The Surgeon (2 page)

gloved hand in, her short fingers straining to explore the cavity.
"Nothing else was removed?" she asked.
"Just the uterus," said Tierney. "He left the bladder and
bowel intact."
"What's this thing I'm feeling here? This hard little knot, on
the left side," she said.
"It's suture. He used it to tie off blood vessels."
Rizzoli looked up, startled. "This is a surgical knot?"
"Two-oh plain catgut," ventured Moore, looking at Tierney
for confirmation.
Tierney nodded. "The same suture we found in Diana
Sterling."
"Two-oh catgut?" asked Frost in a weak voice. He had
retreated from the table and now stood in a corner of the
room, ready to bolt for the sink. "Is that like a--a brand name
or something?"
"Not a brand name," said Tierney. "Catgut is a type of
surgical thread made from the intestines of cows or sheep."
"So why do they call it catgut?" asked Rizzoli.
"It goes back to the Middle Ages, when gut strings were

used on musical instruments. The musicians referred to their
instruments as their kit, and the strings were called kitgut. The
word eventually became catgut. In surgery, this sort of suture
is used to sew together deep layers of connective tissue. The
body eventually breaks down the suture material and absorbs
it."
"And where would he get this catgut suture?" Rizzoli looked
at Moore. "Did you trace a source for it on Sterling?"
"It's almost impossible to identify a specific source," said
Moore. "Catgut suture's manufactured by a dozen different
companies, most of them in Asia. It's still used in a number of
foreign hospitals."
"Only foreign hospitals?"
Tierney said, "There are now better alternatives. Catgut
doesn't have the strength or durability of synthetic sutures. I
doubt many surgeons in the U.S. are currently using it."
"Why would our unsub use it at all?"
"To maintain his visual field. To control the bleeding long
enough so he can see what he's doing. Our unsub is a very
neat man."
Rizzoli pulled her hand from the wound. In her gloved palm
was cupped a tiny clot of blood, like a bright red bead. "How
skillful is he? Are we dealing with a doctor? Or a butcher?"

"Clearly he has anatomical knowledge," said Tierney. "I
have no doubt he's done this before."
Moore took a step backward from the table, recoiling from
the thought of what Elena Ortiz must have suffered, yet unable
to keep the images at bay. The aftermath lay right in front of
him, staring with open eyes.
He turned, startled, as instruments clattered on the metal
tray. The morgue attendant had pushed the tray next to Dr.
Tierney, in preparation for the Y-incision. Now the attendant
leaned forward and stared into the abdominal wound.
"So what happens to it?" he asked. "Once he whacks out
the uterus, what does he do with it?"
"We don't know," said Tierney. "The organs have never
been found."

two
M    oore stood on the sidewalk in the South End
neighborhood where Elena Ortiz had died. Once this had
been a street of tired rooming houses, a shabby backwater
neighborhood separated by railroad tracks from the more
desirable northern half of Boston. But a growing city is a
ravening creature, always in search of new land, and railroad
tracks are no barrier to the hungry gaze of developers. A new
generation of Bostonians had discovered the South End, and
the old rooming houses were gradually being converted to
apartment buildings.

Elena Ortiz lived in just such a building. Though the views
from her second-story apartment were uninspiring--her
windows faced a Laundromat across the street--the building
did offer a treasured amenity rarely found in the city of Boston:
tenant parking, crammed into the adjacent alley.
Moore walked down that alley now, scanning the windows in
the apartments above, wondering who at that moment was
looking down at him. Nothing moved behind the windows'
glassy eyes. The tenants facing this alley had already been
interviewed; none had offered any useful information.
He stopped beneath Elena Ortiz's bathroom window and
stared up at the fire escape leading to it. The ladder was
pulled up and latched in the retracted position. On the night
Elena Ortiz died, a tenant's car had been parked just beneath
the fire escape. Size 8 1/2 shoe prints were later found on the
car's roof. The unsub had used it as a stepping-stone to reach
the fire escape.
He saw that the bathroom window was shut. It had not been
shut the night she met her killer.
He left the alley, circled back to the front entrance, and let
himself into the building.
Police tape hung in limp streamers across Elena Ortiz's
apartment door. He unlocked the door and fingerprint powder
rubbed off like soot on his hand. The loose tape slithered

