Wendell Black, MD

by Gerald Imber, M. D.

  What did it mean? The girl was a guy, and the breast implants were a vehicle for transporting heroin. She—it was hard for me to think he—had implants in the pockets before, maybe drug-filled implants, and this time the string ran out, killing the mule. But this was only a disturbance on the surface. The big stuff was deep underwater, and I didn’t have a clue if it was a whale or a flounder. I didn’t even know where to look. That wasn’t my job. But I was curious enough to ask some questions. I knew I wouldn’t get more than a greeting out of the DEA or Customs guys—unless they needed something from me, which was not likely. Even if I could help, they wouldn’t admit it outright. That’s how close they are to the NYPD, and I’m not even a real cop.

  I drained my beer and used a fingertip, wet from the condensation on the mug, to mop up the salty dregs of the popcorn. I was tempted to wash it down with another beer, but even one on a work afternoon was breaking with precedent. You work with enough middle-aged alcoholics and it becomes easy to see how it creeps up on you. A beer or two at lunch, a few drinks after a trying day—share the pain with people who understand—and who knows how many with dinner or after. You think you get used to the headache, the edge, the irritability, and it eases a bit with a cold one or a shot in hot black coffee. I’m probably overreacting, but these guys aren’t all genetic alcoholics sliding down the slippery family path. You can do it to yourself. It was too easy to fall into the trap and it was too hard to get out, and I wasn’t going there. I was already an NYPD statistic with a failed marriage, and that was enough belonging for me. I paid for the beer and left a generous tip for the smile. I got my jacket off the hook, pulled the collar up around my neck, and snuggled in for the walk back to my car at the academy.

  By the time I drove across town, parked, and picked up my mail, it was nearly six. It only took a quick glance to reveal that most of the mail was junk and not worth the trouble. Before I reached for my apartment keys, I could hear my pal stomping and snorting, banging his tail on the door and whining at the threshold. Naturally, I ratcheted up his excitement with some throaty encouragement. “Yes, Tonto . . . yes, baby . . . yeah.” By now I knew the big Lab was spinning in circles. It was always a nice welcome. “Don’t jump” doesn’t work with Tonto, and I let him bounce a few times before scratching his neck. I bent down and took the obligatory slurps, tossed the mail on the entry table, and said, “Get the leash, Tonto,” but he was in mid-fetch mode before I started talking. Routine.

  Having a dog in New York is a pain, and it’s expensive. There’s no guilt about leaving him at home because he’s never at home. Tonto has more playdates than a five-year-old. The dog-walker and the doggie gym wear him out, and I’m sure he’s putting on this show so I’ll know I’m loved. So, out we go for a quick turn and some sniffing. He did his business quickly. I cleaned up after him, that’s the law, and we headed home. The late-night walk is a game changer, and much more of a chore.

  We settled in. I switched on the news and stretched out on the sofa. Tonto took the club chair. It was Monday, and I could feel smart winging through the Times crossword puzzle. Later in the week it got progressively more difficult and took too much time. I had planned my evening no further. Back home after five days away, and the only person I was anxious to see was otherwise engaged. Sad. I had no work to catch up with and I’d been reading constantly, so there was no book I was dying to dig into. Order in, and waste the night in front of the tube.

  Dinner arrived about half an hour after I had called it in, and by eight forty-five I was looking at pork soup dumplings, fried rice laced with unidentifiable morsels, and braised tofu over spinach. A feast I would barely make a dent in, and all for twenty-four dollars. One of the rough parts of living alone is trying to maintain a reasonable level of civility. Tonight that meant eating from real dishes instead of the paper cartons and Styrofoam plates that came with the food. I set up a tray with a pair of pretty, ebonized chopsticks left over from my marriage, a large bowl for the rice, on top of which I doled out dumplings and tofu. The spinach didn’t do much for me. I folded a cloth napkin onto the tray instead of the more sensible paper toweling I usually favored, poured a glass of water and another of Sancerre, and carried the feast to the coffee table in front of the television. An hour, a sip of Sancerre, and I was fast asleep fully dressed.

