Gone Before Goodbye

Chapter Ten

God, how Maggie has missed this.

In medical terms, the suffix plasty — as in rhinoplasty and blepharoplasty and genioplasty and mammoplasty — means “repair,” “restore,” “replace.” It comes from the Greek word “plastia,” which means “to mold” — and that is what it means to Maggie. Mold. Repair. Restore. It’s science. It’s art. The clay you create with is human flesh. There is no greater honor or responsibility than being a surgeon. For most of her career, Maggie dealt with soldiers and children with severe injuries and deformities. With her own two hands, she had the ability to mold, repair, restore them. Imagine that for a moment. Imagine what a privilege it is to do that kind of work, to make a living that way, to have people put that kind of trust in you and your abilities, to make them whole again.

How had she let herself betray that trust?

The obvious rationales — a butchered husband, a dead mother, whatever — none of that could ever excuse what she did. She had been given the greatest gift possible — the ability to heal through artistic creation — and she had squandered it.

Now she has been gifted this reprieve — for one day, at least.

Maggie goes through the same routine she’s gone through hundreds if not thousands of times before — wash the hands, don the scrubs, tie the mask over the nose and mouth, snap on the gloves — but there is nothing routine about it. Not today. When she enters the surgical theater, emotions fly toward her hard and fast, nearly overwhelming her. Tears come to her eyes. She holds steady. She stops and takes a few deep breaths before approaching the table where Oleg Ragoravich lies unconscious. Her support staff — that’s how she views them, as hers — are poised and ready.

This, Maggie knows, is where she belongs.

The operating room is her temple, her church, her sanctuary. Marc was home for her. She was home for Marc. But she and Marc both knew that here, in the cathedral they called an OR, was where they felt their most whole, their most complete.

She loved that about Marc. And he loved that about her.

They were the luckiest people in the world, weren’t they?

Once Maggie asks for a scalpel, once she makes the mid-columellar inverted-V incision to access the underlying cartilage, her heart rate slows down. The calm enters her bloodstream. She settles back into this state of blissful creation. She would curse herself for not appreciating this feeling, this reverence, this calling, but she’d always understood and appreciated how special and extraordinary it was to be a surgeon.

And she’d blown it anyway.

That’s what we stupid humans do. We carry the seeds of our own self-destruction.

She focuses now on the work to the point where she gets lost in it. Time passes. She has no idea how much. There are TV-like monitors so she can watch — they are in most operating rooms now — but she almost never needs them. It takes a little longer than she expects to clear away the nose cartilage so she can fit the marvel that is the artificial nose scaffold into place. She had hurried down three hours ago and geeked out when the technician showed the artificial scaffold to her. The material was, well, a nose — flimsy and stiff and malleable and brittle all at the same time.

She starts with this procedure because it is new and thus the most difficult. But it goes smoothly. She then moves on to the eyelids. She wants this feeling to last — to take her time, to remain in this state of pure contentment — but she knows it can’t. It doesn’t work that way. Surgery has its own organic, quasi-circadian rhythm. You can’t mess with it to please your own needs.

She marks the natural folds around the eye and then uses a curved size 15 blade to make the incisions. She removes excess skin, muscle, and fat and closes the wounds up. The sliding genioplasty, a very specific type of chin augmentation, is next. She cuts through the mandibular symphysis — in layman’s terms, the chin bone — and shifts it with her gloved hand. She harvests the fat from Oleg’s abdomen via liposuction and transfers it to the face. Then she molds and shapes and shifts until Oleg’s chin and jawline resemble the chin and jawline in the photographs.

Ivan Brovski is scrubbed and masked. He watches everything in silence. When he sees her close to finishing, he says, “Odd.”

“What?”

“You’re even better than your reputation.”

Maggie should be above feeling pleased by the flattery, but the truth is, she’s not. Maybe she would have been in the past. Not now. She closes up, and when she exits the operating room, Maggie sees that the total operating time on Oleg Ragoravich was three hours and fifteen minutes. Not bad. Maggie paces, feeling wired and jazzed. She can’t wait to get back in there. The operating room is soon ready for Nadia’s breast augmentation. Ivan Brovski is already there. Like before, she ignores him. Not out of malice or annoyance. She’s just in the zone. She doesn’t want anything interfering with that. If Brovski wants to watch, so be it. But she doesn’t feel the need to facilitate or hinder.

