At twenty-five, Simon Worth is a med school dropout, facing the grim reality of failure and massive student loans. Left with few options, he becomes an organ broker for a black-market organization, matching cash-strapped donors with recipients whose time on the transplant list is running out.
Tasked with finding a donor for Lenny Pellegrini, a severely depressed ex-NFL player who’s been drinking himself to death, Simon’s luck appears to change when he’s contacted by Maria Campos, a young woman desperate for cash whose liver happens to be the perfect match.
The transplant goes according to plan . . . until soon afterward, when Maria disappears and Lenny makes a cruel and destructive decision. As Simon’s world becomes increasingly dangerous, he learns of an unspeakable secret from Maria’s past and must decide, against his better moral judgment, that the only way he’ll survive is to trust her.
Chilling and fast-paced, The Dismantling questions the meaning of atonement and asks how you can reconcile the person you once were—and the person you want to be—with the person you are today.
|Publisher:||Penguin Publishing Group|
|Product dimensions:||5.20(w) x 7.90(h) x 0.80(d)|
|Age Range:||18 Years|
About the Author
Read an Excerpt
Thank you to Richard Abate and Melissa Kahn for sticking with this project far longer than might have seemed reasonable. Thank you, also and profoundly, to Liz Stein for your willingness to take a gamble and your tenacity in seeing that gamble all the way through.
Thanks to Katie Arnold-Ratliff and Christopher Beha, both of whom read many more iterations of this novel than anybody should rightly be subjected to. Your suggestions and guidance were indispensable, as always, and you are as good friends as you are readers. I’m also grateful to my friend Dr. Lauren McCollum for generously sharing the story of her own liver donation.
And thank you, finally, to the Corporation of Yaddo for providing the welcome time and space to complete a crucial portion of this book.
SIMON looked again at the girl’s photo on his screen. There was no denying it: she might as well be Lenny’s younger sister. Besides the Mediterranean coloring, there was a certain leonine quality to the face, the strong jaw, canted eyes. The photo was from the shoulders up, the background a tan stucco wall presumably somewhere in Los Angeles. She looked directly into the camera, smiling with her mouth only. He wondered if she was an actress, or trying to become one. She was young enough; pretty enough too, or nearly.
I hope I’ve understood your company’s website correctly, her first e-mail had begun. I’m twenty-two years old. I don’t smoke. I don’t drink. I live a healthy lifestyle, or as healthy as you can in LA when you don’t have much money. This has been a difficult year for me financially, which is why I’m interested in the kind of deal I think you’re offering. Please be in touch with more of the specifics. Yrs., Maria Campos.
Simon had replied, through Health Solutions’ encrypted server, in the usual manner: direct, impersonal, detailed. He told her that if her blood type was a match, she would need to undergo some tests—first blood work, a physical, and a CT scan in Los Angeles, and then if these were satisfactory, liver function tests at the hospital here in New York. Next would be the screening interview. After all that would come, if she passed, the surgery itself and a few days of in-patient follow-up. Then she could go back home, and that would be the end of it. If she was still interested, she should send him the record of a recent physical examination, a photograph, and a phone number. He didn’t mention money yet.
The next morning she had responded: Before I wrote, I thought about what you might need, so I got these records ready. The photo request is weird—this isn’t a date—but here you go. You can reach me at 562-820-1980. Please advise the next step. Yrs., Maria.
Simon had looked at the attached photograph and medical records; then he’d looked at the photograph again. He’d hardly been able to believe his good luck.
• • •
SIMON pursued an obvious strategy in the winnowing of transplant applicants: it’s easier to convince the hospital’s social workers that people who look as though they belong together—which really means looking as though they have roughly the same amount of money—are involved in an altruistic partnership. If the recipient is a pasty rich guy from Connecticut, then flying in a donor who doesn’t speak English, from, say, Brazil, is probably not going to be particularly convincing. And if they look physically enough alike, as if they might be first or second cousins, it all becomes even easier. Now, finally, after a week and two dozen applicants he’d been forced to toss aside—wrong blood type, wrong attitude; too old, too sick, too fat—it appeared he had the perfect candidate.
The next step was securing Peter DaSilva’s approval, which was the reason Simon was sitting in the Health Solutions office at nine on a Sunday morning. This was a rare in-person audience with his employer, who preferred to communicate via cryptic text message or hurried calls from one of the five boroughs’ remaining handful of public pay phones. DaSilva was half an hour late, but at last Simon heard a key slide into the lock, and then the door swung open and in he walked, Yankees cap perched loosely on his cinder-block head, black blazer draped over his bulk, laptop bag slung over his shoulder. Peter DaSilva was a droopy-eyed, corpulent man who always seemed on the verge of falling asleep. He nodded at Simon and slumped onto the couch, where he lit a cigarette and rubbed at the pouches under his eyes. He looked as though he should be permanently installed on the bleachers of a horse-racing track somewhere, preserved in the amber of stale cigarette smoke and fried food. But there was something about this shambolic persona that set his patients at ease as he led them and their families—in his other, legitimate job as associate transplant coordinator at Cabrera Medical Center—step by arduous step through the emotionally brutal transplant process, as he played the roles of advocate and counselor and confessor. He exuded calm. It wasn’t exactly an act—more like camouflage. Because Simon knew that Peter DaSilva was very good at what he did—both his coordinating job at Cabrera and also as the shadow proprietor of Health Solutions—and he didn’t get to be that way by not paying attention.
“So, who is she?”
Simon lit his own cigarette and turned the monitor to face the couch.
“Hmm.” DaSilva exhaled smoke through his nostrils like a cartoon bull. “I don’t see the resemblance.”
“You . . . what?”
“I’m fucking with you. Nice break, for once. What’s the age difference?”
“Maybe we go with a second cousin angle. That should satisfy social.”
“She already e-mailed me her records.” Simon handed over a printout. “Take a look. Compatible blood. No underlying conditions. Healthy. Young.”
DaSilva flipped through the pages. “A hundred and thirty-five pounds? I hope her liver’s fat and happy. Lenny’s a big boy.”
“I’d say it’s worth pursuing anyway, wouldn’t you?”
“She’s in Los Angeles?”
DaSilva took a binder off the bookshelf, flipped it open to a tabbed page. “Here’s the number of a lab in Glendale. Tell her to go for the usual screening package.”
“So I should call her?”
