The Angel Maker lbadm-2

by Ridley Pearson

  "And if it's not done in a hospital?"

  She thought about this for a long minute. She nodded and nibbled at her fingernail, eyes on her desk. Boldt looked out the window at the weather. He felt tigbt-throated and hot. It was growing dark out there. More rain. She didn't say anything. "You look puzzled." Frightened was more like it, he thought. "The thing of it is," she said, "it's possible. You're right about the Third World. market. If I'm the procuring surgeon, I don't want to mess with UNOS-they would catch something like this. I don't want to get anywhere near the system. I'm telling you, the safeguards in this country are just too established. But overseas? A kidney is good for sixty hours these days, that's plenty of time to reach any foreign destination. And the money-the money would be phenomenal, I should think. You hear about prices like fifteen- and twenty-thousand dollars a kidney. Cash, no taxes. No questions. A couple of those a month, and you're doing just fine."

  Excitement stole into Boldt so that his writing was illegible.

  He slowed and took down the same notes a second time. Miles snatched his pen and threw it to the floor. With the boy in the harness, Boldt couldn't lean down to reach it. Dr. Light Horse handed him a replacement. She seemed to be waiting for him to say something. He checked his notes once again. "So he does the harvesting outside a hospital?"

  "Absolutely. This makes much more sense. But there would be a high risk of infection. Hospitals invest hundreds of thousands-millions-of dollars on their surgical suites. Filtered air, double doors, regular cleaning. You can't duplicate that on your own unless you have more money than God."

  Her fear fed his excitement. These were leads to follow, ideas to pursue. The more they talked, the more he saw an investigation developing. He now saw the investigation dividing into several areas: Connie Chi, the Bloodlines employee, these technical leads, and the bones that Dixie suggested might have started it all.

  She looked even more frightened when he asked, "Could I lease such equipment?"

  "The scent you were talking about … something to follow?"

  "Yes. "Not my field. But I would guess that you could."

  "What about transporting the organs? How difficult is it?"

  "Technically, it's not difficult at all. You can use anything from Tupperware to stainless steel. Some Viospan. Ice. Depending on the organ, it'll keep anywhere from a couple of hours to several days." She added, "Ice chests igloo coolers or Styrofoam-are the most common ways to ship them. One of those small picnic coolers. UNOS uses disposable Styrofoam coolers with bright red labels sealing the joints. If you're going to walk a transplant organ through airport security, you're going to want a UNOS container. Now there is something you could check on." She brightened. "Stolen UNOS containers or labels. Air-freight cd organs are usually handcarried by the pilot or another member of the flight crew. The legal ones are. But a passenger could do the same thing if he or she could get through airport security."

  Boldt wanted to grab for the phone. He wanted to rush out of here and put a team on it immediately. He wanted to reach across the desk and kiss this woman. This was the exact information he had hoped for: a different angle. A different point of view. If they couldn't trace the victims to the harvester, perhaps they could trace the movement of the organs: a courier. He said, "My feeling is that you overrate airport security. As long as an object doesn't appear to be a weapon or a bomb, they're not going to stop it."

  "You're probably right." She picked up the autopsy photos and studied them intently. She was getting caught up in this as well. "That's a large incision for a kidney. Did I mention that?" "Large?" Boldt asked. "Is that significant?" She had mentioned it, he realized; he'd even made a note of it on the top of the page. Was the surgical method unique? Would it provide them with a "signature" that they could later use to prosecute a suspect? He caught himself holding his breath, waiting for her.

  She appeared so deeply in thought for such a long time that he wondered if she had forgotten his question. She tested her coffee and avoided his eyes in a way that prevented him from interrupting.

  Miles was being a real pain in the ass. He wouldn't hold still.

  Boldt tried to occupy him with a plastic ring, but Miles wasn't having anything to do with it. He wanted some floor space. He wanted some moving room.

