Michael Palmer - The Last Surgeon

“Who would have done this?” Nick asked aloud. “It’s hard to believe his death was unexpected. There was no damn cardiac tumor. What we witnessed was an execution-a lethal charade that amounted to the ticket to freedom for Aleem Mohammad. I’ll bet that bastard was thousands of miles away when Umberto died.”

“A very public execution,” Mollender said. “The ultimate witness protection hoax.”

“That’s horrible,” Noreen said.

“Belle must have been unable to let matters lie,” Jillian said. “Maybe she’s the only one who heard and understood what Umberto was screaming. Maybe she said the wrong thing to the wrong person.”

“What we just saw ties Umberto to the Singh Center,” Nick said. “Poor Manny Ferris, too. Maybe Manny was the one who was supposed to be on that operating table, but something about his plastic surgery didn’t work out. They couldn’t make him look enough like Mohammad to pull off the switch.”

“Possible,” Nick said. “If he were partway through a sequence of surgeries, that would explain Manny’s appearance. Listen, I know it’s painful to watch, but we might have missed something important in the initial viewing. I need to watch the operation again and maybe again. You guys don’t have to.”

“I’m in,” Jillian said. “I’m feeling stronger than I have since Belle died.”

“Noreen?” Mollender asked.

“I don’t know what help I could be, and I’m really shaken up,” she replied, “but if the solidarity will help, I’ll try.”

Noreen and Mollender stood beside Nick and Jillian, forming an arc in front of the television. Then they took their seats and Nick pressed Play. Out of the corner of his eye, Nick observed Mollender take hold of Noreen’s hand as the first images of the operating room appeared. They watched the video twice through, until Jillian broke down crying and Nick felt his own eyes begin to well. Finally, Jillian excused herself from the room-to clear her thoughts, she explained. Noreen decided to go with her. Of the four of them, Mollender seemed to be the most composed, although it was clear that he too was affected.

“You okay to see it once more?” Nick asked.

“It’s easier to take if I keep telling myself it’s only a movie.”

This time, at the moment just before Umberto’s death, Nick paused the disc. Using the remote control, he advanced the video a single frame at a time, then back and forward once more.

“Umberto grabs his head here,” Nick said, tapping his finger against the television screen. “It’s as though something erupted in his brain. I haven’t actually witnessed an aneurysm bursting in someone’s head, but a rupture like that is accompanied by a sudden, massive increase in volume within the skull. The victims experience a blinding headache, which he showed signs of having, but he wasn’t vomiting from the huge increase in intracranial pressure. A seizure is typical, too, but he didn’t have one of those either. The whole thing with Umberto took no more than a couple of minutes from beginning to end. I don’t know what else it could have been besides a ruptured aneurysm, but something seems off to me.”

“Are you suggesting that someone might have done this to him?” Mollender asked, just as Jillian and Noreen returned.

“I don’t know. All I keep thinking is that the surgeon could never have been allowed to open Umberto’s heart to operate because he didn’t have anything wrong with it. No tumor. Nothing. If their plan was to have it look like Aleem Mohammad died on the table, it had to happen before his actual operation. That means someone had control of the situation the whole time.” Nick turned to Jillian. “I think Umberto was killed right there. It looks like an aneurysm, but I don’t believe it was. Someone did something to him-to his brain. Otherwise, they would have operated on his heart and found no tumor.”

“But what about the tests?”

“Tests can be faked. The surgeon could have been brought in to do the case on the basis of someone else’s MRI. The people who did this are no amateurs, and I would bet they have technology available to them that the average man or even doctor knows nothing about.”

“So, who do you think is responsible?”

Nick’s anger was pulsing through him now, driving his thoughts. Pieces of the mystery surrounding Umberto were falling into place almost too rapidly for him to integrate them.

“You mean what person is responsible,” he said. “Or what government agency with three letters beginning with a C , that just happened, at least according to the papers, to be pumping information from one Aleem Syed Mohammad.

“Noreen,” Nick asked, more energized perhaps than at any time since Sarah’s death, “do you have a large piece of paper and something to write with?”

She left the room, returning moments later with a flip chart and several markers. Freezing the list of those in the OR, Nick transcribed it to the flip chart in a two-column format.

Dr. Abigail Spielmann-Surgeon : Dr. Yasmin Dasari-Olan-Surgical Resident

Dr. Lewis Leonard-Asst. Surgeon : Cassandra Browning-Leavitt-Circulating Nurse

Dr. Thomas Landrew-Anesthesiologist : Yu Jiang-Medical Student

Roger Pendleton-Perfusionist : Belle Coates-Nursing Student

Kimberly Fox-Scrub Nurse :

“What are you doing?” Jillian asked.

“These are the people who were in the OR that day. I noticed something on that last viewing, but I need to confirm it first. Jillian, I have to play some of the video again.”

“It’s okay. I can handle it.”

He located a shot that contained a full view of the room.

“There are ten people in the OR, not counting the patient,” Nick said. “There are nine names on this chart. I noticed the tenth man when he helped wheel Umberto in. There were two of them, actually. One left, and he stayed.”

“I remember,” the Mole said. “The one who left was quite a bit taller.”

“Exactly. I thought maybe the two of them, or at least this guy, were from security. That made sense at the time. But take your eyes off of Umberto and keep them fixed on the tenth man.”

Once again, Nick had the strange feeling of having seen the heavyset man before. He appeared quite a bit in the view from the camera above the foot of the narrow table. Not once during the terrible commotion surrounding Umberto’s death did he move from his spot-not so much as an inch to get a better vantage point or to help. This time through, Nick also noticed that, unlike Belle, the medical student, the perfusionist, or the anesthesiologist, the tenth man was wearing a surgical gown. In addition, he kept his hands inside the gown throughout the grisly ordeal.

Nick’s pulse was hammering. He ran the DVD again, and then once more. His eyes remained fixed on the man. At the instant the team finished transferring Umberto from the gurney to the operating table, Nick paused the playback, backed up a few frames, and then walked it forward again, his focus intensifying with each advance.

“There!” Nick exclaimed. “Did you see it? His hands stay underneath his surgical gown while Umberto is going through whatever it was that killed him. And look at his eyes. He is like dead calm.”

“You think he has some sort of device under there?” Mollender asked. “Something that could fry Umberto’s brain or burst an artery?”

“Maybe they had implanted some sort of radio receiver in there. Poor Umberto had multiple procedures done at the Singh Center. One of them certainly could have been that.”

For a time, there was only silence as each of the other three-Mollender, Noreen, and Jillian-mulled over the awesome possibilities. Finally, Jillian spoke.