Michael Palmer

by The Last Surgeon

  “So you’re worried that maybe people might actually, I don’t know, use your services?” she asked.

  “Funny, very funny. But yes. First of all, our services, such as they are, are dwindling with each record we make electronic. Ever hear of a position whose job it was to make itself obsolete? We’re literally working ourselves out of existence. The only way we three can stay employed is if no one knows we’re there.”

  “Easy, Saul. Easy,” Jillian said gently. “You can only do what you can do.”

  “I guess.”

  “Now, can you tell us what you found out?”

  Mollender motioned the waitress over and ordered a tall glass of skim milk, warmed on the stove, not in a microwave.

  “And don’t try and trick me,” he said to the girl. “I can tell.” He turned back to Nick and Jillian. “What I found out is that Fred Johnson is even more of a jackass than I originally thought.”

  “Fred Johnson?” Nick asked.

  “Before I delve into him, can you tell me why somebody would have wanted to steal the DVD of that operation?”

  “Did you say steal? I thought you just said it was gone.”

  “And that’s the truth. If it ever existed, it’s gone now.”

  “Why am I not surprised,” Nick said.

  “I personally supervised setting up the video camera system in the ORs over six years ago. For that reason, let alone everything else I’ve done for my unit over the past twenty years, you’d think I’d be the one selected to run the electronic medical records department. But no. Smarmy Fred Johnson gets the position over me, just because he’s the CTO’s nephew or cousin or something.”

  “That true?”

  “That’s what I heard. The personnel lady told me I was lacking people skills, whatever those are, but I never believed her. Smarmy. I think the word was invented for Fred.”

  “Do you have any proof that somebody stole the DVD of Mohammad’s operation?”

  “We have three cameras in each of our twenty-four operating rooms on three separate floors—a direct overhead shot into the incision, one up from the foot of the table, and one that continuously pans the room, including the anesthesiologist’s station at the head of the table. Each camera is attached to a DVR machine by cables, like a supercharged TiVo.”

  “Amazing,” Nick said, pleased to sense that the Mole had regained much of his equilibrium.

  The waitress returned with the stove-warmed milk, and Mollender sampled it like a wine connoisseur before nodding his approval.

  “Supervising the recording process,” he went on after a few sips, “is one of the few functions my little department still has, but I’ve heard rumors that it might not be for long. Damn Johnson. Anyhow, as things stand, the OR supervisor tells us which operations they want recorded, and we push the buttons—well, my assistant Annette does, anyway. She has a booth in the operating suite and works from there. At the end of each day, she burns the cases onto DVDs because we can’t store all that data indefinitely on the DVR machines.

  “We also keep a registry of the discs, which is what the instructors use to look up operations they want to show their students. We catalog them not only by date and time, but also by IDC code and keywords. I checked after you called, Doctor. There is no entry anyplace for Aleem Syed Mohammad’s surgery.”

  “Could somebody have taken the DVD and deleted the entry in your database as well?” Jillian asked.

  “Anything is possible, I suppose. But why would somebody do that? Actually, I asked myself that very question any number of times. Tell me about this Mohammad fellow. What do you know about him?”

  Nick produced the folder of articles Reggie had printed out during the evening.

  “Mohammad was born and raised in Jordan,” Nick said. “He was in his late forties when he was captured in Karachi by U.S. and Pakistani Special Forces in a joint operation code-named Shining Star. There’s no telling how many deaths he was responsible for. He was a prime suspect in several major bombings, including the massacre at the United States Embassy in New Delhi.”

  “What’s his affiliation?” Mollender asked. “Are we talking Al Qaeda?”

  Nick shook his head.

  “I haven’t had time to go through all this yet,” he said, “but I think not at first. Apparently at some point after the Iraq invasion, his organization, Islamic Jihad in Jordan, merged with the Al Qaeda terror network, making him one of the most powerful and wanted terrorists in the world.”

  The Mole thought for a few beats. “Yes, I remember now. His capture was touted as a major victory in the war against terror.”