  6

  I slept the sleep of the innocent but still woke up feeling like hell. I’m a fairly solid six feet, with regular features, a nicely shaped broken nose that turns a bit to the right, and more smile lines than the average fifty-year-old. Most women think I’m attractive . . . maybe handsome, but staring at my face in that mirror was enough to make anyone lose their appetite. My eyes were puffy and my cheeks had sleep folds like knife wounds. My short-cut salt-and-pepper hair stood like a punk rocker’s in an acid dream, and my mouth tasted like the inside of a trash can. I’m probably too old for salted popcorn and Chinese food in the same day.

  In an hour I was alive again. I took Tonto for a trot, did forty minutes in the barely functional gym that occupied part of the building’s lower level, had coffee, showered, and dressed. Then down to my car in the garage that took up most of the building’s basement. I liked the privacy of driving to work. Manhattan traffic was no picnic. Subways were definitely faster than the streets, but I liked my cocoon. I listened to the news and some music and spaced out. Parking was not an issue. The official NYPD vehicle placard was a major perk of the job. I hadn’t spent a second thinking about Azul Capinpin since returning home last night, and he was the furthest thing from my thoughts when I arrived at the office.

  That changed quickly. As usual, Mrs. Black timed her tea service perfectly. “Two detectives from Narcotics are in the waiting room,” she said, as I entered the office. “When can you see them?”

  “At nine when clinic starts,” I answered ever so slightly curtly.

  Mrs. Black shot me a glare and headed for her desk before I could apologize.

  She turned back to me. “They are not patients, doctor. They want to interview you.” I knew better than to ask why.

  “Okay, show them in, but let me have a sip of tea first.”

  Mrs. Black poured out a cup of properly brewed, not quite steaming, sencha, a simple green tea that we both liked. I thanked her, sipped my tea, and admired her as unobtrusively as possible as she left the room.

  The two detectives from Narcotics Division looked about as official as a pair of muggers. Blue jeans, ugly high-top sneakers, hooded sweatshirts, and scruffy hair. One wore a goatee; and the other, two or three days of sparsely distributed bristle. Both had IDs and gold badges on chains around their necks and, I assumed, holstered pistols in the waistbands of their jeans. That was the Narcotics drill.

  They introduced themselves. John Griffin was the big guy with the goatee. He was about forty, and a sergeant. His partner, Michael Rodriguez, was a good five inches shorter than Griffin, wiry and twitchy, with olive skin. Rodriguez was a sergeant as well. They were both friendly. Everyone was friendly to the surgeons; you never knew when the goodwill might come in handy. Griffin did most of the talking, and it wasn’t long before he said, “Either these yo-yos got their plan straight from the movies, or they were doing it first.”

  “Is this something you guys look for?” I asked. I wasn’t questioning their systems, just curious.

  “No, not really, but a few cases have been reported over the years. We consider them in the same category as mules that swallow condoms filled with cocaine, or shove them in their anus or vagina, which is much more common and doesn’t need surgical assistance for recovery.” Griffin seemed awkward using anatomic terminology. They weren’t even testifying. Street talk would come a lot more naturally, but I wasn’t one of them. I nodded and encouraged him to go on. “Mostly, the dogs don’t find these people, so we work backward from tips, CIs, or undercover info.”

  Most of Narcotics worked that way. There was very little sleuthing. These guys had their eyes and ears open and were on the fir
ing line all the time. You had to respect them, except when you didn’t. The temptation was always there. And the job couldn’t help but screw up your perspective on behavior and reward. It was a hard day’s work . . . and for most of them, definitely not a life’s work. Mostly, only the feds made a career of it, and they weren’t on the streets.

  The conversation continued in that inside-baseball way for a while. They asked a few questions about the situation on the plane, any traveling companion with the victim, anything else I might have noticed, that kind of stuff. Then Rodriguez asked, “Any idea who the receiving surgeon might be, doc?”

