The Surgeon

Twenty

Peter Falco was up to his elbows in blood. He glanced up from the table as Catherine pushed into the trauma room. Whatever tensions had grown between them, whatever uneasiness she felt in Peter’s presence, were instantly shoved aside. They had assumed the roles of two professionals working together in the heat of battle.

“Another one coming in!” said Peter. “That makes four. They’re still cutting him out of the car.”

Blood spurted from the incision. He grabbed a clamp from the tray and thrust it into the open abdomen.

“I’ll assist,” said Catherine, and broke the tape seal on a sterile gown.

“No, I can handle this. Kimball needs you in Room Two.”

As if to emphasize his statement, an ambulance wail pierced the hubbub of the room.

“That one’s yours,” said Falco. “Have fun.”

Catherine ran out to the ambulance loading dock. Already, Dr. Kimball and two nurses were waiting outside as the beeping vehicle backed up. Even before Kimball yanked the ambulance door open, they could hear the patient screaming.

He was a young man, tattoos mapping his arms and shoulders. He thrashed and cursed as the crew rolled out his stretcher. Catherine took one glance at the blood-soaked sheet covering his lower extremities and knew why he was shrieking.

“We gave him a ton of morphine at the scene,” said the paramedic as they wheeled him into Trauma Two. “Didn’t seem to touch him!”

“How much?” said Catherine.

“Forty, forty-five milligrams IV. We stopped when his BP started dropping.”

“Transfer on my count!” said a nurse. “One, two, three!”

“Jesus fucking CHRIST! IT HURTS!”

“I know, sweetie; I know.”

“You don’t know a FUCKING THING!”

“You’ll feel better in a minute. What’s your name, son?”

“Rick… Oh Jesus, my leg—”

“Rick what?”

“Roland!”

“Do you have any allergies, Rick?”

“What’s wrong with you FUCKING PEOPLE?”

“We have vitals?” cut in Catherine as she pulled on gloves.

“BP one-oh-two over sixty. Pulse a hundred thirty.”

“Ten milligrams morphine, IV push,” said Kimball.

“SHIT! GIMME A HUNDRED!”

As the rest of the staff scurried around drawing bloods and hanging IV bags, Catherine peeled back the blood-soaked sheet and caught her breath when she saw the emergency tourniquet tied around what was barely recognizable as a limb. “Give him thirty,” she said. The lower right leg was attached by only a few shreds of skin. The nearly severed limb was a pulpy red mass, the foot twisted nearly backward.

She touched the toes and they were stone cold; of course there would be no pulse.

“They said the artery was pumping out,” said the paramedic. “First cop on the scene put on the tourniquet.”

“That cop saved his life.”

“Morphine’s in!”

Catherine directed the light onto the wound. “Looks like the popliteal nerve and artery are both severed. He’s lost vascular supply to this leg.” She looked at Kimball, and they both understood what had to be done.

“Let’s get him to O.R.,” said Catherine. “He’s stable enough to be moved. That’ll free up this trauma room.”

“Just in time,” said Kimball as they heard another ambulance siren wailing closer. He turned to leave.

“Hey. Hey! ” The patient grabbed Kimball’s arm. “Aren’t you the doctor? It fucking hurts! Tell these bitches to do something!”

Kimball shot Catherine a wry look. And he said, “Be nice to ’em, bud. These bitches are running the show.”

Amputation was not a choice Catherine ever made lightly. If a limb could be saved, she would do everything in her power to reattach it. But when she stood in the O.R. a half hour later, scalpel in hand, and looked down at what remained of her patient’s right leg, the choice was obvious. The calf was macerated and both the tibia and fibula crushed to splinters. Judging by the uninjured left leg, his right limb had once been well formed and muscular, a leg deeply bronzed by the sun. The bare foot — strangely intact despite the shocking angle at which it pointed — had the tan lines of sandal straps, and there was sand under the toenails. She did not like this patient and had not appreciated his cursing or the insults he’d hurled in his pain at her and the other women on the hospital staff, but as her scalpel sliced through his flesh, shaping a posterior skin flap, as she sawed off the sharp edges of the fractured tibia and fibula, she worked with a sense of sadness.

The O.R. nurse removed the severed leg from the table and wrapped a drape over it. A foot that had once savored the warmth of beach sand would soon be reduced to ash, cremated with all the other sacrificed organs and limbs that found their way to the hospital’s pathology department.

The operation left Catherine depressed and drained. When at last she stripped off her gloves and gown and walked out of the O.R., she was not in any mood to see Jane Rizzoli waiting for her.

She went to the sink to wash the smell of talc and latex from her hands. “It’s midnight, Detective. Don’t you ever sleep?”

