Flawless

by Joshua Spanogle

  “Strawberry Canyon,” Dorothy said, naming the semi-wilderness a short distance east of the Berkeley campus.

  “Why here?”

  “It’s quiet,” she said.

  And a great place to get rid of a half-blind, pesky doctor, I thought.

  Her arm threaded through mine and she led me to what must have been the trailhead. Arm in arm, we began our odd journey upward along an old fire trail canopied by spreading oaks.

  “I used to come up here a lot,” she told me. “When I was a student. We used to go running here.”

  As if on cue, I heard the thump-thump of feet on the trail and glimpsed a blur of white, blue, and pink bounding toward us. I saw Dorothy tilt her chin, shielding the view of her face with that big hat.

  I tensed as the footsteps passed. Dorothy seemed to notice. “It’s just a couple joggers.”

  We walked in silence for a few moments. “I had a lot of first dates here, too,” she said. “Hiking dates. Better than coffee. If it doesn’t go anywhere, you still get your workout in.”

  Her touch was strong and tender. Her voice, too. I guessed it wasn’t just her knockout looks that had kept the viewing public coming back for more, night after night.

  “I had a first date up here.”

  “How’d it go?”

  “Great, until the girl pulled out the pepper spray and blasted me.”

  “I had to do that, Dr. McCormick.”

  “Nate.”

  “Nate. I couldn’t take chances until I trusted you. Those people show up at my place right after I tell you where I am…”

  “But you trust me now?”

  “I’ll trust anyone who’s stupid enough to try to be funny while they’re crying their eyes out.”

  So, first dates and Strawberry Canyon. Who’d a thunk Dorothy Zhang and I had anything in common besides our names in a dead man’s data storage?

  As a swinging single in that first year of medical school, I’d been set up on a blind date with a Renaissance Studies grad student at Berkeley. We bonded over the phone enough for a first get-together, then decided on a low-pressure hike up through the canyon. The orchestrator of the event was a friend from Penn State who was at Berkeley for engineering. Why he thought an MD-PhD student and a PhD in Renaissance Studies would mix any better than ammonia and bleach, I still can’t figure. But there I was, over a decade before, sweating up that same hill.

  The conversation with the Renaissance PhD withered after we’d moved through the easy topics: where are you from, how was undergrad, and boy the weather is nice. It completely died after she told me I looked just like her old boyfriend. Somehow, the woman took my silence as dumbstruck love. When she called to set up another date, I pleaded stomach trouble and overwork. When she called a second time to check on the dyspepsia and workload, I came up with a lie about a girl back home. After that, I let all her calls go to the answering machine and never called back. Nate McCormick, paragon of chivalry.

  I don’t know why, but I told Dorothy the story. Maybe I wanted to show her I didn’t bear any grudges after the pepper-spray incident. Maybe her arm in mine was making me feel too comfortable.

  Dorothy’s hand tightened on my arm and her head dipped again. Two humanoid shapes were approaching us.

  The couple murmured cheery hellos as they passed.

  “Why don’t you tell me what you’ve been up to for the past few weeks?” Dorothy asked. “Since Paul died.”

  “After you tell me what I’m dealing with.”

  “Don’t get greedy, Dr. McCormick. You don’t want me to not trust you again.”

  “You still have the spray?”

  “Poised and ready to strike one for jilted Renaissance PhDs everywhere.”

  I smiled, surprised that this woman—the woman I’d been seeking for so long, the beautiful TV celebrity, the mauled fugitive, my only solid link to a murdered friend, the woman who’d caused me such physical pain—was charming my socks off.

  Thus charmed, I began to talk.

  74

  “I FEEL LIKE I’M IN the dark,” I said, having just finished my long spiel. “All of these things are happening, but I can’t put it together. I can’t point to anything.”

  By that time, my vision was pretty much back to normal. The view to the west was impressive. In the foreground, Berkeley was a pastiche of green and gray, the campus and town interwoven with oaks and eucalyptus like patches on a quilt. The big tower in the middle of campus—the Campanile—jutted up like a middle finger, a not-so-subtle fuck-you to reactionary forces everywhere.

