The First Patient

The First Patient

by Michael Palmer


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The First Patient by Michael Palmer

From the blockbuster, New York Times bestselling author comes a high-concept, high-octane thriller at the crossroads of presidential politics and cutting-edge medicine. . . .

Gabe Singleton and Andrew Stoddard were roommates at the Naval Academy in Annapolis years ago. Today, Gabe is a country doctor and his friend Andrew has gone from war hero to governor to President of the United States. One day, while the United States is embroiled in a bitter presidential election campaign, Marine One lands on Gabe’s Wyoming ranch, and President Stoddard delivers a disturbing revelation and a startling request. His personal physician has suddenly and mysteriously disappeared, and he desperately needs Gabe to take the man’s place. Despite serious misgivings, Gabe agrees to come to Washington. It is not until he is ensconced in the White House medical office that Gabe realizes there is strong evidence that the President is going insane. Facing a crisis of conscience—as President Stoddard’s physician, he has the power to invoke the Twenty-fifth Amendment to transfer presidential power to the Vice President—Gabe uncovers increasing evidence that his friend’s condition may not be due to natural causes.

Who? Why? And how? The President’s life is at stake. A small-town doctor suddenly finds himself in the most powerful position on earth, and the safety of the world is in jeopardy. Gabe Singleton must find the answers, and the clock is ticking. . . .

With Michael Palmer’s trademark medical details, and steeped in meticulous political insider knowledge, The First Patient is an unforgettable story of suspense.

Product Details

ISBN-13: 9781250100382
Publisher: St. Martin's Press
Publication date: 12/30/2008
Pages: 512
Sales rank: 640,843
Product dimensions: 5.10(w) x 7.90(h) x 1.00(d)

About the Author

Michael Palmer (1942-2013) wrote internationally bestselling novels of medical suspense, including The First Patient, The Second Opinion, The Last Surgeon, A Heartbeat Away, Oath of Office and Political Suicide. His book Extreme Measures was adapted into a movie starring Hugh Grant and Gene Hackman. His books have been translated into thirty-five languages. Palmer earned his bachelor's degree at Wesleyan University, and he attended medical school at Case Western Reserve University. He trained in internal medicine at Boston City and Massachusetts General Hospitals. He spent twenty years as a full-time practitioner of internal and emergency medicine. In addition to his writing, Palmer was an associate director of the Massachusetts Medical Society Physician Health Services, devoted to helping physicians troubled by mental illness, physical illness, behavioral issues, and chemical dependency. He lived in eastern Massachusetts.

Read an Excerpt

The First Patient

By Michael Palmer

St. Martin's Press

Copyright © 2008 Michael Palmer
All rights reserved.
ISBN: 978-0-312-93775-1


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.

Fifty feet away, still in the saddle, Gabe Singleton calmed his horse with a few pats behind the ear. The midmorning appearance of a Secret Service agent at the Ambrose Regional Medical Center had given Gabe warning that the presidential drop-in was going to take place, but the man hadn't been specific about the time and, following an exhausting all-nighter caring for two patients in the ICU, even a visitor of this magnitude couldn't keep Gabe from his customary ride out into the desert and back.

"Hey, cowboy," President Andrew Stoddard called out, descending the stairs and sincerely saluting the lone Marine as he passed, "whattaya say?"

"I say you and your choppers scared the crap out of this world-weary old nag. ... Frightened my horse, too."

The two men shook hands, then embraced. Stoddard, who Gabe felt looked presidential even when they were first-year roommates at the Naval Academy, showed the stress of three and a half years in office. Silver highlighted his razor-cut dark brown hair, and deep crow's-feet had appeared at the corners of his iridescent blue eyes. Still, he was every bit the man in charge—the decorated Desert Storm pilot and former governor of North Carolina, whose star had been on the ascendancy since the day he took his first privileged breath.

"One of the downsides of the job," Stoddard said, gesturing toward his entourage. "Twin helicopters so that any whacko who decides to take a bazooka shot at one of them has only a fifty-fifty chance of blowing me away, Secret Service studs checking out every inch that's gonna be stepped on by these size elevens and every toilet seat that's gonna be graced by these presidential cheeks, plus a medical team trained to know that it's not if something terrible happens to their boss, it's when."

"If you're looking to make a job change, I could use a wrangler on my ranch."

"How many do you have working for you now?" Stoddard asked, glancing about.

"You would be the first. I'm afraid our benefits package is a little thin, too, starting with that you'd have to pay me to work here."

"Hey, put me on the list. I don't know if you follow the polls or not, but I haven't got a hell of a lot of job security at the moment. Got some time to talk with an old pal?"

