OU AWAKE?" I WHISPERED.

"I am now."

"People are being murdered for their organs."

"Uh-huh." Ryan stretched out a hand. I took it.

"Cruikshank figured it out."

Ryan propped himself up onto one elbow. His hair was tousled, and the baby blues were heavy with sleep.

"The idea crossed my mind, but it seemed so far out there I didn't even mention it."

"It's true."

"A drugged traveler wakes in an ice-filled bathtub? A college student comes to sporting stitches after a wild party?" Ryan's tone was beyond skeptical. "Organ theft stories have been making the rounds for years."

"What Cruikshank stumbled onto is far worse than any urban myth. People are being choked to death, Ryan. Their organs are being carved from their bodies."

"No way in hell."

I ticked off points on my fingers. "Inexplicably dead MPs. Skeletons with cut marks." Ryan started to speak. I blew past him to ring man. "Cut marks consistent with scalpel nicks. A sketchy doctor in the United States, with a med school classmate who's dropped off the map. A mysterious health spa in Mexico."

Ryan scootched up and put a pillow behind his head. "Show me."

Crawling under the covers, I sat Indian style, opened Cruikshank's laptop and rested it on my crossed ankles.

"Cruikshank spent a lot of time researching transplantation, black marketeering in organs, Charleston MPs, and a place called Abrigo Aislado de los Santos near Puerto Vallarta."

"The Mexican resort in the brochure?"

"Yeah," I snorted. "Last resort."

I nibbled a cuticle, debated how to take Ryan through this since I'd just begun to comprehend most of it myself.

"Since the early fifties, transplantation has become relatively common. A kidney or a portion of liver can be given by a living donor, even a single lung, though that's rare. Heart, cornea, double-lung, or pancreas transplants have to come from cadaverous donors.

"The problem is there aren't enough organs to go around. If you can use a live donor, you're better off. You might be compatible with a family member, a friend, or a charitable donor, though those are few and far between. If you need a cadaverous donor, you could sit for months, or even years."

"And die waiting."

"In the United States, those needing cadaverous donors become part of OPTN, the Organ Procurement and Transplantation Network, operated by an independent nonprofit organization called UNOS, the United Network for Organ Sharing. UNOS maintains a database of eligible transplant recipients, as well as information on all organ transplant centers throughout the country. UNOS also establishes policy with regard to priority and who gets which organs."

"How does a patient get into the network?"

"You have to find a transplant team qualified with UNOS. That team decides if you're a good candidate, physically and mentally."

"Meaning?"

"It's complicated, but drug and alcohol abusers and smokers are usually disqualified, for example. UNOS also ranks potential recipients based on health, urgency of need, compatibility, length of time on the list, that sort of thing. They want available organs used where they are likely to do the most good."

Ryan cut to the core. "So those rejected and those tired of waiting go outside the system."

"So-called brokers arrange sales of human organs to patients who can pay. Usually the sellers are willing participants. Kidneys are the most commonly traded, and, in most cases, it's poor people in developing countries selling their organs to the wealthy. The cost can run over one hundred thousand dollars, with the donor receiving only a fraction of that."

"This is widespread?"

"Cruikshank had tons of research on his computer. Some of his sources describe the kidney trade as a global phenomenon. Nancy Scheper-Hughes, a Berkeley anthropologist, has established an NGO called Organ Watch, which claims to have documented organ harvesting in Argentina, Brazil, Cuba, Israel, Turkey, South Africa, India, the United States, and the United Kingdom. Cruikshank also found information on Iran and China."

I clicked a few keys, and Ryan and I skimmed a report on the use of executed criminals as donors in China.

"You can actually purchase package deals." I opened a series of files and we both read in silence.

An Israeli-led syndicate offered transplant tours to Turkey and Romania for $180,000 U.S. A New York woman bought a kidney from a Brazilian donor, then traveled to South Africa for surgery at a private clinic at a total outlay of $65,000 U.S. A Canadian went to Pakistan in a cash-for-kidney deal costing $12,500 Canadian.

"Check out this Web site."

I clicked to another download. A Pakistani hospital described itself as a fifty-bed private facility in operation since 1992. The site offered a package that included three weeks' lodging, three daily meals, three presurgical dialysis sessions, donor expenses, surgery, and two days' post-discharge medication for $14,000 U.S.

