Gone Before Goodbye

Chapter Seven

Ivan Brovski brought her to yet another room.

“How many rooms does this place have?” Maggie asks.

“I’m not sure anyone knows.” He gestures with his arm. “Please.”

It reminds her of Barlow’s conference room. Not an exact replicate like her OR, but then again, all these sleek rooms look the same. Ivan signals for her to take a seat. He moves around the table, sits across from her, and touches the tablet in front of him. The large-screen TV on the far wall comes to life in bright white.

“So you’re a physician?” Maggie says to Ivan.

“Oxford trained.”

“What’s your specialty?”

“I’m a general internist. Nothing fancy. Like you, I served in the military. When I resigned my commission, Oleg hired me to be his full-time physician and liaison.”

“Liaison,” Maggie repeats. “I bet that term is pretty flexible.”

A small smile comes to Ivan’s lips as he taps something on his tablet. The white vanishes from the television screen. “This is Mr. Ragoravich’s electronic medical records.” He taps another icon, and the file slides to the left, making room for another. “And this one belongs to Nadia Strauss.”

“Nadia’s last name is Strauss?”

He gives her a noncommittal shrug and hands her the tablet so that she can control the screen. The first page for both patients displays what one might expect: height, weight, date of birth, gender. Unlike the electronic medical files Maggie was used to from the hospital, there are no spaces for billing information — nothing about insurance company, address, social security number, occupation.

“You met your surgical team,” Ivan says.

“Briefly.”

“Just so you are aware, it’s not just the operating room we’ve duplicated.”

Maggie looks up from the tablet. “Meaning?”

“We interviewed members of your surgical team in Baltimore.”

“When you say interview—”

“For training purposes,” he says. “So your team here has been schooled on your operating room preferences and protocols.”

“You don’t miss much.”

“We believe in minimizing risk, Doctor McCabe. We want to assure your success.”

“I see.”

“Assuming you approve, the schedule for tomorrow is as follows: Meet with the team at seven a.m. to go over procedures. Personally inspect the surgical facilities and all implantation devices. We are told you usually do this three hours before a surgery. Is that correct?”

“Yes.”

“Very good. So Mr. Ragoravich will go into surgery at ten a.m. He will undergo three procedures. One, a blepharoplasty. Two, a sliding genioplasty using fat transfer, so that his jawline more resembles the one in Photo A.”

Maggie clicks on what is marked as Photo A. It offers up a black-and-white, oddly grainy view of the lower half of a man’s face.

“And three, a rather unique open rhinoplasty. I think you’ll find that most exciting.”

“Why’s that?”

“You’ll be implanting an artificial nose scaffold.”

Maggie makes a face. “I’m not familiar with that.”

He grins. “I know.”

“I’m familiar with nose scaffolding using cartilage and tissue.”

“That isn’t what this is, though there is a lot of overlap, and that’s why it’s an open rhinoplasty. You’ll make the incision below the nose” — Ivan points with his beefy finger at the space between the upper lip and the start of the nose — “peel the skin up, do whatever you need to clear out space, and then insert the scaffold.”

“An artificial scaffold?”

“Yes, that’s correct.”

She frowned. “I didn’t know such a thing existed.”

Again the grin. “It didn’t. Until now. But I assure you it’s been tested.”

“Who built the scaffolding?”

“We did,” he says. “Via AI on our MB Reps 3D printer.”

Maggie sits back. “Are you serious?”

“I am.”

“You have an MB Reps 3D printer?”

“That surprises you?”

They sell, Maggie knows, for nearly a quarter million dollars. “Not really, no. But like I said, I never heard of this before. What’s the scaffolding made of?”

“It’s a patented biocompatible polyethylene.”

Maggie nods. That’s a common and proven material for implanted medical devices. Trace and Marc had done their work with that too. “And it’s a full nose scaffold?”

“Yes.”

“And you know I’ve never done that procedure before, right?”

“Truth?” Ivan leans in conspiratorially with the same grin. “I’m not sure anyone has. Do you think that’s a problem?”

She looks at the chart, considers the procedure, visualizes herself doing it. Her pulse picks up pace. She can’t help feeling excited at the prospect. “Not really, no.”

“It’s why we picked you.”

“Pardon?”

He settles back. “We didn’t think it would be an issue for you.”

“Who is ‘we’?”

