‘Thanks. I need this.’
She went back to her seat. ‘Don’t thank me yet, you haven’t tasted it.’ She smiled. Relaxed. ‘So, what is it I can do for the Metropolitan Police today?’
Ray leaned back in his chair. This was difficult. It was likely to shock. He didn’t want to give too much away. He didn’t know if they would end up identifying medical professionals involved from their NHS. That would be a complete disaster. But that was some of what he needed to know: who and what this organisation needed to carry operations like this off. He took a deep breath.
‘It’s a bit of a delicate matter.’
‘Detective Inspector, everything that comes into my office is delicate,’ Sandford replied with a smile that made her face light up. The weak afternoon sun lit her from behind and made random strands of hair stand out as though electrified.
‘Ray,’ he replied.
‘Ray,’ she said. ‘There’s no need for subtleties in here. Not with me anyway. Little can shock me in my line of work. You have to be quite hardened. Or good at compartmentalising, anyway. Otherwise you’d go home at the end of some days a quivering wreck and wonder how or why you even put one foot in front of another.’
This time it was Ray’s turn to nod in appreciation. His job did the same to him. Human nature made him wonder if the kindness of strangers existed or if it was just a phrase someone had created to keep hope alive so that they would all continue to put that foot in front of the other one.
‘Okay, good. I have an investigation that you may be able to help me with. Not directly, but I do need a lot of help to understand the peripherals of the job and who the people involved might be, both on a professional level and a personal.’
Sandford put her mug on the desk and leaned forward, elbows resting on the wood. ‘I’m all ears.’
Ray took a drink from his mug and wondered why he’d bothered. She hadn’t been kidding when she’d said she didn’t know how to make coffee. He did his best to keep his face straight and not let on how awful it was.
‘We have a case of illegal organ trading and I know very little of the transplant world, I’m afraid,’ he said.
Sandford didn’t appear shocked. It surprised him. Did he need to bear her in mind for this, as one of the doctors used?
‘Yes, I’ve heard of transplant tourism. The World Health Organisation keeps us up to date with these issues.’ So that was where she was coming from. ‘You’ve had victims travel out to foreign countries to buy new organs?’
‘No, I’m afraid it’s closer to home than that.’ He didn’t want to give too many details away, but this needed to be a two-way street. He needed information from the consultant, and she asked direct questions, ones that were difficult to ignore or answer around. Ray supposed that came with her job, the ability to ask the right questions; and that was why he was here, to get the information she knew.
‘It’s here in the UK?’ Now she did look incredulous; it was so plain on her face that Ray could recognise it.
‘I’m afraid so.’
‘How can you be sure?’
‘Mrs Sandford, let me assure you, our investigation is thorough and our information solid. This is happening and it’s happening now on UK soil. And people are dying.’
‘Oh my God.’ She leaned back in her chair. The colour had drained from her already pale face. ‘What can I do?’
‘I need a crash course in transplants. Specifically living transplants.’
‘That’s a lot of information, can you be a little more specific?’
Ray put his mug down. He wouldn’t drink it anyway. ‘To be honest, the best way for us to get ahead of this is for us to understand it, so I need to know as much as I can.’ He bent down to the soft leather briefcase at his feet and pulled out his hardback notebook. ‘I’ve jotted down some of the first questions that came to me, to get us started, if you have the time for us to go through them?’
Sandford waved her arm across the room a couple of times as though wafting away a fly. Ray took this as a sign that he was to carry on and he had the floor. She’d give him the time he needed. A light scent of vanilla with a floral undercurrent floated up to him as she moved the air in front of him. It wasn’t unpleasant.
Ray opened his notebook and clicked on his pen.
‘How many people, bare minimum – not what you think you need in case of emergency, or in case you are sued, or any other random factor, but bare, bare minimum –’ Ray looked at her to get his point across and she nodded ‘– are needed to do the transplants on living donors, both for the donor op and recipient op, and what equipment is needed? Again,’ he eyed her for impact, ‘bare minimum, for these ops?’
‘You’ve asked me two questions, I need to answer them individually, okay?’
‘It’d probably be more helpful to me. To help me follow.’
‘Okay, we’ll go with the first question, people, and I’ll try my best to pare it down for you and not give you all the people we would have in the theatre, which, to be honest, some days is like a merry-go-round with people coming in and going out.’
Ray was grateful that she understood his meaning. ‘Thank you.’
‘You obviously need an anaesthesiologist and a surgeon. If you’re looking at bare minimum, I’ll take it that you’ll use the same team for transplant as you do for the retrieval. Which is perfectly reasonable, particularly with a kidney as it can be held on ice the longest of all retrieved bodily organs, at thirty-six hours.’
Ray whistled. ‘I did not know that.’
‘Not many people do. They think the turnaround time is short, which it is for other organs. The liver is eight to twelve hours. This is incredibly short if you want to get it from one end of the country to the other.’
‘Hence the allowance for blue lights on transport vehicles.’
‘Yes, and the use of helicopters. But back to our transplanters.’
Ray got the impression that she didn’t quite have as much time as he’d imagined. That, or she didn’t go in for small talk, even if it did relate to their subject.