"Tabarnac!" Ryan sounded as appalled as I felt.

"Most countries outlaw this, but not all. In Iran, for example, it's legal but regulated." I opened another file. "The U.S. National Organ Transplant Act of 1984 prohibits payment to those providing organs for transplantation. The Uniform Anatomical Gift Act allows individuals to specify that some or all of their body may be donated after their death. Nineteen eighty-seven revisions to the act prohibit the taking of payment for donated parts."

"OK. Cash for kidneys. But murder?"

I opened several downloads.

South Africa. June 1995. Moses Mokgethi was found guilty of the murder of six children for their organs.

Ciudad Juárez and Chihuahua, Mexico. May 2003. Hundreds of women had been killed since 1993, and bodies continued turning up in the desert. Federal investigators claimed to have evidence the women were victims of an international organ trafficking ring.

Bukhara, Uzbekistan. No date. A family named Korayev was found with the passports of sixty missing persons, an enormous sum of money, and bags of body parts in their home. Their company, Kora, promised visas and overseas jobs. Instead, according to police, the Korayevs killed their clients and, working with a doctor, pipelined their organs to Russia and Turkey.

"Jesus."

"Theft from fresh cadavers is even more common," I said. "And not just in the Third World. Organ Watch has also reported on U.S. cases in which families of brain-dead patients have been offered as much as a million dollars to give organ harvesters access to the bodies immediately upon death."

The room was brightening. I got up and slid open the glass door. The smell of the ocean made me think of boogie-boarding with my kid sister, Harry, beach blanket gossip with high school best friends, sand castle construction with Katy and Pete.

Pete. Again, that pang deep in my chest.

I wanted to go back to one of those long summer days, to forget putrefied bodies, and scalpels, and wire nooses.

"So you believe someone at the GMC clinic is snuffing street people to harvest their organs." Ryan's voice brought me back. "And that Cruikshank was about to blow the whistle."

"I think Cruikshank was killed to keep him quiet. And I'm wondering about Helene Flynn, too."

"Suspects?"

"I'm not sure. The operation would have to involve several people, and a clinic has to be at the core. The average guy on the street can't just yank out a kidney."

Returning to bed, I opened another file.

"Removing an organ isn't all that complicated. In the case of a heart, for example, the vessels are clamped, and a cold, protective solution is pumped inside. The vessels are then severed, and the heart is placed in a bag filled with preservative. The bag is packed in ice in an ordinary cooler and flown or driven to its destination."

"How long do you have?"

"Four hours for a heart, eight to ten for a liver, three days for a kidney."

"Tight schedule for a heart. But plenty of time for transport to kidney recipients."

"Waiting in pre-op at some sterile facility tucked away in the hills." I clicked some more keys. "Cruikshank was looking into Abrigo Aislado de los Santos. Know what that means?"

Ryan shook his head.

"Isolated health shelter. Read the language on their Web site."

The more he read, the more deeply Ryan frowned. "'Unique therapeutic regimes available to individually qualified customers.' What the hell does that mean? You need a pedigree to get a pedicure?"

"It means call us. Provide background. If your story and portfolio check out, we'll get you a kidney."

"I'm guessing putting organs in isn't as simple as taking them out."

I looked Ryan directly in the eye. "Implantation requires a surgeon working in a relatively sophisticated facility."

Ryan's expression told me he was careening along the same deductive pathways I'd followed, speeding toward the same appalling finish. After a full minute, he spoke.

"You've got the GMC clinic on this end, serves druggies, crazies, the homeless. A few patients disappear now and then, no one notices. You would need a small plane, a cooler, a pilot who doesn't ask a lot of questions. Or maybe the mule's actually in the loop. You've got an experienced surgeon operating in an isolated location, catering to those needing organs and willing to pay a substantial price."

"Lester Marshall and Dominic Rodriguez attended the same med school, dropped out of sight around the same time," I said. "Rodriguez is a surgeon."

Ryan picked up the thread. "Two old classmates hook up, hatch a cash-for-organs scheme. Marshall comes here. Rodriguez goes to Puerto Vallarta, sets up a clinic disguised as a spa."

"Or Rodriguez might have left San Diego to practice medicine in Mexico. Could be Marshall got into some kind of trouble, went south, and the two reconnected," I said.

