Michael Palmer - The Last Surgeon

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The New York Times bestselling author and master of medical suspense delivers another shocker of a thriller filled with insider details and a terrifying psychopath
Four murders.
Three accidents.
Two suicides.
One left.
THE LAST SURGEON
Michael Palmer's latest novel pits a flawed doctor against a ruthless psychopath, who has made murder his art form. Dr. Nick Garrity, a vet suffering from PTSD – post traumatic stress disorder – spends his days and nights dispensing medical treatment from a mobile clinic to the homeless and disenfranchised in D.C. and Baltimore. In addition, he is constantly on the lookout for his war buddy Umberto Vasquez, who was plucked from the streets by the military four years ago for a secret mission and has not been seen since.
Psych nurse Gillian Coates wants to find her sister's killer. She does not believe that Belle Coates, an ICU nurse, took her own life, even though every bit of evidence indicates that she did – every bit save one. Belle has left Gillian a subtle clue that connects her with Nick Garrity.
Together, Nick and Gillian determine that one-by-one, each of those in the operating room for a fatally botched case is dying. Their discoveries pit them against genius Franz Koller-the highly-paid master of the 'non-kill' – the art of murder that does not look like murder. As Doctor and nurse move closer to finding the terrifying secret behind these killings, Koller has been given a new directive: his mission will not be complete until Gillian Coates and Garrity, the last surgeon, are dead.

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“Parker. I drop in at Parker every day.”

The doctor sounded curious, but not suspicious, Koller decided.

“Couldn’t have picked a better morning, eh?” the killer replied with a chuckle.

Drenched from ocean spray, Landrew’s silver hair escaped in spots from underneath his REI baseball cap. His distinguished good looks and best-that-money-could-buy gear were, Koller thought, a perfect compliment to his type A personality.

“If you like fog, you’re certainly getting the most out of the experience,” Landrew said, sounding just a bit rushed.

“I certainly am,” Koller agreed. “Mind if I anchor against your boat for just a moment? Mine’s pretty unsteady in these swells and I want to secure my dry bag.”

“I… suppose so.”

Okay, time’s up.

Koller pulled his craft alongside Landrew’s, which was downwind and closer to the lighthouse. The mark, seeming slightly annoyed now, leaned over to help steady the other boat. Oh, how Koller loved it when his mark helped him to make the kill. The lighthouse, as he anticipated, shielded both men from the steady roll of waves, benefiting him with additional stability. The classic Three Dog Night song “Joy to the World” popped into his head and brought an audible chuckle.

“What’s so funny?” Landrew asked.

“This is,” Koller said.

With serpentlike quickness, he tipped his kayak to starboard, giving him the additional inches he needed to reach the base of Landrew’s neck, focusing on a spot next to the spine. In virtually the same motion he drove the needle deep into the man’s trapezius muscle and depressed the plunger, dispensing the sux. He pushed a few feet away and watched with undisguised delight as the nature of the attack registered in his victim’s patrician face. Koller knew that beneath the man’s Patagonia jacket, Landrew’s muscles were already beginning to fasciculate-the individual fibers twitching and wriggling like so much spaghetti.

“What’s wrong?” Koller asked with a grin. “Ocean beauty leave you breathless?”

“Why?” the physician pleaded, fumbling with his paddle but getting nowhere.

“You all ask that same question,” the master of the non-kill replied. “Why is that?”

Then he laughed out loud.

With the sux working its magic, Landrew was motionless inside his kayak. His eyes were alert, though frozen in a horrified stare.

“Hey, fish got your tongue?” Koller asked, and laughed even louder.

Landrew’s body, still upright, began gently moving from side to side, lolled by the waves passing beneath his craft.

“Yes, that’s the effect of your old friend sux,” Koller said. “How many times in the OR have you used it on others? Hundreds? No, no, thousands. I’ll bet you can feel your heart racing in a desperate effort to get oxygen to your brain. Don’t bank on your brain winning that one.”

Landrew’s eyes remained fixed. Koller paddled forward and gripped the gunwale of the man’s boat.

