I brought my hand to my head, rubbed the temples. “More than a couple of cases. Shit.”
“Yeah.”
“These people are sick, Ravi. They need to get into treatment. And they’re not going to do it when…Have the Ming murders hit the news? I haven’t had the chance—”
“Yes.”
“Press mention the mutilation?”
“Sure did.”
“Damn. No mention of fibrosarcoma though, right?”
“That, too.”
“How the hell did they know about that?” I played back the previous day. “Oh, no, man. You did not—”
“Some reporters got to me when I was leaving the Mings’ place last night. I thought if I put the word out, more people might come forward.”
“Shit, Ravi. Shit—”
“You’ll be happy to know that people here are real pissed I talked to the media. They got me on a short leash—”
I couldn’t care less about the fallout at Ravi’s workplace, the length of his leash. “This is going to drive everybody underground. The people who have this know. They don’t want to get shot in the face for talking to us.”
“I thought the cops think it’s all tied to loan-sharking.”
“They do think that, or they might think that. It’s not what we think. Damn it.” I told Ravi about the photographs displayed on the Mings’ piano. I told him I thought she’d had some cosmetic procedure done either in Hong Kong or around that time.
“You can’t just jump to conclusions about cosmetic procedures because of one picture on a piano—”
“I—”
“And you can’t say that the Mings were offed because the wife had fibrosarcoma. Think about it: too complicated and too wild. Who gets killed because they have cancer? Come on, bucko, the cops’ explanation is way better than that.”
“And Murph and his photos? These people with cancer vanishing from the radar? What’s that?”
“I can’t explain it,” he said.
“Of course you can’t. Because you don’t see that the fibrosarc and the missing people and the murders are the same thing.”
“Try telling the police this,” he said.
“I’ve tried. There’re too many pieces missing.”
“Stop worrying about missing pieces and start worrying about a goddamned tongue under your windshield wiper, McCormick. Worry about that.”
“I am.” I looked at my watch. “Go find the guy from Kaiser. Get him connected and start treatment. We can’t have people hiding out and rotting away. Oh, man, maybe your fuckup with the press will help us. Maybe someone will come forward.” Ravi made no response. “You gonna hang in with me, Ravi? Quick now: I need a yes before I get off the phone.”
“Okay, McCormick. Sure.”
You will get hurt, Tang had promised.
I sat in the idling car at the entrance to the rental lot.
I thought about where I’d been identified, where paths had crossed. I thought about how a tongue had found its way to my motel. I thought about the Mings.
The Mings.
I’d let my guard down at their house, consumed as I was with having noticed things. I hadn’t even bothered to glance behind me as I traced my way through the city to the Buena Costa Motel. And that morning, consumed as I was with the discovery on my windshield, I hadn’t bothered again.
Which meant I could have been followed to the police station, followed to the rental car lot.
I began to sweat.
After a quick look left and right, I jammed the accelerator and blasted into the street.
South through the city, then back north. I ran a red light. I turned the wrong way into a one-way alley. I ran another red light, desperate to avoid bad guys who wanted to do me in and cops who wanted to ticket me.
After fifteen minutes of this kind of driving—a quarter hour with my eyes as much on the rearview as on the road in front of me—I turned onto California Street.
68
CALIFORNIA STREET RAN FROM ONE end of San Francisco to the other, from downtown to Lincoln Park. Near the end of its course, near the Presidio, it bisected a neighborhood called Pacific Heights. Pac Heights, where the rich nested. Like Beverly Hills, but foggier, with a bay view and a 94115 zip code. All this is to say that there are worse places in the world to locate a dermatology practice. And it was on California Street, smack in the middle of Pac Heights, that I found Premiere Aesthetic Associates, PC.
I parked curbside, sat in the car, hands on the wheel, watching the block.
From the corner of my eye, I saw a vehicle pull next to mine and stop. I figured the guy was waiting for the light to change, but he just hung there in the middle of the block. I felt myself go rigid. Again, I wished I still had the goddamn gun.
Slowly, I looked to my left.
