by Ben Mezrich
Alger’s face went slack as he watched Gomez push the corpse away. His eyelids suddenly seemed as if they were filled with lead. He felt Dennis Crow’s hand on his shoulder. “We did everything we could. People die, and despite what the Duke might think—sometimes it’s not our fault.”
Alger looked at him, then toward the double doors at the front of the room. He sighed as he watched another stretcher skid into the ER.
Twelve hours later, Mike Lifton fought back nausea as Josh Kemper yanked open the heavy steel drawer. The thick scent of dead flesh mixed with the antiseptic chill of the refrigerated storage room, and Mike grimaced, wishing he had never agreed to accompany his classmate on the harvest.
“You get used to it,” Josh said, as he pulled the cadaver drawer forward with both hands. Josh was tall, gangly, with oversize ears sticking out from beneath long, stringy brown hair. “It helps to remind yourself how much money you’re making. Twenty bucks an hour beats the hell out of pouring coffee at Starbucks.”
Mike tried to laugh, but the sound caught somewhere in his throat. He nervously pulled at the sleeves of his green scrubs, rubbing the soft material between his gloved fingers. He could feel the sweat cooling against his back, and he shivered, staring down over Josh’s right shoulder.
The body in the drawer was wrapped in opaque plastic with a zipper up the front. Mike took a tiny step back as Josh drew the zipper downward. “Here we go. One stiff, medium rare.”
Mike blinked hard, his mouth going dry. Then he ran a gloved hand through his short, auburn hair. He had worked with cadavers before; as a first-year medical student, he had poked and prodded enough dead bodies to fill a zombie movie. But he had never seen a body so fresh.
The man inside the plastic bag was unnaturally pale, almost a blue-gray color, with fuzzy blond hair covering his muscular chest. His eyes were closed, and his face was drawn, the skin tight against his cheekbones. Early rigor mortis had begun to set in, and his square jaw jutted stiffly forward, his neck arched back against the steel storage drawer. There were no obvious signs of injury, no gaping wounds or visible bruises. The only distinguishing mark was a colorful tattoo high up on the man’s right arm.
“Nice dragon,” Josh continued, pointing. “That’s about three hundred dollars of wasted skin.”
Mike shivered at the macabre thought. He knew that the part-time job with the skin bank was a good way to make money—and great practice if he decided to go into surgery after med school—but he couldn’t help feeling ghoulish. His classmate’s attitude didn’t help matters. It was more than just cynicism bred by experience; Josh Kemper had been born without a deferential bone in his body. During his first year at Columbia Medical School, he had nearly gotten himself suspended for playing catch with a pancreas during anatomy section. No doubt, he was heading straight for a career in pathology.
Mike had always been more sensitive than his classmate. His first day of anatomy, he had nearly fainted when his professor had made the first “Y” incision. And although he had grown stronger over the past three years, he still had a long way to go before he was ready to hold a surgeon’s scalpel.
“Aside from the tattoo,” Josh continued, unzipping the bag the rest of the way, “he looks pretty good. Both arms, both legs. And the eye bank hasn’t gotten here yet. He’s still got both peepers.”
Mike turned away from the corpse as he steadied his nerves. It’s necessary and important work, he reminded himself. The human body was recyclable. And that meant someone had to do the recycling. Heart, liver, kidneys, eyes, skin—someone had to harvest the raw material.
Still, the thought didn’t make it any easier. He bit down against his lower lip, trying not to count the steel drawers that lined three walls of the deserted storage room.
“If you’re going to puke,” Josh interrupted, “do it now. Once we’re in the OR, we’ve got to keep things sterile.”
“I’m not going to puke.”
“Well, you look worse than our buddy here. Mike, you’ve got to get used to this sort of thing. It’s just a hunk of meat. And we’re the guys behind the deli counter.”
“You’re disgusting.”
“That’s why you love me. Check the toe tag.” Josh started across the storage room, toward a filing cabinet by the far wall. “I’ll get the chart.”
