Lethal Incision

By Dobi Cross

When a series of nameless patients vanish after they arrive, Dr. Zora Smyth scrambles for answers. There's a dark secret...

Chief surgical resident Dr. Zora Smyth is used to the atypical: a sister that has disappeared, false murder charges from a serial killer, and a brush with death.

So when nameless patients show up on her operating table and subsequently disappear on her watch, Zora seeks to discover why.

But she soon realizes that the stakes are higher than ever when her sanity is questioned, and a hidden enemy—that wants the dark secrets covered at all costs—endangers everything she holds dear.

As Zora races to save herself and those precious to her, will she survive and win against the evil that threatens to swallow her up?

LETHAL INCISION is the second book in Dobi Cross' gripping suspense-filled series of medical thrillers. If you like page-turning non-gory medical thrillers filled with unexpected rollercoaster twists and intrigue, you’ll love LETHAL INCISION.

• Language: English
• Publisher: Luxhaven Publishing
• Release date: Dec 22, 2022
• ISBN: 9781005619916

Book preview

1

The man watched the young woman’s eyes open and then widen in shock as she looked down at herself lying on an operating table with sterile drapes covering her lower body. Her attempts to speak were futile against the duct tape that sealed her lips, and clink - clank sounds rent the air as she struggled against the soldered metal restraints that held her down.

His eyes gleamed at the sight, and his breath quickened. She looked ethereal with her skin glistening with sweat, a delectable artwork in an otherwise sterile white room, even as the recessed ceiling light washed over her and yet cast shadows over where he stood. The man sniffed the air, and the aroma of fear, confusion, and dread that radiated from the woman filled his nostrils and tingled his senses.

The corners of his lips twitched upward. Just the right combination, which meant she was ready for him. Yet he lingered for a moment on the scene before him, enjoying it for a few minutes before stepping out from the shadows.

Shh, relax, he said as he picked up a syringe filled with clear liquid from an open sterile pack that lay on a nearby instrument table. You want to be free, right?

The young woman managed a nod, the bouffant cap that covered her head slipping backward to expose her blonde bangs.

Good. I’ll do just that, he said and grinned behind the surgical mask that covered his face. She would know soon enough what he meant. But first, you need to fulfill your end of the bargain.

Her brows creased into a frown as her eyes blinked in rapid succession.

The man shook his head in disbelief. It was amazing how they always seemed to forget. Don’t you remember? he asked. He ran his gloved hand down her arm, which was supple to the touch. Such beautiful skin. It was a pity. You agreed to it in the contract.

The woman’s face turned ashen at his words. Her chin trembled, and she struggled to pull her arm away from him. But the restraint held it in place and instead left red marks around her wrist.

He brushed his fingers against the marks as if to smooth them. It wouldn’t do to mar his masterpiece. You read the fine print, didn’t you? he continued.

The woman’s eyes bulged, and her whole body trembled as understanding of what would happen next dawned on her.

This was the moment he loved the most: when they realized they were now at his mercy, and that they’d brought it upon themselves. How could they have believed he wouldn’t enforce the terms of the contract? He chuckled at the thought.

Then he patted her arm as if calming a fussy child. Shh, now relax, he said. I’ll take care of you nice, quick, and easy. With no warning, he plunged the needle into her arm.

The young woman jerked upward from the gurney as much as the restraints allowed, a muffled cry rising from the back of her throat. The man watched, enraptured at the scene before him, which never grew old no matter how many times he’d seen it.

Then he discarded the empty syringe in a surgical bowl and waited for the drug to kick in. In about three minutes, her body grew limp, though her eyes remained opened and stared out into space. Perfect. Just the way he liked them—somewhat dissociated but still awake, able to feel pressure but no pain.

He glanced at the clock on the wall. It was time. He’d already prepped her abdomen while waiting for her to wake up, so he picked up a scalpel from the instrument table and started from the left.

The man slashed a four-inch midline incision down her abdomen and then used the electrocautery probe to divide the subcutaneous tissue, muscles, fascial layers, extraperitoneal tissue, and the peritoneum before returning the probe back on the instrument cart.

As usual, the ash-flavored tang from the electrocautery lingered on his lips, but he ignored the taste and instead searched the left upper quadrant of her abdomen with his gloved fingers until he found what he was after.

Her kidney. A precious commodity that was ever smooth to the touch. He had to be careful with it since it was already spoken for.

The man secured the blood supply, extracted the precious organ from the surrounding tissues that held it back, and placed it in a waiting receptacle—an innovative organ transporter that was yet to be released and for which he’d paid a premium. Then he took a quick look at the clock.

Seven more minutes before he had to finish.

The man turned back to the business at hand, reached into the right upper quadrant, and repeated the same procedure. The second organ went into an identical transporter. Then he sutured back the abdominal layers and rechecked the time.

He grinned in satisfaction. He’d shaved two minutes off his latest record. Still, he could do better, and he already had another idea he planned to try with the next case.

For now, it was the end of the road for the young woman in front of him. She was dead or would soon be—the second organ extraction had sealed her fate. This was why she shouldn’t have tried to run away. Signing the contract had been her choice, and she’d been warned she’d pay a heavy price if she broke the conditions of the deal. It was only fair that he’d taken the extra kidney as compensation for sending the boys after her. He could have removed more organs since she didn’t need them anymore, but he wasn’t a greedy man, and he liked to keep to the terms of the contract.

