Under the Knife

by Tess Gerritsen

  “If Ann knew something dangerous, why didn’t she go to the police?”

  “Maybe she couldn’t. Maybe she was afraid of self-incrimination. Or she was protecting someone else.”

  A deadly secret, Kate thought. Had all three victims shared it? Softly she ventured, “Then you think Ellen was murdered.”

  “That’s why I’m here. I want you to tell me.”

  She shook her head in bewilderment. “How can I?”

  “You have the medical expertise. You were there in the O.R. when it happened. How could it be done?”

  “I’ve already gone over it a thousand times—”

  “Then do it again. Come on, Kate, think. Convince me it was murder. Convince me I should drop out of this case.”

  His blunt command seemed to leave her no alternative. She felt his eyes goading her to recall every detail, every event leading up to those frantic moments in the O.R. She remembered how everything had gone so smoothly, the induction of anesthesia, the placement of the endotracheal tube. She’d double-checked the tanks and the lines; she knew the oxygen had been properly hooked up.

  “Well?” he prodded.

  “I can’t think of anything.”

  “Yes, you can.”

  “It was a completely routine case!”

  “What about the surgery itself?”

  “Faultless. Guy’s the best surgeon on the staff. Anyway, he’d just started the operation. He was barely through the muscle layer when—” She stopped.

  “When what?”

  “He—he complained about the abdominal muscles being too tight. He was having trouble retracting them.”

  “So?”

  “So I injected a dose of succinylcholine.”

  “That’s pretty routine, isn’t it?”

  She nodded. “I give it all the time. But in Ellen, it didn’t seem to work. I had to draw up a second dose. I remember asking Ann to fetch me another vial.”

  “You had only one vial?”

  “I usually keep a few in my cart. But that morning there was only one in the drawer.”

  “What happened after you gave the second dose of succinylcholine?”

  “A few seconds went by. Maybe it was ten. Fifteen. And then—” Slowly she looked up at him. “Her heart stopped.”

  They stared at each other. Through the window, the last light of day slanted in, knifelike, across the kitchen. He leaned forward, his eyes hard on hers. “If you could prove it—”

  “But I can’t! That empty vial went straight to the incinerator, with all the rest of the trash. And there’s not even a body left to autopsy.” She looked away, miserable. “Oh, he was smart, David. Whoever the killer was, he knew exactly what he was doing.”

  “Maybe he’s too smart for his own good.”

  “What do you mean?”

  “He’s obviously sophisticated. He knew exactly which drugs you’d be likely to give in the O.R. And he managed to slip something deadly into one of those vials. Who has access to the anesthesia carts?”

  “They’re left in the operating rooms. I suppose anyone on the hospital staff could get to them. Doctors. Nurses. Maybe even the janitors. But there were always people around.”

  “What about nights? Weekends?”

  “If there’s no surgery scheduled, I guess they just close the suite down. But there’s always a surgical nurse on duty for emergencies.”

  “Does she stay in the O.R. area?”

  She shrugged helplessly. “I’m only there if we have a case. I have no idea what happens on a quiet night.”

  “If the suite’s left unguarded, then anyone on the staff could’ve slipped in.”

  “It’s not someone on the staff. I saw the killer, David! That man in Ann’s apartment was a stranger.”

  “Who could have an associate. Someone in the hospital. Maybe even someone you know.”

  “A conspiracy?”

  “Look at the systematic way these murders are being carried out. As if our killer—or killers—has some sort of list. My question is: Who’s next?”

  The clatter of her cup dropping against the saucer made Kate jump. Glancing down, she saw that her hands were shaking. I saw his face, she thought. If he has a list, then my name’s on it.

  The afternoon had slid into dusk. Agitated, she rose and paced to the open doorway. There she stood, staring out at the sea. The wind, so steady just moments before, had died. There was a stillness in the air, as if evening were holding its breath.