  “Correct,” Nick said. “The controversy that erupted when word got out that Mohammad required surgery to remove a dangerous cardiac tumor, and that a team of doctors had been assembled for the operation, was intense.”

  “I guess there were those who felt the famed Hippocratic Oath phrase ‘Do no harm’ applied to the doctors, but not to the patients,” Mollender said, chuckling at his own humor.

  “There were threats made by extremist groups who wanted him saved, and others who wanted him not treated at all,” Nick added. “They promised retaliation against anyone who helped keep Mohammad alive, which they believed would have made it possible for us to torture him some more. That’s why the location where his surgery was scheduled to be performed was kept a closely guarded secret, right up until the day of the operation.”

  “According to Nancy Lane at the nursing school,” Jillian said, “a lot of people felt justice had been served when Mohammad died on the operating table that day. Autopsy results indicated he suffered a massive brain aneurysm and subsequent cardiac arrest from chronic high blood pressure.”

  “Tough way to go,” Mollender said.

  “That’s why we need to see the tape of his operation. Maybe Belle’s death was some sort of retribution for his death, even though it’s hard to understand why they waited three years.”

  “But why her?” Nick asked. “Saul, that operation is all we have at the moment. We need to know everything we can about it. I can’t believe you, of all people, don’t have a backup.”

  Mollender snickered. “Hence my statement that Fred Johnson is a jackass.”

  “What does he have to do with any of this?” Nick asked.

  “Before Johnson took over, I would send the DVDs by mail to my friend Noreen Siliski, who runs a disaster recovery business in Sutton, Virginia. She would then copy the files to her servers and mail the DVDs back to me and, bingo, we’d have our backup. Noreen is a wonderful person. Very bright, very unique. We were once quite close. Now we’re just . . . good friends.”

  “You don’t sound so pleased about that.”

  “I’m not, really. But like you said, what can you do?”

  “Sorry. Can you go on?”

  “So when Fred Johnson takes over and sees this minuscule payment we’re giving Noreen each month, the guy decides to flex his muscles, make it a point to the hospital administrators that he’s looking after every nickel and dime. Meanwhile his EMR department is a million over budget. I was told to stop sending backups to Noreen.”

  Jillian frowned. “I’m afraid to ask when Johnson made you stop using your friend for disaster recovery.”

  “Four years ago. A year before Mohammad’s operation.”

  “So that’s it, then. No video. Even if we were able to find out what personnel were in the OR that day, it won’t tell us anything about what happened during the operation.”

  For the first time, Jillian noted a glint in the Mole’s eyes.

  “Well, all might not be as bleak as it seems, my friend,” he said. “You see, if Mohammad’s surgery was ever recorded, then there is a copy of that video nobody knows about. That’s why I asked who would want to steal it and cover their tracks by deleting it from my database log, and the real reason why I wanted to meet here. If someone’s stolen the original DVDs, I didn’t want to meet anywhere near the place.”

  “But you just told u
s there wasn’t any backup,” Nick said.

  “I told you there wasn’t supposed to be any backup. Well, with Fred Johnson being so self-righteous about Noreen, and at the same time being so wrong, I guess I forgot to put in the paperwork to shut down our little disaster recovery operation.”

  “You mean . . .”

  “Yup. Fred Johnson assumed, as did everybody else, that we stopped sending DVDs to Noreen. But as with most things, the pompous jackass was wrong. Buried in that massive budget of his is one tiny line item that he wouldn’t find unless he went through the whole thing ten times with a fine-tooth comb. You see, I changed the name of Noreen’s company but I never canceled her contract with us.”

  “Saul, let me buy you another milk,” Jillian said.

  CHAPTER 39

  Better Safe Than Sorry Electronic Storage, Noreen Siliski’s data backup and recovery business, was located in an isolated three-story brick business center on the outskirts of Sutton, Virginia. It was ten in the morning when Nick pulled into the nearly deserted parking lot. Rush hour traffic away from the city had been intense, although he suspected it was not unusually so. Nick had the entire day free. Junie would be working the RV with one of his backups, a seventy-year-old retired professor of medicine from Georgetown—a brilliant, caring woman, who was beloved by the patients and utterly devoted to the evening each week she spent on the roads with Helping Hands.

