Michael Palmer - The First Patient

First and always, thanks to Jennifer Enderlin, my extraordinary, brilliant, compassionate, and hard-working editor at St. Martin 's Press. You are and always will be my kind of bookkeeper.

Jane Berkey and Meg Ruley of the Jane Rotrosen Agency are everything literary agents should be and more.

Talented singer, musician, novelist, computer wizard, songwriter Daniel James Palmer is responsible for lots of good and helpful things surrounding this book, including Alison's blues.

In addition:

Dr. David Grass shared his strength and vast neurological knowledge.

Remarkably talented artist and children's book author Dara Golden shared her considerable understanding and love of horses.

Robin Broady read and read and read some more.

Chef Bill Collins ( www.chefbill.com) reasoned out problems with me while putting together one award-winning meal after another.

Bless you, Sally Richardson, Matthew Shear, and Matthew Baldacci at St. Martin 's.

Attorney Bill Crowe taught me how to shoot straight, Jay Esposito taught me how to buy a used car, and Dr. Ruth Solomon gave me veterinary advice.

Thanks to the staff at the White House Medical Unit for your hospitality, and to the Big Book for always having the right answers.

And finally, thanks to Luke for suggesting nanotechnology when I told him I was stuck.

Anyone I overlooked, I promise to get you next time.

The rotors of Marine One slowed, then stopped. Dust clouds billowed into the still air. Minutes later, a second, identical helicopter landed twenty yards away. A short staircase lowered to the parched ground. A Marine sergeant in formal dress left the shelter of the first chopper and took a position at attention at the base of the staircase. The door of the chunky Sikorsky Sea King swung open.

And with no more fanfare than that, the most powerful man on Earth, his ubiquitous, well-publicized dog at heel, stepped out into the warm Wyoming evening.

Fifty feet away, still in the saddle, Gabe Singleton calmed his horse with a few pats behind the ear. The mid-morning appearance of a Secret Service agent at the Ambrose Regional Medical Center had given Gabe warning that the presidential drop-in was going to take place, but the man hadn't been specific about the time and, following an exhausting all-nighter caring for two patients in the ICU, even a visitor of this magnitude couldn't keep Gabe from his customary ride out into the desert and back.

"Hey, cowboy," President Andrew Stoddard called out, descending the stairs and sincerely saluting the lone Marine as he passed, "whattaya say?"

"I say you and your choppers scared the crap out of this world-weary old nag… Frightened my horse, too."

The two men shook hands, then embraced. Stoddard, who Gabe felt looked presidential even when they were first-year roommates at the Naval Academy, showed the stress of three and a half years in office. Silver highlighted his razor-cut dark brown hair, and deep crow's-feet had appeared at the corners of his iridescent blue eyes. Still, he was every bit the man in charge-the decorated Desert Storm pilot and former governor of North Carolina, whose star had been on the ascendancy since the day he took his first privileged breath.

"One of the downsides of the job," Stoddard said, gesturing toward his entourage. "Twin helicopters so that any whacko who decides to take a bazooka shot at one of them has only a fifty-fifty chance of blowing me away, Secret Service studs checking out every inch that's gonna be stepped on by these size elevens and every toilet seat that's gonna be graced by these presidential cheeks, plus a medical team trained to know that it's not if something terrible happens to their boss, it's when ."

"If you're looking to make a job change, I could use a wrangler on my ranch."

"How many do you have working for you now?" Stoddard asked, glancing about.

"You would be the first. I'm afraid our benefits package is a little thin, too, starting with that you'd have to pay me to work here."

"Hey, put me on the list. I don't know if you follow the polls or not, but I haven't got a hell of a lot of job security at the moment. Got some time to talk with an old pal?"

"If you'll let me put my other old pal Condor, here, in the stables."

"Fine-looking horse."

"And that's a fine-looking pooch. Liberty, right?" Gabe patted the dog's rock-solid flank.

"Good memory," Stoddard said. "Liberty's making quite a name for himself, tagging along with me and changing people's misperceptions about pit bulls, just like we're changing people's misconceptions about America. I've had dogs all my life, Gabe, but Liberty, here, is the best. Strong as a tiger, wise as an owl, and as gentle and dependable as that horse of yours."

"Maybe you should have named him Simile."

The president laughed out loud. "I love it. This here's my trusty dog, Simile. He's tough as a Tennessee hickory nut, but gentle as baby powder. Carol will think that's very funny, too, especially since, unlike her husband, she's actually likely to know the difference between a simile and a metaphor. Hey, Griz."

A thick-necked, barrel-chested, balding Secret Service man wearing the obligatory black suit and reflective shades seemed to materialize from nowhere.

"You rang?"

"Griz, this is my old college roomie Gabe Singleton. Doctor Gabe Singleton. It's been five years or so since we last saw one another, but it seems like yesterday. Gabe, this here's Treat Griswold, my number-one protector and probably the number-two man in the whole Secret Service. Obsessive to a fault. Swears he's telling the truth when he says he'll take that proverbial bullet for me, but with that crooked smile and those beady little eyes of his, I just don't believe him."

"In that case, sir, you'll just have to wait and see," Griswold said, stopping just short of pulverizing the bones in Gabe's hand at the same time. "I'll be happy to get Condor settled in, Doctor. I used to muck out stables and ride warm-ups when I was a kid."

Gabe liked the Secret Service agent immediately.

"In that case you've come a long way," he said, handing over the reins. "Tack room's in the barn. Maybe we can go for a ride sometime."

"Maybe we can, sir," Griswold said. "Come on, Liberty, let's put this big ol' fellow to bed."

Stoddard took Gabe by the arm and led him to the back door. The house, seven rustic rooms that still had the feel of the cabin it was before some additions, was Gabe's cut from the end of his five-year marriage to Cynthia Townes, a bright, vivacious nurse from the hospital who loved him to pieces from day one to day last. Her mistake.

Cinnie's last words to him before she handed over her keys and took off for a teaching job in Cheyenne were to beg him to finish dealing with his past before he made any further attempts to build a future with anyone. For seven more years he had taken her at her word, and so had carefully avoided another in-depth connection. He might be done dealing with his past, but he had serious doubt it was ever going to be done dealing with him.

"Sorry I haven't gotten out here for so long," Stoddard said. "I used to really enjoy the evening rides and our fishing trips up into those mountains."