A man in a blue Jaguar flipped his hand at me. White guy. Sixties. Unarmed. I caught the universal signal: You leaving? I shook my head, and the Jaguar motored on.
Get a grip, McCormick.
I exited the car.
Yount’s practice had done well, it seemed, metastasizing through the first floors of at least two adjacent buildings. “William Yount, MD” shimmered in gold on the glass doorway of a gray stone building with deep inset windows. “Premiere Aesthetic Associates” was also written in gold. This contrasted with Premiere Aesthetic Associates Day Spa, which occupied the storefront next door. Big picture window, with gargantuan plants taking over inside. From the street, I could see the blond wood and brushed-metal furnishings inside. I could see the displays of chic beauty products and the tasteful blowups of perfect female forms on the walls. There was something predatory about this place, as if my own flawed, worried face reflected back at me in the glass was a disease, and a quick trip to Premiere Aesthetic offered the only cure.
I walked to the corner entrance and pushed into Bill Yount’s reception area. Three people waited on plush antique chairs, perusing Vogue and Elle and other anxiety-producing fare. Bill had preserved much of the original character of the building: carved wooden lintels, a dark wooden floor with a large Oriental rug thrown across it. It looked more like a private surgery plucked in toto from Harley Street—that ancient center of British medicine in London—than a twenty-first-century derm’s office in a far-flung region of the colonies. It jarred me, then, to see the very modern android sitting behind the carved receptionist’s desk.
The woman’s filler-injected lips pulled to a smile. “May I help you?”
I walked close to her, lowered my voice. “I’m here to see Dr. Yount. I’m an old friend of his from medical school.”
The smile didn’t budge on this poster child of cosmetic medicine. In addition to the bee-stung lips—wasp stung? hornet stung?—she’d had a face-lift so severe it gave her the look of someone stuck in a wind tunnel. The plastic sheen of her skin suggested dermabrasion. That her raised eyebrows generated nary a brow line told me she’d been Botoxed. And at least two sectors of her anatomy had been implanted and were straining at the low-cut blouse. It was a battle to keep myself from staring.
“Do you have an appointment?” she asked pleasantly.
“No. Like I said, I’m an old friend—”
“Dr. Yount is very busy. Would you like to make an appointment?” She began tapping on the keyboard to her sleek, flat-screened computer.
“I—”
“Best we can do is three months from now. Or we could give you an appointment with one of Dr. Yount’s associates, in which case—”
I put my palms on the desk. “We’re not connecting here. I am not a patient. I am a friend of Bill’s from—”
Just then, the heavy door to the receptionist’s right opened violently. A short, bespectacled man strode two steps into the room. His blond, thinning hair was unkempt. With his sparse beard, sagging cheeks, and creased face, he looked a decade older than his thirty-something years. Obviously, the man didn’t practice his trade on himself. He didn’t wear a white coat, sporting instead c
heckered golf pants and a lime green golf shirt.
Bill Yount stopped cold when he saw me.
The receptionist opened her puffed mouth. “Dr. Yount—”
“Wait,” he said, eyeballing me, shaking a finger like a school-teacher. “I know you.”
I nodded. “Bill, it’s N—”
“No, I can get this. Ned Ertel. Academy meeting, Chicago, two years ago. December.”
“No.”
“Derm surgery conference, Philadelphia? Braxton? Neal Braxton. You gave a dynamite talk on flap repairs—”
“Bill—”
“Wait. No. I’m Bill.” He laughed, the three patients in the room laughed, the receptionist laughed. Don Rickles of the dermatology set. I could see why he was fully booked.
“Bill,” I said. “Nate McCormick. We were at med school together. I was two years behind you.”
Yount’s mouth bloomed to a big smile, revealing perfect white teeth. “Nate,” he said, crossing to me and slapping me on the back. “Nate, Nate, Nate. How’re you doing?”
“I’m doing—”
“That’s terrific. Terrific. Good to see you. Just book an appointment with Tina—hey, Tina, give the doctor here a slot next week—” He looked at the three waiting women, who most likely didn’t enjoy such speedy service. “Professional courtesy, ladies.” He turned back to me. “I’ll see you—”
“Bill, I don’t need an appointment. I need to talk to you.”