"If you'll let me put my other old pal Condor, here, in the stables."

"Fine-looking horse."

"And that's a fine-looking pooch. Liberty, right?" Gabe patted the dog's rock-solid flank.

"Good memory," Stoddard said. "Liberty's making quite a name for himself, tagging along with me and changing people's misperceptions about pit bulls, just like we're changing people's misconceptions about America. I've had dogs all my life, Gabe, but Liberty, here, is the best. Strong as a tiger, wise as an owl, and as gentle and dependable as that horse of yours."

"Maybe you should have named him Simile."

The president laughed out loud. "I love it. This here's my trusty dog, Simile. He's tough as a Tennessee hickory nut, but gentle as baby powder. Carol will think that's very funny, too, especially since, unlike her husband, she's actually likely to know the difference between a simile and a metaphor. Hey, Griz."

A thick-necked, barrel-chested, balding Secret Service man wearing the obligatory black suit and reflective shades seemed to materialize from nowhere.

"You rang?"

"Griz, this is my old college roomie Gabe Singleton. Doctor Gabe Singleton. It's been five years or so since we last saw one another, but it seems like yesterday. Gabe, this here's Treat Griswold, my number-one protector and probably the number-two man in the whole Secret Service. Obsessive to a fault. Swears he's telling the truth when he says he'll take that proverbial bullet for me, but with that crooked smile and those beady little eyes of his, I just don't believe him."

"In that case, sir, you'll just have to wait and see," Griswold said, stopping just short of pulverizing the bones in Gabe's hand at the same time. "I'll be happy to get Condor settled in, Doctor. I used to muck out stables and ride warm-ups when I was a kid."

Gabe liked the Secret Service agent immediately.

"In that case you've come a long way," he said, handing over the reins. "Tack room's in the barn. Maybe we can go for a ride sometime."

"Maybe we can, sir," Griswold said. "Come on, Liberty, let's put this big ol' fellow to bed."

Stoddard took Gabe by the arm and led him to the back door. The house, seven rustic rooms that still had the feel of the cabin it was before some additions, was Gabe's cut from the end of his five-year marriage to Cynthia Townes, a bright, vivacious nurse from the hospital who loved him to pieces from day one to day last. Her mistake.

Cinnie's last words to him before she handed over her keys and took off for a teaching job in Cheyenne were to beg him to finish dealing with his past before he made any further attempts to build a future with anyone. For seven more years he had taken her at her word, and so had carefully avoided another in-depth connection. He might be done dealing with his past, but he had serious doubt it was ever going to be done dealing with him.

"Sorry I haven't gotten out here for so long," Stoddard said. "I used to really enjoy the evening rides and our fishing trips up into those mountains."

"The Laramies. There's no place on earth quite like them. But stow the apologies, matie. From what I've heard, you've had a few other things on your plate— like saving the world."

Stoddard grinned wistfully.

"It's a little bigger a job than I once thought," he said, settling in at the round oak table in the kitchen, "but I still intend to make a dent in it."

"I remember you talking like that during our first or second night of bar-hopping together at the Academy. I kept trying to stay cynical and believe that you were an idealistic jerk, but this little voice inside me kept saying that this was a guy who might actually be able to do it. Then, when you drank me under the table, I really decided to give you the benefit of the doubt."

"That was beginner's luck, and you know it. You must have had a virus or something."

"Speaking of which, it should come as no surprise that I can't offer you a beer, but I can brew you some coffee, or—or some tea."

"Tea would be great," the president said, placing a manila folder in front of him. "While I'm in apology mode, sorry I couldn't make it in for your dad's funeral. I appreciated your letting me know he had passed."

"And I appreciated that you would take the time to call from South America."

"Your dad was a bit ... quirky, but I always did like him."

"He was very proud of you, Drew, you being a fellow Annapolis grad and all."

The instant he spoke the words, Gabe wished he hadn't. Cinnie's pleas notwithstanding, he had done what he could to deal with Fairhaven and his father's reaction to it. He hadn't meant the statement to come out the way it did.

"I'm sure he was very proud of you, too, Gabe," Stoddard said, a bit uncomfortably, "what with your M.D. degree and all those medical missions you've been on, and that youth foundation you're running."

"Thanks. Hey, speaking of sires, how's yours doing?"

"Same old LeMar. Still trying to micromanage everything, including me. He tells me he's bought his way onto a Russian space shot. Fifteen million and he becomes the first seventy-five-year-old to soak his hemorrhoids in the international space station tub."

"Fifteen million. God bless him."

