The Organ Broker

by Stu Strumwasser

  “You’re talking about a big project,” I said quietly.

  “It’s a half million. That’s two-fifty each. I’m not negotiating. That’s the real deal and we split it.”

  I didn’t say anything. The money worried me. It was too much. For a liver I normally got around $200K total, meaning about a hundred and fifty to me. If I co-brokered it, with Wallace for instance, it might mean only seventy-five grand. A half a million was big, and that meant a commensurate risk, despite the fact that Wallace would surely argue otherwise.

  “You can’t do that deal here in the States,” I said.

  “And thus,” he said, looking up from his lunch and smiling, “I called you.”

  ◆

  Wallace knew greedy doctors in the US and circulated in wealthy circles. Fifteen or twenty years ago, when this all really got started, he was a nurse at the Cleveland Clinic, one of the leading transplant centers in the US. I learned that tidbit years ago through a doctor I stumbled upon who knew him. I’ve never told Wallace. Hell, his last name is Kendrickson and he lives in South Norwalk, but I never had a reason to tell him I knew that either.

  Wallace still took risks to unearth buyers, exposing himself in small ways I had stopped doing years ago. I fully expected to see him destroyed one day, either by a jail sentence or something more gruesome and unexpected. He was one of the main reasons I never let down my guard or relaxed my protocols, always rotating phones, always changing email addresses. He was a pro, and he managed his risk, but he was arrogant, and that brings men down.

  “They’re gonna have to go to Jozi,” I said to Wallace.

  “That’s what I already told the husband. Johannesburg, I told him.”

  “Lucky she’s AB. At least that’s easier.”

  “That’s what I told him.”

  “So I’m going to have to travel too,” I said. “I wouldn’t want to arrange this by phone. I’m going to have to go back there now.”

  “Okay,” he said without looking up.

  “I’ll need fifty up front.”

  “I brought you a hundred,” he said quietly, motioning to the backpack on the seat beside him.

  ◆

  A week later I went back to Jozi to find the Fifteen we needed for Wallace’s client. Sitting at the hotel bar of the Michelangelo in Sandton with Dr. Mel Wolff and his slimy sidekick, I was feeling fatigued. I didn’t want to be back in South Africa. I was sick of the long flights. It did allow me to move a few hundred grand in cash to Jozi, but it made me feel caught up in the baseness of the business. Even in the wealthiest neighborhoods in Jozi you always run the risk of a good car-jacking. I wanted to be back in Tucson, by the pool at my condo, listening to some old Texas blues and thinking about my putting. I needed some time with a woman whose touch was a balm against my isolation. I was tired of Wolff and Pierre and Wallace and the thought of that kid with a nephrectomy scar etched into his lower back.

  “The human body, it is an amazing thing, an amazing network of interrelated systems all perfectly in sync. I take it you don’t believe in God, Jack?” Wolff asked me. I returned his gaze, giving him all the answer he needed. He laughed. “Well, if you were a surgeon you might.”

  “Why’s that, Mel? I thought men of science don’t get religious,” I said, softening a little at the sound of his laugh and the sight of his smile. The man was a crook, and a bit of a fiend, but he was likable as hell. I always gave him the benefit of the doubt.

  “Quite the contrary. We see his handiwork firsthand.” He smiled, almost paternally, and continued. “What we’re talking about here, a liver, it’s very interesting. Some things in the human body, some organs, they don’t regenerate. But many do. The liver does, and this is why we can get you a living donor. You see the liver has two main blood supplies—”

  “I know,” I said. “I know it regenerates.”

  “Like a starfish,” Wolff said.

  “Okay. So you just explain that they are selling a third of their liver?” I asked very quietly.

  “If the donor even needs to know that.”

  “What do you mean?”

  “Jack, Pierre suggested that we just source a kidney donor and while we are in there we could easily remove the portion of the liver needed for your client. It doesn’t have to be complicated. Why does the starfish need to know?” He sipped his Sauvignon Blanc and turned and looked at Pierre who remained silent.

