The Organ Broker

by Stu Strumwasser

  Marlene’s priest was leading them through the Valley of the Shadow of Death. People huddled around her fresh grave in small groups and held each other’s glove-covered hands. There was no wind, but it was cold. We could all see our breath that day in Pennsylvania. White puffs of vapor constantly dissipated in the air in front of our faces as we stood in the graveyard.

  She had received a South African kidney. It was standard issue, from a poor black woman who lived in a tin shanty home. The Browns had paid $150K. The South African probably got about fifteen hundred. No one ever made follow-up calls to the sellers. There was a good chance that the South African got no aftercare. She might have gotten an infection or become unable to work.

  In his eulogy the priest mentioned that Marlene’s husband had gotten a second mortgage to pay for her operation. It didn’t fully cover it, but neighbors and fellow parishioners donated enough to make up the difference. I didn’t know that. I didn’t talk too much to Wallace’s buyers. From what Wallace had said, the guy didn’t really try to negotiate. He just paid us. It wasn’t the new knowledge of how the Browns had funded their purchase that struck me, but rather, the fact that I had been completely unaware of it.

  “Traded his home for a few more months with his beloved wife,” the priest said, while the cold, wet snow started to seep through the seams where the soles of my shoes met the soft Italian leather. I didn’t know a thing about the Browns prior to that funeral. They belonged to Wallace. I had no idea about what they had gone through to buy my extraordinarily overpriced product that had, apparently, only extended her life for another few months. I realized then that I knew so little about any of them. I had stopped asking years ago. It caught me off guard.

  Standing there in the snow, I thought about them all, and started to feel sick. I thought about the sellers in South Africa and Asia and South America, poor people living wretched lives all further cut off at the knees by the lies spewed by a network of finders that I had built and managed for years. I thought about all of our American and European clients who we had charged triple the fair price. They all went on to lead Marlene Brown–like lives, in varying degrees—although most did live much longer. Her husband, Joe, was crying, constantly wiping at his nose and his eyes with the fingers of a black leather glove. Then I found that I was crying, silently. It was not for Marlene; it was for me. I was crying for the life I had lost because I realized clearly that day that I had not saved a soul, but instead, I had played a part in destroying all of us. The magnitude of that loss was pushing down on my shoulders, sinking me deeper into the soft snow, pushing me down into the magma in the core of the Earth.

  There is one thing that all priests and atheists have in common—they all hope the priests are right. But standing in the remnants of snow on the frozen grass in New Hope I certainly did not believe that priest when he said that Marlene Brown was in a place called heaven.

  About twenty people in the US who need a kidney transplant are going to die today. They’ll die waiting. A handful of others will die while waiting for a liver, heart, lung, pancreas, or for bone marrow. Twenty more will die tomorrow. The ones with the most money and the most determination are my potential customers. For them, greed for more life is a powerful motivator and that makes for incredible profit margins in my business. The rest spend days, months, and then years waiting, withering away in dialysis centers. The average wait for a kidney on a legit list these days is over seven years. That’s no way to put up a fight.

  ◆

  What Wallace had said about things usually picking up in January was true. After the New Year, I was usually required to spend more time attending to some of the mundane and dirty details of my profession. This year was no different. Over the last decade or so, as I built up the business and became more efficient at getting things done, it seems like I’ve been a little busier each year. Over the last few years, it has also been accompanied by a sickening feeling, an apprehension of a coming closure, of an end—of getting caught, maybe. The more successful I am, the more deals I do, the more I am exposed to risk. It escalates.

  ◆

  In the car on the drive home, I thought about the church I went to, growing up in Queens. We took “Religion” classes on Wednesday afternoons. Sometimes my father picked us up in his big Oldsmobile, collecting us from the nuns and then distributing my friends and me to our respective houses for supper. We always left Religion feeling giddy. We snickered and elbowed each other in the ribs. The rides with my dad were strange, with a pervasive tension filling the quiet interior of his big car, his cigarette burning down gently in the ashtray. “Trayner’s dad’s such a hard-ass,” the others would say at school. My dad drove without speaking. When we piled into his car, he might have managed, “How was it tonight?” sort of rhetorically, to which I guess I said, “Good.” That was all. I didn’t believe those nuns. He didn’t believe them either, not at 5:45 on a Wednesday, the sky overhead already devoid of light.

