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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Ray Dreyer's phone number wasn't listed. But he had logged in at the ER desk yesterday. Monks coaxed the charge nurse into looking up his address and phone.

It was almost nine a.m. now, but he was reasonably sure that Dreyer was not an eight-to-fiver. If anything, the call might wake him up.

After four rings, a digital voice answered. "The person you are calling is not available right now -" It seemed that Dreyer wanted to stay anonymous.

Monks waited for the beep, then said, "Mr. Dreyer, this is Dr. Monks. I attended Eden Hale-"

The phone clicked, and a male voice said, "Yeah, I remember."

So Dreyer was screening calls, too. His tone made it clear that he was not feeling any friendlier. Monks decided to forget about social graces and get right to it.

"It turns out that Eden had salmonella in her bloodstream. Food poisoning. Any ideas how she might have gotten that?"

"Hey, I don't know what she ate," Dreyer said. "She had stuff in the refrigerator."

"You didn't stop anyplace after the clinic? A deli, takeout?"

"Uh-uh. We went straight back to her apartment."

"Did Eden keep anything around, like chemicals?"

Dreyer's tone turned wary, probably from worry about recreational drugs. "What kind of chemicals?"

"Insecticides?" Monks said. "Photography equipment, heavy-duty cleaning fluids?"

Dreyer laughed thinly. "She never cleaned anything in her life, except when she took a bath. There's about five tons of makeup, if that counts."

It was a tender sentiment for a lost love.

"What about drugs?" Monks said. "This is just between us. Did she take anything besides the Valium the doctor gave her?"

"No way, man. All she wanted to do was crash."

And so she had, Monks thought.

"Okay, thanks," he said. "We're still working on this."

"So am I," Dreyer said mysteriously.

Monks hung up, walked back out to his battered Bronco, and drove to D'Anton's clinic.

Chapter 15

The clinic's parking lot was almost empty this morning, but the front door was unlocked. When Monks pushed it open, Gwen Bricknell was busy at her desk – exactly as he had last seen her yesterday, except that she was wearing an eggshell-colored dress of light, fine cotton. Monks was not much of a judge of women's clothing, or men's for that matter, but he had a feeling that it was the kind of simple attire that was very expensive. The room was otherwise deserted. When he walked to the desk he caught the scent of her perfume, very faint, musky rather than sweet.

He did not expect her to be friendly, and he was surprised when she smiled and said, "Good morning, Dr. Monks."

He murmured hello, struck again by her sheer beauty. If there was any flaw, it was flawlessness – as if, when D' Anton had sculpted her face, he had razored off the imperfections that lent humanness.

But her eyes, dark like olives, were alive – wary, but not hard with hostility. If anything, she seemed a little frightened. The shock of Eden Hale's death had had time to sink in, he thought. This was not the ER; losing a patient was not something that happened with inevitable regularity.

"We're closed, officially," she said. "I'm just rescheduling appointments."

"Dr. D'Anton was going to leave some records for me. Sorry if this is bad timing."

"No, no, it's fine. Welles – Dr. D'Anton – is taking a couple of days off. He asked me to make you at home. He apologizes for being abrasive yesterday. He was very upset."

"Understandable, of course," Monks said.

"I know this is awkward, Doctor," she said, surprising him again. "I don't mean for it to be."

"I appreciate that, Ms. Bricknell," he said. "I don't like it either. But I need to find out what happened to that young woman."

For the next couple of seconds, Monks had the eerie sensation that whoever was behind Gwen Bricknell's eyes had gone – that he was looking at an absolutely still body whose owner was someplace else. By the time he was aware of it, she was back.

"I'll get the records," she said. She stood and opened the door into the rear office, started to step through, and stopped abruptly.

Monks realized that the nurse, Phyllis, was walking past, just on the other side of the door.

Gwen's shoulders sagged in exasperation. "Phyllis, you are everywhere I turn."

"I cover a lot of ground," Phyllis said crisply. "Somebody has to."

"There's really no need for you to be here today."

"There's always a need for me to be here." Phyllis marched swiftly on, a squarish, formidable presence. Gwen glanced back at Monks, rolling her eyes.

"She surprised me, too, yesterday," he said.

"She's incredibly competent. She does most of the low-level procedures. It's almost like having another doctor. But sometimes she decides she's in charge, especially when Welles isn't around."

Gwen went on into the office, leaving the door open. Monks glimpsed another figure, down the hallway that opened onto the procedure rooms. It was the maintenance man, Todd, apparently still at work on the air-conditioning. He raised a hand in cheerful greeting. Monks returned it.

Gwen came back a minute later, with a manila folder clasped in her hands. Her fingers were long and slender, tipped by crimson ovals. She did not wear a wedding ring.

"I wish I had such devoted staff," Monks said. "Coming to work when the clinic's closed."

"Todd's a gem," she said. "He can fix anything. That's how we found him. He was working at Bayview Hospital, and Welles came out one day and his Jaguar wouldn't start. Todd just happened to be there and got it going. Now we can't do without him. He's like that character on M*A*S*H, what's his name? Who always knows what everybody needs ahead of time?"

"Radar," Monks said.

"Well, that's Todd."

She walked ahead of him to one of the screened-off waiting rooms. Her dress was almost translucent, clearly outlining her body. It was an odd sensation, following her past the nude photos of herself on the wall. They had obviously been taken years ago, but she did not seem to have changed much. Eden Hale must have coveted those breasts, Monks thought. They were peach-sized, high and firm. No doubt, they, too, had been enhanced by D' Anton's touch.

At the waiting room's door, Gwen turned to him and offered him the folder. But she held on to it for just a second, so that there was a curious little tug of war between them before she let go.

Monks was reevaluating fast. Apparently, she did not hold grudges.

He sat in one of the comfortable chairs and opened the folder. It contained a standard sheaf of medical records. He paged through Eden Hale's history. It was clean, as they tended to be with young affluent patients; even things like chickenpox and measles rarely appeared these days. She had had persistent ear infections, requiring occasional draining and antibiotic treatment, until age eleven. There were no allergies or adverse reactions to drugs, no operations or broken bones. Her blood work showed her to be O positive, with no diseases, and white cell count well within the normal range.

A copy of D' Anton's chart from the breast procedure confirmed that it was an augmentation, using saline-filled implants, inserted through endoscopic incisions in the armpits. Most of the chart was a checklist, in technical jargon and abbreviations. Monks was not familiar with all the terms, but D'Anton's terse, handwritten notes at the bottom confirmed that the procedure had been routine and had gone smoothly. All in all, the records were thorough and excellent, the work of a top-notch professional.

There was a copy of her discharge form, the same form that the paramedics had found in her purse. It contained postoperative instructions – no strenuous activity, sponge baths only for five to seven days, sexual relations permitted to resume after that time provided the breasts were treated gently – and it stipulated that the patient must be cared for by a competent adult for at least twenty-four hours afterward. This was signed underneath with a scrawl that Monks was able to read only because he already knew the name: Raymond L. Dreyer.

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