31

"YOU AWAKE?" I WHISPERED.

"I am now."

"People are being murdered for their organs."

"Uh-huh." Ryan stretched out a hand. I took it.

"Cruikshank figured it out."

Ryan propped himself up onto one elbow. His hair was tousled, and the baby blues were heavy with sleep.

"The idea crossed my mind, but it seemed so far out there I didn't even mention it."

"It's true."

"A drugged traveler wakes in an ice-filled bathtub? A college student comes to sporting stitches after a wild party?" Ryan's tone was beyond skeptical. "Organ theft stories have been making the rounds for years."

"What Cruikshank stumbled onto is far worse than any urban myth. People are being choked to death, Ryan. Their organs are being carved from their bodies."

"No way in hell."

I ticked off points on my fingers. "Inexplicably dead MPs. Skeletons with cut marks." Ryan started to speak. I blew past him to ring man. "Cut marks consistent with scalpel nicks. A sketchy doctor in the United States, with a med school classmate who's dropped off the map. A mysterious health spa in Mexico."

Ryan scootched up and put a pillow behind his head. "Show me."

Crawling under the covers, I sat Indian style, opened Cruikshank's laptop and rested it on my crossed ankles.

"Cruikshank spent a lot of time researching transplantation, black marketeering in organs, Charleston MPs, and a place called Abrigo Aislado de los Santos near Puerto Vallarta."

"The Mexican resort in the brochure?"

"Yeah," I snorted. "Last resort."

I nibbled a cuticle, debated how to take Ryan through this since I'd just begun to comprehend most of it myself.

"Since the early fifties, transplantation has become relatively common. A kidney or a portion of liver can be given by a living donor, even a single lung, though that's rare. Heart, cornea, double-lung, or pancreas transplants have to come from cadaverous donors.

"The problem is there aren't enough organs to go around. If you can use a live donor, you're better off. You might be compatible with a family member, a friend, or a charitable donor, though those are few and far between. If you need a cadaverous donor, you could sit for months, or even years."

"And die waiting."

"In the United States, those needing cadaverous donors become part of OPTN, the Organ Procurement and Transplantation Network, operated by an independent nonprofit organization called UNOS, the United Network for Organ Sharing. UNOS maintains a database of eligible transplant recipients, as well as information on all organ transplant centers throughout the country. UNOS also establishes policy with regard to priority and who gets which organs."

"How does a patient get into the network?"

"You have to find a transplant team qualified with UNOS. That team decides if you're a good candidate, physically and mentally."

"Meaning?"

"It's complicated, but drug and alcohol abusers and smokers are usually disqualified, for example. UNOS also ranks potential recipients based on health, urgency of need, compatibility, length of time on the list, that sort of thing. They want available organs used where they are likely to do the most good."

Ryan cut to the core. "So those rejected and those tired of waiting go outside the system."

"So-called brokers arrange sales of human organs to patients who can pay. Usually the sellers are willing participants. Kidneys are the most commonly traded, and, in most cases, it's poor people in developing countries selling their organs to the wealthy. The cost can run over one hundred thousand dollars, with the donor receiving only a fraction of that."

"This is widespread?"

"Cruikshank had tons of research on his computer. Some of his sources describe the kidney trade as a global phenomenon. Nancy Scheper-Hughes, a Berkeley anthropologist, has established an NGO called Organ Watch, which claims to have documented organ harvesting in Argentina, Brazil, Cuba, Israel, Turkey, South Africa, India, the United States, and the United Kingdom. Cruikshank also found information on Iran and China."

I clicked a few keys, and Ryan and I skimmed a report on the use of executed criminals as donors in China.

"You can actually purchase package deals." I opened a series of files and we both read in silence.

An Israeli-led syndicate offered transplant tours to Turkey and Romania for $180,000 U.S. A New York woman bought a kidney from a Brazilian donor, then traveled to South Africa for surgery at a private clinic at a total outlay of $65,000 U.S. A Canadian went to Pakistan in a cash-for-kidney deal costing $12,500 Canadian.

"Check out this Web site."

I clicked to another download. A Pakistani hospital described itself as a fifty-bed private facility in operation since 1992. The site offered a package that included three weeks' lodging, three daily meals, three presurgical dialysis sessions, donor expenses, surgery, and two days' post-discharge medication for $14,000 U.S.

"Tabarnac!" Ryan sounded as appalled as I felt.

"Most countries outlaw this, but not all. In Iran, for example, it's legal but regulated." I opened another file. "The U.S. National Organ Transplant Act of 1984 prohibits payment to those providing organs for transplantation. The Uniform Anatomical Gift Act allows individuals to specify that some or all of their body may be donated after their death. Nineteen eighty-seven revisions to the act prohibit the taking of payment for donated parts."

"OK. Cash for kidneys. But murder?"

I opened several downloads.

South Africa. June 1995. Moses Mokgethi was found guilty of the murder of six children for their organs.

Ciudad Juárez and Chihuahua, Mexico. May 2003. Hundreds of women had been killed since 1993, and bodies continued turning up in the desert. Federal investigators claimed to have evidence the women were victims of an international organ trafficking ring.

Bukhara, Uzbekistan. No date. A family named Korayev was found with the passports of sixty missing persons, an enormous sum of money, and bags of body parts in their home. Their company, Kora, promised visas and overseas jobs. Instead, according to police, the Korayevs killed their clients and, working with a doctor, pipelined their organs to Russia and Turkey.

"Jesus."

"Theft from fresh cadavers is even more common," I said. "And not just in the Third World. Organ Watch has also reported on U.S. cases in which families of brain-dead patients have been offered as much as a million dollars to give organ harvesters access to the bodies immediately upon death."

The room was brightening. I got up and slid open the glass door. The smell of the ocean made me think of boogie-boarding with my kid sister, Harry, beach blanket gossip with high school best friends, sand castle construction with Katy and Pete.

Pete. Again, that pang deep in my chest.

I wanted to go back to one of those long summer days, to forget putrefied bodies, and scalpels, and wire nooses.

"So you believe someone at the GMC clinic is snuffing street people to harvest their organs." Ryan's voice brought me back. "And that Cruikshank was about to blow the whistle."

"I think Cruikshank was killed to keep him quiet. And I'm wondering about Helene Flynn, too."

"Suspects?"

"I'm not sure. The operation would have to involve several people, and a clinic has to be at the core. The average guy on the street can't just yank out a kidney."

Returning to bed, I opened another file.

"Removing an organ isn't all that complicated. In the case of a heart, for example, the vessels are clamped, and a cold, protective solution is pumped inside. The vessels are then severed, and the heart is placed in a bag filled with preservative. The bag is packed in ice in an ordinary cooler and flown or driven to its destination."