Paulo Ferrara, a young Portuguese man, lies comatose in the Intensive Care Unit of Timbergate Medical Center, shot in the spine. The neurosurgeon who would normally be in charge of his care has left town to attend to an injured daughter, and the only other neurosurgeon, the rude and egotistical Dr. Godfrey Carver, is about to be suspended for not completing his continuing education requirements. The unpleasant duty of ensuring that the staff obey the rules lies with Aimee Machado, the medical center's forensic librarian and Continuing Education Coordinator. Aimee and her pilot boyfriend Nick live together on her grandparents' llama farm. While dealing with Dr. Carver, Aimee learns the circumstances of Paulo's injury and enlists Nick's help. Aimee is half Asian and half Portuguese, and her parents live on Faial, one of the Azores Islands off the coast of Portugal. Faial is the closest neighbor to Pico, home of Paulo and his family. Paulo came to rural Northern California in search of his fifteen-year-old sister Liliana, who vanished two weeks ago. Nick's wealthy employer Buck Sawyer takes an interest in the girl's plight as well, especially when they learn that she left the Azores on a superyacht. Not only is Buck a yacht owner, but he is also on a crusade against drug trafficking, and Paulo and Liliana have clearly stumbled onto a criminal operation of some kind. The trail leads Aimee and Nick from Timbergate, to the Azores, to San Francisco. Paulo's condition is deteriorating, and he might never be able to explain what got him shot. Can Aimee, her brother Harry, and Nick unravel the mystery in time to save Liliana? Book 4 in the Aimee Machado Mystery series, which began with Due for Discard.
About the Author
Sharon St. George's writing credits include three plays, several years writing advertising copy, a book on NASA's space food project, and feature stories too numerous to count. She holds dual degrees in English and Theatre Arts, and occasionally acts in, or directs, one of her local community theater productions. Sharon is a member of Sisters in Crime and Mystery Writers of America, and she serves as program director for Writers Forum, a nonprofit organization for writers in northern California. For more information, go to sharonstgeorge.com.
Read an Excerpt
Jared Quinn burst into the Timbergate Medical Center Library minutes after I arrived for work on a sunny Thursday morning, dashing my hopes for a tranquil June day.
"Machado, are your parents still here?"
The administrator knew that my parents were visiting from the Azores, but I was puzzled by his question and his demeanor. He stood across from my desk, shoulders stiff and jaw clenched, waiting for my answer.
"Yes. They're at the waffle place down the block right now, having breakfast with my brother. After that, they're coming by the library — "
Quinn cut me off. "Call them, Aimee. See how fast they can get here."
"Why? What's going on?"
"A gunshot victim just arrived in the Emergency Room. He doesn't speak English and has no ID and no phone. Dr. Preston can't communicate with him, other than a word or two that resembles Spanish. He thinks the man's speaking Portuguese."
"None of our medical interpreters speak it?"
"There's only one on the list who's fluent in Portuguese. He's out of town. Some family thing. Wedding, funeral ... I'm not sure." He tapped a finger on my desk. "Has your mother kept up her credentials?"
I understood why he was asking. My parents had retired two years earlier and were living in the Azores, where Dad had inherited property in the port city of Horta on the island of Faial. Before retiring, Mom had been on TMC's list of medical interpreters. Though my father is Portuguese and my mother is Chinese, it was my mother's help that Quinn needed.
I answered with my phone in my hand. "Yes, she's current. She's been interpreting for a hospital in Horta. How much time do we have?"
"Not much." Quinn glanced at his watch. "The neurosurgeon is fifteen minutes out. They're trying to stabilize the patient in the ED, but he'll be transported to an operating room as soon as possible." My usually well groomed boss was obviously stressed. His dark, wavy hair looked a little wild, and his tie had flipped back-side out. "Ask them to hurry," he said. "A couple of policemen are hoping to question the patient before he goes into surgery."
Mom answered right away. I explained the situation, and she agreed to come immediately. I hung up and told Quinn my parents were on their way.
He backpedaled toward the exit. "Tell them thanks. I'll take care of the paperwork. Come over to the ED as soon as you can." He hurried out with his phone to his ear.
I admired Quinn for coming to the library in person to explain the situation. A bachelor with a memorable smile, he was easy on the eyes and nice to be around, but it was his compassion for patients over concern for revenue that made working for him rewarding. His rugged good looks and muscular build belied the stereotype of the soft-bodied, heartless hospital administrator.
