© Kyle R Fisher
Transplant Unlimited Excerpt

Prologue

Chapter 1

No one could deny that Walt Bartell was dead. Of course, in the twenty years that Nelson Taft had known Walt, he’d seen him dead before: dead serious, dead certain, dead tired, even dead drunk, but this was a dead that not even a stiff Bloody Mary or a twelve-hour binge coma could cure. This dead was of the permanent variety. The police found Walt’s prized possession, a 2008 Chevrolet Corvette with the 7.0-liter, 505 horsepower gasoline engine, twelve coats of OEM Atomic Orange Metallic paint, and Ebony leather interior at the bottom of a steep ravine outside the town of Corona, smashed into a twisted, burning fusion of antique aluminum, magnesium, and fiberglass. Not even the white historic vehicle vanity license plate escaped unscathed. Where it once read “ORNGCRSH” in crisp, red letters was now an illegible smear of blackened, bubbled paint on a warped rectangle of aluminum. What was once a museum-quality, vintage sports car was now a smoldering monument to the inherent flammability of hydrocarbon fuels. The police found his body—at least what remained of it— amid the wreckage of the Corvette he loved so much. The personal effects found at the scene were Walt's, and his wife made a positive identification of his face, which had, through happenstance, survived the petrochemical’s thermal event relatively intact. Even the compulsory DNA testing, performed by police for all questionable deaths, confirmed it was Walt. No one could logically refute this was Walt’s corpse, and in fact, nobody did. Walt’s funeral was moving; a tribute to the impact he made in his short life. Nelson gave a speech about Walt that was overflowing with praise, and, yes, even love: brotherly love. Tears flowed in abundance from those whose lives Walt had touched. He was well known and well loved for his selfless concern for the clients, and his quirky sense of humor. He would be missed. Everyone, from his wife, Lillian, to his life insurance company, accepted as fact, like gravity or string theory, that Walt Bartell died in that crash. Yet there he stood, only weeks later, brandishing a pistol pointed unerringly at Nelson’s chest, and wearing the desperate look of a strung-out junkie. At that instant, a sick feeling of panic finally settled into Nelson’s core, previously present, but pushed forcibly into the background, waiting for this confirmation, this proof, before getting intimate with his awareness. He knew exactly what Walt had done, to what depths his best friend would plunge. What he didn’t know, despite the twenty-year history, was how the next few minutes were going to play out.
The small group of doctors stood in the control room at Transplant Unlimited, and watched the intricate machine in awed silence. They peered through a floor-to-ceiling glass wall as the delicate, coffee-cup- sized mechanism traversed rapidly back and forth above the stainless-steel tank. Accompanying each graceful movement across was a persistent, high-pitched, electronic whine that, although muted by the glass, was still pervasive almost to the point of irritation. The stereo effect from the second machine, located twenty feet away and running a half second behind in period, only served to increase the irritation. Intermittent blue light peeked out indirectly from between the mechanism and the tank, reminiscent of the light emitted from a welder joining molten metal. The twin machines behind the glass nearly filled the small room, and represented the height of modern medical engineering. These two in particular, built as much for presentation as for function, shined with gleaming stainless steel, crisp white engineering-grade polymer nanocomposites, and multicolored medical-grade tubing everywhere the doctors looked. When he built them, Walt went to great efforts to ensure the visual presentation of these two machines was every bit as impressive as the products they generated. The room, and in fact, the entire suite of offices, conveyed a faint hospital sterilization smell that was only partially disguised by the abundant application of cream-colored Steelcase and HON. Dressed in their stereotypically appropriate white lab coats, the group of five doctors crowded in front of the glass next to the control console. All but one watched the flickering blue light as if a religious miracle would soon occur. A mocha-skinned technician wearing tight-fitting, navy blue surgical scrubs with the Transplant Unlimited logo over her left breast sat at the console monitoring the process. She was a stunning Latina with carefully placed deep auburn streaks radiating through her long, black hair, currently pulled back into a sensible ponytail. Next to her stood Walt Bartell in a blue lab coat, similar in design to the doctors’ but bearing the Transplant Unlimited logo. “Our timing is good. The heart should be emerging soon,” Walt said. He gave a quick glance at the stunning technician, attempting, with limited success, to