by Helen Fields
‘And what do you get in return?’ Callanach asked. ‘I’m guessing your enterprise isn’t entirely altruistic.’
‘Cigarettes. I don’t smoke of course, but they’re bank notes in here. Some women pay me in drugs which I can then prescribe to others who need them for whatever their condition is. Favours, information, beauty treatments, the expertise of others. You’d be surprised how sophisticated this economic system is. The really big earner is the criminal lawyer convicted of tax fraud. Her cell’s never empty, as you can imagine.’
‘It’ll be difficult,’ Jean-Paul said. ‘Medical implements have metal parts. The governor will be concerned about safety, and even more worried about his liability in allowing you to practise quasi-medicine with no licence. There’ll be an issue about getting sued.’
‘I’ll sign an agreement to say I’m only allowed to perform research with the kit, not to diagnose or treat fellow prisoners. I’ll even keep a copy of it hanging on my cell wall for everyone to see. That’ll stop the lawsuits. Do you think I haven’t discussed this with my friend the lawyer already?’
She’d come in fully prepared, Callanach thought. No doubt she’d been planning exactly this conversation from the second she was notified that Interpol had requested an interview.
‘As for the danger posed by a stethoscope and an otoscope, I’d accept having them handed to me at certain times for a specified period, and handing them back to a guard for safe keeping. Say two hours a day, Monday to Friday. That way it’ll be obvious if I can’t return them or if parts of them have been removed. Not that I’d allow that to happen. I do have some pride, you know.’
‘I’ll ask,’ Jean-Paul said. ‘I can do that right now. But the deal’s off the table if you try to delay.’
‘Did you just grow some balls, Jean-Paul?’ she asked. ‘I don’t recommend speaking to me like that again, though. That might work with the drug importers and paedophile rings you normally deal with, but not with me.’
Callanach guessed she was right. Her IQ was well beyond normal limits, even for a surgeon, and her sense of entitlement carried with it a stubbornness that was their most likely stumbling block.
‘Give me a moment,’ Jean-Paul said. He knocked on the door for a guard to open up and went outside into the corridor. There, a phone call with the waiting governor was all that was required for authorisation to do the deal or not. It would be a yes, Callanach knew. Interpol didn’t have carte blanche, but it still held enough sway to get what it wanted.
Giorgia waited until the door was locked again.
‘There’s some tension between the two of you,’ she observed. Callanach didn’t answer. ‘Does he compare himself to you, do you think? He won’t turn his body towards you fully when you speak. He won’t allow himself to nod, or show any normal signs of enthusiasm even when you’re working effectively. It’s as if he’s trying to cut himself off from you.’
‘You didn’t give evidence at your trial, and yet you’d easily have been a match for the prosecutor. Why did you opt for silence?’ Callanach asked. She would immediately recognise the question for what it was – a change of subject – but he wasn’t going to discuss Jean-Paul with her.
‘Perhaps I wanted to end up in here,’ she said. ‘You see things as black and white, which is what hampers most police investigations. There’s an unwillingness to accept the humanity or the complexity of the perpetrators of crime. Most law enforcement personnel lack imagination. They’re so caught up in right and wrong, justice, laws, that they fail to explore the evidence in ways that might be truly disturbing, as in this case. The organs are gone, therefore it must be harvesting. Simple, clean.’
‘Isn’t it?’ he asked.
‘Of sorts. Then again, not really. It’s your face, isn’t it? He hates that women can’t stop staring at you. Being with you is a constant drain on him. It must be like being the less attractive twin. He’s diminished by you.’
‘He’s a little old for that,’ Callanach said.
‘We’ll see, shall we?’
Jean-Paul re-entered the room.
‘All right,’ he said. ‘Your requests have been guaranteed. They’re being reduced to writing, and will be signed by the governor before we leave. Provided you supply us with valuable information.’
‘Fine,’ she said. ‘I’ll need your colleague to take off his shirt.’ She turned her head and gave Callanach the tiniest wink at an angle hidden from Jean-Paul.
