Chapter 8
George Washington University Hospital, located just minutes from the White House, has treated many presidents. Because of the seriousness of the situation, both Hackett and Butterfield automatically determined that GW was the best hospital. Advance agents had already arrived at the hospital and cleared the Emergency Room out of all but essential personnel. Trauma Room 1 was readied for the President.
The head of Cardiology, Dr. Richard Martin, and the head of Emergency Medicine, Dr. Susan Jones, were paged and arrived in the ER within minutes. After being briefed by Dr. Hackett from the ambulance, Dr. Martin called the heart cath lab and told them to be on standby. They and their staff were ready when the ambulance with the President pulled up to the back entrance.
As soon as the stretcher was out of the ambulance, Dr. Jones was getting a report from Dr. Hackett while making an initial assessment.
"BP 100 over 50. Pulse 120 and weak. Sinus rhythm with occasional PVCs. O2 mask at 30. Conscious but groggy. Responds to commands. IV Normal Saline 100 cc/hr."
The doctors were glad that the President was conscious, but they knew there were still possible complications ahead.
The stretcher was pushed into the trauma room and locked.
At this point, Dr. Hackett stepped back and let the staff do their jobs.
Heart monitor pads were placed on his chest and attached to the monitor. The oxygen mask was switched to hospital equipment. The IV was hung from a hook above the bed.
Orders were coming from both doctors at the same time. "Chest x-ray. CBC, cardiac enzymes. Morphine."
Their staff was well-trained and knew exactly what to do. To a casual observer it might look like chaos. But to a trained observer it was a carefully scripted ballet whose main focus was to save a life.
In a matter of minutes, Dr. Jones and Dr. Martin decided that the best action was an immediate catherization to assess any blockages and hopefully open blocked vessels.
Dr. Martin leaned over the stretcher. "Mr. President? This is Dr. Martin. We need to know how bad the heart attack was and try to open whatever is blocked. We are transferring you to the cath lab immediately."
The President nodded his understanding. Marriage to a thoracic surgeon allowed him a head start on the medical jargon that was flying around him.
Jed looked around the room, finally spotting Ron nearby. He motioned to him and Ron walked over and bent down. "Yes, sir?"
Struggling to talk through the oxygen mask, Jed moved it aside. "Abbey?"
"Sir, she's on her way. Mr. McGarry caught her at the airport before she left."
"Tell her…"
"Yes, sir, tell her what?"
Jed momentarily closed his eyes, but somehow found the strength to finish. "Tell her I love her."
Even stoic Ron felt his eyes moisten. "Yes, sir. I'll tell her."
Dr. Jones stepped forward. "Mr. President, we really need to go."
Jed closed his eyes and nodded. He was satisfied that, should anything happen, at least Abbey would hear his last words.
The stretcher was rapidly pulled into an elevator and taken to the sixth floor. This floor contained three cath labs as well as an operating room. This room was currently being prepared in case emergency surgery was needed. Everyone hoped this would not be the case.
Ron had already sent an agent to the cath lab to scout the area. Ron himself would also accompany the President wherever he went. No matter where the President was, protection was automatic. Even during open heart surgery, if it came to that.
"Do you want to observe?" Dr. Martin asked the President's doctor while scrubbing his hands at the sink outside the cath room while the President was being prepared.
"Yes, I would. I care about him like he's a brother. Anything I can do to support him I will certainly do."
Dr. Martin smiled. He had heard about the loyalty of the President's staff to the man lying inside the room. And he was finding out it was true.
"When is Mrs. Bartlet supposed to arrive?"
"Any minute, from what I've been told. She was preparing to leave on a trip when she was contacted so she's on her way."
"Good. He may need her when this is all over. Put on some scrubs and come on in. Glad to have you."
Pushing the doors open, Dr. Martin stepped in. "Okay, folks. Let's get started." Again, a well-trained staff automatically stepped into their roles and performed their job to perfection.
"Mr. President, can you hear me?"
Jed sluggishly nodded his head. The President had been given some morphine in the Emergency Room so Dr. Martin did not order any medication for relaxation and sedation. Due to past reactions, Dr. Hackett knew that the President didn't really care what was going on around him at the moment.
"Are you having any pain?"
Jed shook his head.
"Good. Just try and relax. We'll be finished in a few minutes."
Dr. Martin numbed the site in the groin with local anesthesia and made an incision. Next, he inserted a thin plastic tube into an artery. A long, narrow, hollow tube was passed through the sheath and guided up the blood vessel to the arteries in the President's heart. A small amount of contrast material was injected through the catheter so Dr. Martin could better assess the President's blood vessels, heart valves, and heart chambers on a TV screen.
"Okay, what do we have?"