Читать книгу Miracle Drug - Richard L. Mabry M.D. - Страница 10

Chapter 3

3

Jerry Lang spoke softly, but the state-of-the-art two-way radio picked up his voice loud and clear. “Cowboy is leaving his house now. ETA to Preston Medical Clinic is 0930.”

“Roger that.”

“Do we always have to go through that Dick Tracy wrist radio stuff?” David Madison asked from the backseat of the town car. The question was the same one he always asked, and his grin took any possible sting out of the words.

Lang turned from his position in the front seat. “Sir, you’re at liberty to cancel your Secret Service protection at any time, but if I were you, I’d speak with Mrs. Madison before doing anything that rash.”

“I know, I know,” Madison said. He coughed and cleared his throat. “But you’d think, after a couple of years out of office, I wouldn’t be worth much to any terrorist who’s out to kidnap me.”

Lang didn’t answer. He kept his eyes moving, quartering the area as the car rolled through the streets of Dallas. This assignment to guard the former President might not be as glamorous as his former post at the White House, but he was determined to carry it out to the best of his ability.

His wife—actually, his ex-wife—had told him repeatedly he had to stop making the Secret Service his life, but it was hard to do, especially after that incident at 1600 Pennsylvania Avenue. Shortly after that, he got this assignment to follow Madison into retirement. Say what you will, despite his boss’s calling it a lateral transfer, in Lang’s mind it had been a demotion. Now he was determined to prove to everyone he was still at the top of his game.

The car pulled to a stop in the circular drive of the four-story white stone building that housed the cadre of doctors—both generalists and specialists—that made up the Preston Medical Clinic. An agent hurried from the area of the front door and assisted Madison from the car.

“I think I’ll be safe in here, fellows,” Madison said as he strode through the sliding glass doors.

Lang fell in beside him. “Agent Gilmore there has already done the sweep of the clinic building. I spent the morning checking out Dr. Pearson. I’ll hang out in the waiting room while you’re in there with him. Give me a heads-up when you’re ready to leave, and I’ll have the car pulled around.”

***

Dr. Josh Pearson shrugged into a crisply starched white coat. He wasn’t sure why he’d changed before seeing this patient. After all, David Madison put on his pants one leg at a time. Maybe the difference was that the pants were part of a suit worn by a man who was the immediate past president of the United States.

Josh tapped on the exam room door before opening it. “Good morning, Mr. President.”

Madison was perched on the edge of the examining table, a faint smile on his face. He’d shed his suit coat, which hung on the back of the exam room door, a tie peeking out of one pocket. The collar of his dress shirt was open.

“I’ve reviewed your chart, so let’s get right to your present status. Last night you said some things were bothering you. I’d like to hear more about them.” Josh pulled out a rolling stool and sat. “While you’re telling me, would you please slip out of your shirt?”

Madison unbuttoned his shirt and shrugged out of it. “Let’s drop that ‘Mr. President’ stuff at the door if we can. In here, I’m David . . . or, if you prefer, Mr. Madison. Treat me like any other patient. Okay?”

Josh knew that, despite Madison’s attempts to put him at ease, he’d always be aware of this man’s status, of what he’d been, and what he’d done. But he appreciated the gesture. “I’m flattered, Mr. . . . Madison. Now, how can I help you?”

Madison coughed. “This has to stay between us.”

“Everything you tell me is in confidence. Your records are doubly encrypted, and I’m the only one with access to them.”

Madison went on to relate the scene Rachel had described to Josh the night before. “Rachel’s pretty good at hiding things, but I had a hunch she was getting sick about the time they were loading Ben Lambert’s coffin on the private jet for the return to Dallas.”

“I can tell you that Rachel related this same story to me last night. One of the other clinic doctors is examining her this morning. And, before you ask, I’m sure we can trust Dr. Neeves to be discreet.” Josh rolled his stool forward a bit. “Now let’s talk about you. After that incident, what kind of symptoms have you developed?”

“I didn’t say I had symptoms,” Madison said. He coughed again. “Well, I might have picked up a little respiratory infection while I was gone.”

“I noticed that. You have to be honest with me.”

“Even if it’s nothing serious?” Madison asked.

“Yes. Because you’re used to being invulnerable. I suspect chiefs of state, even those no longer in the limelight, feel that way.” When Madison started to speak, Josh stopped him with an upraised hand. “Don’t worry. It’s the same with doctors.”

