SYLVIE CHARMET BLEW INTO the restaurant like a squall off the South Atlantic, bussed Gilda once on each cheek, and slipped into the chair the waiter had hastened to pull out. Gilda waited until she had Sylvie’s full attention before pointedly looking at her watch. Then she lifted her eyes and stared at her friend.
“Once, just once, Sylvie, it would be nice if you’d show up for lunch on time.”
Sylvie made a dismissive gesture. She was big on dismis-sive gestures. “I’ve got a new shrink,” she said.
Sylvie was a cardiovascular surgeon, a lithe brunette in her early thirties and, like Gilda, still unmarried. When it came to her work, Sylvie was meticulous, but the rest of her life was a mess. Only the attentions of a full-time faixineira could keep her small apartment in order. The inside of her car looked like a teenager’s room. She couldn’t seem to find a new boyfriend and was flitting from psychiatrist to psychiatrist, trying to fig-ure out why her fiancé of four years, another doctor, had aban-doned her for a medical secretary with wide hips and thick glasses.
“What’s a new shrink got to do with anything?”
“She’s got man trouble, too. I got her to talk about it.”
Gilda rolled her eyes at the breach of professionalism. “The halt leading the blind. Are you helping each other?”
“Too early to tell.” Sylvie settled back in her chair and studied Gilda’s face. “What’s the matter with you?”
“Nothing,” Gilda said, and buried her nose in the menu.
“Oh, come on. You can’t honestly be in a tiff just because I’m a few minutes late.”
“It’s not that.”
“But it’s something. Man trouble?”
Sylvie was also big on projecting. If she had a problem, she was prone to believe that others had the same problem.
“I wish,” Gilda said. “My boss is sixty-five if he’s a day, happily married with grandchildren. The only young bache-lor in the medical examiner’s office is gay, and my patients are all dead.”
Sylvie didn’t bother to grin. She’d heard the crack about dead patients before.
“Prospects?” she said.
“Maybe one,” Gilda admitted.
Sylvie wriggled in her seat. “Tell,” she said.
“He’s a federal cop, and he’s cute.”
“A federal cop?”
“Not just a cop. A delegado. You have to be a lawyer to be a delegado.”
“Yeah. I know. But Gilda, a
cop?
”
“You think I should hold out for another doctor?”
“Touché. You have a picture?”
“Not yet.”
“How’d you meet him?”
“I’ll get to that later. And Sylvie . . .”
“Yes?”
“I don’t want you shooting your mouth off about this. It’s in the early stages yet.”
“Your secrets are safe with me, querida. I don’t even know any cops. Yet.”
“Alright then. I’ll trust your discretion. How’s it going with you?”
“In the man department?”
Gilda nodded.
“The usual,” Sylvie said.
“A complete disaster?”
“I work with an anesthesiologist who’s interested, but he’s a creep. I met a guy at a party who wasn’t wearing a wedding ring, and I thought he was a legitimate target, but then his namora-da showed up and dragged him off to her lair. My boss is unmar-ried, but he’s even older than yours, and for all the attention he pays to women, he must have shelved his sexuality. Sometimes I think I should have dropped all the medical-school crap and become a secretary. Secretaries find men and get married.”
“So do doctors.”
“Yeah, but most of them marry nurses. Can you see me with a male nurse?”
“Frankly? No.”
“Me neither.” Sylvie picked up the menu and perused it. “What are you going to have?”
“While I was waiting for you, I had a long talk with the waiter. About half an hour’s worth. I know his life story.”
“Married?”
“Yes. Happily.”
“And your point?”
“He said the snapper in lemon butter is good.”
Actually the conversation with the waiter had taken all of thirty seconds, Gilda had no idea whether he was married or not, and he hadn’t said a word about the snapper in lemon butter. It was just that the snapper was the cheapest thing on the menu. The waiter had nodded in a superior fashion when she’d asked him if he could recommend it. Compared to what Sylvie earned, Gilda’s salary was paltry, and she was still reeling in shock over the prices on the menu.
“And it’s your turn to pay, right?” Sylvie said, as if she could read Gilda’s thoughts.
Gilda nodded.
Sylvie perused her menu, then looked Gilda straight in the eye and said, “I’m going to have lobster Thermidor and a split of Cordon Rouge.”
“Sylvie—”
“On the other hand, I might have the snapper, but only if you come clean and you do it right now. What’s bugging you?”
Gilda rested her forearms on the white damask and leaned forward.
“Let’s order and I’ll tell you.”
