Rizzoli & Isles [01] The Surgeon

by Tess Gerritsen

  She said, “The first really big case I worked on in Vice and Narcotics, I was the only woman on a team with five men. When we cracked it, there was this press conference. TV cameras, the whole nine yards. And you know what? They mentioned every name on that team but mine. Every other goddamn name.” She took another swallow of beer. “I make sure that doesn’t happen anymore. You guys, you can focus all your attention on the case and the evidence. But I waste a lot of energy just trying to make myself heard.”

  “I hear you fine, Rizzoli.”

  “It’s a nice change.”

  “What about Frost? You have problems with him?”

  “Frost is cool.” She winced at the unintended quip. “His wife’s got him well trained.”

  They both laughed at that. Anyone who overheard Barry Frost’s meek yes dear, no dear phone conversations with his wife had no doubt who was boss in the Frost household.

  “That’s why he’s not gonna move up very far,” she said. “No fire in the belly. Family man.”

  “There’s nothing wrong with being a family man. I wish I’d been a better one.”

  She glanced up from the carton of Mongolian beef and saw that he wasn’t looking at her but was staring at the necklace. There’d been a note of pain in his voice, and she didn’t know what to say in response. Figured that it was best not to say anything.

  She was relieved when he turned the subject back to the investigation. In their world, murder was always a safe topic.

  “There’s something wrong here,” he said. “This jewelry thing doesn’t make sense to me.”

  “He’s taking souvenirs. Common enough.”

  “But what’s the point of taking a souvenir if you’re going to give it away?”

  “Some perps take the vic’s jewelry and give it to their own wives or girlfriends. They get a secret thrill from seeing it around their girlfriend’s neck, and being the only one who knows where it really comes from.”

  “But our boy’s doing something different. He leaves the souvenir at the next crime scene. He doesn’t get to keep seeing it. Doesn’t get the recurrent thrill of being reminded of his kill. There’s no emotional gain that I can see.”

  “A symbol of ownership? Like a dog, marking his territory. Only he uses a piece of jewelry to mark his next victim.”

  “No. That’s not it.” Moore picked up the Ziploc bag and weighed it in his palm, as though divining its purpose.

  “The main thing is, we’re onto the pattern,” she said. “We’ll know exactly what to expect at the next crime scene.”

  He looked up at her. “You just answered the question.”

  “What?”

  “He’s not marking the victim. He’s marking the crime scene.”

  Rizzoli paused. All at once, she understood the distinction. “Jesus. By marking the scene . . .”

  “This isn’t a souvenir. And it’s not a mark of ownership.” He set down the necklace, a tangled filigree of gold that had skimmed the flesh of two dead women.

  A shudder went through Rizzoli. “It’s a calling card,” she said softly.

  Moore nodded. “The Surgeon is talking to us.”

  A place of strong winds and dangerous tides.

  This is how Edith Hamilton, in her book Mythology, describes the Greek port of Aulis. Here lie the ruins of the ancient temple of Artemis, the goddess of the hunt. It was at Aulis where the thousand Greek black ships gathered to launch their attack on Troy. But the north wind blew, and the ships could not sail. Day after day, the wind was relentless and the Greek army, under the command of King Agamemnon, grew angry and restless. A soothsayer revealed the reason for the ill winds: the goddess Artemis was angry, because Agamemnon had slain one of her beloved creatures, a wild hare. She would not allow the Greeks to depart unless Agamemnon offered up a terrible sacrifice: his daughter, Iphigenia.

  And so he sent for Iphigenia, claiming that he had arranged for her a great marriage to Achilles. She did not know she was coming instead to her death.

  Those fierce north winds were not blowing on the day you and I walked the beach near Aulis. It was calm, the water was green glass, and the sand was as hot as white ash beneath our feet. Oh, how we envied the Greek boys who ran barefoot on the sun-baked shore! Though the sand scorched our pale tourist skin, we reveled in the discomfort, because we wanted to be like those boys, our soles like toughened leather. Only through pain and hard wear do calluses form.