“Does Lenny have a secret twin I don’t know about? No? Then I don’t see the point in waiting for anybody else. Just do me a favor: when you talk to her, make sure she’s not a mopey jerk-off. One per pair is enough.”
“Lenny was that bad?”
“Let’s just say his attitude didn’t inspire confidence. I don’t want him doing any improvising in the psychosocial, okay? Everything he says should be something he’s heard coming out of your mouth first.”
“You know I’ll do my best to prep him.”
DaSilva stubbed out his cigarette and stood up. “That’s all I ever ask.”
• • •
THE search for a donor had begun eight days before, when Simon pulled his rental car into Howard Crewes’s driveway at the terminus of a quarter-mile cul-de-sac tucked within a gated development off Route 1. Simon had stepped out into the late-summer haze, feet crunching on gravel, and squinted up at the house, a blinding-white neo-Georgian. This, apparently, is what a decade in the NFL buys you: brick chimneys, black-tile roofing, Ionic columns flanking your front door. Crewes had called Simon that morning and disclosed that he’d been “guided” to the Health Solutions website and wanted to speak with somebody from the company in person. Simon had known about Crewes for years before he received the man’s call. He was the Bruiser back then, an enforcer at strong safety for the Jets, accused cheap-shot artist. But now he was just a middle-aged man living by himself in a big house in the middle of New Jersey, and he was, Simon had to assume, dying.
Simon had walked up the path and rapped the knocker, a brass lion’s head. A tall, stooped black man with a head of receding salt-and-pepper hair opened the door. He wore a crisp blue dress shirt tucked into tailored khakis, a pair of leather slippers on his feet. It was Crewes, looking some years older than he’d appeared in the most recent photograph Simon had found online, new tributaries of wrinkles creasing the landscape of his face.
“You must be Simon Worth,” Crewes said, squinting against the glare.
“Yes, sir.” Simon wondered what the man thought of his appearance, of his bland gray suit, his nondescript white-guy’s face and salesman’s smile; whether Crewes had expected somebody flashier or more rugged looking, or at least a few years older. Simon was twenty-five, but he knew he looked about five years short of even that.
“Come on inside.”
Crewes turned, limped across the foyer. The lights were dim; the air-conditioning roared. Sunlight filtered through tall bay windows to reveal the improbable scale of things: acres of oak flooring, a cavernous fireplace. There was very little furniture, nothing on the walls. Crewes led the way to a study in the back, all mahogany, velvet, and brass, which appeared to be the only room on the ground floor in regular use. He waved at a club chair and installed himself behind a leather-topped desk.
“Don’t be offended,” he said. “But I gotta admit you guys were my last choice.”
Simon nodded; this was typical client throat clearing. “We usually are.”
“You understand I tried to do this the right way. The legal way. I asked family. Close friends. Hell, I even asked other guys from the team. But either people weren’t interested, or the ones who were didn’t match up right.”
“And now let me guess: the transplant centers are telling you to get on the list and wait. As though you had all the time in the world.”
“Worse. You ruin your liver drinking? Forget it. Don’t even bother with the list.”
“Six months clean.” Simon shook his head ruefully. “UNOS won’t consider you otherwise. Most units won’t either.”
“I’ve been made aware of that, yeah.”
It was a familiar story, but what Simon saw when he looked at the man didn’t fit. As discreetly as he could, he checked for the usual signs of liver failure: jaundiced skin and eyes, whitened nails, the crooked stiffening of flexion contracture in the fingers. He saw none of this. Crewes’s shirt lay flat across his belly, no sign of the telltale bulge of fluid in his abdomen. Simon hadn’t thought somebody this desperate would be able to hide it.
“The drinking,” Crewes said. “We do things your way, will it be a problem?”
“I can’t make guarantees yet. But if there’s any possible way around it, we’ll figure that out.”
Crewes leaned back in his chair, clasping his hands behind his head. “I know what you’re thinking: why does this sick guy look so healthy? Or maybe I’m flattering myself, maybe I don’t look so great either. Anyway, this isn’t for me. This is for Lenny. Leonard Pellegrini. He’s a guy I played with, a teammate; a friend too, or at least he used to be. He’s messed himself up, bad enough that he’s going to die if he doesn’t do something about it. If he doesn’t do . . . this.”
“And you’re . . . funding everything?”
“Funding. Organizing. Making sure the thing happens.” Crewes sighed regretfully. “I’m not a match, or else I’d just donate myself.”
“A gift, yeah. Lenny can be an asshole, but that doesn’t mean he deserves to die. You see this house.” He pointed up at the ceiling, then swung the finger down to his own chest. “I’m the only one living in it. I can guess how much this is going to cost, but what else am I saving my money for?”
The arrangement was unorthodox, but Simon didn’t think that was enough of a reason to turn Crewes down. “I need to speak with him before we go any further. In person.”
“I figured. I’ll drive you out to see him tomorrow. I just wanted to check you out myself first.”
“You’re a real live human being, which is a start. You people screw me, you’re the one I’ll be looking for.”
He stood up: the meeting was over. He stuck out his hand, and Simon took it, Crewes’s grip firm and rough as a brick.
Driving home on the Turnpike, Simon thought again of the play that had briefly made Howard Crewes the most infamous football player in America. He’d seen it live on television a dozen years before, as a thirteen-year-old kid sitting alone in the den of his father’s Rockaway Beach home. He remembered gangly Alvin Plummer running his pattern to the middle of the field. Flying out of the left side of the screen, Howard Crewes led with his head. Plummer was focused on the overthrown ball; he didn’t see the hit coming. The temple of Crewes’s helmet met the crown of Plummer’s. The second man’s head snapped down and to the side as though on a well-oiled hinge. The two men collapsed to the ground. Crewes got up; Plummer did not. Trainers huddled over the receiver, his fingers curling into odd, baby-like fists. A golf cart crawled across the turf. Medics parked it near Plummer, assembled the gurney and backboard. Crewes stood, hands on hips, his back to the felled man. Simon remembered feeling as though he were witnessing something, in this raw moment before the imposition of a palatable narrative (tragedy, contrition, redemption), that he was not meant to witness: the unadorned fact of a man lying crippled on a field and the man who had crippled him turning away.
