The Bone Thief (Body Farm 5)

The nurse was tugging her helmet back onto her head. I was about to say that we were fine when an agitated voice cut in. “LifeStar One, LifeStar One, this is Flight Control, do you read?”

“Control, LifeStar One reading you loud and clear.”

“What the hell, Hawk?” The agitation in the controller’s voice had been replaced by a mixture of relief and anger — the mixture a parent’s voice tended to have when a small son or daughter narrowly but successfully dodged danger. “Damn it, Hawk, what the bloody hell are you doing taking off in these conditions? This might cost you your job. Maybe your license, too.”

“Look, here’s what happened,” began Hawkins.

“What happened,” broke in Wimberly, “was the strangest damn thing. All of a sudden this hole opened up in the ceiling.”

“Oh, bullshit,” spat the controller. “You stay out of this, Wimby.”

“No kidding, a hole,” insisted Wimberly. “Four hundred, maybe five hundred feet high. Three, four miles visibility. I can’t believe you didn’t see it.” The flight nurse and I looked at each other. She rolled her eyes and shook her head dramatically: No way. I began to catch on to what the second pilot was doing. “It was amazing,” he said. “Hawk, how’s the ride up there?”

“The ride’s good,” Hawkins said. “We’re just coming out on top at seven thousand feet. Beautiful up here.” He paused. “I don’t suppose that hole’s still open down there, is it, Wimby?”

“Say again?”

“Any chance that hole’s still open?”

I held my breath.

“I’ll be damned,” said Wimberly slowly. “Sure enough, still is. LifeStar Two’s departing.” His voice ratcheted up half an octave and a dozen decibels as he said it. “Whoa,” he added after a moment, “that was interesting.”

The flight controller radioed again, and I pictured him scanning the rulebook to see how many regulations the pilots had violated. This time, though, his voice seemed to contain concern and a touch of admiration. “Wimby, did you make it up through that…uh, hole in the sky okay?” The nurse grinned at me.

“Sure did,” he said. “Piece of cake. LifeStar Two’s climbing to seven thousand.” His voice had switched back to the polished smoothness of the professional pilot, though I thought I detected a big dose of relief and a slight hint of swagger underneath.

“Have a safe flight,” said the controller. “You guys must have friends up there.”

Let’s hope, I thought, as the second helicopter emerged from the clouds below us and both aircraft banked toward Atlanta.

I glanced at the heart monitor above Faust’s gurney. He was still with us. It was amazing he’d made it even this far. As an experimental procedure, hand transplantation wasn’t covered by the standard organ-donor consent Faust had on file. Mercifully, the rules for organ donation allowed for verbal consent. I’d recounted Faust’s last wish—“Give my hands to Garcia”—and Rankin had corroborated my story. I wasn’t sure how Rankin had managed to hear the words, since Faust couldn’t speak above a whisper, but he swore he had, and I chose to believe him. Within minutes after Faust’s brain ceased to function, UT’s organ-donation coordinator called Tennessee Donor Services, and a few hours after that, Dr. Alvarez had accepted the donation. Her original plan had been to bring Faust down by conventional ambulance, but when UT notified her that his condition was rapidly deteriorating, she’d arranged for the airlift — the airlift into the teeth of a gale.

We caught up with the storm front swiftly, just as the helicopter reached the crest of the Smoky Mountains. Pressing my head to the helicopter’s window and looking down, I glimpsed the grass-lined bowl of Cades Cove and, looming above it, Thunderhead Mountain, where I’d been caught in the cold and the darkness.

