The Organ Broker

by Stu Strumwasser

  All those years, whether I fully believed it or not, I was helping people, saving them, and I wanted to remain on the right side of that. I was determined to get that kid a heart but I was not going to steal one from some naïve victim of a vulture like Pierre Kleinhans. If we got the heart at Royston it would have opened the floodgates to a slew of murders—and the balance in my karma account was already low enough. The door to China had been shut tight. There was no other place I felt safe enough to even raise the question—except for one. So I booked a flight to Recife to go see my friend Juan Guillermo.

  Juan Guillermo is not his real name, and he’s one of the few worth protecting. It’s common knowledge that the hospitals in Recife are corrupt. Everything in Recife is corrupt. No one cares very much, but it’s better if he remains anonymous. I hooked up with Guillermo and that schmuck Dr. de Mendoza when transplant tourism was first taking off. When I found better and more sophisticated transplant centers in places like Jozi I still continued to feed Guillermo a fairly steady diet of routine kidney patients in order to keep my suppliers diversified, and also out of regard for our association. Even after 2004, when a ring of Israeli brokers got busted for picking up sellers in Recife and shipping them off to Durbin, South Africa for the procedures, I continued to patronize his facility out of affection for its stout and humorous administrator.

  In a country of enormous natural resources with a very large population and scattered pockets of deep wealth, Brazil was still completely backwards in regard to golf, but Guillermo was a prince among paupers. On his best days, if he got me drunk on the back nine, he could even close within a few strokes. I emailed Guillermo from a new account and arranged to meet to play at nine a.m. on Wednesday. I had considered having the conversation by phone, but it was not the time to get careless so I made the fifteen-hour journey.

  I was staying at the Vila Rica Recife in Boa Viagem, a wealthy neighborhood on the beach, ten minutes from Guararapes International Airport. Recife is the most dangerous city in a rather dangerous country, and not the kind of place to go out sightseeing. Nearly 70 percent of the population lives in shanty-towns or favelas. As in Jozi, they are often right next to wealthy enclaves. However, unlike Jozi, where the shanty-town townships seem to crop up in indentations between neighborhoods, almost like puddles forming where the land is a bit low, in Recife it is the other way around. Affluent pockets of modern life spring up from a landscape of poverty; affluence is the exception, while poverty is the rule.

  Recife is a tourist destination for Brazilians but not for foreigners. It is a poor city with a very high crime rate, but scattered pockets of wealth make for a satisfactory infrastructure. It’s an ideal place to pick up Eighties with almost no risk of interference from law enforcement or oversight from any medical agency.

  I had arranged for a driver, and on Wednesday morning we set out for the club at Caxanga at seven thirty to beat traffic and ensure a timely arrival to meet Guillermo. I didn’t like to drive in Brazil. We left the beach and headed through the middle of Recife. That early, the streets were nearly deserted and we cruised swiftly through the center of the city.

  We continued on a local highway, little more than a one-lane mountain road, heading northwest toward the hospital and the golf course a few minutes beyond it. Then, the driver said something to me in Portuguese which I did not understand and accelerated abruptly, throwing me back against the seat. The Mercedes we were riding in, like most cars in Recife, had blacked out windows to prevent outsiders from seeing in, but I could see out. There was a motorcycle with two men on it, back and to the left of us, in what was probably the driver’s blind spot. They accelerated and pulled even with the rear window on our left side, and my driver slammed harder on the gas, jerking the car forward and past them.

  “What’s the problem?” I asked.

  He replied in Portuguese.

  “English,” I said. “What do they want?”

  “No good,” he said.

  I glanced at the speedometer; he was doing over a hundred and sixty kph, which equates to around a hundred miles per hour. He tore down the one-lane highway with the motorcycle close behind until it suddenly took a sharp left and peeled off the highway toward what I supposed was some other object of their attention. Once they were gone for a few minutes the driver turned back over his shoulder and said, “Obrigado, Senhor. I am sorry.”