• • •
Simon dropped the car off at the rental agency in Long Island City and took the subway to Roosevelt Island, that sliver of land tossed carelessly into the East River between Manhattan and Queens. He lived on the cheaper side of his apartment complex, facing east, toward the southern end of Astoria, rather than west onto a foreshortened slab of Midtown. His view from the twelfth floor looked straight across a narrow band of river onto the Astoria power station, its four candy-striped smokestacks rising higher than Simon’s own building, higher than any building on the island.
In the apartment, he went to his computer to search for a clip of the play on the internet. Plummer had been paralyzed from the neck down; he’d nearly died. Simon remembered learning about this in the sports pages the following day and finding his own confused adolescent feelings to be incommensurate with the reality of what had occurred. He knew sadness was the appropriate emotional response, but he’d found it difficult to think of Plummer as an individual existing off the field, as a person rather than a player; before the injury, he hadn’t been notable enough for anybody to interview, and when Simon tried to think of his face, all he saw was the shadowing helmet and face mask. Years later they’d trot Plummer out, in his wheelchair, to various functions—hall of fame inductions, stadium dedications—but the trickle of appearances slowed and then stopped, and Alvin Plummer again faded out of the public imagination until he died, just a few months ago, of some kind of lung infection, a delayed complication of his paralysis.
And now, in one of the NFL’s occasional paroxysms of brand management, the hit seemed to have been wiped from the internet. Simon clicked from one YouTube clip to the next, sifting through dozens of brain-rattling hits from pro, college, and high school games. He wanted to see how his memory of the injury matched its visual record, but he couldn’t find Crewes and Plummer. He stopped instead on some of the high school clips. They had a snuff-film feel to them: ripped from shaky handheld footage, climaxing with a laid-out body, coaches kneeling over the injured player while the other team’s kids—fifteen- and sixteen-year-olds—jumped around and slapped each other on the helmet. In the comments section people wrote things like “That dude got raped!!!” and “OWNED.” Simon watched a few of these, the collisions replayed in lascivious slow motion. It was difficult to look away, but finally, overwhelmed by a greasy sense of complicity, he forced himself to close the window.
• • •
ON the following humid and colorless morning, he waited down the block from the Health Solutions office, at the corner of Sixty-Second and Second, chain-smoking Parliaments until a black Lexus with tinted windows pulled up exactly on time and emitted three short blasts of its horn. Inside, Crewes wore a black cardigan and a pair of circular, purple-tinted sunglasses that gave him the appearance of a dandyish, late-career jazzman. He acknowledged Simon with a nod before he pulled away from the curb, cutting east and accelerating across the Fifty-Ninth Street Bridge, the Roosevelt Island tram dangling in the murk outside the window like some giant tree-borne fruit. They swooped down onto Queens Boulevard and exchanged one eastbound highway for another until, forty-five minutes later, Crewes exited the Southern State for local roads. Soon they were in Leonard Pellegrini’s town, a collection of single-family clapboard homes, strip malls, and auto dealerships wedged between its wealthier bayside neighbor and the Sunrise Highway.
Crewes pulled onto the weedy yard of a small yellow house. He got out of the car without comment, and Simon followed him across the yard and up the porch steps. Midday was shadowless, without contrast; no visible sun, just a high, white brightness. Crewes opened the screen and rapped on the front door, which was yanked open quickly enough to suggest their arrival had been watched.
“Yeah?” A sunburned nose surfaced out of a sea of freckles. The girl was sixteen or seventeen, streaky blond hair pulled back into a tight bun.
She looked at Crewes, then Simon, then behind them. “Why are you parked on the lawn?”
“It’s where Lenny tells me to park. So I don’t block the garage.”
“Bullshit,” she said, then blushed.
“Look, sweetheart,” Crewes said, “why don’t you tell him I’m here. Howard. He’s expecting me.”
She seemed about to tell them off, then reconsidered. “Wait,” she commanded, before disappearing into the darkened recesses of the house, letting the door bang shut in their faces.
Crewes shrugged. “Who knows? Lenny’s lived around here his whole life. A lot of people still want to help him.”
The door opened again, and the girl, looking pissed off, said, “He’s in the kitchen.” She marched by them and picked up off the grass a bicycle Crewes had nearly run over, wheeling it onto the sidewalk before pedaling around the corner and out of sight.
“Let me start the talking.” Crewes took off his sunglasses. “You take over whenever you think it’s best.”
Simon nodded. He didn’t like sharing control of the situation like this, but he wanted to observe Crewes and Lenny, to better understand the dynamic of their relationship, before he made his pitch and asked his questions.
The inside of the house was dim, as Crewes’s had been, but any similarities ended there. Simon’s general impression was of mildew and unleveled floors. Leonard Pellegrini sat at a Formica table in the kitchen, swirling a glass of what appeared to be Coca-Cola on ice. He glanced at Simon, then continued to inspect his drink. “Nancy said there were two of you.”
“You know who he is,” Crewes said.
“The organ grinder.”
“Don’t be an asshole, Lenny.”
Simon fixed a neutral smile onto his face. So: it appeared Leonard Pellegrini hadn’t agreed to any of this yet. It would’ve been helpful if Crewes had let Simon in on this little fact. The man downed half his drink, the glass a toy in his hand. He was enormous, six foot five or six and wide as a car, and yet his bulk seemed inflatable, as though he’d been drained of all substance.
“Have a seat,” he said. He reached out and opened the refrigerator without getting up, grabbing a can of Coke and refilling his glass. “Soda?”
“You got Jack in yours,” Crewes said. “I can smell it from here.”
“Not true.” Lenny assembled his features into a hurt expression. “I really resent that, Howard.” He winked at Simon as though they were schoolmates goofing off in class. His hair fell across his face, and he brushed at it distractedly.
“Let’s have that soda.”
Lenny reached into the refrigerator, pulled out another can. Then he reached under his chair and came up with a fifth of Jim Beam. “Told you it wasn’t Jack.”
“I came here to save your ass,” Crewes said, “and you want to fuck around.”
Lenny just smiled into his drink. In the fluorescent light of the kitchen his skin was waxy and sallow; acne scars flecked his cheeks and forehead. His legs emerged from his mesh shorts like a pair of weather-ravaged marble columns, a pink scar running down the middle of each knee.
“They bother you much?” Simon asked. Crewes shot him a quick glance. “The new knees.”
