The Fifth Profession

1

The neurosurgeon's name was Anthony Santizo. He had thick dark hair, swarthy skin, and extremely intelligent eyes. His handsome features were somewhat haggard-the consequence of fatigue, Savage guessed, since the doctor had just completed seven hours of surgery. In contrast, his body was trim-the consequence of addiction to racquetball games, one of which Santizo had explained he was scheduled to play in an hour.

“I know you're busy,” Savage said. “We're grateful you made time for us.”

Santizo raised his shoulders. “I normally wouldn't have. But the neurosurgeon your physician spoke to in Harrisburg happens to know a former classmate of mine, a good friend from Harvard Medical School. Harrisburg has excellent physicians, of course, but the way your problem was described to me, I think my friend was right to send you here.”

Here was Philadelphia, the hospital of the University of Pennsylvania. A hundred miles east of Harrisburg, it was quicker to get to than Pennsylvania 's other major university hospital, twice as far to the west, in Pittsburgh.

“I'm intrigued by mysteries,” Santizo said. “Sherlock Holmes. Agatha Christie. The wonderful clues. The delicious riddles. But the brain is thegreatest mystery. The key to the door to the secret of what makes us human. That's why I chose my specialty.”

A secretary entered the immaculate office, bringing in cups and a pot on a tray.

“Excellent,” Santizo said. “On time. My herbal tea. Would you care for…?”

“Yes,” Akira said. “I'd like some.”

“I'm afraid it's less strong than you're used to in Japan.”

Akira bowed. “I'm sure it's refreshing.”

Santizo bowed in return. “I went to Harvard with one of your countrymen. I'll never forget what he said to me. We were both just starting our internships. The long, brutal hours wore me down. I didn't think I'd survive. Your countryman said, ‘When you're not on duty, you must find an exercise you enjoy.’ I told him I didn't understand. ‘If I'm already tired, why would I want to exercise?’ You know what his answer was? ‘Your fatigue is caused by your mind. You must combat that fatigue by physical fatigue. The latter will cancel your former.’ That made no sense to me. I told him so. He responded with one word.”

“Wa,” Akira said.

Santizo laughed. “Yes! By God, you remind me of your countryman!”

“ ‘Wa’?” Rachel asked, assessed the word, and frowned. As everyone looked at her, she reached self-consciously for a cup.

“It means ‘balance,’” Akira said. “Mental fatigue is neutralized by…”

“Exercise,” Santizo said. “How right your countryman was. It's tough to find time, and after the days and nights I put in, I'm usually so exhausted I hate to do it. But I have to do it. Because racquetball makes me abetter neurosurgeon.” Preoccupied, he glanced at his watch. “And in fifty minutes, I'm due at the court. So show me these supposedly baffling X rays.”

He took the oversize folder. “Hey, don't look depressed. Remember ‘wa.’ Racquetball and neurosurgery. Sherlock Holmes.”

2

“Mmmmm.”

Santizo stood in a corner of his office, glancing back and forth at two X-ray films of skull profiles that he'd clipped onto a fluorescent screen.

He'd been studying the films for several minutes, his arms crossed, listening to Savage's explanation of the events that had brought them here.

“Executive protectors?” Santizo continued to assess the films. “It sounds like the two of you have a fascinating profession. Even so…”

He turned toward Savage and Akira, took a penlight from his shirt pocket, and examined the left side of each man's head.

“Mmmmm.”

He sat behind his desk, sipped his herbal tea, and thought a moment.

“The surgeon did an excellent job. State of the art, Mind you, I'm referring only to the cosmetic aspects of the procedure. The skillful concealment of the fact of the surgery. The minimal calcification around the portion of each skull that was taken out and then replaced. You see, the standard method is to drill holes in the skull, at the corners of the area to be removed. These holes are carefully calculated so the drill doesn't enter the brain. A thin, very strong, very sharp wire is then inserted into one of the holes and guided along the edge of the brain until the wire comes out another hole. The surgeon grips each end of the wire and pulls, sawing outward through the skull. He repeats the process from one pair of holes to another until the segment of skull can be removed. The wire is thin, as I explained, but nonetheless not thin enough to prevent the demarcation between the skull and the segment that's been removed and later replaced from developing obvious calcification. Even without that calcification, the holes in the skull would be impossible to miss on an X ray. In this case”-Santizo rubbed his chin-“there aren't any holes, only this small circle as if a plug of bone had been removed and then replaced. The demarcation between the plug and the skull is so fine that calcification is negligible. I'm surprised the general practitioner you went to detected the evidence. Someone not prepared to look for it might not have seen it.”

“But if a standard technique wasn't used, what was” Savage asked.

“Now that's the question, isn't it?” Santizo said. “The surgeon could have used a drill with a five millimeter bit to make a hole the same size as this plug. But he wanted a technique that wouldn't leave obvious signs. The only solution that occurs to me is…The plug was removed from the skull by a laser beam. Lasers are already being used in such delicate procedures as repairing arteries and retinas. It's only a matter of time before they become common procedure in other types of surgery. I've experimented with them myself. That's what I meant-this was state of the art. There's no doubt-in terms of getting in and out, whoever did this was impressively skilled and knowledgeable. Not uniquely so, I should add. Among the top neurosurgeons, I know at least a dozen, including myself, who could have concealed the evidence of the procedure equally well. But that's a superficial test of excellence. The ultimate criterion is whether the surgeon accomplished his purpose, and because we're not aware of why the surgery was required, I can't fully judge the quality of the work.”

“But”-Akira hesitated-“could the surgery explain…?”

“Your dilemma? Perhaps,” Santizo said. “And then again maybe not. What was the term you used? The opposite ofdeja vu?”

“Jamais vu,” Savage said.

“Yes. Something you think you've seen, but you've never seen. I'm not familiar with the concept. But I enjoy being educated. I'll remember the phrase. You realize”-Santizo set down his teacup-“that if it weren't for these X rays, I'd dismiss you as cranks.”

“I admit what I told you sounds bizarre,” Savage said. “But we had to take the risk that you wouldn't believe us. Like you, we're pragmatists. It's our business to deal with facts. Physical problems. How to get our principal safely to his or her destination. How to anticipate an assassin's bullet. How to avoid an intercepting car. But suddenly the physical facts don't match reality. Or our perception of it. We're so confused, we're not just nervous-and it's normal for us to be nervous. We're scared.”

“That's obvious,” Santizo said. “I see it in your eyes. So let me be honest. My schedule's so crowded the only reason I agreed to see you was that my former classmate asked me. He thought I'd be intrigued. He was right. I am.”

Santizo glanced at his watch. “A half hour till I'm due for my racquetball game. After that, I need to make rounds. Meet me back here in”-he calculated-“two and a half hours. I'll try to arrange for a colleague to join us. Meanwhile, I want you to go to Radiology.” He picked up his phone.