“Hearts. Hearts from people recently dead. The ones you use for transplants. Where do you source them from?”
Sylvie frowned. “From donors, of course. Why?”
“I’m paying. I get to ask my questions first. Where else do you get hearts from?”
“Nowhere else. That’s it. Donors.”
“And these . . . donors? They make that decision, to be donors, before they die?”
Sylvie shook her head. “Mostly not. Consent from their next of kin is what we usually get. And that consent has to be quick. If we don’t get a heart into refrigeration within three hours after death, my boss won’t use it. He won’t use it, either, if the person died from any one of a number of dis-eases, and he won’t use a heart from anyone over fifty, no matter what shape it appears to be in.”
“And lots of people do it?”
“Do what?”
“Agree to donate their next of kin’s hearts.”
“Not enough. It’s the biggest problem we have.”
“So how do you go about it?”
The waiter was back with their fish. Sylvie put down her wine glass, picked up a fork, cut off a small piece of snapper, popped it into her mouth, and savored it.
“Delicious,” she said. “You know something? I don’t like lobster anyway.”
“How do you go about it?” Gilda insisted. “The sourcing, I mean.”
“I don’t go about it,” Sylvie said. “I just implant them.”
“But you must have some idea.”
“Some idea, yes. Basically, it works like this: a good prospect comes into a public hospital; maybe some kid shot to death in a favela, maybe a young woman run over by a car. Anyway, somebody who didn’t die of a debilitating disease, someone who met a sudden, usually violent, end. If the upper torso doesn’t seem to have sustained any major dam-age, if the area around the heart seems to be in good shape, somebody at the hospital tips off my boss and—”
“Why would somebody at the hospital do that?” Gilda interrupted. “Tip off your boss?”
Sylvie took a sip of wine.
“Good stuff, this,” she said.
“Sylvie . . .”
Sylvie glanced at the neighboring tables and lowered her voice.
“There’s this woman we have on staff,” she said. “Once he gets the tip, she goes over there, has a chat with the family, tells them how much good they can do by helping someone else, and gets them to release the heart to us.”
“Why don’t they release it to the hospital?”
“Get real, Gilda. You have any idea how much my boss charges for a heart transplant?”
“What’s that got to do with it?”
“It’s got everything to do with it. He pegs his fees to the American dollar, and he gets the whole sum in advance. There’s nothing unusual in that. All the private clinics do it. The current price is four hundred thousand dollars.”
“Dollars?” Gilda did a quick calculation. Four hundred thousand dollars was only a little less than eight hundred thousand reais.
“God,” she said. “I had no idea. Are you suggesting that he uses part of that to pay for tips from hospital staff and part to pay survivors? That he buys hearts?”
“I’m not suggesting anything,” Sylvie said.
But both of them knew she was. And both of them knew it was illegal. In Brazil, as in most countries, the law pro-scribes trafficking in human organs.
“Four hundred thousand dollars,” Gilda repeated, still try-ing to come to terms with the enormity of the sum. “How can he get away with charging so much?”
Sylvie continued to dissect her fish. “He not only gets away with it, he has patients standing in line to pay. If shelling out the money is the only thing that’s going to save your life, you shell out the money. And, if you don’t have it, you beg, borrow, or steal. You know where I worked before?”
“You worked in a number of places. You mean where you first started doing transplants? The Hospital das Clinicas?”
The Hospital das Clinicas was owned and run by the state of São Paulo. Most of the patients were people who received free treatment under the government health scheme.
“Uh-huh,” Silvie said. She put a morsel of fish into her mouth, chewed, and swallowed. “Any idea what their official charge is for a heart transplant?”
“Why ‘official?’ ”
“They have to put a number on it. Some people fall out-side the government health scheme, and that’s what they’d charge, if they charged, but they never do. Guess. Guess how much it is.”
“I haven’t the slightest idea.”
“Twenty thousand reais.”
“So why doesn’t everyone elect to do their procedure there?”
“Because, querida, the Clinicas, like every other public hospital, has a hell of a time getting healthy hearts. They source only one or two a month on average. And if you want one, there’s a waiting list as long as my ex-fiancé’s penis— which is very long indeed, believe you me.”
“How does one—”
Sylvie anticipated her question. “Get to the top of the list?”
Gilda nodded.
“You make sure you’re young, suffering exclusively from heart failure, and just about to die. And you make sure you’ve been on that list for at least six months, because, all other considerations being equal, hearts are doled out on a first-come, first-served basis.”
While Gilda digested that, Sylvie ingested the rest of her snapper. She left the vegetables and potatoes on the plate and poured herself another glass of white wine.
“So,” Gilda said, “Many patients at the Clinicas die while they’re waiting for a heart?”
Sylvie nodded.
“If you’re over sixty, or if you suffer from a life-threatening disease in addition to your heart problem, your chances of getting an organ through the Clinicas are nil.”
“So that’s the patient profile at your boss’s clinic? The old? The people who suffer from other diseases?”
