Michael Palmer: The First Patient

Gabe desperately needed to speak with both Carol Stoddard and Magnus Lattimore, but there was no way at this point that he would leave his patient to do so. Lattimore saved him the anguish.

"Whatever you need to say to us, Doctor, you can say before the president."

There was no panic in his voice and little, if any, anxiety. Gabe wondered if Lattimore's odd demeanor was at least in part due to the fact that Drew Stoddard now appeared to be rapidly improving. Lattimore moved over to where Carol Stoddard stood, stroking her husband's hand. Her expression was odd-more one of annoyance, perhaps, than concern.

"Okay," Gabe said, "it's your call." He calmed himself with a deep breath and slow exhale. "To begin with, it looks like whatever is going on here is beginning to resolve. Drew's life doesn't appear to be in immediate danger. But we all know that for the last hour or so, he has not been in control of his faculties. The implications of that are obvious."

"Go on," Lattimore said, his expression unchanged.

To Gabe's left, the president had sunk down on his bed, eyes closed. His breathing was still somewhat rapid and shallow. The redness had drained from his face, which now looked drawn, pale, and utterly spent. Concerned, Gabe checked Drew's pulse and blood pressure once more.

"Fairly normal," Gabe said, shaking his head in bewilderment. "Give me a minute to draw a few tubes of blood."

"What for?" Lattimore asked.

"I'm not sure yet, but it's better to have them and not need them than to realize tomorrow I should have gotten them."

"Do you need to put them on ice?" Carol asked calmly.

"I don't think so. I'll refrigerate them in the clinic until I'm ready to send them off."

"You won't put his name on them, will you?"

"No, I promise. I'll identify them some other way."

"Honey," the First Lady said gently, her lips brushing her husband's ear, "Gabe's going to draw some blood. Is that okay?"

"Go for it," Stoddard managed, through lips that were stiff and dry.

Gabe drew three vials of blood and set them in his bag. The president barely reacted to the procedure.

"Well, there's still an impressive collection of diagnostic possibilities," Gabe said when he was done. "Some sort of atypical seizure or even unusual migraine is on the list along with a small hemorrhage in some strategic area of his brain, or a tumor-possibly one in a part of his body away from the brain that is secreting some sort of hormone or other psychoactive chemical. There are a number of possible organs in this regard. He certainly seems toxic, but unless he has some pills hidden away that we don't know about, I don't have an explanation for how that toxicity could have happened. Then there's the diagnosis that is at or near to top of the list at this point."

"Namely?" Lattimore asked.

"Namely, that the stress of the job and the reelection campaign has pushed his emotional and mental faculties past the breaking point."

"You have no idea the hours he puts in," Carol said.

"Well, it's not a physician's job to guess. So, at the moment, the field of possibilities is wide open, and we've got to get him to the hospital for an MRI and some other tests. At this moment I am quite concerned about a tumor or a small hemorrhage."

"It's not a tumor," Lattimore said. "And it's not a hemorrhage."

"How could you possibly know that?"

"Because," the chief of staff said, meeting Gabe's gaze intently, "the president's already been recently checked for those by Dr. Ferendelli. He's run every test in the book."

"I don't understand."

"Gabe," Carol said evenly, still massaging her husband's hand, "this isn't the first episode like this that Drew has had… It's at least the fourth."

Incredulous , Gabe stared across the bed at Carol Stoddard and Magnus Lattimore.

"I can't believe this," he said, barely maintaining control. "How many episodes?"

"Four," Carol said. "All within the last three months. Jim Ferendelli was actually with us when the first attack occurred. It was right here in the residence. He was up here for dinner. All of a sudden Drew began shaking his head as if he were trying to clear something out of it. It turns out he was hearing voices."

"I just can't believe this," Gabe said again, making no attempt to lower his voice. "How in the hell could Drew come all the way out to Wyoming to ask me to take over as his doctor and manage not to tell me about this? And you two. Carol, we've known each other for years. Magnus, you had plenty of chances to talk to me before I flew out here. Who in the hell do you think this man is-an organ-grinder? How can you ask me to uproot my life and come here to take care of him and then withhold information like this?"

"Gabe, please," Carol replied. "I understand why you're upset. We debated how and when to tell you what had been happening, but with all the tests coming out negative, and no attacks for a few weeks, Drew thought we'd be better off hoping the whole matter was a thing of the past. He really needed you, Gabe. Then and now."

"So that's why he lied to me? That's why you lied to me? Because you all needed me?"

Gabe glanced down to see the president's reaction, but Andrew Stoddard, eyes closed, was lying motionless, breathing coarsely, and had clearly not heard a word. Reflexively, Gabe reached down and checked his pulse. One hundred and regular.

Then suddenly Gabe found himself reflecting upon the meeting with Drew in Wyoming. There was time then, plenty of time, for Gabe to tell his longtime friend about the self-prescribing he had been doing-about the pain pills and the antidepressants. He hadn't said anything to the president for the same reason he had never said anything to his former AA sponsor-the same reason he had gradually cut back on his meetings until he stopped going altogether. He was ashamed-not frightened, not worried he was heading for an alcohol relapse like so many warned at the meetings-just ashamed of his weakness and maybe of his foolhardiness and denial as well.

Whatever the reason, he had lied by omission just as Carol and Latti-more had been lying since his arrival in D.C. Just as Drew had done back in Tyler. Different stripes, same zebras.

"The episodes haven't all been the same," Carol said, maintaining her composure against Gabe's onslaught. "The second one happened at a press conference. Jim was there, and so was Magnus. The moment Drew's color changed and his speech became disjointed, they got him off the stage. The whole thing didn't last half an hour. There were more audio and visual hallucinations than there were today, but no rocking. That was when Jim had him brought to the presidential suite at Bethesda Naval. After all the tests were negative, including an evaluation by a team of neurologists, the diagnosis was made of atypical migraine. I'm surprised you didn't read about the whole thing in the papers or else hear about it on TV."

Gabe's smile was mirthless.

"I don't own a TV that works with any reliability, and the only newspaper I ever read is the Tyler Times . Life has been much easier that way."

"I guess that's why you never asked us about the atypical migraines," Lattimore said.

"I guess," Gabe replied acidly. "Drew mentioned something about migraines when he was in Tyler. Listen, you two, I don't know what's going on with him, but I do know this man is in no position to function as the President of the United States. We've got to do something, and quickly. I haven't had the chance to study up on the Twenty-fifth Amendment, but I would imagine a call downstairs to the vice president is in order."

"Wait," Lattimore said sharply. "Please, Gabe, just wait… and listen… Please?"

Gabe flashed on the desert behind his ranch. The sun would be setting just about now. The perfect time for a ride.