  Berkeley. Christ.

  Then there was the Bay, dotted with sailboats, and sliced this way and that by enormous tankers. And San Francisco itself, the downtown. Not a lot of glass there. Mostly white or dun-colored stone solidly rising skyward like fossilized teeth in the jaw of some prehistoric reptile. From up there, everything seemed so still, so stable, so peaceful.

  I looked at Dorothy. In profile, I could see under the large sunglasses to a few bumps at the corners of her eyes. The hat brim shaded her face, but not the scarred knot of flesh at her lip, which, at rest, pulled her mouth into a snarl. I found it difficult to look at her, difficult to turn away. Like the proverbial train wreck.

  She caught me staring at her, and shifted away to face the view.

  “So, what’s going on?” I asked her. “What am I missing?”

  “I can only tell you what happened to me.”

  “That’s more than I have now.”

  “I suppose,” she agreed softly. “Okay, me. What I’ve been doing for the past…Oh, God…the past year.” Her fingers nudged the sunglasses higher. “Thirteen months ago, I heard about this new cosmetic treatment. Better than Botox. Better than Restylane. Much, much better. I was working as an anchor at the time, and had done my duty with Botox. Such a pain. Literally. Needles every few months. And the results were good, but not great. You still get the slackness of the skin, the drooping. You still age. Anyway, this is to say that I’d been somewhat familiar with cosmetic medicine so, when I heard of this new treatment, I was intrigued.”

  “Where’d you hear about it?”

  “My mother, actually. Her sister had it done. Her sister had friends and those friends had friends and they’d all had it done, according to my mom. Everyone was thrilled with the results. My aunt, she looked great. I mean, here was this woman in her late fifties who looked like she was forty.”

  “Oh, man. Why did you do it?”

  I don’t think she’d been expecting that question. The sunglasses turned toward me, then away.

  “Because my priorities were screwed up,” she answered after a moment. “Because in my business how you look is worth a helluva lot more than what’s going on between your ears. Because there’s a goddamned website that rates TV newswomen and I was high in the rankings and I loved it, and because I had just dropped behind that KRNO bitch Kristin McField and I hated that.”

  We walked for a bit before she continued, “I was an average-looking kid. I lie: I was kind of ugly. My head was too big for my body, my face was chunky. But things began to change when I hit puberty. I didn’t really notice the changes, but I did notice when other people noticed. Doors that had been closed to me for my whole life began to open. School plays, slumber parties, dates. It only became more obvious during college. If I’d been the same awkward thing I’d been in sixth grade, no one would have suggested broadcast journalism to me. If no one had suggested broadcast journalism…You get the picture.”

  “The mysterious power of beauty.”

  “It’s not mysterious if you pay attention. Anyway, I knew that my career, my prospects with men, even some of my mother’s love, owed a lot to my face. So I owed a lot to my face. I never wanted to be that ugly kid again.”

  The last sentence contained, perhaps, more savagery than she’d intended, because she hastily changed the subject. “Anyway, Auntie Joan gave me a name of the guy who represented the man who did her cosmetic work, and aft
er going through a few intermediaries, I finally saw the pictures.”

  “The pictures?”

  “The Before and Afters. This man—Jasper, he said his name was—brought along a binder of photos. The women looked fabulous. There were a couple of men, too, and they looked great. Amazing, like someone had just erased lines and rolled back the years. A decade younger at least.”

  “Did this Jasper guy talk about the risks?”

  “He didn’t, and I didn’t ask. I did not want to know the risks then. All I saw is what it did for these people and what it could do for me.”

  I shook my head.

  “Do not judge me, Dr. McCormick. That’s already been done. And I’m paying the price, okay?”

  “Okay.”

  She turned toward the west, toward a fat yellow sun that was dropping like a bomb onto the city.