‘You’ll need a scrub practitioner and I’d say a recovery ODP, but your scrub could probably do that job if they were short on staff. I’ve dropped several staff out of this equation. Staff that I’d say were quite vital, like an assisting surgeon and a surgical ODP.’
‘I do appreciate that. So. These are very specialist medical staff they have on their books.’
‘They are, and it worries me that this is happening, that these staff are available to people like this.’ Sandford moved the file of papers from one side of her desk to the other. ‘I do hope you manage to track them down.’
‘With this help from you, it’ll make it easier. Before I spoke to you I had no idea what was involved.’
Sandford picked up the file again, tapped the edge of it on the desk, straightened the papers. ‘The equipment is a more difficult topic to cover, particularly in the way you want me to answer it.’
‘In what way?’
‘In that there is so much medical equipment needed for retrieval and transplant. Stuff you really can’t do without. The people who pay for the transplant stage of the process will pay huge sums of money for a new organ. They’ll risk it all, but they think it’s worth it because they feel let down by the system, the waiting list, they feel their life won’t hold out long enough for the NHS to save them. So, on that premise they give huge sums of money for a third party to provide the service. And when they pay this amount of money they expect to see certain things – I imagine, because I certainly would.’
‘They’d expect to see a proper surgical theatre is what you’re saying?’
‘Exactly. And all that goes with it. The operating table, the lights, the apparatus that supplies the anaesthetic, the surgical equipment that goes on the trays, pulse oximeters, capnographs, resuscitator, defibrillator, ECG machine –’
‘I get the picture.’
‘Really? Because I wasn’t even halfway thro
ugh. Then there’s also your ancillary equipment and medications to manage emergencies, which no surgeon in his right mind would operate without.’
Ray rubbed his head at the sheer volume of medical kit Sandford talked about. ‘And what about premises?’ He knew Sandford had got his point about it not having to be to her standard.
She looked at him. ‘Bear in mind the equipment we’ve discussed, they could set it up anywhere discreet. So long as they have power and they can make the surfaces sterile – because I presume if they run it as a business, they don’t want patients to die – then they can set up in any room they wish. There is absolutely no way to narrow down a location for you. But, as I’ve mentioned, it will probably look semi-professional, or I’d hope so, otherwise these customers –’ she put her fingers up and made air quotes round the word customers ‘– who buy the organs take their lives into their hands coming off the NHS waiting list to do it this way, more than I already think they are. They’ll also need a ward of sorts, and twenty-four-hour nursing staff to take care of the recipient – you can’t kick the recipient out straight after surgery. You can do that relatively quickly with the donor, especially nowadays when you can do the retrieval laparoscopically, but the recipient will need to walk away with a whole host of anti-rejection meds. This needs to be a well-run business if it’s to be a lucrative one.’
It suddenly felt so very grim. Ray picked up his mug and drank, then remembered why he’d put it down.
‘I told you I make dreadful coffee.’ She smiled.
He thought he’d managed to keep a straight face.
‘Do you want to finish this in the canteen, grab a decent drink?’
With a steaming mug of fresh coffee in front of him and a slice of lemon drizzle, Ray opened his notebook again. Left it on the table and started to eat the cake. Sandford had tea. No cake.
‘I get why people might think it’s easy money to sell an organ they don’t need.’ He paused, reconsidered what he’d said, and started again. ‘Okay, I don’t quite get it, but people are desperate and take desperate actions all the time.’ He shoved the rest of the cake in his mouth, swirled his finger in the air like a washing machine as though Sandford couldn’t see he was eating, and waited until he’d finished before he continued. He hadn’t realised how hungry he’d been. ‘What I don’t get is why the recipients act so desperate. Why they put themselves at such risk. If they’re already on a transplant list, waiting for an organ, why then go to a shady organisation, to a shady place, to have an op that needs continual medication afterwards, with such high-risk factors when the NHS has you sorted?’
She stared at him with the look he recognised from earlier: that one of incredulity. He didn’t know if it was due to the fact that he’d paused the conversation long enough to eat cake, or because of the question he’d asked.
‘You think everyone who's on the transplant list will get well?’ she asked.
‘Won’t they?’ Ray swallowed some coffee, draining away the remains of his cake.
She nearly laughed and he felt a little stupid, but she managed to stop at a wide smile. Not a comfortable feeling though. ‘Do you realise how many people are placed on the transplant list every year? In fact, let’s talk about kidneys, shall we, because that’s the main living-donor organ we transplant.’
‘Okay, give it to me. That’s what I’m here for.’ Ray knew they were headed into serious territory now. Not that any subject they’d covered so far hadn’t been, but they were talking about real people on National Health waiting lists who were waiting for other people to die. He put his mug down and picked his pen back up.
‘This year we have a little over five thousand people on the kidney transplant waiting list alone. Five thousand people. Imagine that.’
He did. Five thousand people needed to offer up kidneys or five thousand people needed to die and their relatives needed to agree that their organs could be harvested. That was a lot of people, by anyone’s standards.