Madison gave a wry grin. “You got me. All right. I had a raw throat a few days ago—probably two days after the incident with the native woman. A day or two later I developed a mild cough. I still have it. And I might have a bit of a fever.”

Josh nodded. “Well, let’s have a look at you.” When he’d finished, he stowed his stethoscope in the pocket of his lab coat. “I’m going to take a swab from your throat and ask our lab to culture the material and also to make a slide, stain it, and look for bacteria. I want to get a chest X-ray and some blood work. The nurse will assist you and bring you back here when you’re done.”

“What do you think?”

“It may be nothing more than a routine viral or bacterial respiratory infection, but I want to be certain.” He smiled.

“Sounds like you’re being extra thorough, but you’re the doctor,” Madison said. “I can see why Ben Lambert thought so highly of you.”

As Josh exited the exam room, he wondered if that confidence was misplaced. Was he overreacting? He hoped not. But the incident with the woman flinging liquid at Madison troubled him. It could be that she was just someone angry with the Americans who’d come to their small town. But perhaps there was more to it than that.

Meanwhile, he wanted to double-check something in Madison’s medical records. And maybe he could catch Allison Neeves and see what she thought about Rachel.

He’d asked Allison to see Rachel because, of the half-dozen internal medicine specialists at Preston Medical Clinic, she was probably the sharpest. Besides, she was female and something told Josh that Rachel might prefer a doctor of the same sex.

He and Allison had done their residency at different facilities, so much of what he knew about her he’d learned after she came to Preston Medical Clinic. Allison had always been hesitant to reveal details of her personal life, but Josh finally learned that she’d married during her first year in medical school. However, she and her husband had been divorced about the time of her graduation. Allison’s natural beauty plus her bare ring finger had quickly made her a target for most of the single doctors at the clinic as well as a couple of the married ones. She’d gently rebuffed these approaches, some more gently than others, but had never been anything but cordial to Josh.

Allison was closing the door to the exam room when Josh rounded the corner heading down the hall toward her. She ran her fingers through her short blonde hair and smiled at him. “Josh, I was going to see if I could find you, but you found me first.”

Josh nodded. “I’m concerned about Rachel.”

“I saw her a few minutes ago. Now she’s gone for some lab work and a chest film.”

“And . . .”

“My philosophy is to expect the common diagnoses but check for the worst-case scenarios, too. That’s what I’m doing here.”

A nurse, escorting an older woman, came down the hall toward them. Josh was itching to continue his conversation, but waited until they passed by and entered one of the several exam rooms that lined the hall. Then he said, “Rachel and President Madison were on the same trip to South America. I presume she told you about the incident—”

“With the woman who showered them with an unknown liquid? Yes. Ordinarily, I might not be too concerned, but when I look in her throat—”

“You see not just redness but a few tiny patches of exudate. Right?”

Allison nodded. “And she has cervical lymph nodes that are more prominent than you’d see with a run-of-the-mill pharyngitis. So I’m getting a throat culture and smear.”

Josh grimaced. “I’m doing the same thing. And while we wait, I’m going to go over the list of immunizations the group received again.”

As Josh walked away, he tried to ignore the ominous thought that kept popping up. Surely this wasn’t— No, it couldn’t be.

***

Josh sat before the computer in his office and scrolled through David Madison’s medical records until he came to the visit before the former president left for his South American trip. Madison had undergone a complete physical, even though his previous one had been only nine months earlier. That included a cardiac stress test, which he passed with flying colors. Josh pulled a notepad toward him and jotted down a reminder to recheck Ben Lambert’s cardiograms. Maybe there’d been something there that had been missed.

What about immunizations? Before the trip, Madison had received multiple immunizations, including a tetanus-

diphtheria booster and preventive shots against hepatitis A, typhoid, and yellow fever. That made what Josh was concerned about less likely, but then again, no immunization is 100 percent effective. And there was always the possibility of a rare type of infection, not covered in the routine spectrum of immunization. He’d double check that—another note to himself.

Dr. Ben Lambert hadn’t provided the ex-president with any prophylactic antibiotics at the time of that visit, but since Lambert was part of the group that would be traveling, he might have planned to give those out to everyone at the time of departure or even while on the plane. Josh would have to look into that. Rachel or Madison should be able to tell him. He scratched out another reminder.

His intercom buzzed. Josh pulled his eyes away from the screen long enough to hit the button. “Yes?”

“Doctor, Ethan Grant at the lab just called. He’s made a smear of the throat swab you took and thinks perhaps you should look at it yourself.”

