The Organ Takers (McBride #1) Preview Page

 

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“Robin Cook fans will relish this taut and powerful medical thriller set in Manhattan … Van Anderson makes good use of his own medical training in the service of a superior page-turner.” —Publishers Weekly (starred review)

 

“In this engaging novel, the author wields dynamic characters and intelligent prose like a skilled surgeon’s instruments.” —Kirkus Reviews

 

“Richard Van Anderson’s experience as a surgeon at the UW Medical Center gives him the ability to write a convincing debut thriller. The Organ Takers focuses on the moral failings and sociopathic behavior of corrupted medical practitioners. The verdict: Read if you like surgery and a standard thriller, but do not expect to trust your doctor after reading this.” —The Daily at the University of Washington

 

 

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About the Story

Failed surgeon David McBride is in exile from the surgical community after making a costly error in judgment. Down but not out, he perseveres and is given a second chance to establish a career in surgery. But, as David stands on the threshold of a new life, the malignant underside of his fellow man intervenes. Under the threat of violence, David is forced to perform illegal organ harvests in a makeshift operating room hidden in a dilapidated meatpacking warehouse in lower Manhattan. Unable to resolve the excruciating moral dilemma faced each time he invades the body of an unwilling victim, David fights to free himself from the situation and in the process, loses everything. When he finally loses the last shred of his humanity, he seeks revenge with surgical precision … and instrumentation.

 

 

                                                The Inspiration

During the mid- to late-nineties, an email-propagated urban legend firmly took root. The emails served as a warning to travelers and described how a well-organized crime ring had set up shop in major American cities. This ring, according to the senders, was using seductive women to drug business travelers in hotel bars (and in a later iteration, Vegas gamblers) in order to lure them upstairs. The victims, as was detailed in the emails, were waking up in hotel bathtubs full of ice, with surgical incisions on their sides, and notes scrawled in lipstick—either on the mirror or across their chests—telling them to call 911, their kidneys have been stolen.

 

The rumors were investigated by various law-enforcement agencies to no avail, and later debunked by the National Kidney Foundation and the United Network for Organ Sharing. As a surgery resident in the 90s, I found these rumors to be fascinating but implausible. I had performed kidney transplants and concluded that excising a human organ in a hotel room would be very difficult if the surgeon wanted the patient to live, and there is no reason to submerge a postoperative patient in ice. The core temperature drops. The heart fibrillates. The person dies.

 

In 1999 an ad appeared on eBay, advertising a human kidney for sale. Bids reached nearly six million dollars before the ad was removed. It may have been a hoax, but the frenzied bidding demonstrated that there were individuals who were willing to pay millions of dollars for a life-saving organ. A few years later I found an article in the New York Times that documented the sale of a kidney by a Brazilian slum dweller to an American woman. The article also described a thriving international black market for human organs.

 

About this time I was ready to write my first novel, and having followed the organ-theft stories for a number of years, I had a ready-made premise: somebody will steal kidneys from a downtrodden group and implant them into rich individuals who are too sick or are unwilling to languish on the transplant waiting list. The end result is The Organ Takers. The story merges fact with fiction to bring the organ-snatcher legend to life. Storylines are drawn from medical topics of both ethical and economic importance, including human organ trafficking, transplant waiting list abuse, tissue engineering and organ fabrication, and human stem-cell research.

 

 

Read an Excerpt

 Chapter 1

Fate, indifferent to the suffering of men, had dealt Michael Smith a bad brain. But it was his fellow man who went beyond indifference, who conspired against Michael without conscience, who stripped him of his humanity when they violated his body for their own gain and on a frozen January morning, discarded him as if he were a bag of trash. It was his fellow man who left him in a dark alley in Midtown Manhattan, left him to wake up alone, freezing under a wool blanket, a pain in his side, a severe pain he didn’t have before. Before what? Before when? He couldn’t remember. He had lost a chunk of time somewhere.

He tried to sit up. A ripping sensation tore through him. He screamed, clenched his eyes tight and lay there, balled up like a fetus. He must’ve been stabbed, may be bleeding to death. He fumbled with the zipper on his coat and felt his shirt.

