Neil McMahon - To the Bone

Late one hot summer night, a beautiful young actress named Eden Hale -- only hours removed from breast-augmentation surgery, and writhing in pain -- stumbles to the telephone and dials 911. Within minutes, an ambulance rushes her to San Francisco's Mercy Hospital. But by the time she arrives, she is dying, fast, of a mysterious, unrecognizable condition.

Dr. Carroll Monks, the ER physician on duty, races to sort through her baffling symptoms in the few minutes he has left to save her. Monks has a sudden insight and, against the advice of his peers, risks a radical treatment, which will prove to be either a brilliant maneuver or a potentially deadly mistake. It fails. Eden Hale, vibrantly healthy and barely twenty-five years old, is dead.

The fallout is immediate and intense. The plastic surgeon who operated on Eden -- Dr. D. Welles D'Anton, whose reputation as a surgical guarantor of perfection and agelessness has conferred on him a guru-like status -- blames Monks for her death. Criticism from Monks's hospital colleagues quickly follows and the threat of a lawsuit is not far behind. Monks's career is in jeopardy, but his own guilt and uncertainty are what haunt him worst of all.

Convinced there's a hidden cause to Eden's death, Monks starts to delve into her past. Despite roadblocks that spring up in his path, he soon learns that the former prom queen was not the all-American girl she seemed to be: she was caught up in the world of pornography, and was even, possibly, having an illicit affair with D'Anton. Then Monks uncovers a secret that is far more frightening: other young women in D'Anton's care have wound up missing, dead, or horribly disfigured.

In his search for the truth, Monks is drawn into a culture of unimaginable wealth and vanity -- only to discover that he is being used as a pawn in a decadent game of glamour and cruelty, one that places him in the crosshairs of a deadly psychopath.

Copyright (c) 2003 by Neil McMahon

For Drs. Barbara and Dan McMahon
Heart empowers mind
Mind informs heart

She was not old, nor young, nor at the years
Which certain people call a "certain age,"
Which yet the most uncertain age appears.

--Lord Byron

A feverish tormenting dream of fire, spreading through her, forced her awake. She was in bed, knees drawn up to her chest, hands clenched tightly. The apartment was dark and still. The overhead fan whispered, cooling the air, but the sheets were soaked with sweat. Her blurred eyes could just make out the glowing red numbers on the alarm clock: 3:18 a.m.

The fire stayed behind in the dream, but the pain was real. She twisted with nausea, moaning.

"Ray?" she whispered. Her throat was parched, her voice hoarse. "Is anyone here?"

Nothing stirred in the darkened rooms. Her mind was foggy from drugs, but she remembered that the boyfriend who was supposed to stay with her had gone out for cigarettes. Someone else had stopped by after that-someone kind, feeding her soup and more painkillers, that had eased her into sleep.

But that was hours ago. The pain had been only in her breasts then, but now it was everywhere-fierce cramping and burning that worsened in quick stages, like the tightening of a vise.

She focused her teary vision on the phone, on her bedside table. It was out of reach, and the thought of moving was intolerable. But the pain pierced like shards of glass. Sobbing, still curled up tight, she inched across the endless expanse of bedsheet. As she groped for the phone, an image flitted through her brain, a memory or dream as she had drifted into sleep, of hands disconnecting and lifting away her answering machine.

Her fingers found the receiver and pressed the lighted numbers 911.

"Please help me," she managed, to the operator's crisp answer. "I need an ambulance." She gasped out the syllables of her address.

Then she dropped the phone, distantly aware of the concerned voice saying, "Ma'am? Ma'am? Are you there?"

She tightened back into herself, hugging her knees with all her strength as if she could compress her body into a point so tiny, the agony would have no place to remain.

It remained.

But then, inside her mind, she glimpsed a hazy image, like a window opening up. Someone was on the other side-a taffy-haired teenaged girl, dancing alone in front of a full-length mirror. She was bold, saucy, her movements graceful and provocative. The girl was herself, she realized, ten years ago, already showing the earthy beauty that she would grow into.

When the chance had come to make that beauty perfect -- to turn herself into a different person, a better one-she had taken it.

Who wouldn't have? she silently asked her younger self. Why should that have led to this?

The girl ignored her, continuing to prance, absorbed in her own reflected promise.

The window was getting brighter and closer, with thousands more images springing up, a swirling videotape of her life fast-forwarded into a few instants, and yet all perfectly clear. She knew that she could step through, into it -- that that would free her from this nightmare. But if she did, there would be no coming back.

In the distance, she heard a siren.

"Mercy ER, this is Medic Twelve with Code Three traffic."

The voice, choppy with static and backed by a wailing siren, came over Mercy Hospital's paramedic radio, from an ambulance out on the San Francisco streets. Code Three meant that it was racing toward the hospital as fast as the night allowed.

The Mobile Intensive Care nurse monitoring the radio leaned closer and pressed the talk button on the handset.

"Medic Twelve, this is Mercy ER," she said. "Go ahead."

Carroll Monks walked across the Emergency Room and stood beside her, listening.

"Mercy ER, we're bringing you a young white female, age approximately twenty-five. She's unconscious, with almost no blood pressure. She does have a very weak femoral pulse, but no radial pulses. Ah, hold on a second, Mercy."

Monks heard the driver yell something to his partner in the ambulance's rear. His words and the reply were lost in noise.

The driver's voice came back on. "We haven't been able to start an IV. We can't find any veins. Repeat, she does not have an IV running. She has respiratory depression and we are oxygenating her."

The nurse said, "Medic Twelve, do you have any history on her?"

"Negative, Mercy, not much. She was in an apartment, alone. Looks like she's had a recent surgery, probably her breasts. We found some Valium, but we don't think it's an overdose."

"Who called her in?"

"She managed to call 911. We got sent by City Triage."

Monks took the microphone from the nurse, and said, "Any signs of massive bleeding?"

"There's some vomit with blood in it," the driver rasped through the static. "But not massive."

"Nothing from the surgery? Other external wounds? Blood around the apartment, or in the bathroom?"

"Negative, Mercy," the driver said again.

Monks's mind started tracking a flow chart of probabilities, for a young woman who was bleeding badly, with the blood staying inside her. None of them were good.

The nurse watched him questioningly, a look asking if he wanted any more information. He shook his head, giving her instructions as he handed her the microphone.

'Take her directly to the trauma room, Medic Twelve," she said.