be in two places at one time.
Then there were his other patients. Despite Nadeel Kahn’s assurances to him that his patients would be covered, Josh couldn’t shake the obligation he felt toward them. “Just take care of President Madison,” was what Kahn said. What he really meant, of course, was “Give your best efforts to caring for the ex-president. The publicity will be good for Preston Medical Clinic.”
Josh looked at his watch: a bit after four in the afternoon. Lang had suggested he wait to call the CDC duty officer back until the agent could run the situation by Karen Marks and discuss whether to invoke Madison’s name. It seemed Karen was the “get it done” person on the ex-president’s staff. Well, Josh hoped—
His thoughts were interrupted by a brisk knock at his closed door. Josh brought his swivel chair upright and planted his feet squarely on the floor. He shrugged to ease the fit of his white coat—it had never seemed so uncomfortable—and took a deep breath. What now? “Come in,” he called.
The woman who entered was striking, to say the least. Josh’s gaze was immediately drawn to sparkling blue-green eyes accented by a just a hint of mascara. Her pale blonde hair fell to her shoulders in soft waves, framing a beautiful face. A faint amount of make-up was applied to porcelain-like skin.
At first glance, Josh decided she could have been a model or a movie star. But when he looked more closely, he saw something more. There was ice in the sparkling eyes. Her features were exquisite but displayed no emotion. Josh sensed she would be a dangerous enemy.
She stepped forward and extended her hand. “Dr. Pearson? I’m Karen Marks. Nice to meet you.”
Josh took the proffered hand. At first, he wondered if he was supposed to shake it or kiss it. He settled on the former, and she gave him what he decided was a politician’s handshake—grasp the other person’s hand as far in as possible, to avoid getting your own hand crushed; one quick squeeze, neither too strong nor too gentle; then release.
He figured that Karen Marks was probably slightly on the far side of forty, but she could easily be mistaken for thirty—that is, until you looked into her eyes. Within them he could see experience and something more. He wasn’t sure what else he saw, but it told him he didn’t want to challenge this woman.
“Please, sit down,” Josh said, indicating one of the two side chairs opposite his desk.
She smoothed the skirt of her perfectly tailored navy business suit and lowered herself with ease. “Jerry Lang explained you needed some . . . what did he call it? Oh, yes. Diphtheria antitoxin. DAT, I think he said. Anyway, I’ve talked with the CDC. Your antitoxin is in Houston. I arranged for Agent Gilmore to fly down, pick it up, and deliver it here.” She reached into her handbag and extracted a sheaf of papers. “I had these faxed here. After you’ve signed them, give them to Jerry or me and we’ll see they’re faxed back. The last two pages are instructions for administering the DAT.”
Josh had that feeling again, the same one he had in the limo when he first met David Madison. Things were going too fast for him. On the one hand, he thought he needed to regain control of the situation. On the other, he appreciated this newfound ability to simply say, “I need something” and it was done. No question, this was a different world.
“Thank you,” Josh said. “Did you have to use President Madison’s name?”
“I used his influence, but there was never any suggestion that the drug was for him,” Marks replied. “You’ll learn how to do that, too.”
Yes, and probably to lie and cheat a bit if I’m not careful. “Look, I’m happy that you got the DAT for President Madison and Miss Moore, but let me be clear. All I want to do is practice the best medicine possible. If there’s any political maneuvering to be done, I want to know about it ahead of time.”
Marks gave him a sweet smile that was totally devoid of mirth. She rose, smoothed her skirt, and picked up her purse. “I think you’re telling me to stand aside. Well, I promise I won’t challenge your medical judgment or interfere with your treatment. But I guess I should warn you, if you haven’t already got the message. I’ll do anything for David Madison.” At the door, she turned and said over her shoulder. “Anything!”
***
Josh found Allison Neeves in her office at the clinic. She was working her way through a pile of charts, dictating from a stack of notes scattered across her desk. Allison looked up when Josh tapped on the frame of the open door.
“Come in,” Allison said. “I checked on Rachel and she seems to be holding her own. But if we’re going on a presumptive diagnosis of diphtheria, we need to get her started on some diphtheria antitoxin.” She put down the chart she was holding. “And the same for President Madison, of course.”
Josh dropped into a chair across the desk from Allison. “Look,” he said, “this could get awkward, and I don’t want it to be. I’m Madison’s doctor. I didn’t lobby for the position, but I’ve got it. You know that he and Rachel probably have the same infection. I’d like to treat her too, but I agree that would present something of an ethical problem. However, you and I need to stay on the same page. Can we do that?”
“I think what you’re saying is that you’d like to call the shots for both patients, with me acting like your intern on Rachel’s case—writing the orders, reporting to you.” She leaned back in her chair and sighed. “I’ll try to cooperate, but you should realize that Rachel is my patient, not yours, and I have to make the final decisions about her treatment.”
Josh rose. “I don’t think we need to argue right now. That DAT should arrive—” He looked at his watch. “It should be at the hospital in a couple of hours. Is it okay if I write the orders for both patients to receive it?”
Allison shook her head. “Just call me when it comes in. I’ve already reviewed the protocol. I’ll check Rachel and write the orders for her; you take care of Madison.”
“If that’s the way you want it,” Josh said. He rose, turned, and headed for the door. I don’t know what I did to step on her toes, but I can’t worry about that. I’ve got to give David Madison the best possible care. And Rachel, of course.
***
“Mr. Madison,” Josh said as he entered the ex-president’s hospital room. “How are you feeling?”
“Not great,” Madison admitted. “My throat’s getting pretty sore.”
Josh noted a raspiness in his patient’s voice—something that hadn’t been there before. “Any difficulty breathing?” he asked.
“Not . . . well, maybe occasionally.”
“Okay. The diphtheria antitoxin has arrived, but before we give it to you, I have to ask you some questions, then do a skin test.” Seeing the confusion in Madison’s eyes, Josh said, “The DAT is made from horse serum, so I have to be certain you won’t have a reaction to it.”
Josh went through the litany, using the checklist he’d made so he wouldn’t forget anything. Hay fever? No. Asthma? No. Hives? No. Madison couldn’t recall previously receiving any products made from horse serum.
The skin tests were negative, as Josh expected. Now it was time. A nurse brought in a small bag of sterile saline and Josh added DAT to it. He attached a needle to the tubing and piggy-backed the mixture into the IV already in Madison’s hand, then started
