Neil McMahon - To The Bone

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"Neil McMahon's thrillers have the precision of a surgeon's scalpel." – Michael Connelly
***
Late one hot summer night, a beautiful young actress named Eden Hale – only hours removed from breast-augmentation surgery, and writhing in pain – stumbles to the telephone and dials 911. Within minutes, an ambulance rushes her to San Francisco's Mercy Hospital. But by the time she arrives, she is dying, fast, of a mysterious, unrecognizable condition.
Dr. Carroll Monks, the ER physician on duty, races to sort through her baffling symptoms in the few minutes he has left to save her. Monks has a sudden insight and, against the advice of his peers, risks a radical treatment, which will prove to be either a brilliant maneuver or a potentially deadly mistake. It fails. Eden Hale, vibrantly healthy and barely twenty-five years old, is dead.
The fallout is immediate and intense. The plastic surgeon who operated on Eden – Dr. D. Welles D'Anton, whose reputation as a surgical guarantor of perfection and agelessness has conferred on him a guru-like status – blames Monks for her death. Criticism from Monks's hospital colleagues quickly follows and the threat of a lawsuit is not far behind. Monks's career is in jeopardy, but his own guilt and uncertainty are what haunt him worst of all.
Convinced there's a hidden cause to Eden's death, Monks starts to delve into her past. Despite roadblocks that spring up in his path, he soon learns that the former prom queen was not the all-American girl she seemed to be: she was caught up in the world of pornography, and was even, possibly, having an illicit affair with D'Anton. Then Monks uncovers a secret that is far more frightening: other young women in D'Anton's care have wound up missing, dead, or horribly disfigured.
In his search for the truth, Monks is drawn into a culture of unimaginable wealth and vanity – only to discover that he is being used as a pawn in a decadent game of glamour and cruelty, one that places him in the crosshairs of a deadly psychopath.

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But between Martine and him, it had built on its own, unseen and unnoticed except in tiny increments – the unhappy expression in a passing glance, the slight reluctance to touch. The sense that there was something going on in the background that was never brought forth.

"You're changing the subject," he said.

"I don't want to be away from you, Carroll. I just don't think I can keep on making it here."

"I understand that, Martine. I really do."

But he knew in his guts, even if she did not, that that was not the entire truth.

"We can do it half and half," she said. "Your place and mine."

"You bet."

"I've talked to some people about work. That's all, just talking, feeling around. I think I could move into a practice without too much trouble."

"I'm sure you could," he said.

"I didn't tell you about it because – goddammit, quit giving me that stoic act."

"It's not an act."

"I know it's not," she said. "Fuck you."

They both drank.

"Let's take a walk," Monks said.

"The food will get cold."

"Just around the place."

"Okay," she said doubtfully.

He offered his hand. She took it. They walked down the deck's steps onto a hard red dirt path that skirted the perimeter of the property's three acres.

Thirty yards or so farther on, Monks paused, pointing at a tire-sized flat rock. "I killed a rattlesnake right there once."

Martine pulled her hand away and turned quickly in a circle, her gaze darting around the nearby earth, littered with twisted snakelike madrone twigs.

"Quit it," she said. "You're scaring me."

"I didn't want to. But the kids were still little. I couldn't take the chance."

"Did you face it hand-to-fang? Like those guys on TV?"

"Are you kidding? I snuck up behind it and whacked it with a garden hoe."

She shivered. "Are there a lot of them around? Rattlesnakes?"

"I only ever killed one other. I was getting firewood and it came out of the woodpile, between me and the door. Things got pretty tight for a minute there." Monks pointed at the woodshed, an old board-and-batten structure with only a narrow aisle between the stacks of split rounds. "The cats have taken out a few. They leave them on the doorstep."

"I didn't know cats would hunt snakes."

Another harsh image from his past seared Monks's brain – the cats on the hood of the Bronco, leaping and howling in the moonlight, while on the front seat a cobra weaved from side to side, trying to strike at them through the venom-smeared windshield.

"These cats will," he said.