Dry.

He went limp with relief, probably a broken rib. He’d cracked one a year ago and it hurt like hell, but not this bad. Maybe he broke two. He put his hand on the ground and tried again to push himself up, made it this time, sat against the wall with legs drawn up and breath held, tears streaming down his face. It felt as if someone had taken a swipe at him with a sword.

After several moments he relaxed, took a shallow breath, and another, then lifted his head and looked around. He was deep in the alley. To the right, a dead end. To the left, the open end. An overflowing dumpster blocked his view of the street. He tried yelling for help but choked on the pain. He listened for cars passing or people talking but heard nothing. New York City was quiet, like three a.m. quiet. He was on his own.

He carefully touched his ribs, feeling for a bulge. There was something there, but it was soft and didn’t hurt. He blew into his hands, opened and closed them a few times and worked the buttonson his shirt, struggling with numb fingers. Not much light, but he could see a bandage taped to his side. White gauze. White and clean like the brightly lit room. He’d been strapped to a bed. For hours? For days? People in hooded baggy suits had done things to him, monitored him with instruments, mumbled but never spoke. He peered at the gauze with dread.

Wide strips of tape secured it in place. Using his thumbnail, he peeled up a corner and pulled. The skin tented up, felt like it was going to rip. He let go, rolled up more of the edge, pinched it tight and yanked.

He blinked, squinted, struggled to focus through the tears and murky light, and what he finally saw drew a wave of nausea up from the pit of his stomach. He shut his eyes and fought the urge to vomit. The pain caused by heaving would be unimaginable. His mind raced, tried to comprehend, but what he had just seen was incomprehensible. Staples. A line of them starting on his side and disappearing around his back.

When he looked again, he saw a long cut stapled together the same way the ER doctors had fixed a gash on his leg some time ago. Con Edison. They did this. They’d been following him for years, their blue vans and trucks parked all over the city, everywhere he went, watching him, the men in hardhats peeking out of manholes, cameras and listening devices hidden in their steam stacks. The baggy suits in the white room were blue like the Con Ed trucks. They had implanted a tracking device inside him. Now they’d be able to follow him without all that equipment. He had to get to Bellevue. Whatever Con Ed put into him, the Bellevue doctors would take it out. He buttoned his shirt and zipped his coat. If he could stand, he could get to the street. If he could get to the street, he’d find help, or help would find him. He shuffled his feet under him, put a hand on the cold ground, and clutching his side, he stood.

He tried to stand up straight. Pain doubled him over. He teetered backward, his butt hitting the wall, then felt dizzy and nearly toppled forward. He waited a moment for the dizziness to clear, then slowly straightened and took a step, then another. Every movement sent ripping jolts through his midsection, and after four or five steps he stopped, the pain intolerable, the shivering uncontrollable. He wanted to sit, but he’d never get up.

He made it to the mouth of the alley and leaned against the corner of the building. Except for a plume of steam rising from a manhole cover, the street was empty. No Con Ed trucks, no steam stacks. Lights were on in some apartments, but the buildings all had stoops. He tried yelling for help, but the effort was feeble. He looked up and down the block, to the Avenues at either end, but he had nothing left. Time to give up.

He relaxed. The shivering eased. His eyelids drifted shut.

A clatter startled him awake. A flurry of yellow cabs passed through the intersection to his right, a hundred feet away. If he could just get there …

He staggered up the sidewalk, his legs heavy, then heavy legs became dead weight, and black curtains lowered over his eyes. As he fell, he reached for the rail at the base of a stoop. He missed, smashing his face into the steps.

 

Chapter 2

The ambulance pulled away from the all-night diner and drove south on Lexington. Traffic was light—garbage trucks, delivery trucks, taxicabs. Paramedic Tom Burnett steadied two cups of coffee as his partner, Freddy Ramirez, maneuvered the box-shaped vehicle around the potholes at 34th and Lexington. They were headed for Bellevue Hospital, their home base.

They turned left onto East 26th Street, then crossed Third Avenue. As Burnett sipped his coffee something caught his eye. He snapped his head to the right, but parked cars blocked his view. He spun to look out the rear windows, but the glass dripped with condensation. “Did you see that?” he asked Freddy as they crossed Second Avenue.

