“One other aspect to help you with your decision, Doctor, after we work out the financial details. If anything goes south—cops, loss of a patient—your response to law enforcement and the medical community would be that Ka Hui forced you into this arrangement. And we would validate that assertion. You have my word.”
Dr. Rakoso retrieved his champagne glass from the cup holder.
The doctor might have thought he was still on the fence, undecided, but his sips from the glass, embracing his host’s hospitality, told Wally his pitch had connected.
The Escalade claimed a parking space that faced a storefront window papered over from the inside in brown, like an overnight package. They exited the limo, straightened themselves out, and entered the shade of the overhang. The storefront was wider than it appeared in Magpie’s cell phone photo, looked to be about the size of…
“An urgent care facility?” Dr. Rakoso said.
“A pain management clinic. Hell, why bother with the charade, it was a pill mill. A few sensational ODs by former patients put them out of business. Before we go inside”—Wally’s congenial expression turned serious—“tell me here and now that what you’re about to see, you will share with no one.”
“A verbal non-disclosure? Sure, no problem.”
“Too cavalier. You must remain discreet, Doctor. Otherwise…”
“Fine. Dire consequences otherwise. I get it. You have my word.”
They pulled at the glass-door entry and filed inside the single-story building. Two large men worked the lobby’s front desk, their attire casual: loose-fitting tropical shirts, gabardine trousers, boat shoes. How much of what the clothing covered was girth and how much was concealed weaponry was indistinguishable. The men nodded, their expressions blank; they returned to their phones.
“Nurses’ station, coming right up,” Wally said.
The station functioned as a nerve center, its three walls cloaked with medical supply parts hanging on pegboards, standing oxygen tanks, shelved respirators, and more, outfitted to look like a parts desk at a warehouse yet it still performed its original duties.
“’Sup, gentlemen?” A tiny, elderly Hawaiian woman in a pink smock over nurse scrub pants looked away from a desktop computer. She rose to greet them from behind the counter.
“How is our patient doing today, Nancy?” Magpie said.
“One day into post-op. Our associate madam justice is doing splendid. And at her age, mind you,” Nancy said, beaming. “She leaves tomorrow for the medical spa. No signs of organ rejection, and she’s convalescing well. Her children are beside themselves at how much more coherent she’s already become. And she’s stopped having lengthy discussions with her deceased husband. All appears well.”
Dr. Rakoso’s eyebrows rose. “Am I supposed to believe you have Supreme Court Justice—”
Wally held up his hand. “No names. You may believe whatever you want, just don’t share it with anyone. Let’s move on. I’ll show you the operating theater, then we’ll come back out here and talk.”
He stopped them with a raised hand in front of a set of swinging doors. “All surgeries are performed here. It’s a sterile environment.” He pointed to bins on a table next to the entrance. “Gloves, masks, footies. Let’s suit up, Doctor. Nothing is in session, but keep your hands to yourself when we get inside.”
What was once a spacious meeting room had been repurposed with operating room essentials, intensely bright lighting, and two sets of everything. Wally gestured left, then right.
“A simple arrangement,” he said. “Donor surgery on one side, recipient surgery on the other.”
“Screening?” the doctor asked.
“For recipients, it’s based on family physician statements and recommendations. The donors are prescreened at another Kauai clinic. A standardized evaluation process including a psych eval. They’re one hundred percent voluntary.”
One very noticeable machine sat in a corner. “A hotdog cart?” Dr. Rakoso said. Transplant surgeon parlance for a heart-lung machine. “You’re doing other transplant surgeries here?”
“Exclusively livers, but shit happens. As circumstances present themselves, the surgeons may need to improvise.”
“Which means you’ve lost patients,” Dr. Rakoso said, his wince noticeable, “and you’ve harvested other organs.”
“Yes. So far, not here. On the mainland, in Philly. The nature of the beast, Doctor. You know that.”
The doctor moved onto a different topic. “Tell me about post-op care.”
“Some patients receive it right here, on site, from a few surgeons beholden to me. Most patients prefer getting it from their own doctors, privately, elsewhere on the islands.”
“The donors?”
“Paid for by the organ recipient, even lost wages. A week at a special health spa with medical oversight. No heavy lifting for—”
“Six to eight weeks. I know.”
More stops, at a scrub room, a kitchen with a freezer, and a rear storage room with access to an alley, then came Wally’s redirection as host and tour guide: “Let’s head back out front so we can talk.”
Wally’s arm found its way around the doctor’s shoulder as they walked. He made a final push.
“I won’t ask you what you think, Doctor, I already know. The site is basic, the equipment minimal. The clientele, however, is impressive. You are intrigued, you like the trailblazing surgical procedures aspect, the potential long-term medical community recognition you will receive, but you’re still apprehensive. So let me make this simple.” A friendly shoulder squeeze. “I will pay you a hundred grand for each surgery, donor or recipient. You do both ends of the transplant, that’s two hundred K in donations for maybe eighteen hours of surgery, tax-free. That should put a dent in your legal fees. Sound good to you?”
They emerged from a hallway, passed tiny Nancy at her nurses’ station, and reentered the lobby secured by its two casually dressed guards who perked up at their entrance. Wally put his hand out there for the doctor to take, confident a deal was only a handshake away.
Dr. Rakoso accommodated him. The doctor’s congenial smile became a straight face. “This isn’t a yes, Mr. Lanakai. I’m going to need more time.”
They were sharing a moment, their hands pumping, the guest trying to remain gracious, the host doing his best to remain calm after not having
