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  A gray warning box appeared.

  The following report contains sensitive

  information protected under HIPPA. Are you

  authorized to access such information?

  “No, I’m not,” Eli said aloud as he clicked a smaller box marked Yes.

  A second warning box appeared.

  “I don’t think they want us to be here,” Meg said.

  This patient died during the operation.

  The confidentiality of all patients,

  including those deceased, is protected.

  Do you wish to continue?

  “Hell, yes. I wish to.”

  The patient’s name and list of personnel were arranged similarly to the previous case. Eli found the name of the most recent victim, nurse Virginia Brewer.

  He imagined what must have occurred. The calm of an operation coming to a close. A shift into terror. He saw flashes of the anesthesiologist checking the airway, nurses scrambling, Liza watching from the robotic console, her career crashing in a sea of red.

  Meg realized that Eli was staring at the screen. “Eli?”

  He refocused. Scrolled down to a section labeled Comments:

  Intraoperative death occurred at one hundred forty-seven

  minutes. Patient pronounced dead by Dr. French at 10:27 a.m.

  “I should know,” Meg said. “I did the autopsy. It was awful.”

  She had Eli’s full attention.

  “And Liza French did not agree with my findings or the cause of death.”

  “Yes, I remember.” Eli said. “A vascular injury, right?”

  “Aortic laceration. Right at the bifurcation. Likely from a misplaced trocar. They opened her, tried to repair it, but she was gone.”

  Again, Eli saw flashes of the operating room. He sensed that stomach-to-the-floor feeling of a bad complication. But he’d never had a fatality in the OR. Eli read the names of the victims again. He thought of the other personnel in the operation as survivors. At least for now.

  For the first time there seemed to be a link between the three murders and this operative death. Only he could not imagine how.

  “Maybe it’s just coincidence, Eli. These three people died and they happen to work together.”

  “Not just died, Meg. They were murdered. Bones and tongues cut out, stomachs put on display.” Eli realized that he’d raised his voice, was almost shouting. But he kept on. “And not just worked together but were assigned to the same operation during which the patient happened to die.”

  Meg said nothing while Eli calmed down somewhat. Then she pointed at the screen. “Are we looking at the names of the next victims?”

  “Put it this way,” Eli said. “I wouldn’t want my name written on this page.”

  They stared at the screen in silence until Meg asked, “What’s this?” She pointed to another Comment at the bottom of the page.

  This operation was broadcast live on the Internet until the complication occurred, at which time SurgCast terminated the transmission.

  “SurgCast?” Meg asked.

  Eli knew of operations webcast in real time, but he’d never seen one. Why didn’t Liza tell me about this?

  “That operation was an unfortunate choice to post live on the Internet,” Eli said.

  “No kidding,” Meg agreed. “Why did the hospital do it?”

  “Reality surgery on the web. It’s great advertising.”

  “Maybe I’ll just start filming my autopsies. I could use some extra cash.”

  “It’s being done, I’m sure.”

  Meg shook her head. “I could’ve filmed this woman’s autopsy. That way,” Meg explained, “the viewers could have seen her die in the OR, then watched her postmortem exam. Bet that hasn’t been done.”

  “Probably not,” Eli agreed. “Hang on to that one for sweeps week.”

  CHAPTER FORTY-THREE

  At eight o’clock in the morning, The Poplar Avenue Free Clinic felt like a sauna. By midday, the temperature would be nearly intolerable, with a predicted high of 103. Not a good day for the clinic’s single air-conditioning unit to quit.

  Cate discovered this when she arrived at seven a.m. to prepare for the day’s patients. Out of habit, the first thing she did was turn on the window unit. Straight to high. When she flipped the switch, only an electric hum emanated from the aged machine. The fan did not blow at all. Not even hot air. Cate turned it off, then back on again, stopping at the low setting this time, saying a desperate prayer.

  Nothing.

  She had run the unit on high each day, nonstop, all summer. Single-handedly she had killed it.