"Marshall takes the organs out, Rodriguez puts them in. Donors don't complain because they've been paid or because they're dead. Recipients don't complain because what they've done is illegal. A hundred thousand a pop buys a lot of margaritas."

"Illegal drugs are flown to the U.S. from Mexico all the time," I said. "Why not organs going the other way? They're small, easy to transport, and the payoff is huge. It explains the nicks, the garroting, the hidden bodies."

"The Burke and Hare script taken to a different level."

A gull touched down on the deck railing. Boyd lunged toward the screen, tail wagging. The bird took flight. The chow turned and looked at us. Ryan and I looked at the chow, thinking the same thought. Ryan voiced it.

"What we've got is speculation. We need to background Rodriguez, find out if the guy's in Mexico. We need to know where Marshall spent those missing six years. And why. And we need info on pilots and planes in the Charleston area. And boats."

Ryan looked confused.

"Willie Helms's body had to have been taken by water to Dewees Island. Unique Montague was dumped in the ocean. I doubt the killer used a ferry for either of those jaunts."

"Doesn't everyone and his granny own a boat in this town?"

I thought a moment. "Let's review Cruikshank's notes some more. You think some of the letters represent initials. You're probably right. What if we check those letter combinations against other Charleston MPs?" I was thinking out loud. "If we find a match it probably puts that MP at the GMC clinic."

"From the dates I saw in the notes, Cruikshank was only staking the place out during February and March of this year."

My mind was cranking now. "OK. I have the MP files from Emma. I think they cover the period of Cruikshank's investigation. I'll check the date each MP was last seen and compile a list. Maybe we can cross-check the list against flight plans logged by small-plane pilots."

"That would be a major law enforcement undertaking, particularly if it involved more than one Charleston-area airport. Also, smugglers rarely log flight plans."

"OK. The disappearances could coincide with times a plane was taken from an airfield."

"Assuming the plane's not kept in a barn somewhere. If they're not filing flight plans, they won't be logging in or out of an airport."

Sudden thought. "What about GMC? They've got a plane. Is it possible this thing goes higher than Marshall? Herron and his staff refused to respond to Helene's complaints. Then she went missing."

"I thought Helene was suspicious about the mishandling of funds."

"That's always been Herron's version. But he and his people refused to help Cruikshank find her, then Cruikshank dies. Stonewalled Pete, too, for that matter, then Pete is shot. Could someone high up at GMC be involved? Oh my God, Ryan, GMC operates clinics throughout the Southeast!"

"Let's not get carried away. When's Gullet coming by?"

"He wanted Cruikshank's computer first thing this morning." Ryan threw back the covers. I grasped his wrist. "Gullet hasn't been busting a gut helping me out. Do you think he could be protecting Herron?"

Pulling my hand to his lips, Ryan kissed the knuckles. "I think Gullet's solid."

"You're probably right. But do we have enough to convince him?"

"Call Emma. Explain our thinking. Helene's complaints to her father and to Herron, then her sudden disappearance. Cruikshank's link to Helene. Cruikshank's files on Burke and Hare, UNOS, the organ trade, Rodriguez, and the Puerto Vallarta clinic. The evidence of garroting on Cruikshank, Helms, and Montague. The scalpel nicks on Helms's and Montague's vertebrae and ribs. Find out when Emma expects a DNA report on the eyelash you found with Helms's bones."

"Planning on snatching some discarded chewing gum?"

"Saw that on TV Slick. But I'm a used-soda-can man myself," Ryan said.

"The snail shell that held the eyelash came from a freshwater species, yet it was found with Helms's body on a saltwater beach. We should find out if Marshall lives near a freshwater swamp or beside a stream or river."

"You dazzle, Dr. Brennan."

"And think about Dewees. The island population is less than that of Mayberry. There's no bridge or connector and the ferry is only for residents and their guests." I was pumped. "Where does a perp typically dispose of a body? Within his or her comfort zone."

"Incandescent!"

"Thank you, Detective Ryan."

"Here's a plan. Call the hospital, find out how Pete's doing. Then pull out your spreadsheet and make a list of dates MPs were last seen. In the meantime, I'll make a few calls. When I finish, we'll do some digging on Marshall and the gentle folk of Dewees."

Ryan grabbed his surfer shorts.

"Deputy Dawg Gullet won't know what hit him."