Focus. Stay in the moment.

As with most surgeries, intermittent pneumatic compression devices — think inflatable leg-squeezing machines or high-tech compression boots — are placed on the patient’s legs. This is to regulate blood flow and prevent deep vein thrombosis or again, layman’s terms, a blood clot. The Bovie pad is already stuck on Nadia’s upper thigh. Put simply, it’s a grounding pad used to channel electric currents away from the patient’s body.

Maggie would have wanted to go with the most cutting-edge method of breast augmentation — using a patient’s own fat — but Nadia didn’t have enough fat to donate, and that procedure would have been too subtle a change for what she (or Oleg) wanted. Instead, they were going with the aptly nicknamed, state-of-the-art “gummy bear” implants — solid gel breast implants known for shape retention and realistic consistency. If you slice traditional silicone breast implants in half, the material will leak out like honey. That’s not the case with the more solidified gummy bears.

Most people think they know how breast augmentation works: The surgeon makes the incision, creates a pocket behind the pectoral muscle, places the implant in the pocket, and then centers it behind the nipple. That’s all true, but for the best work, you need to strap the unconscious patient to the operating table so that at some point, you can sit them up in a Fowler position. It is really the only way to evaluate the breast shape and assess the placement. Think about it. Do you want them to look natural only when you’re lying down? Or do you care what they look like when you’re sitting or walking? Duh. To not have the patient cranked up to a seated position because of hemodynamic concerns that have pretty much been laid to rest in study after study is, in Maggie’s view, negligence.

The scrub nurse presses the operating table’s button, moving the strapped-in Nadia into an upright position. Maggie inserts the various sizers and then stands back to see which ones are most symmetrical and appropriate for Nadia’s frame. She has, as Brovski mentioned, the three sizes from which to choose. Dr. Deutsch, her mentor in this procedure, told her that when in doubt, go with the larger one because when it’s over, almost every woman he’s worked on says they wished they had gone a little bigger. Maggie keeps that in mind, but she also believes, perhaps wrongly, that Nadia is being somewhat coerced into doing this. In the end, the three hundred ccs, the smallest of the three sizes, provide the best aesthetic anyway, so Maggie goes with that.

At some point Ivan Brovski exits without a goodbye. Maggie idly wonders about that, but again this isn’t about him. It’s about the patient and the procedure.

A few minutes later, Maggie finishes up with sutures and steps back.

It’s over.

Except it most definitely is not.

The scrub nurse turns off the ESU or Electrical Surgical Unit. Then she pulls the Bovie pad off Nadia’s upper right quadricep.

And everything changes.

Maggie freezes and feels her world start to spiral.

“Doctor?”

Nadia has a tattoo on her leg. Maggie bends down for a closer look.

The tattoo is garish orange and purple. It’s a cartoonish image of a goofily smiling serpent with a halo and a silly wink.

“Doctor McCabe, are you okay?”

Maggie has seen only one tattoo like this before.

On Marc’s leg.

Maggie can’t move.

The scrub nurse says, “Doctor?”

Her eyes finally move off the tattoo and up to Nadia’s face. Nadia’s eyes are closed. It’ll be thirty to forty minutes before she’s awake and able to converse. Maggie’s gaze is drawn back to the tattoo.

There is no way this is a coincidence.

She thinks about that tattoo — how Marc regaled her with its college-spring-break origin story and how bad Marc was at handling his alcohol (which he was) and how his friends got him drunk (though it was his fault too, he’d admit) and how they stumbled down the French Quarter — and when he told the story, you could see the New Orleans night sky and feel the thick Creole humidity and touch the brick of the old buildings — and how he ended up in that small tattoo parlor and it was just a dare, no one thought Marc would go through with it, and how the artist, who was definitely drunk or stoned or worse, drew it in pen in mere seconds and that was it, it wouldn’t go any further than that, surely, just a pen drawing, and then the artist — his name was Agent or something like that — took out the needle, and ha, ha, okay it’s time to stop kidding around except no one did and it hurt like hell even with all the alcohol, and when he woke up, the area was all red and Marc thought it might be infected...

