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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There was a single message on his answering machine. He had a feeling he knew who it was going to be, and he was right.

"Carroll!" Baird Necker's voice roared. 'That girl's father called up screaming that you'd come by, talking about murder. Are you fucking crazy? If you pull anything else like that, I'll kill you with my own hands!"

Monks put away the groceries. Then he opened a fresh bottle of the Finlandia vodka and sliced a lemon into wedges. He poured the liquor into an old-fashioned glass, watching it smoke slightly over the ice. He gave it a minute to chill, then raised the glass to his lips. The first taste brought goose bumps.

Ordinarily, he would have worked out first, but tonight he was not even going to pretend. He had been scheduled to work the day after tomorrow, but he had called Vernon Dickhaut and arranged for Vernon to take over for him. Monks had not given a reason – just said something had come up. He had not wanted to explain that he might not be coming back to work ever again.

It had been a long time since he had felt like this.

He finished the drink in three strong swallows and poured another one to take with him to the shower. He stayed in for a long time, as if the almost scalding water could wash away the past two days. Then he dressed in clean jeans and a sweatshirt, poured a third drink, and took it out onto the deck.

Pacing, drinking steadily, he went through the story in his head, piecing together the information that he and Larrabee had coaxed out of Josh Hale.

Eden and Ray Dreyer had been living together in Los Angeles until several months ago. On a visit to San Francisco, through some connection, they had attended a party at the home of Dr. D. Welles D' Anton. There, Eden had caught the eye of Julia D' Anton, the doctor's wife.

Julia was a sculptress – Monks recalled her strong hands, work clothes, and the stone chips he had seen in the back of her SUV – and a patroness of the arts. She had asked Eden to pose for her.

Not long after that, Eden had started an affair with Dr. D'Anton. It must have been a hot one. She had moved to San Francisco, receiving quite a bit of money from him – along with free cosmetic surgery. It seemed that D'Anton planned to make her into a showpiece.

And Eden was trying to change her life accordingly. She was getting rid of Ray and her connections to his sleazy world. She was upgrading her wardrobe. There was something childishly wistful about it – the belief that by changing her clothes and body, that would change her being, too.

Never mind that the trigger for it all was an affair with a married man, which, given its intensity, seemed likely to end in divorce. Eden may have been sweet and naive, but she obviously had no compunctions about taking D'Anton away from his wife.

Monks wondered if that was why Gwen Bricknell had lied about Eden being "just another patient"-if Gwen had known about the affair and was trying to protect D'Anton. If the news came out, it would make for a juicy scandal.

But while it might be unethical for a physician to have sex with a patient, it was not illegal. And none of the information put Monks any closer to knowing who might have murdered Eden Hale, or why – or even whether that was, in fact, what had happened.

Still, some potential motives were starting to appear, like shapes in fog.

Maybe D' Anton had wanted to end the affair – in spite of what Eden had told her brother Josh – and Eden had blackmailed him.

Or Julia D' Anton, fearing that her marriage was being destroyed, might have decided to remove the threat.

Ray Dreyer – jilted as a lover, and losing his long-term investment – was still on the charts, too.

There were many other possibilities that might or might not ever come to light. Including the damnable one that the salmonella in Eden Hale's bloodstream was what had killed her. That if Monks had recognized it and treated it differently, she might have lived. And all the rest of this was a waste of time and effort, a pathetic attempt at exoneration – an epilogue to a ruined medical career.

He went back inside and poured another drink, noting that the bottle was more than one quarter empty. He took the drink and the cordless phone back outside with him.

Martine answered on the third ring.

"It's me," he said.

"Hi." Her voice sounded remote.

"I just wondered what you're doing."

"Nothing. Fixing dinner."

Monks thought he heard talking in the background. It was probably the TV.

"Any developments?" she said. "On your – situation?"

"Yes," he said, but then stopped, unable or unwilling to continue, at this remove. "Is there somebody there?"

She sighed. "No, Carroll."

"Just asking. It will be good for you to make new friends."

"Are you drinking?"

"Yes." He took a long swallow, clinking the ice close to the phone so she would hear it.

"You really want to know what I'm doing?" she said. "I'm watching movies. The kind you were watching yesterday."

Monks's forehead creased. Martine had occasionally brought a rented video home, but he was pretty sure they had not watched any in the past week or two, and he had not been to a theater in years.

"Yesterday?"

"Porn," she said patiently.

"You're watching porn movies?"

"I never really have before. But – I don't know. I keep thinking about that young woman. What all that's about."

"Are you learning anything?"

"You wish," she said wickedly. Then, serious again: "I'm trying to imagine myself doing those things. Like, with two men at once, or even three."

Monks was not sure he liked where this was going. "So, your interest isn't completely academic?"

"I don't know what it is," she said. "Just looking at a different world. No, that's not all. There's some – prurience – is that the word?"

"One of them. Does it arouse you?"

"Some of it. Not much. It gets repetitious pretty quick."

"There are only so many permutations," Monks said.

"The dialogue's unbelievably bad."

"I expect they improvise a lot."

"Do I make sounds like that?" she said.

"Yes. But they're very musical."

"You're blessed with the blarney, Monks."

"Do you wish you were here?" he said.

"Yes. No. Carroll, I want to make this as easy as possible."

"Of course, Martine. That's the right way to look at it."

"Oh, go away." This time, she sounded like she was starting to cry. The phone clicked off.

Monks thought about calling back. Instead, he finished the drink and poured another one. It occurred to him just how precise was the term heavy heart. When things started to go wrong, they seemed to go like an avalanche – first a few rocks that you might be able to dodge, but then the whole mountainside tearing loose and coming down on your head.

He drank, remembering, unwillingly, the other time in his life when he had been in a similar situation. The year was 1988. Monks was chief of emergency services at Bayview Hospital, in Marin County. He had been losing popularity there for some time: with some other physicians, because he would not look the other way at certain good-old-boy practices, such as uncredentialed procedures; with staff, because he had no tolerance for various forms of slackness that were considered perks in big hospitals.

One night Monks had monitored, by radio, a team of paramedics in the field who were attending an elderly seizure victim. The senior of the medics was certain it was a heart attack and that a shot of adenosine would save the elderly lady's life. Monks, miles away and unable to see the victim, had only pulse rate and blood pressure to go on. These, together, suggested that a heart block might be the only thing keeping her alive. Adenosine would remove it.

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