Mike breathed through his mouth as he circled around the open drawer. Don’t overthink. Do your job. He reached the back end of the drawer and pulled the plastic bag down on either side. The dead man’s legs were long and muscular, covered with more downy blond hair. His feet were heavily callused, his toenails yellowed like an old man’s. Mike wondered if he had suffered from some sort of fungus.
Now you’re thinking like a doctor. He smiled inwardly, then searched the big toes for the tag. The skin above his eyes wrinkled as he realized it was missing. He searched the drawer beneath the man’s callused heels, but there was no sign of the plastic ID. “Hey, Josh. I don’t see the tag.”
Josh returned from the other side of the room. He had a manila folder open in his gloved hands. “Sometimes it falls down below their feet.”
“I’m looking everywhere. There’s no tag.”
Josh stopped at his side, cursing. He held the manila folder under his arm and lifted the corpse’s feet with both hands. Working together, the two students searched the drawer, but came up empty.
“Fuck,” Josh said. “This is just great. Eckleman is such a moron.”
“Who’s Eckleman?”
“The ME’s assistant. He runs the storage room. Tags the bodies, makes sure the files are coded correctly. He’s a big fat piece of shit, and he drinks.” Josh retrieved the folder from under his arm and leafed through it with gloved fingers. “Derrik Kaplan. Caucasian, mid-thirties. Blond hair, blue eyes. Acute aortic dissection, died in the ICU.”
Mike glanced down at the body in the drawer. “Well, he’s blond, and he’s got blue eyes. But he doesn’t look like he’s in his mid-thirties. Does it say anything about the tattoo?”
Josh shook his head. “No, but like I said, Eckleman is a moron. Look, this is locker fifty-two. Eckleman blows the tags all the time. Especially when the ER is jumping, and after the accident last night—”
“Josh, are you sure we shouldn’t ask somebody? What if it’s the wrong cadaver?”
Josh paused, rubbing a gloved finger under his jaw. He glanced toward the elevator in the corner of the room, where a stretcher waited to take the body up to the OR for the harvesting. Then he shrugged. “We’ve got consent, we’ve got a body. More importantly, we’ve got an OR reserved for the next hour. So let’s go slice up some skin.”
He turned, and headed for the stretcher. Mike glanced back at the dragon tattoo. He hoped his classmate knew what he was doing.
“Watch carefully. I promise, you’re going to like this.”
Mike bit his lips behind a papery surgical mask, as Josh played with one of the saline bags that hung from the IV rack above the operating table. There was a sudden hiss as the infusion pump came alive. Mike watched, shocked, as the skin covering the dead man’s chest inflated like an enormous water balloon.
“The saline empties into the subcutaneous base,” Josh explained, pointing to the three other saline bags that stood at the corners of the operating table. “The pressure lifts the dermis up from the layer of fat underneath. Makes it easier to get a smooth cut.”
Mike nodded, repulsed but fascinated. The cadaver’s chest—shaved, prepped with Betadine, and inflated with saline—no longer looked human. The inflated skin was slick, smooth, rounded, a sort of beige color Mike had never seen outside of a J. Crew catalog. “Is this going to be bloody?”
“Not very,” Josh answered, reaching into the surgical tray by the operating table. “Until we turn him over. Most of the blood has pooled along his back.”
He pulled a shiny steel instrument out of the surgical tray, showing it to Mike. It looked like an oversize cheese slicer, with a numbered knob near the razor-shar
p blade. “I’m going to set the dermatome for point-oh-nine millimeters. The goal is to get a piece that you can just barely see through.”
He leaned forward, placing the dermatome right below the cadaver’s collarbone. Mike considered looking away, then dug his fingers into his palms. In a few months he would be doing rotations in the ER, and he’d see things just as bad—or worse.
He watched as Josh drew the dermatome down across the man’s chest. A trickle of dark, deoxygenated blood ran down into the chrome table gutters. The thin layer of skin curled behind the blade, and Josh deftly twisted his wrist as he reached the bottom of the cadaver’s rib cage, slicing the strip of skin free. He lifted it gently by an edge and held it in front of Mike. It was nearly transparent, a little more than a foot in length.