I was still weary from the ordeal in the mountains and the maelstrom of events since, and I closed my eyes and let the aircraft’s drone and vibration lull me to sleep. I was just drifting off when an urgent voice snapped me awake. “We’re losing him.” It was the flight nurse. “Guys, we’re losing him.” Her eyes were darting between the gurney and the monitor. “Pulse is irregular, blood pressure’s dropping.” The pulse line on the screen grew ragged, the peaks fluctuating in height, like a stock-market graph charting a volatile month. The heart-rate readout skittered rapidly: 88, 72, 79, 67, 59. The blood-pressure readout on the monitor edged downward: 140/80, 117/72, 88/60. Suddenly the blood-pressure numbers were replaced by dashes. The heart line went flat, and the pulse readout went blank. Even through the thick cushions of the headset, I could hear the monitor’s shrill alarm. “He’s coded; he’s coded. I’m going to defib.” She snatched a pair of defibrillator paddles from the rear wall of the compartment and pressed them to Faust’s chest. She glanced to make sure I wasn’t touching Faust or the gurney—“Clear”—and squeezed a switch in the handle of one of the paddles; as the electricity coursed through Faust’s body, it jerked against the nylon straps. She glanced at the monitor, still flashing its dashes and shrieking its alarm. “Clear.” The body jumped again, but that was the only response to the jolt of current.

“Damn it,” said the nurse, “don’t do this to me.”

Flipping back the lid of a medical case, she removed a syringe and tore open a sterile wrapper, then depressed the plunger just far enough to spray a droplet out the end of the needle. “I’m giving him epinephrine,” she said. Sliding the needle into Faust’s arm, she slammed the plunger home and then yanked the empty syringe into a waste slot. She applied the defibrillator paddles again. “Clear.” The body twitched, and the blinking dashes on the monitor were replaced by numbers. Fluctuating, frightening, beautiful numbers.

I took a deep breath and looked up. Out the front windshield, the approaching skyline of Atlanta glittered like the Emerald City of Oz. Minutes later we settled onto a small rooftop helipad. A metal door at one side opened, and a pair of nurses jogged a gurney toward the helicopter, ducking beneath the spinning rotor. I checked the monitor: Faust’s heart was beating weakly and irregularly, but it was still beating, by damn. Within seconds the nurses had shifted him onto the gurney and hurried into the hospital with him. I unbuckled my harness, removed my headset, and followed.

Ten minutes later I found Carmen in an alcove outside a third-floor operating room. She hugged me and then wiped her eyes. I held my breath, bracing for disappointment again. “It looks good,” she said. “The transplant surgeon says they’re starting the procedure.”

Over the next twelve hours, updates trickled from the operating room: The bones of Faust’s left forearm had been grafted onto Garcia’s radius and ulna by the left-hand team. The bones of the right forearm had been joined by the other team. Left-hand nerves. Right-hand nerves. Right-hand tendons. Left-hand tendons. Left-hand blood vessels. Right-hand blood vessels. By the thirteen-hour mark, I was exhausted, but Carmen seemed as focused and quietly intent as she had at the beginning. When the head of the transplant team, Dr. Alvarez, appeared, Carmen and I stood to receive the news, our eyes boring into the doctor’s in an effort to see if she was bringing good news or bad. “We’ve had a setback,” she said quietly, and for the first time I sensed fear in Carmen. “A damaged blood vessel on the left side.”

Carmen’s voice was quiet but hard as granite. “Does that mean the left hand will fail?”

Dr. Alvarez shook her head. “I hope not. We’re taking a short section of vein from your husband’s leg and splicing it in to repair the damaged section. It’s not difficult to do, but we need to get the blood flowing to that hand as soon as possible. I’m going back to the OR, but I wanted to let you know.”

Carmen nodded. “Thank you, Doctor. Thank you for everything you’re doing for him.”

The surgeon smiled through her mask of fatigue as she turned to go.

An hour later she returned. “We’re finished. We got the bleeding stopped. Everything looks very good. There are no guarantees, of course. His body might reject the hands, the nerves might fail to regenera

te, the immunosuppressants might cause complications. But if we’re lucky, none of those things will happen. And if we’re very lucky, within six months he’ll be able to hold a scalpel again, and be able to hold hands with you and your son again.”

Carmen’s face quivered, and then she began to tremble from head to toe, and she allowed herself to cry. “I am…so very grateful. To you. To everyone here at Emory. To that man who gave his hands for my husband. To…” She raised her arms wide, then let them fall with a teary smile. “So grateful.”

“So am I,” said the doctor with a tired but warm smile.