  “Don’t be,” I said, and then I caught his eye in the rearview mirror. “It’s good,” I said, shaken a bit. I smiled and gave him a thumbs-up. A minute later I asked, “What did they want from us?”

  “To rob. Steal the money.”

  “Is that all? Only to rob?”

  We made eye contact in the rearview mirror and he made a face that amounted to the equivalent of a shoulder shrug. People get killed here, I thought as we sped away. People get killed here routinely.

  ◆

  We arrived at the Caxanga Golf & Country Club at about eight thirty. I changed and went out to the practice greens, where a few members were putting and chatting in quiet, private conversations. Caxanga has operated for nearly eighty years. A few years ago it got a bit of an upscale facelift but there was still a swimming pool where families sat around waiting for dad to finish playing, and it had the atmosphere more of a pedestrian middle-class country club on the Connecticut side of the Long Island Sound than of a prestigious golf course where real players sharpened their skills.

  A little after nine my associate strode out onto the practice greens with a wide smile beneath his wide-brimmed hat. Juan Guillermo was a short and rotund man whose ability as a golfer far surpassed what his appearance would lead one to expect. We embraced and he said, “New York Jack,” quietly, with the elegance of a gentleman, vastly different from the vulgar manner of a finder like Pierre Kleinhans or the polite pretense of Dr. Wolff.

  “It’s good to see you, Juan,” I said affectionately.

  “Maybe not. I have played a lot the last few months.”

  I smiled but said nothing. I’d be glad to lose a legitimate round to Juan Guillermo. What a sight that would be.

  “Did you bring your good clubs, Jack?” he said with a warm smile and a lighthearted tone.

  “I did.”

  “And you are well rested? Slept well at your four-star accommodations? I don’t want any excuses when I finally beat you.”

  “There will be no excuses,” I replied, “but neither will there be a surprise upset today.”

  “Ha!” he exclaimed. “New York Jack! Here in Recife. Come!” He clapped me on the back, pushing me toward the first tee.

  Over the years I have probably sent Guillermo a hundred kidney buyers. I may have made him one of the richest men in Recife. There is one thing I have always found notable about playing golf with Guillermo: while he swings with the stilted motion of a plump man, the sound of that swing is, for some inexplicable reason, musical. I often closed my eyes to listen to the swing of other golfers. The wind generated by the motion, the grunts or utterances they might release, the concussion of club face on ball. When Juan Guillermo teed off it had the momentary sound of a symphony string section. Perhaps that’s why I always trusted the guy.

  When we hit the turn it was only a little past eleven and without asking, Juan ordered me a Scotch, but only sparkling water for himself. We both laughed—he was trying to get me drunk. Throughout the back nine, he kept my drink refreshed and entertained me with a string of stories and dirty jokes in an intentionally transparent attempt to distract me, but by the last few holes he was throwing his clubs at seagulls on the edge of the rough. On three occasions he asked me, “So, are you going to tell me what you came all this way to discuss?” Each time I prevailed upon him to play first and talk later.

  ◆

  When we were settled in at the clubhouse in the early afternoon, a Scotch in front of each of us, Juan Guillermo turned and looked at me with the warm, familiar gaze of an old friend. “It must be something bad,” he said.

  “Wh
y do you say that?”

  “You flew a whole day, wouldn’t discuss it on the course, and then barely let me keep the score close. You usually at least let me stay close,” he said with a laugh.

  “Juan,” I said and lowered my voice, “I’ve got a guy in New York, a very wealthy guy, from a wealthy family. He needs a heart.”

  “Ooohh,” Juan Guillermo replied with a small grimace. “Jack, we don’t do many heart transplants. Why come to me with this? You would need to go to Rio or really, better yet, to South Africa.”

  “There’s more to it. He’s also got AIDS.”

  Juan did not reply. He took on a more sober expression and patiently waited for me to continue, listening intently when I did.

  “He’s got full-blown AIDS, cardiomyopathy, and Stage Four congestive heart failure. He’s going south and has very little time.”

  “So he’ll never make the list in the states,” Juan said thoughtfully. “You can’t pay someone?” he asked, now matching my own low level of volume.