  She finally said, "This incision is larger than necessary. These closure techniques are antiquated. It's doubtful that this is the work of a contemporary surgeon. A retiree is more likely. Unless the surgeon simply doesn't care how it comes out. But cosmetics are an important part of any surgery: Keeping the scar small. The subcutaneous closure is a continuous-interlocking stitch. It's an unusual stitch, but very strong."

  Boldt wrote down in large letters: STITCHING. Retiree? This meant something, though he didn't know what. More to investigate; more to work with. Impatience stole into him-a cop's biggest enemy. Where was Sharon Shaffer at this moment? What had they done to her? What did they have planned for her?

  Dr. Light Horse glanced at her watch, and Boldt took his cue.

  He packed up Miles, put his notebook away. As she walked them to the elevator, he stopped and said, "Let me ask you this … If type O is the best blood type for transplants, why would this harvester want someone with type AB-negative?"

  Bloodlines had provided Boldt with Sharon's records that included her blood type. The Professor had confirmed that the blood found on the chair in her apartment was also AB-negative.

  She appeared puzzled. "Is this person soliciting organs?" He explained, "We believe he's kidnapped a woman. She's blood type AB-negative, not O." Her face tightened. "What is it?" he asked. "AB-negative is an extremely rare blood group."

  "So I'm told. But what's that mean for a transplant?" She led him over to a string of seats by a Coke machine. He felt nervous, worried about Sharon. She obviously felt this would require some explanation.

  Miles liked the lights of the Coke machine; he seemed mesmerized.

  She explained, "The human body is blessed with an immune system to fight disease. The technical aspects of transplant surgery were pretty much worked out twenty years ago. Haven't been improved much since then. The main avenue of research has been into convincing the body's immune system not to destroy the transplanted organ. The body will reject any organ to some degree, unless it is from an identical twin. Blood is a tissue. A transfusion is the simplest example of a tissue transplant. Are you with me?" Boldt nodded. "We all belong to certain blood groups, and many of those blood groups are incompatible with one another. An organ is made up of both a blood type and several different tissue types, making matching-for the transplant surgeon-even more complex. The focus for the last twenty years has been to suppress the body's immune system far enough to accept a transplanted organ, but no so far as to allow infection. That's a fine line. in the past five years, drugs have come a long way in helping to accomplish that. One day soon, immune suppression may be a thing of the past. But for the present, in the more critical organs-the heart, the liver, the pancreas-you need an organ not only the right size but also the best possible tissue match. The closer the match, the less rejection; the less you have to suppress the immune system, the less chance of a fatal infection. Okay? We talked about kidneys. It is true that type O organs transplant well because O is accepted more easily by the other blood groups. The body puts up less of a fight. If someone is selling organs, as you suggest, it makes sense to procure type O-it's your biggest market; not only the largest blood group but a good second choice if you don't have an exact blood-type match. Type ABNEGATIVE is less than four percent of the population. In the major organs, if you had an AB-negative recipient, you'd want an AB-negative donor to have any chance at all."

  "A custom job, is that what you're saying?"

  She cringed at the term. "It's a specific match. That is what I'm saying. A special order."

  The elevator opened. Dr. Light Horse caught it and held it for Boldt and his restless passenger.

  She walked him to the front of the
building. She walked quickly, expecting him to keep up.

  As they stopped to shake hands, she said, "The implications of what you're suggesting are horrible, of course. The medical community as a whole and surgeons in particular are just beginning to address ways of more closely monitoring the donor crisis. If more people donated their organs at death, we wouldn't be seeing any of this. If you're looking for a possible candidate," she continued, "I would start with surgeons reprimanded by the AMA-someone suspended and out of work. Frustrated. Angry. I assume we agree this person is deranged, and such thinking could easily distort the Hippocratic Oath. As doctors, we're sworn to save human life wherever possible. He or she reasons that the donor can get by on one kidney, that the recipient will die without that replacement organ. You have three dead, you said. Three out of a hundred or three out of five? That is how he is thinking. He may be playing percentages, I'm sorry to say." She touched his arm. "All this is just the long way of saying that it could be anyone disturbed enough to convince himself that what he's doing is not only acceptable, but ethically sound. He may see himself as an angel of mercy."