“Probably about as much as you do. I have some questions for you.”

“I thought you were no longer on the case.”

“I’ll never be off this case. No matter what anyone says.”

Catherine dried her hands and turned to look at Rizzoli. “You don’t like me much, do you?”

“Whether or not I like you isn’t important.”

“Was it something I said to you? Something I did?”

“Look, are you finished up here for the night?”

“It’s because of Moore, isn’t it? That’s why you resent me.”

Rizzoli’s jaw squared. “Detective Moore’s personal life is his business.”

“But you don’t approve.”

“He never asked my opinion.”

“Your opinion’s clear enough.”

Rizzoli eyed her with undisguised distaste. “I used to admire Moore. I thought he was one of a kind. A cop who never crossed the line. It turns out he’s no better than anyone else. What I can’t believe is that the reason he messed up was a woman.”

Catherine pulled off her O.R. cap and dropped it in the rubbish bin. “He knows it was a mistake,” she said, and she pushed out of the O.R. wing, into the hallway.

Rizzoli followed her. “Since when?”

“Since he left town without a word. I guess I was just a temporary lapse in judgment for him.”

“Is that what he was for you? A lapse in your judgment?”

Catherine stood in the hallway, blinking away tears. I don’t know. I don’t know what to think.

“You seem to be at the center of everything, Dr. Cordell. You’re right up there onstage, the focus of everyone’s attention. Moore’s. The Surgeon’s.”

Catherine turned in anger to Rizzoli. “You think I want any of this? I never asked to be a victim!”

“But it keeps happening to you, doesn’t it? There’s some kind of weird bond between you and the Surgeon. I didn’t see it at first. I thought he killed those other victims to play out his sick fantasies. Now I think it was all about you. He’s like a cat, killing birds and bringing them home to his mistress, to prove his worth as a hunter. Those victims were offerings meant to impress you. The more scared you get, the more successful he feels. That’s why he waited to kill Nina Peyton until she was in this hospital, under your care. He wanted you to witness his skill firsthand. You’re his obsession. I want to know why.”

“He’s the only one who can answer that.”

“You have no idea?”

“How could I? I don’t even know who he is.”

“He was in your house with Andrew Capra. If what you said under hypnosis is true.”

“Andrew was the only one I saw that night. Andrew’s the only one…” She stopped. “Maybe I’m not his real obsession, Detective. Have you thought about that? Maybe Andrew is.”

Rizzoli frowned, struck by that statement. Catherine suddenly realized that she had hit on the truth. The center of the Surgeon’s universe was not her but Andrew Capra. The man he emulated, perhaps even worshiped. The partner Catherine had wrenched from him.

She glanced up as her name was called over the hospital address system.

“Dr. Cordell, STAT, E.R. Dr. Cordell, STAT, E.R.”

God, will they never leave me alone?

She punched the Down button for the elevator.

“Dr. Cordell?”

“I don’t have time for any of your questions. I have patients to see.”

“When will you have the time?”

The door slid open and Catherine stepped in, the weary soldier called back to the front lines. “My night’s just begun.”

By their blood will I know them.

I survey the racks of test tubes the way one lusts over chocolates in a box, wondering which will be tastiest. Our blood is as unique as we are, and my naked eye discerns varying shades of red, from bright cardinal to black cherry. I am familiar with what gives us this broad palette of colors; I know the red is from hemoglobin, in varying states of oxygenation. It is chemistry, nothing more, but ah, such chemistry has the power to shock, to horrify. We are all moved by the sight of blood.

Even though I see it every day, it never fails to thrill me.

I look over the racks with a hungry gaze. The tubes have come from all over the greater Boston area, funneled in from doctors’ offices and clinics and the hospital next door. We are the largest diagnostic lab in the city. Anywhere in Boston, should you open your arm to the phlebotomist’s needle, the chances are your blood will find its way here. To me.

I log in the first rack of specimens. On each tube is a label with the patient’s name, the doctor’s name, and the date. Next to the rack is the bundle of accompanying requisition forms. It is the forms I reach for, and I flip through them, scanning the names.

Halfway through the stack, I stop. I am looking at a requisition for Karen Sobel, age twenty-five, who lives at 7536 Clark Road in Brookline. She is Caucasian and unmarried. All this I know because it appears on the form, along with her Social Security number and employer’s name and insurance carrier.

The doctor has requested two blood tests: an HIV screen, and a VDRL, for syphilis.

On the line for diagnosis, the doctor has written: “Sexual assault.”

In the rack, I find the tube containing Karen Sobel’s blood. It is a deep and somber red, the blood of a wounded beast. I hold it in my hand, and as it warms to my touch, I see her, feel her, this woman named Karen. Broken and stumbling. Waiting to be claimed.