I excused myself to make a phone call. Sixteen hours earlier, just after they’d begun the transplant procedure, I’d phoned Miranda. She hadn’t answered, and the call had rolled to voice mail. “I’m at Emory,” I’d said. “They’ve just taken Eddie into surgery. They’re going for the bilateral transplant. I know you don’t want to talk to me or see me, but I’m sure Carmen and Eddie would appreciate it if you could come.” Then I’d turned off the phone.

Now, when I switched it back on, it chirped at me. The display told me I had new voice-mail messages — twenty-three, in fact, a number that astonished me. Before I got a chance to listen to even one of the twenty-three, though, the phone buzzed in my hand. It was Miranda calling, and she sounded breathless. “Tell me what’s happening.”

“It’s done,” I said. “Both hands. The doctor sounds very hopeful.”

The whoop of delight from my cell phone nearly split my ear. Then I heard a second whoop, this time in stereo: Miranda came sprinting around the corner, nearly careening into Carmen, the surgeon, and me.

“Ohmygodohmygodohmygod!” Miranda cried. “Oh, how wonderful. Oh, hallelujah!” She threw her arms around Carmen. “I was in Texas, in the middle of a job interview, when the FBI called me.” The words tumbled out of her. “I ran out and jumped on a plane as soon as I heard the message. Oh, happy, happy day!”

Then she turned to me, her face wet with tears. “Damn you,” she said, and I felt my heart begin to crack, but suddenly she hugged me, as unreservedly and joyously as she’d hugged Carmen. “Damn you,” she repeated, this time through a mixture of tears and laughter. “Don’t ever do that to me again.” She pulled back and wiped her eyes. “I just saw your picture half a dozen times on the CNN monitors in the Atlanta airport. Black-market kidneys from Pakistan, butchered and stolen bodies, a murderous bone thief, and a daring professor who risked his life in an undercover sting. Hell of a story. If I weren’t so mad at you for keeping me in the dark, I’d be really, really proud.” She shook her head. “Damn you for playing your sleazy part so well”—she laughed—“and damn the FBI for being so secretive.” She smiled and planted a big kiss on my cheek.

“Not so fast,” I said. “You were in Texas for a job interview? Out at the Body Ranch — our new competition?”

She shrugged sheepishly. “They’re just getting off the ground. They thought maybe I could be helpful.” She smiled once again — her old, full-face, eye-contact smile. “It’s nice to be wanted, but it didn’t mean a thing. Really. If you’ll take me back, I’ll never stray again.”

“Promise?”

She held up the three fingers of the Boy Scout salute. “Promise.”

“Deal.”

EPILOGUE

I awoke to find a strange hand on my shoulder, shaking me gently. The hand was attached to a nurse, who’d found Miranda and me slumped and sleeping in chairs in the surgery waiting room. I checked the wall clock: Four hours had passed since the surgery ended. Before falling asleep, I’d spent a while checking my many voice-mail messages and returning a handful of the calls.

Steve Morgan had called; I hadn’t gotten a chance to talk with him after the FBI press conference, so he’d phoned to relay his personal good wishes, as well as those of the TBI. “I should have known there was a good reason — a very good reason — for whatever you were doing,” he said when I called him back. “I forgot some of the most important lessons you taught me in your class — lessons about character and integrity and trust. I’ll try not to forget those again.”

I also returned a call from Burt DeVriess. He’d dropped the Willoughby paternity suit, he said — his client was not, the DNA reported, Willoughby’s child — but he was suing for $20 million on behalf of Willoughby’s legitimate daughter and the former students who’d paid for the burial of Miss Elizabeth Jenkins. Most of the voice mails turned out to be media calls — from WBIR-TV, CNN, the Knoxville News Sentinel, the National Enquirer, and a host of other news outlets I didn’t know or didn’t care about. Mercifully, my cell phone’s battery died just as my brain and body began shutting down, so I had a good excuse for ignoring the majority of the messages clamoring for my attention.

At the moment, though, it was the scrub-clad nurse tugging at my sleepy sleeve. “He’s awake, and he’d like to see you both.” She smiled.

