Ridley Pearson - The Angel Maker

"The procuring surgeon is looking for cadavers.

I suppose the first resources I would draw upon would be the hospital morgue, the Medical Examiner's office, and any of a number of mortuaries."

Boldt took notes. Miles took his pacifier out and threw it across the desk at Dr. Light Horse, who scooped it up, brushed it off, and offered it back to him. Miles liked that. He accepted it gladly and sucked noisily. Boldt asked, "And if those resources weren't available to you or were exhausted for one reason or another, what then?"

She offered him a cold and puzzled look. "You're not suggesting?"

"What am I suggesting?"

"Someone living?"

"It's possible, isn't it? I've read about Egypt, India …"

"But those people are desperate for money.. "There are people desperate for money in this country as well-in this city as well."

"But it's different there," she protested, clearly upset, "in terms of professional health services. It's true that some Third World countries have limited resources, limited access to technologies such as dialysis. The reason for the high prices, for the whole transplant mess in these parts of the world is that without those transplants people die. It's different here. Much different."

He admired her vehemence. She was morally and ethically undone by what he was suggesting. "Which means that your market is overseas, if I'm reading you right."

"Now you're scaring me."

"Good." He wanted her scared, because he felt scared for Sharon Shaffer, for whoever else was scheduled next for the knife. "Here in Seattle?"

"You can't quote me on that," he said.

She thought long and hard. "Blood type? Depends what kind of resources you have, I suppose. You would need computer access, of course, but what comes immediately to mind are hospital records, the Red Cross, the insurance companies. Any of those databases would be likely to list blood type. / "A plasma bank?" he asked. "Just exactly how far along in this investigation are you?"

He handed her several autopsy photos of two of the incisions.

"Dixie suggested you have a look at these."

She studied them thoughtfully. "Anything special?" he asked.

She continued to look them over. "Perfectly competent closures.

Although the incisions are a little large."

As Boldt wrote this down, one of his notes caught his eye. "What kind of team does he need? How many assistants?"

"It depends on which organ we're talking about and which procedure." "Kidneys," he said. "Harvesting kidneys."

"For a kidney procurement it's helpful to have an assistant. But again, I'm thinking in terms of cadavers," she corrected herself. "A live procurement? An anesthesiologist, a surgeon, a nurse or two." "Could it be done with less?"

She nodded. "A surgeon and an assistant at the bare minimum." She added, "You'd be busy."

Miles was getting restless. Boldt contained him, but lost his train of thought. "Have you thought about where this would be done?" she asked. "A location?" Then in a professorial tone of voice: "I see problems with this premise of yours. First, when a procurement is done in a hospital, the organ becomes part of the system. There's an airtight system in place. There has to be, because of the public's wariness about the whole transplant process. It's called UNOS-the United Network of Organ Sharing. The procuring institution assigns the organ a UNOS number. The recipient of that organ is assigned that same number. It all has to match. There is a paper trail a mile long the moment an organ leaves a body-hearts, kidneys, livers, marrow, it doesn't matter. The procuring surgeon lists an organ's destination as part of that paperwork the name of the hospital or organ bank. The paperwork follows that organ everywhere. The organ is transported in specially sealed and labeled ice chests. It's all computerized. UNOS does an incredible job. I just don't see how someone could get away with what you're implying."

"And if the procedure was not done at a hospital? Could I get an organ into the system?"

"That's just my point. You can't without a UNOS number. No surgeon is going to touch an organ without the proper paperwork. At the end of every year UNOS follows up on every single organ procured or transplanted. Numbers have to match. If your numbers don't match, you come up for review-you're in deep trouble."

"And if it's not done in a hospital?"

She thought about this for a long minute. She nodded and nibbled at her fingernail, eyes on her desk. Boldt looked out the window at the weather. He felt tigbt-throated and hot. It was growing dark out there. More rain. She didn't say anything. "You look puzzled." Frightened was more like it, he thought. "The thing of it is," she said, "it's possible. You're right about the Third World. market. If I'm the procuring surgeon, I don't want to mess with UNOS-they would catch something like this. I don't want to get anywhere near the system. I'm telling you, the safeguards in this country are just too established. But overseas? A kidney is good for sixty hours these days, that's plenty of time to reach any foreign destination. And the money-the money would be phenomenal, I should think. You hear about prices like fifteen- and twenty-thousand dollars a kidney. Cash, no taxes. No questions. A couple of those a month, and you're doing just fine."

Excitement stole into Boldt so that his writing was illegible.

He slowed and took down the same notes a second time. Miles snatched his pen and threw it to the floor. With the boy in the harness, Boldt couldn't lean down to reach it. Dr. Light Horse handed him a replacement. She seemed to be waiting for him to say something. He checked his notes once again. "So he does the harvesting outside a hospital?"

"Absolutely. This makes much more sense. But there would be a high risk of infection. Hospitals invest hundreds of thousands-millions-of dollars on their surgical suites. Filtered air, double doors, regular cleaning. You can't duplicate that on your own unless you have more money than God."

Her fear fed his excitement. These were leads to follow, ideas to pursue. The more they talked, the more he saw an investigation developing. He now saw the investigation dividing into several areas: Connie Chi, the Bloodlines employee, these technical leads, and the bones that Dixie suggested might have started it all.

She looked even more frightened when he asked, "Could I lease such equipment?"

"The scent you were talking about … something to follow?"

"Yes. "Not my field. But I would guess that you could."

"What about transporting the organs? How difficult is it?"

"Technically, it's not difficult at all. You can use anything from Tupperware to stainless steel. Some Viospan. Ice. Depending on the organ, it'll keep anywhere from a couple of hours to several days." She added, "Ice chests igloo coolers or Styrofoam-are the most common ways to ship them. One of those small picnic coolers. UNOS uses disposable Styrofoam coolers with bright red labels sealing the joints. If you're going to walk a transplant organ through airport security, you're going to want a UNOS container. Now there is something you could check on." She brightened. "Stolen UNOS containers or labels. Air-freight cd organs are usually handcarried by the pilot or another member of the flight crew. The legal ones are. But a passenger could do the same thing if he or she could get through airport security."

Boldt wanted to grab for the phone. He wanted to rush out of here and put a team on it immediately. He wanted to reach across the desk and kiss this woman. This was the exact information he had hoped for: a different angle. A different point of view. If they couldn't trace the victims to the harvester, perhaps they could trace the movement of the organs: a courier. He said, "My feeling is that you overrate airport security. As long as an object doesn't appear to be a weapon or a bomb, they're not going to stop it."