Lethal Incision
Contents
Title Page
Author's Note
Chapter One
Chapter Two
Chapter Three
Chapter Four
Chapter Five
Chapter Six
Chapter Seven
Chapter Eight
Chapter Nine
Chapter Ten
Chapter Eleven
Chapter Twelve
Chapter Thirteen
Chapter Fourteen
Chapter Fifteen
Chapter Sixteen
Chapter Seventeen
Chapter Eighteen
Chapter Nineteen
Chapter Twenty
Chapter Twenty-One
Chapter Twenty-Two
Chapter Twenty-Three
Chapter Twenty-Four
Chapter Twenty-Five
Chapter Twenty-Six
Chapter Twenty-Seven
Chapter Twenty-Eight
Chapter Twenty-Nine
Chapter Thirty
Chapter Thirty-One
Chapter Thirty-Two
Chapter Thirty-Three
Chapter Thirty-Four
Chapter Thirty-Five
Chapter Thirty-Six
Epilogue
Other Books by Dobi Cross
About the Author
Dedication
Copyright Page
Lethal Incision
A Dr. Zora Smyth Medical Thriller
Dobi Cross
Lethal Incision is the second book in the Zora Smyth Series. Sign up HERE to be notified when the next Dr. Zora Smyth Book comes out!
AUTHOR’S NOTE
Thank you for choosing LETHAL INCISION. Zora Smyth was a character that I was fortunate to meet a couple of months ago as I brainstormed ideas for my first medical thriller story for an anthology.
LETHAL INCISION continues the story of Zora Smyth as she navigates life as a surgeon. She is happy with where her life is, yet the shadows from her past have caught up with her. We see how Zora is able to remain true to who she is, and how her compassion and love shines for those she holds dear.
It was important for me as I penned this series to have Zora Smyth not be some super hero or a person with extra ordinary abilities—she needed to be an every day person who just had unfortunate events happen to her. And who through the journey of the next few books comes to fully understand and appreciate who she truly is and is able to heal from the childhood baggage that she has carried all her life.
Please continue this journey with me in LETHAL OBSESSION, which will be coming out later in 2019. Would you also want to be notified when it releases? Sign up HERE.
Once again, thank you so much for purchasing LETHAL INCISION and for meeting Zora Smyth. If you enjoyed it, please consider leaving a review HERE or recommending it to a friend.
Thank you again for your support!
Dobi Cross
CHAPTER ONE
The man stood still and watched as the girl’s eyes opened and then widened as she looked down on herself—she was lying on an operating table with her lower body covered with sterile drapes, her confused face evidence that she had no idea how she had gotten there. She moaned as she tried to speak against the duct tape that sealed her lips, and a clink clank sound filled the air as she struggled against the metal restraints that held her down. But it was a futile exercise; he had soldered the metal cuffs to the table.
His eyes gleamed at the sight. He could never get tired of seeing this. She looked ethereal with her skin glistening from the sweat on it, the sole painting in a large room that was otherwise sterile white with bare walls. A recessed ceiling light washed over her, casting shadows over the rest of the space, even over the instrument table that stood next to where she lay. He sniffed the air and inhaled the scent of fear that radiated from her. The corners of his lips twitched upwards. Just the right combination, which meant she was ready for him.
He lingered for a moment at the scene before him, enjoying it before it would fade away never to reappear again. Then he stepped out from the shadows to where she could see him. “Ssh, relax,” he said as he picked up a syringe filled with clear liquid from the open sterile pack that rested on the instrument table. “It won’t take long. You want to be free, right?”
The girl managed a nod and the bouffant cap that covered her head slipped backwards to expose her blonde bangs.
“Good. And I will set you free, but maybe not in the way you expect.” He chuckled against the surgical mask that covered his face. “But before then, you have to fulfill your end of the bargain.”
The girl’s brows creased into a frown and her eyes blinked in rapid succession.
“Don’t you remember? It’s what you agreed to in the contract,” he continued. He ran his gloved hand down her arm; it was soft and supple to touch. She had beautiful skin. It was a pity.
Her face turned ashen at his words. Her chin trembled, and the girl 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 smoothen them. “It wouldn’t have been this way if you hadn’t tried to run away. And now you have to pay the price. You read the fine print, didn’t you?”
The girl’s eyes bulged and her whole body trembled, as the import of what would happen next dawned on her.
