The President's Doctor

by David Shobin

  The sturdy Suburban had survived the crash well. The impact was forward of the passenger compartment, and although the front end was caved in, the occupants appeared to have escaped severe injury. The airbags had deployed, leaving them shaken. Townsend continued toward the sedan.

  The small car was crushed like a pack of cigarettes. The buckled frame had collapsed on itself, front to back. The mangled destruction was so complete that Townsend was amazed anyone had survived. But as he reached the car, he could clearly see the driver through the void of the former windshield. Unlike his passenger, the olive-skinned driver had been wearing his seatbelt. He was conscious, gazing ahead through dull, dazed eyes. He didn’t seem able to move. The remnants of the dashboard were snugged-up about him like a mangled vest. The steering column protruded over his right shoulder, barely missing his chest. The steering wheel itself had broken into several ragged shards.

  As Townsend approached, his eyes took everything in. Caucasian, late twenties, in shock. The victim was very pale, and his lower jaw sagged. His breathing was shallow.

  “Take it easy, pal,” Townsend softly reassured. “Help’s on the way. What bothers you most?”

  The driver didn’t answer. Townsend couldn’t tell if the man heard him or not. The car had the pungent, metallic odor of spilt blood. He reached through the windshield-that-wasn’t and felt for the man’s carotid pulse. It was very rapid, very weak. It occurred to Townsend that the shock might be of the hemorrhagic variety. The man’s head bobbed.

  “Don’t go out on me, man. Can you hear me?”

  The driver’s bloodless lips pursed. “Can’t…my legs,” he managed, in heavily accented English.

  “Can’t what? Can’t feel ’em, can’t move ’em?”

  “Can’t.”

  The man’s legs were trapped, pinned under the buckled dashboard. His shock might be explained by the fact that his legs were crushed. Alternatively, if the driver couldn’t move them, it could be because of the way they were held down. But if he couldn’t feel them, there might be a spinal cord injury. Another vehicle pulled up and illuminated the sedan. And then, in the headlights’ glare, Townsend noticed the spurting blood.

  It was a steady crimson jet that shot sideways in a gentle arc. Backlit by the headlamps, a fine steam wafted upward from the spray, curling ghostlike toward the roof. The blood squirted like dark oil, splattering the passenger seat. At first, Townsend couldn’t tell where it was coming from; but as he peered closer, he found its source in the man’s upper arm.

  One of the steering wheel’s sharp edges had lacerated the biceps. The torn belly of the muscle bared the humerus, and the bone glistened with an otherworldly whiteness. Above it, a severed branch of the brachial artery pumped blood toward oblivion.

  “Need a hand?” said the driver of the car that had pulled up.

  “He needs an ambulance,” Townsend replied, quickly removing his belt. “Do you know if anyone called for help?”

  “I did, and I think other people did, too.” He looked into the wreck. “Jesus, this looks like a butcher shop. Can we get him out of there?”

  “Not yet.” Townsend reached through and wrapped his belt around the driver’s upper arm. When he cinched it tight, the bleeding immediately ceased.

  “I hope you know what you’re doing.”

  “I’m a doctor. I can’t tell if he has a neck or back injury, so unless you see something else that needs fixing, we’d better let the paramedics move him. It looks like they’ll need the Jaws of Life anyway.”

  “You’re the boss, Doc—oh, boy, there he goes.”

  Townsend saw the driver’s chin sag to his chest. “No sir, can’t have you doing that!” he shouted. The man didn’t stir. Townsend slapped his cheeks, and when that failed, he pinched the skin on the side of the man’s neck. The driver didn’t stir.

  Townsend again felt for the carotid pulse, which was still present. But when he put his hand under the man’s mouth and nose, he felt no respirations.

  “Wonderful, he just stopped breathing,” he said to no one in particular. He immediately jumped onto what was left of the hood and wormed his way through the windshield opening. Half on his side, he carefully tilted back the patient’s head. Squeezing the man’s nostrils with his fingertips, Townsend placed his mouth over the victim’s and began artificial respiration. But it was soon apparent that the driver’s lungs wouldn’t expand.