  The drive across the river and south was made in virtual silence. Mollender, sitting in back with his hands folded tightly in his lap, stared out the window of Nick’s 1995 Cutlass Cierra. In the front, Nick and Jillian were each engrossed in the same gnawing question: Would the recording of Aleem Syed Mohammad’s ill-fated surgery shed any light at all on the strange one-way ambulance trip of Umberto from the Singh Center to Shelby Stone, or on Belle’s subsequent murder three years later?

  “Just pull in there a couple of spaces left of the Dumpster,” Mollender said, breaking the prolonged silence. “The chute is coming out of Noreen’s office on the third floor. She’s always remodeling.”

  “You got it,” Nick said, easing into the spot.

  Down on the seat, where the Mole could not see, Jillian squeezed Nick’s hand. Then they followed Mollender into a rather stark, tiled lobby and up two flights of stairs.

  At that instant, a gunshot rang out from within Noreen’s office, then several more in rapid succession.

  Nick pounded once on the door and grasped the knob. The door flew open.

  The woman’s outer office, which was about the size of a two-car garage, had been stripped down to the studs. On a stepladder at the center of the room, wielding a hefty cordless nail gun, was Noreen Siliski.

  “This is what one can do when there is almost no human traffic,” Noreen said, making no mention of Nick’s rather sensational entrance as she stepped down to the floor and shook hands heartily with the new arrivals. “Business was good when I petitioned the owner to add storage space. When he finally approved the changes, business was bad. But I love building things so I’m doing it anyway.”

  Half the office was covered by bedsheets, sprinkled with a fine misting of sawdust. The smell of freshly cut wood hung pleasantly in the air. In the center of the main room next to the ladder was a wooden rolling workbench, underneath and on top of which were an assortment of tools, including a circular saw and cordless drill.

  Noreen Siliski was a pleasant-looking brunette, slightly on the muscular side, with her dark hair pulled back in a sizeable ponytail. Nick sensed that her jeans and white denim work shirt might be the central elements of her wardrobe.

  “It’s wonderful that you’re doing this all yourself, Noreen,” Jillian said.

  “It’s sort of learn as you go, but I’ve always been able to handle most tools.”

  Finally, Mollender stepped forward.

  “I like what you’re doing here, Noreen,” he said, seeming somewhat cowed.

  “That’s nice of you to say, Saul.”

  “So you have the recording?” Jillian asked, anxious to break the negative vibes she sensed were building between the two.

  “I believe I do. Saul told me the date. I digitize and archive all the video files he sends me, so it was easy to find. I burned it to DVD so we can watch it here in the office. Can you pull the shades over there?”

  Noreen went to the back room and quickly returned, struggling some to push a steel AV cart over the threshold and into a free corner of the room, in front of a quartet of folding chairs. On the top of the cart was a forty-inch HD television set with a DVD player on the shelf beneath it. As the door she came through began closing, Nick caught a glimpse of the work space that lay behind it—one with a raised floor, similar to the call center at Don Reese’s precinct headquarters, and racks that he figured were used to house her computer equipment.

  Nick proceeded over to the wall housing three double-hung windows. The chute to the Dumpster, an absolute marvel of practical engineering, opened at the center one. The chute was constructed of large, heavy rubber trash barrels with the bottoms cut out, stacked one just inside another, and held in place by chains looped through the handles and bolted above the inside of the window. The three-story drop to the Dumpster was a modest arc rather than a straight shot, and the overall appearance of the green barrels was that of a giant caterpillar.

  “Remarkable,” Nick said, calling Jillian over to see.

  “How did you know how to do this?” she asked, amazed.