This was the moment he loved the most. When their eyes registered shock, awareness, and horror at what was about to take place. And then the realization that they had brought this upon themselves. It was stupidity as far as he was concerned for them to assume that the terms of the contract would not be carried out. He chuckled again. “Now relax.” He patted her arm. I’ll take care of you nice, quick, and easy.” With no warning, he plunged the needle into her arm.
The girl jerked from the gurney as much as the restraints allowed, and a muffled cry rose from her throat.
The man discarded the empty syringe in the surgical bowl and waited for her body to relax—usually took about three minutes for the drug to kick in. He’d timed it too many times to know. Her body grew limp, though her eyes remained opened and stared out into space. Everything had been chosen for a reason: the injection site and the anesthetic drug of choice—he liked them to be somewhat dissociated but still awake, to feel pressure but no pain.
The man glanced at the clock on the wall. It was time. He’d already prepped her abdomen while he’d been waiting for her to wake up. So he picked up a scalpel from the instrument table. He would start with the left.
He slashed a four-inch midline incision down her abdomen instead of the more common flank one. He could finish his work faster, and it wasn’t like she was going to need this body in pristine condition where she was going. He switched to electrocautery and divided the subcutaneous tissue, muscles, fascial layers, extraperitoneal tissue, and the peritoneum. As usual, the ash-flavored tang from the electrocautery flirted on his lips. He ignored the taste and probed the tissues in the left upper quadrant of the abdomen with his gloved fingers till he reached what he was looking for.
Smooth to the touch, this was precious commodity. He would have to be careful with it since it was already spoken for. He secured the blood supply, and then extracted the precious organ from the surrounding tissues that held it back. He lifted it from her body before placing it into the waiting transporter. It was a cutting-edge organ transporter that hadn’t been released to the market, and for which he had paid a premium. It suited his needs and had more than proved its worth since he started using it.
He took a quick look at the clock. He had about seven minutes left.
He 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. He sutured back the abdominal layers and then checked the time on the clock. He had managed to shave two minutes off his total time. An improvement, but he could still do better. He already had another idea in mind that he would try with the next case.
He knew without looking that the girl was dead. The second procedure had ensured that she would not survive. That was the punishment for trying to run away. It wasn’t like he had forced her to sign the contract. It had been her choice, and she had been warned that she would pay a heavy price if she broke it. He’d gotten an extra organ for the inconvenience of sending the boys after her. He probably could have taken more, but he was not a greedy man, and he liked to keep to the terms of the contract in question.
He wrinkled his nose at the pungent smell of roasted flesh in the air. Time to clear it all out. He pressed a button on the wall. Erik, his bodyguard, would dispose of the girl’s body, get the organs to their new owners, and ensure that the room was scrubbed down back to its pristine condition. He tossed off the surgical garb and dumped it with the gloves into a nearby chute. It led directly to an incinerator he had installed a couple of years ago for more effective waste disposal. He moved to the sink and scrubbed down his hands.
His phone buzzed an alert in his pocket. It was an alarm, reminding him of his next appointment.
It was time to head to the hospital.
CHAPTER TWO
The beeping and hissing sound of the cardiac monitor filled the air in Trauma One on Monday evening 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, took a quick scan of the patient—a young man, probably in his thirties, who lay still on the gurney except for the rise and fall of his chest.
A narrow tube snaked from his mouth and was held in place with stripes of tape. 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; the EKG pads on his chest provided a colorful contrast. His abdomen appeared slightly 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, hit in a car accident by a drunk driver. Wife has been rushed to the labor room. Patient arrived unconscious to the ER.
“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. CT scan revealed a possible splenic rupture. Blood has been sent for STAT results and cross-match, and we are waiting for fresh blood and frozen plasma.”
Zora put on her stethoscope to confirm what the resident said. The abdomen was quiet—silent like a grave. Not good. She checked his lungs; they were well ventilated, the endotracheal tube properly placed. She listened to his heart, which was barreling against the chest wall. Rapid sinus, but no murmurs. She replaced the stethoscope back on her neck. “Any medical history?” she asked.
“Wife confirmed there were none,” Stewart responded.
A nurse called out. “V-fib! He’s in V-fib! I can barely feel the pulse!”
Time seemed to pick up at a frantic pace.