“Open the cooler,” Josh said, and Mike quickly found the plastic case by his feet. The cooler was a white-and-red rectangle, with the New York Fire Department seal emblazoned across two sides. Mike opened the cooler and retrieved a small tray filled with bluish liquid.
Josh put the slice of skin into the liquid, and Mike sealed it shut. The cooler would keep the skin fresh until it could be transported to the skin bank. There, it would be soaked in antibiotic liquid and stored indefinitely at minus seventy degrees Fahrenheit.
Josh went back to work on the man’s chest. His strokes were deft and sure, and in a few minutes he had skinned most of the man’s chest and abdomen, both arms, and both legs. He left a small circle around the dragon tattoo, which stood out like a colorful island against the whitish pink background of subcutaneous fat.
“Help me turn him over,” Josh said, sliding his hands under the man’s back. Mike moved to assist him, and together they heaved the body onto its side. Mike noticed a small, circular rash on the back of the corpse’s neck.
“Josh, look at that.”
Josh glanced at the rash. It was no more than three inches in diameter and consisted of thousands of tiny red dots. “What about it?”
“Was it in the chart?”
Josh finished turning the body over, then went back for the dermatome. “It’s nothing. An insect bite. A random abrasion. Maybe we scratched him when we transferred him to the operating table.”
“It looks kind of strange—”
“Mike, the guy’s already dead. Someone else is out there with a really bad burn, and this guy’s been generous enough to sign away his skin. So let’s just do our job and get out of here.”
Mike nodded, realizing that Josh was right. The man on the operating table had already gone through the ER. The doctors had tried to save his life, and there was nothing anyone could do for him anymore. But because of Josh, Mike, and the New York Fire Department, someone else was going to benefit from his death. Derrik Kaplan was finished—but someone else needed his skin.
Mike gritted his teeth, then gestured toward the dermatome in his classmate’s hand. “If you don’t mind, I’d like to give it a try.”
Josh Kemper raised his eyebrows, then smiled behind his mask.
One week later, in the private-care ward at Jamaica Hospital in Queens, Perry Stanton jerked twice beneath his thin hospital smock, then suddenly came awake. Dr. Alec Bernstein beamed down at him.
“Professor Stanton,” Bernstein said, his voice affable, “good afternoon. You’ll be happy to hear, the procedure was a complete success.”
Stanton blinked rapidly, trying to chase the fog from his vision. Bernstein watched the little man with almost fatherly pride. He always felt this way with his burn patients. Unlike the face-lifts, breast augmentations, and other elective procedures that made up the bulk of his caseload, the burn patients filled him with pride.
Dr. Bernstein felt that pride as he gazed down at Stanton. A forty-nine-year-old associate professor of history at nearby Jamaica University, Stanton had been wheeled into the emergency room eight hours ago, a full-thickness burn covering most of his left thigh. A boiler had exploded in the basement of the university library, and huge drafts of superheated steam had literally flayed the skin from Stanton’s leg.
Bernstein remembered getting the emergency summons; he had been right in the middle of a liposuction and had scrubbed out immediately. He had surveyed the damage and made a quick call to the skin bank. An hour later he had gone to work on Stanton’s thigh.
Bernstein glanced up as a nurse brushed past him and attached a new bag of fluids to the IV rack above Stanton’s bed. Teri Nestor smiled at the surgeon, then looked down at the slowly awakening professor. “You’re going to be as good as new, Professor Stanton. Dr. Bernstein is the best the hospital has to offer.”
Bernstein blushed. The nurse finished with the IV rack, then moved to the pair of large picture windows that looked out on the hospital parking lot, two floors below. She fiddled with the blinds, and orange sunlight glinted off the twenty-inch television screen on the other side of the small private-care room.
Perry Stanton coughed as the light reached his pale, puggish face, and Bernstein turned his attention back to his patient. The cough bothered him; steam could easily damage lung capacity, and Stanton had shown some signs of respiratory distress when he first came into the ER. Stanton was a small man—barely five-four, no more than 120 pounds, with stubby limbs and diminutive features. It wouldn’t take much steam to diminish his breathing ability to dangerous levels.