‘No,’ Callanach said.
Giorgia grinned.
‘Purely for anatomical purposes. I need a specimen to show you how I’d have made the incisions. This is the easiest way without an anatomical dummy here.’
Jean-Paul gritted his teeth.
‘Shirt off,’ he growled.
‘I’m not part of the deal,’ Callanach said quietly.
‘Apparently you are,’ Jean-Paul muttered.
Callanach had a choice. Continuing the argument would undermine Jean-Paul’s authority in the room. Giving Giorgia what she wanted was a backward step in the negotiations, and gave her another reason to draw out the process she was already enjoying too much. He opted for the path of least resistance, gratuitous as it was, undoing his buttons, dropping his shirt on the chair and standing up.
‘I need a pen. Not a pencil. I’ll be drawing on your colleague.’ Giorgia grinned at Jean-Paul who sighed but took a pen from the inside pocket of his jacket and handed it over.
Callanach took a moment to consider how much of a threat the pen was. Shoved into his eye or his neck it could kill him, yet Jean-Paul had handed it over without argument.
‘You can relax,’ Giorgia told him. ‘You’re too pretty to kill.’
‘Not a consideration you gave some of your other victims,’ Callanach said, as she turned him so his chest was facing the single light in the centre of the room.
‘Ah, but then there was money involved. Now it would just be gratuitous killing. That’s something I could never be accused of.’ She ran her fingers down his chest, pressing on the breastbone, feeling the curve of his ribcage and back up to where she left her fingers over his heart. ‘You have a very slow heartbeat,’ she said. ‘You must keep fit. Watch that, though. You’ll have problems with low blood pressure if you’re not careful.’
‘Can we start?’ Jean-Paul asked.
Giorgia raised one arrogant eyebrow at Callanach, making it clear she’d won their earlier argument. Callanach looked away.
‘All right,’ she said, sliding her glasses back on, and looking across the table to where the photos of Malcolm Reilly’s opened chest and abdominal cavity lay. ‘Let’s begin.’
She positioned the pen at the top of Callanach’s chest and drew a single downward stroke from the top of his breastbone to the top of his pubic bone.
‘This was the first incision. Single cut all the way. Then the second cut was made across the abdominal cavity. If the abdominal cut was made first, there would have been some snagging as the vertical incision hit the wound, and there’s none reported. There is, however, a tiny additional nick at the crosspoint of the right-hand section of the abdominal incision.’
She drew one line across the right side of Callanach’s abdomen, left a space to show where the snag was, then completed the right-hand section.
‘You’re assuming that these organs were all harvested at once. Obviously if the donor is deceased you take all the useable organs as quickly as possible. Multiple surgeons on a team, everyone conscious of the ticking clock, putting whatever you can into storage for transportation. It’s done under pressure and because there are no options. Also, it’s a relatively simple, clean process because without the heart pumping you have less to concern yourself with in terms of blood loss, the cavities filling up, no need to tie off the arteries and so on.
‘My experience was different. I performed organ transplant operations on patients who were still alive – kidneys, liver sections, and once a single testicle – and I can tell you that the less damage you d
o while you operate, the healthier the organs will be when they’re transplanted into the new host. For this reason, it only makes sense to perform the operation initially to remove any organs that can be removed without a threat of loss of life. It also allows you to deal with those organs and repair the damage one organ at a time. There’s a reason for that. Black markets operate differently to regulated medical practices. There’s an upfront fee – a sort of booking cost – a second payment when the organ is delivered and transplanted, and a final payment is due if the organ has not been rejected after twenty-eight days. Perfectly good commercial practice, and it means the surgeon works harder to do everything possible not to allow the organ to become overly starved of blood or damaged by trauma during the operation. Did your tox screen show anything like propofol, pentobarbital or thiopental in his system?’
‘Only liquid morphine in his stomach.’
‘Which would have killed his pain, but it’s not a proper anaesthetic. It’s almost impossible to control anaesthesia through oral drugs. If he’d come round, the surgical team would have been in trouble. So they were intent on taking everything in one go. If they were going to take organs over a longer period they’d have used one of the drugs I mentioned to keep him in a medically induced coma.’