  In the evening, when the day had cooled, we went to the Temple of Artemis.

  We walked among the lengthening shadows, and came to the altar where Iphigenia was sacrificed. Despite her prayers, her cries of “Father, spare me!,” the warriors carried the girl to the altar. She was stretched over the stone, her white neck bared to the blade. The ancient playwright Euripides writes that the soldiers of Atreus, and all the army, stared at the ground, unwilling to watch the spilling of her virgin blood. Unwilling to witness the horror.

  Ah, but I would have watched! And so, too, would you have. And eagerly, too.

  I pictured the silent troops assembled in the gloom. I imagined the beating of drums, not the lively throb of a wedding celebration, but a somber march toward death. I saw the procession, winding its way into the grove. The girl, white as a swan, flanked by soldiers and priests. The drumming stops.

  They carry her, shrieking, to the altar.

  In my vision, it is Agamemnon himself who holds the knife blade, for why call it sacrifice if you are not the one who draws the blood? I see him approach the altar, where his daughter lies, her tender flesh exposed to all eyes. She pleads for her life, to no avail.

  The priest grasps her hair and pulls it back, baring her throat. Beneath the white skin the artery pulses, marking the place for the blade. Agamemnon stands beside his daughter, looking down at the face he loves. In her veins runs his blood. In her eyes he sees his own. By cutting her throat, he cuts his own flesh.

  He raises the knife. The soldiers stand silent, statues among the sacred grove of trees. The pulse in the girl’s neck is fluttering.

  Artemis demands sacrifice, and this Agamemnon must do.

  He presses the blade to the girl’s neck, and slices deep.

  A fountain of red spurts, splashing his face with hot rain.

  Iphigenia is still alive, her eyes rolled back in horror as the blood pumps from her neck. The human body contains five liters of blood, and it takes time for such a volume to be discharged from a single severed artery. As long as the heart continues to beat, the blood pumps out. For at least a few seconds, perhaps even a minute or more, the brain functions. The limbs thrash.

  As her heart beats its last, Iphigenia watches the sky darken, and feels the heat of her own blood spout on her face.

  The ancients say that almost immediately the north wind ceased to blow. Artemis was satisfied. At last the Greek ships sailed, and armies fought, and Troy fell. In the context of that greater bloodshed, the slaughter of one young virgin means nothing.

  But when I think of the Trojan War, what comes to my mind is not the wooden horse or the clang of swords or the thousand black ships with sails unfurled. No, it is the image of a girl’s body, drained white, and the father standing beside her, clutching the bloody knife.

  Noble Agamemnon, with tears in his eyes.

  seven

  It’s pulsating,” said the nurse.

  Catherine stared, dry-mouthed with horror, at the man lying on the trauma table. A foot-long iron rod protruded straight up from his chest. One medical student had already fainted at the sight, and the three nurses stood with mouths agape. The rod was embedded deep in the man’s chest, and it was pulsing up and down in rhythm with his heartbeat.

  “What’s our BP?” Catherine said.

  Her voice seemed to snap everyone into action mode. The blood pressure cuff whiffed up, sighed down again.

  “Seventy over forty. Pulse is up to one-fifty!”

  “Turning both IV’s wide open!”

  “Breaking open t
he thoracotomy tray—”

  “Somebody get Dr. Falco down here STAT. I’m going to need help.” Catherine slipped into a sterile gown and pulled on gloves. Her palms were already slippery with sweat. The fact the rod was pulsing told her the tip had penetrated close to the heart—or, even worse, was actually embedded in it. The worst thing she could do was pull it out. It might open a hole through which he could exsanguinate in minutes.

  The EMT’s at the scene had made the right decision: they had started an IV, intubated the victim, and brought him to the E.R. with the rod still in place. The rest was up to her.

  She was just reaching for the scalpel when the door swung open. She looked up and gave a sigh of relief as Peter Falco walked in. He halted, his gaze taking in the patient’s chest, with the rod protruding like a stake through a vampire’s heart.