Sylvie snapped her menu shut.
“Snapper it is, then,” she said, “but you’ve got to promise you’ll brief me on the cop before I leave this table.”
Gilda raised her hand and crossed her fingers as children do when they’re making solemn promises.
The waiter thought she was signaling him, and promptly came to the table. They ordered the snapper and compro-mised on a bottle of Chilean white.
When he was gone, Sylvie gestured with her hands, as if she were presenting the place.
“Well?” she said with a proprietary air.
“Very nice, but expensive.”
“Worth every centavo. You’re going to love it.”
Gilda wasn’t sure about that. Even the snapper in lemon butter was a strain on her budget. The waiter came back with the wine and let Gilda taste it. She nodded. He half-filled each of their glasses and went away again.
“So out with it,” Sylvie prompted. “You pregnant? Been fired? Have a particularly bad morning cutting up one of your patients?”
“None of that,” Gilda said.
“Then what?”
“I want you to tell me how you source human hearts.”
SILVIE HAD BEEN LEANING forward, resting her chin on the heel of one hand. She put her hand on the table and sat up straight in her chair.
“What?”
“Hearts. Hearts from people recently dead. The ones you use for transplants. Where do you source them from?”
Sylvie frowned. “From donors, of course. Why?”
“I’m paying. I get to ask my questions first. Where else do you get hearts from?”
“Nowhere else. That’s it. Donors.”
“And these . . . donors? They make that decision, to
be
donors, before they die?”
Sylvie shook her head. “Mostly not. Consent from their next of kin is what we usually get. And that consent has to be quick. If we don’t get a heart into refrigeration within three hours after death, my boss won’t use it. He won’t use it, either, if the person died from any one of a number of dis-eases, and he won’t use a heart from anyone over fifty, no matter what shape it appears to be in.”
“And lots of people do it?”
“Do what?”
“Agree to donate their next of kin’s hearts.”
“Not enough. It’s the biggest problem we have.”
“So how do you go about it?”
The waiter was back with their fish. Sylvie put down her wine glass, picked up a fork, cut off a small piece of snapper, popped it into her mouth, and savored it.
“Delicious,” she said. “You know something? I don’t like lobster anyway.”
“How do you go about it?” Gilda insisted. “The sourcing, I mean.”
“I
don’t
go about it,” Sylvie said. “I just implant them.”
“But you must have some idea.”
“Some idea, yes. Basically, it works like this: a good prospect comes into a public hospital; maybe some kid shot to death in a favela, maybe a young woman run over by a car. Anyway, somebody who didn’t die of a debilitating disease, someone who met a sudden, usually violent, end. If the upper torso doesn’t seem to have sustained any major dam-age, if the area around the heart seems to be in good shape, somebody at the hospital tips off my boss and—”
“Why would somebody at the hospital do that?” Gilda interrupted. “Tip off your boss?”
Sylvie took a sip of wine.
“Good stuff, this,” she said.
“Sylvie . . .”
Sylvie glanced at the neighboring tables and lowered her voice.
“There’s this woman we have on staff,” she said. “Once he gets the tip, she goes over there, has a chat with the family, tells them how much good they can do by helping someone else, and gets them to release the heart to us.”
“Why don’t they release it to the hospital?”
“Get real, Gilda. You have any idea how much my boss charges for a heart transplant?”
“What’s that got to do with it?”
“It’s got everything to do with it. He pegs his fees to the American dollar, and he gets the whole sum in advance. There’s nothing unusual in that. All the private clinics do it. The current price is four hundred thousand dollars.”
“
Dollars?
” Gilda did a quick calculation. Four hundred thousand dollars was only a little less than eight hundred thousand reais.
“God,” she said. “I had no idea. Are you suggesting that he uses part of that to pay for tips from hospital staff and part to pay survivors? That he
buys
hearts?”
“I’m not suggesting anything,” Sylvie said.
But both of them knew she was. And both of them knew it was illegal. In Brazil, as in most countries, the law pro-scribes trafficking in human organs.
“Four hundred thousand dollars,” Gilda repeated, still try-ing to come to terms with the enormity of the sum. “How can he get away with charging so much?”
Sylvie continued to dissect her fish. “He not only gets away with it, he has patients standing in line to pay. If shelling out the money is the only thing that’s going to save your life, you shell out the money. And, if you don’t have it, you beg, borrow, or steal. You know where I worked before?”
“You worked in a number of places. You mean where you first started doing transplants? The Hospital das Clinicas?”