  “Wait,” I said, and a laugh escaped me. It didn’t even feel like me laughing. It almost surprised me. “You’re just going to clip a third of the guy’s liver and not even tell him?” I felt the corners of my eyes contract in a slight grimace, involuntarily. “Really?”

  “You know, Jack, I said too much. I apologize.” Wolff placed his hand on my shoulder. “My friend, don’t get caught up in this. At Royston all of these donors get the best care. We give them real after-care. This isn’t India. We don’t dump them on the street to get sepsis. You know that. Let Pierre deal with the common aspects of all of that mess. You and I are in the healing business.”

  “What you’re saying isn’t right, Mel.”

  “Jack, together we have done a hundred transplant procedures. Every single one of them saved someone’s life. Now that I am in charge of the whole hospital we can expand, help thousands, not just hundreds. Send your client to us in Sandton. We can do this as early as the week after next. It’s going to cost more of course, but I have to look that over with Carolyn. I’ll email you next week when you’re back in New York. Okay, my friend? Not to worry.”

  Again, I said nothing. I was distracted by the sound of the chatter in the background.

  “Okay, my friend?” he repeated.

  “That’s fine.”

  “Jack, now that I’m in charge we can source anything. Anything. For the right price, Pierre can get anything we might need to help one of your clients. Like this liver. We have a very good system and we are accomplishing something important here that will help save a lot of lives in the coming years.”

  For the first time I understood the magnitude of the word “anything” when it was coming from Pierre Kleinhans or Mel Wolff. Perhaps, I mused, I had tapped a pipeline to living donors as significant to the US transplant tourism demands as the Alaskan pipeline was to California’s oil needs.

  When Wolff was in the restroom I quickly said to Pierre, “I need to go back to Alexandra.”

  “No, Jack. You saw it already. There’s nothing there for you.”

  “Pierre, I need to go back there tomorrow and I need Thaba to come with me. If you don’t want to come that’s fine but I want you to tell Thaba to meet me here at noon tomorrow so we can take a ride over to Alexandra. Don’t bring Wolff into this, just tell Thaba.”

  “Jack, that’s a very bad idea.”

  “Pierre, you need to have Thaba go with me or I am going to Alex without him.”

  We stared at each other for a moment and Kleinhans looked as if he might spit in my face. His lips seemed to pucker slightly with indignation. Perhaps he was clenching his teeth behind his pinkish lips. “All right, Jack. Anything for a friend,” he said in a saccharine tone. “I’ll call your tour guide and we’ll come pick you up here at noon. Will it be just another short visit?”

  “Yes.”

  “All right then, Jack. And this will be the last one?”

  “Fine.”

  ◆

  Once we were all in the car the next day I told Pierre to take us to the same place we had seen the first time, back in January.

  At one point, without turning around from his position in the front passenger seat, Thaba said, “Have you been back to Alex since we went together, Jack?”

  “No.”

  Then, he and Pierre exchanged some words in a local language I could not understand. Did they know? We entered Alex through that same alleyway, and I led them to the clearing, not worrying that I might seem too familiar with the route. The square opened up before me and I immediately saw Lesedi, sitting on the ground in
the dirt near the boys playing soccer, his ball made out of tape lying beside him in the sun. He might never leave that spot, I thought. From across the yard, when I saw his attention focused on us, I waved him over. He slowly stood and strode right at us. He saw that I was with Pierre and Thaba, and he said nothing. Neither did my colleagues. Finally I said, “Thaba, give this boy four thousand rand.”

  “What?” he asked, laughing a little.

  “Give it to him.”

  “What are you talking about, Jack?” Pierre asked.

  Thaba said something to Lesedi that I didn’t understand and I cut him off and yelled, “Don’t talk to him!” I turned toward Thaba. “Don’t talk to this child. Talk to me. You told him a price, now give him the rest.” All of the kids that had been playing soccer and the handful of other people in the square were looking at us.

  “You don’t belong here, New York Jack,” Thaba said confidently and calmly. “Go back to Sandton.”

  “You told him ten thousand. Do you know what you took from him? Give him the other four thousand rand.”