  I hate when people call me doc. It happens too often to take a stand, but in my edgy way I think of it as a kind of sloppy disrespect. Most people use the term as a measure of friendly respect, maybe even endearment. I’m sure it’s meant that way, but I wouldn’t call them cop. Yes cop, no cop, sorry cop. If I took the trouble to call him Sergeant Rodriguez, he could call me Dr. Black. I let it pass and thought about the meaning of what he said. That pissed me off more. Why would they think I had any idea who could be involved? I was a Good Samaritan in all this. Nothing more. A few seconds passed silently. I hadn’t actually been considering the question, and I snapped back into the present.

  “No, no idea at all. Why would you expect that I would?”

  “Just routine. You were there and you’re a doctor and all.”

  “Sorry, guys, no dice. I have to work now . . . so if you will excuse me.” I walked toward the door and opened it, not bothering to shake hands with the two detectives as they left.

  The rest of the day passed normally. That is to say, dull. I saw twenty-two officers at sick call in less than three hours. Not exactly high-end medicine, but neither were the complaints. There was the usual autumn flu going around New York, and some of the guys looked like hell. Pale, lethargic, dehydrated, dull eyes, and others were florid-faced from fever, with upper respiratory symptoms. As far as diagnosis was concerned, it was all part of the same disease. Early phase, late phase, different manifestations of the same virus, or maybe different viruses. They would all pass. These were young, healthy guys. Bed rest and fluids for everyone, aspirin or Tylenol for fever, and call me if it got worse. Sometimes antibiotics were appropriate when bacterial pneumonia seemed near, but for the most part there was nothing to do but let the virus run its course.

  Then there were guys injured on the job. Before your imagination runs away with you, most were injured from tripping, falling, twisting an ankle, and an occasional bruise from physical interaction in the line of duty. Never a gunshot wound. Those were emergencies treated at hospitals. We always came by to oversee care and follow the officer’s progress. Maybe oversee is an exaggeration. Observe was more like it. That was my afternoon. Two bedside visits. Perusing the charts, chatting a bit, and asking the officers if they needed anything. I felt more like a priest than a doctor, but I got home early.

  There was an eight-hour shift coming up in the emergency room where I did my moonlighting. It was sanctioned, and I had been at it for years. I have been a certified emergency physician since my residency, and I like to ply my trade. Sometimes I wish I had continued on my original course as a surgical resident, but it was a bad time for me and I took the easy way out. The era of long days and longer nights didn’t do much to stabilize an insecure young wife. I opted for regular hours and a regular life, but a decade later, the marriage died on its own, as it should have. It just took a while for us to realize that.

  A couple of times a week I work the overnight shift in the emergency room in an affluent community just over the border in Westchester County. Not too much happens there, and you practically need a platinum American Express card to be admitted to the ER. It wasn’t very taxing and they paid well. With two salaries and a healthy family endowment, I really had no money worries. I’d never be rich, but I never bargained for that anyway. That level of comfort probably stifled my career ambitions, but I liked what I did, and I liked my life. I also really liked the people I worked with, particularly Dr. Sheppard.

  Alice Sheppard had been working occasional shifts at the hospital for nearly a year. For a lot of reasons, I made it my business to try to work the same schedule as Alice whenever I could swing it. Tonight we were both on, and I hadn’t seen her for a week. We had been going out for a few months now. It’d been fun, and I thought she liked me almost as much as I liked her, which was an issue for both of us. Still, it always gave me a thrill to see her, and working together was a bonus. Alice and I had planned to spend the long weekend together in London. We each had two jobs to juggle, and when her schedule changed at the last minute, I couldn’t accommodate. But now I was back.

  Alice was a pretty good example of what patients wanted their plastic surgeon to look like. She was five-eight, weighed in at a hot one-twenty-five, tops, and was almost head-spinning gorgeous, in a nonchalant, casual way. Alice didn’t need short skirts, paint and powder and ploys to command men’s attention. You could feel it . . . smell it. She was finishing up yet another fellowship before hanging out her shingle. Alice was going to knock ’em dead—which may not be exactly the best choice of words to apply to a medical practice. She had a fabulous English accent, and on top of it all, she was a very good surgeon.