  The patients would start showing within the hour. She could open the windows. That would help for a couple of hours. But then—

  The care basket of snacks from her brother sat on the table in the break room. She had given most of the goodies away. She reached in the pocket of her white coat and felt for her cell phone tangled up in the rubber tubing of her stethoscope.

  She called her brother. He was good at fixing things. Had the touch, as they say. She looked at her chipped fingernails, at a long scratch on the back of her hand that she had clumsily scraped on the counter’s edge in her apartment. Funny that he was the one born with the hands of a surgeon.

  Her brother said he would be there in an hour. Fifty minutes later, he pulled his black Trans Am to the back of the clinic. An air-conditioning unit bulged from the open trunk which was held down with a piece of rope.

  Cate was busy dressing a diabetic foot ulcer. By then, Mary and her shopping cart had arrived and she helped with the procedure by opening packages of sterile gauze. When her brother walked in, Cate was so happy to see him she wanted to hug his neck.

  He tested the air conditioner with the same dead result. While Cate wrapped the final bandage around the patient’s foot, she watched her brother unscrew the bolts on the front panel. He wore a sleeveless black T-shirt.

  Mary watched him as well. She approached him as he strained against a rusty bolt, reached over and pinched his flexing bicep.

  “Cate, your brother’s got rats tattooed on his arm.”

  He said nothing.

  Cate glanced at her brother’s tattoo, a crest of three slender animals drawn one on top of the other.

  As usual, Mary wouldn’t let it go. “Why’s he got rats on his arm?”

  “They’re weasels, okay?” He pulled away from Mary. “And don’t touch me again.”

  Mary backed up. “Sorry.” Then under her breath. “Rat man.”

  He finished removing the panel and returned outside.

  When Cate opened the door to call in the next patient, she was surprised to see her brother standing out front near the patients. While he admired Cate’s work with the indigent population, he preferred to have no interaction with them. But there he was, talking with Joey the Flicker. By the way her brother motioned with his hands, he seemed to be explaining something to them. Joey took a step back, and for once stopped flicking his lighter, as though surprised himself at the interaction with this man.

  Cate closed the door and watched them through the window. By then, Foster and the Meatman had become curious and moved to stand beside Joey. The three men stepped closer. Cate watched her brother open his wallet and hand each man what she thought was a twenty dollar bill. Then he led the men around to the back of the clinic. Cate called in the next patient.

  A few minutes later, Cate’s brother pulled the air-conditioning unit out of the wall, without the help of the men he’d just hired. Not only does he have good hands, Cate thought, but he’s also strong as hell. She wondered why he even paid the men if he wasn’t going to use them.

  He removed the replacement unit from the back of his car and carried it toward the clinic. Foster, the Meatman, and Joey the Flicker shuffled alongside and held to the side of the unit as though trying to help. They held the unit in place while her brother secured it with screws. He flipped a switch and cool air blew into the clinic. Her brother waved to
her and left. The three men returned to the end of the line.

  CHAPTER FORTY-FOUR

  Nate Lipsky drove his squad car down South Cooper Street and stopped at a light before turning onto Central Avenue. The timing of this homicide call was unusual—4:30 in the afternoon. Lipsky blocked the sun with his hand so he could see the light change. What was most unusual about this call was its location. He looked again at the address for the Zante Repository.

  How could someone have been killed in the Zante?

  Primarily an attraction for school groups and admirers of odd Southern culture, the Zante held the logical combination of stuffed animals, from anteaters to nutria the size of a small horse, various Native American artifacts, and a historical exhibit on the contribution of the comman American chicken to the Southern way of life. A planetarium brought visitors into the 21st century and allowed gazers to learn about the constellations as tiny lights twinkled against a pitch-black fabric sky.

  From the initial call, Lipsky came to a conclusion, or at least an educated guess, about the mode of death. When he heard Zante Repository, he figured someone ambled into the museum from the street in the final throes of heat stroke. But the officer first on the scene had called from the planetarium. He said that in the middle of a shooting star show, a human body part fell from the ceiling, straight through the constellation of Orion.