  “Jasper told me that the procedure involved injections into the skin, just like Botox. That the results were very long-lasting. That the doctor who performed the injections had done some of the original research on the substance at university.”

  “Which university?”

  “The University of Illinois in Chicago, I think. Why?”

  There was a flutter in the back of my mind, a tickle. I concentrated on that for a moment, then zeroed in: Tom Bukowski, the founder of Tetra Biologics, now deceased, had his lab at the UIC before setting up shop in California. “What was the doctor’s name?”

  “Wei-jan Fang. Anyway, Jasper showed me pictures, assured me it was perfectly safe. He said the effects lasted for years, and he had all these testimonials. He said that the treatment was being used all over China and there had been no major complications. He said the injections were legal over there, that they just hadn’t reached the States yet.”

  “Is it available in China?”

  “He said it was.”

  “You didn’t check?”

  “My aunt had it done. Her friends had it done. They looked great. It seemed safe.”

  “I’d just assume that if you were going to get something like this—”

  “Not everyone is a damned physician who does fifteen years of research on everything.”

  Everywhere I stepped, I seemed to tramp on a nerve. “How much did it cost?” I asked. That seemed like a safer question.

  “Twelve thousand dollars. Cash.”

  I tried to whistle, but there was still too much goop in my mouth. The sound fluttered pathetically. “This happened a year ago?”

  “Nine months.”

  “Where did you get it done?”

  “The Richmond, on Geary Street. There was a nail care shop in front, which, I think, was just that—a front—since there was never anyone getting their nails done there. The back was just like a doctor’s office. Just as clean, just as professional looking. There were four other women in the waiting room. All Chinese, except for one I thought looked Vietnamese.”

  “What was the name of the nail place?”

  “What does it matter? I heard they moved to a place called Spectacular Nails a few months ago.”

  “Where was it?” I persisted.

  “Clement and Thirty-sixth.”

  “What exactly did they tell you they were injecting?”

  “They called the product ‘Beautiful Essence.’ Great name, huh?”

  “Sounds like aromatherapy. What did they tell you Beautiful Essence was supposed to do?”

  “Regrow tissue that had been lost.”

  “Regrow tissue? How?”

  “They refused to discuss that. They called it a trade secret.”

  I thought about that, about “regrowing tissue.” This can be done in a few different ways: implanting stem cells that take root and proliferate, adding substances to make cells already in the body grow, or turning off the cellular mechanisms that stop growth. But engineering tissue growth isn’t easy. The body has checks and balances against uncontrolled growth, better known as cancer. Like Bill Yount told me, the early work on fibroblast stem cells had been disappointing.

  For me, the most likely culprit would be the fillers, which Yount had said were substances that bring cells to the injection site. The technology is old and widely available. I didn’t have too much trouble imagining a poisoned batch of fillers cooked up in some lab in China.

  But whatever it was, it had sprayed cancer into Dorothy Zhang’s face like buckshot.

  “Did you at least ask about side effects?” I heard the impatience in my voice. So, it seemed, did she.

  “They said there would be swelling. And that I should stay out of the sun for a couple of days.”

  “That’s it?”

  “That’s it.” She raised her head and looked off into space for a moment, zipping through the atmosphere, visiting distant planets. “The procedure itself was easy. There were more injections than with Botox. I think they said they gave me over fifty separate injections—around my eyes, my mouth, on my forehead. Wei-jan Fang himself administered the injections. I should have left as soon as I saw him.” She said it bitterly.

  “Why?”

  “I’d never seen someone looking so stressed out. He came into the room looking like a fugitive—”

  “Maybe because he was a fugitive? Because what he was injecting was illegal?” Again, I sounded harsher than I intended.

  More than ten million cosmetic procedures were performed in this country last year. Four million Botox injections. A million chemical peels. Three hundred thousand boob jobs. Liposuction. Eyelid surgery. Sclerotherapy. Face-lifts. Of course, there’s the fringe stuff, too. For the girls: buttock implants, vaginal rejuvenation. For the guys: calf and pectoral implants. All in all, ten million chances for a better life, or at least a tighter jawline or a J.Lo rear.

