Skin Deep

96

For days the media fed upon the story like jackals.

And every day was a jubilee for the headline makers, trying to outdo each other with lurid catchiness as details spurted out from the investigation:

NOTED COSMETIC SURGEON TURNED SERIAL KILLER

FAMOUS FACE DOC KILLS TO REMAKE STEPMOM

TRANSSEX FACE—OFF, DOC WANTED TO BE MUM

One tabloid even filled the front page with the King Kong declaration: IT WAS BEAUTY KILLED THE BEAST.

The investigation carried on for weeks during which time Monks’s office, Lexington home, and Vita Nova site had been thoroughly searched. He had been meticulous in not leaving incriminating evidence linking him to the murders of the other women. He either had doctored his records or had arranged for the women to pay by cash so as to eliminate any paper trails.

Likewise, no physical evidence connected him to any of the crime scenes—no black stocking collection, no photographs, no journal, no correspondences. Because he had used freelance surgical teams and conducted all reconstructions at the offsite location, anonymity was maintained.

The only trophy of his crimes would have been Dana’s face.

Following extensive interrogations, the three surgical assistants had confessed to being accomplices to the attempted transplant of Dana, although they pleaded not guilty to murder. Each had been trained in the country of his origin—Korea and Martinique. However, they became associated with Monks when accepted for advanced fellowship training in transplantation under a program allied with the prestigious Institute of Reconstructive Surgery headed up by him. He had taken them under mentorship, and in exchange for the opportunity to work with the renowned leader in facial transplantation—which eventually would help establish them in successful practices back home—they went along with his scheme. Allegedly Dr. Monks had claimed that Dana was suffering from terminal cancer, thus minimizing her sacrifice.

They also claimed to have known nothing of Monks’s other killings. According to the U.S. Immigration Service, none of them was in the country when the others were committed. On those Monks had apparently acted alone. Subsequent autopsies showed that he had made implants on other women to assimilate the facial structure of Lila Monks, his stepmother, a woman whose beauty had gotten her modeling jobs and a few small parts in movies and television.

It was not clear the exact hold she had had on his psyche, but it was assumed that she had sexualized him as a child to the point that he never developed a normal, healthy relationship with other females. Following her alleged murder of his father, she committed suicide by hanging herself with a black Wolford stocking. According to police records, young Monks had found her and suffered her loss. Nearly inseparable from her, he fell into deep depression, according to sources. Twice during college he attempted suicide. It was hypothesized that Lila Monks’s death had permanently scarred him, possibly rendering him sexually dysfunctional and bitter.

Over the years, his obsession morphed into the quiet hunt for patients whose facial structure resembled that of his stepmother, iconized in the sepia illustration in the negative that hung in his office. With the use of old photographs and MRI software, he had approximated the muscle-skeletal contours of her face to the point of calculating the exact requirements necessary to refashion hers from others.

“One possibility,” Jackie Levini had said, “is that he kept remaking the woman and killing her out of deep rage for abandoning him.”

“You mean,” Steve had replied, “he was killing his wicked stepmother over and over again.”

“Yes. Of course, the other possibility is that he murdered them because they were not Lila Monks. That he was killing his misses—his botched attempts to re-create her.”

“Pygmalion crossed with Ted Bundy.”

“Exactly.”

“Apparently he came to the realization that he’d have to continue killing until he was either stopped or he died.”

“Which was risky and not very fulfilling,” Steve said.

“Yes. And because of his skills, he saw a way to fulfill his profoundest desires while resolving his own sexual conflicts and those with the woman whom he both adored and hated.”

“The sex change.”

“Yes.”

A few weeks after the story broke, Steve’s office was contacted by a urologist at a clinic in Prague. Six years ago, Monks had apparently convinced the doctors of his gender dysmorphia, and during a leave of absence from his practice—and unbeknownst to any friends or colleagues—he flew to Czechoslovakia, where he underwent a transsexual operation. When he returned to the United States, he continued his practice while he waited for the proper candidate to present herself.

Then Dana walked into his office.

Monks was a clever planner. According to Air France, he immediately purchased tickets to Paris and booked hotels for a medical conference in August. After a five-day stay, he was scheduled to fly to Martinique for another three weeks aboard the Fair Lady, after which he would return to Boston. He had even arranged for the yacht to be leased out to others in the Caribbean the week after he returned and to remain down there for the next seven months, after which he’d fly down to motor it back to Boston next spring.

That was the cover.

The real plan was to have his surgical team replace his own face with Dana’s and to stage a fatal heart attack by leaving behind a dead homeless man, kidnapped months before and whose face Monks and his team had refashioned to a near duplicate of Monks’s own, right down to the mole. For the right occasion, the body had been stored in a refrigeration unit at Vita Nova. Bolstering the visual identity they had even grafted Monks’s own prints onto the dead man’s fingers. Were an autopsy conducted, his death had been affected by curare to assimilate a heart attack. And the obituary would lament the premature death of a world-renowned plastic surgeon. The dead man was never identified.

Meanwhile, completing the diabolical plan, Aaron Monks would be taken on the Fair Lady to Martinique, where in a small villa he owned in backcountry hills he would recover to live out the rest of his life as Lillian Arona. All necessary documents, deeds, and passport had already been fabricated. Containers of red hair dye found aboard the boat revealed his plan to let his hair grow long and to color it.

As a chilling afterword, Steve returned to Aaron Monks’s Web site, where he found a recent article by the doctor that concluded:

Up to this point, the only real technical challenge has been the revitalizing of dead tissue from cadavers. But the future in face transplantation is to lift tissue from living donors, say those with terminal diseases who bequeath their faces. Aside from that, the only other problem is nonsurgical—the secondary effects of anti-rejection drugs.

But great strides are being made in overcoming immunosuppressive problems as shown in clinical trials with humans. Should they prove as effective as we suspect, it will not be long when full-face transplantation for cosmetic reasons will be routine.

In spite of arguments to the contrary, I see no more of an ethical problem than in transplanting a heart or a liver, because the whole purpose is to help the patient in need.

Ironically, because the transplant was interrupted by police, Monks’s own removed skin suffered deterioration, as did the exposed muscles and blood vessels of his face. Because so much time was lost while his colleagues were forced to mend Dana, a last-minute attempt to reattach Monks’s skin failed. For more than a week he was in intensive care at Massachusetts General Hospital, where doctors tried in vain to reverse the infection that had set in.

He died in a state of gross disfigurement, poisoned by his own face.

Because he left no records, the Essex River woman had still not been identified. The case remained open. Of course, there might have been other victims yet undiscovered. More secrets that Aaron Monks took with him to the grave.