  A few days after Marlene Brown’s funeral I was back at home in New York, thinking about her husband, Joe. It was just after New Year’s. For a long time I had been aware of what I was doing, but I felt justified. I had endured an abusive father and an uncaring universe—as if that was special. Every kidney transaction I closed felt like another act of debasement that I was somehow forced to suffer, like a martyr. And each life-saving transaction became a small deposit I made in a karma savings account that I thought I could draw upon later. It turns out they were withdrawals, not deposits. When I tally it now, it’s impossible to deny the magnitude of the mess I have made.

  I pulled out some cash from under the luggage in my closet that I would have otherwise taken to the safe deposit boxes. I placed stacks of hundred-dollar bills into the cutouts I’d made with a box-cutter in the middle of a two-volume set of The Complete Works of William Shakespeare. I wrapped the books in tin foil and then wrapped that in bubble wrap and tucked them into a box with a typed note that said: “Joe, Enclosed is $50K. It is for you and you deserve it. You also need it, so don’t do something stupid and give it to the Church. Don’t try to deposit it in a bank or it will cause big problems for you. Don’t tell anyone about your windfall for reasons obvious enough. Just use the money so you can do a little better than you might have done. I am sorry for your loss.” That was it. Of course, when he read the last sentence, “I am sorry for your loss,” he would know that his anonymous benefactor was referring to Marlene. I hardly felt worthy of making reference to Marlene, but I sent my condolences anyway. In years prior to that, if I had said, “I’m sorry for your loss,” I probably would have just been referring to the fucking money. But not anymore.

  ◆

  I thought about that poor guy spending every last penny and then some, and having her go and quit just the same. It was too late to buy her a new kidney. And I found myself shaking my head and fighting off crying while I wrapped those books up in a shroud of bubble wrap. I decided to book a flight to Johannesburg and go see a farm for the first time in many years.

  That was the first time that I considered the mechanics of what I am now preparing to do. In addition to quitting, I’m going to have to stop Wallace as well, which is much more complicated. He has been my associate and sometime-partner for over ten years. My plan is to have him meet me in the lobby of the emergency room at Columbia Presbyterian—one of the best transplant centers in the world. Wallace and I have met in person only on infrequent and important occasions. I’m confident that he will come but what I feel, much more than anxiety, is resignation.

  I guess the way you’re going to feel about all of this depends on whether you place a greater value on kindness or on honesty. It’s more important to me now to tell you the truth than to spin the story to try and somehow make you see it my way. The hospital doesn’t have a machine to filter out the impurities in one’s soul, but in a way that’s why I’ll meet Wallace there. I think that what I’m looking for, perhaps for the first time, is the same as that which most people ar
e seeking: a little bit of meaning. I only hope it’s more than a symbolic gesture.

  CHAPTER THREE:

  DUE DILIGENCE

  About a week after I got back from Marlene Brown’s funeral I made the trip to South Africa. I hadn’t been there in a while, and felt compelled to check on my supply chain, but something else drew me there as well—that same feeling that had driven me to Pennsylvania.

  After our initial conversation about Marlene Brown, the subtle tension that had lingered between me and Wallace remained unremarked upon. Heading into the winter things were getting busier again, as expected, and that was good, but it also made me feel a new kind of urgency about everything.

  Dr. Mel Wolff ran the transplant center at Royston Hospital in Sandton, a posh neighborhood about fifteen minutes north of downtown Johannesburg. Johannesburg isn’t Joburg anymore. They call it Jozi now. I have no idea why. It’s still a pain in the ass of a fourteen-hour flight, even with the new reclining beds in first class. I was staying at the Peermont D’oreale Grande at Emperor’s Palace but asked Wolff’s associate, Pierre Kleinhans, to meet me at the bar at the Hyatt Regency downtown.