The Hospital das Clinicas was owned and run by the state of São Paulo. Most of the patients were people who received free treatment under the government health scheme.
“Uh-huh,” Silvie said. She put a morsel of fish into her mouth, chewed, and swallowed. “Any idea what their official charge is for a heart transplant?”
“Why ‘official?’ ”
“They have to put a number on it. Some people fall out-side the government health scheme, and that’s what they’d charge,
if
they charged, but they never do. Guess. Guess how much it is.”
“I haven’t the slightest idea.”
“Twenty thousand reais.”
“So why doesn’t everyone elect to do their procedure there?”
“Because, querida, the Clinicas, like every other public hospital, has a hell of a time getting healthy hearts. They source only one or two a month on average. And if you want one, there’s a waiting list as long as my ex-fiancé’s penis— which is very long indeed, believe you me.”
“How does one—”
Sylvie anticipated her question. “Get to the top of the list?”
Gilda nodded.
“You make sure you’re young, suffering exclusively from heart failure, and just about to die. And you make sure you’ve been on that list for at least six months, because, all other considerations being equal, hearts are doled out on a first-come, first-served basis.”
While Gilda digested that, Sylvie ingested the rest of her snapper. She left the vegetables and potatoes on the plate and poured herself another glass of white wine.
“So,” Gilda said, “Many patients at the Clinicas die while they’re waiting for a heart?”
Sylvie nodded.
“If you’re over sixty, or if you suffer from a life-threatening disease in addition to your heart problem, your chances of getting an organ through the Clinicas are nil.”
“So that’s the patient profile at your boss’s clinic? The old? The people who suffer from other diseases?”
“Our patients aren’t
all
old, and they don’t
all
suffer from other diseases, but they’re
all
people that can scratch up four hundred thousand dollars. Mind you, even with us there’s no guarantee. We still have more patients than we can find hearts for. The money buys you a better chance, but it doesn’t give you a guarantee. If we could guarantee a heart to any-one who asked, we’d probably be able to charge twice as much. But one thing’s for sure: if you’re poor, you can’t afford us. You have to take your chances with a public hospital.”
“Where the likelihood of someone getting a heart is akin to one’s chances of winning the national lottery?”
“Exactly.”
“And you think that’s right?”
“I’m not a jurist, Gilda. I’m a surgeon. I don’t dictate how the system works. I’m just telling you how it is. Besides, rich people have as much right to life as poor people, wouldn’t you say?”
“But—”
“It’s all regulated, Gilda. The survivors can donate the heart to whomever they want.”
“But not for gain.”
“Not legally, no. But who’s to say it’s for gain?”
“You just implied that—”
Sylvie waved a finger in front of Gilda’s nose.
“No audit by health or tax authorities has ever detected an irregularity in my clinic’s paperwork. I made sure of that before I took the job. I want to earn money, that’s only nat-ural, but not if it involves a risk of losing my license to prac-tice medicine. What with my love life being the way it is, my profession might be the only thing I’ll have to sustain me in my old age.”
Gilda shook her head, more in condemnation of the prac-tice than denial at Sylvie’s prospects. Sylvie reached out and put a hand over one of hers. “Gilda, Gilda, you’re always painting things in black-and-white. The world doesn’t work that way. You have to see the other side of things.”
“Other side?”
Gilda tried to withdraw her hand, but Sylvie held on to it and leaned forward in her chair.
“Look,” she said, “if I’d stayed at the Hospital das Clinicas, I might have done a heart transplant every six months. These days, on the average, I do three times as many. I save more lives and I make more money. What’s wrong with that? Everybody wins. Not only me. The patients win, too.”
“But the public hospitals—”
“Forget the public hospitals. They can’t compete. Stop looking at me like that and eat your fish.”
“I lost my appetite.”
Sylvie shrugged and released Gilda’s hand. “Suit yourself. But now it’s your turn. I’ve been doing all the talking, and you haven’t told me a damn thing. What sparked all this curiosity about heart transplants, and what’s it to you?”
Gilda thought for a moment about how to begin. Finally, she just plunged in. “Have you seen the press coverage on that clandestine cemetery?”
“The one up in the Serra da Cantareira? All those desa-parecidos?”
“They weren’t desaparecidos. They couldn’t have been killed by the military government. The corpses hadn’t been in the ground long enough.”
“Okay. So
when
were they killed? And
why
were they killed? And who killed them?”
“That’s what I’m struggling with. The cop I’m seeing tonight is assigned to the case. That’s how I met him. He came to the morgue to view the bodies.”