  Lipsky asked him if it was a heavenly body. The young officer didn’t get it, but said, “No, it looks more like a heart.”

  “A heart?”

  “And what’s weird, we found a drawing of the heart pinned to the victim’s clothing. Like a name tag or something.”

  “Have you found the body?”

  “Yeah, stuffed in a closet in the back of the museum.”

  A few minutes later, Lipsky arrived at the Zante Repository. An ambulance, two squad cars, and a Memphis fire truck were already there. A group of children huddled at the entrance, their adult chaperones reporting frantically into cell phones.

  CHAPTER FORTY-FIVE

  Before making the call, Eli moved to the far side of the autopsy room with his cell phone, as though he needed privacy.

  Meg mouthed the question. “Who you calling?”

  Lipsky answered.

  “I know who the next victim will be,” Eli told him.

  “That’s good. So you can tell me whose heart this is splattered across the floor.”

  When he first dialed the phone, Eli had an I’m-calling-too-late feeling. If Lipsky was already at a crime scene, Eli’s feeling was valid. What alarmed him most, however, was not that another victim had been killed.

  “Did you say heart?”

  “Looks like it to me, Doc.”

  Once again, not the pattern of Vesalius and the Fabrica. But now Eli had the list of operating room personnel.

  “A male or female?”

  “Hmm.” Lipsky groaned. “I’m pretty good with female anatomy, but I’ll be damned if I can look at this piece of meat and call sex. Hold on.”

  In the background, Eli heard Lipsky ask for the victim’s driver’s license.

  A few seconds later, Lipsky said, “Female. Fifty-eight years old.”

  “Wait.” Eli moved to the computer screen. “Don’t tell me the name.” He switched the call to speakerphone.

  Lipsky hummed an off-key version of the Jeopardy theme.

  Meg rolled her eyes.

  The remaining females on the list were the medical student, attending surgeon Liza French, and the circulating nurse. Both the student and Liza were much younger than fifty-eight.

  Eli called out the name and added, “She’s a nurse.”

  “Nnnnnnn,” Lipsky buzzed. “Try again.”

  Lipsky read the name from the license.

  “Damn it,” Eli whispered. It didn’t match with any name on the screen.

  “What?” Meg tried to catch up on the conversation.

  Eli answered by shaking his head, still listening to Lipsky.

  “You did get one part right, though,” Lipsky told him. “About her being a nurse. We found a Gates ID badge in her purse.”

  CHAPTER FORTY-SIX

  Eli stepped into the dark sanctuary of Madison Avenue Episcopal Church, a place where he found himself more often during the past few weeks. Sometimes, as he did now, he entered the empty church in the evening, alone, except for an occasional church worker who prepared the sanctuary for the next morning’s services, leaving Eli to himself on the back pew, merely nodding to him in affirmation of his need to seek a few moments of refuge. Once, he slipped into a back pew on a Sunday morning. He made it through the entire service, but he preferred his solitary visits in an empty chapel.

  Today, another visitor had arrived before him. A few pews in front of him, a dark green blouse covered shoulders that bowed. She rocked slowly forward and back again, meditating.

  Eli sat as quietly as he could, not wanting to distract the woman, or not wanting to be known. That was it, he realized. That was why he came here. A place where he was anonymous, shielded by a thick wooden door and stone walls and an expectation of safety. But it wasn’t just the violence he had faced in the past few weeks, as disturbing as that was. Eli sought to reexplore where his life had landed—a father who had betrayed him and his family with his secret. The once respected anatomist had ultimately betrayed those who donated their bodies and the families who had taken the safety of their loved ones for granted.

  With his parents dead, he was left to fend for his older brother. He had not only failed emotionally with his only sibling, but Eli now feared financial failure as well, his funds to pay rent to Henry’s institution dwindling fast.