I closed the library and headed across the hospital complex to the Emergency Department. When my mom and dad arrived, Quinn introduced them to Dr. Preston. I appreciated the care Quinn took to pronounce our family name, Ma-SHAW-doe, correctly.
My mother and the doctor entered the trauma room, where the patient still awaited transfer to surgery. Two police officers went in with them, while Dad stood by just outside the door, along with Quinn and me.
I raised my eyebrows at Quinn. Do I stay or go back to the library?
He shrugged his answer, which I interpreted as, Suit yourself.
If there was anything to learn from the patient, my mother would be able to help. Opting to go back to work, I invited Dad to come with me to the library, but he chose to wait for Mom.
I asked the nurse at the ED desk to send my parents to the library when my mother was finished. Back across the hospital complex, in the building that housed the library, I began my usual morning routine by checking email. Most of the messages were requests for resources in the form of articles from the medical journals in our database. I spotted a terse email from Cleo Cominoli, Director of Medical Staff Services, a close friend as well as my most trusted colleague. Call me.
Cleo was at least ten years my senior, a full-figured and feisty Italian who grew up in Brooklyn but found her way to Timbergate, my hometown of ninety thousand residents, in rural Northern California. She had lost her accent, but not the spirit and toughness that kept more than three hundred doctors on our medical staff in line. When she wanted to talk, it was wise to find out what was on her mind. I punched the number I kept on speed dial.
"What took you so long?" she said.
"Sorry, something came up." I explained about the gunshot patient.
"I just heard a few minutes ago. Didn't realize you and your parents were involved."
"They're still in the ED, but they'll be coming by the library when they're finished. Why did you ask me to call?"
"I wanted to give you a heads-up about Dr. Carver. He's probably going to show up in your library. If not today, then soon."
"Dr. Carver? That would be a first. Why?" Dr. Godfrey Carver was a gifted neurosurgeon, known for enjoying fast cars and fast women in spite of being married and approaching sixty. He liked to tell new acquaintances, "Just call me God." Carver might have been an attractive man once, but time had not been kind, leaving him balding and jowly, with dark, bushy eyebrows.
"His medical staff membership is up for renewal this month," Cleo said, "but there's a problem."
"Really? What's the problem, and why does it involve me?"
"The obstacle is his continuing medical education credits. He's fallen short of the fifty credits he needs for renewal."
"How short?" I asked.
"He wouldn't say. I took that to mean he's seriously in arrears."
"I get it," I said. "Carver hasn't been doing his homework. TMC's bylaws say he can't renew his medical staff membership if his CME credits are deficient."
"Exactly right," Cleo said. "You've learned well."
"How much time does he have?"
"Until the end of the month, but that's only two weeks from today. It may not be long enough, depending on how many credits he has to make up."
"If it's the full fifty, he's going to be a busy boy," I said, "even if he's doing most of it online."
"He has a demanding solo practice to maintain at the same time," Cleo said. "Carver isn't a gracious fellow at his best, so be prepared. And make sure he understands that we have to handle this by the book."
On my first day as an employee, Cleo met with me to explain how continuing medical education was tied in with the privilege of medical staff membership. The renewal of membership and privileges coincides with the renewal of state medical licenses, which happens every other year, in the physician's birthday month.
Cleo requests license confirmations from the medical board. If the state board has renewed the medical license, the physician's TMC membership renewal request goes to the TMC Credentials Committee and works its way up the chain of appropriate medical staff committees until it reaches the governing board. It's an exacting process, and most patients have no clue that it is going on behind the scenes.
A dilemma arises at times because the Medical Board of California accepts the physician's certified, signed statement that he or she has completed the required continuing education credits, but the TMC Medical Staff Organization isn't so trusting. If Carver didn't show proof of his CME credits, his medical staff membership would be suspended as of midnight on his birthday.
"Are you saying the state board went ahead with his license renewal?"
"Apparently so. He's paid his renewal fee and passed their scrutiny. He's had no disciplinary actions by a government agency or other disciplinary body, and he hasn't been convicted of any crime in any state."
"So, according to the state board, his license has been renewed, but TMC's medical staff still won't renew his membership or privileges?"
"That's what I'm saying. Even if the doctors on our medical staff sign the certification of completed CME hours on the state's renewal application, our credentials committee wants proof. Apparently, TMC has had some cheaters in the past who put the hospital's accreditation standing in jeopardy."
"They claimed they'd done the work when they hadn't?"