Lenny ran his fingers across one of the scars as though he’d just noticed it. “Not that new anymore. Howard, buddy, what’d I say about all this, huh? What’d I tell you?”
“What you said wasn’t worth hearing. You know what your problem is? You have no sense of yourself anymore. You were a professional football player, Lenny. That’s something just about nobody gets to be. You should respect that. But instead you sit in this kitchen five miles from where you were born and drink yourself to death like you don’t have a choice.” Simon got the impression that this speech was as much for his benefit as Lenny’s. “It’s like the good part of your life never happened,” Crewes continued, “and you just woke up eight years later, fatter and with two titanium knees.”
“And arthritis,” Lenny said.
“And the headaches.”
“We all get the headaches.”
“Not like I do.”
“Did Cheryl find him?”
“I did. But it’s nice you remember you still have a wife. Do I need to remind you about your kids too?”
Lenny suddenly turned to Simon. “So who would it be? Some sad fuck from Mexico?”
Simon suppressed a flinch. Lenny’s attention was flavored with hostility and bitterness, his entire personality expressed as a challenge. “I can guarantee the donor will be American.”
“Oh, good. The homegrown poor.”
“Whoever he is,” Crewes said, “he’ll be a lot less poor afterward.”
“That doesn’t mean I have to feel good about it.”
“The donors,” Simon said, trying to gain control of the conversation, “they come looking for us. They know what they’re getting into. We tell them exactly what to expect. Maybe you’ve read stories about what happens in other countries. Careless doctors. No follow-up care. Shady brokers.” He allowed himself a small smile, sinking into the familiar patter—all the easier because he believed it to be more or less true—and feeling it temporarily muffle his anxiety. “That’s not what we’re talking about here. Our transplants take place at a top New York City hospital, with top surgeons. It’s as safe as this surgery can be. Which, by the way, is very safe.”
“You’re not mentioning the fact that it’s illegal.”
“But I don’t think it should be. Neither do all the people we’ve helped who’d still be waiting for a legal transplant when they’re dead.”
Lenny shrugged, unmoved. “Maybe that’s how things were meant to go for those people.” He grimaced as he stood up, his hand straying to a stomach that Simon now noticed was swollen and bloated looking. He limped out to the back porch, carrying the bottle of Beam with him. Crewes motioned for Simon to stay put before he followed Lenny outside.
Simon looked around the kitchen, which was small and neat, though he couldn’t imagine Lenny was the person who cleaned it. Stuck to the refrigerator was a note that read, in loopy, optimistic handwriting, “Every Tues 1 PM: session w/ Jen. Every 2nd wknd: Greg and Dani. Sunday AM: CHURCH.” He sat at the table, fiddling with Crewes’s can of soda. He didn’t like how he was being forced to persuade Lenny of the moral viability of Health Solutions’ entire business model. This meeting was supposed to be about his evaluation of Lenny as a recipient, not a referendum on the ethics of how he’d spent the last eight months of his life; he was ambivalent enough about that already without a gravely ill potential client piling on. He could see the two of them through the window, leaning against the porch railing. Crewes pointed back at the house—at Simon maybe—but Lenny wouldn’t look.
Crewes came back inside a few minutes later.
“He’ll come around,” he said, walking through the kitchen. “You did all right.”
• • •
CABRERA Medical Center had always been the second of Roosevelt Island’s two hospitals: second built, second choice, second rate. Silver River Memorial, at the northern tip of the island, was a solid, geriatrics-centric public hospital that knew what it was and didn’t try to be anything else. Cabrera, down on the island’s south side, past the Fifty-Ninth Street Bridge and the pustular tennis bubble, had been conceived in the 1970s as an oncology center to challenge Sloan Kettering, yet it had somehow ended up, thirty years later, as a repository for the overflow of gunshot and car-crash victims from Long Island City, Astoria, and Greenpoint. The buildings were shabby; the manner of care chaotic. In 2005 the facilities were purchased by a national hospital chain whose first order of business was the construction of a new transplant wing. Before it could become the money maker the chain was betting on, the first thing this new wing needed was surgeons; these it now had. The second was patients (or, perhaps more accurately, “clients”); these the hospital’s administrators were still working on, which put the unit under enough pressure to churn out transplants that its surgeons weren’t inclined to look too closely at whatever donors their coordinators fed to them.
Not long after Simon had learned all of this from DaSilva, he got to see the transplant wing for himself. On his first day after moving into an apartment building near Silver River Memorial, he walked the perimeter of the island. It wasn’t much of a walk: the island was only two miles long and less than a quarter mile wide. After crossing beneath the bridge and its deep pool of shadow, he was presented with his first view of Cabrera: a long, squat central building streaked with soot and bisected by three smaller wings. (Later, looking down on the hospital from the tram, he’d thought it resembled a giant stitch sewn into the land.) He kept walking south along the riverside path, past a group of young men in wheelchairs—all smoking cigarettes and staring at the river, bundled under blankets, not speaking—past a cluster of willow trees, a parking lot, and then there it was, the new wing: a weird, asymmetrical structure, like an oval with a dent in one side, constructed out of turquoise glass and steel. According to DaSilva, the building had been designed in the shape of a kidney, although this seemed too ridiculous to be true and was likely just Peter fucking with him. It was as though a small chunk of one of the new condos springing up like weeds in Williamsburg had somehow ended up here, flicked aside like a bitten nail. A glass-sided skywalk ran over the parking lot, connecting the new wing to the old hospital. A group of nurses burst out of the main building and headed toward the riverside path, breath steaming and hands flashing as they produced cigarettes, lighters, gum, candy bars. Simon stood and watched as the light drained from the sky, the new wing glowing, doctors rushing back and forth across the skywalk, the wheelchair-bound patients quiet and shadowed under the willows by the river’s edge.
Eight months later, and Simon had still not set foot inside Cabrera. He did his work in his apartment or at the Health Solutions office, a small room in an anonymous building in the East Sixties, off Second Avenue. The building was filled with small-scale independent businesses—dentists, physical therapists, tax accountants, the kind of operations that didn’t require more than a room or two. There was no company name on the office’s door, only the suite number. It was more important that their room appear to be a functioning office than actually be one, and so the space exhibited a sense of the generic, like an IKEA display: a blond-wood desk, a bookcase lined with medical reference texts, a Barcelona Couch, desktop PC, printer, fax machine, ergonomic chair.