Then I hear a voice that startles me, and I look up.

Catherine Cordell has just walked into my lab.

She is standing so close, I can almost reach out and touch her. I am stunned to see her here, especially at this remote hour between darkness and dawn. Seldom do any physicians venture into our basement world, and to see her now is an unexpected thrill, as arresting as the vision of Persephone descending into Hades.

I wonder what has brought her. Then I see her hand several tubes of straw-colored fluid to the technician at the next bench, and hear the words “pleural effusion,” and I understand why she has deigned to visit us. Like many physicians, she does not trust the hospital couriers with certain precious body fluids, and she has personally carried the tubes down the tunnel that connects Pilgrim Hospital with the Interpath Labs building.

I watch her walk away. She passes right by my bench. Her shoulders sag, and she sways, her legs wobbly, as though she is struggling through deep mud. Fatigue and the fluorescent lights make her skin look like little more than a milky wash over the fine bones of her face. She vanishes out the door, never knowing that I’ve been watching her.

I look down at Karen Sobel’s tube, which I am still holding, and suddenly the blood seems dull and lifeless. A prey not even worth the hunt. Not when compared to what has just walked past me.

I can still smell Catherine’s scent.

I log onto the computer, and under “doctor’s name” I type: “C. Cordell.” On the screen appear all the lab tests she has ordered in the last twenty-four hours. I see that she has been in the hospital since 10:00 P.M. It is now 5:30 A.M., and a Friday. She faces a whole clinic day ahead of her.

My workday is now coming to an end.

When I step out of the building, it is 7:00 A.M., and the morning sunlight slices straight into my eyes. Already the day is warm. I walk to the medical center parking garage, take the elevator to the fifth level, and head along the row of cars to stall # 541, where her car is parked. It is a lemon-yellow Mercedes, this year’s model. She keeps it sparkling clean.

I take the key ring from my pocket, the ring I have been guarding for two weeks now, and slip one of the keys into her trunk lock.

The trunk pops open.

I glance inside and spot the trunk release lever, an excellent safety feature to prevent children from being accidentally locked inside.

Another car growls up the garage ramp. I quickly close the Mercedes trunk and walk away.

For ten brutal years, the Trojan War waged on. The virgin blood of Iphigenia that was spilled upon the altar at Aulis had sped the thousand Greek ships on a fair wind toward Troy, but a swift victory did not await the Greeks, for on Olympus the gods were divided. On Troy’s side stood Aphrodite and Ares, Apollo and Artemis. On the Greek side stood Hera and Athena and Poseidon. Victory fluttered from one side to the other and back again, as fickle as the breezes. Heroes slew and were slain, and the poet Virgil says the earth streamed with blood.

In the end, it was not force but cunning that brought Troy to her knees. On the dawn of Troy’s last day, her soldiers awakened to the sight of a great wooden horse, abandoned at her scaean gates.

When I think of the Trojan Horse, I am puzzled by the foolishness of Troy’s soldiers. As they wheeled the behemoth into the city, how could they not know the enemy was burrowed within? Why did they bring it within the city walls? Why did they spend that night in revels, clouding their minds in drunken celebration of victory? I like to think I would have known better.

Perhaps it was their impregnable walls that lulled them into complacency. Once the gates are closed, and the barricades are tight, how can the enemy attack? He is shut out, beyond those walls.

No one stops to consider the possibility that the enemy is inside the gates. That he is right there, beside you.

I am thinking of the wooden horse as I stir cream and sugar into my coffee.

I pick up the telephone.

“Surgery office; this is Helen,” the receptionist answers.

“Could I see Dr. Cordell this afternoon?” I ask.

“Is it an emergency?”

“Not really. I’ve got this soft lump on my back. It doesn’t hurt, but I want her to look at it.”

“I could fit you into her schedule in about two weeks.”

“Can’t I see her this afternoon? After her last appointment?”

“I’m sorry, Mr. — what is your name, please?”

“Mr. Troy.”

“Mr. Troy. But Dr. Cordell’s booked until five o’clock, and she’s going right home after that. Two weeks is the best I can do.”

“Never mind then. I’ll try another doctor.”

I hang up. I know now that sometime after five o’clock, she will walk out of her office. She is tired; surely she will drive straight home.

It is now 9:00 A.M. This will be a day of waiting, of anticipation.

For ten bloody years, the Greeks laid siege to Troy. For ten years, they persevered, flinging themselves against the enemy’s walls, as their fortunes rose and fell with the favor of the gods.

I have waited only two years to claim my prize.

It has been long enough.