  “AIDS,” I said. “None of my domestic guys would ever take that kind of chance. You go to jail for that. That’s how you get caught.”

  “But not in Brazil?” he asked with a touch of sadness.

  “Well, no. Maybe not. I’m sorry.”

  “But that’s incorrect, Jack. Even Brazilian hospitals have records. And even Brazil has a government. Plus, there’s no way to do it,” he said.

  “The fee is very large.”

  “But there’s no way to do it,” he repeated, this time a little more forcefully.

  ◆

  I had traveled for fifteen hours and played eighteen holes to get to this moment. “Juan, let’s say we brought him down here and set him up under your watch. Maybe we even install an L-VAD to keep him going for a while longer while we wait—”

  “An L-VAD? Jack, we do very few of these.”

  “Hold on. Maybe I even bring a surgeon down.”

  “How rich is this family?” Juan Guillermo asked. The look in his eyes was not greed. It looked like the same discomfort I feel when someone says they’ll pay me 500K for a liver.

  “Juan, they are that rich. So if we did that, and waited, and you kept him at the top of the list … What then?”

  “Jack, my friend, anything is possible, but to have one come in brain-dead, with matching blood type and MHC, the right age and size … You could wait a long time. If he were stable, maybe. He could live somewhere near the hospital. But if he is weak and getting worse… .”

  “What are the odds, Juan? What are the odds that you could pull it off?”

  He frowned in frustration and shrugged his large round shoulders. “One in three, maybe? Thirty percent?”

  “That’s not good enough,” I replied, more to myself than to him.

  Something about my reaction prompted Juan to say, “I’m sorry, Jack. Is it a lot of money?”

  “Yeah, but, I know the guy. I know him.”

  “He’s a friend of yours?” Juan asked, surprised.

  “I fucking know the guy. It’s personal, Juan. It’s my… . I really have to help this guy and you were kind of my last option.” I felt trapped. “Shit,” I whispered. I never felt rage at the system the way I did at that moment in Brazil with Juan. Why should Philip die? Why should some unlucky native from Alexandra die just so bastards like me can drive golf-carts around country clubs? Juan Guillermo put his fat, stubby fingers on my forearm. I looked up at him. He’s a good man, I thought.

  “There’s always one other way, Jack … in Recife you could get something like that for a price. You could find a heart, intentionally, for the right price.” We looked at each other for a moment. “But you’d never do that, Jack. You wouldn’t be part of that.”

  “That’s true,” I replied, shaking my head slightly. And it was. That much was decided. That was the very reason I was in Brazil.

  “Right,” he said, looking away. He sipped his drink and seemed far away in his thoughts. “Jack, are you okay?” he asked then. I turned and looked at him but did not answer. Then, Juan Guillermo said, “Hey, do you think I’m a good doctor?”

  I laughed a little. “Better than you are a golfer.”

  “Really,” he said, soberly.

  “Do you mean … do I think you’re a good man?” I asked him. “Have you done good? I don’t judge people that way. That’s your business, Juan.”

  “Jack, my family, we have a gated home in Leblon, near the water in Rio. I have no brothers or sisters. It’s mine since my parents died. I take my family there occasionally, but not too often the last few years. It would be a good place for someone to stay if they needed a place to get away for a while. Rio. It would be a good place for an American who wanted to avoid attention for a while—”

  “Oh,” I interrupted him, quietly, “I’m fine, Juan. Thank you.”

  “It’s yours if you ever need it, Jack,” he said, and he put those stubby fingers to my wrist again for a moment. “Just so you know… .”

  “Thanks. It’s nice to have a friend,” I said. Guillermo raised his eyebrows a little. “A good friend …”

  He nodded silently without smiling. Somehow it was Guillermo’s reaction that alerted me, perhaps for the first time, to the fact that I really was in trouble.