  “Christ, he’s obstructed,” Townsend said, backing off. “Quick, see if anyone’s got a penknife. A flashlight would help, too.”

  His assistant backed off and spoke rapid fire to the small but growing crowd. In the distance came the first, faint wail of a siren. Keeping the man’s head back, Townsend explored the man’s neck, touching, probing. Soon a light shined on the driver’s anatomy, and Townsend located the crucial depression beneath the thyroid cartilage. Someone passed him a knife, handle first. Townsend steadied its point on a spot on the skin and then deftly pierced the cricothyroid membrane. The victim’s chest heaved, and there was a whistling sound as air rushed through the newly created opening.

  “I need a pen,” he said, “the fatter the better.” Within seconds, he inserted a fat ballpoint through the incision to keep its edges open. Satisfied, he wriggled out of the wreck just as the ambulance pulled up.

  The paramedics rushed over and brushed Townsend aside.

  “Outa the way, folks, let us in. We’re the good guys.”

  “This good guy’s a doctor,” someone called, “and he just saved that man’s life.”

  There is an unspoken pecking order in emergency healthcare, and no matter how skilled the EMS personnel, they give deference to physicians. “Sorry, Doc,” said the lead paramedic. “What can you tell us?”

  “Something’s obstructing his airway,” said Dr. Townsend, of an object that later proved to be a large was of chewing gum. “You’ve got a Nu-Trake, right?” he said, referring to a temporary tracheotomy tube that would go through the incision.

  “You bet.” The paramedic motioned for his assistant to get it.

  “He’s also in shock, probably hypovolemic. There’s a lacerated brachial artery, and he needs volume fast. His passenger’s across the street, dead. The people in the Suburban are probably just shaken up.”

  “Okay, Doc. We’ll take it from here.”

  Soon three ambulance crews were on site attending to the victims. When Townsend returned to his car, he realized he was shaking. His white Naval uniform was bloodstained and smudged with grease. There was no way he could go to his daughter’s play like that; he’d embarrass her if he tried. But if he hurried home and changed, he might be able to catch the tail end of the event.

  Failing that, there was one other place he just might visit.

  CHAPTER 5

  The White House

  He was late.

  In fact, fifty-year-old Jon Townsend, M.D., wasn’t even supposed to be there. When the invitations to the White House dinner had been mailed four weeks ago, he’d declined because his daughter’s play posed a scheduling conflict. But then his schedule was unexpectedly freed up. Although he couldn’t arrive at the start of festivities, Jon might get there in time for the main meal. Ever since the White House got a new chef, Townsend never missed an opportunity to dine. As the president’s personal physician, he was a frequent White House visitor, and he could show up virtually whenever he wanted.

  Having changed from his soiled whites, he was still adjusting the tie to his dress blue uniform when he drove through the Northwest Gate. His hands still shook slightly. Although his heart rate had slowed, he felt emotionally drained from the recent accident. The guard waved him past, and he headed for his reserved space in the back. Although he was known to the Secret Service, he still had to pass through a metal detector and be officially checked in before he could gain entrance to the mansion proper.

  Once inside, he made his way through the Cross Hall and past The Parlors to the State Dining Room. He paused at the doorway, takin
g in the scene. Tonight, the president and first lady were hosting the Israeli Prime Minister at a formal dinner. The room’s one-hundred-thirty-person capacity was limited to a modest seventy invitees, all of whom were seated, looking at the dais. The president stood before the famous George Healy portrait of Abraham Lincoln as he finished his prepared remarks.

  Townsend always considered it a pleasure to be an official White House guest. Though it was the First Family’s abode, it was still the people’s house, with an ongoing, pervasive sense of history. Yet despite its being owned by the common man, it had a sense of majesty most exquisite in its artwork and ornate furnishings. On the mantle above the dining room’s central fireplace was the John Adams quotation that Townsend found inspiring: “I Pray Heaven Bestow the Best of Blessings on This House and All that shall hereafter inhabit it. May none but the Honest and Wise Men ever rule under this Roof.” Noble words, he thought.