keep from looking at her chest, which was barely contained in scrubs at least a size too small. “How long, Erika?” Erika tapped the screen on the control panel, and gave Walt a large smile. “Thirteen more minutes.” “Our timing is not good,” he said, smiling to the MDs. “Looks like I’ll have to ad-lib for a while. It's not a successful tour unless you see an organ come out.” “Said the actress to the bishop,” muttered one of the doctors in a heavy, French accent. The other doctors in the group attempted to quell their high-school-like giggles and titters, mostly unsuccessfully. “I’m sorry, what?” Walt said. “Oh, nothing,” came the French-accented reply from a short, heavyset doctor wearing wire frame glasses and a thin goatee. “It is a British thing. I could not resist.” Walt’s brow rose in confusion as the laughter faded, and with a puzzled grin and a slight shake of his head, he removed the tablet-sized electronic file folder from the control panel’s docking bay. He tapped the screen a few times and studied the display, his eyes shifting over the surface. “Okay,” he said, reading from the screen. “This is the Meir heart being printed for a thirty-four-year-old woman with advanced extrinsic cardiomyopathy. She was scanned about a week ago, and is currently being prepped at St. Joseph next door to receive her heart today at ten a.m.” Walt ran a calming hand through his thick head of brown hair, which fell rakishly back where it started. Although he looked ten years older than his current mid-thirties, partly due to the slight paunch where his middle-aged spread started early, he still carried the remnants of striking, almost aristocratic good looks from his youth. Now, however, the fine lines on his face and dark circles under his puffy eyes betrayed his late nights and general lack of healthy upkeep. He replaced the electronic file folder into its docking station with a glance at Erika. She looked up to catch Walt staring at her, but rather than surprise or indignation, she responded with a wry smile. Walt returned the smile, and turned back to his guests. “Can I ask a question?” said a distinguished looking, gray haired doctor. “Sure, Dr. Abbott.” Walt said. “How does your technician stand listening to this noise day after day?” Walt smiled. “Let’s ask her.” He turned to Erika. “How about it, Erika. How do you stand listening to this noise all day?” “I’m sorry,” she replied, with a well-rehearsed cadence. “Did you say something?” The group was slow to catch on, but aided by Walt’s wide grin and Erika’s duplicitous laugh, they got the joke. “Same old Walt,” mumbled Dr. Julie Mills, the only female doctor in the group. “The annoyance factor goes away pretty quickly,” Erika said, more serious this time, “but I swear Walt could turn it off in a second if he wanted to. I think he leaves it there so people ask that question and he can make me do that joke.” “Nope, just a happy coincidence,” he said. “That sound is an unavoidable part of the printing process.” “Walt,” said Dr. Mills. “We all have a basic understanding of how the organic printing process works, but since we have a few extra minutes, can you go into a little more detail on it?” “Sure thing,” he replied. “Good idea.” Walt stepped closer to the doctors. “We begin with—” A door behind them opened, and all eyes turned to see a man in his mid-thirties enter the room. He carried a briefcase and wore a wide-eyed look of surprise at seeing the group of doctors. “Excellent,” Walt said. “Our resident genius has arrived. Nels, come and meet everyone. Everyone, this is Nelson Taft, the brains of our organization.” Nelson’s look of surprise quickly faded, replaced by a large smile until his eyes fell on Dr. Julie Mills. Her dark brown hair was much shorter now, just about shoulder length, but she was still as beautiful as when they dated in college, perhaps more so, if that were possible. Gone from her face was the roundness and smoothness of youth, replaced with confidence and a sharpening of features that only enhanced her beauty. Hoping no one noticed his faltering smile, he mustered a new one and stepped toward the group. “Good morning, folks.” “Julie,” Walt said, “I think you’ve met Nelson before, haven’t you?” Nelson looked once again into those gray-green eyes that were so familiar, made more enchanting by the contrasting black eyeliner surrounded by that perfect, alabaster skin. “Hi Julie, it’s been a long time.” She smiled at Nelson as if they were just old friends from college. “Hi, Nelson. I see Walt’s still an ass.” Walt was smiling broadly. “Sorry, I couldn’t resist.” “Well, same old Walt,” Nelson said. She turned to the other doctors and their puzzled expressions. “Sorry, guys. I’ve known these two for years. We went to college at UC Irvine together. It’s how I’m able to get these tours on such short notice.” “Well,” Walt broke in, “If you’re finished insulting me, why don’t you introduce everyone to Nelson.” “All right, but I doubt I’m done insulting you.” Turning to