  It was serendipity that we ended up working in the same place and kind of falling in together. She had only just gotten over being dumped by her husband, a London investment banker who, she said, considered himself single. Hubby took up with an airhead model that earned even more than he did, which was a lot. Alice took it hard. She was way down and had reached the stage where she was blaming herself. She needed to vent, which was my good fortune. I’m a good listener and a pretty sensible friend. Alice did it for me from the first second, but it took a bunch of friendly dinners, a zillion e-mails, and a few hesitant gropes before two consenting adults fell together. I was the happiest guy in the world; she cried and I loved her for it. Not immediately—in the moment it was confusing—but when I thought it through. This was a serious person. The real deal, and I had a shot. I wasn’t going to blow it. It was the first time in years that I had calculated my behavior with a woman. I was almost fifty-one and found myself desperate to get serious. What goes around comes around.

  “Hello, lovely,” she said. That should have been my line. We kissed chastely, like friends. I hoped we were more than that, but I was never certain. She wasn’t at all cold, just the opposite, and she was treating me the way she treated all her friends. I was jealous. I know that’s crazy, but it’s the truth.

  7

  The bullpen, where doctors sit to write up charts or drink coffee before the onslaught of patients, is a feature common to most emergency departments. It is usually a glassed-in cubicle that makes it possible for the staff inside to have eye contact with the ever-changing emergency scene. It also puts you on display. I brought in two containers of black coffee from the machine in the back of the ER. It was brewed freshly to each complicated, computerized order, and once you understood the directions, it was pretty good stuff. Despite that, I made the simplest choice and brought back two black coffees.

  “Thank you,” said Alice, smiling up at me through delicious, angelic lips, flashing natural, white teeth as uniform as the spines of the Harvard Classics. She had a stack of charts in front of her and tossed another onto the pile, picking up the paper cup. The after-dinner rush had diminished to a trickle. As usual, it consisted of people with lingering complaints not important enough to disturb their daily routines with a scheduled doctor visit. Most of the real emergencies happened later. Even automobile accidents had a predictable time frame. When heavy traffic made it impossible to do much more than crawl the streets and highways, the ER was quiet, as it was now. It would last another hour at most. I rolled one of the hideous blue-green plastic chairs beside Alice and sipped my coffee.

  “Ever hear of people smuggling drugs into the country in breast implants?”

  Her head snapped around. “Excu
se me. I think I missed what you said.”

  I repeated myself.

  “Hear of it, yes,” she answered.

  “Well, that puts you and everybody else a step ahead of me. I never heard of it until yesterday.” I retold an encapsulated version of my story, carefully setting up the punch line.

  “A man! Wow. You couldn’t tell? There are lots of clues, you know.”

  “Don’t say it. It all happened so fast; there was no time to evaluate physical characteristics. It was try to save her . . . his . . . life and go back to my seat.” I had ceased being embarrassed, or at least I had an excuse I believed in. I continued talking. “Would you have to be a plastic surgeon to do the operation?

  “Which operation?”

  “Removing the implants.”

  “No, not at all. Anyone familiar with simple surgical technique could remove the implants and get away with it. Inserting new implants would require a greater level of skill.”

  “Why?”

  “Well, the first time around, a pocket for the implant has to be developed either between the breast and pectoralis muscle or under the muscle itself. In a man it would be a tougher, bloodier dissection than in a woman. It would be easiest in a woman who had nursed children . . . the fibrous tissue is looser. Either way, one needs to know the anatomy. You know, control bleeding and use good sterile technique or it’s asking for disaster. Inserting a foreign body, even an inert material like silicone, is a setup for infection. It’s something we take really seriously.”

  “Got it. So, whoever put the heroin into the implants had to do it under sterile conditions. That should limit the field.”