At What Cost

by James L'Etoile

  “What is it?” Melissa repeated.

  “Gone. All of Tommy’s medications are gone.”

  John ran down to the boy’s bedroom and pushed open the door. Two dresser drawers were pulled open and empty.

  “Oh my God,” she said.

  John turned and followed Melissa’s gaze to Tommy’s bed. There, on top of the quilt, lay the stuffed animal from the hospital. The bear was a flattened hulk. All of the stuffing had been ripped through a ragged incision in the animal’s fabric skin. The exact method the Outcast Killer used on his victims.

  With leaden legs, John approached his son’s bed. The stuffed animal’s corpse bore an obscene resemblance to Daniel Cardozo’s body—chest flayed wide and the cavity empty. Inside, John caught a glimpse of something that didn’t belong, a folded piece of paper. It looked like a small origami figure, a human form.

  John picked up the paper doll and saw subtle blue lines. His fingers trembled as he unfolded the note. A message from the Outcast Killer.

  You have a decision to make. Either your son gets a donor, or he becomes one. You know how to contact me. You have until 9:00.

  THIRTY

  Police technicians swarmed through the Penley home, swabbing, dusting, and collecting. John witnessed this process hundreds of times as a cop, but this time it felt invasive. The techs carried out their crime-scene sweep, leaving dark smudges of fingerprint powder on doorjambs and counter tops, on any surface their suspect could have touched. John had never noticed before how the blotches looked like bruises.

  Two of the techs carried on a conversation about the local NBA franchise and the odds of the team leaving town after the city dumped millions of taxpayer dollars into a downtown arena deal. The shorter of the two snapped a photo of the spilled coffee mug. “I don’t get why people are all worked up about losing the Kings to another city. They don’t buy tickets and go to games, so what’s the big surprise?”

  “The city needs to step up and invest in the team,” the taller one said as he brushed dark powder on the desktop surface. “Otherwise, the Kings could make more money somewhere else.”

  “Where are we gonna get city money, Chuck? Lay off some crime-scene techs? Why do taxpayers have to help a millionaire make more money? That ain’t right, is it, Lieutenant?”

  Barnes appeared in the room without John noticing.

  “Why don’t you guys pipe down and get to work,” Barnes said.

  The techs looked at one another, shrugged, and returned to their evidence-collection routine.

  Barnes went to John, in a corner of the room, out of the way of the activity.

  “Sorry about that,” Barnes said.

  “That’s what we do, isn’t it? We come into people’s lives at the worst moment and then we act like it’s no big thing. We just go on with our lives, while theirs are shattered.”

  “How’s Melissa holding up?”

  “By a thread, like me. She kept insisting it was her fault.” John turned to the lieutenant. “He was here. In my house.” John punctuated his words with a fist into his open palm.

  “He took clothes and medications for Tommy. You know that’s a positive thing,” Barnes said.

  “It means he plans to keep him.”

  “Keep him alive,” Barnes corrected.

  John turned away and peered out a window that overlooked the street. “I sent Melissa to her sister’s place across town with Kari. I didn’t want her to have to deal with this.” He tilted his head to the window.

  Yellow crime-scene tape draped across the driveway, secured to a tree on one end and a patrol car’s door handle on the other. Official police vehicles, marked and unmarked, lined both sides of the street. Neighbors and the morbidly curious nosed up to the yellow-taped line for a peek at a real crime scene. Some left when they discovered it wasn’t like one of those television cop shows, with well-dressed sexy investigators trading quips over a dead body.

  Two television news crews held big, boxy cameras and filmed the spectacle for the eleven o’clock news. The police public information officer spoke with one reporter under the glare of camera light.

  “What’s the PIO saying?” John asked.

  “The press release says Tommy was abducted. Photos and descriptions of Tommy and the nurse last seen with him are out.”

  John looked past Barnes to the desk where the crumpled envelope and photograph of Patrick Horn sat near the keyboard.

  “You releasing the ID on the guy?” John asked.