  “He’s out there,” she whispered. “Looking for me. And I don’t even know his name.” The touch of David’s hand on her shoulder made her tremble. He was standing behind her, so close she could feel his breath in her hair. “I keep seeing his eyes, staring at me in the mirror. Black and sunken. Like one of those posters of starving children…”

  “He can’t hurt you, Kate. Not here.” David’s breath seared her neck. A shudder ran through her body—not one of fear but of arousal. Even without looking at him, she could sense his need, simmering to the surface.

  Suddenly it was more than his breath scorching her flesh; it was his lips. His face burrowed through the thick strands of her hair to press hungrily against her neck. His fingers gripped her shoulders, as if he was afraid she’d pull away. But she didn’t. She couldn’t. Her whole body was aching for him.

  His lips left a warm, moist trail as they glided to her shoulder, and then she felt the rasp of his jaw.

  He swung her around to face him. The instant she turned, his mouth was on hers.

  She felt herself falling under the force of his kiss, falling into some deep and bottomless well, until her back suddenly collided with the kitchen wall. With the whole hard length of his body he pinned her there, belly against belly, thigh against thigh. Her lips parted and his tongue raged in, claiming her mouth as his. There was no doubt in her mind he intended to claim the rest of her, as well.

  The match had been struck; the powder keg was about to explode, and her with it. She willingly flung herself into the conflagration.

  No words were spoken; there were only the low, aching moans of need. They were both breathing so hard, so fast, that her ears were filled with the sound. She scarcely heard the telephone ringing. Only when it had rung again and again did her feverish brain finally register what it was.

  It took all her willpower to swim against the flood of desire. She struggled to pull away. “The—the telephone—”

  “Let it ring.” His mouth slid down to her throat.

  But the sound continued, grating and relentless, nagging her with its sense of urgency.

  “David. Please…”

  Groaning, he wrenched away and she saw the astonishment in his eyes. For a moment they stared at each other, neither of them able to believe what had just happened between them. The phone rang again. Jarred to her senses at last, she forced herself across the kitchen and picked up the reciever. Clearing her throat, she managed a hoarse “Hello?”

  She was so dazed it took her a few seconds to register the silence on the line. “Hello?” she repeated.

  “Dr. Chesne?” a voice whispered, barely audible.

  “Yes?”

  “Are you alone?”

  “No, I— Who is this?” Her voice suddenly froze as the first fingers of terror gripped her throat.

  There was a pause, so long and empty she could hear her own heart pounding in her ears. “Hello?” she screamed. “Who is this?”

  “Be careful, Kate Chesne. For death is all around us.”

  CHAPTER SEVEN

  THE RECEIVER SLIPPED from her grasp and clattered on the linoleum floor. She reeled back in terror against the counter. “It’s him,” she whispered. Then, in a voice tinged with hysteria she cried out: “It’s him!”

  David instantly scrabbled on the floor for the receiver. “Who is this? Hello? Hello?” Cursing, he slammed the receiver back in the cradle and turned to her. “What did he say? Kate!” He took her by the shoulders and gave her a shake. “What did he say?”<
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  “He—he said to be careful—that death was all around….”

  “Where’s your suitcase?” he snapped.

  “What?”

  “Your suitcase!”

  “In—in the bedroom closet.”

  He stalked into the bedroom. Automatically she followed him and watched as he dragged her Samsonite down from the shelf. “Get your things together. You can’t stay here.”

  She didn’t ask where they were going. She only knew that she had to escape; that every minute she remained in this place just added to the danger.

  Suddenly driven by the need to get away, she began to pack. By the time they were ready to leave, her compulsion to escape was so strong she practically flew down the porch steps to his car.

  As he thrust the key in the ignition, she was seized by a wild terror that the car wouldn’t start; that like some unfortunate victim in a horror movie, she would be stranded here, doomed to meet her death.

  But at the first turn of the key, the engine started. The ironwood trees lunged at them as David sent the BMW wheeling around. Branches slashed the windshield. She felt another stab of panic as their tires spun uselessly in the sand. Then the car leaped free. The headlights trembled as they bounced up the dirt lane.

  “How did he find me?” she sobbed.