They walked on, past the workout shed. It was almost dark, cool and still now, with the jays quiet. Higher up, a breeze rustled the redwood fronds and madrone leaves. A few tree frogs were tuning up for the night's concert. He walked slowly and she kept pace with him, swinging her leg without complaint. But on this rough and hilly terrain, she would get tired quickly. Monks stopped again, on the edge of the gully that led down to the creekbed.

"That old cabin down there?" he said. The neighboring place had been abandoned decades ago and had mostly fallen into the creek, a couple hundred yards down the steep hill. "I forbade the kids to go near it, but of course it was a magnet. One day, I'd worked all night and was trying to get some sleep, and I heard this shriek. I ran down there and found poor little Stephanie, she was maybe eight, screaming bloody murder. She'd jumped off something and landed on a rusty old fence post, broken off to a point, sticking a couple inches out of the ground. Went right through her tennis shoe and clear up through her foot."

Stephanie, his daughter, was now in medical school at UCSF. She and Martine had gotten quite close.

For a minute or so, Martine was silent. He could see her head moving, her gaze wandering the woods, but not turning to him.

Then, abruptly, she said, "I don't think I want a kid. My mind doesn't. I don't even think my body does. I don't know what it is."

She was forty-three. Monks was long since vasectomized and out of the child-raising mode. He did not consider that he had done all that good a job the first time around.

"Sorry I can't help you there," he said.

"No, you're not."

"You're right. I'm not."

"Have any of your women ever told you you're too honest?"

"No," Monks said. "You're the first."

"Liar."

He smiled gravely. They turned and started back. He knew, and supposed she did, too, that this had been a last-ditch attempt to woo her – offering the things that made him what he was.

When they had first been together, there were words of passion, each assuring the other that this was what they had been waiting for. But it was useless to invoke that. The problem was not any single one of the obstacles, or even all of them together. The affair was just something that had run its course, and this was like the point in a really great party that had gone on most of the night, when a silence touched the room, and everybody knew that there might be a few more drinks and laughs, but the good-byes were going to start soon.

If he hadn't pushed, it might have lasted longer – maybe quite a while. But Monks could not leave things like that in general, and she was right. Today's events had put him in the mood to have it out. He could have pushed it the other way, and asked her to marry him. But that would only be trying to bind her, to keep her from what she wanted – another chance at the kind of life most people considered normal, the kind of life that he had pretty much let go.

He had not thought he would ever live with a woman again. But once he had started, he had come to realize that when she was not here, he felt a sour gnawing absence.

They managed to keep up small talk while they ate. She asked more questions about what had happened today and Monks told her, but it was dutiful from both sides. Afterward, with his belly full and drowsiness coming quickly, he turned on the TV and settled back on the couch, head in her warm lap and her hand stroking his hair.

"I do love you," she murmured. "You know that." Monks nodded. "I love you, too," he said, in a voice that was thick with exhaustion.

Chapter 11

Her voice leads you to a different street, another doorway. It's darker and quieter in here than the last place. The bottles lined up on the back-bar shelves glitter with dusty colored light.

She's a silhouette, alone at the bar, posed for you.

She gives you a quick smile when you walk up next to her. She's in her late twenties, thin, wearing a tank top and jeans. She's probably been hit on several times already tonight, by men and women both. You look better than most of what she sees.

You order a glass of wine, a Clos Pegase merlot this time. Then you admire the bracelet on her right forearm. It wraps around, a silver and turquoise snake crawling up her skin. The silver seems liquid, but not from the room's light. From her.

"Where'd you get it?" you ask.

"In LA. It's Navaho."

You touch it, feeling her warmth shoot up through it into your finger.

"It looks alive," you say. She smiles again and tosses her hair.

She tells you she's from the Midwest. She's been traveling, working part-time here and there, crashing with people she meets. Her name is Lynn. You tell her a name, too, and let her know right away that you're a doctor.

Her eyes flicker. That could mean drugs.

She chatters on, but you listen past her words to what her voice is telling you in your head – what has hurt her all her life. She's almost pretty, but her chin recedes, and her nostrils flare at the tip.

You'll start with a rhinoplasty – remove a little cartilage from the base of each nostril, then tighten them together. Then implants in the mandible to move the chin bone forward. When it's finished, her face will have a beautiful balance. She'll wish you'd found her years ago.

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