  “Patrick Horn and Brice Winnow. We’re showing that surveillance photo around to anyone who might have seen him,” Barnes said.

  “Who’s handling that?”

  “Paula.”

  From the direction of the living room, a crime tech called out, “Lieutenant, I got something you need to see.”

  John followed the lieutenant out of the office to the living room, where a crime-scene tech had emptied the contents of a floor-to-ceiling bookshelf. An assortment of novels, old college textbooks, and children’s storybooks lay askew, heaped on the hardwood. A single book remained on the top shelf.

  “I was dusting for prints along the edge of the door, and I saw this,” the tech said, pointing to gouges in the hardwood flooring near the corner of the bookshelf.

  “Looks like it was moved,” Barnes said.

  “Exactly, but this is a built-in unit, so why would it get moved?” the tech added.

  John knelt near the shelf and ran his finger along the gouge marks. “I’ve never noticed these.”

  “It’s hard to see. The scratches blend in with the wood grain. But check this out,” the tech said. He bent over, took hold of the lower section of millwork on the cabinet, and pulled it free. The entire five-foot-long trim piece below the bottommost shelf came loose in his hand. A single red eye reflected back from the dark, hollow space under the bookshelf.

  “What the hell is that?” Barnes asked.

  “A battery power supply,” the tech said. He rose up and took the sole remaining book from the top shelf in his hand. “For this.” A thin white wire fed from the back of the book to a small hole in the plaster wall.

  The tech unplugged the wire from an input jack glued into the pages of the book and stepped away with the volume in his hands. He cracked the cover and revealed a hollowed-out core in the center of the book’s pages.

  “Paula and I saw something like this at the Weber kid’s apartment,” John said. “Cameras.”

  “This one is wired to the battery pack and to a recording device.” The tech pushed the edge of the black plastic rectangle hidden in the book, and a memory card popped into view. “If it weren’t for the scratches on the floor from the guy swapping out batteries or memory cards, I might not have found it at all.”

  “This asshole has been watching my family?” John asked. “How long has he been doing this?”

  “No way to tell for sure. The scratches show the trim board was moved five, maybe six times. Each battery pack would last a month, maybe more, if the camera was motion activated.”

  “Any way we can see what’s on that card?” Barnes asked.

  “It’s an XD card. I don’t have anything with me to read it. I can get it back to the nerds at the lab.”

  John snatched the card. “My computer has a card reader.” He quickstepped back to the computer in his office and shoved the small memory card in a slot on the computer console.

  Lieutenant Barnes and the tech stood, looking over John’s shoulder as the PC read the memory card. A window popped up with a single file listed in the menu. John took a breath and tapped the mouse button, pulling up the video file.

  The monitor bloomed with a sharp image of the Penley living room. The lighting in the room said that it was nighttime. Streetlights, visible through a window in the background of the frame, confirmed it was well after dark.

  A sudden blur filled the screen, and the camera autofocused on the source of the movement.

  A male figure wearing a dark-blue hooded sweat
shirt crossed the living room and disappeared toward the kitchen. Faint shuffling sounds came through the computer speakers. John hit the control to increase the volume. Faint rustling noises, cabinet doors slamming, and the crinkle of a paper bag rang through the small computer speaker. The distinct sound of pill bottles being tossed into a bag came next. The male figure crossed the screen again and made a trail to the bedrooms. The sound of his footfalls grew faint as he went down the hallway. A creaking floorboard and the sound of louder footsteps preceded the image of the hooded man in front of the camera. This time he stopped directly in front of the lens, pulled the hood down, and stared into the camera.

  There was a slight pause before a smirk formed on his face. The half grin looked out of place. Patrick Horn faced the camera and made certain there was no doubt as to his identity. The man moved differently than he had when he had presented himself as Brice Winnow. The fluid stride and arrogant, self-important posture were replaced with choppy movement and a slouch. He shifted his weight from foot to foot, like a junkie impatient for the next fix.