“How romantic. What a great story to tell your grandchil-dren. How grandpa and I met one morning over the—”
“Not funny, Sylvie.”
“No? I thought it was. Maybe you should lighten up.”
“And maybe you should pay attention to what I’m saying. The cops seem to think that some cult is responsible for the murders.”
“Some cult?”
“People performing ritual murders. It’s happened before, apparently.”
“But you—”
“Have another idea. And it seems crazy, even to me. I don’t know whether I should tell him about it or not. I need a second opinion. You’re a cardiovascular surgeon; you’re the ideal person to ask.”
“Gilda, what the hell are you getting at?”
Gilda leaned across the table. “Sylvie, in every case,
in
every single case,
the sternums of the victims had been sawn through. Not hacked, not chopped,
sawn.
”
Sylvie paused with her wine glass halfway to her lips. “With a sternal saw?”
“Yes. With a sternal saw.”
Sylvie put down her glass, pursed her lips, took in a deep breath, let it out slowly.
“Look, I wouldn’t tell you that organ theft doesn’t hap-pen—”
“So it
does
happen?”
“Let me finish, okay? I’m attuned to all of this stuff be-cause it directly affects what I do. There was a case a few months ago in one of the municipal mortuaries. A university student slit his wrists and died. His family sent clothes to dress him for his funeral. This is pretty macabre stuff. You sure you want to discuss it over lunch?”
“Have you forgotten what I do all day? Do you think I could do it if I had a weak stomach?”
“Okay, okay, take it easy.”
Gilda sniffed. “Yes, I want to discuss it.”
Sylvie took a hefty swallow of wine before she continued. “The student’s mother got it into her head that she didn’t like the choice of clothing, that she wanted to dress him herself. Last thing she could do for her son and all that. She goes to the mortuary, strips off his shirt, and finds stitches right down the middle of his chest. She goes ballistic and calls the cops. It turns out that one of the attendants had a nice little business going for himself, selling organs to a research lab.”
“Not for transplant?”
“No. They were no good for that. He wasn’t getting them out quickly enough. Then there was this ex-Israeli defense forces colonel up in Recife. You heard about him?”
“No.”
“I’m surprised. It was in all the papers.” Sylvie reached for the bottle of wine, refilled her glass, and made to top up Gilda’s. Gilda put her hand over the mouth of the glass.
“I must have missed it,” she said.
Sylvie shrugged and put down the bottle.
“It wasn’t a case of theft per se. The colonel wasn’t steal-ing, he was buying. Kidneys to be precise.”
“Kidneys?”
“Yeah. It’s damned near impossible to get kidney donors in Israel because there’s something in their religion about the body being buried intact. The colonel was recruiting poor people who were willing to sell one of their kidneys. He had a deal going with a hospital in Johannesburg. The recipients would fly from Israel, the donors from Recife. They’d do the operation there, and the donors would come back without one of their kidneys. It took awhile for the federal cops to catch on. The colonel’s partner was the local police chief.”
“Jesus.”
“Yeah. And then there was a couple who were willing to sell their kid.”
“Sell their kid? So somebody could extract his organs?”
“Uh-huh. How sick is that? They were Albanians, living in Italy. They held an auction. Infant hearts are extremely rare, so they figured they could get a good price. The cops heard about it, mounted a sting operation, and nailed them.”
Sylvie speared her last piece of fish and popped it into her mouth.
“So the baby survived?” Gilda asked.
Sylvie, still chewing, nodded. Then she swallowed and said, “In that case, yes.”
“A couple of years ago,” Gilda said, “I had a maid who told me foreigners were coming into the country, adopting kids out of favelas, taking them home, and cutting them up for their organs.”
“The consensus on that one,” Sylvie said, “is that it’s an urban legend, but the rumor was widespread enough for the government to tighten adoption regulations.”
“What about the regulations pertaining to transplants? Why don’t they do something about that?”
“They already have. Clinics like mine are very strict about the paperwork. The origin of any organ we receive has to be proven beyond a shadow of a doubt.”
“‘Clinics like mine,’ you said. Are there other kinds of clinics?”
Sylvie put down her fork and wiped her mouth with her napkin.
“At the Hospital das Clinicas,” she said, “we had an aver-age of six young men die of gunshot wounds every single day. Most of them, the ones who weren’t shot in the chest, would have made pretty good donors. Those victims, alone, would have generated over two thousand hearts a year. You know how many hearts were donated last year?”