The man wrinkled his nose at the pungent smell of roasted flesh that permeated the air and pushed a switch on the wall to alert his bodyguard, Erik, to come in. Erik would take care of the young woman’s body, get the organs to their new owners, and return the room to a pristine condition in readiness for its next use.

Then the man tossed off the surgical garb and dumped it along with the gloves into a nearby chute, which led to an incinerator he’d installed a few years ago for more effective waste disposal.

The phone in his jeans pocket buzzed an alert as he scrubbed his hands, reminding him of his next appointment

It was time to head to the hospital.

2

The beeping and hissing sound of the cardiac monitor filled the air in Trauma One like a time bomb counting down. A rapid sinus rhythm raced across its screen, the mirror of a desperate heart holding on for dear life. Zora Smyth, the fifth-year surgical resident-on-call for the night at the ER, took a quick scan of the patient—a young man in his thirties, who lay on the gurney, still except for the rise and fall of his chest.

A narrow tube, held in place with strips of tape, snaked from his mouth. IV poles stood at a salute on either side of the patient’s head, one line of Ringer’s lactate running into a central line, the other into a vein on his arm. Bruises in explosive colors of red, black, and purple covered his face and torso in abstract patterns and created a colorful contrast against the EKG pads on his chest. His abdomen appeared distended.

What do we have here? Zora asked as she grabbed a pair of gloves and snapped them on.

Five sets of eyes looked back at her. Thomas Stewart, the junior surgical resident-on-call, rubbed his bulbous nose before giving her a quick report. "Rick Williams, traveling with his pregnant wife, and hit in a car accident by a drunk driver. Patient arrived unconscious, and his wife has been rushed to the labor room.

Pupils are equal and reactive, lungs are clear, but the abdomen is distended. There are no bowel sounds, and BP is seventy over thirty. Paracentesis showed blood in the abdomen, and CT scan revealed a possible splenic rupture. We’ve sent his blood for STAT results and cross-match, and we’re waiting for fresh blood and frozen plasma.

Zora examined the patient. His lungs were well ventilated, and his heart had a rapid sinus, but no murmurs. However, like her resident had said, the abdomen was as silent as a grave. She tucked the stethoscope she’d used back into her coat pocket. Any medical history? she asked.

Wife confirmed there were no issues, Stewart responded.

V-fib! He’s in V-fib! a nurse called out.

Zora shot a glance at the monitor screen. The cardiac rhythm was now rapid, unorganized, and barely discernible. Start CPR, she ordered. Stewart, you’re in charge of the code. By now, the first nurse had already started pumping the patient’s chest.

We’ve got blood and frozen plasma! someone called out.

Let’s hang them up, Zora said. Fresh blood and plasma soon replaced the Ringer’s lactate dripping into the patient. Time seemed to pick up at a frantic pace, and every drop and every second now counted.

Paddles ready? Stewart asked. One hundred joules.

Another nurse placed the defibrillator paddles on the chest. Everyone, step back! she yelled.

The paddles discharged, and the patient jerked off the gurney and back.

Still in V-fib! the first nurse responded.

The air cackled with uncertainty. You can’t give up now, Mr. Williams, Zora urged the patient in her heart, even as she remained alert to support Stewart as needed. You have a baby who needs his father.

One milligram of epinephrine IV, then shock again at one hundred, Stewart called out.

Another nurse injected the epinephrine through the central line, and soon after, the patient’s torso jerked again at another shock of the paddles.

Rhythm’s back! the first nurse shouted.

Zora checked the cardiac monitor, relieved at the sinus rhythm advancing across the screen. What’s the BP?

Seventy-five over forty, the same nurse replied.

That was good enough for now. Good job, everyone, she said, looking around the room as she removed her gloves. But we’re not out of the woods yet. She turned to Stewart. Have we paged Dr. Edwards about this patient? she asked. Dr. Chris Edwards, an associate professor of both surgery and oncology, was the surgical attending-on-call and Zora’s mentor.

He’s in the OR, Stewart replied.

Let’s get him on a call.

Okay. Stewart hurried off toward the nursing station, his average legs eating up the distance.

Zora turned to the nurse standing beside her. Do we have an open OR?

There isn’t one available, and there won’t be one open for the next two hours, although… The nurse exchanged a glance with her colleague on her left.

Zora drummed her fingers on the bedrail. What is it?

Dr. Graham has an OR booked for a breast biopsy, but the patient is running late.

Is there any reason we haven’t rescheduled his surgery?

It’s for a VIP patient.

Zora groaned inwardly. VIP patients were the most difficult to deal with. They made all kinds of demands and expected the medical staff to cater to their every whim. But elective surgeries weren’t scheduled in the evenings as a norm, so Zora was almost certain the VIP patient had requested it.

Everyone also knew that Dr. Ronald Graham could make your life more difficult. Zora and Graham were both chief residents, but Graham was the department chair’s—Dr. Anderson’s—lackey, and his pompous attitude didn’t make him anymore likable. She couldn’t afford to get on his bad side; it was the same as stepping on Dr. Anderson’s toes, a risk she couldn’t afford. This was Zora’s final year in the general surgery residency program, and she needed Dr. Anderson’s sign-off to get a chance at the hospital’s colorectal surgery fellowship. There was only one spot available, and Zora wanted it.

Lexinbridge was the only place she’d ever called home, and she had no plans to leave soon. She loved the town—a blend of the old with the new, with its charming colonial houses surrounded by modern edifices that radiated vitality and progress. Besides, she’d gone to school here, and all her friends and family lived in the area. Yes, she