How can Nadia have that same tattoo?

“Doctor?”

She looks over at the anesthesiologist. “How long will the patient be out?” Maggie asks.

“An hour.”

Maggie nods, turns her attention back toward the scrub nurse. “Where is Doctor Brovski?”

“He left in the middle of the surgery.”

“Do you know where he went?”

“Perhaps he is looking in on Mr. Ragoravich?”

Maggie doesn’t hesitate. She hurries out of the operating room and heads down the corridor. Post-op is the corner room. Maggie pulls up when she enters Oleg Ragoravich’s recovery room.

It’s empty.

That’s wrong. She looks for the attending nurse. Nope, not there either.

Where the hell is Oleg?

He should still be here. The plan was to keep him in the recovery room for the next few hours at the very least before moving him to his bedroom upstairs.

So where is he?

Doesn’t matter. Not right now. Right now, she wants to find Brovski and get her phone back. She wants to bring up the griefbot. She wants AI Marc to explain to her how the hell the twenty-four-year-old mistress of an oligarch has the exact same one-of-a-kind Serpent and Saint tattoo that he had.

This palace has workers everywhere, but suddenly Maggie can’t find one. She heads through the abandoned indoor pool area, which is dark and humid, which again reminds her of Marc’s tale about that humid New Orleans night. She still has on her scrubs. The heat from the pool is cloying. She rips off her lowered surgical mask and cap and tosses them in a bin.

When she exits by the other end of the pool, she’s back in the corridor Oleg had led her down when she arrived... wow, was that only yesterday?... when he showed her the locked Mona Lisa room.

The door to the Mona Lisa room is wide open.

Maggie half sprints toward it. When she turns the corner, she sees three identical paintings on the wall, except they are all oil paintings of wildflowers.

No Mona Lisas.

What the...?

No time to worry about it. She continues down the corridor. She passes the fake Gardner Museum pieces and notices that one, the Vermeer, is now missing.

Something is going on.

She isn’t sure what to do when she hears a bellow from above. “Doctor McCabe?”

Maggie spins. It’s Ivan Brovski.

“Where are you going?” he asks. “Why are you still in your scrubs?”

She moves back toward him and starts up the stairs. His face is set. She doesn’t like that. “I need my phone,” she says.

“You can’t have it. You were told as part of your employment there was to be no communication—”

“And I told you that I wasn’t communicating with anyone.”

Ivan Brovski stares her down. “Then why do you want it back so badly?”

“That’s not your concern.”

His voice becomes soft. “It’s not really him, you know.”

“Yeah, no shit.”

“It’s an unhealthy crutch. You don’t need it.”

“What I really don’t need,” Maggie replies, “is mental health tips from an oligarch’s lackey. Give me my phone, please.”

Another man — Maggie recognizes him as one of the guards from last night — runs up to Brovski. The man is big, with a giant rectangular head. It’s as if someone just dropped a cinder block between his shoulders. He looks Maggie over with disgust, as though she’d dropped out of the back of a dog’s behind, and whispers something in Brovski’s ear. Brovski’s eyes close in what appears to be exhaustion. Then Brovski barks what sounds like an order in Russian. CinderBlock nods — tricky when you have no neck — and hurries over to another big man in another ill-fitting black suit.

“What’s going on?” Maggie asks.

“It’s time for you to leave, Doctor McCabe.”

“Wait, what?”

“The helicopter will be here within the hour.”

“I just finished the surgeries.”

“An hour should give you time to shower and change.”

“I told you up front. I need to stay with the patients—”

“No, you don’t. I’m here. We have staff. The surgeries went spectacularly. As I mentioned before, you are as gifted as your reputation. We will let Doctor Barlow know how pleased we were with your services. If you’ll excuse me—”

“I want my phone.”

