Lynda La Plante - Deadly Intent

"One of my own designs— very light and battery-controlled.""You're a cripple?"Manuel gave a strange half smile. "Does it worry you? I do not operate with my feet, but if it concerns you ...""What's the matter with you?"Manuel had dialed a number on his mobile phone, but he didn't connect the call."I was addicted to crack cocaine. My spine was injured in a fall.""Are you still an addict?""I will be for the rest of my life, but I am no longer a user. I've been clean for four years." He held the phone up. "Have you changed your mind?"Mr. Smith hesitated and then gave a curt shake of his head. "Make the call," he said.Manuel wished he had walked out, but his client was obviously satisfied, so he called Enrico to come to the surgery. In contrast to the reception room, the adjoining operating theater was cold. Mr. Smith felt every hair on his body tingle. He was instructed to use a small shower room to scrub his body clean with the disinfectant provided. Then Manuel introduced Enrico, who led Mr. Smith to the table. He had already prepared a row of needles and the vials of Fentanyl. He checked the client's heart rate and blood pressure, which he noted was high—180 over 120. He prepared a vein catheter for Mr. Smiths right hand and found a vein easily, attaching it for the anesthetic to be given. An aspirator machine stood ready for the liposuction; large packs of gauze and two big bottles of Xylocaine and adrenaline, plus dark bottles of iodine were at hand. Different rubber tubes were ready to connect to the cannula tubes, to attach to the liposuction machine. Next, Enrico opened Mr. Smith's gown and, using a paintbrush, painted three quadrants, center of his stomach and to both sides.He checked that there was an oxygen mask ready and a resuscitation machine in full working order. He attached a small clip onto Mr. Smith's index finger, which led to a machine to enable them to read the heartbeat. All of this was completed in total silence.Enrico then went to assist Manuel to scrub up in a large sink. Manuel let him scrub both his hands with alcohol gel and wheel him to the trolley so he could open the paper-wrapped gloves."Do you wish to inject yourself?" Manuel asked his client. It took a while for Mr. Smith to measure the exact amount before clenching his left fist and then watching as Enrico adeptly found a strong vein and injected him. It was very fast; Mr. Smith just had time to lie back before he felt the warmth spreading throughout his body."You can get started." he said, his voice slurred.He eventually became used to the hideous sound of the suction pump working. The incisions for the cannula tubes pressed deeply and painfully into the fat. Enrico used his foot to keep the pump working as the fat drained into two big vats. It took three and a half hours. At one point Manuel was concerned: Mr. Smith's pulse rate was at ninety-eight. He used the oxygen mask and waited for the pulse to return to normal.Manuel worked quickly, inserting the tubes and pumping out the fatty tissue. For him, it was a tedious, long-drawn-out procedure. He sat making drawings for the facial work he was asked to complete. Twice during the liposuction Enrico gestured for Manuel to double-check their patient; he also needed his help to turn the big man over to take the fat from his buttocks. Manuel, for all his incapacity, was very strong in the upper part of his body, and together they had been able to move him.One of the most strenuous parts of the suction process was drawing on the tight elastic bandages to make sure the body parts, where the fat had been removed, were held in place. The gauze was wrapped around first, then the bandages, then an elastic corset eased over the belly and chest. In truth, the wrapping this time was perhaps too tight, but Mr. Smith was a very big man and Manuel reckoned he was so macho, he would be able to deal with the constrictions and the painful bruising he was going to feel. They had removed an astonishing two and half liters of body fat. The next process was to tighten his buttocks. A banana-shaped incision was to be made across each cheek. Manuel calculated that he would spend at least an hour and a half on each, due to the number of internal stitches required layer by layer. The first general anesthetic was administered.Whatever pain he felt, three hours later Mr. Smith sat up asking for water. He drank thirstily before resting back and closing his eyes. His entire body felt as if it had been run over by a ten-ton truck. The pain was making his head throb; it was excruciating and he could find no comfort, even lying on his side."How long do you need before you work on my face?" he asked hoarsely.Manuel leaned close to him, checking his pulse."I really cannot begin any more surgery. I suggest you rest for two days. Then we will be able to remove these bandages so you will be more comfortable.""I don't have that amount of time. I want it done today.""I have to refuse. Your blood pressure was very high and you will need to have a second general anesthetic. It will be impossible to operate using only Fentanyl.""You get another ten thousand dollars if you continue.""It is too much of a risk. The work will take at the very least three hours. I have to virtually lift your entire face off and—""Just do it.""I advise you to rest at least for tonight and return tomorrow.""Do it!" the man hissed. He needed to be awake, to make sure he did not overdose on the Fentanyl. He trusted no one but himself to measure it. The pain dulled by the Fentanyl, he closed his eyes.Enrico was silent, as usual, as he cleaned up and removed the bloody gauze pads. He was surprised when Manuel asked if he could remain all night at the surgery. He gave a small nod of his head and continued clearing up.When Manuel returned to the table, Mr. Smith was already lying motionless, his eyes closed."He is mad," Enrico whispered."For Jesus' sake, don't let him die on us. And make me some strong black coffee." Manuel raised his electric wheelchair to its maximum height. He would now be able to work from above the sleeping man's head and move easily around to the left and right of the table.Using a black marker pen to draw the lines on Mr. Smith's face where he wished to cut, Manuel lifted both eyebrows up and took a section from the brow. He marked the upper and lower lids and made a line around both ears for an auricular incision. He then marked the lips to augment with silicone and put dotted marks between the eyes for Botox.As he worked, he drank two small cups of thick black coffee, with heaped spoonfuls of sugar. His patient remained oblivious, eyes closed and sleeping.Enrico prepared the prosthetic implants for the cheeks and chin, and when Manuel was ready, he administered the second general anesthetic. It was, by now, almost six o'clock and cooler outside, but as always IManuel maintained a very low temperature in the operating room. They both went through the same procedure of scrubbing up, and now that the anesthetic had kicked in, work began.The first incision was to the eyebrows. Manuel removed a slice, like a small section of orange, drawing the skin upward, and stretching out the lines in the forehead. This took a lot of pulling and stretching before he was satisfied. Then he cut a long line from behind the ear, continuing down to the chin. He drew up the scraggy skin of the neck, again removing a slice like another section of orange, so he could restitch and pull tightly back toward the lobes of the ears. He also implanted a small section of what looked and almost felt like a sponge. He inserted a piece into the lower chin, then used a thin flattening spatula to ease up two more sections to rest over each of the cheekbones, working with the finest suture scissors. He removed the mole from Mr. Smith's right cheek and gave two neat stitches, before he began work on his nose.Twice, Manuel became concerned as his patient's pulse shot up; his heart rate was worrying too and it was a while before he felt he could continue.Читать дальше