Eight months, and he’d already put together a dozen deals; all kidneys and all medically and financially successful. This case with Lenny was his first liver, and livers, DaSilva told him, were where the real money was. It was the more expensive surgery, the more valuable organ. (Also the more risky surgery and grueling recovery, for both donor and recipient.) Liver transplantation was the field in which Cabrera Medical Center had decided to make its name and its fortune, and so it was the field on which Health Solutions would now focus. In addition, the few other domestic brokers DaSilva was aware of traded exclusively in kidneys, which made livers, he said, the definition of an opportunity.
So far Health Solutions had not been, for Simon, a particularly difficult job, at least not operationally. (Morally was perhaps another question.) The donors were always enmeshed in some pedestrian sort of financial trouble, and what concerned them were the hard figures: the payout, the time away from work, the insurance ramifications. Is the surgery safe? they’d sometimes ask, and Simon would tell them yes, it is. They’d nod, as though they hadn’t researched this themselves before they found the courage to send an e-mail to the contact address listed on the slickly designed and factually scant Health Solutions website. That their sale might buy someone ten or twenty more years of life was understood as a kind of bonus, a renewable interest on their payout, the kind of thing they could turn to for some small measure of consolation when the new money ran out, which it nearly always did, DaSilva admitted, and often sooner than they expected.
Simon had found the buyers trickier. Some of them wanted to know everything about their donors; they wanted to be told exactly how their money would transform these people’s lives. Others wanted to know nothing and seemed to prefer to think of the purchased kidney as the miraculous product of a lab.
When he first took the job, Simon wondered how he would possibly locate donors. Recipients he understood. These people talked to each other; there were message boards, forums, as well as old-fashioned word of mouth. Theirs was a community that traded in the currency of hope. Besides, Peter DaSilva had access, through his coordinating job at Cabrera, to two of the relevant waiting lists: the United Network for Organ Sharing’s and Cabrera’s own. He knew who needed a liver or a kidney, who wasn’t going to get one anytime soon, and who could afford to pay a lot of money not to wait any longer. When someone fulfilled all three criteria, he might offhandedly direct the candidate to one of a few online message boards populated by the transplant community, where, under pseudonymous handles, Simon posted testimonials describing how a friend or a spouse or an uncle had found the answer to his transplant troubles by contacting the good folks at Health Solutions. That DaSilva himself was involved with this company—was, in fact, its proprietor—never occurred to the candidates, which was, of course, exactly how he wanted things.
Donors though? It wasn’t as if Simon could just walk around Times Square, waving a wad of cash. This wasn’t Chennai or Manila in the nineties, where whole neighborhoods of young men, he’d heard, would suddenly exhibit the exact same scar in the exact same location on their torsos. During his first meeting, before DaSilva had finished explaining how Health Solutions worked, Simon imagined he’d have to fly to Brazil, Turkey, Syria, Moldova, offering a few thousand dollars and a trip to New York City to whomever was willing to part with a kidney. He’d imagined skulking around the worst neighborhoods of New York like a drug dealer or a pimp, trawling for the desperate, the easy marks. He didn’t know if he could bring himself to do it. The exploitation was too frank, the moral ambiguity of utilitarianism shading into the self-evident amorality of raw, unfettered capitalism.
But it turned out none of this was necessary, not anymore. Not in 2008. It turned out that plenty of people in what one might think of as the middle class—or people who were once in that class or who wanted to appear to be in that class—were open to the idea. Why not sell something that cost you nothing to own in the first place? It was a kind of entrepreneurship of the body, a utilization of previously untapped resources. These weren’t people in need of food or shelter. These were people in need of a car, college tuition, debt relief. Simon’s very first client wanted LASIK and a nose job; why not, she reasoned, let one surgery pay for two more? As the spring of 2008 slipped into summer, and now turned to fall, the list of people—American citizens, no less—who might be interested in the company’s services grew longer and longer, and Simon’s e-mail inbox began to brim with the kind of inquiries he’d feared he would have to sift through the most wretched corners of the third world to find. As the jobs accumulated, Simon’s ethical queasiness over his role in these transactions was calmed by his donor-clients’ embrace of a wonderfully mutable philosophy of self-empowerment, a worldview that made easy room for the conversion of flesh to cash, for the literal capitalization of the self. These people knew the score, knew what they were getting into, at least as much as they could without having gone through it already. Who was he to stand priggishly in judgment of them or of himself?
Also, he was making badly needed money—and fast—which didn’t hurt.
• • •
IMMEDIATELY after visiting Lenny, Simon told DaSilva about Howard Crewes’s role as sponsor and planner. He also told DaSilva that Lenny was still drinking. But Peter didn’t think this would be a problem: “Can this Crewes guy really pay?”
“He’s got the money, yeah.”
“All right.” DaSilva’s voice came through the pay phone clear and strong, Bronx street traffic fulminating somewhere behind him. “Then unless Leonard Pellegrini dies before I can get him into the OR, we’ll make it happen.”
“Peter,” Simon said. This attitude seemed unusually aggressive for DaSilva, who for the last eight months had preached nothing but risk management, turning aside dozens of candidates, both donors and recipients, because of one irregularity or another. Maybe the success of the last run of deals had emboldened him, or maybe landing a lucrative liver job was incentive enough to bend his own rules. “The guy’s an alcoholic. There’s no hiding it. Forget six months. It probably hasn’t even been six hours since his last drink.”
“What did I say? I’ll get him in there. Those regulations are too conservative anyway, you know they’re just there to protect the hospital’s ass. Just make sure he tells Klein he’s been clean four or five months and I’ll do the rest.”
“What about the piss test?”
“I said I’ll fix it. Worry about your own job.”
And so a week after his excursion to Long Island, Simon sat in the office, scrolling through a batch of applicant e-mails. Crewes had called Simon the day before to inform him that Lenny was going forward with the transplant. He was doing it, Crewes had said somewhat melodramatically, for his children’s sake, not his own. Crewes and Cheryl, Lenny’s estranged wife, had returned to Lenny’s house the day after Simon’s visit, and they’d sat with him in the kitchen, turning the screws and refusing to leave until he deigned to allow them to help save his life. It was now the morning of Lenny’s physical exam at Cabrera; Lenny and Crewes were due at the office any minute. Lenny was scheduled to undergo a battery of laboratory tests—liver function, electrolyte levels, blood typing, coagulation—as well as radiographic studies of his liver and an EKG. The point was to determine his general fitness for surgery, as well as what sort of characteristics Simon would need to look for in his donor. Simon hoped DaSilva hadn’t exaggerated his ability to massage these test results, or at least to place them into some kind of more favorable context (which most likely meant emphasizing Lenny’s financial solvency by proxy), since Simon was fairly sure the machines would paint an internal picture of widespread alcoholic waste and ruin.