  When Horn spoke, it came out in raspy chunks of words. “Detective Penley . . . you . . . can’t . . . stop me. What I do is for the greater good, for all mankind.” Horn stopped to catch his breath.

  “All mankind? Horn’s a frickin’ psycho,” Barnes said.

  Horn continued, “I don’t expect you . . . to have the capacity . . . to understand.” He lifted his arm, pointed at his watch, and said, “Tommy understands.” He took a ragged breath. “I left something for you. Your son doesn’t need it anymore.” He sidestepped out of view and disappeared.

  “Understands? Understands what?” Barnes asked.

  John stood transfixed, hoping that his son would magically appear on the screen and this nightmare would end.

  “What does he mean?” Barnes said. “Has he contacted you?”

  John shook his head and looked to the kitchen where Horn had rummaged about. He recalled the sounds from the video. He willed his legs to propel him to the kitchen. He opened the cabinets and drawers but found nothing out of place except for the missing medications. John leaned back against the counter and rubbed a thumb into his temple to fight off the throbbing that echoed in his head.

  He had looked around the kitchen and mentally ticked off each and every storage shelf when he locked eyes on the refrigerator.

  He stepped across the kitchen floor and grasped the fridge door handle with his sweat-soaked palm. The crack of light spilled from the refrigerator and illuminated John’s trembling hand. He pulled the door open, and his neck stiffened.

  On the center of the top shelf, Horn had left a clear plastic freezer bag. A bloody mass in the outline of a human kidney.

  John dropped to his knees while the killer’s words replayed in his head:

  “Your son doesn’t need it anymore.”

  THIRTY-ONE

  “It is a child’s kidney,” Dr. Sandra Kelly said. “I can confirm that much from the size and mass of the tissue.” She removed her glasses and gently placed the plastic bag into a small foam container, one that looked more accustomed to holding beer at the beach, except this bore a bright-orange biohazard label on the side.

  “Thanks for coming, Doc,” John said.

  “Of course,” she said. The doctor went to the sofa, sat next to John, and placed her hand over his.

  “How long can Tommy last without one of his kidneys? I mean, he was barely hanging on with both of them. Now this . . .”

  John looked fragile, a shell ready to fracture. He didn’t look at her, or anything really; he simply stared at a swirl in the hardwood floorboards.

  “We don’t know if this . . .” Dr. Kelly caught the clinical tone in her voice. “Let me show you something.”

  She reached for her shoulder bag and retrieved a tablet computer. The doctor powered up the small unit, flicked through the screens, and tapped a button. The screen came alive with photos, text, and autopsy diagrams.

  John never lifted his head toward the screen.

  “You’ve seen these before, the autopsy reports for Mercer and Johnson. I completed the report for Cardozo. I don’t have an ID on the body you hauled out of the water, but take a look at something.” She held the tablet out for John.

  His hands trembled as John took the tablet computer. A series of gruesome images were displayed on the small screen.

  “What am I looking at?” he asked.

  Dr. Kelly pointed at the top photo. “The Mercer autopsy. The victim’s aorta transected in a downward left-to-right direction.”

  John’s forehead wrinkled. “Okay, so?”

  “This is from the Johnson autopsy.” She tapped the middle photo. “The aorta is severed at nearly the same location, downward left to right.”

  Dr. Kelly saw that John wasn’t tracking. She rotated the photo one hundred eighty degrees, so that the space where the victim’s head would have been pointed downward. “The incision was made top to bottom.”

  John couldn’t see the difference or the significance.

  “Remember how I said that it was like an autopsy was already done?”

  “Yeah, sure. Because of the way the chest was opened up and the Y-shaped incision.” John handed the tablet back to Dr. Kelly.

  “I was looking at it the same way you did, we all did. I expected to see an autopsy, and that’s what I saw. When I was a little girl, my daddy took me hunting. When he’d bag a deer, he would string it up in a tree by its hind legs and do what he called ‘field dressing.’ He’d bleed the deer out and cut the carcass open from the top to the bottom, exactly like this.”