  “You should have told me this before we came, Jack,” Pierre said. But we all stood there and stared at each other and had ourselves a bit of a Mexican standoff, right there in the middle of hell in Gauteng Province, South Africa.

  “I don’t have that money,” Thaba said.

  “Get it from Pierre,” I said, my voice dripping with anger. “He’ll give it to you and you can give it back to him later.”

  Pierre stepped between us and said, “All right, all right …” and removed his wallet and handed the cash to Thaba. They exchanged soft but heated words I didn’t understand. Thaba handed the cash to Lesedi without looking at him, and then spit at Lesedi’s feet.

  I looked at Lesedi. He looked like a kid again, a tall and lanky kid who could have come from the Bronx or Brooklyn, who might have fought his way out of that mess, who still might, but probably wouldn’t.

  “There is nothing else I can do,” I said to him.

  “No one can do anything,” he said quietly. Those were the first words he had spoken to us that day. Tears were welling up in his eyes.

  “Your sisters?”

  “I do not have sisters now,” he said.

  “Good luck,” I said quietly. I turned on my heel in that dirt and walked away. I could hear the footsteps of Pierre and Thaba behind me. I thought for a moment that I might feel the sting of Thaba’s knife piercing my skin and spine, but I did not. I was still their connection to the customers. I still had leverage, and the ability to walk out of the Dark City unscathed.

  CHAPTER TWENTY:

  RETIREMENT PLANNING

  We got that Fifteen off to Royston okay in late May and she was back at home in Washington DC about a week after Memorial Day. A half a million dollars. Two hundred K for each of us after expenses. I felt the rush, but I felt ready to put it aside. Sometimes scoring a big deal made me want to pause, to savor it and be patient, like a serial killer. But for Wallace, I knew that the scale of the opportunity unfolding before us was going to be problematic and too hard to resist. I knew he couldn’t leave it alone. It’s funny, but if the government ever asked the pharmaceutical companies to add up how much cyclosporine and Prograf and other immunosuppressant drugs they sell to transplant recipients, and then cross-referenced it against the number of legal transplants done domestically off of the UNOS lists, they would find a huge disparity that would equate to a rough representation of the illegal foreign organ trade. But they don’t ask. That’s the protocol.

  It wasn’t until after we did that Fifteen in May before everything seemed businesslike and back to normal between me and Wallace. I was careful not to impose on his confidence again after the mistake I had made by mentioning Marlene Brown. When he contacted me at the beginning of July, a month had slid by since the live liver deal. I would have preferred a little calm followed by a few regular Eighties shipping off to Jozi for Mel Wolff, bolstering my portfolio incrementally, fifty K at a time. Not Wallace.

  In early July he proposed something different than anything I had ever before encountered. That was the second thing that changed it all for me.

  “This is a very different thing,” I said then, thinking about the fact that he had somehow truly become my partner.

  “Yeah. More profitable. Like done profitable,” Wallace replied.

  “Wallace,” I said, matter-of-factly, “ten deals. That’s more profitable than one. Or five is. But this is a different kind of deal. It is a different enterprise. Do you follow what I’m saying? It is not even our industry.”

  “But it is,” he said. “Jack, this is like winning the lottery and then pretending there’s a decision to be made about whether or not to redeem the ticket.”

  “It’s different …” I said, more to myself than to him.

  “I find buyers; you find sellers. That’s how it is. How it’s been. This is not different. The only thing different is usually it’s extra money, maybe that new car, a condo down-payment—like the Fifteen last month. But this time it’s a finish line.” He paused, then added, “Really.” The “really” somehow sounded like a threat. “You know, you’re not the only seller’s agent.”

  “Hmm.” It was a remedial negotiating tactic and we both knew it. I wondered if he even felt embarrassed for saying it. We both knew it didn’t matter at all. In our business, the more tense a situation, the less negotiating that actually takes place. The more critical a situation, the more weighty the merchandise, the less margin for the push and pull and dance that consumes so much time in more frivolous transactions, like real estate, or the stock market, or love. In our business, the best players negotiate by simply showing up, committed to the deal.