• • •
The two men buzzed from street level. Simon let them into the building and waited in the hallway. They exited the elevator, Lenny stuffed into a pinstriped suit like a parody of Mob muscle, Crewes wearing black slacks and a fitted purple sweater, and it was as though the hallway had suddenly shrunk, squeezing in around them. They carried a presence beyond their height and weight, a largeness that must have been a residue from their playing days. It wasn’t arrogance or swagger. It was almost the opposite: a carefulness as they made their way down the hall, a delicacy of motion, as though they were afraid of damaging anything with which they might come into contact. As Simon shook Crewes’s hand, he thought of Alvin Plummer’s body, lying broken on the turf, and was immediately ashamed of the thought.
He ushered them into the office and sat them on the two chairs facing his desk. He explained the tests, and then asked if the hospital had been in touch regarding the day’s schedule. Lenny said that the transplant coordinator, “a guy named DaSilva,” had called a few days earlier to introduce himself. “He said he’d meet me in the lobby and escort me through the procedures.”
Simon nodded. “You’ll be in good hands.” He wrote the name and address of a diner on a slip of paper and slid it across the desk. “When everything’s finished, Howard and I will meet you here for lunch. It’s just a few blocks from the hospital.”
Lenny looked at him very seriously throughout this conversation. Beads of sweat puckered on his upper lip; he slipped a gold wedding band on and off his finger. Under the suit jacket, his white shirt was stippled with moisture. Was he nervous? Maybe, but Simon didn’t think that was it, or at least not all of it. Then he realized Lenny probably hadn’t taken a drink yet that day, or maybe for the last few days, as though he could trick the hospital’s instruments into believing his body to be clean and blameless. Well, good, Simon thought. Better to start late than never. At least he’d have a week of practice at being sober before the screening interview.
They left Crewes’s Lexus parked on the street and rode the tram across the river. The tram car lifted out of the station and swung above the traffic on First Avenue, climbing alongside the bridge’s vaulted underbelly. As they rose above York, they drew even with the higher floors of an apartment building; Simon caught a glimpse of a cat sunning itself in a window, a curtain tangled in the needles of a cactus. They crested the midsection of the bridge, and he pointed out the curve of the United Nations Headquarters a dozen blocks downtown, the ruined smallpox hospital at the southern tip of the island. Back on the ground, he led them toward Cabrera, stopping a few hundred feet from the entrance. Clusters of nurses and staff sat on the grass outside the hospital, eating their lunches in the sun, smoking, laughing, their scrubs pink, baby blue, lime green—pieces of candy scattered across the lawn. Simon shook Lenny’s damp hand, told him he’d be fine. Lenny nodded, saying nothing; then he walked away, stolid and deliberate.
• • •
NOW Simon turned the monitor back around to face him, the last of DaSilva’s cigarette smoke drifting across the office. He stared at Maria Campos’s fake smile and wondered what particular variety of financial misfortune could have pushed her to this decision. She was so young; usually it was the middle aged, the overextended and overleveraged, whose cagey, probing e-mails piled up in his inbox. He’d have to be careful not to reveal his curiosity. He didn’t want to risk scaring her off, and, besides, DaSilva paid him not to pursue these things, to leave the inessential questions about his clients’ lives unasked.
He dialed her number. Just as he was sure it was about to go to voice mail, she picked up: “Yeah?”
“It’s Simon Worth, an associate at Health Solutions.” For a few long seconds, he listened to her breathing, the faint murmur of a television in the background. “We’ve been e-mailing.”
“Simon,” she said. “Right.” Her voice was raspy, as though she’d just woken up.
“I’m calling to tell you that our initial evaluation of your candidacy is positive.”
“That sounds like a good thing.”
“It is. We’d like to do some testing to assess your compatibility with our client. I have the number of a lab you can visit for some additional blood work and liver imaging. Is that something you want to do?”
“Livers are worth more,” she said, “aren’t they?”
“I looked it up.” Her voice straightened, sloughing off its sleepiness. “Liver transplants, they cost more than kidneys. So a piece of liver—a piece of my liver—it’s gonna be worth more than a kidney, right?”
“In theory, yes.”
“In theory? Either it is or it isn’t.” She paused. “I’m sorry. I just need to know if this is worth it to me before we go any further.”
“If you qualify—and I can’t make any promises yet—but if you qualify, we can offer you $150,000.” Silence. “Plus we’ll pay for your travel, which includes two weeks in a Manhattan hotel.”
“One fifty.” Her voice was neutral, but Simon thought he heard a tremor of the effort required to keep it that way.
“Yes. You would receive $5,000 in good faith when you arrive in New York. The rest follows the operation.”
“I’m not trying to be rude, but how can I be sure this isn’t a scam?”
“You can’t. But what would we get out of flying you across the country and putting you up on our dime?”
“Not that. I mean how do I know you’ll pay me the rest after the operation?”
“I suppose you can’t know. But think of it this way: we don’t want anybody angry with us. The way we arrange things, everybody wins. The hospital. The recipient. You, the donor. Everybody’s happy.”
“I’ve never been to New York.”
“You’d have $5,000 and two weeks to see how you like it.”
“Yeah,” Maria said. “So what’s the number of that lab?”
Simon gave it to her.
“They’re ready for me?” He could sense her eagerness and at the same time her attempt to suppress it, as though she could take or leave what he was offering. “When can I call?”
“Today, if you want.”
“Today is all right,” she said. “Today is good.”
THE next evening Simon waited in the fluorescent bowels of Penn Station, under the LIRR departures board. He was on his way to Leonard Pellegrini’s house, where they would begin preparations for the Cabrera psychosocial interview. Simon had suggested meeting in his office, but Lenny said he didn’t like taking a train into the city—he wasn’t driving these days—unless he had absolutely no choice. Looking around Penn Station, Simon couldn’t blame him. The place—low ceilings, crappy food, horror-show lighting—would depress anyone. At 6:15 p.m. the station was crowded beyond even what he’d expected. Each time a track number appeared on the board, a portion of the waiting mass of commuters detached itself and stampeded toward the track entrance, a riot of elbows and briefcases and shopping bags. When his train’s number came up, he waited until the rush had cleared and was rewarded with a standing-room spot next to the lavatory, its stale, uric smell wafting through the train compartment each time somebody wrestled open the sliding door.