  He watched the president receive polite applause and return to the head table. The staggered seating included the president’s wife Roxanne, the Prime Minister and his wife, and the vice president’s wife, Amanda, with whom Roxanne was animatedly talking. Jon had known the president for several decades. President Robert Meredith had aged well.

  At sixty-five, he was still vigorous and trim. His white hair, combed straight back, remained long and full. A charismatic speaker, most people considered Meredith an attractive man in the prime of adult life. When he took his seat, the first course was served.

  Still in the doorway, Townsend searched for a place at one of the tables. Although attendance at state dinners was a high honor, there were invariably a handful of no-shows. Tonight, however, he couldn’t spot any available seats. He’d have to wait for the dinner staff to find him a place. Standing on his right was a uniformed official of the National Park Service. Nominally in charge of the park that comprised White House grounds, Park Service employees were rarely seen at official functions, and Townsend didn’t recognize this one. On his left, however, was a female Secret Service agent he’d known for several years. He whispered what was on his mind, and she called over one of the staff. Moments later, he was shown to a place hidden from view.

  The guests on either side of him had already begun to eat. Their appetizer was some sort of dumpling in a green herb sauce—very colorful, very appealing. The guest on his left was Mitchell Forbes, the president’s chief of staff. He didn’t recognize the woman on his right. Townsend clasped Forbes on the shoulder and held out his hand.

  “Hello, Mitch. What’d I miss so far?”

  Forbes looked up, wiped his mouth with his napkin, and shook hands. “Hi, Jon. I didn’t know you were coming tonight. Everything okay? You look a little pale.”

  “I’m fine. I wasn’t going to come, but I finished up early,” he said simply. He didn’t want to talk about the crash or about missing his daughter’s play. “I like to be here whenever this chef’s working.”

  “She’s something, isn’t she? I don’t think you missed much. The president was waxing poetic on the long years of American-Israeli friendship.”

  “Ah,” said Townsend, leaning closer. “I think I heard that one already.” He turned to his right and smiled. “Hi, my name’s Jon Townsend. I see you saved me a seat.”

  “Yael Meyer,” she said with a pinched expression. “I’m the Prime Minister’s press secretary. Actually, that seat wasn’t for you, General—”

  The smile never left his face. “Admiral.”

  “Yes, of course. My husband was supposed to sit there, but he’s ill.”

  “He’s missing a great meal,” Townsend said, studying the woman. She was fortyish and moderately attractive, but severe-looking, with a sabra’s humorless intensity. Her voice had only a trace of Israeli accent, more Netanyahu than Barak. “I hope it’s nothing serious.”

  “His asthma acts up in weather this humid. We live in Jerusalem, where it’s always dry. Are you in the administration?”

  “I’m the president’s doctor. I can usually weasel my way into a state dinner if it’s not too crowded.”

  “And here I’d taken you for a military man. So, you’re not going to command the ship that brings your troops to Israel?”

  “No, ma’am, I’m not.”

  “And what do you think of the president’s proposal, in general?”

  The proposal she referred to was Bob Meredith’s suggested way out of the Syrian-Israeli logjam. After the framework of an Israeli-Palestinian peace was erected, the last regional obstacle was Syria. The president modernized the old idea of sending American troops to the Golan Heights as a way of finalizing peace in the area. Not surprisingly, right-wing militant Arab groups like Hamas and Hezbollah strongly opposed the suggestion, as did some Americans. Tonight’s dinner was a way of showing unified support for the proposal.

  “Frankly, Mrs. Meyer, politics are not my strong suit. I’d rather talk about the food. How are the dumplings?”

  “You’re more of a diplomat than you admit, Doctor. The ‘dumplings’ are actually salmon and mango ravioli, and they are superb. Kosher, too, I’m told.”

  As she resumed eating, Townsend turned back to Forbes. “How’s the old man doing tonight?”