‘How would you have harvested the organs?’ Callanach asked.
‘Well, I’d have kept the stress away from the heart as long as possible, and minimised surgical entry until the very end. I’d have started with the testicles, then I’d have gone into the abdomen.’ She drew a short line across Callanach’s stomach. ‘Liver first as it’s so large and I’d have wanted it out of the way, followed by pancreas and gall bladder. For a kidney, I prefer to make an incision in the side, just below the ribcage. It’s a cleaner removal system.
‘Now, by the time you get to the lungs, the lack of medical knowledge becomes more stark. A thoracotomy, to remove a lung, is properly performed by way of a horizontal incision across the chest, positioned more towards the arm on the left side where the lung is positioned against the heart.’ She made a mark several inches long below Callanach’s left pectoral muscle. ‘Which tells me that they took the heart first as they went in through the central chest incision. Obviously by this stage your young man was dead anyway. Eyes last. Mess around with the brain like that at the outset and the patient goes into shock and the organs would start to degrade too fast, particularly without proper anaesthesia.’
‘So it could be organ harvesting,’ Jean-Paul said. ‘Badly done by an inexperienced surgeon, or someone with some medical knowledge attempting to rip customers off, not concerned about whether or not the organs were rejected by the new host. If they didn’t have a contract with a final payment, that would make them less likely to be careful, right?’
‘It’s possible,’ Giorgia agreed. She patted Callanach on the chest as if he were a pet. Jean-Paul rolled his eyes. ‘You can sit down now, darling. What you two don’t understand is the market. You don’t put an ad in the local paper, you know. I located my hosts – my clients – through their doctors. Real doctors, with licences and good reputations, who were more than willing to drop my name into the conversation for clients who were out of time and hope.’
‘You never gave up their names to the prosecution,’ Jean-Paul noted.
‘And I destroyed every contact I had with every one of them, digital or on paper. Why did those men and women deserve to be ruined just because I’d been caught? They were doing their best for their patients, exactly what the brief is when you go into medicine.’
‘You killed people,’ Callanach reminded her. ‘For money.’
‘For every person I killed, my work enabled an average of six other people to live. So if, for example, I killed ten people, I saved sixty. I should have been given a reward not imprisoned.’
Callanach stared at her.
‘You were only convicted of seven,’ Jean-Paul reminded her.
‘How sweet,’ she replied.
Callanach knew she believed it on some level. Not that she didn’t appreciate what she’d done wrong, but her self-justification was genuine.
‘We were talking about the doctors in your … referral scheme,’ Jean-Paul reminded her.
‘Ah yes, well, we contacted them, discreetly of course, and let them know that we might have organs available. There was a convoluted system for them to contact us in return, in case any of them notified the police, but they all had one thing in common. Wealthy clients with failing organs who’d been on waiting lists long enough to have lost hope. The organ donation system doesn’t work effectively, in spite of recent attempts to impose a scheme where people are assumed to be in until they opt out. People are dying needlessly, on a daily basis. We were oversubscribed at times. For a couple of organs we actually held auctions. That was my downfall, before you feel the need to point it out to me.’
‘The doctor who lost the auction was the one who contacted the police and gave evidence against you?’ Callanach asked.
‘Indeed,’ she said. ‘But what I was trying to explain is that we had carefully established systems. In our arrogance we assumed them foolproof, but they were good. We made contact with the right doctors. They checked me out. They gave very specific information regarding donor types, blood types, age groups. There was no amateur element to what we did. We ran a private hospital to all intents and purposes. My husband hired premises under a false company name, then we’d kit out the operating theatres and recovery rooms with the best equipment, engage experienced staff, and I performed both ends of the transplant. We paid cash everywhere we went. No one asks questions when you’re paying a little extra and they don’t have to wait for money to transfer. We were good at what we did, because we knew what we were doing.’
‘The relevance?’ Jean-Paul asked.