“See what?”

“A body on the sidewalk.”

“Probably a homeless dude sleeping one off.”

“Doubt it. When it’s this cold, homeless dudes find a shelter or die. Besides, he’s face down with nothing covering him.”

Freddy switched on the flashing lights and circled back. Moments later they were inching along East 26th.

Burnett pointed. “There, by the trash cans.” He radioed their status as Freddy parked, then they hopped out, unloaded the gurney and equipment, and trotted up the sidewalk.

The man seemed homeless—ratty clothes, tangled hair—but he wasn’t sleeping one off. His arms and legs were splayed as though he’d lost consciousness first, then fallen. Freddy dropped to his knee and pressed his fingers into the man’s neck. “Weak pulse. Let’s log roll him.”

They threw on latex gloves and tucked the man’s arms by his sides. Freddy crouched above the head and held it like a basketball. Burnett knelt down and grasped the shoulder and hip. The move required perfect coordination. If they rotated the torso before the head, or the head before the torso, a fractured cervical spine could slice through the spinal cord. They had no idea what had happened, so they had to assume spinal injury until proven otherwise.

Freddy counted, and on three they rolled the man onto his back. Congealed blood covered his face. A jagged laceration extended from the left eyebrow to the hairline. They’d worry about that later. Right now, the A, B, C’s of trauma resuscitation—airway, breathing, circulation—had priority.

Freddy unzipped the man’s jacket and put a stethoscope on his chest. “He’s breathing, but his respirations are agonal.”

Burnett opened the equipment box, handed his partner a laryngoscope and an endotracheal tube. On his first try, Freddy slid the plastic tube between the vocal cords and into the trachea. He inflated the seal, attached the oxygen bag and started squeezing.

Burnett slipped the man’s arm out of his jacket and checked his blood pressure. “Sixty systolic. We need to get some fluids going.” He tied a tourniquet above the elbow and tapped the fold of the arm. No veins, the dim light not helping. He stabbed blindly with a large-bore IV needle. Nothing. Changed the angle and tried again, and a third time. There, a red drop from the end of the needle. He advanced the catheter into the vein, connected the tubing and started the IV fluid wide open.

After a few minutes, Burnett checked the pressure. “Ninety systolic. He likes the fluid. I’m gonna hang another liter and we should scoop and run.”

“No primary assessment?” Freddy asked.

“We’re a block away. Let the ER docs do it.”

With the A, B, C’s established—the patient had a stable airway, Freddy was helping him breath, the blood pressure was rising—immobilization and transportation was now the priority. Burnett placed a C-collar around the neck to immobilize the cervical spine, then strapped the man to a backboard to stabilize the thoracic and lumbar spines. Using the backboard, they lifted him onto the gurney, pushed the gurney to the ambulance and loaded him inside. Burnett climbed in, attached the heart monitor and took over the oxygen bag. Freddy jumped in the driver’s seat and headed for Bellevue, lights flashing and siren blaring.

Burnett bagged with one hand while patting the man’s pockets with the other. No wallet. No surprise there, but in the left front, something hard and flat. He slipped a finger into the pocket, hooked a ring and pulled it out. Burnett braced himself as Freddy laid on the horn and turned sharply onto First Avenue. Once the ride settled, he opened his hand to find a piece of plastic, about two inches square, a key ring with no keys. Inside the plastic, a head-and-shoulders photo of a young girl. She appeared to be eight or nine, had pigtails, a missing tooth and wore a frilly dress with a lacy bow tied at the neck. On the back it said, “Third Grade, October ’99.” Given to her father at a time when he needed a key ring. Burnett thought of the trinkets and keepsakes his young daughter had given him, and now, the dirty and feculent-smelling man was no longer human waste. He was somebody. He was a father.

They wheeled the man into the ER. The waiting area overflowed with homeless people, many faking illness to get out of the cold. More lay on stretchers lining the hallway. As they passed the triage desk the nurse hollered, “Trauma One, guys. Any ID?”

“A John Doe,” Burnett said.