Zora shot a glance at the monitor screen. The rhythm was rapid, unorganized, and barely discernible. “Start CPR. Stewart, you are in charge of the code.”
Zora could see that the nurse had 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 now replaced the Ringer’s lactate dripping into the patient. Every drop and every second 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.
“One milligram of epinephrine IV, then shock again at one hundred,” Stewart called out.
The epinephrine slid through the central line. The torso jerked again at another shock of the paddles.
“Rhythm’s back!” the first nurse shouted.
Zora checked the monitor. She could never get tired of seeing the sinus rhythm tracing advance across the screen. “What’s the BP?”
“Seventy-five over forty.” Good enough for now.
Zora took and released a deep breath. The aseptic smell of the hospital rushed into her nostrils but she didn’t gag. She was used to it. “Good job, everyone,” she said, looking around the room as she removed her gloves. “But we are not out of the woods yet. Have we paged Dr. Edwards?” she asked Stewart. Dr. Chris Edwards was an associate professor of both Surgery and Oncology; he was the surgical attending-on-call and Zora’s mentor.
“He is in the OR.”
“Could you connect me to him?” Stewart strode off to summon Dr. Edwards, his average legs surprisingly eating up the distance to the nursing station.
Zora turned to the nurse standing next to 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 strummed her fingers on the bedrail. “What is it?”
“Dr. Graham has an OR booked for a breast biopsy, but the patient is running late.”
“Was there any reason why the surgery hasn’t been rescheduled?”
“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. Elective surgeries were typically not scheduled in the evening. Zora was sure 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 departmental 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 her 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 had ever called home, and she had no plans to leave anytime 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 had gone to school here, and all her friends and family lived in the area. Yes, she definitely had to stay in town, which probably meant she had to remain in Dr. Anderson’s good graces.
But Zora looked at Mr. Williams again. They had barely managed to stabilize him, and they needed to get him into the OR as soon as possible. That way he had a fighting chance to live to see his first child. Because cases like this always drew at Zora’s heartstrings. She had grown up without a father when hers died in an accident, and she’d vowed to stop it from happening to anyone else if it was in her power to do so. She would regret it if she didn’t do everything she could to save him. Even if it meant offending Graham.
She let out a deep sigh and looked at the nurse. “Do we have an ETA on when the VIP patient would be here?”
“I’m not sure, but unofficially, I’ve heard it might take the patient an hour-and-a-half to get here.”
Zora rubbed her hand along her
jaw. It would take about another thirty minutes for the VIP patient to be prepped for transfer to the OR, so she had about two hours. She could make it. She could be in and out of the operating room with enough time for OR turnover. She turned to see that Stewart was back at her side, the top of his light brown hair sticking out in weird angles. Zora resisted an urge to pat it down.
“We are still trying to reach Dr. Edwards,” he said. “The nurse-on-duty will let me know once she hears back from him.”
“Okay. Which anesthesiologist is available?”
“Dr. Brennan is on-call. He just arrived,” Stewart replied.
Zora liked Dr. Brennan. She had worked with him on multiple occasions and found him passionate about his work, yet very approachable. All the OR nurses loved him. He was the sort of person she needed in her corner to help this patient.
“Zora, I’ve got Dr. Edwards on the line,” Christina called out. Christina was one of the ER nurses-on-duty and her best friend and current roommate. They’d been friends since high school and Christina had moved in with her when Zora’s mother had been hesitant to let Zora live alone for medical school. And there had been no reason to move out since then. Christina had chosen a nursing career, training both as a trauma nurse and an OR nurse. It was always fun working with her in the same unit. And they were as different as night and day. Christina was petite with the most gorgeous red hair, while Zora was tall and curvy with curly dark hair.
Zora walked over to the nurses’ station and mouthed a thanks at Christina as she grabbed the phone receiver from her. “Dr. Edwards, we have a thirty-year old male patient with blunt abdominal trauma from a car accident, and a suspected splenic rupture,” Zora spoke into the receiver. “We need to get him into the OR for an emergency laparotomy. He’s already coded once and we’ve stabilized him for now, but an OR won’t be available for the next two hours. And I’m not sure he’ll last that long.
“But Dr. Graham has an OR booked for a breast biopsy. It is open right now, and the patient is not expected to arrive in the next hour and a half. I can get this surgery done and be out before then. Dr. Brennan is the anesthesiologist on call so we are in good hands.”