After an hour, he stepped out of the train and into the failing dusk. Headlights sliced though the parking lot’s busy shadows. His taxi driver nodded at the address and sped over the Sunrise Highway and past a high school, the football field’s goalposts glowing white against the sky. At Lenny’s house all of the lights were out. Simon opened the screen and knocked on the door. He waited, then knocked again. The door was locked. He dialed Lenny’s number on his cell phone, and he heard the ringing in his ear and its echo inside the house. He stepped back onto the porch and looked up at the second-floor windows. The curtains were pulled tight; if Lenny was in there, he didn’t want anybody to know it. Simon sat down on the porch steps. Ten minutes passed, then fifteen. Screw this guy, Simon thought. Why should I help him when he can’t even be bothered to help himself? As he was dialing a taxi to take him back to the train station, a black Lexus swung around the corner and pulled to a stop in front of the house. The driver’s-side window rolled down; Crewes’s head popped out.
“I drove as fast as I could,” he said. “Lenny just remembered about you. Shit, man, you gotta tell me about this stuff. You can’t expect him to remember.”
“Where is he?”
“Get in. I’ll take you.”
They quickly left Lenny’s town behind, heading north on the Cross Island Expressway. Crewes drove fast, weaving in and out of traffic, Al Green pleading on the stereo. Fifteen minutes later they exited the highway for a new town. Here, large houses were set back from the road; hedges shielded the properties from each other. Crewes drove up a gravel driveway and parked behind six or seven other cars. The house was large, not as big as Crewes’s, but older, more solidly built. A brick chimney rose out of a shingled roof; lights blazed in every window.
Simon looked at Crewes. “Where are we?”
“Don MacLeod’s house.” Simon knew the name; MacLeod had played fullback for the Giants during the early nineties, one of those players reliably cited by announcers for the integrity of their “fundamentals.” “Once a month,” Crewes said, “some guys, some retired players with the same problems as Lenny, they come over with their wives. Etta MacLeod hired a therapist to lead some discussions. Sessions, I guess you call them.”
“The same problems? You mean drinking?”
“Can be. But more the headaches. The moods. The screwed-up marriages. Get your bell rung enough times while you’re playing, and these things seem to go together.”
“So what are you doing here?”
“You think he would come if I didn’t show up at his door and drive him? He and Cheryl went once, when they were still living together. He hated it. Said he was being condescended to. Said it was humiliating. So they never went again. But I knew if I could get him here, she’d come too. That’s her car right there.” He pointed at a maroon Honda. “I drive him, hang out in the car during the meeting. When the session’s over, I’ll come in, have some coffee, and talk to Don. Reminisce about the time I popped his helmet off in a preseason game.”
“You’re not allowed inside during the meeting?”
“Of course I’m allowed. But I don’t come here for myself. It wouldn’t be right to sit there and watch, like it’s some kind of show.” Crewes checked his watch. “We’d just arrived when he remembered he was supposed to be meeting with you. This will be over in fifteen minutes. If he doesn’t want to do it now, you can reschedule with him in person. He’ll remember it better that way.”
They stared at the house in silence for a few minutes, like cops stuck on some desultory stakeout. Simon again felt as though he’d lost control of the situation, this job still refusing to fall in line with the choreographed procedures of his first dozen.
What People are Saying About This
Praise for The Dismantling:
"With its high tension plot and atmosphere of unease, The Dismantling is a morally ambiguous thriller in the grand tradition of Graham Greene and Patricia Highsmith. It has smart things to say about memory, redemption, and what it's like to live in a world where everything is for sale, but it says them by telling a gripping story." —Christopher Beha, author of Arts & Entertainments
“Intense, spare, and unflinching, DeLeeuw’s The Dismantling treads risky, ethically nuanced territory, exploring the nature of absolution and revenge, the lies we tell our families, and the honesty we can find with strangers. A psychologically insightful, gripping novel.” —Michaela Carter, author of Further Out Than You Thought
"While this is a fast-paced, engaging thriller, it is also much, much more. It is, at its heart, a fully and tenderly rendered exploration of loss and shame and the deep yearning for some manner of redemption. It is about the difficult choices put before us—and that might very well damn us—when possible redemption is close at hand." —Thomas O’Malley, author of This Magnificent Desolation
"A whip-smart modern noir. Brian DeLeeuw's writing is as keenly intelligent as it is eerily propulsive." —Jennifer duBois, author of Cartwheel
Praise for Brian DeLeeuw’s In this Way I Was Saved:
“Elegant, unsettling and wildly original, In This Way I Was Saved reads like a coming-of-age-story with the heart of a nasty thriller." —Gillian Flynn, #1 New York Times–bestselling author of Gone Girl
“Terrifying and terrifyingly good.” —Vanity Fair
“Haunting and persuasive.” —Los Angeles Times
“Spellbinding.” —Publishers Weekly
“Original, subversive, funny, twisted, and totally engrossing, In This Way I Was Saved is a mind-bending tour de force. I read the last page, flipped back to the beginning, and immediately started again.” —Chelsea Cain, New York Times–bestselling author of Heartsick and Sweetheart
“In This Way I Was Saved gave me chills, not only for its dead-on depiction of the searing loneliness of a hermetically sealed mind, but because it is so thrillingly well-executed. A superb first novel” —Kate Christensen, PEN/Faulkner award-winning author of The Great Man and Blue Plate Special
“[W]ill keep you guessing right until the book reaches its inevitable conclusion. I haven't been this entertained by a debut novel in years.” —Dale Peck, author of Drift House
“In this Way I Was Saved is a frightening, gripping tale about a sadistic secret sharer, a shadow self who is ready to devour its host. This is one of the most fascinating and controlled first novels I’ve ever read—a sustained performance that hypnotizes and terrifies the reader.” —Edmund White, author of A Boy’s Own Story
“In this original, inventive debut, Brian DeLeeuw delivers a suspenseful and surprisingly tender psychological thriller that gives shape to the torment of isolation.” —Helen Schulman, author of This Beautiful Life
“A story of friendship and betrayal, violence, madness, lust, and power that will keep you guessing until the very last page—and leave you gasping for air.” —BookPage
“Riveting ... suspenseful and terrifying.” —Library Journal
“Mysterious, psychologically, craggy, and highly readable.” —Time Out New York
“Creepily compelling.” —Daily Mail (UK)
“DeLeeuw's precise, vivid prose has that visceral power of both a successful psychological thriller and a gripping ghost story.” —The Daily Telegraph (UK)
Most Helpful Customer Reviews
