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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“I never heard a word about any of those attacks,” Nick said.

“You didn’t hear about them in the news because they never happened. The information we… extracted from Mohammad kept them from happening.”

“You didn’t extract information from him, Ramsland. He gave it to you. We didn’t capture him like the news said. He gave himself up. He gave the information to you in exchange for my friend’s life. You cut a deal with him. Public, high-profile death-the ultimate disappearing act.”

“You know as well as I do that the United States does not negotiate with terrorists. We capture them and learn what we can through due process of law, abiding by whatever protection the Geneva Convention grants these monsters.”

“That’s bullshit and you know it, Ramsland. You don’t play by anybody’s rules but your own. It was a trade-pure and simple. If you want me on your side, then at least tell the truth. That’s the best starting point.”

Again Nick made a cautious glance over at Koller. The killer appeared as though he were enjoying the banter, despite his hearing only half of the conversation. The pistol was no longer pointing at the center of his chest.

Good. Lower your guard just a fraction. That’s what I need .

“Rules are what keep men like me from making a real diff erence in the world. We’re all walking contradictions, Nick. In Afghanistan you patched up soldiers just so we could put them back in theater again. We don’t torture prisoners. All we do is use every means to make them give us information they don’t want to share. If promising them something they want will get that information out quicker and more completely, that’s a road worth considering. Don’t you think?”

“I suppose so.”

“Do you think we enjoy trading soldiers like your friend Umberto? Of course not. But men like us know our duty as patriots is to act. We do so to save lives, just as Truman traded one set of lives for another when he sent out the Enola Gay . That’s the nature of war, Nick, and you know that as well as I do.”

“I’m beginning to understand.”

“I hoped you would. You’ve suffered a great deal for the cause.”

Nick continued to shake on the inside. His stomach was churning. Still, with Koller watching his every step, gun at the ready, he managed to keep a calm demeanor.

Nick marched back and forth in front of the workbench, willing himself to look on occasion at Mollender’s and Noreen’s bodies, now using that emotion to help fuel his resolve.

Soon , he thought.

“What is it you want from me?”

“I want you to cooperate. Give the DVD to my associate. Forget about Umberto. Forget about your friends here. Focus on yourself for a change, Nick. How involved is Ms. Coates?”

Nick felt a new flash of anger rip through him.

“You leave her out of this!”

“Maybe we will. Maybe; it all depends on you. You see, I can trust you if you say you’ll do something. Know why?”

“No, tell me.”

“Because I know everything. I know what people think. I know what they say before they even say it. I know when they break with my program. You could have asked your friend Phillip MacCandliss.”

“MacCandliss? What’s he got to do with this?”

“Nothing, now. You see, he went against his country. That’s when we had Mr. Koller pay him a visit.”

“You’re a sick, sick man.”

“Don’t feel sorry for MacCandliss, Nick. You can thank him for bringing us Umberto. And true, your friend was the right profile for our mission, but I also knew how much MacCandliss despised you. Umberto was his pathetic little way of beating a man that he couldn’t beat on his own.”

Nick clenched the phone, wishing he had the strength to crush it into tiny pieces. He closed his eyes, counting backward to slow his pulse. Turning his back to Koller, he leaned up against the workbench. For his plan to succeed, he had to get the killer even closer to him. Keeping his hands out of the assassin’s line of sight, Nick hoped it would be enough of a lure to get him to move for a better angle. In seconds, Koller had changed position, crossing the room and moving diagonally toward the bench.

“I don’t believe MacCandliss had anything do to with Umberto’s death,” Nick said.

“And I don’t care,” Ramsland replied. “Believe what you want. Both are dead. But you still have a choice. Give us the DVD and your pledge to be a patriot, and we’ll see about letting you move along with your life. Ms. Coates, too.”

“By patriot, you mean silent.”

“Call it what you will. We’re soldiers, Nick. You and I. I felt I owed you a chance.”

Koller was in the best position possible, directly to Nick’s right. Nick had served Ramsland’s purpose by even considering going in with him. There was absolutely no chance he was going to be allowed to survive this day.

Now! Do it now! Nick thought.

His senses were heightened by another intense surge of adrenaline. The pungent, coppery stench of blood, noticeable before, was now overpowering. Koller’s empty left hand was the target. There was no way to get at his pistol.

Panic is not an option , Nick was thinking, remembering his days in the OR. Panic costs lives .

He silently repeated the mantra, while praying Koller had not noticed his hand inching closer toward the tool bucket.

With Ramsland still on the line, Nick set the phone down on the middle of the workbench. His pulse was hammering in his throat. Chances were he was about to die.

“He wants to talk to you,” he managed.

Koller kept his weapon level. As his left hand moved to pick up the phone, his eyes left Nick for perhaps a second. It was just enough time.

The nail gun’s bright orange handle stuck out of the tool bucket holster like an outlaw’s six-shooter. It was a cordless model, not the compressor type Nick had used in his early teens to help his father frame a modest addition on their house.

The magazine on the Paslode gun was designed to be easily visible. Nothing upset a framer or roofer more than running out of nails mid-job. Nick had already noticed that the tool was full with what looked like three-inch nails. If the battery was charged, he had a chance. If not, he hoped it would be over quickly.

Koller’s gun hand dropped several inches as he looked down to locate the phone. In that moment, Nick went for the nail gun. Koller saw movement, but turned his head just before he raised his pistol. In that instant, Nick snatched the nail gun out of its holster and in a continuous motion drove the tip into the back of Koller’s hand with all the force he could muster.

There was a sharp pop, followed by a geyser of blood from the spot. Simultaneous with the sound, Nick heard the cracking of bone as the nail plowed through skin, then metacarpal, then nerves and muscle, and finally through skin again. The shaft shot down its full three inches, exiting the palm and entering the wood, impaling the killer’s hand onto the workbench.

Koller’s feral scream was more surprise and rage than agony.

Nick dove for the floor, clutching the nail gun with both his hands as he hit. He was positioned directly beside Koller, and hoisted the nail gun again, this time driving the steel nail into the top of Koller’s shoe. Koller’s scream, louder this time, reverberated throughout the office.

Run! Nick yelled to himself. Run now!

Koller remained cool enough to work his hand free and turn to shoot. The bullet tore through Nick’s upper right arm with the sensation of touching a hot stove. A second shot missed.

Crouching, Nick charged toward the windows, zigzagging sharply. He had considered the stairs, but those were to his back and turning around would have cost seconds he didn’t have.

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