  “What made you think of that?”

  “John Doe made the connection for me. Remember the body from the river? There were wounds on the back of the legs consistent with the body being hung upside down.”

  She let that sink in and remained silent.

  John pulled the tablet closer and took another deep look at the graphic photographs of the murder victims in a new light. The recollection of the meat hooks in the Layton barn made a horrific connection. He turned to Dr. Kelly and asked, “You’re certain?”

  “As the medical examiner, it’s kind of what I do,” she said with a wry smile.

  “These people were butchered.”

  She nodded. “It would appear so.”

  “Were they alive when . . . ?”

  “No. The tissue samples from Johnson, Mercer, and the waterlogged John Doe confirmed they were no longer alive when the organ harvesting occurred. Cardozo, well, that’s a different story.”

  “Tox screens?” John asked, mentally checking another box.

  “We did a limited tox panel, in that we didn’t have blood or organ tissue, but nothing turned up.”

  John stood and flexed the kinks from his knees, paced to the far end of the room, and lifted a photo of his family from a mahogany side table. The picture portrayed happier times, before Tommy’s diagnosis. The boy’s face was fresh, happy, and innocent back then.

  “Is there a way to check the DNA or find out who donated the kidney to Cardozo’s daughter? Can we find out if it’s a match for Cardozo?” John asked.

  “I can check. She’s not doing well, by the way. You’re getting at the hacking of the UNOS database, aren’t you?” she asked. “You know that would explain some things.”

  “What do you mean?” he asked.

  “If the database and the waiting list were compromised, it would explain why the Gunderson boy’s mother thought he received a mismatched kidney.”

  “The autopsy? You were able to do that?”

  “Yes. I haven’t gotten the entire tox panel back, but the organ was indeed a mismatch for young Mr. Gunderson. But it would have been a match for Tommy.”

  John stiffened. “With Zack Weber hacking into the system, Patrick Horn, or Winnow—whoever the hell he is—accessed the data on patients awaiting transplant and purposely gave patients mismatched tissue. He cancelled Tommy’s transplant.”

  “O
kay, I follow, but you’re assuming that he gives a crap about tissue match. It could be that he is simply carving up people for profit,” Dr. Kelly said.

  “I think there is more to him than that. Zack Weber was an idealist, convinced that he was serving mankind.”

  “Maybe Horn threatened Weber,” she said.

  “He protected Horn after we uncovered the lab tampering. Weber actually believed that they were helping people the big medical corporate machine wouldn’t touch.”

  “Daniel Cardozo’s daughter needed a kidney, so Horn and company killed her father for the perfect match? Where are the idealistic values in that?”

  “Daniel Cardozo was a thug, a gang member, and a drain on society, but he would have willingly given his daughter a kidney,” John offered.

  “So these guys play a sick game of Robin Hood with human organs—take from the undeserving and give to the poor? Tissue typing and matching isn’t difficult, but I’m willing to bet it’s beyond the capability of Weber and Horn. A simple blood-type match, maybe.”

  John paced back toward the sofa. “I don’t buy the idea they were fueled by a misguided ideology. These victims weren’t random. Each gang member was selected as much for who they were as for any tissue match. Do you know anything about the last victim?”

  The doctor stuffed her tablet computer in her shoulder bag and said, “I’m going to see if I can pull some strings at the Department of Justice lab. They owe me, and we can’t wait weeks to get a response. The first thing I’m going to ask them to do is rule out that this tissue came from Tommy.”

  “You can do that?”

  “I’ve already pulled your son’s DNA profile from the transplant center for comparison, so it’s not like we need to search the entire DNA database for a cold hit,” Dr. Kelly said.

  John followed the doctor to the kitchen, where the Styrofoam cooler containing someone’s entrails waited. Dr. Kelly hefted the case from the countertop and tucked it under one arm. She patted the top of the insulated container. “The moment I have anything . . .”