Powerful imagery: THE DISMANTLING is a suspense filled, medical thriller storyline focusing on the illegal procurement of organ donation. Twenty five year old, former medical school student Simon Worth is in the illegal and unethical business of buying organs. Simon is an organ broker –the go between for people willing to pay and those in need of a quick influx of cash. THE DISMANTLING focuses on a liver transplant where the recipient is reluctant to save his own life, and the ensuing fall out of an illegal operation. Told from third person point of view using memories, flashbacks and current day to day storytelling, THE DISMANTLING follows the ill-fated procurement, interviews, surgery and after care of a liver transplant that should never have been done. From donor to reluctant recipient, family and friends, operation and recovery, the reader is pulled into an intense story of one man’s spiral from promising med student to illegal organ broker to murder and revenge. Simon Worth is a young man, who for seven years, has mourned the drowning death of his only sister. Unable to cope with the guilt and medical school requirements, Simon finds himself in the awkward position of trying to hide his failure while embarking on a life of illegal organ procurement. His latest ‘donor’ is a young, cash strapped woman whose past life will slowly be revealed as the storyline unfolds. Simon and Maria will quickly discover that not everything goes according to plan, when the recipient of Maria’s liver becomes headline news. With Simon on the run, Maria devises a plan to silence the man in charge. Brian DeLeeuw is an amazing storyteller. The build up of suspense, powerful imagery, and the catastrophic unraveling of an ill-fated transplant will leave you wondering about the potential reality of the entire situation. The characters are colorful and engaging; the premise original, alarming and sensational; the outcome startling and intense. What are you willing to do to save the people that you love? There are always consequences to every action and decision that you make.
kept my attention and will order another one of this authors books he has written,
Brian DeLeeuw's novel The Dismantling has some topical elements in its plot- injuries suffered by NFL players, the lack of available organs for those needing a transplant- and combines them with a young man trying to come to terms with the loss of his younger sister years ago and a woman with a mysterious past into a fast-paced thriller that also makes you think. We meet Simon, a twenty-five year-old man who has dropped out of medical school but has yet to tell his father. His friend hooks him up with a under-the-radar company that connects people who need kidney or liver transplants with people who are willing to sell them their body parts. Simon lost his mother to a horrible death when he was just a young child, and his teenage sister died, the circumstances of which are unraveled during the story. We do know that Simon feels that her death was his fault, but we don't know why for a long time. Simon is tasked by his boss to find a liver donor for Lenny Pellegrini, a retired NFL player with a drinking problem who suffers from too many hits to the head during his playing days. Lenny's friend Howard, also a former NFL player, is paying for the liver and he and Simon must convince Lenny to do this for his wife and two young children. Through their website, Simon has found Maria, a single young mother willing to sell a piece of her liver to Lenny. Since it is illegal to sell organs for transplant, the woman is presented as a cousin of Lenny's, and she is flown in and coached as to how the process works. Maria seems like the perfect candidate, but things start to unravel shortly after the transplant. Maria disappears and Lenny is still in a state of severe depression. Simon's boss threatens him that he better fix this situation before too many questions are asked. The Dismantling is a fast read, one that you want to finish in one sitting while at the same time taking time to ponder all of the bigger issues here. At its heart, it is Simon's story, about his coming to terms with everything in his life, where he has been and where he is going. While Simon is in medical school, he has to participate in autopsying a cadaver, and the scenes set there are vivid and not for those with weak stomachs. It is in these sessions that Simon's past comes back to haunt him, and he ends up in the dangerous situation he finds himself in. Simon is an interesting character, and his relationship with his dad was so real and heartbreaking. The Dismantling combines a thought provoking story with some heart-stopping action scenes and twists and turns, and seems tailor-made for a movie, maybe for a Hemsworth brother. I also enjoyed the New York City setting, especially since Simon and I lived on the same street.
Brian DeLeeuw in his new book, “The Dismantling” published by Plume gives us an adventure with Simon Worth. From the back cover: At twenty-five troubled med-school dropout Simon Worth is faced with the grim reality of failure and massive student loans. Haunted by the accidental death of his sister, he accepts a lucrative job at Health Solutions as a black market organ broker, arranging the sales of kidneys and livers from donors who need the money to recipients whose time on the transplant list is running out. Eight months into the job, Simon is tasked with finding a match for Lenny Pellegrini, a severely depressed ex-NFL player with a serious drinking problem and a failing liver. When Simon is contacted by Maria Campos, he believes he’s found the perfect donor. The surgery goes according to plan, but soon afterward Lenny makes a cruel and destructive decision, while startling secrets from Maria’s past further complicate the situation. Under tremendous pressure to keep the media and authorities from exposing Health Solutions, both Simon and Maria find themselves the targets of Peter DaSilva, Simon’s boss, who is desperate to protect himself and his organization at all costs. Backed into a corner, Simon is forced to decide that, against his better moral judgment, the only way to survive is to put his trust in Maria. Let’s face it a person cannot live without a functioning liver. Once that goes the individual dies it is just that simple. So there are lots of persons on waiting lists for acceptable matches however it seems that you can age off of these lists. That is when the black market kicks in. To me this whole premise was terrifying. Simon is a broker of illegal organs to that these individuals who are aging off these donor lists can live. From practically page one this is one suspense filled, medical thriller. Be assured “The Dismantling” is going to have you reading just as fast as you can trying to keep up with what happens next. The good news is you will breathe a satisfied sigh when you finish even though you might have given up sleep to get there. It will certainly be worth it. Disclosure of Material Connection: I received this book free from TLC Book Tours. I was not required to write a positive review. The opinions I have expressed are my own. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”
The plot seem very predictable the way it unfolded and then didn’t. Pretty much what I expected