“You’ll get it when you depart.”

Maggie is confused. Why the sudden rush? Why the change in demeanor? Maggie isn’t big on vibes, but the whole vibe here has taken an unexpected turn for the worse.

“Oleg Ragoravich isn’t in his room,” Maggie says.

“That’s not your concern.”

She looks down by the front door. Two more men in ill-fitting black suits rush outside.

“Tell me about Nadia.”

Brovski looks annoyed by the question. “What?”

“Where is she originally from?”

“I have no idea.”

“Come on, Ivan. You know everything about me.”

“Because you’re a physician hired for discretion and ability. So yes, of course, we vetted you.”

“And you don’t vet the boss’s mistress?”

“Exactly. He said not to, so we didn’t.”

More black-suited men rushing back and forth.

“I have to go,” he says.

“Are you going to tell me what’s going on?”

“Nothing. Shower, get changed. I’ll bring your phone to your room. Then you can leave.”

He rushes off then. Maggie isn’t sure what to do. That garish tattoo — on Marc’s leg, on Nadia’s leg — keeps strobing through her mind. She can’t stop it. Part of her wants to follow Brovski and demand her phone, but it’s pretty clear that he’s not going to give in on that yet.

So what next?

Stay calm. Think. Plan.

Okay, since Nadia is still unconscious, Maggie decides the best move forward is to shower quickly and change. If they are serious about her leaving — and they seem to be — is that really such a bad thing? Brovski was right — these surgeries are, in the end, fairly routine.

The staff seem competent in handling the post-op, and if something goes wrong, they should be able to handle it.

So why shouldn’t she head back to the United States as soon as possible?

Because she needs to know about that damned tattoo first.

One step at a time, she tells herself. Do your job. Shower, change, hurry back to the medical wing, find Oleg Ragoravich — they probably moved him to his bedroom already — check on him, make sure he’s okay, and by then, Nadia should be waking up.

She hurries to her room, turns on the faucets, and steps under the spray. Funny thing: Even the shower gives her a nostalgic pang. That had been part of her old surgical ritual — the post-op shower — and she missed this feeling, the light exhaustion, the satisfaction of accomplishment, the clearing of the mind, the gentle cusp between her professional life and whatever awaited her (Marc) when she was done. Okay, yeah, it’s just a shower, but even the tiny remnants of blood and tissue, the workday spiraling down the drain, had been her own sort of purification ceremony.

The shower is also a good place, perhaps the best place, to think, so Maggie tries to come up with a rational reason that Nadia has the same tattoo as Marc.

She can’t think of a single one.

She needs more information. Simple as that. Ask Nadia when she wakes up. Ask the griefbot when she gets it back. Ask both.

Deep breaths.

She changes into loungewear and heads to the door. When she opens it, CinderBlock is standing there like a second door. She tries to move past him, but he blocks her.

“Please move out of my way.”

“You stay,” he says with a thick Russian accent.

“I need to check on my patients.”

“Stay.”

His eyes are on hers, and she doesn’t like what she sees. It isn’t anger or hatred or even determination in them. It’s more... nothing. Lifeless. Like she’s staring into the eyes of a filing cabinet.

She has a few options here, none of them good, but she tries the simplest. She channels the backyard touch football games of her youth. She loved them, especially on Thanksgiving. Her mother, a huge New York Jets fan, would play quarterback. Mom would imitate her NFL quarterbacks, shouting out nonsense. Maggie has always been quick as opposed to fast. That made her dangerous in the game. So, odd as it sounds, right now, with CinderBlock looming over her, Maggie fakes left like a running back. Cinder shifts his body to follow. Maggie pushes off her left foot and explodes past him on the right.

She doesn’t know whether she can run faster than him. She doubts it. But she has now put him in an uncomfortable position. The only way to stop her is to use physical force. That’s a big step up from blocking her path. CinderBlock would have to sprint after her now — perhaps grab or even tackle her. And she might resist. That would be forcing him to take this to a different level.

Maggie is hoping that he doesn’t want to go there.