  “Now that’s something you don’t see every day,” he said.

  “BP’s bottoming out!” a nurse called.

  “There’s no time for bypass. I’m going in,” said Catherine.

  “I’ll be right with you.” Peter turned and said, in an almost casual tone, “Can I have a gown, please?”

  Catherine swiftly opened an anterolateral incision, which would allow the best exposure to the vital organs of the thoracic cavity. She was feeling calmer, now that Peter had arrived. It was more than just having the extra pair of skilled hands; it was Peter himself. The way he could walk into a room and size up the situation with just a glance. The fact he never raised his voice in the O.R., never showed a hint of panic. He had five years’ more experience than she did on the front lines of trauma surgery, and it was with horrifying cases like this one where his experience showed.

  He took his place across the table from Catherine, his blue eyes zeroing in on the incision. “Okeydoke. We having fun yet?”

  “Barrel of laughs.”

  He got right down to business, his hands working in concert with hers as they tore into the chest with almost brutal force. He and Catherine had operated as a team so many times before, each automatically knew what the other one needed and could anticipate moves ahead of time.

  “Story on this?” asked Peter. Blood spurted, and he calmly snapped a hemostat over the bleeder.

  “Construction worker. Tripped and fell on the site and got himself skewered.”

  “That’ll ruin your day. Burford retractor, please.”

  “Burford.”

  “How we doing on blood?”

  “Waiting on the O neg,” a nurse answered.

  “Is Dr. Murata in-house?”

  “His bypass team’s on its way in.”

  “So we just need to buy a little time here. What’s our rhythm?”

  “Sinus tach, one-fifty. A few PVC’s—”

  “Systolic’s down to fifty!”

  Catherine shot a glance at Peter. “We’re not going to make it to bypass,” she said.

  “Then let’s just see what we can do here.”

  There was sudden silence as he stared into the incision.

  “Oh god,” said Catherine. “It’s in the atrium.”

  The tip of the rod had pierced the wall of the heart, and with every beat fresh blood squirted out around the edge of the puncture site. A deep pool of it had already collected in the thoracic cavity.

  “We pull it out, we’re going to have a real gusher,” said Peter.

  “He’s already bleeding out around it.”

  The nurse said, “Systolic’s barely palpable!”

  “Ho-kay,” said Peter. No panic in his voice. No sign of any fear whatsoever. He said to one of the nurses, “Can you hunt me down a sixteen French Foley catheter with a thirty cc balloon?”

  “Uh, Dr. Falco? Did you say a Foley?”

  “Yep. A urinary catheter.”

  “And we’ll need a syringe with ten cc’s of saline,” said Catherine. “Stand by to push it.” She and Peter didn’t have to explain a thing to each other; they both understood what the plan was.

  The Foley catheter, a tube designed for insertion into a bladder to drain urine, was handed to Peter. They were about to put it to a use for which it was never intended.

  He looked at Catherine. “You ready?”

  “Let’s do it.”

  Her pulse was throbbing as she watched Peter grasp the iron rod. Saw him gently pull it out of the heart wall. As it emerged, blood exploded from the puncture site. Instantly Catherine thrust the tip of the urinary catheter into the hole.

  “Inflate the balloon!” said Peter.

  The nurse pressed down the syringe, injecting ten cc’s of saline into the balloon at the tip of the Foley.

  Peter pulled back on the catheter, jamming the balloon against the inside of the atrium wall. The gush of blood cut off. Barely a trickle oozed out.

  “Vitals?” called out Catherine.

  “Systolic’s still at fifty. The O neg’s here. We’re hanging it now.”

  Heart still pounding, Catherine looked at Peter and saw him wink at her through his protective goggles.

  “Wasn’t that fun?” he said. He reached for the clamp with the cardiac needle. “You want to do the honors?”

  “You bet.”

  He handed her the needle holder. She would sew together the edges of the puncture, then pull out the Foley before she closed off the hole entirely. With every deep stitch she took, she felt Peter’s approving gaze. Felt her face flush with the glow of success. Already she felt it in her bones: This patient would live.