"Hey, come on. When we're talking about my father, it's like Monopoly money. Just do the math. The ten billion or so he's worth minus the fifteen million or so he spent is ... um ... take away three, carry the one—still ten billion or so. I wouldn't be surprised if he paid in cash with bills he pulled out of his sock drawer."

Gabe smiled. If, over the years, he had suffered from too little father, Drew Stoddard had suffered from too much. From his days in diapers, Stoddard had been molded by the charismatic, wildly successful industrialist. The heartache Buzz Singleton endured when Gabe was drummed out of the Naval Academy had to pale next to LeMar Stoddard's having to explain to his pals at the hunt club or the polo pitch or wherever that Drew had become a Democrat—and one of the shining stars of the party at that.

Did Drew's remarkable transformation from elitist Republican to populist Democrat have its roots in the accident at Fairhaven all those years ago? Gabe often wondered. In such an inestimable tragedy, not even the bystanders and innocents like Drew Stoddard escaped unchanged.

Gabe set a pot of Earl Grey tea and some shortbread on the table. There was a time before the last presidential election when the two of them got together once or twice a year to hike and fish in the Smokies or Laramies, and exchange news and stories, but now, despite their long-standing friendship, Gabe felt strangely edgy about taking up the time of the most powerful man in the solar system with small talk. Still, this last-minute trip to Tyler was Stoddard's doing, so it seemed right to let him set the agenda.

Gabe didn't have long to wait.

"Did you know that in addition to the comprehensive medical facility on the first floor of the Eisenhower Office Building we have our own medical clinic right in the White House?" Stoddard began.

"You said something about it in one of our conversations, yes."

"It's run by the White House Medical Unit. Which, for reasons lost in antiquity, is actually a division of the White House Military Office. Pretty nice setup, too— recently renovated, state-of-the-art equipment, top-notch nurses and paramedics, and the best doctors from all branches of the service. Twenty-five or thirty staff altogether. They take care of me and Carol and the boys when they're home from school, as well as Vice President Cooper and his family, and anyone else who happens to need medical care while they're at the White House."

"The boys—they doing well?"

"Terrific. Andrew's going into eleventh; Rick'll be in ninth. Both are at school in Connecticut. Right now they're at soccer camp. Andrew's an all-star goalie. Rick plays because he thinks he should. He wants to go to the Academy and be an astronaut."

"Think you can get him in?"

"I think he can get in on his own, but I may keep an eye on his application."

"Eleventh and ninth—that's amazing."

"They're happy and healthy. That's all that really matters."

"Speaking of healthy, you had your doc from North Carolina come up to D.C. to care for you, yes?"

"Jim Ferendelli. He's been a great doctor for me and the family. The best. Kind, knowledgeable, empathetic. Plays beautiful classical piano, too."

"I'm really glad to hear all that, Drew. Having a doctor one can trust is a huge weight off of anyone's shoulders."

"I agree, but I'm glad to hear you verbalize it just the same."

"Well, that's how I feel, although when it comes to caring for the President of the United States, I assume you know I'm just stating the obvious. Your well-being and good health have an effect, one way or another, on every person on the planet."

Stoddard laughed with no great glee. "I understand what you're saying, but I still get the willies thinking about things that way."

"It's a hell of a job you signed on for. I don't envy that responsibility in the least."

"But I still have your support?"

"Of course."

"In that case, it should come as no surprise that I didn't break away to fly here in the midst of a heated campaign just because I missed your smiling face. I need something from you, Gabe. Something important."

"Name it."

"I need you to come to Washington and be my doctor."

Gabe sank back in his chair and stared at his onetime roommate in utter disbelief.

"But ... you said this Jim Ferendelli is a terrific doctor."

"He is ... was."

Gabe felt as if a band were tightening around his chest.

"I don't understand," he finally managed.

"Gabe," Stoddard said. "Jim Ferendelli's gone. ... Vanished."


"What about the FBI?"

"You don't think they're all over this? Hundreds of agents have been on the case for almost two weeks. Nothing."

Evening had settled in, and a steady breeze from the north had dispelled the last of the day's warmth. Gabe had listened in stunned silence to the description of a fifty-six-year-old widower, devoted father of a grown daughter, personable and diligent, churchgoing and humble, who one day simply failed to show up at work. A search of his apartment in Georgetown and his Chapel Hill home revealed nothing out of the ordinary, and a check of his phone and e-mails had also been of no help.

With the presidential campaign just heating up, Andrew Stoddard's advisors had managed to keep the potentially distracting disappearance out of the news until they were certain the search was not going to be successful. For more than a week, now, that was clearly the case, and what scant details there were had just been released to the press.