“Our patients aren’t all old, and they don’t all suffer from other diseases, but they’re all people that can scratch up four hundred thousand dollars. Mind you, even with us there’s no guarantee. We still have more patients than we can find hearts for. The money buys you a better chance, but it doesn’t give you a guarantee. If we could guarantee a heart to any-one who asked, we’d probably be able to charge twice as much. But one thing’s for sure: if you’re poor, you can’t afford us. You have to take your chances with a public hospital.”
“Where the likelihood of someone getting a heart is akin to one’s chances of winning the national lottery?”
“Exactly.”
“And you think that’s right?”
“I’m not a jurist, Gilda. I’m a surgeon. I don’t dictate how the system works. I’m just telling you how it is. Besides, rich people have as much right to life as poor people, wouldn’t you say?”
“But—”
“It’s all regulated, Gilda. The survivors can donate the heart to whomever they want.”
“But not for gain.”
“Not legally, no. But who’s to say it’s for gain?”
“You just implied that—”
Sylvie waved a finger in front of Gilda’s nose.
“No audit by health or tax authorities has ever detected an irregularity in my clinic’s paperwork. I made sure of that before I took the job. I want to earn money, that’s only nat-ural, but not if it involves a risk of losing my license to prac-tice medicine. What with my love life being the way it is, my profession might be the only thing I’ll have to sustain me in my old age.”
Gilda shook her head, more in condemnation of the prac-tice than denial at Sylvie’s prospects. Sylvie reached out and put a hand over one of hers. “Gilda, Gilda, you’re always painting things in black-and-white. The world doesn’t work that way. You have to see the other side of things.”
“Other side?”
Gilda tried to withdraw her hand, but Sylvie held on to it and leane
d forward in her chair.
“Look,” she said, “if I’d stayed at the Hospital das Clinicas, I might have done a heart transplant every six months. These days, on the average, I do three times as many. I save more lives and I make more money. What’s wrong with that? Everybody wins. Not only me. The patients win, too.”
“But the public hospitals—”
“Forget the public hospitals. They can’t compete. Stop looking at me like that and eat your fish.”
“I lost my appetite.”
Sylvie shrugged and released Gilda’s hand. “Suit yourself. But now it’s your turn. I’ve been doing all the talking, and you haven’t told me a damn thing. What sparked all this curiosity about heart transplants, and what’s it to you?”
Gilda thought for a moment about how to begin. Finally, she just plunged in. “Have you seen the press coverage on that clandestine cemetery?”
“The one up in the Serra da Cantareira? All those desa-parecidos?”
“They weren’t desaparecidos. They couldn’t have been killed by the military government. The corpses hadn’t been in the ground long enough.”
“Okay. So when were they killed? And why were they killed? And who killed them?”
“That’s what I’m struggling with. The cop I’m seeing tonight is assigned to the case. That’s how I met him. He came to the morgue to view the bodies.”
“How romantic. What a great story to tell your grandchil-dren. How grandpa and I met one morning over the—”
“Not funny, Sylvie.”
“No? I thought it was. Maybe you should lighten up.”
“And maybe you should pay attention to what I’m saying. The cops seem to think that some cult is responsible for the murders.”
“Some cult?”
“People performing ritual murders. It’s happened before, apparently.”
“But you—”
“Have another idea. And it seems crazy, even to me. I don’t know whether I should tell him about it or not. I need a second opinion. You’re a cardiovascular surgeon; you’re the ideal person to ask.”
“Gilda, what the hell are you getting at?”
Gilda leaned across the table. “Sylvie, in every case, in every single case, the sternums of the victims had been sawn through. Not hacked, not chopped, sawn.”
Sylvie paused with her wine glass halfway to her lips. “With a sternal saw?”
“Yes. With a sternal saw.”
Sylvie put down her glass, pursed her lips, took in a deep breath, let it out slowly.
“Look, I wouldn’t tell you that organ theft doesn’t hap-pen—”
“So it does happen?”
“Let me finish, okay? I’m attuned to all of this stuff be-cause it directly affects what I do. There was a case a few months ago in one of the municipal mortuaries. A university student slit his wrists and died. His family sent clothes to dress him for his funeral. This is pretty macabre stuff. You sure you want to discuss it over lunch?”
“Have you forgotten what I do all day? Do you think I could do it if I had a weak stomach?”
“Okay, okay, take it easy.”
Gilda sniffed. “Yes, I want to discuss it.”
Sylvie took a hefty swallow of wine before she continued. “The student’s mother got it into her head that she didn’t like the choice of clothing, that she wanted to dress him herself. Last thing she could do for her son and all that. She goes to the mortuary, strips off his shirt, and finds stitches right down the middle of his chest. She goes ballistic and calls the cops. It turns out that one of the attendants had a nice little business going for himself, selling organs to a research lab.”
“Not for transplant?”
“No. They were no good for that. He wasn’t getting them out quickly enough. Then there was this ex-Israeli defense forces colonel up in Recife. You heard about him?”
“No.”
“I’m surprised. It was in all the papers.” Sylvie reached for the bottle of wine, refilled her glass, and made to top up Gilda’s. Gilda put her hand over the mouth of the glass.
“I must have missed it,” she said.
Sylvie shrugged and put down the bottle.
“It wasn’t a case of theft per se. The colonel wasn’t steal-ing, he was buying. Kidneys to be precise.”