  “How else?” Noreen replied. “The Internet. I just drop that canvas flap down over the window when I leave. It took a few trips to a few hardware and Home Depot stores to get enough barrels, but it wasn’t that expensive or that hard to build.”

  Nick closed the blinds and dropped the canvas over the window opening. With the room sufficiently dark they gathered in front of the television. Nick and Jillian were both feeling too anxious to sit.

  “Well, I hope this disc is holding what you’re looking for.”

  “We hope so too,” Nick said.

  “In that case, I think we should get on with this.” Noreen slipped the DVD into the slot and with a nod of understanding to her guests, pressed Play.

  CHAPTER 40

  “You ready for this?” Nick asked as the screen lit up with static.

  “Dunno,” Jillian said grimly. “Are you?”

  “I’m not sure. We’ve come so far.”

  “I can’t believe I’m going to see Belle alive.”

  “Want me to stop it?” Nick asked, holding up the remote, given to him by Noreen.

  “No, but I want to sit down, I think.”

  Jillian inhaled deeply and took Nick’s hand in the darkness. They were six feet from the screen, about to watch a video that included the death of a patient. It also was probably going to include shots of Jillian’s younger sister, subsequently murdered in a manner that every policeman involved with the case believed was suicide.

  Saul Mollender and Noreen Siliski sat next to each other, behind and to the right of the others. The tension in the room was high.

  In half a minute, the static gave way to a set of standard legal notices, yellow on black, that included a summary of the HIPAA laws surrounding patient confidentiality, an outline of who was allowed to view the recording and for what purposes, and the name of the editor, Annette Furst, Department of Medical records. Finally came the hospital name, date, and operating room number. Jillian was rigid in her seat, squeezing blood from Nick’s hand.

  The introductory information was in the same yellow print.

  PATIENT: Aleem Syed Mohammad

  Hospital ID: 881-83-7782—Karachi, Pakistan

  Condition: Cardiac rhabdomyoma

  Procedure: Cardiopulmonary bypass; excision of rhabdomyoma; cardiac reconstruction

  Present in the Operating Room:

  Surgeon: Abigail Spielmann, M.D.

  Asst. Surgeon: Lewis Leonard, M.D.

  Cardiac Surgical Resident: Yasmin Dasari-Olan, M.D.
r />   Anesthesiologist: Thomas Landrew, M.D.

  Perfusionist: Roger Pendleton, CCP, Cert. ABCP

  Scrub Nurse: Kimberly Fox

  Circulating Nurse: Cassandra Browning-Leavitt

  Medical Student: Yu Jiang

  Nursing Student: Belle Coates

  Nick felt the energy in Jillian’s grip increase at the sight of her sister’s name. He froze the picture.

  “Do we know who Dr. Abigail Spielmann is?” he asked.

  “I think she was brought in from another hospital,” the Mole replied. “Probably an expert in cardiac tumors like this one.”

  “She must be big stuff if the cardiac surgical chief would allow it,” Jillian said.

  Nick undid the pause.

  The printing gave way to a gleaming operating room. Three cameras, according to Mollender—one of them straight down into where the patient would be placed on the now empty table; one up from the foot; and the other giving a wide-angle shot of the entire operating room. The video editor’s job, Mollender explained, was to mix the various camera angles into a cohesive and useful presentation.

  The opening sequence was shot from the wide-angle camera and showed the perfusionist, wearing scrubs, a mask, and hair cover, but set back from the sterile field where the surgeons would be working. Seated behind the long heart-lung bypass machine, he looked like a concert pianist preparing for a performance. He was chatting with the scrub nurse.

  “Need anything?” the perfusionist said. “Cassandra’s right outside.”

  The audio and visual feeds were excellent.

  “As a matter of fact, yes,” the scrub nurse replied. “The only thing from Dr. Spielmann’s instrument list that I don’t have here is a Loc-Ness tissue stabilizer. Could you ask Cassandra to get one for me, please?”

  “Will do. Have you met Spielmann?”

  “She came by to see me a little while ago. She seems terrific.”