When he hesitates, Maggie keeps moving. “I’ll be right back, I promise,” she calls out, glancing behind her. “I just need to make sure my patient is okay.”

She can see the wheels turning, even behind the lifeless eyes, but she doesn’t give him time to weigh the pros and cons. He will either use physical force or not. If he does, so be it. She will deal with the consequences.

But there is no way Maggie is getting on that helicopter without talking to Nadia first.

She turns and sprints down the corridor.

CinderBlock doesn’t follow. Or at least not yet. She sneaks a glance over her shoulder. No, he’s not running after her. Of course there is more suited security around. He may be contacting one of them to get in her way. No point worrying about it. Better to just keep moving. The only way they should be able to stop her is to use force.

She doesn’t think they will.

Think. Not know. Think.

But again, what are her options?

She runs past the Mona Lisa room. The door is closed again. Up ahead she sees three black-suited men running toward her. Reality hits. Doesn’t matter how much hand-to-hand combat training she has. There is no way she will be able to get past all three of them.

But also, there is no way she’s going to go down without a struggle.

She braces herself. But the three men veer away from her and run the other way.

What the hell is going on?

She sprints through the humid pool area and back into the medical wing. She checks Oleg Ragoravich’s room. Still empty. She heads down two more doors to Nadia’s recovery room. The door is closed. She knocks once, just out of habit, and reaches for the knob. She turns it and pushes in, worried now that Nadia will have vanished.

But she is there.

Nadia is in the bed, her eyes in that half-closed post-op way Maggie has seen a thousand times before. Maggie feels her heart beating wildly against her chest. She slows herself down, focuses on her breathing, steps into the room. No one else is here. Where the hell is all the support staff?

When Maggie closes the door behind her, Nadia stirs. Maggie waits. Nadia starts blinking open her eyes. Maggie sees the full water glass. She grabs a straw.

“Here,” Maggie says. “Sip this.”

She places the straw between Nadia’s lips. Nadia sips.

“How do you feel?”

“Groggy,” Nadia manages.

“That’s normal.”

Maggie has automatically switched into physician mode. She checks Nadia’s vitals and stitching. All normal. Nadia starts waking up. Maggie can feel her eyes on her. It’s always interesting to see how various patients react to their doctor. Some look away. Some watch with reverence or worry or even mistrust, as though trying to read what the doctor is really thinking versus what they are willing to admit out loud.

She hears someone run down the corridor past the door. A man shouts in Russian. Maggie doesn’t understand what he’s saying, but there is panic in his tone. Time is not on Maggie’s side here. She gets that. She locks the door and sits on the edge of Nadia’s bed. More personal this way, she thinks. Less intimidating.

“I want to ask you something.”

Nadia’s eyes are blue and wide and beautiful. “Is something wrong? Did the surgery—”

“No, no, you’re fine. The surgery went perfectly.”

Nadia just looks at her and waits.

“When I was doing your surgery...” Maggie isn’t sure how to ask this. She reaches to pull back the blanket on Nadia’s leg. It’s the wrong move. Nadia jolts, cringes, holds the blanket in place.

Just dive in, Maggie tells herself.

“You have a tattoo on your upper thigh.”

There is a brief flare in those eyes now. “You saw it?”

Maggie can hear the fear in Nadia’s voice now.

“Yes.”

“I don’t understand. My leg. It was covered. You were supposed to be working on my chest—”

“I saw it at the end,” Maggie says. “When the surgery was over. The nurse took off the Bovie pad.”

Nadia looks terrified.

“It’s okay,” Maggie says, trying to reassure. “I didn’t mean to...” She stops, tries again. “Could you tell me where you got it?”

Nadia closes her eyes and shakes her head no.

“Please,” Maggie says. “It’s important.”

“Why?”

Maggie needs to keep this moving. “I’ve seen the design before,” she says.

“What do you mean?”

“Please, Nadia. Can you just tell me where you got it? Why do you have it?”

Nadia pulls up her legs as though trying to protect them.

“Nadia?”

“Leave me alone.”

“They’re making me leave soon.”

“What?”

“Something is going on. I can’t find Oleg. They want me to leave. Please, Nadia, I need to know about the tattoo.”