the first doctor, a curly-haired Hispanic man, she said, “This is Dr. Pena. Nelson Taft.” Nelson turned to Pena and shook his hand. “He's in his first year of residency, so feel free to completely ignore anything he says,” Julie said. “Wow,” Nelson said to Pena, “She’s really softened up over the years.” Pena laughed. “And she’s one of the nice ones.” He shrugged. “Everyone treats the first-years that way.” “Sorry, it’s a rite of passage,” she said, smiling. “Have to cull the weak from the herd, you know.” “I'm fascinated by your operation here,” Pena said. “Can't wait to see the finished product.” Nelson turned to the next doctor, a slight, dark haired Asian man. “This is Dr. Wong,” Julie said. “He's been at St. Joseph for—” Julie looked at Dr. Wong for confirmation. “—Five years?” “Yes, five years. Nice to meet you.” “He's transplanted quite a number of your organs, but never had the chance to come over and look around.” “You're right next door, but I’ve just never found the time,” Dr. Wong said. “You don’t have to tell me twice. I know the life of a transplant surgeon is a busy one.” Julie shot Nelson a sideways look but continued. “Next is Dr. Abbott.” Nelson turned to the next white-coated doctor and offered his hand. “Good to meet you,” he said. Although easily the oldest person in the room, Dr. Abbott carried a youthful look that made it difficult to guess his age. “St. Joseph just stole him from Hartford Hospital in Connecticut,” Julie said. Dr. Abbott chuckled, accentuating the crow’s feet at the corners of his eyes. “The jury's still out on who got the better end of that deal, but I do prefer the weather here. The higher cost of living I could do without.” A chorus of scoffs and catcalls erupted from the other doctors, leaving Walt and Nelson to look on curiously. “Nice to meet you,” Nelson said, “what’s the joke?” “Dr. Abbott’s grandfather was one of the original founders of Intuitive Surgical, developer of the da Vinci surgical robot,” Julie said. “He has more money than some small countries. We don’t let him complain about the cost of anything.” “Hey,” Abbott replied with a smile, “I told you, it's my parents’ money, not mine. I don’t get to touch it.” More catcalls and even a few bullshit-coughs followed while Abbott fended off the good-natured rich- kid accusations of his coworkers. Erika’s one speaking role already concluded in yet another parade of visitors through this place, she focused on the control panel and the nearly completed heart in the printer. It wasn’t until the mention of money in the conversation piqued her interest that she took a long, hard look at Dr. Abbott. For an older guy, she thought, he’s kind of cute. He was now busily attempting to salvage some dignity from the situation. Prior to the outburst, she noticed him land a few too many glances her direction for chance to explain. She’d been attractive all her adult life, and could always tell when a man thought so, too. In this case, she was not mistaken, at least not completely mistaken. While the other doctors were mesmerized by the flickering blue light of the organic printer, something entirely different was mesmerizing Dr. Abbott. Yes, this machine was actually printing a human organ for immediate transplant, and yes, she was a very pretty girl, but there was something else that captured Dr. Abbott’s attention above all others, and held it in a persistent, almost primitive grip. Dr. Abbott couldn’t get past the fact that this company seemed to provide hospital scrubs to their employees that were excessively small, especially in the chest area. “And last but not least,” Julie said, “this is Dr. Édouard Bertrand.” The short, portly man standing in the rear stepped forward and shook Nelson’s hand. He wore square, wire-rimmed glasses, and sported a thin mustache and tiny caterpillar goatee at the point of his chin. “Good morning, so glad to meet you.” Although sufficiently fluent in English, his strong French accent hinted that he wasn’t a local. “Édouard,” Julie said, “is visiting from Paris for a few months.” “Welcome to California,” Nelson said. “What brings you here?” Édouard smiled widely through his thin mustache. “It is for a technical exchange program between St. Joseph and Bicêtre Hospital in Paris, regarding surgical techniques… and, more importantly, I think, to work with Juliette on her French.” He gave a nod to Julie to make his reference clear, but it was unnecessary. Her alabaster face already glowed with a deep auburn hue at the mention of her linguistic tutoring, and Nelson knew it was no small task to embarrass Julie. She shrugged it off and said, “Oui, monsieur, but, I’m a bit rusty since college. I don’t know if two months will be enough.” “Nonsense,” Édouard said, “You speak French beautifully.” He turned back toward Nelson. “Another reason I’m here is—” “Here we go,” Wong interrupted, smiling and shaking his head. Édouard cast a peripheral glance at Dr. Wong, but continued speaking. “Few people are aware that St. Joseph