across his shoulders as he stepped into the apartment.
The living room was as he remembered it from his walk-
through the day before, with Rizzoli. It had been an unpleasant
visit, simmering with undercurrents of rivalry. The Ortiz case
had started off with Rizzoli as lead, and she was insecure
enough to feel threatened by anyone challenging her authority,
especially an older male cop. Though they were now on the
same team, a team that had since expanded to five
detectives, Moore felt like a trespasser on her turf, and he'd
been careful to couch his suggestions in the most diplomatic
terms. He had no wish to engage in a battle of egos, yet a
battle was what it had become. Yesterday he'd tried to focus
on this crime scene, but her resentment kept pricking his
bubble of concentration.
Only now, alone, could he completely focus his attention on
the apartment where Elena Ortiz had died. In the living room
he saw mismatched furniture arranged around a wicker coffee
table. A desktop computer in the corner. A beige rug
patterned with leafy vines and pink flowers. Since the murder,
nothing had been moved, nothing altered, according to
Rizzoli. The last light of day was fading in the window, but he
did not turn on the lights. He stood for a long time, not even
moving his head, waiting for complete stillness to fall across
the room. This was the first chance he'd had to visit the scene
alone, the first time he'd stood in this room undistracted by the
voices, the faces, of the living. He imagined the molecules of
air, briefly stirred by his entry, now slowing, drifting. He wanted

the room to speak to him.
He felt nothing. No sense of evil, no lingering tremors of
terror.
The unsub had not come in through the door. Nor had he
gone wandering through his newly claimed kingdom of death.
He had focused all his time, all his attention, on the bedroom.
Moore walked slowly past the tiny kitchen and started up
the hallway. He felt the hairs on the back of his neck begin to
bristle. At the first doorway he paused and stared into the
bathroom. He turned on the light.
Thursday is a warm night. It is so warm that all across the
city, windows are left open to catch every stray breeze, every
cool breath of air. You crouch on the fire escape, sweating in
your dark clothes, staring into this bathroom. There is no
sound; the woman is asleep in the bedroom. She has to be
up early for her job at the florist's, and at this hour her sleep
cycle is passing into its deepest, most unarousable phase.
She doesn't hear the scratch of your putty knife as you
pry open the screen.
Moore looked at the wallpaper, adorned with tiny red
rosebuds. A woman's pattern, nothing a man would choose. In
every way this was a woman's bathroom, from the strawberry-
scented shampoo, to the box of Tampax under the sink, to the

medicine cabinet crammed with cosmetics. An aqua-eye-
shadow kind of gal.
You climb in the window and fibers of your navy-blue shirt
,
catch on the frame. Polyester. Your sneakers, size 8 1/ 2,
leave prints coming in on the white linoleum floor. There are
traces of sand, mixed with crystals of gypsum. A typical mix
picked up from walking the city of Boston.
Maybe you pause, listening in the darkness. Inhaling the
sweet foreignness of a woman's space. Or maybe you waste
no time but proceed straight to your goal.
The bedroom.
The air seemed fouler, thicker, as he followed in the
intruder's footsteps. It was more than just an imagined sense
of evil; it was the smell.
He came to the bedroom door. By now the hairs on the
back of his neck were standing straight out. He already knew
what he would see inside the room; he thought he was
prepared for it. Yet when he turned on the lights, the horror
assailed him once again, as it had the first time he'd seen this
room.
The blood was now over two days old. The cleaning service
had not yet come in. But even with their detergents and steam
cleaners and cans of white paint, they could never fully erase

what had happened here, because the air itself was
permanently imprinted with terror.
You step through the doorway, into this room. The curtains
are thin, only an unlined cotton print, and light from the
street lamps shines through the fabric, onto the bed. Onto
the sleeping woman. Surely you must linger a moment,
studying her. Considering with pleasure the task that lies
ahead. Because it is pleasurable for you, isn't it? You are
growing more and more excited. The thrill moves through
your bloodstream like a drug, awakening every nerve, until
even your fingertips are pulsing with anticipation.
Elena Ortiz did not have time to scream. Or, if she did, no
one heard her. Not the family in the unit next door, nor the
couple below.
The intruder brought his tools with him. Duct tape. A rag
soaked in chloroform. A collection of surgical instruments. He
had come fully prepared.
The ordeal would have lasted well over an hour. Elena Ortiz
was conscious for at least part of that time. The skin on her
wrists and ankles was chafed, indicating she had struggled. In
her panic, her agony, she had emptied her bladder, and urine
had soaked into the mattress, mingling with her blood. The
operation was a delicate one, and he took the time to do it
right, to take only what he wanted, nothing more.