  “Pretty damn good. Relaxed and funny. The Israelis are enjoying it. Well, most of them, anyway.”

  One of the servers brought his appetizer, and Townsend quickly ate a bite-size piece. It was astonishingly good, with a rich flavor that made him want to close his eyes and sigh. The flavors were textured, and he could taste the sweetness of coconut, the tartness of lemongrass, and, in the background, the hearty fullness of basil. Heaven had descended upon the dinner table.

  There was a sudden commotion from the direction of the dais. It began as intense murmuring, increased to shrilly-raised voices, and was soon punctuated by a scream. Startled, Townsend listened for a moment. He suspected there was another emergency, and he worried that he might be expected to perform feats of medical magic once again—here, on stage, in front of an international audience. His eyes widened and his heart began to pound, nearly paralyzing him with fear. All heads turned in the direction of the excitement, and most expressions had the uncertain, momentary paralysis that accompanies confusion. It was the alert, wide-eyed look of startled deer. But as the others stared, Townsend suddenly got hold of himself. He leapt from his seat, galvanized into action, running toward the source of the noise.

  Bob Meredith had risen from his seat, leaning slightly forward, hunched over at the waist. His mouth was slightly open, and although he didn’t make a sound, he appeared to be struggling. His open hand trembled claw-like at his neck. The expression on his face mixed panic with terror, and his color was fast going from pale to gray. He was clearly in dire straits.

  The first lady remained in her seat, both her fluttering hands about her mouth as she helplessly, repeatedly mumbled, “Oh my God.” Two Secret Service agents came up behind the stricken president. While one scanned the room for danger, the other took Meredith under the armpits and was trying to lower him to the floor.

  Townsend knew many of the agents, but he’d never met these two. They both wore necklace IDs. The name of the African-American agent nearest Townsend began with capital letter L, but before he could decipher it, he heard people whisper, “CPR.” He was aghast. His trained mind quickly processed the visible clues: the patient was conscious, had obvious anxiety, couldn’t talk, and was struggling to breathe. He’d been stricken in the middle of a meal. Much as those around him wanted to help, CPR was the last thing they should try. Dr. Henry Heimlich had described what to do years before.

  “Oxygen!” he shouted. Emergency medical equipment was strategically placed throughout the White House, and Townsend knew one such location was just beyond the dining room. “Get that oxygen out here!”

  Seeing someone race toward the president, a third agent materialized and was moving in to intercept. But the second agent raised an arm to stop him.

  “Let him go, that’s Dr. Town
send.”

  By now the other Secret Service man had lowered the president to a sitting position. Meredith’s eyes were starting to glaze over.

  “Let me in, he’s choking!” Townsend shouted.

  The president was dead weight. As Meredith’s eyes started to close, Townsend pulled him up by one arm while the agent lifted by the other. Once the president was up and leaning toward the dinner table, Townsend went behind him and circled the president’s midsection. Meredith was heavy, and he slumped forward in Townsend’s grasp. Townsend quickly clenched his right fist and placed it midway between the president’s umbilicus and lower sternum. Then, grasping the fist with his left hand, he delivered a sharp upward thrust to Meredith’s abdomen.

  While this was happening, the president sensed everything from afar, in a daze. He was in a nether state—not quite unconscious, but not awake, either. He didn’t realize the sensation came from oxygen deprivation; the only thing he was aware of was someone’s arms hugging him from behind. There was something familiar about those arms, something reassuring. They were the same arms that had held him thirty years before, on a bloody morning on a hillside thousands of miles away. He felt safe.

  With Townsend’s forceful thrust, a large piece of food was dislodged from the president’s throat onto the table. The moment it did, Meredith audibly gasped. His color quickly became pink. As he hungrily sucked in air, his strength began to return. He leaned forward onto the table, wheezing, resting on his palms. His eyes moistened with tears of exertion.

  Too frightened to speak, the first lady, still shaken, got up and took her husband’s arm. All she could do was hold on.