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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“ ‘Some years ago, after the death of my oldest son, I grew extremely weary of war and of the jihad. For reasons that will become clear to you, I sought out Mr. Lionel Ramsland of the CIA, and he agreed to meet with me.

“ ‘My capture by U.S. forces was arranged, and I was transferred from the American military to the CIA. Over the next year, my appearance was totally altered by a number of plastic surgical procedures performed by Dr. Paresh Singh. At the same time, two men with bone structures similar to my own were chosen to be made to look exactly as I did before my surgeries. In the meanwhile, medical evidence was created showing that I was dying from a rare cardiac tumor.

“ ‘It is my understanding that my doubles were brainwashed with very sophisticated methods, and taught to speak enough Arabic to converse with people, and in particular with the physicians who would be caring for me.’ ”

Nick glanced behind him to the second row from the back, where Bill Pearl, wearing his trademark black suit and dress shirt, was sitting next to Manny Ferris, who looked remarkably well in a tan sports coat and tie. Thanks to Jillian, Manny had begun a series of plastic surgery procedures designed to reverse the disfiguring that had resulted from his escape from the Singh Center. In addition, a team of therapists from Shelby Stone had been deprogramming him and treating his PTSD. According to Jillian, progress was slow, and there was some doubt among his treaters as to how far back Manny could make it. But no one was inclined to stop trying.

“ ‘After a year,’ ” Conklin continued, “ ‘my perfect double was sent to the operating room at Shelby Stone Memorial Hospital, where he died before the operation could be performed. By that time, I was safely ensconced in the country and the home where I am living now. In exchange for my life, I fed a great deal of legitimate information to Mr. Ramsland regarding various activities of the groups you refer to as terrorist.

“ ‘Mr. Ramsland came to see me every couple of months and pumped me with more questions. After three years, Mr. Ramsland resigned to pursue his political ambitions. His replacement, Mr. Arthur Senstrom, began visiting me. But on the second visit, he made the mistake of telling me that the operation in which I allegedly died had been recorded. I, of course, demanded to view the recording. As you will learn, I had the leverage with Lionel Ramsland to make such a demand.

“ ‘The recording showed me sitting up before my surgery in great distress, screaming in Arabic and in Spanish for a man named Dr. Nick Fury, then collapsing and dying from a device that I am certain was triggered by Lionel Ramsland, who was in the room. Clearly, the others in the operating room that day heard the same thing I did. It was my feeling that so long as they were alive, my safety and security would be in jeopardy. I met with Mr. Ramsland, and he assured me he could and would take care of the matter in such a way that no one’s attention would be called to the operation. Further, he promised that all copies of the recording would be destroyed. As far as I know, Mr. Ramsland kept his promise in that regard.’ ”

William Conklin set the transcript aside and folded his hands. The packed hall was deathly silent. All eyes were fixed on Lionel Ramsland, who sat rigidly erect and looked to Nick as if he were going to launch into a tirade of self-justification and patriotism, similar to the one he had spewed at Nick in Noreen Siliski’s office.

This time, the silence held. There was no need for Blackstone to gavel for order. There was one unanswered question, and the room was waiting for the senator from Missouri to ask it.

“Assuming what we have heard is true, Mr. Conklin, this is a terrible, terrible revelation, and I am sure that all who have heard it are as stunned as I am.”

Ramsland could stand matters no more. He leaped to his feet and shouted, “There are two sides to every story! I saved lives, hundreds of lives! Thousands of lives. This is war, Senator! War! Young American soldiers are being killed every day!”

Blackstone’s gavel thundered down again and again. Bailiffs rushed over to silence Ramsland, who had lost all composure and was now an apoplectic crimson. His lawyer whispered harshly into his ear. Meekly, he sank back into his chair.

“Mr. Conklin,” Blackstone said finally. “Is that second tape going to further enlighten us as to just what this so-called leverage was?”

“It will, Senator, but it is more than an hour long.”

“Can you paraphrase it for us?”

“I can, sir.” Conklin adjusted his notes. “It is a conversation that occurred six years ago in Karachi, and was secretly recorded by Aleem Mohammad. The meeting was instigated by Lionel Ramsland. In it, Ramsland promises Mohammad the delivery of a large cache of untraceable weapons, mostly Russian in origin, as well as five million dollars in untraceable cash in exchange for the death of Mr. Ashai Bayoumi, the Egyptian foreign minister, who was openly anti-American. Ramsland then promises to inform Mohammad of the precise time and place when Mr. Bayoumi would be at prayer. Our intelligence shows that a month later, that small mosque was blown up, killing Bayoumi and a dozen others. Neither I nor anyone else at the Agency had any knowledge of such a deal being made.

“It was Mohammad’s possession of that tape that led him to contact Lionel Ramsland regarding his desire to pass on vital information to Jericho, and then to have his death staged. That tape, which we have here, has been the leverage-the dead man’s switch if you will-that Mohammad has used to insure his own survival.”

Again, Ramsland was on his feet, screaming. “Dispensing of Bayoumi kept Egypt from forming alliances with several terrorist groups! Thousands of lives were saved! Thousands.”

This time, the chambers were in chaos.

Helpless, Blackstone gaveled the session to a close. But few heard him. Everyone seemed to be running at once, wedging through the double doors.

Ramsland was surrounded and led away.

As Ramsland and the bailiffs neared the exit, Nick felt certain the man turned and glared at him.

At last.

For a time after the room was nearly empty, the six of them-Nick, Jillian, Reese, Junie, Reggie, and Bagdasarian-remained silent in their seats.

“I thought it would feel better than it does,” Nick said finally.

“How could it?” Jillian replied. “Dead is dead. Ramsland will go to his grave believing that what he did, the good, innocent people he had killed, was in the best interests of the country.”

Again, there was a pensive silence.

“Well, I think we’ve all heard enough for one day,” Reggie said suddenly. “Can we go home?”

“Not only can we,” Junie said, “we should.”

“In the limo?”

“In the limo, my friend,” Nick echoed.

EPILOGUE

Thanksgiving dinner at the new headquarters of the Helping Hands Foundation was at once joyous and bittersweet. The broad rented table in the waiting room was piled high not with food but with boxes of food, prepared by volunteers and supervised by Jillian. Board and staff members set up a human chain to pass the boxes to a waiting line of patrons. Sam Wright and the Levishefsky twins worked alongside members of the Washington and Baltimore professional sports teams handing out the turkeys. The mayor was there, shoulder to shoulder with Reggie, and Nick’s PTSD students were there in force and unusually good humor.

“Hey, Nick,” Matthew McBean called across the room. “I think my SUD score is a three today. Seeing all these people outside makes me so appreciative of what I have that I’m having trouble feeling lousy.”

Nick smiled at his friend. Since the death of Phillip MacCandliss, a number of the former enlisted men had gotten the benefits that had previously been denied. Several more had gone back to work and one, Eddie Thompson, had actually gone to work for the VA.

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