"Right. And when they were audited by the state after the fact, the truth came out that they'd been practicing without a license in good standing. No one here wants to see that happen again."
"Of course not. This situation hasn't come up since I was hired," I said. "Any advice?"
I heard Cleo's heavy sigh. "You can imagine how steamed Carver is. Knowing him, he'll try to get you to dummy up some CME credits. He tried to convince me that he's already earned the necessary fifty, but I told him he was barking up the wrong tree." She made a derisive noise that sounded a little like a snort. "I told him you're in charge of TMC's continuing education program.
I had to laugh. Cleo wasn't intimidated by doctors. She had probably used those exact words. Barking up the wrong tree.
"Sorry, I didn't realize this was his year to renew, or I'd have been looking more closely at his total credits. I didn't see him on the list of pending renewals you usually provide.
"Don't apologize. A new trainee prepared the list from our database, and she somehow missed his name. The buck stops with me on medical staff renewals and I should have checked her work. Besides, you only have stats on the credits Carver's earned through TMC's education programs. He claims he's done most of his continuing education through other sources."
"If that's true, he shouldn't have any trouble providing proof."
"That's what I said, but by that time, he was so angry he stormed out of my office muttering about incompetence and threatening to raise hell — blah, blah, blah." Cleo laughed. "Sorry, it's not funny, but his comb-over flopped down off the top of his head as he stomped out of my office. It looked so funny, hanging there alongside his ear." She snickered. "Wish you could have seen that."
"Glad I didn't," I said, "but thanks for the heads-up. He's in for another disappointment if he comes to me."
"Even so, I wanted you to be prepared." Cleo had recovered from her giggles. "He mentioned he'll be tied up in surgeries all day today, so he might not get to you until tomorrow. When he does, he'll try everything to get you to cave."
"His timing isn't good. I'm taking tomorrow off and Nick and I are flying my parents home to the Azores this weekend. We're going to be vacationing there all of next week. If Carver's problem isn't resolved while I'm gone, I'll do what I can to make this work out for him and the hospital when I get back."
"I'll see what I can do in the meantime," Cleo said. "I feel somewhat responsible for not catching this sooner. If Carver raises too much of a stink while you're gone, I'll get Dr. Poole to step in."
Dr. Phyllis Poole was the medical supervisor of our continuing education program and chair of the hospital's CME Committee. An exceptional urologic surgeon, she was fearless in the OR and in the conference room. Carver wouldn't have any better luck with her than he had with Cleo. Both women were impervious to sweet talk or intimidation.
With the emails and Cleo's call out of the way, I was about to walk back to the ED for a progress report when Mom and Dad entered the library, holding hands. To my proud eyes, they're still an attractive couple who look young for their years. Dad is strong and muscled, with sun-bronzed skin and a thick shock of salt-and-pepper hair. Mom has delicate Asian features and a petite figure. Their combined genes resulted in my black hair, and dark brown eyes. I owe my physical strength to years of my father's coaching in jujitsu, and my height of five four to my mother. Thanks to her, a subtle hint of Asian ancestry in my eyes and cheekbones sometimes prompts people to ask if I'm Hawaiian.
"How did it go?" I guided them over to a reading area where we could sit around a table.
Compassion etched my mother's brow. "His name is Paulo Ferrera. He's definitely Portuguese. From the Azores."
Dad answered, giving Mom's hand a comforting squeeze. "He's from Pico, our nearest neighbor. How about that?"
Faial, where my parents live, and Pico are the two islands situated closest in the nine-island Atlantic archipelago. Only a thirty-minute ferry ride separates them. Pico takes its name from the volcanic Mt. Pico, one of the highest Atlantic mountains.
"Were you able to help the police?" I asked.
"I'm not sure." Mom's forehead creased. "I was able to interpret what the patient was mumbling, but it was mostly anxiety about his sister. In spite of his dismal prognosis, he was only concerned about her. If he survives, he could end up permanently paralyzed by the bullet in his spine. He kept begging to be taken home to Pico if he dies. He's very young, barely twenty-one." Mom paused to take a deep breath. "He reminded me of Harry."
Dad glanced at my mother. "This was hard for her."
My brother, Harry, is two years younger than I am, and since there are just the two of us, he's still Mom's baby at twenty-seven.
She took a breath and continued, "The poor young man kept saying he didn't want to live if he's paralyzed. In spite of that, he repeatedly begged the police to find his sister."
"What happened to his sister?"