“But why?” Nadia asks — and now there seems to be a small accusation in her tone. “Have you seen that tattoo before?”

“Yes,” Maggie says.

“On other young girls?” Nadia asks. “Or boys?”

“No,” Maggie says. “On someone I loved very much.”

Nadia blinks. “I don’t understand.”

“Nadia, please tell me how you got it.”

Her voice turns stone-cold. “You know already.”

“What? No, I don’t.”

“This loved one,” Nadia says. “Did he also donate a kidney?”

“No. Why would you ask that?”

“Because,” she says, “that’s when I got mine.”

Maggie makes a face. “When you donated your kidney?”

She nods. “He put me under for the operation. When I woke up, my kidney was gone, and on my leg...” She shrugs away the end of the thought.

Maggie tries not to look horrified. “The tattoo was just on your leg?”

“Yes.”

“So they put it on while you were under?”

Nod.

“And you’d never seen it before?”

Tears push into Nadia’s eyes.

“Nadia?”

“It was his sign.”

“Whose sign?”

“I need more water.”

Maggie puts the straw between her lips. Nadia lifts her head to sip. When she’s done, her head falls back on the pillow.

“My mother told me that her grandfather used to brand camels,” Nadia says. “Always on the left side of the face. Always. So you knew what tribe it belonged to. Here, with him, it was always on the upper right thigh. Where no one in my village would see it.” Nadia winces and tries to sit up. “Who do you know who has it?”

“Like I said” — Maggie’s head is swirling — “a loved one.”

“No.”

“No?”

“That’s not good enough,” Nadia says. Her voice has more edge now, bordering on anger. “What loved one?”

Maggie’s mouth goes dry. She’s right, of course. She has every right to know. “My husband.”

“Did he donate a kidney too?”

“No. He was a surgeon.”

Nadia’s eyes lock on her. “Did he do mine?”

“No,” Maggie says too quickly.

“How can you know for sure?”

Maggie says nothing. She feels lost.

“Where is your husband now?” Nadia asks.

“He’s dead.” Maggie hears the distant monotone in her voice. Then she adds, “He was killed.”

Nadia doesn’t look surprised. “They murdered him?”

The question throws her. An odd question. Or was it? “What do you mean by ‘they’?”

“Who killed him?”

“I don’t know.”

Nadia shakes her head. Maggie feels cold inside.

“Nadia?”

“You’re lying,” Nadia says.

“What?”

“I see it in your eyes. Who killed your husband?”

Maggie isn’t sure how to answer that. “Marc was on a humanitarian mission in a war zone. The camp was overrun by men with guns and machetes. It was a slaughter. He...”

She stops.

“How did he die?”

“What?”

“You said guns. You said machetes.”

“I don’t know,” Maggie says, her voice soft. “I hope a bullet, but...” She stops. There is no reason to say more about that.

Silence.

“The surgeon,” Nadia says, her eyes steady now. “The one who took out my kidney. He was a white man. They called him the Snake. I didn’t know why. Until I saw the tattoo.” Nadia looks away. “He was not kind.”

And then Nadia says it: “Trace.”

Maggie freezes. “What?”

“There was a man there. Someone called him Trace.”

“He was the surgeon?”

Nadia shakes her head. “No. He tried to stop it.”

The door bursts open then.

It’s Ivan Brovski with CinderBlock and a nurse. They look at the bed behind Maggie. Maggie follows their gaze and sees that Nadia has her eyes closed, feigning unconsciousness. The nurse crosses the room and checks Nadia’s pulse.

Brovski grabs Maggie’s arm.

“Let go of me,” Maggie says, pulling her arm free.

Between clenched teeth, Brovski says, “What are you doing in here?”

“I told you. I wanted to check on my patient. I was waiting for her to wake up.”

“Why did you lock the door?” Before she can come up with a lie, Brovski shakes it off. “Doesn’t matter. Nadia is in good hands. Let’s go.”

“Where’s Ragoravich?” she asks.

But Brovski is not having any of it. “Please get your stuff. It’s time to leave.”