Hospital can trace its beginning directly to a small group of Roman Catholic women from Le Puy, France in 1650. So, it only seems right that we come back occasionally to check up on you.” “He loves that line,” Pena agreed. “Well…,” Nelson said to Édouard, not completely certain how to respond. “That’s interesting.” “Next he’ll be telling us the French have the best military record in the world,” Wong said. “No, no,” Édouard replied, smiling with the thrill of the battle, “I would never make that claim. What I said was the French have the best military record in Europe.” “Okay, guys, quit dog-piling on the foreigner,” Julie said. Turning to Walt, “Now that the introductions are finished, you were about to explain how this all works.” “Well,” Walt said, turning to Nelson, “I was just going to give them my canned speech, but you know the biology part of the process so much better than I, would you mind going through it?” “No problem.” Nelson placed his briefcase on the floor and gathered his thoughts. Far from looking like an expert who could explain the complex process of manufacturing human organs, he appeared to be more like one of the local surfers, with his short, spiked hair, two-day stubble growth, and outdoorsy color. Like many of the surfers, he was trim and muscular, making him look a decade younger than his true age. “Walt is being very humble when he calls me the resident genius, and humility is normally out of character for him.” Nelson laughed and the doctors joined in with smiles of comprehension at the friendly jab. “I'm far from the brains of this organization, more like in the right place at the right time. However, Walt is, without a doubt, the beating heart of Transplant Unlimited. Starting the business was his idea. He gutted the entire floor of this building, built all the structures, all the equipment, and has been tweaking our scanner over the last few years to give us finer and finer resolution. I'm assuming you've already been through the scanning room?” The doctors all nodded in affirmation. “Well, as you know, human organ donation is fraught with complications. Not only are donors rare, but they must also be viable: they must be fairly young, they must be within certain size limitations, they must be healthy, the blood groups must be compatible… the list goes on and on. Fortunately, the need for donors has become obsolete. Thanks to breakthroughs across a number of different scientific disciplines, instead of harvesting them from other humans, we make human organs on the 3D printers you see here behind the glass. These printers are not much different from the printers used in business offices every day. They are much larger, of course, and instead of colored ink, we use organic tissue precursors, but I'm getting a little ahead of myself.” As Nelson spoke, Dr. Abbott took turns watching the presentation and glancing at Erika, one of the few women he’d seen who could make hospital scrubs look sexy. Glancing over at Walt only confirmed Abbott’s earlier assessment that Transplant Unlimited made a habit of buying their uniforms too small. Like Erika’s uniform top, Walt’s lab coat was also too tight for him, except it was around his midsection rather than his chest, and, in Abbott’s opinion, not nearly as awe-inspiring. “There are four other organ printing facilities in the U.S. and only two in Europe,” Nelson said. “Our franchise owner, the inventor of the process, has plans for more in other parts of the world as the list of printable organs grows, but it doesn't take too many of these machines to cost-effectively meet all the world's current transplant needs. We begin the process with the complex PET/MRI scan, which, as Walt probably told you, utilizes the MRI to create a detailed model of the organ being replicated, and then uses a PET scan to give us a 3D image of the functional process of the organ. Next, we take ten CCs of adipose tissue from the patient—” “Fat?” Dr. Pena interrupted. “Yes, fat, which contains an incredible abundance of stem cells. Using a person's own stem cells completely eliminates any organ rejection issues and the resulting need for anti-rejection drugs.” “Is the fat removal process anything like liposuction?” Pena asked. “In fact, it's exactly like liposuction. We do it here in our office, but if a patient wanted to lose some weight along with getting their new organ, they could get the full liposuction treatment at St. Joseph next door and we would need just ten CCs of that. So far, nobody has opted for it, but this is California: it's bound to happen.” There were chuckles and nods of agreement. “Speaking of that, it's no coincidence that we're situated right next door to St. Joseph's here in Orange. Proximity to a transplant center is one of the requirements of our franchise. Of course, the limited number of organ printers means the organs must still be transported to where they're needed; however, as you know, it's always best practice to avoid any delays.” Nelson pointed to