“Kidneys?”
“Yeah. It’s damned near impossible to get kidney donors in Israel because there’s something in their religion about the body being buried intact. The colonel was recruiting poor people who were willing to sell one of their kidneys. He had a deal going with a hospital in Johannesburg. The recipients would fly from Israel, the donors from Recife. They’d do the operation there, and the donors would come back without one of their kidneys. It took awhile for the federal cops to catch on. The colonel’s partner was the local police chief.”
“Jesus.”
“Yeah. And then there was a couple who were willing to sell their kid.”
“Sell their kid? So somebody could extract his organs?”
“Uh-huh. How sick is that? They were Albanians, living in Italy. They held an auction. Infant hearts are extremely rare, so they figured they could get a good price. The cops heard about it, mounted a sting operation, and nailed them.”
Sylvie speared her last piece of fish and popped it into her mouth.
“So the baby survived?” Gilda asked.
Sylvie, still chewing, nodded. Then she swallowed and said, “In that case, yes.”
“A couple of years ago,” Gilda said, “I had a maid who told me foreigners were coming into the country, adopting kids out of favelas, taking them home, and cutting them up for their organs.”
“The consensus on that one,” Sylvie said, “is that it’s an urban legend, but the rumor was widespread enough for the government to tighten adoption regulations.”
“What about the regulations pertaining to transplants? Why don’t they do something about that?”
“They already have. Clinics like mine are very strict about the paperwork. The origin of any organ we receive has to be proven beyond a shadow of a doubt.”
“‘Clinics like mine,’ you said. Are there other kinds of clinics?”
Sylvie put down her fork and wiped her mouth with her napkin.
“At the Hospital das Clinicas,” she said, “we had an aver-age of six young men die of gunshot wounds every single day. Most of them, the ones who weren’t shot in the chest, would have made pretty good donors. Those victims, alone, would have generated over two thousand hearts a year. You know how many hearts were donated last year?”
“No idea.”
“One hundred and forty-seven. I’m not talking about the city of São Paulo, Gilda, or even the state. I’m talking nationally. One hundred forty-seven hearts donated in the whole damned country. You know how many people are on the waiting list as of this morning? Three thousand two hun-dred and twelve.”
“Most of those people are going to die?”
“Yes.”
“Because they can’t get a heart?”
“Yes. So that brings me back to your question. There have to be other kinds of clinics. Personally, I don’t know of any, but I know this country. I know you can pay to have some-one killed. It happens all the time. And, if you can buy death . . .”
“What if a clinic was doing both the implants and the . . . harvesting?”
“Killing people to get at their hearts? It wouldn’t surprise me at all. Someone could earn a bundle of money. Someone probably is. Hey, are you going to eat your fish?”
Chapter Thirty
“ABOUT TIME,” SILVA SAID. “Where are you?”
Arnaldo mumbled something. Silva stuck a finger in the ear that wasn’t covered by his cell phone.
“Speak up. I can hardly hear you.”
“I said God knows where I am.” Arnaldo raised his voice only a little. “Can you hear me now?”
“Yes,” Silva said. “Go ahead.”
“The Argentinian handed me over to some guy w
ith a van. He made me sit in the back on the floor. No windows. After about an hour, the van stops and we’re in a garage. The driver takes me to a bedroom. No, not a bedroom, more like a dormitory. It’s full of other people. They assign me a mat-tress on the floor. I sit around for a while making small talk with my fellow emigrants, or maybe it’s immigrants, I always get those two words mixed up. And then the driver comes back. He wants a blood sample.”
“A blood sample?”
“Claims it’s for the Mexican visa. All the other guys nod. He’s done it to them, too, so I decide not to make a fuss.”
“It’s crap. The Mexicans don’t ask for a blood samples.”
“You know that, and I know that, but the other guys don’t. They’re simple people by and large, laborers mostly. When the driver leaves, I ask if anybody tried to make any calls, and they look at me like I’m some kind of nut. They all paid five thousand American dollars to get into the States, and that’s a fortune for them. They’re gonna follow the rules. They’d finger me in an instant if I pulled this cell phone out of my sock and started to use it. You see why I didn’t call?”
“Who’s that talking in the background?”
“Television set. I turned it on to cover the sound of my voice.”
“How come you can get away with calling now? What happened to the others?”
“The driver came back this morning and picked them up. They’re on their way.”
“How come you’re not?”
“They said there wasn’t time to get the visa.”
“You believe it?”
“Why not? I can’t think of any other reason to send them on and keep me here. One other thing: remember that post-card of South Beach? The one you showed me? The one Maria de Lourdes got from her son?”
“I remember.”
“That guy from the agency was here, the Argentinian. He gave me one just like it.”
“Uh-oh.”
“Yeah, uh-oh, is right. He told me it was part of the service.”
“Part of the service?”
“He said that family members tend to get worried, and that they’d come up with this system to put their minds at rest. I could fill it out as if I’d already arrived, address it to anyone I liked. They Fedex all the cards to Miami, mail them as soon as they get word their customers are safely across the border.”
Mario Silva - 02 - Buried Strangers Page 15