"They've all been told that for now the White House Medical Unit would handle any problems I might have, but as competent as the unit is, I really want my own physician."

"This is absolutely incredible," Gabe said. "The doctor to the President of the United States has vanished without a trace. What about his family? Have they heard anything?"

"As I said, Jim's wife died of cancer about five years ago. His mother's in a nursing home, and two older sisters haven't heard a word from him."

"But you also said he had a daughter. Has she heard anything?"

"Actually, Jennifer's disappeared, too."


"She's a graduate film student at NYU. The evening of the day Jim disappeared, Jennifer's roommate came home from a date and Jennifer wasn't there, but the FBI already was. There was no evidence she had packed anything, no note, nothing. They tried every number the roommate could think of, but just like her father, the girl had simply ... vanished."

Gabe could only shake his head.

"Jesus," he muttered. "Do you make any sense of this, Drew? Any sense at all? Do you think this is politically related? Maybe it's just a coincidence of some sort, like an accident, or ... or a mental crisis. Was the daughter stable?"

"A terrific kid. Some therapy after her mother died, but none for years as far as we can tell. No drugs, minimal drinker. No current boyfriend, but her last one had only good things to say."

"Was Ferendelli seeing anyone?"

"Not that we've been able to determine."

Gabe rubbed his eyes and studied the vaulted redwood ceiling.

"I wish I could help you, Drew," he said at last. "Really I do. But there's just too much going on here."

"Actually," Stoddard said, "Magnus Lattimore, my chief of staff, has been here in Tyler for a few days nosing about. He's discreet and very, very efficient, and he can move very quietly when he needs to."

"Like the guys in the suits and sunglasses out there."

"Just like them, yes."

"Terrific. I'm not sure I want to know what he learned."

"Well, let's see. Both of your partners say they can hold down the fort for the time between now and the election in November. Apparently you guys just hired a new physician's assistant named Lillian Lawrence, who's in a position to absorb a lot of the load that sending you off on a working sabbatical would generate. One of your partners said Lillian is probably smarter than you are anyway."

Gabe was unable to stifle a grin.

"Which one?" he asked.

"Sorry. He swore Magnus to secrecy."

"It's not that simple, Drew. In addition to my patients I have a commitment to my foundation."

"You mean Lariat?"

"Uh-oh. What'd Magnus learn about that?"

"He learned that over the years you've kept more than a few kids from heading down the wrong path by getting them involved in rodeo and other riding projects."


