THE FIRST PATIENT

ALSO BY MICHAEL PALMER

The Sisterhood
Side Effects
Flashback
Extreme Measures
Natural Causes
Silent Treatment
Critical Judgment
Miracle Cure
The Patient
Fatal
The Society
The Fifth Vial

THE FIRST PATIENT

MICHAEL PALMER

This is a work of fiction. All of the characters, organizations, and events portrayed in this novel are either products of the author's imagination or are used fictitiously.

THE FIRST PATIENT. Copyright © 2008 by Michael Palmer. All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles or reviews. For information, address St. Martin's Press, 175 Fifth Avenue, New York, N.Y. 10010.

Library of Congress Cataloging-in-Publication Data
Palmer, Michael, 1942–
The first patient / Michael Palmer.
           p. cm.
       ISBN-13: 978-1-4299-2833-5
       ISBN-10: 1-4299-2833-6
       1. Physicians—Fiction. 2. Presidents—United States—Health—Fiction. 3. Physician
and patient—Fiction. I. Title.

PS3566.A539 F57 2008
813'.54—dc22
                                                                                                                    2007040443

10 9 8 7 6 5 4 3 2 1

To Dr. E. Connie Mariano, Rear Admiral (Ret.),
Renaissance woman,
physician to presidents:
Without you, this book would never have been.

And
to Matthew, Daniel, and Luke,
for making it all worthwhile

ACKNOWLEDGMENTS

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.

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 FIRST PATIENT

CHAPTER 1

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.