  “That’s what I’m wondering.” David hit the gas pedal as the car swung onto paved road. The BMW responded instantly with a burst of power that sent them hurtling down the highway.

  “No one knew I was here. Only the police.”

  “Then there’s been a leak of information. Or—” he shot a quick look at the rearview mirror “—you were followed.”

  “Followed?” She whipped her head around but saw only a deserted highway, shimmering under the dim glow of street lamps.

  “Who took you to the cottage?” he asked.

  She turned and focused on his profile, gleaming faintly in the darkness. “My—my friend Susan drove me.”

  “Did you stop at your house?”

  “No. We went straight to the cottage.”

  “What about your clothes? How’d you get them?”

  “My landlady packed a suitcase and brought it to the hospital.”

  “He might have been watching the lobby entrance. Waiting for you to be discharged.”

  “But we didn’t see anyone follow us.”

  “Of course you didn’t. People almost never do. We normally focus our attention on what’s ahead, on where we’re going. As for your phone number, he could’ve looked it up in the book. The Santinis have their name on the mailbox.”

  “But it doesn’t make sense,” she cried. “If he wants to kill me, why not just do it and get it over with? Why threaten me with phone calls?”

  “Who knows how he thinks? Maybe he gets a thrill out of scaring his victims. Maybe he just wants to keep you from cooperating with the police.”

  “I was alone. He could have done it right there…on the beach….” She tried desperately not to think of what could have happened, but she couldn’t shut out the image of her own blood seeping into the sand.

  High on the hillside, the lights of houses flashed by, each one an unreachable haven of safety. In all that darkness, was there a haven for her? She huddled against the car seat, wishing she never had to leave this small cocoon of safety.

  Closing her eyes, she forced herself to concentrate on the hum of the engine, on the rhythm of the highway passing beneath their wheels—anything to banish the bloodstained image. BMW. The ultimate driving machine, she thought inanely. Wasn’t that what the ads said? High-tech German engineering. Cool, crisp performance. Just the kind of car she’d expect David to own.

  “…and there’s plenty of room. So you can stay as long as you need to.”

  “What?” Bewildered, she turned and looked at him. His profile was a hard, clean shadow against the passing streetlights.

  “I said you can stay as long as you need to. It’s not the Ritz, but it’ll be safer than a hotel.”

  She shook her head. “I don’t understand. Where are we going?”

  He glanced at her and the tone of his voice was strangely unemotional. “My house.”

  * * *

  “HOME,” SAID DAVID, pushing open the front door. It was dark inside. Through the huge living-room windows, moonlight spilled in, faintly illuminating a polished wood floor, the dark and hulking silhouettes of furniture. David guided her to a couch and gently sat her down. Then, sensing her desperate need for light, for warmth, he quickly walked around the room, turning on all the lamps. She was vaguely aware of the muted clink of a bottle, the sound of something being poured. Then he returned and put a glass in her hand.

  “Drink it,” he said.

  “What—what is it?”

  “Whiskey. Go on. I think you could use a stiff one.”

  She took a deep and automatic gulp; the fiery sting instantly brought tears to her eyes. “Wonderful stuff.” She coughed.

  “Yeah. Isn’t it?” He turned to leave the room and she felt a sudden, irrational burst of panic that he was abandoning her.

  “David?” she called.

  He immediately sensed the terror in her voice. Turning back, he spoke quietly: “It’s all right, Kate. I won’t leave you. I’ll be right next door, in the kitchen.” He smiled and touched her face. “Finish that drink.”

  Fearfully she watched him vanish through the doorway. Then she heard his voice, talking to someone on the phone. The police. As if there was anything they could do now. Clutching the glass in both hands, she forced down another sip of whiskey. The room seemed to swim as her eyes flooded with tears. She blinked them away and slowly focused on her surroundings.

  It was, somehow, every inch a man’s house. The furniture was plain and practical, the oak floor unadorned by even a single throw rug. Huge windows were framed by stark white curtains and she could hear, just outside, waves crashing against the seawall. Nature’s violence, so close, so frightening.

