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.
Chapter 4
4
I can’t be in the hospital,” David Madison said. Although he was clad in a skimpy exam gown and sitting in a treatment room on the edge of an examining table, the man still managed to exude both authority and dignity. “I don’t feel that sick. Can’t you just put me on some medications and look in on me every day or two?”
Josh had known this might be coming. Now here it was, on his first day as physician to a former president. “Mr. President.” Seeing Madison’s lips open, he started again. “Mr. Madison, you’ve been in charge of the most powerful nation on earth. You’ve had to make decisions that involved millions of people. And most of us feel you made the right ones. But here, in this situation, in this circumstance, you’ve put your trust in me, effectively saying I’m the person most qualified to make decisions involving your health. Well, my decision is that you should be hospitalized.”
“So what’s the treatment?” Madison asked. “IV antibiotics?”
“Actually, there are a couple of antibiotics, penicillin and erythromycin, that are effective against diphtheria. Either can be given by injection or by mouth.”
“Then why can’t you give me some pills and send me home?”
“We’ll give you an antibiotic, but the treatment of choice is antitoxin, and there’s not a lot of it around. I have to locate some and start you on it.” And Rachel . . . I can’t forget Rachel. “And we need to watch you carefully.”
“Why?”
Josh studied Madison’s face, but the man seemed calm enough. Then again, what would you expect from a former president? Crisis? Deal with it. Okay, here comes the rest of the story. “The main reason to keep you in the hospital is that we need to be ready to do emergency surgery to open your windpipe if we can’t halt the progress of the disease. You could die of airway obstruction.”
Madison was silent, but Josh could tell he’d succeeded in shaking the man. When the ex-president spoke again, it was in a softer voice. “Okay. You’re the doctor. Call the CDC or whoever you need to and get the ball rolling to locate some antitoxin.” Madison was moving ahead, once more the man in charge. “And you’d better call Jerry Lang and make him a part of the planning. At hospitals like Bethesda where they take care of presidents and high-profile patients every day, they’re set up for this kind of stuff. I’m not sure you know what you’re letting yourself in for.”
I have an idea . . . and it won’t be any picnic . . . especially if the response to treatment doesn’t go well.
***
Allison Neeves wasn’t certain whether her job was easier or harder than the one Josh Pearson faced. It was never easy to give a patient the news that they had a serious illness and would have to be hospitalized. But what if the patient was in the health care field? What if they could read between the lines and imagine the worst?
Before she could tap on the exam room door, Allison was brought up short by Josh’s voice behind her. “Allison, hang on a moment.”
She watched Josh hurry down the hall. When he reached her, she said, “I was about to give Rachel the news.”
“Would you rather I do it?” Josh asked.
Allison took a deep breath. Technically, Josh outranked her, since he’d been at the clinic a year longer, but for practical purposes they were equals professionally. If this was going to be a problem, it was better to settle it now. “Josh, Rachel is your girlfriend—from what I’ve seen the past few months, probably even more than that—but that’s the very reason you shouldn’t be her treating physician. I am. And I’ll tell her.”
She saw him absorb this, accepting the fact, but uncomfortable with the implications. “Look, you can see her as soon as I’ve told her our findings,” Allison said. “And we’ll consult with each other on treatment. But you’ve got to take a step back. Trying to manage her treatment would be the worst possible thing you could do.”
“Okay,” Josh said. “I’m getting ready to hospitalize Mr. Madison. I presume we’re both thinking the same treatment: isolation, antibiotics, diphtheria antitoxin just as soon as I can get it, tracheotomy tray at the