  “With us,” Wallace said, “it gets done. I can call the man in Seattle. The people in Rio, they can always be called … But why do that when you and I … It gets done, and I can’t risk this not being done correctly.”

  “Because,” I responded, calmly, “it is different.”

  “Yes, Jack. Fine. Of course it is.” That’s how things start sometimes.

  “Wallace,” I said, “even if I wanted to do this, what makes you think I could?”

  “Because no one else can and it has to get done.”

  “But without the Chinese, how could I even do this now? Even if I wanted to?”

  “The way we both know it’s going to happen.”

  “Wallace,” I said, hearing myself pleading a bit, “even if my guys were up for this at Royston … I mean, let’s say they could do it. Even if they could type it out in advance and… .”

  “Now, New York Jack!” Wallace said, more animated.

  “Now wait,” I said, “because you only get four hours with a heart once it’s outside of the donor’s body. A kidney can last two days on ice, but not this. So the guy would have to go live there at the hospital, for months, waiting, and maybe that’s still not long enough. It would be very tough.”

  “That’s why you had it right the first time. They have to type it out in advance. Just say it already, Jack. Who fucking cares? You can say it, New York. No one’s been listening for years. All of this changing phone numbers … No one cares.”

  “Do you realize what we’re ultimately talking about?” I asked in a near whisper.

  “Yes.”

  “Do they understand it? Do these people who hired you understand what they’re asking for? What it takes to get a living donor heart?”

  “I don’t care,” he said casually.

  “Well you sound pretty cavalier in light of what we are talking about.”

  “I am not.”

  “It is, a heart,” I said gravely.

  There was a long pause. I felt like we were both waiting, like two gunfighters about to draw in the high noon sun.

  “A contract hit,” he said quietly. “In this country you can get something like that done for as little as ten or twenty grand. In some countries it’s a few hundred bucks. This is something very specialized. It
’s for very rich people who know exactly what they need and want top-quality merchandise. The fee is five million, of which you will be paid two.”

  There was a long uncomfortable silence. “Suddenly we’re sixty-forty?” I asked.

  “On this we are.”

  “Five million?” I said, almost involuntarily. I might have guessed one, and I was struck by it.

  “Yes. Cash. They’re good.”

  “Someone on a god squad could be paid off for a lot less.”

  “Not on this. Even paying off someone on a hospital’s transplant committee wouldn’t help. There are other complications,” Wallace said.

  “And?”

  “There is no other way to fill this order,” Wallace said. “Not for this particular patient.”

  “Why? Why can’t we just bribe someone on a committee or send him to wait in a hospital in SA and just pay his way to the top of the list? Is he such an impossible match? We shouldn’t even be going back to Royston right now. I should do it in the Philippines. Plus, the thing about a heart, he could be kept alive for a while with an L-VAD while he’s waiting. People sometimes last for a year on those now. It could buy him the time he needs… .”

  “L-VAD? One of those artificial heart pumps—”

  “Yes. An artificial heart pump.”

  “It wouldn’t matter. It would buy more time but it wouldn’t make a difference. Not for this guy. He has AIDS, Jack. All the time in the world can’t help this guy. He needs us to get it for him. There’s no other way. No list is helping a guy with his profile. So, it’s five million, Jack. Two for you.”

  “Yes. I heard you the first time.”

  There was a pause, and suddenly I felt a little sick. Philip? I thought. Could it possibly be for Philip? No …

  Wallace interrupted. “Then why aren’t we working out details instead of debating whether or not to accept a gift?”

  ◆

  Someone HIV positive who needs a transplant does have an outside shot now, but certainly not one that you could bank on. They remain extremely low on the legitimate lists and only get secondary merchandise (someone also infected with AIDS who went brain-dead; someone with Hep C; perhaps an organ from the elderly). It’s tough because putting a second-class organ into an already compromised immune system that has to sustain the stress of major surgery, and then tolerate immuno-suppressant anti-rejection drugs… . It doesn’t make for good statistical outcomes. And that’s if the guy only needs a kidney.