‘The relevance, obviously, is that whoever is performing the surgery in this case, while they have some medical knowledge – the incision is correct in depth, so the organs could have been successfully removed – is no expert. No professional anaesthesia. Incisions that do not maximise operability. Any doctor they contacted would check them out immediately and tell their patient not to go anywhere near an organ offered by such a provider. Taking such a risk would only hasten death, not prolong it.’
Jean-Paul wrote lengthy notes on a pad while Giorgia perused her own markings on the copy of the postmortem report.
‘What else?’ Callanach asked, noting the smile playing at the corners of her mouth.
‘Some basics. I’d really need to examine the body myself to be clinically certain, but it looks unlikely that whoever operated left sufficient lengths of blood vessels attached to make for an easy transplant at the recipient end. But they chose their donor well. Someone did research. He was healthy, a non-smoker, no obvious alcohol use, no sign of disease, fit, no body fat. I couldn’t have chosen better myself.’
‘So he’d have made a good donor? But you’re saying harvesting wasn’t what this was about.’ Jean-Paul threw his pen on the desk.
‘I’m telling you he’s good marketing material. You choose the donor to make the sale as easy as possible, the same as any other product you’re trying to sell.’
‘The question is what they were selling precisely, if not organs for transplant,’ Callanach said, doing up the last button of his shirt.
The governor appeared at the door with a sheet of paper in his hand, looking as relaxed as if he were about to join them for coffee.
‘Dr Moretti-Russo,’ he greeted her with respect. ‘I’m so glad you’ve been able to assist our friends from Interpol. That was good of you. If you’re finished, you can check this agreement and we’ll both sign it.’
‘I don’t know,’ she smiled and ran a hand through her hair. ‘Do you think I’m finished?’ she asked Luc and Jean-Paul.
‘I think we’re done here.’ Jean-Paul stood up, gathering the photos and report from the table.
‘What is it?’ Callanach asked her.
; ‘Do you have faith in me?’ Giorgia replied.
‘I accept your expertise.’
‘Cold fish,’ she smiled. ‘Offer me something else. You won’t regret it.’
‘I’m afraid this is the best we can do,’ the governor interjected. ‘We literally haven’t the staff or resources to make any further concessions.’
‘Shame. You’ve heard my expert opinion. No one thought to ask me about my gut instinct.’
‘That could be anything,’ Jean-Paul said. ‘We’re after hard leads, not fairy tales.’
‘But the fairy tale is what’s going to help you,’ Giorgia said. ‘Last chance.’ She turned her back on Jean-Paul and the governor, standing directly in front of Callanach instead.
‘Your choice. Have a crown fitted to replace the missing tooth or have your eyes lasered so you can lose the glasses. I’ll secure funding,’ he directed at the governor.
‘What the fuck?’ Jean-Paul sighed.
‘Shut up,’ Giorgia told him. ‘Tell me which one I’m going to choose and why, then we have a deal.’
Callanach didn’t hesitate.
‘You’ll choose the eyes. The tooth you carry like a badge of honour. It’s a war wound that secures your position in here. Repair it and you’ll lose credibility because it’ll look like it was bothering you. The problem with your vision is that you hate it because you feel it diminishes you. Visible ageing reduces your prowess, both to others and for you internally.’
‘More psychoanalysis than I was expecting – or wanted – but fine. Add it to the agreement.’
Callanach picked up a pen and took hold of the contract, scribbling an additional note at the bottom and adding his own signature to it, before both Giorgia and the governor added their own. Jean-Paul held out his hand for Giorgia to return the pen. She did so slowly with a faint smile.
‘Your turn,’ Callanach told Giorgia, as Jean-Paul secured the pen in his pocket.
‘All right,’ she said, taking both his hands in her own and staring up at him like a teenage girl waiting for her first kiss. Callanach tolerated the touch of the hands that had killed in cold blood, and waited. ‘What’s the one thing you need more than anything else in life, that’s personal to you? Something that has become so important to you, it’s close to an obsession.’