“Doctor Barlow, mostly. He says you’re a bit of a risk-taker.” Ivan quickly waves both hands in front of his face as though clearing away his own words. “No, no, not like that. He meant like a maverick. You understand the best way to improve medical care is to push boundaries, no?”

When she doesn’t reply, he adds, “Anyway, Doctor Barlow thought you’d relish this challenge.”

The truth is, Dr. Barlow was correct. Maggie had read tons over the years on building and creating custom implants via AI and 3D printing — Marc and Trace had been working on something similar with the THUMPR7 — but the technology still felt like years in the future. A nose scaffold is not a heart or a liver — but it’s a pretty exciting step.

You have to walk before you can run.

“In most ways,” Ivan continues, “it works like any other facial implant.”

“Except,” Maggie says, studying the images, “it will more radically change the way Oleg’s nose appears.”

“Yes.”

“Most people want a smaller nose.”

“Oleg Ragoravich does not. Click Photo B.”

She does. The image — grainy black-and-white again, which is strange — is of a nose that would politely be called “prominent.” The vast majority of people go through plastic surgery to improve their aesthetics. This is fairly obvious. Some want to look like a favorite celebrity, but between this new nose, the chin implant, and the eye work via the blepharoplasty, Oleg Ragoravich clearly did not want that.

He wants to look like someone else.

Or at least, not like himself.

“We figure the three procedures should take you between three and four hours,” Ivan continues. “Would you agree?”

She would. Probably three, but it pays to have extra time with the nose scaffold. She’d want to inject some fat and stem cells into the area, just to make sure the device wasn’t rejected.

“Which brings us to Nadia,” he says, tapping the screen. “Assuming we begin Mr. Ragoravich’s procedures promptly at ten a.m., we will have Nadia prepped and ready for a two p.m. start. Does that work for you?”

“It does. I assume we are using silicone for the breast augmentation?”

He nods. “We can choose either round three hundred ccs, three fifty ccs, or four hundred cc implants, all on standby.”

The four hundreds would be too big, but keeping three sizes ready for an operation was standard. Silicone was back in — saline was out. In the nineties, there were headlines about silicone leaks causing cancer and lupus, but after extensive studies, they found no link between silicone breast implants and an increased risk of breast cancer.

“What kind of incision are you going with?” Ivan asks her.

“I prefer the inframammary,” she says. “Assuming that’s okay with Nadia.”

He nods. There are three types of incision used in breast augmentation: inframammary (under the breast), periareolar (around the edge of the areola, a sort of half-smile incision), and transaxillary (in the armpit). The inframammary is most common. The periareolar sometimes affects sensation, and the transaxillary is used only for saline and makes positioning difficult.

Maggie starts clicking through the pages, seeing if anything sticks out. “Can I keep these medical files to review in full?”

“Of course. That tablet is yours.” Ivan checks his watch. “The gala ball is in a few hours,” he says, putting his hands on the sides of his chair as though ready to push himself up. “So if there’s nothing else—”

“Hold up a second,” Maggie says. Ivan waits. She clicks back, then forward. She reads the history again. “It says here Nadia only has one kidney.”

“Yes. She donated the other, what, six, seven years ago.”

“To whom?”

“Her brother.”

“Do you know what he had?”

“The brother?” He looks up as though trying to remember. “Nephrotic syndrome, I think. We ran a urine test and bloodwork on Nadia, of course. She has no signs of it.”

Maggie mulls that over. Something isn’t adding up. “Where is Nadia from?”

“Originally? I have no idea.”

“How did she meet Oleg Ragoravich in the first place?”

“In a club in Dubai. What difference does it make?”

“Having only one kidney could be an issue.”

“Could be, but it’s not. Nadia has been medically cleared. She’s in excellent health. As for the rest of your questions, Oleg Ragoravich is a private man.”

“Which reminds me,” Maggie says. “If he’s so private, why is he throwing a huge party tonight?”

“It’s a ball, not a party.”

“What’s the difference?” Maggie asks. Then, thinking better of it, she adds, “I’d rather not go.”

“You should. For one thing, you’re expected. For another, you will want to see the difference between a party and a ball with your own eyes.”

“Would it be a cliché to say I have nothing to wear?”

“It would be,” Ivan says, rising from his seat, “if that were true. But come on, my dear, you must know by now that we are prepared.”