Michael Palmer - The First Patient

The White House Physician's clinic was situated directly across the corridor from the elevator to the First Family's residence. Standing before the bathroom mirror in the elegant three-room office, Gabe sensed he would have been more at ease had he been stationed in a clinic in downtown Baghdad.

It was just after seven in the evening. As promised, the tuxedo, complete with shoes, had arrived at the office at precisely six. The size was perfect in every respectnot surprisingly, since the arrangements had been made through the Social Office of the President by Magnus Lattimore. Unfortunately, the garment bag failed to include either a clip-on or instructions on how to knot the enclosed bow tiea rare, if understandable, Lattimore oversight.

Gabe watched as the hands that had lassoed steers, hung on to bucking broncos, and sutured innumerable lacerations struggled to create even a passable knot. The directions he had printed out from the Internet were propped up on the sink. In addition to his limited dexterity, he looked tired and strained. The zygomatic arches above his cheeks were even more pronounced than usual, and his dark eyes, which Cinnie had called his sexiest feature, seemed lost. No surprise. Four whirlwind days in a new apartment, new city, and new job were taking their toll.

The formal dinner reception, scheduled for eight in the State Dining Room, was ostensibly to welcome the recently reelected President of Botswana. According to the Africa expert sent by Lattimore to brief Gabe, the country was a staunch ally of the United States and one of the enduring democracies on the continent. In truth, the guest list had carefully been stacked with dignitaries and cabinet members who were interested in meeting the man the president had selected to bring stability to the White House medical office.

Another try at the knot, another morbid failure.

The muscles in Gabe's neck and shoulders, always the physical receptacle in his body for stress and emotional fatigue, were drumhead tight, and a throbbing headache was developing beneath his temples. Some sort of medicine would help make the evening more bearable, he decidedmaybe a couple of Tylenols with codeine.

Since Fairhaven he had sworn off alcohol forever, and for his first few years out of prison he had expanded that pledge to boycott all manner of drugs as well. But with an array of orthopedic maladies dating back to his rodeo and football days, and stress-related head- and neck aches, Tylenol and ibuprofen had intermittently begun surrendering to Darvon and Tylenol No. 3, with whatever happened to be in the medicine cabinet thrown in from time to time for those discomforts that crossed the imaginary line between dull ache and disruptive pain.

He knew relying on pain pills and even the antidepressants he resorted to from time to time wasn't the smartest behavior for an alcoholic in recovery, and he knew that there was always the danger he would be conjuring up the pains to justify taking the drugs, but he had gone about as far in life as he could go in terms of doing the right thing.

He set the tie and the instructions in the sink, brought a glass of water to the exquisite cherrywood desk the White House decorators had determined was appropriate for the inner office of the physician to the president, and fished out two Tylenols with codeine from the thirty or so he had transferred to a bottle that read simply: TYLENOL. If anyone found out about the deception, or discovered the envelopes of Demerol and antidepressants in the eyeglass case in the back of his drawer, so be it. If Drew had asked him about pills, he would have told him the truth. Probably should have said something anyhow. If he had, he might still be back in Tyler taking care of folks with calluses on their hands and teaching kids how to throw a lasso. But in the end, he decided it was his business and his business only. The world knew quite enough about him as it was.

The codeine had just begun its journey from stomach to brain when, with a firm knock, the door to the receptionist's office opened.

"Hello?" a man's voice, not one that Gabe recognized, called out.

"I'm in here," Gabe replied.

The admiral's dress whites seemed to throw off at least as much light as the desk lamp, and the golden "scrambled eggs" insignia on the brim of his cover appeared possessed of its own inner glow. He stepped across the threshold and, with his gaze fixed on Gabe, reached back and closed the door.

"Ellis Wright," he said, giving Gabe's hand a perfunctory pump. "My apologies for not having come by sooner, but I was overseas when you came on board. I assume you know who I am."

The two photos of the man Lattimore had shared with Gabe did not do the imposing officer full credit, nor did craggy and steely, the adjectives that had first come to Gabe's mind when he saw them. Ellis Wright was every fiber a military commanderramrod straight and rock jawed, with gunmetal eyes and shoulders that seemed mitered at perfect ninety-degree angles. Given just one guess as to what he did for a living, few would ever be wrong. Gabe wondered if Wright's eyes were always this cold or the look had been reserved for him.

"Ellis Wright holds sway over virtually everything that moves or breathes around the president," Lattimore had said during his briefing, "except you, and to a much lesser extent, me. Nobody has any control over you other than the POTUS himself, and even he had better be careful trying to order you about. Before President Stoddard took office, his predecessor Brad Dunleavy allowed Wright to choose a military M.D. to be his personal physician, so it should come as no surprise that Wright resented having a civilian assume this position when Jim Ferendelli was appointed. I think it's safe to anticipate that he'll have issues with you for the same reason. Around here everything boils down to proximity and access to the POTUS, and first Ferendelli and now you nudge Wright back a notch in that regard."

"I'm the head of the White House Military Office," Wright, still standing, was saying. "The military's involvement with the smooth, efficient running of the presidency dates back to George Washington. We're responsible for communications, emergency operations, the airlift group, Helicopter Squadron One, Camp David, the White House Transportation Agency, the White House Mess, and"he paused unsubtly for emphasis"the White House Medical Unit. We're Military with a capital M. If the president so much as thinks of something he wants done, our people will have already started doing it. Is that clear?"

"Pretty clear, yes. You... um... want to sit down?"

Gabe stopped himself at the last possible moment from asking if the admiral also headed a department that knew anything about bow ties.

"I intend to say what I have to say and leave," Wright went on. "I can do both standing. You sound like something of a wiseass, Singleton. Are you a wiseass?"

Gabe cocked his head and hoped his expression said that he was open to any frank discussion, but he was not going to be easily pushed around.

"Admiral," he said, "I've been brought here to take care of the president. I'm board certified in internal medicine, and I've worked in big, gleaming hospitals and in Central American jungles. Most people who know me and know medicine think I'm pretty competent at what I do. If that's your definition of a wiseass, then maybe we have a problem."

"I told the president when he was considering a replacement for Dr. Ferendelli, and I'm telling you now: We have doctors in every branch of the military who are so knowledgeable, precise, and clinically competent that I doubt most doctors, including you, could carry their instrument bags. This is a military operation, and you are needed here about as much as a bull needs tits."