Excerpted from The First Patient by Michael Palmer. Copyright © 2008 Michael Palmer. Excerpted by permission of St. Martin's Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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First Patient 3.7 out of 5 based on 0 ratings. 228 reviews.
Anonymous More than 1 year ago
Right off the bat, we have harriet klausner ruining another book. Another lost sale for bn because i refuse to buy a book after this self righteous poster reveals every detail of the book. Why waste money? Harriet klausner seems to think other ppl are too stupid to read, so she takes it upon herself to divulge every detail of the book.
Anonymous More than 1 year ago
I've learned to check reviews and to not read harriet klausner or other long reviews for fear of getting spoilers. I agree that people need to limit the amount of info given in their reviews.
dancin_wida_pen More than 1 year ago
I read this book from the CDs in my car on an crosscountry holiday trip. I did not finish before I arrived at my destination and found myself creating reasons to drive in my car so I could hear the book. Now that's a great book. If you like thinking about clues and enjoy credible characters embedded in mystery setting, you will like this one.
BookmarkCP More than 1 year ago
I loved this book. Palmer never lets me down. I thought that the plot was original, the characters entertaining and the conspiracy completely believable. I would definitely give this book as a gift.
Guest More than 1 year ago
Michael Palmer outdoes himself with this one! This book is brilliantly crafted and well written. The plot is unique, filled with suspense,twists and turns,and VERY VERY SCARY. The reader is held captive with the question: COULD THIS REALLY HAPPEN? The suspense builds and builds. The height of surprise and pathos comes near the end when the mastermind behind the president's mysterious illness is revealed.
Anonymous More than 1 year ago
This is a great read. Could do without the xx language though.
Leslie_Everett More than 1 year ago
We do not often get a treat that comes in the form of a new look at a subject, particularly the timeless subject of political intrigue. Although the story, at times, rides on the edge of fantastic, it it wholly believable. My difficulty in providing a more comprehensive review comes from the fact that the story holds some surprises and it would be unfair to the readers to reveal too much. Michael Palmer has been placed high on my list of favorite authors.
Anonymous More than 1 year ago
Somebody please! B &N you have got to put a stop to Ms. Harriet!! You are going to lose another sale because you continue to let her post full blown reviews! WE CAN READ HARRIET!!!! WE ARE ADULTS!!!! You can fix this, somebody just needs to have some balls to do it. Yes I know, we dont have to read it, but she can quit being so friggin RUDE!!!!!!!!!!
Prasvadh More than 1 year ago
This novel brings to the spotlight issues of the Twenty Fifth amendment act & the high relevance role payed by the president's physician in the Washington suites. There is a lot of suspense & thrilling moments attached to every part of the story & gets you enthralled in the cobweb of incidents leading to the predictions of who could be held responsible for inducing drugs/hallucinating the president to such a great extent. This novel surely brings into the reader immense interest on nanotechnology field and the immense potential it holds for future drug delivery & treatment approaches.
pm23 More than 1 year ago
This was the first book I have read by Palmer and I was not disappointed in the least. Palmer did a wonderful job with the plot (kept me guessing the whole time), the characters were well planned also. You won't go wrong with purchasing it. The only downside is there some bad language towards the end of the book.
Anonymous More than 1 year ago
This book keeps you guessing right to the end. Good, fast page turner.
Marnie Abutin More than 1 year ago
Captivating plot and very well written! You wont be able to put it down.
Anonymous More than 1 year ago
This is the first book by Mr. Palmer that I was disappointed in. I usually love his books but I found this story too drawn out to really enjoy. It didn't keep me on the edge of my seat and was easy to put down. I will continue to read books by this author - I just didn't care for this one. --K--
whiterose_1943 More than 1 year ago
As other reviewers mentioned, this book starts out well. The characters are fairly well developed and the premise is believable. As the storyline progresses, the twists-and-turns become more implausible until the climax is as hallucinogenic as the behavior of the main character. The author's good intentions get derailed by the drift from reality....
Charli More than 1 year ago
I was surprised all the information it revealed; about the white house. It would make sense for them to act like this.
bookworminGA More than 1 year ago
The plot on this book is creative. I have read many of Michael Palmer's books, and this one is in the top 3. It had enough edge of your seat moments that made you want to keep reading, but did not quite make you look over your shoulder to make sure you weren't being followed. The plot is plausible, especially for anyone who is a government comspiracy theorist. Once you start it, you won't want to put it down!
JETTA More than 1 year ago
suzNC More than 1 year ago
A fast moving book, with lots of twists and turns. Truly enjoyed it.
CeCeCS More than 1 year ago
The overall read was good. However, I did not think there was enough development of the character who ended up being the villain. I will agree that it was a cliffhanger. I did not expect the villain to be who it was. But I was dissappointed in the villain's reason for what was done. The author did not expound on this enough.
Guest More than 1 year ago
Michael Palmer has always been one of my favorite authors for years, and this one did not disappoint! It grabbed me from the very beginning and I was so enthralled that I never wanted to put it down. It's full of twists and turns and surprises, intertwining all of the different stories seamlessly. Just when you think you know who 'the villain' is, you'll find yourself wondering if it could be someone else, which to me made it all the more interesting. I was anxious to get to the end and see if I had figured it all out! If you are a fan of Michael's, you won't be disappointed. I recommended this to a co-worker, and we both want it to be made into a movie! It was that good!
KenCady More than 1 year ago
Pardon me if you find this book rather implausible, but I enjoyed reading it. If a novelist can't take a few liberties to tell a tale, we'll all be reading non-fiction. Somehow I will never view the White House or the president the same, but I guess I always had my suspicions!
Guest More than 1 year ago
In an election year, Michael Palmer has added politics and a bit of nanotechnology to the excellent medical fiction he writes. I found the writing to be extremely good, the characters well-drawn, and the surprises just kept on coming until the very end. I'm looking forward to Palmer's next work. My advice is to suspend your disbelief (hey, this is fiction) and enjoy the ride.
Anonymous 9 days ago
Not the greatest. I read much better books before
tschnitzler 3 months ago
I do not know much about how the Whitehouse is run and the processes and procedures involved in serving the President of the United States. I tend to believe Michael Palmer has set forth the basics in The First Patient. That being written, how in the hell did Dr. Gabe pull this off? Wow! Incredible! President Stoddard came off as very charismatic, but in the end, I was woefully disappointed in how self-serving he really was. The First Patient is a good read as long as you keep in mind it is fiction and you can get through the few slow spots throughout the book.
Anonymous More than 1 year ago
Kept me on the edge of my seat