‘And for each of those people so many criteria must be met for the transplant to go ahead, and then if the patient finally gets to the top of the list –’ Sandford stopped and looked at Ray ‘– and when I say gets to the top of the list, I don’t mean the list works in order of who goes on it first rises up fastest, it doesn’t work that way, there are so many criteria involved in matching available donor organs to those waiting – so when I say they get to the top of the list, I mean when their time comes, okay?’
Ray agreed. Made more notes in his pad.
Sandford continued where she had stopped. ‘So if a patient gets to the top of the list –’ she looked at Ray and he waved his pen to show that he understood her meaning ‘– and a donor becomes available, we have to cross-match the donor and recipient, and that doesn’t always work out the way you want it to. Do you know the patients who hold the majority on the long-wait list?’ She fiddled with a napkin on the table, folding corners over into neat right-angles.
Ray shook his head. It was swimming.
‘Black and ethnic minority patients. They’re more difficult to match, as well as patients with blood group O, which may surprise you. And patients get matched by their life expectancy after the surgery.’ Sandford’s face was serious, eager now, she wanted him to understand. ‘They need to have a good chance of life after the transplant. But the problem is, if they’ve been on the transplant list a long time, their health has deteriorated and therefore their life expectancy chances have decreased. It’s a vicious decreasing circle and these people are desperate.’ She made another fold; this time she halved the napkin and seared the fold close with her nail.
‘Jesus.’ Ray had no other words. Policing was tough but these people were in a limbo like no other. Sick and in need of someone else’s death, and the quicker the better.
‘And that’s not all,’ Sandford continued. ‘Since 2012, the number of people who have donated organs, be it either as a deceased donor or as a living donor, has halved as of this year. Halved.’
33
Ray lifted the lid of the laptop, a can of beer open beside him. It was already dark outside. The day had been a long one, though the daylight hours themselves were short. Night stole in, silent and heavy. Ray tended to like this time of year as the season changed. Signs of life started to creep in again. Light was the main clue that spring was creeping towards them, but Ray could also feel the wet and freezing winter slip away, the days become less harsh. Easier on the soul.
He opened the TOR network browser again, and, in another window, the hidden Wiki page with listed websites. He needed to go in and keep up his search. It wasn’t an easy place to navigate. The people who found their way here, he decided, were both desperate enough to do it and also intelligent enough to figure it out. That, or, when it came to those who wanted to sell, knew someone who would point the way.
He took a deep slug and stared at his screen. Joe had outsourced this work to the eCrime Unit before Billy had given them a direct URL address, and since Billy’s death the website had moved. The group were really twitchy. He didn’t know how much work eCrime would be able to do, how deep they’d be able to go or if indeed they’d be able to get any information if they found the website. That was the whole point of the dark web. People wanted to be untraceable. That was why he had to do this off the books. He would hold back, though, and see how the investigation went. He wouldn’t be stupid enough to screw up the investigation by trampling his size tens all over it. No, he’d wait and see if they could get somewhere the proper way, and if not, then he’d have to see what he could do from this point of view.
The front door opened. Keys dropped onto the side table with a clatter. Heels clicked, then stopped. Ray knew stockinged feet now walked towards him. He took another swig of his beer. Remember, there’s going to be a disconnect, he told himself.
Then another swig of beer.
He could feel her waiting behind him. Waiting for him to put the can down. Ray leaned forward and placed it on the table, ne
xt to the laptop, which was still open. He pushed down on the screen, clicked the laptop closed.
Celeste wrapped her arms around his neck. Her face came to meet his. A routine they’d got into. A closeness they enjoyed.
Ray could feel the warmth of her, heard the soft hum from her throat as she pulled in close, the back of the chair still between them, smelled the sweetness of her perfume mixed with the chill from the night; her body heat was pushing through but the cool from the street had clung to her as she’d swept into the warm house. The familiarity of all this made his chest contract. He’d missed the intimacy. Missed her. Craved normality back in his life. He lifted his hand and touched Celeste’s cheek where the chill and warmth battled.
A physical sigh went through his shoulder as she leaned over him.
Ray didn’t want to break this moment. This was the relationship he remembered. This was him and Celeste from before. He needed this. If he turned around now he’d be shocked by the lack of connection between the person in front of him and the memory of her. Of them. He was still adjusting and it was still a jolt when the face of those closest to him didn’t connect to the memory. The wiring had disconnected and it wasn’t easy for him to hide how he felt.
‘Good day?’ he asked
‘Mmm. You?’ she murmured. Her voice so familiar and warm.
‘Busy – you know how it is.’
‘You smell good.’ Her nose nestled into his neck. Ray closed his eyes. Her hand pushed its way down the front of his jumper. This was the woman he was falling in love with. He knew her voice, recognised her touch, her scent. Ray relaxed as her hand caressed his chest and then slid down. A moan escaped. He could be in the here and now.
Suddenly Celeste was laughing.
‘Ray, I can’t reach your jeans from back here. I’m not Mr Tickle.’
She moved. She was at the side of him and then she was in his lap, moving in to kiss him. They stopped to face each other.
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