  Eli closed his eyes, felt the silence surround him. He wanted to feel protected, however briefly, from drought and disease and the senseless killings that he knew weren’t senseless at all but were a series of calculated deaths in a pattern that he was unable to discern.

  He shivered. The ambient temperature must have been in the low sixties. He was surprised that half the city wasn’t camped out in this air-conditioned haven. But he knew that for most, the threat of a spiritual reckoning was far greater than the fear of suffocating in the heat. Images of garbage and fire and a corpse in a warehouse melted into one as rational thought slipped drowsily away.

  Shuffling past his pew, the woman in the green blouse startled him. He nodded to her, but her gaze remained grounded and she left the sanctuary.

  Eli rubbed his eyes and then refocused on a figure standing near the pulpit. The robed priest clasped his hands at his waist and watched Eli. He made his way purposefully down the aisle.

  Eli shifted in his seat. He turned and hoped that the woman had returned and was the focus of the priest’s attention. As he suspected, they were alone.

  The clergyman stopped beside his pew.

  “Hello to you, young man.”

  He was not as old as Eli initially thought. Late fifties, he wore a close-cut beard speckled with grey.

  “Hello, Father.”

  “I am glad that you visit us.”

  Eli nodded.

  “You are welcome any time.”

  “Thank you.”

  The priest began to turn toward the pulpit again but he stopped. “May I be of any particular assistance?”

  “No. I’m just here to sit a while, if that’s okay.”

  The priest nodded in confirmation, but he wasn’t finished. “I recognize you from the newspapers.”

  Eli realized his anonymity, even here, was not assured.

  The priest went on. “I know times have been hard for you.”

  Eli had not expected this. He had let his guard down, and he tried to harden what must have appeared as a vulnerable shell. But instead, he felt a softening, suddenly aware that no one had acknowledged the life-changing events that plagued him. Eli said, “I’m fine,” but he hoped the priest would continue his absolution.

  “I knew your father.”

  Eli assumed his father had not been inside a ch
urch in decades. Stunned by the mention of him, Eli stood. “I need to go.”

  In a surprising gesture, the priest stepped inside the pew to block his exit. “Your father, he struggled. Just as you are now. You should know that.”

  Eli shook his head. “He didn’t struggle enough.”

  “We all have our demons. Some more than others.”

  “I can’t do this, Father. Not now.”

  Eli stepped toward the priest, who gave him room. He exited the sanctuary and reentered the sultry world.

  CHAPTER FORTY-SEVEN

  It happened after a code blue at three in the morning almost ten years ago. They were interns, paged stat to the hospital room of an obese male admitted with a bowel obstruction but found unconscious and pulseless by the night nurse. The room was full of nurses and medical residents barking out orders. Liza and Eli were relegated to doing the chest compressions, alternating positions every few minutes.

  Eli started first. After three minutes of compressions, he yelled “switch” and Liza slid a standing stool beside the bed, locked her elbows, and delivered sequential crunches to the man’s sternum. It was a difficult position for each of them, leaning past the edge of the bed over the man’s rotund chest and abdomen. Liza was determined to deliver effective compressions, her thin frame bucking with each blow. Then Eli took over so Liza could catch her breath. On Liza’s next turn, just as she bent over the man, he vomited around the breathing tube, a forceful spray that sent a plume of yellow bile onto Liza’s face and scrubs. Eli motioned to switch places, but Liza waved him off. Using her forearm, she wiped the vomit off her face and resumed the compressions, more forceful than before.

  Having been a doctor for only two months, Eli knew, even then, that the resuscitation was not going well. Each check of the patient’s heart tracing showed no electrical rhythm. A central venous line was inserted, through which multiple rounds of atropine and epinephrine had been infused. A few minutes later Liza stepped away, and Eli took her place. As he leaned over the patient, his scrubs absorbed the pool of vomit that ran off the man’s chest. A minute later, he felt the now chilled liquid soaking down to his underwear.