“It is a child’s kidney,” Dr. Sandra Kelly said. “I can confirm that much from the size and mass of the tissue.” She removed her glasses and gently placed the plastic bag into a small foam container, one that looked more accustomed to holding beer at the beach, except this bore a bright-orange biohazard label on the side.
“Thanks for coming, Doc,” John said.
“Of course,” she said. The doctor went to the sofa, sat next to John, and placed her hand over his.
“How long can Tommy last without one of his kidneys? I mean, he was barely hanging on with both of them. Now this . . .”
John looked fragile, a shell ready to fracture. He didn’t look at her, or anything really; he simply stared at a swirl in the hardwood floorboards.
“We don’t know if this . . .” Dr. Kelly caught the clinical tone in her voice. “Let me show you something.”
She reached for her shoulder bag and retrieved a tablet computer. The doctor powered up the small unit, flicked through the screens, and tapped a button. The screen came alive with photos, text, and autopsy diagrams.
John never lifted his head toward the screen.
“You’ve seen these before, the autopsy reports for Mercer and Johnson. I completed the report for Cardozo. I don’t have an ID on the body you hauled out of the water, but take a look at something.” She held the tablet out for John.
His hands trembled as John took the tablet computer. A series of gruesome images were displayed on the small screen.
“What am I looking at?” he asked.
Dr. Kelly pointed at the top photo. “The Mercer autopsy. The victim’s aorta transected in a downward left-to-right direction.”
John’s forehead wrinkled. “Okay, so?”
“This is from the Johnson autopsy.” She tapped the middle photo. “The aorta is severed at nearly the same location, downward left to right.”
Dr. Kelly saw that John wasn’t tracking. She rotated the photo one hundred eighty degrees, so that the space where the victim’s head would have been pointed downward. “The incision was made top to bottom.”
John couldn’t see the difference or the significance.
“Remember how I said that it was like an autopsy was already done?”
“Yeah, sure. Because of the way the chest was opened up and the Y-shaped incision.” John handed the tablet back to Dr. Kelly.
“I was looking at it the same way you did, we all did. I expected to see an autopsy, and that’s what I saw. When I was a little girl, my daddy took me hunting. When he’d bag a deer, he would string it up in a tree by its hind legs and do what he called ‘field dressing.’ He’d bleed the deer out and cut the carcass open from the top to the bottom, exactly like this.”
“What made you think of that?”
“John Doe made the connection for me. Remember the body from the river? There were wounds on the back of the legs consistent with the body being hung upside down.”
She let that sink in and remained silent.
John pulled the tablet closer and took another deep look at the graphic photographs of the murder victims in a new light. The recollection of the meat hooks in the Layton barn made a horrific connection. He turned to Dr. Kelly and asked, “You’re certain?”
“As the medical examiner, it’s kind of what I do,” she said with a wry smile.
“These people were butchered.”
She nodded. “It would appear so.”
“Were they alive when . . . ?”
“No. The tissue samples from Johnson, Mercer, and the waterlogged John Doe confirmed they were no longer alive when the organ harvesting occurred. Cardozo, well, that’s a different story.”
“Tox screens?” John asked, mentally checking another box.
“We did a limited tox panel, in that we didn’t have blood or organ tissue, but nothing turned up.”
John stood and flexed the kinks from his knees, paced to the far end of the room, and lifted a photo of his family from a mahogany side table. The picture portrayed happier times, before Tommy’s diagnosis. The boy’s face was fresh, happy, and innocent back then.
“Is there a way to check the DNA or find out who donated the kidney to Cardozo’s daughter? Can we find out if it’s a match for Cardozo?” John asked.
“I can check. She’s not doing well, by the way. You’re getting at the hacking of the UNOS database, aren’t you?” she asked. “You know that would explain some things.”
“What do you mean?” he asked.
“If the database and the waiting list were compromised, it would explain why the Gunderson boy’s mother thought he received a mismatched kidney.”
“The autopsy? You were able to do that?”
“Yes. I haven’t gotten the entire tox panel back, but the organ was indeed a mismatch for young Mr. Gunderson. But it would have been a match for Tommy.”
John stiffened. “With Zack Weber hacking into the system, Patrick Horn, or Winnow—whoever the hell he is—accessed the data on patients awaiting transplant and purposely gave patients mismatched tissue. He cancelled Tommy’s transplant.”
“Okay, I follow, but you’re assuming that he gives a crap about tissue match. It could be that he is simply carving up people for profit,” Dr. Kelly said.
“I think there is more to him than that. Zack Weber was an idealist, convinced that he was serving mankind.”
“Maybe Horn threatened Weber,” she said.
“He protected Horn after we uncovered the lab tampering. Weber actually believed that they were helping people the big medical corporate machine wouldn’t touch.”
“Daniel Cardozo’s daughter needed a kidney, so Horn and company killed her father for the perfect match? Where are the idealistic values in that?”
“Daniel Cardozo was a thug, a gang member, and a drain on society, but he would have willingly given his daughter a kidney,” John offered.
“So these guys play a sick game of Robin Hood with human organs—take from the undeserving and give to the poor? Tissue typing and matching isn’t difficult, but I’m willing to bet it’s beyond the capability of Weber and Horn. A simple blood-type match, maybe.”
John paced back toward the sofa. “I don’t buy the idea they were fueled by a misguided ideology. These victims weren’t random. Each gang member was selected as much for who they were as for any tissue match. Do you know anything about the last victim?”
The doctor stuffed her tablet computer in her shoulder bag and said, “I’m going to see if I can pull some strings at the Department of Justice lab. They owe me, and we can’t wait weeks to get a response. The first thing I’m going to ask them to do is rule out that this tissue came from Tommy.”
“You can do that?”
“I’ve already pulled your son’s DNA profile from the transplant center for comparison, so it’s not like we need to search the entire DNA database for a cold hit,” Dr. Kelly said.
John followed the doctor to the kitchen, where the Styrofoam cooler containing someone’s entrails waited. Dr. Kelly hefted the case from the countertop and tucked it under one arm. She patted the top of the insulated container. “The moment I have anything . . .”
“I know,” John said.
Dr. Kelly nodded. She understood that the contents of that cheap foam cooler represented his son’s life in many ways.
A small mass of tissue meant life or death—an end to suffering or simply an end. Patrick Horn sent this flesh-and-blood proclamation—he alone held the power over Tommy’s life.