as he could on his wobbly legs and fixed his eyes on the mirror. Having not seen him since he woke up, the news it delivered shocked him.
A bruised forehead, two black eyes, and the nose... yes the nose definitely had a new shape. Jack managed a smile at his new feature; he could pass himself off as a boxer if he ever wanted to. After all, what could you expect after eating
the bark of a tree with your face? "I'm lucky I didn't end up looking like the imprint on the Shroud of Turin," Jack said to the mirror.
He stood there at the sink and gave himself a quick once over, relieved to find everything else intact. His ribs were sore along with the rest of him. Pain medicine would remedy any discomfort; the nurse had told him. Yes, he was a very lucky man.
He wiped his face, and then lathered up to shave, when the vertigo returned. This time it came with flashes of memories. Still photographs passed before his eyes, bits and pieces of the past week. After a minute, it abated, but he continued to hold onto the sink as if it was a life preserver. The doctor told him he might experience flashbacks until his memory returned completely. As he stood there, a jolt of electric shot through his brain.
Then he remembered...
Of course! I came here to cover a news story, he said to himself, knowing he was damned lucky to be anywhere at all. According to the doctor, the Zurich Ski Patrol had been in the area where Jack was skiing and had actually witnessed his accident. As bad as his odds were when they brought him in, had they not, well, he didn't want to think about that grim possibility. The nurse opened the door, and then closed it just as quickly when she saw Jack naked. He saw her take a quick look at his rear and smile.
"I'll come back in a few minutes," she said from behind the door.
"No problem," Jack said, as he wiped the shaving cream from his face.
He finished cleaning up and decided to get back to bed before another dizzy spell hit him. Besides, he felt weak and the pain in his head had returned. Not quite up to speed ole buddy.
The nurse returned still wearing a smile. "Feel better?" she asked.
"Still weak, but I think my memory is returning slowly. And at least I feel clean. Now if I could just get some real food."
"I can take care of that," she said. "I'll call the kitchen. By the way, we're going to move you to a new unit in a little while. You're not sick enough to be up here anymore."
Jack grinned. "This is one time I'm glad to get kicked out."
"I'll come down and visit you."
Jack shifted his weight to face her. "That'd be great."
"All right, I'll see you later."
Now it was Jack's turn to check out her rear as she walked out. Yes, I'm definitely getting better. A smile formed across his bruised face.
Chapter Eleven
Gwen Lloyd stared at her husband. He looked totally helpless. Unlike the strong and confident man she knew and loved, his color was sickening pewter, as if the Angel of Death himself had painted it. His face, balloon-like and laden with tubes, was barely recognizable. The steady cadence of the heart monitor was the only thing that hinted of life.
"This must be very difficult for you," the nurse on duty said, adjusting the ventilator.
Gwen Lloyd turned to her and thought how young she looked. She hesitated. "Yes, I'm used to him being in charge. I'm just really scared," she confided in the young woman.
"That's perfectly normal. Try not to worry too much. He's getting the best care possible. I know he'll pull through."
Gwen Lloyd stared. She appreciated the empathy, but knew how nurses were trained. Unfortunately, she also knew all the empathetic statements in the world could not change the facts. Short of a miracle, her husband would die. No matter how much power he had, on this day, he was helpless.
The nurse adjusted the President's IV drip, made some notes on a clipboard, then turned back to Gwen Lloyd.
"How about some coffee?"
Gwen Lloyd gazed up from her trance. "Yes, that sounds good."
After the nurse left, she turned back to her husband. Alone in the dim light, she felt herself reeling backward into oblivion...
The first time she'd met Tom Lloyd, he didn't impress her. In fact, she thought he was a jerk. Reluctantly, though, she accepted a date. Being a first- year student year at Dartmouth, she thought it would be cool to go out with a junior, even though Tom Lloyd was not her first choice. Her feelings soon changed after that first date. She found him warm, funny, and sincere. She quickly became fond of him, and spent every minute of her free time with him. In her senior year, he rented a place near the college so he could stay as close as possible to her. One night over dinner, he bent down on one knee and proposed. She found it the most romantic thing she had ever seen. Married the next year, she'd remained at his side ever since.
An alarm bell yanked Gwen Lloyd from her nostalgic reverie just as the nurse walked in. She handed Lloyd a Styrofoam cup full of coffee. "Is he all right?" Lloyd asked.
The nurse turned off the offending alarm. "He's fine. Sometimes they go off if the patient moves or coughs."