  CHAPTER TWENTY-NINE:

  THE LESSER OF TWO EVILS

  The next day I didn’t go back to New York. Instead, in the morning I went to Juan Giullermo’s office at the hospital and showed up unannounced. His assistant led me into Juan’s interior office. It was carpeted and rather elegant. Juan sat behind a huge oak desk. The room was cluttered but it was also large and did not feel cramped. Rather, it just felt lived-in. Guillermo eyed me and motioned with his hand for me to sit.

  “I need to talk to you,” I said.

  “Clearly,” he said, a smile breaking out across his robust cheeks. I didn’t say anything. “Give me a few minutes,” he said. “The café two blocks up, to the west of here …” he said. “Meet me there in a half hour.”

  ◆

  Guillermo arrived a little sooner than he had said he would and I was sitting at a counter in front of an untouched espresso. He sidled up onto the stool beside me, sat facing forward and sighed. “So? Why are you still here, my friend?”

  “Juan,” I began quickly in a low and raspy voice, “I’ve been thinking a lot about what you said yesterday, what you said I would never be a part of, what I wouldn’t do …”

  “I see,” he said, seeming to be holding off on any sort of reaction beyond simply acknowledging my words.

  “Well, we were talking about how someone innocent would have to get hurt in order to get what my client needs. But I’ve been thinking, what if it wasn’t someone innocent? What if it was the very guy putting others at risk? Juan, I mean, what if you knew someone was going to hurt someone innocent, is it wrong then to stop them? Are there different degrees?”

  “Degrees of killing a man?” he asked sternly and under his breath. He looked right at me but neither of us said anything for another long moment. “Jack, I’m a Christian.”

  “Well, I’ve been doing this so long,” I said. “Juan, I’m not sure I even know anymore what’s right and what’s not. Really.”

  “I can’t answer that kind of question,” he said. “But you know, the business we’ve done on the kidneys, over all these years, those fees paid for a big portion of the new wing. Kids who have cancer. It’s children who would die here without ever getting to Rio or San Paulo. Now they get help … The sellers from Recife, would things have been very different for most of them? Probably not. But now there’s a new wing.”

  “So what we’ve done, you think it’s justified now?”

  “I didn’t say that. I have my own peace to make. But there is a wing. That’s all.”

  I sat silently looking down at the yellow countertop. I sat quietly for a long while and Juan Guillermo sat beside me and said nothing. I felt like I might cry. I felt like going to sleep. Finally I tu
rned to Juan and began to conduct business by saying, “Well, the guy who is the root cause of this situation I have, he’s no good. If no one does anything, then there will be a lot of innocent people affected. I don’t know his blood type, this guy. But what if he came here, if I brought him, and something happened to that guy, something that allowed for a healthy heart to survive,” I said in a whisper. Guillermo looked at me with a furrowed brow and a look of despair in his eyes. It was the look of a family member receiving the bad news. “If that put a heart into the system, and if my client was here too, at the same time, could you pull together a domino transplant and justify the AIDS factor?”

  “Domino?” he said out loud, but apparently talking to himself.

  “That guy’s heart goes to a patient he matches and then my AIDS guy gets a match out of your list, justified by the domino chain. They could still never do that in the states because of the HIV. Could you do that here?”

  “I know ‘Domino transplant,’ Jack, but not here,” he said, and I felt sicker. I felt like the temperature in the room—already uncomfortably warm—had just risen another ten degrees. Then Guillermo added, “In Rio. We’d have to go to Rio. I have a relationship. I think I could do that in Rio with my counterpart there. We just don’t do those surgeries, but they do. It would be very expensive, but I think he could do that. I think a domino could get your guy the part. I think they’d be willing to cover the paperwork at the facility in Rio. For a lot of money, Jack. American money. But I do think they could.” He shook his head a little and added, “I wouldn’t take anything. Just pass it along.”

  “You wouldn’t have to do that,” I replied.

  “Yes I would.”

  “Juan, tell me … what should I do? What would you do?”

  “Jack, you haven’t told me who this is, I mean, you never do, but this is different… . Is this guy family?”

  “Yes. What would you do?”

  “I said I’m a Christian.”

  “Yeah. I’m not.”

  “Then you’re going to hell anyway,” he said softly with a wry smile.