“Talk? Talk? That’s new. Here, step into my office.” Yount looped an arm around me and we pushed through the door onto the street.
Once we were safely on the sidewalk, Yount said, “What’s the hubbub, bub?”
“I need to know about injectables. Fillers, Botox, all—”
“What about injectables?”
“All about them.”
Behind the glasses, his eyes narrowed. “You’re not thinking about starting a cosmetics practice? You were—what?—surgery?”
“Internal medicine. And no, this is just interest.”
Yount glanced at his thick gold watch. “Now’s not the best time, since I got—” He stopped himself, and he flashed the teeth. “Since I just got stood up. Tell you what. You do something for me, I’ll tell you all you need to know about injectables.”
“What do I need to do?”
Yount smiled. “You play golf?”
That’s how I found myself, thirty minutes later, swinging a couple of warm-up irons with Yount, a bowling pin–shaped venture capitalist named Tobler, and a squat surgeon named Lee. There was no end to the scorn heaped on the missing fourth—a patent lawyer in the city called, variously, “Dickhead,” “Nutless Wonder,” and “Ted.” When they achieved a quorum, these guys called themselves “the Duffer Quartet.”
“We all suck,” Yount explained.
Yount had been kind enough to loan me his wife’s clubs—“she’s used them exactly zero times,” he said—which happened to be three inches too short for me. Her golf shoes were five sizes too small, so I played in my utilitarian, box-toe oxfords.
“Looks great.” Yount was watching me hunch over the stubby driver. “Have a beer.” He thrust a Budweiser into my hand.
I took a sip. “About the injectables, Bill…”
“After the first hole. I need total concentration until then.”
The Duffer Quartet, unmotivated novices all, hit the links at the Lincoln Park Golf Course in the city every Wednesday afternoon. It wasn’t about actually playing a sport, Yount said, more about escaping the humdrum of work and family. The Quartet eschewed golf lessons and had picked up the game only a few months before. I could see why they chose Lincoln Park.
The course covered the high ground near the Palace of the Legion of Honor, and looked out over the Pacific and the Golden Gate Bridge. Stunning, really. But the course itself? Not stunning. Pockmarked greens, debris-strewn bunkers, fairways so overgrown with grass and weeds with tiny white flowers you were as likely to lose a ball on a perfect drive down the middle as on a line drive into the rough. A perfect place for golf stooges to relax and hack divots.
At the first hole, I found myself scanning the grounds, looking for armed Chinese men emerging from the foliage. There was nothing, then something.
In a clutch of trees and bushes between two fairways, I saw the leaves shiver. I focused on them, felt my legs tense as I readied myself to run.
But it was just a septuagenarian in a green windbreaker rummaging for a ball. He stepped out, a golf club in one hand, dropped the ball on the grass, and swung.
“You all right there, Nate?” Yount asked.
To get my mind off the grinding, permeating threat I felt, I made a stab at normal conversation. I brought Bill Yount up to speed on what I’d done in the past twelve years—med school, Peace Corps, med school, residency, CDC. He brought me up to speed, as well—med school, derm residency, fellowship, quick entry into the world of cosmetics. “Should’ve done derm,” he told me.
“I should have done a lot of things,” I replied.
We teed off.
The Duffer Quartet—now the Duffer Trio—did, as Yount had warned, suck. Truly. Each of them hooted and hollered as their Titleists sank into the ground ten yards ahead of us or sliced dangerously into the next fairway.
After they’d taken their shots, I stepped to the tee box and swung the mini-driver a few times.
“Make us proud, Nate,” Lee said.
“Not too proud,” Tobler said.
“Let the man focus,” Yount said.
For the first time in ten years, I addressed a golf ball. I chose my line, then circled to the left for the swing. Lay off the arms, I told myself. Easy swing. Surprisingly, the club felt natural in my hands. I took a last practice swing before settling into my stance. Head up, relax into your stance like you’re sitting on a bar stool, forget you haven’t played in years.