  Mention of the word "angel" triggered vivid images from his youth. He remembered playing in the snow, lying down and fanning his arms and legs so that the impression he left behind resembled that of an angel. Only now he saw things differently: Inside that impression lay the bleached white bones of a skeleton. He said, "An angel? Hardly. An angel maker is more like it."

  It gave Pamela Chase a sense of importance to be summoned at a moment's notice out to the farm. He needed her! Perhaps he would make love to her again; perhaps his calling-her out here had nothing whatsoever to do with work, as his phone call had implied.

  A low, mid-morning smoke-gray fog hung over the area where the farm sat, running from the ground to the tops of the tall trees that rimmed the ridges behind it. She spotted the fog only briefly before disappearing into it, and this made her wonder whether you ever saw things for what they were while you were inside them, a part of them.

  The fog forced her to drive more slowly, and it gave her a few minutes to think. Seemed like all she did was think-that's how a person all alone spends her time, she thought, trapped inside your thoughts and dreams as this car was trapped inside the fog. Moving slowly. Crawling. Waiting for the phone to ring. Waiting for the workday to start. Waiting. Always thinking ahead, never really being where you are, but somewhere you hope to be. Strange way to live your life.

  She parked alongside his Trooper and watched the mud as she climbed out, because she had been on her way to work when the phone had rung and wasn't very well prepared for the conditions out here. She loved the man-that was her problem. He knew it, too, which put her at a disadvantage because there was little she wouldn't do for him, and he made the most of it. With sex now part of their relationship, she wondered where it might lead next. Either it would turn magical or sour-no telling which. If those tics of his were any indication, then it was going sour. She wasn't sure where they had come from, but it gave her an incredibly creepy feeling each time one happened, and they were getting worse. No doubt about that.

  She trudged around to the basement door and knocked. It was colder in the fog. She was shivering by the time he answered.

  He locked the door securely behind her and started giving orders before he even said hello. "Run the blood tests, will you? Then scrub up and prep him please. Right kidney and spleen." "Both?"

  He stopped, turned, and looked her in the eye. "Are you questioning me?" It was just a flicker, just something passing across his eyes like a reflection on a pair of mirrored sunglasses, but it ran her blood cold. There was an implied threat behind this question of his. There was someone else someone she didn't know-behind his eyes. just a flicker, then gone, like the tics when they had first started. "Right kidney and spleen," she repeated obediently. "Good," he said, turning his back on her. He had one of those tics then. His head snapped violently toward his lifting shoulder, remained pinched there, intractable, and finally relaxed. She wanted to offer her hands to him-to rub the knots out of his back. She knew the pain of these tics because she had witnessed his face recently all the muscles twitching and distorting like some kind of Halloween mask. It just had to hurt. A short backrub was just the thing for him. But she didn't offer it. They didn't talk about the tics; they both pretended they never happened at all.

  She had to think: Was that the way their moment of intimacy was to be as well? As if it had never happened at all? It had happened right here in this room, and now she was to go parading about her work as Pam the Helper. Pam the Lover was apparently lost in the shadows. Burned to a crisp along with all the other contaminated waste.

  He was starting to give her the creeps, the way he was so silent over there.

  The donor was a black male between twenty-five and thirty. He was naked, face up, eyes open from the Ketamine, which paralyzed him but didn't actually render him unconscious. She was used to those eyes now, but at first they had really terrified her. Elden used Ketamine on all the donors, despite the dangers, because of its effect on memory. On some, he followed this up with electroshock. She didn't approve, but she understood.

  That was how she felt about much of this. Elden's strength, his power of conviction, left little room for argument. She noticed this man's upper arm then, and like so often in her life, words came babbling out before she could control them. "My God, Elden! What happened to his arm?"

  "His arm! Did Donnie do this to his arm?"

  "Donnie?"

  "It's a mess.

