But it appeared the doctor just wanted to pace around the room. He stopped to look at one of the photographs, showing what Kassian guessed was a son’s graduation.
‘I will respect the confidence of this meeting,’ Frankel said finally. ‘I respect your offices, just as I respect the office of the presidency. And I also believe you’ve come to me in good faith. The events you describe are indeed alarming.’
Bruton let out a noisy sigh. ‘Well, that’s good to hear. People said you were a good man and—’
‘But this is not straightforward.’
‘We understand.’
‘I also swore an oath. You understand that, hmm? I’m a doctor. I can’t make up a diagnosis, no matter how expedient – politically expedient – it might be. The minute I do that, I stop being a doctor. I become one of you.’
‘Dr Frankel, when did you last examine the President?’ Kassian hoped to prevent Bruton coming in too hard.
‘I see him once a week. I saw him on Tuesday.’
‘Tuesday? So before the current …’ Kassian hesitated before lighting on the appropriate word, ‘… situation with North Korea. And how would you describe his health?’
‘He’s not young. He’s overweight. He has some diabetes, which he manages with—’
‘What about his mental health, Dr Frankel? How would you describe his state of mind?’
At this, the doctor paused. Then he paced a little more, before returning to his chair. ‘Look, he’s not like you and me. He’s … unpredictable. He’s volatile. He can have strong … moods.’
Bruton jumped on that. ‘And what if those mood swings made him unable to—’
The doctor overrode him. ‘But to declare that a pathology, that’s something quite different. To declare that that makes him unable—’
Kassian tried to find a way through. ‘We’ve seen the evidence of it, Dr Frankel. We’ve seen how his violent temper, his mood, has led him to act directly at odds with his oath to protect and defend the United States.’
‘Are you sure you haven’t seen him merely discharge the powers and duties of his office in a way that you – and I perhaps – do not like? That does not make him unable to discharge those duties. There is a difference.’
‘For Christ’s sake, doctor.’ Bruton was now on his feet. ‘This is not medical school. This is not debate camp. This is not a drill. You’ve got to see that there’s more at stake here.’
‘I do see that.’
‘This is a life and death situation. But not just one or two lives. This is about the life of the whole fucking human race.’
‘I understand. More, perhaps than you realize. But you must see that I cannot make my decision on that basis.’ He looked down at his fingers. ‘You don’t need to tell me how high the stakes are. This cannot be a political judgement. If it is, it’s worthless. It has to be a medical one. They’re not the same thing.’
‘So what would—’
‘I’ve seen some signs of what you describe. It is undeniable that there are signs of … erratic behaviour. But the same could be said of many men, especially of his age.’
‘But we’re not talking about “many men”,’ said Bruton, his patience thinning and his voice rising. ‘We’re talking about the President of the United States, the man with his finger on the trigger of an arsenal that could destroy the entire goddamn world!’
The doctor ignored Bruton. His gaze remained fixed on his fingers. To Kassian, he seemed like a man locked in his own thoughts, wrestling with the dilemma. Now he spoke, but less to them than to himself.
‘The medical question is: what symptoms would have to be present for this to constitute an inability to fulfil his duties? Would we need to establish mental impairment? Is a tendency to ignore evidence, or to act rashly, sufficient? Or must there be clear proof of an unwillingness, or inability, to think through the consequences of one’s actions? How high, or low, does the bar need to be set?’
‘Dr Frankel?’
The doctor looked up, to meet Kassian’s gaze. ‘I cannot make this decision straight away. I must examine the patient, run a full battery of tests. I would, ordinarily, wish to consult with colleagues to—’
‘That definitely cannot happen.’ Bruton, his voice raised.
‘Complete confidentiality is, as you know, of paramount importance,’ said Kassian, pausing to let his words sink in. When he was satisfied, he said: ‘Besides, there isn’t time. What happened last night could happen again.’
‘At the very least, I need to consult my files at length—’
‘On him?’ Bruton said, barely keeping the lid on. ‘I hear there aren’t any medical records. It was an issue in the campaign, remember? Press thought he hadn’t let any doctor come near him in years.’
‘What the rumour mill says is not relevant to me. I need to have another look through my notes and weigh the question that you’ve put to me. This is not a decision to be taken lightly. It takes time.’
Bruton seemed poised to throw a punch. Kassian cut in: ‘That’s fine, doctor. The Secretary and I will wait for you in the hallway.’
‘No. I need several hours at—’
‘If we had more time, we’d give it to you. We’ll wait for you in the hallway.’
And so they waited, the pair of them, Kassian sitting, Bruton pacing and occasionally the other way around. Once, Mrs Frankel appeared – a kindly woman of the same vintage as her husband – who asked if either of them would like something to drink, perhaps some homemade lemonade on this warm evening. Kassian was thirsty, but he didn’t say yes. Somehow he sensed that a patina of normality would only make this situation even more enervating, for him at least.
Finally, perhaps forty minutes later, the doctor emerged from his study. He looked at both men, moving his gaze from one to the other, until finally, and with no expression either of them could discern, he said: ‘Come inside. Let me give you my answer.’
Chevy Chase, Maryland, Tuesday, 6.05am
At just after six, the sun already bright, the call came. The doctor answered it, barely dipping his voice. Unlike him, his wife was a heavy sleeper. There was no risk she would wake.
‘Yes. I understand. I’ll be there right away. No, no, you did the right thing. If he’s asleep now that’s very good. Certainly no need to wake him up. What? We can assess that when I get there. I won’t be long.’
He dressed quickly, working through the possible scenarios in his own mind. Nothing in what he had heard alarmed him. But this was a relatively new administration; the staff at the Residence were still getting to know their new charge. They did not yet know what was ordinary, which made it harder to work out what was extraordinary.
As he brushed his teeth, Jeffrey Frankel reflected again on his meeting the previous evening with Robert Kassian and General Bruton. Nothing like that had ever happened before. Indeed, he doubted if he had ever exchanged more than two words with either man’s predecessors.
He wondered if he had given them the right answer. He had spent most of the night wrestling with that question.
He reached for his briefcase, by the front door, as always; grabbed his keys, on the hook by the front door, as always, and stepped outside.