  But not nearly as frightening as the violence of man.

  * * *

  AFTER DAVID HUNG UP, he paused in the kitchen, trying to scrape together some semblance of composure. The woman was already frightened enough; seeing his agitation would only make things worse. He quickly ran his fingers through his ruffled hair. Then, taking a deep breath, he pushed open the kitchen door and walked back into the living room.

  She was still huddled pitifully on the couch, her hands clenched around the half-empty glass of whiskey. At least a trace of color had returned to her face, but it was barely enough to remind him of a frost-covered rose petal. A little more whiskey was what she needed. He took the glass, filled it to the brim and placed it back in her hands. Her skin was icy. She looked so stunned, so vulnerable. If he could just take her hands in his, if he could warm her in his arms, maybe he could coax some life back into those frozen limbs. But he was afraid to give in to the impulse; he knew it could lead to far more compelling urges.

  He turned and poured himself a tall one. What she needed from him right now was protection. Reassurance. She needed to know that she would be taken care of and that things were still right with the world, though the truth of the matter was, her world had just gone to hell in a handbasket.

  He took a deep gulp of whiskey, then set it down. What she really needed was a sober host.

  “I’ve called the police,” he said over his shoulder.

  Her response was almost toneless. “What did they say?”

  He shrugged. “What could they say? Stay where you are. Don’t go out alone.” Frowning at his glass, he thought, What the hell, and recklessly downed the rest of the whiskey. Bottle in hand, he returned to the couch and set the whiskey down on the coffee table. They were sitting only a few feet apart but it felt like miles of emptiness between them.

  She stirred and looked toward the kitchen. “My—my friends—they won’t know where I am. I should call them.”

  “Don’t worry about it. Pokie’ll let them know yo
u’re safe.” He watched her sink back listlessly on the couch. “You should eat something,” he said.

  “I’m not hungry.”

  “My housekeeper makes great spaghetti sauce.”

  She lifted one shoulder—only one, as if she hadn’t the energy for a full-blown shrug.

  “Yep,” he continued with sudden enthusiasm. “Once a week Mrs. Feldman takes pity on a poor starving bachelor and she leaves me a pot of sauce. It’s loaded with garlic. Fresh basil. Plus a healthy slug of wine.”

  There was no response.

  “Every woman I’ve ever served it to swears it’s a powerful aphrodisiac.”

  At last there was a smile, albeit a very small one. “How helpful of Mrs. Feldman,” she remarked.

  “She thinks I’m not eating right. Though I don’t know why. Maybe it’s all those frozen-dinner trays she finds in my trash can.”

  There was another smile. If he kept this up, he just might coax a laugh out of her by next week. Too bad he was such a lousy comedian. Anyway, the situation was too damned grim for jokes.

  The clock on the bookshelf ticked loudly—a nagging reminder of how much silence had passed between them. Kate suddenly stiffened as a gust rattled the windows.

  “It’s just the wind,” he said. “You’ll get used to it. Sometimes, in a storm, the whole house shudders and it feels like the roof will blow off.” He gazed up affectionately at the beams. “It’s thirty years old. Probably should have been torn down years ago. But when we bought it, all we could see were the possibilities.”

  “We?” she asked dully.

  “I was married then.”

  “Oh.” She stirred a little, as though trying to show some semblance of interest. “You’re divorced.”

  He nodded. “We lasted a little over seven years—not bad, in this day and age.” He gave a short, joyless laugh. “Contrary to the old cliché, it wasn’t an itch that finished us. It was more like a…fading out. But—” he sighed “—Linda and I are still friendly. Which is more than most divorced couples can say. I even like her new husband. Great guy. Very devoted, caring. Something I guess I wasn’t….” He looked away, uncomfortable. He hated talking about himself. It made him feel exposed. But at least all this small talk was doing the trick. It was bringing her back to life, nudging the fear from her mind. “Linda’s in Portland now,” he went on quickly. “I hear they’ve got a baby on the way.”