I pulled my arms across my body, pivoted my hips, let my arms follow.
Under most circumstances, the shot would be considered average. But relative to my competition, it was one hundred percent Tiger. The ball sailed straight up the fairway, bounced, and came to rest a decent eight-iron shot from the green.
“Holy shit,” Tobler breathed.
“A ringer,” Lee said.
“You sonofabitch,” Yount said.
Eight-iron, chip, two-putt. A bogey on the first hole.
As we rode the carts to the second hole, Yount looked at me. “So, injectables…”
“Yes,” I said.
“A man who plays golf like that gets all his questions answered. Can I ask the interest?”
“Work.”
“Fair enough.” Yount stopped the cart. “Is your work something I should know about? I mean, we’re not talking Ebola contamination or anything, right? I use this stuff all the time.”
“No Ebola.”
Lee and Tobler pulled out their drivers for the short par four. Yount and I followed suit. As we did, he began to talk quietly.
“A little history of the injectables. Botox, I assume you know. Botulinum toxin paralyzes muscles and reduces the wrinkles caused by the bunching of those muscles.”
“I know Botox.”
“How much do you know about skin and wrinkles?”
“About as much as you know about Ebola.”
“Okay. The beginning, then.” He did a little half-swing with the driver. “For starters, wrinkles result from the loss of three skin components—elastin, collagen, and hyaluronic acid. The drug companies have done a pretty good job with the latter two. Injectable collagen has been around since the seventies, though the original stuff came from cows, didn’t last very long, and generated allergic reactions in some patients. A couple of years ago, human bioengineered collagen came on the market. No allergic reactions, but it still only lasted a few months.” Yount paused while Lee smacked his ball into a clutch of tall grass. “A few years back, we get hyaluronic acid, or Restylane. She holds together collagen and elastin and pulls
water molecules into the space where she’s injected. But hyaluronic acid is problematic. Injecting her hurts and causes inflammation and results are good only for a few months.”
“Beauty’s a bitch,” I said.
The Quartet played ready golf, and Tobler was ready next. His ball skated off the club’s toe and tunneled through the bushes to our right. “I’m taking a mulligan,” he said.
“What’s big now,” Yount told me, “is the new fillers. Sculptra, poly-L-lactic acid. Radiesse, calcium hydroxylapatite. And Artecoll, polymethylmethacrylate.”
Tobler nailed his second shot, and Yount approached the tee. He hunched over his club, used too much arm, and sent the ball skidding along the fairway. I followed with a shot that landed fifteen feet from the green.
“A ringer,” Lee said again.
After finishing out the hole, me with a double bogey, the other three with even less respectable scores, we climbed back into the carts. This section of golf course skirted the beaux arts Legion of Honor, which was, in fact, an art museum, a three-quarter-size concrete replica of a similarly named building in Paris, complete with Corinthian columns and friezes. I wondered what the French would think of this setup. Art museum in the middle of a golf course? Sculpture an errant five-iron from hole two? C’est fou.
As we dropped from the building, a break in the trees afforded a view of the Pacific all the way to the Farallon Islands.
Unconsciously almost, I looked around for any threat. Stop it, I scolded myself.
“The last two you mentioned—the Radiesse and Artecoll,” I said. “They’re used in bone repair.”
“Yes. Well, the substances themselves came from orthopedics. For the skin, there’s a different carrier.”
“They all work the same way?”
“More or less. You want mechanisms?”
“Give me mechanisms-lite.”
“Okay. Basically, the endpoint of all three of the new fillers is to bring fibroblasts into the treatment sites. The fibroblasts lay down collagen and, voilà, you end up looking like your picture from the senior prom.”
“Any word on tumors being caused by this stuff?”
Yount gave me a sideways glance as he stopped the cart. “No. No reports of cancer for any of them. We get granulomas sometimes”—granulomas are the body’s reaction to foreign material, fibrous collections that create bumps in the skin—“or deposits of the material in tissue. But no tumors.”
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