  In addition to all that, you got the black market. No one really keeps track of the illegal stuff, but every once in a while, a body floats to the surface. Liposuction in a basement in Massachusetts, a blob of fat travels to the lungs, a young woman dies. Four people paralyzed after their doctor (who’d already lost his license) injects them with a non-FDA-approved form of botulinum toxin. There are the gray areas—the ob-gyn legally injecting Restylane after a weekend workshop—and the black areas—anyone injecting a substance not approved by the FDA for use in humans. What Dorothy Zhang was describing to me sounded pretty black—a clinic moving around, nondisclosure about what was being injected, refusal to talk about risks. A thousand-to-one chance that injecting Beautiful Essence into someone’s face was about as legal as injecting diesel.

  “Twelve thousand a pop, huh?” I asked.

  “And forty minutes.”

  “A ton of money.” My public health antennae began to quiver anxiously. “And a lot of people. What do you think: ten patients a day? More?”

  “More, I think.”

  “How’s your aunt?”

  “Fine, as far as I know.”

  “And her friends?”

  “I haven’t spoken with anyone in the family for months, except my brother. I think they’re fine.”

  “It’s not everyone then…the fibrosarcoma.”

  “No. Only the unlucky few.” Her voice wobbled, and she swiped at a rivulet of saliva that had escaped from her mouth. “After the injections, Dr. Fang said I should see results in the next week or so, and then ‘positive changes’—that’s how he put it, ‘positive changes’—would continue over the next few months as the tissue began to fill in. He told me to set up an appointment for a checkup in two weeks. After that, I’d need bimonthly checks.”

  “And the results?”

  “All the hype was true. Everything went just as Dr. Fang said it would. My face looked even better after a month. I began formulating the story I’d run when the drug hit the U.S. market. You know—a before-and-after piece, the kind of thing that drives up your ratings. I was stupid enough to think about talking to Dr. Fang about an exclusive. I was so stupid, Nate, so pathetically naive…Four more months passed before I saw the first bump.”

&n
bsp; “Where?”

  “Free Beautiful Essence treatments if you guess right.”

  “Your lip. Right lip.”

  She gave me the barest smile; it lasted only an instant.

  75

  “IT STARTED WITH A TINY bump, so small I could barely feel it with my fingertips. I showed it to Dr. Fang when I saw him in follow-up. He got a little worked up about it, asking me when it started, if there were any other spots. He took a little tissue, to analyze it, he said. His reaction made me nervous, so I told him I planned to go to my regular dermatologist to get it checked out. That’s when he flipped out. He told me they’d take care of it in the clinic, not to worry, blah, blah, blah.”

  “You didn’t listen to him.”

  “Hell no, I didn’t. I scheduled an appointment with my doctor for the following day.”

  “You got a next-day appointment with a dermatologist?”

  “One of the perks of being on TV. Anyway, my dermatologist biopsied it. He called it dermatofibrosarcoma protuberans.”

  “Nice pronunciation.”

  “I’ve had plenty of time to practice it. I freaked out, of course. I mean—cancer?” She got quiet again. “Dr. Fang called me the day after I got the biopsy results, to make sure I hadn’t seen another doctor.”

  “What did you tell him?”

  “I told him to take his MD and shove it up his ass. And I told him that I was going to seek further treatment at UCSF. He said doing that would be a mistake, that he wanted to protect me from people who would hurt me, hurt my family. He said he knew that I knew what he was talking about.”

  “Did you know?”

  She said nothing.

  “Come on,” I prodded. “Your brother said the same thing. Talking about ‘these people’ and ‘you don’t know who you’re messing with’—”

  “I do know who I’m messing with. So does Daniel.”

  “Who the hell are they?”

  “Remember I said my mother’s sister had the procedure done?”

  “Yeah.”

  “Well, Auntie Joan is married to Uncle Tony.”