Mom glanced down at a small notepad in her hand. "It was hard to follow, but best as I can tell, she took the ferry from Pico to Faial to go to a yacht party at the Horta Marina. She hasn't been heard from since. That was almost two weeks ago. Her name is Liliana. She's barely fifteen, and her family's been frantic. Her brother set out a week ago to search for her."
Dad looked around the room, as if searching for the girl himself. "Somehow he ended up in Timbergate with a bullet in his spine."
"Mom, were you able to help the police find out who shot him? Or why his search for his sister led him from the Azores to Timbergate?"
"I'm afraid not," she said. "There wasn't enough time before they rushed him into surgery."CHAPTER 2
That afternoon in the library seemed endless, probably because it was my last workday before starting my vacation. My boyfriend, Nick Alexander, and I had been set to fly my parents back to the Azores on Friday morning, starting with a flight to Boston. From there, a five-hour Atlantic flight would take us to the island of Faial.
Now, with my mother acting as interpreter, our departure plans were temporarily on hold. For Nick, a corporate pilot for a billionaire philanthropist, the trip would combine business and pleasure. His boss, Buck Sawyer, had business interests in Boston and had already agreed to arrange his meetings so he could be dropped off there while Nick and I continued on to the Azores with my parents.
The Cessna Citation we were using was one of Buck's fleet. It seated eight passengers, in addition to the two seats in the cockpit, so there was room for everyone. I hoped we wouldn't be delayed for long. Nick and I had our hearts set on spending some quality time together. After a prolonged breakup followed by an on-again off-again reconciliation, Nick and I had finally gotten back together. That was almost three months ago. Since his job kept him away so often, we rarely had more than a few days at a time together.
We first met on a gun range, where Nick was a volunteer instructor. I fell for his smiling blue eyes and fair hair the color of summer wheat, but more than that, I loved his hands. I still get a rush thinking about that first lesson, when he taught me how to squeeze a trigger. Slowly and gently. It's a wonder I remembered anything he tried to teach me that day.
I reluctantly dragged my thoughts back to the present and how much I looked forward to spending an entire week in the Azores with Nick. I could almost taste the Vinho Verde, a tender and delectable green wine, and the buttery and spicy cheeses, made from the milk of the world's most beautiful and pampered cows. Together with the mild, temperate climate and the passionate sounds of Portuguese Fado music, it promised to be the perfect romantic getaway.
I had expected to finish packing after work, but my last update from Quinn changed everyone's plans. The gunshot victim was out of surgery, in the ICU, and in a coma. The coma was an unexpected complication, but every effort was being made to discover its cause.
That news led to a hastily convened meeting around a wrought-iron, glass-topped table in Amah and Jack's rustic, open-beamed family room. Dinner was courtesy of Colonel Sanders. Six of us gathered there at the Highland Ranch in Coyote Creek, a ranching community a few short miles from Timbergate. The group consisted of Mom and Dad, Amah and Jack, and Nick and me.(Continues…)
Excerpted from "Spine Damage"
Copyright © 2017 Sharon St. George.
Excerpted by permission of Coffeetown Enterprises, Inc.
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Most Helpful Customer Reviews
Reviewed by Liz Konkel for Readers' Favorite Spine Damage by Sharon St. George is an Aimee Machado Mystery. When Paulo Ferrara is brought into the Intensive Care Unit after being shot, he gives a message to Aimee Machado's mother: find his missing sister, Liliana. The only neurosurgeon that can help him is Dr. Godfrey Carver, who is on the brink of suspension for not completing education requirements. Told to let the police handle the case, Aimee can't just let it go, not when she knows she can do more. Retracing Paulo's steps, and questioning Liliana's friend lead Aimee and her boyfriend, Nick, to a yacht, and onto the tracks of a mysterious online American boyfriend. Time is running out as Paulo's condition worsens, but Aimee refuses to give up. Sharon St. George brings strong prose, with vivid details and dedication to the mystery. Spine Damage is intelligently written, with a literary quality to the storytelling, and driven characters. The side characters are well-defined and spring the plot forward, with every scene counting. The case is at the center of the plot, but Aimee's life isn't sidelined. Her daily struggles, work, and family are a large part of what helps her put details together. Aimee is a delightful narrator, full of heart, and is driven not to simply solve the case, but to find answers and justice. The mystery is real, riveting and challenging as Aimee puts forth every effort not to give up. The action keeps you guessing until the very end. A compelling read for any mystery lover!