  Dr. Wolff and I had done a little business together prior to his being put in charge of the entire transplant center about six years ago. That’s when he called and asked me to come meet him and Pierre in Sandton, and business started really taking off. Kleinhans is a finder from Pretoria who works with Wolff, connecting sellers to Royston. In the years since then, I found Pierre to be reliable and efficient. He was one of those people I figured I could trust as long as he believed that doing right by me was in his own best interest. He wasn’t affable like Wolff. Hell, he didn’t even play golf—and I didn’t like the guy. I didn’t like his Germanic Afrikaans accent or the way he talked about sellers as if they were worse than cattle, as if they somehow offended him and his superior sensibility. However, since Wolff took over the clinic, Pierre had probably sourced fifty or sixty kidneys for us. I usually cleared about eighty or ninety grand per kidney, or around half of that if I co-brokered it with a buyer’s agent like Wallace. That made for a few million reasons to maintain a good working relationship with Kleinhans, even though he was a slimy prick.

  I was having a Balvenie neat and skimming the local paper when Pierre walked in and slid onto a barstool beside me. “Good to see you, Jack,” he said, extending his hand. He had an obnoxious “cat-that-ate-the-canary” grin plastered across his face and it immediately annoyed me.

  Pierre was wearing a sport coat, rather formal for him, and had a toothpick lodged in the side of his mouth. His hair was thick, dark, and short, and always had a bit of a shine, as if he was using product left over from the eighties. He was furtive and suspicious and cocky, and had the air of a car salesman or mid-level jerkoff in an organized crime family.

  “You too, Pierre,” I said, smiling warmly.

  “I talked to Dr. Wolff. He wasn’t even aware that you were in town,” he said with his eyebrows raised.

  “I came to see you, not Mel.”

  Something about his posture shifted slightly and I suddenly felt as if the conversation took on a slight air of confrontation. “Oh?” he replied, casually, “Thanks, Jack. It’s always good to see you. Why not meet in Sandton like usual?”

  “Pierre, I want you to take me to a farm,” I said quietly.

  He didn’t respond at first. He looked away, toward the bar, perhaps considering what to order. He ran his hand over his neat, short hair, patting it into place, forced a bit of a smile, and then quietly said, “Why would you want me to do that?”

  “We’ve been doing this together for years now,” I said and then stopped. We looked at each other for a moment. I always thought that Pierre sort of liked me but I would still never turn my back on him.

  “You don’t want to go there, Jack. New York Jack. Isn’t that what your friends call you? New York Jack?” he asked, smiling widely again. “I rarely go myself. It’s not safe. Is that why you came all of this way? To ask me about that, Jack?”

  “Yes.”

  “That’s a very far way to go, New York Jack,” he said. I didn’t respond. “We’ve got an expression,” Pierre continued a bit more softly, “‘Die doodskleed het geen sakke nie meining.’ In English that means, ‘He who dies cannot take any property with him to the afterlife.’ You know what that means for you, Jack?” he asked rhetorically. “It means, stay the hell away from the shantytowns.” He was still smiling, but only to condescend to me.

  I took a sip of my drink. Pierre smiled and mumbled something else in Afrikaans and patted me on the shoulder while waving to get the bartender’s attention. When the bartender approached us, Pierre pointed at my Scotch and said, “The same.” Then he turned back to me and said, “I have a dinner with a young lady in a bit. Going to Michael’s. It’s a new place. Great steak, Jack. You should go while you’re in town. Michael’s,” he repeated.

  “Look, Pierre,” I began, more firmly, “I just flew fourteen hours. I need to go there. I need to see it and I have my reasons, but we both know it doesn’t really matter why so let’s not get into it. The last time I stepped foot inside the gates of a shantytown in Jozi was over ten years ago and some kid threatened to cut my throat. I haven’t gone back. I know better. But I am going to see it and I think that it would be better if you came, as it’s better for our mutual business if I don’t end up as dinner for a bunch of stray dogs.”