Miranda and I struggled to our feet. The nurse took us up an elevator and down a hall to an ICU room, which bristled with monitors. Through the large panel of glass that faced the nurses’ station, I saw Carmen sitting beside the head of the bed, stroking her husband’s cheek.

Eddie opened his eyes and smiled groggily when we came into the room. “My friends,” he murmured. “My good, good friends.” Then his eyes closed again.

His arms were fastened into an elaborate traction harness above the bed. Protruding from the ends of the arms were a pair of white oval bundles, roughly the size and shape of handmade loaves of bread. Five fingertips protruded from the end of each loaf. The swaddled hands looked awkward and out of place, strangely foreign, because just twenty-four hours before there had been nothing there. Nothing but emptiness and loss.

The hands — like the surgery’s outcome, and like Eddie’s future, and like all our hopes for it — hung in the air, suspended. And just for a moment, those bright white bundles of suspense and hope were transformed. In my mind they shone like a pair of binary stars at the center of the universe, and they were the most beautiful things I had ever seen, or ever would.

AUTHOR’S NOTE: FACT AND FICTION

“This book is a work of fiction,” reads the disclaimer in the front of this novel. “Any resemblance to actual events or persons, living or dead, is entirely coincidental.”

That very disclaimer itself is part fiction: Although many characters and most plot threads in The Bone Thief are woven entirely out of thin air, this book has many bases in scientific and biomedical fact. Within this subject area, truth rivals or surpasses fiction in ways that are mostly inspiring but occasionally horrifying.

The thriving trade in bodies and body parts — including illegal black-market sales of corpses and tissues — was recently the subject of a riveting nonfiction book, Body Brokers, by Annie Cheney. Published in 2006, Cheney’s book documents — among other things — shocking postmortem “chop shops” (our term, not hers) operated by a California funeral-home owner and a Texas medical-school staff member. Body Brokers also describes multiple instances of bodies and body parts being sent to laboratories and even luxury hotels (including, Cheney reports, “forty-two heads and necks to the Marriott Marquis” in New York City’s Times Square) for medical trainings. Cheney’s book also documents the tragic case of a young man who died suddenly from toxic shock after receiving an improperly sterilized bone graft — one contaminated with Clostridium sordellii bacteria.

Crime fiction focuses, by definition, on the seamier side of life. The happier truth is that organ transplants and tissue grafts allow remarkable feats of medical repair and restoration. And as stem-cell technology advances — offering the potential to grow rejection-proof tissues and organs with the patient’s own DNA and tissue type — the possibilities become almost miraculous. Indeed, near miracles are already being wrought: The surgery in Spain that was described by our character Glen Faust — in which a cadaver trachea was used as a scaffold to create a new windpipe from the recipient’s own stem cells — is unvarnished fact

. The one significant bit of artistic license we’ve taken with biomedical fact is the notion that by combining CT scans with advanced composite materials it’s possible to synthesize bones that are virtually exact copies of their originals. That’s not possible — not yet anyhow. But never say never.

A few footnotes about hands: Artificial hands are now very sophisticated and lifelike in their workings, as a glance at the i-LIMB Hand — with its individually controlled fingers — makes clear (www.touchbionics.com/i-LIMB). Soon bionic prostheses will become even more advanced, thanks to millions of dollars’ worth of R&D sponsored by the Pentagon’s Defense Advanced Research Projects Agency (DARPA). DARPA’s Revolutionizing Prosthetics Program — motivated by the military’s commitment to restoring function to soldiers whose arms or hands have been lost to trauma — is led by two premiere R&D laboratories: DEKA Research and Development (the birthplace of the portable insulin pump and the Segway scooter) and the Johns Hopkins University Applied Physics Laboratory (whose numerous other projects include interplanetary satellites and bomb-disposal robots). Within the next few years, Revolutionizing Prosthetics aims to create bionic arms that are virtually identical to natural limbs in performance and durability. For more information on this program, see www.darpa.mil/Docs/prosthetics_f_s3_200807180945042.pdf.