He did not rape her; perhaps he was incapable of doing so.
When he'd finished his terrible excision, she was still alive.
The pelvic wound continued to bleed, the heart to pump. How
long? Dr. Tierney had guessed at least half an hour. Thirty
minutes, which must have seemed an eternity to Elena Ortiz.
What were you doing during that time? Putting your tools
away? Packing your prize in a jar? Or did you merely stand
here, enjoying the view?
The final act was swift and businesslike. Elena Ortiz's
tormentor had taken what he wanted, and now it was time to
finish things. He'd moved to the head of the bed. With his left
hand he'd grasped a handful of her hair, yanking backward so
hard he tore out more than two dozen strands. These were
found later, scattered on the pillow and floor. The bloodstains
shrieked out the final events. With her head immobilized and
the neck fully exposed, he'd made a single deep slash starting
at the left jaw and moving rightward, across the throat. He had
severed the left carotid artery and the trachea. Blood spurted.
On the wall to the left of the bed were dense clusters of small
circular drops flowing downward, characteristic of arterial
spray as well as exhalation of blood from the trachea. The
pillow and sheets were saturated from downward dripping.
Several cast-off droplets, thrown off as the intruder swung
away the blade, had spattered the windowsill.
Elena Ortiz had lived long enough to see her own blood

spurt from her neck and hit the wall in a machine-gun spray of
red. She had lived long enough to aspirate blood into her
severed trachea, to hear it gurgle in her lungs, to cough it out
in explosive bursts of crimson phlegm.
She had lived long enough to know she was dying.
And when it was done, when her agonal struggles had
ceased, you left us a calling card. You neatly folded the
victim's nightshirt, and you left it on the dresser. Why? Is it
some twisted sign of respect for the woman you've just
slaughtered? Or is it your way of mocking us? Your way of
telling us that you are in control?
Moore returned to the living room and sank into an
armchair. It was hot and airless in the apartment, but he was
shivering. He didn't know if the chill was physical or emotional.
His thighs and shoulders ached, so maybe it was just a virus
coming on. A summer flu, the worst kind. He thought of all the
places he'd rather be at that moment. Adrift on a Maine lake,
his fishing line whicking through the air. Or standing at the
seashore, watching the fog roll in. Anywhere but this place of
death.
The chirp of his beeper startled him. He shut it off and
realized his heart was pounding. He made himself calm down
first before he took out the cell phone and punched in the
number.

"Rizzoli," she answered on the first ring, her greeting as
direct as a bullet.
"You paged me."
"You never told me you got a hit on VICAP," she said.
"What hit?"
"On Diana Sterling. I'm looking at her murder book now."
VICAP, the Violent Criminals Apprehension Program, was
a national database of homicide and assault information
gathered from cases across the country. Killers often
repeated the same patterns, and with this data investigators
could link crimes committed by the same perpetrator. As a
matter of routine, Moore and his partner at the time, Rusty
Stivack, had initiated a search on VICAP.
"We turned up no matches in New England," said Moore.
"We ran down every homicide involving mutilation, night entry,
and duct tape bindings. Nothing fit Sterling's profile."
"What about the series in Georgia? Three years ago, four
victims. One in Atlanta, three in Savannah. All were in the
VICAP database."
"I reviewed those cases. That perp is not our unsub."
"Listen to this, Moore. Dora Ciccone, age twenty-two,

graduate student at Emory. Victim first subdued with
Rohypnol, then restrained to the bed with nylon cord--"
"Our boy here uses chloroform and duct tape."
"He sliced open her abdomen. Cut out her uterus.
Performed a coup de grace--a single slash across the neck.
And finally--get this--he folded her nightclothes and left them
on a chair by the bed. I'm telling you, it's too goddamn close."
"The Georgia cases are closed," said Moore. "They've
been closed for two years. That perp is dead."
"What if Savannah PD blew it? What if he wasn't their killer?
"
"They had DNA to back it up. Fibers, hairs. Plus there was
a witness. A victim who survived."
"Oh yeah. The survivor. Victim number five." Rizzoli's voice
held a strangely taunting note.
"She confirmed the perp's identity," said Moore.
"She also conveniently shot him to death."
"So what, you want to arrest his ghost?"
"Did you ever talk to that surviving victim?" Rizzoli asked.
"No."