“You’re a world-renowned anesthesiologist, Doctor,” Koller continued, “but I’ll bet I know succinylcholine as well as you do. Rapidly metabolized depolarizing neuromuscular blocker. Onset of action less than one minute. Half-life less than one minute. Breakdown product, succinic acid, won’t be looked for-especially not in a drowning victim. And yes, even if you can’t inhale, water will still get into your lungs passively, just from being submerged for an hour or so. So, who’s the expert? Ah, but there’s more.”

Koller reached into his dry bag and took out the hammer.

“I still needed to figure out how you were going to drown while wearing a life preserver,” he went on. “Want to guess how? Speechless? I understand. Okay, I’ll tell you, just like the police will tell the good widow Landrew. There was an accident, you see. A wave flipped your boat, or maybe you fainted from an irregular heart rhythm. Either way, you fell out of the kayak and tried your best to get back in. But then, gosh darnit, wouldn’t you know the kayak flipped over from a wave and the gunwale came snapping down onto your head. The blow knocked you unconscious. Floating facedown in the water, kept there by your life jacket, your lifeless body came to rest amidst those rocks over there.”

Landrew’s eyes remained open, but Koller knew he was already dead. He removed the REI baseball cap and tapped the hammer against the man’s scalp until blood oozed out from a small gash. With his gloved hand, Koller rubbed blood from the wound against the gunwale of the corpse’s boat, augmenting the smear with strands of hair ripped from Landrew’s scalp. He then loosened the spray skirt before flipping the kayak over, spilling the lifeless body into the sea.

“Nobody does it better,” Koller sang softly. “Makes you feel sad for the rest.”

He watched until the current carried the body and boat against the boulders at the base of the lighthouse.

Then, with several powerful strokes, he turned his kayak west and disappeared into the morning fog.

“Nicely done,” he said to himself.

CHAPTER 16

It was lunch hour. A steady flow of employees poured out from the Veterans Administration Benefits building, off to grab something to eat. Reggie Smith watched them leave from his position behind a hot dog pushcart on the other side of Vermont Avenue. Strolling leisurely to the next streetlight, the gangly teen crossed the road, then waited until another group had exited before entering the building. Junie and Nick had dropped him off a block away and were waiting there in the car.

The youth was only fourteen, and that worried his foster mother greatly, but he was physically ahead of the curve and had a survivor’s wiliness born of his disjointed upbringing and several stretches in juvenile detention. Barring anything unforeseen, he had assured her, he would be okay.

Junie and Nick had misgivings.

Reggie was five and already in foster care when his remarkable sense of computers began to manifest itself. Initially, he was deemed cute and precocious, but that was before age seven when he began charging video games and CDs to his foster parents, intercepting the shipments to the house, and storing the booty beneath the clothes in his bureau drawer. By age nine he had been caught hacking into the computer at school and changing grades. By eleven, when he moved in with Junie and Sam, he had made another trip to juvenile detention for shoplifting and for frivolous, but disruptive, cyber crime.

“Reggie has the potential to change the world… or to rule a cell block,” the judge had told his new foster parents.

With the Wrights’ steadying hands on the tiller of his life, and Nick’s role as a big brother, the boy was headed in the right direction. Junie’s rationale in asking him to become involved in the search for Manny Ferris was that no one would be hurt, and someone they both loved would be helped. In all her years as a foster parent, caring for God only knew how many children, she had never used a kid or put one in harm’s way as she was doing with this boy. But Nick was increasingly desperate to find Manny Ferris, and Reggie Smith, with an IQ measured in the 150s, was no ordinary teenager.

There was no metal detector. From yesterday’s visit to the building, Reggie knew the lunchtime crowd would distract the lone security guard, making it easier for him to pass by. He was dressed conservatively, in tan corduroy pants and a blue collared shirt, over which dangled a perfect replica of the building’s visitor badge.

Skipping yesterday’s biology class, he had ridden into D.C. with Junie and spent several hours observing people and walking up and down the granite steps to the main doors. Using his cell phone camera, he snapped several quality shots of the building’s visitor badge. It took him half the night to tweak the forgery using Photoshop, but before first light he printed his masterwork, then had it laminated at a nearby Kinko’s. It was virtually indistinguishable from the badge he had photographed, right down to the slight color fade and scratches on the laminate.

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