“Tell him I’ll be right there,” Josh said. For reasons of security, the specimen had been sent with a code instead of a name, but he figured it wouldn’t take long for word to get around that it belonged to David Madison. Josh closed down the open medical record on his computer—he’d have to get used to the extra layers of security in place for this special patient—and headed out the door of his office.

In a few moments, he was seated before a binocular microscope in the lab with Ethan Grant, the chief lab tech in the bacteriology section, standing behind him. Grant rubbed his shaved head nervously. “I think you’ll see what I mean,” he said.

Josh focused the microscope on the glass slide prepared from a swab from David Madison’s throat. There was the usual trash: mucosal cells, white blood cells, but in among it all were dark rods. Their cell walls had absorbed the Gram stain—that is, they were Gram positive—and the organisms were elongated, with a few showing the characteristic clubbing at one end that confirmed the diagnosis Josh had feared.

“This is the best slide you have?” he asked Grant. He knew it was, but he had to ask.

“I made three, and they’re all like that.” Grant leaned closer and almost whispered. “Doctor, I know who your patient is, but don’t worry. I’ll keep it quiet. I also know that Dr. Neeves is seeing Rachel Moore this morning. We got her throat swab at almost the same time as this one came in.”

“And?”

“It shows the same thing. The morphology isn’t quite typical, but I’ve seen the real thing, and it’s my opinion that both these patients are infected with a variant of Corynebacterium.”

Josh nodded silently. The cultures would take days to grow out. Should he wait for them, or treat for something of which he wasn’t quite sure?

It had been years since Josh heard or read the information. Although he, like most doctors, never expected to see a case of this infection in their lifetime, he knew what came next. If the smear and clinical picture fit, start treatment. Better to be safe and wrong than take a chance by waiting for a confirmatory culture. Both he and Allison would need to hospitalize their patients and begin treatment for diphtheria.

***

Jerry Lang felt the familiar vibration of his cell phone. Was Madison ready for his car? No, the caller ID showed an unfamiliar number.

The agent rose from his seat in the waiting room of the Preston Medical Clinic and moved toward the door, answering as he went.

“Mr. Lang, this is Vernon Wells with Sparkman Hillcrest.”

“Beg your pardon?”

“Sparkman Hillcrest Funeral Directors.”

“Oh, yes. Sorry. At first the name didn’t click.” Lang stepped through the door and moved toward the end of the circular driveway, angling away from a middle-aged man helping an older woman out of a Lexus parked there. “How can I help you?”

“I . . . I really don’t know what’s going on, but since you’re the one that originally asked us to pick up Dr. Lambert’s body at Love Field, I thought I should call you.”

“Have the police found Dr. Lambert’s body?” Lang wished he still smoked. This would be an ideal time for one, as he stood in the sunshine doing what his job often entailed—waiting.

“No, the police haven’t called us. But we have Dr. Lambert’s body. At least, I think we do.”

“Explain that.”

“This morning I found a wrapped package on our doorstep. It was simply addressed to ‘Funeral Directors’—nothing else.”

“And—” Lang wished Wells would hurry, but evidently one of the characteristics of a funeral director was the delivery of every word slowly and carefully.

“And, given the mysterious nature of the package, we called the police.”

“Mr. Wells, can you skip to the end of this story? I’m waiting for Mr. Madison and don’t want to miss him.”

“Oh, yes, of course. Well, the police bomb squad unwrapped the package and opened the box. Inside was a plastic container containing what appeared to be cremated human remains. Taped to it was a card with one computer-printed word: ‘Sorry.’ There was also a small plastic bag with a watch, a wedding ring, and a wallet.”

Lang knew where this was going, and he didn’t like it. “So—”

“We have . . . that is, I think Dr. Lambert’s body has been cremated and delivered to us.”

“Thank you, Mr. Wells. Hang on to the material, and keep this information to yourself. I’ll get back to you.” Lang ended the call and headed back toward the waiting room, but before he could get the instrument into his pocket, it vibrated once more. Was this a call from the police, asking how to proceed with the disappearing/reappearing body of Madison’s personal physician?

No, caller ID indicated this was from Josh Pearson. “Yes, doctor?”

“I’m afraid I have some bad news about Mr. Madison.”

Lang listened for a full minute, his mind racing to assimilate the meaning of this latest development. All thoughts of the hunt for Dr. Lambert’s body were pushed aside. Now Lang and his colleagues had a new challenge. Then again, that’s what his job was about, wasn’t it? Meeting challenges.