  “Great way to start the day, isn’t it?” he said. “Ripping open chests.”

  “This is one birthday I’ll never forget.”

  “My offer’s still on for tonight. How about it?”

  “I’m on call.”

  “I’ll get Ames to cover for you. C’mon. Dinner and dancing.”

  “I thought the offer was for a ride in your plane.”

  “Whatever you want. Hell, let’s do peanut butter sandwiches. I’ll bring the Skippy.”

  “Ha! I always knew you were a big spender.”

  “Catherine, I’m serious.”

  Hearing the change in his voice, she looked up and met his steady gaze. Suddenly she noticed that the room had hushed and that everyone else was listening, waiting to find out if the unattainable Dr. Cordell would finally succumb to Dr. Falco’s charms.

  She took another stitch as she thought about how much she liked Peter as a colleague, how much she respected him and he respected her. She didn’t want that to change. She didn’t want to endanger that precious relationship with an ill-fated step toward intimacy.

  But oh, how she missed the days when she could enjoy a night out! When an evening was something to look forward to, not dread.

  The room was still silent. Waiting.

  At last she looked up at him.”Pick me up at eight.”

  Catherine poured a glass of merlot and stood by the window, sipping wine as she gazed out at the night. She could hear laughter and could see people strolling below on Commonwealth Avenue. Fashionable Newbury Street was only one block away, and on a Friday night in summer this Back Bay neighborhood was a magnet for tourists. Catherine had chosen to live in the Back Bay for just that reason; she took comfort in knowing that other people were around, even if they were strangers. The sound of music and laughter meant she was not alone, not isolated.

  Yet here she was, behind her sealed window, drinking her solitary glass of wine, trying to convince herself that she was ready to join that world out there.

  A world Andrew Capra stole from me.

  She pressed her hand to the window, fingers arched against the glass, as though to shatter her way out of this sterile prison.

  Recklessly she drained her wine and set the glass down on the windowsill. I will not stay a victim, she thought. I won’t let him win.

  She went into her bedroom and surveyed the clothes in her closet. She pulled a green silk dress from her closet and zipped herself into it. How long had it been since she’d worn this dress? She couldn
’t remember.

  From the other room came a cheery: “You’ve got mail!” announcement over her computer. She ignored the message and went into the bathroom to put on makeup. War paint, she thought as she brushed on mascara, dabbed on lipstick. A mask of courage, to help her face the world. With every stroke of the makeup brush, she was painting on confidence. In the mirror she saw a woman she scarcely recognized. A woman she had not seen in two years.

  “Welcome back,” she murmured, and smiled.

  She turned off the bathroom light and walked out to the living room, her feet reacquainting themselves with the torment of high heels. Peter was late; it was already eight-fifteen. She remembered the “You’ve got mail” announcement she’d heard from the bedroom and went to her computer to click on the mailbox icon.

  There was one message from a sender named SavvyDoc, with the subject heading: “Lab Report.” She opened the e-mail.

  Dr. Cordell,

  Attached are pathology photos which will interest you.

  It was unsigned.

  She moved the arrow to the “download file” icon, then hesitated, her finger poised on the mouse. She did not recognize the sender, SavvyDoc, and normally she would not download a file from a stranger. But this message was clearly related to her work, and it had addressed her by name.

  She clicked “download.”

  A color photograph materialized on the screen.

  With a gasp, she jerked from her seat as though scalded, and the chair toppled to the floor. She stumbled backward, hand clasped over her mouth.

  Then she ran for the phone.

  Thomas Moore stood in her doorway, his gaze tight on her face. “Is the photo still on the screen?”

  “I haven’t touched it.”

  She stepped aside and he walked in, all business, always the policeman. He focused at once on the man who was standing beside the computer.

  “This is Dr. Peter Falco,” said Catherine. “My partner in the practice.”

  “Dr. Falco,” said Moore, as the two men shook hands.