  Lacerated, bruised. It might even be broken by the look of it."

  "Yes, I noticed that. Perhaps we can help. But not now. Hmm?

  Right kidney and spleen, Pamela. Are you ready for me or not?"

  The image of him, framed against the silvery plastic wall, was something surreal, something not of this world. It seemed fitting somehow, for a man of such talents.

  She collected herself and asked, "Do you want me to dress it?"

  "Prep him," he instructed. He never did pay much attention to what she said. He was in a mood today. More and more so in the last few days. You couldn't reach him when he was in a mood, so she gave up trying. She drew several samples of blood, labeled them, started the HIV test on one of them, the hepatitis A and B test on another, and placed the third in the waist-high fridge. There were a number of drugs missing from the door of the fridge. She was about to mention this when she caught herself. Antibiotics mostly. Some Demerol and Valium, too. The thought briefly crossed her mind that perhaps Elden was experimenting with the drugs himself; perhaps this helped to explain his recent erratic behavior. But not Demerol and Valium, she corrected herself. If anything, he seemed wound up and agitated of late, more like on an amphetamine high.

  Donnie had probably stolen them; he was always sneaking drugs.

  Elden knew it, just as she did. They both did their best to police their supplies, but Elden never called Donnie on it unless he caught him in the act, and then he barely slapped his hand. A strange relationship existed between those two that she would never understand; why Elden would tolerate a man like that was beyond her.

  She soaped and shaved the black man's side. Elden helped her to roll him over and she continued the procedure on his back.

  "I made all the necessary arrangements," he said. "That is, Maybeck did," he corrected her. "You'll be back by this evening. I've written it all down." He hurried over to the work area and returned with a note written in his own handwriting, not Donnie's. Donnie could barely write at all. Elden never made the flight arrangements. "You'll meet Juanita at the gate. The regular flight to Rio. Same as always."

  "All right," she said, accepting the itinerary from him; but it felt wrong. Everything about this felt wrong. Was it just her? she wondered-expectations carried over from their encounter Saturday night? "Now then," he said from over by the sink. He doused his hands in antiseptic and then snapped on a pair of surgical gloves. He turned his back to her to have he
r tie his mask in place, which she did. "All set?"

  "I'm worried about you," she said softly to his back. She placed her hand gently on his shoulder. It was something she could never say while facing him.

  There was a long, heavy silence in which she could hear the deep breathing of the man on the table behind her. She heard the plastic ceiling crinkle as it warmed. Neither she nor Elden was breathing. What she had said had stopped them both.

  Finally his head bobbed slightly. He took a deep breath, filling his lungs completely, and said in a ghostly whisper, "It's him I'd worry about." The way he said it frightened her. "Elden?" His voice returned; he reminded her, "The patient always comes first."

  L L They rose above the city, climbing an on-ramp at the end of Columbia that connected to the viaduct, then headed south toward the docks and Boeing Field. You could see the next wave of rain out over the water, hanging above the stunning green of Bainbridge Island-a mare's tail stretching down, a light gray mist feathered beneath charcoal clouds. If you didn't mind rain, it was a beautiful sight. If you minded rain, you didn't live here in February and March. Boldt turned on the wipers to fend off the spray from a van ahead of them.

  Daphne crossed her legs and leaned over to check the speedometer.

  "I don't like driving fast," Boldt explained. "That's an understatement," she said. "At first I thought there was something wrong with this thing." She had asked to come along with him at the last second. Boldt had warned her it might be a long meeting, but she had persisted. He'd been wondering when she would tell him whatever it was that couldn't wait.

  Finally, his patience ran out. "So what's up?"

  "I hate being wrong," she complained. "It doesn't come easy."

  "You, wrong?"

  "I had that talk with Cindy Chapman. I wanted to run Agnes Rutherford's descriptions of the two men by her-the grating voice, the bad breath. There are tricks you can play with the mind. Subtle ways to make it safe for a person to remember something they would rather not remember." Boldt asked, "Where the hell is the toxicology report on Chapman?