After the nurse left, a couple minutes later, Gwen Lloyd took a few cautious steps toward her husband. She reached out and rubbed the top of his hand. It seemed like a stranger's hand, icy and discolored, not the strong hand of the President of the United States. This couldn't be Thomas Lloyd. This is all a bad dream.
Overwhelmed by the sights and sounds of the Intensive Care Unit, she felt like Alice in Wonderland.
She had fallen into a deep, dark hole, with no way out.
Chapter Twelve
Jonah Bailey spoke with a baritone eloquence any Shakespearean actor would envy. His sonorous voice resonated through the hospital like a loudspeaker. An imposing figure, with two hundred and sixty-five pounds packed on a six-foot-four frame, the African-American doctor commanded attention. As imposing a figure as he was, though, he was just as kind and easy going. His colleagues at Zurich Trauma often told him, if he ever gave up pathology, a bright future as a preacher awaited him.
"Good morning," he said to the receptionist, who blushed every time she heard him speak. Several heads turned at the desk as his voice echoed off the high glass walls.
Jonah had barely passed the receptionist when he heard someone call his name. He turned half around to see the more bantam Dr. Dave Leah running to catch up. He carried several charts under his arm.
"Morning, Jonah," Leah said, out of breath. "What's this meeting all about?"
"Damned if I know. It must be pretty important, though. They've called every doctor in the hospital about it. I'm on my way there now. You wanna join me?"
Leah pulled the charts up higher under his arm. "I have to stop and check on a patient of mine before I go, if you don't mind waiting?"
"No, I don't mind. I'll walk with you," Jonah said.
Leah nodded. "Good, I'll introduce you. He's an interesting case. Lucky he's alive, actually."
After they took the elevator to the third floor, Leah made a beeline for the nurses' station while Jonah held up the wall next to the patient's room. Leah returned with the chart a minute later. Jonah followed.
"Jack, how do you feel?" Leah said, entering the room.
Jack perked up. "Hi, doc, feeling better thanks to you."
"Jack, this is Dr. Bailey. He's making rounds with me this morning."
"Nice to meet you," Jonah said. "I understand you're a lucky man."
Jack raked his hand across his head. "I'll say."
"How do you feel?" Leah questioned. He positioned his stethoscope and had Jack take some deep breaths for him. "Your lungs sound good."
"I feel okay except for some dizziness now and then."
"That will pass," Leah said. "Meanwhile, get some sleep. You've had a long morning. I'll come back to see you later. Right now I have a meeting to go to."
"Nice to meet you," Jonah said.
Jack waved. "You, too."
Chapter Thirteen
On the first floor of Brighton Heart Center, two massive partitions were opened between adjoining conference halls, and they now served as one large briefing room. Phone lines snaked in every direction across the white tile floor, where temporary service was hastily set up. A stack of plastic and chrome chairs were taken down and assembled around a half dozen Formica tables.
The Vice President, Secretary of State, Chief of Staff, National
Security Advisor, and Denton Cogswell, sat waiting for the high level meeting to begin.
Bob Bradley and Dr. Roy Gregg walked in amid hushed babble. The lanky Gregg dwarfed the barely five-foot-six Bradley who introduced him. Gregg unbuttoned his collar and adjusted his glasses before he addressed the group.
"Gentleman, as you know, President Thomas Lloyd suffered a massive heart attack at eight-fifteen this morning. I'll be his primary physician while he is here at Brighton. His condition is such, that to try to move him will be not only detrimental, but also fruitless."
"Can't we transfer him to Walter Reed?" Chief of Staff Noel Collins blurted, obviously confused.
"He cannot be transported," Gregg said, emphatically this time. "He's much too sick, and his only chance of survival is to have a heart transplant as soon as possible."
Whispers immediately filled the room as Gregg continued, raising his voice over the noise. "Having said that, he is at the best cardiac hospital in the world, with the most sophisticated transplant system available. His chances of receiving a new heart and surviving are much greater here. The donor access program has already been activated and he'll be matched to a donor as soon as it can find one."
"How does that work?" Collins asked.
Gregg took a drink from a water bottle he pulled out of his lab coat. "A centralized computer network in Bern links all organ procurement and transplant centers twenty-four hours a day. After we put in a request for a specific organ, if it becomes available, Bern will notify us. Then we can cross reference the information to assure a perfect match. We can also take it a step further and search a list of potential donors; patients expected to die in forty- eight hours, and match those to our recipient. Right now both lists are being checked. Our window of opportunity is very small due to the President's deteriorating condition."
"I see," Collins said, "sounds gruesome."
Vice President Warren Ritter furrowed his brow and stuck his hand up.