Bernstein had already put Stanton on IV Solumedol, a strong steroid that had helped ease his respiratory distress. Now he wondered if he should up the dosage, at least for the next few days. “Professor, how does your chest feel? Any problems breathing?”
Stanton coughed again, then shook his head. He cleared his throat, speaking in a slightly slurred voice. “I’m just a little dizzy.”
Bernstein nodded, relieved. “That’s because of the morphine. How about your thigh? Are you experiencing any pain?”
“A little. And it itches. A lot.”
Bernstein nodded again. The morphine would keep the pain to a minimum, as the temporary transplant helped the burned area heal enough to allow a matched graft. The itching was a little uncommon, but certainly not rare.
“I’ll up the morphine a bit, to take care of the pain. The itchiness should go away on its own. Now let me take a look at the dressing.” Bernstein leaned forward and gently pulled Stanton’s smock up, revealing the man’s left thigh. The area of the transplant was covered by rectangular strips of white gauze. The gauze started just above his kneecap and ran all the way to the inguinal line, where the thigh met the groin.
Bernstein gently lifted a corner of the gauze with a gloved finger. He could just make out one of the small steel staples that held the transplanted skin in place. The skin was whitish yellow, and clung tightly to the nerveless subdermal layer underneath. “Everything looks fine, Professor. Just fine.”
Bernstein pulled the hospital smock back down over the gauze. He decided he could ignore the itchiness, unless it got worse. Bernstein was slightly more concerned about something he had noticed a few hours ago, when he had checked on his sleeping patient for the first time since the transplant procedure.
“Professor Stanton, would you mind turning your head to the side for a moment?” Bernstein walked to the top of the hospital bed and leaned forward, staring at the skin on the back of Stanton’s neck.
The small, circular rash was still there, just above Stanton’s spine. Thousands of tiny dots, a blemish no more than a few inches in diameter. Some sort of local allergic reaction, Bernstein supposed. Nothing dire, but something he would have to keep his eye on.
Bernstein stepped back from the hospital bed. “You try and get some more sleep, and I’ll have Teri up your morphine. I’ll be back to check on you in a few hours.”
Bernstein gave Teri the morphine order, then headed out of the private-care room, closing the heavy wooden door behind him. He turned an abrupt corner and entered a long hallway with white walls and gray carpeting. At the end of the hallway stood a coffee machine beneath a large scheduling char
t.
He paused at the coffee machine, taking a foam cup from a tall pile by the half-filled pot. He poured himself a cup, noticing with a sideways glance that the hospital seemed quieter than usual, even for a Sunday afternoon. He knew there were three other doctors wandering the private-care hallways, and at least a dozen nurses. But at the moment, he was alone with his coffee, his patient, and his thoughts.
He took a deep sip, feeling the hot liquid against his tongue. Not hot enough to burn, to sear skin and cauterize vessels, but hot enough to spark his synapses, to send warning messages to his brain. A little hotter, and his brain would send messages back: Escape the heat before it has a chance to damage and destroy. A little hotter still, and there would be no time for messages. Perry Stanton probably never felt the steam—even now, his pain had nothing to do with the burned area, which had no surviving nerves. It had to do with the steel staples that held the temporary graft in place. But in a few weeks, the staples and the pain would disappear. The professor would leave Jamaica Hospital with little more than a scar and the memory of a wonderful plastic surgeon.
Bernstein smiled, looking up at the scheduling chart above the coffee machine. Then his smile disappeared as he ticked off the rest of his afternoon. A lift at four, a breast consult at five, a liposuction at five-thirty. All elective procedures. Bernstein sighed, taking another deep sip of coffee.
He was about to refill when a sudden scream ripped through the hallway. Bernstein’s eyes widened as he realized that the scream had come from Perry Stanton’s room.
He whirled away from the coffee machine. As he rushed down the hallway, the scream still echoed in his ears. A female scream, filled with terror. Bernstein had never heard anything like it before.