  Pierre knew me well enough from negotiating organ prices to know that I meant what I said. “Ag,” he said in a whisper and exhaled. “Okay, Jack. We can’t have our partner getting himself sliced in half, can we? I gotta do a thing in Pretoria tomorrow. You still here Thursday?” I nodded. “Okay. Meet me here at noon and I’ll take you over. Just for a bit. You don’t plan on talking to anyone, right?”

  “I don’t have to.”

  “Well it’s better if you don’t. Don’t talk to anyone.”

  “Fine.”

  “Did Dr. Wolff tell you the news?” Pierre asked, with the same smug and knowing grin.

  “No.”

  “He was made the head administrator of the entire hospital.”

  “Congratulations,” I said calmly, internally trying to evaluate what that might ultimately mean for me and Wallace.

  “You don’t sound excited, New York Jack.”

  “No?”

  “Do you know what this means for the rest of us?” Pierre asked quietly. I said nothing and then he answered his own question: “No more oversight. Dr. Wolff is the oversight. There is a lot of business to be done now, Jack.”

  “I’ll see you Thursday, Pierre,” I said, but the weight of his words stayed with me.

  “Okay. Go play some golf, Jack. It’ll be beautiful tomorrow. Must be cold as hell in New York these days. Is New York nice in the summer, Jack? Maybe I’ll come visit you some time. Maybe in your summertime I’ll come see New York.”

  “Sure,” I said. Good luck finding me, I thought. “It’s delightful. Cool breezes… . We’ll get our nails done.”

  “Right,” Pierre said, chuckling. “Okay then,” he said, smiling broadly again and shaking my hand. “I’m off.”

  ◆

  That night, tucked into bed at the Peermont D’oreale Grande, the latest of my recurring dreams began, the one I still have now. I was in that slippery state between sleep and wakefulness, aware that I was dreaming. It seemed real, and it seemed to go on for hours. I was at a dinner table with fine china and white linen and lace napkins. The plates were pearl white, with thin, swirling spirals of dark red along the outer edge. I was at the head of the table, dining alone. On my plate was a large piece of meat garnished with a sprig of parsley, and roasted potatoes adorned with rosemary. There were etched crystal glasses in front of me, one filled with water and one with red wine. Beyond the glasses was a floral centerpiece, thick with red and white flowers. The table was very long and I could feel the presence of unseen others in the room, outside of my field of vision.

&
nbsp; Recurring dreams begin for most people when they are seven or eight. There are the dreams about showing up at school naked, and the ones where you realize you hadn’t done your homework. They evolve into dreams about important meetings missed, or mortgage payments forgotten. I had those too, but in recent years, it was only a dream about a feast.

  CHAPTER FOUR:

  LESEDI

  Pierre picked me up on Thursday and we drove north toward Sandton, in the direction of Pretoria.

  “You just want to look at the natives, Jack? Howzit?” Pierre asked me while he drove.

  I didn’t answer him. It was December, so it was getting hot as hell in Jozi.

  “We’ll stop by Alexandra. It’s just a few kilometers east of Sandton, not too far from the middle of Jozi. Do you know of Alex? Would they know of it in the States?”

  “No.”

  “Mandela lived there as a kid. A lot of artists and such come out of that slum. They call it the Dark City because it had no electricity for so many years. It’s smaller than a lot of the townships but there are half a million natives packed in there. You don’t mind the ‘natives’ stuff, Jack? Right?”

  Again, I just watched the road.

  “We sometimes call them ‘Floppies’” Pierre said, grinning. “That’s an old expression. It refers to the posture they assume when shot with an AK-47.”

  “How diplomatic,” I said.

  Pierre didn’t respond. He kept driving. And grinning. I didn’t know what I expected to find in Alex but I wanted to see it. For eighteen years I had bought replacement parts from corrupt doctors in countries with unregulated networks of back-alley brokers who preyed on the villagers. I had created an antiseptic way of touching them through fax machines and meetings held in code-language in four-star hotel bars. I decided it was time to get a better look at the supply chain and stop lying to myself.