the multicolored tubes protruding from the rear wall of the print room behind the buzzing machines. “Behind the print room is the feedstock room where the adipose tissue is washed with a proprietary mix of enzymes that breaks down the scaffolding of the fat and allows the stem cells to be removed. We perform a rapid culture on the stem cells to produce an amount sufficient to replicate the organ, in this case, a heart. Just prior to the manufacturing process, the stem cells are mixed with plasma and exposed to special laser light to photoactivate the stem cell’s functionality.” His outstretched arm and index finger traced a path from where the tubes entered the printer room on the far wall to where they interfaced with the nearest printer. “Next, the feedstock is introduced to the 3D printer where the stem cells are mixed with the correct type and quantity of growth factors, enzymes, proteins, and other nutrients under the laser print head in a bath of proprietary solution. Here, the stem cells are individually placed and converted to the correct type of cell with the exact geometry and functionality necessary. Like any 3D printer, the cells are stacked one at a time until the fully formed organ is complete.” Nelson paused and looked at the doctors. They were hanging on his every word. “Nelson,” Dr. Wong said. “Can you go into a little more detail about the plasma introduction and photoactivation?” Nelson gave him a weak smile. “Actually, no, I can’t. Those are proprietary processes that I’m not allowed to discuss. I guess our franchise owner doesn’t want any little geniuses out there printing hearts as high school science fair projects.” Nelson smiled and the group smiled back. Dr. Wong lifted both hands palms outward. “Fair enough. How many different organs can you make?” “Right now, we focus on the big five.” Nelson began counting on his fingers. “Heart, kidney, liver, lungs, and pancreas, but the list continues to grow. It's not exaggeration when I say we can print anything you guys can transplant.” Dr. Bertrand half raised his hand. “You are able to meet the local demand for organs with just these two machines?” “That’s right. These are our only production units, but we have a third unit that Walt and I spend most of our time on for development work and improving the process.” Walt interjected. “We call it the Skunkworks machine like Lockheed Martin’s secret jet development program in the 1950s.” “Thus, proving Walt is an engineering geek at heart,” Nelson said, smiling, “It's not as compact or elegant as these machines, but does exactly the same thing.” “So how long does it take to print an organ,” Dr. Pena asked. “That depends on the organ,” Nelson replied. “Once we start the actual printing process, a kidney or liver takes just two hours. A pancreas takes about forty-five minutes. Hearts and lungs are a bit more complex, so you’re looking at three to four hours.” Dr. Abbott, silent throughout the explanation, finally spoke. “How do you make healthy organs when the ones you scan are, in many cases, damaged or diseased?” “Ah, an excellent question that not many think to ask. The scanning software automatically compensates for nonviable tissue by running what we call regenerative protocols. For example, when scanning the lungs of a heavy smoker—for those who can still afford to smoke—we don’t want to duplicate the damaged cilia or alveoli, so the scanner replaces it with healthy cells that mimic the rest of the geometry of the patient.” Dr. Abbott nodded thoughtfully at this. “What about the human microbiome?” Dr. Pena asked. “Another question few think to ask, and from the first year. Dr. Mills should really be nicer to you.” Julie feigned a look of indignation. “I don’t have to tell you how much medical science has learned in the last few decades regarding the importance of the microbiome for our very existence,” Nelson said. “What I can tell you is how much medical science still doesn’t know. However, for the purposes of printing human organs, the interaction with the microbiome is no different from when organs were harvested from donors. The body’s microbiome quickly populates the new organ tissue as necessary.” “But the microbiome cells outnumber the human cells ten to one. Don’t they overwhelm the scanning process? I can see the potential for printing the wrong cells.” “No, that’s not an issue,” Nelson replied. “You’re correct that the microbiome cells are much smaller and more numerous than human cells, but the scanning process works so well that it easily distinguishes between host and nonhost cells. Plus, there is no matching genetic feedstock present to make any of these microorganisms, so the printing process doesn’t attempt to reproduce them.” The high-pitched whine of the nearest machine abruptly stopped, leaving a noticeable and welcomed void in the acoustics of the room. A moment later, a gentle alarm tone began ringing on the control panel. Erika tapped the panel once and the alarm stopped. “Okay, folks,” Walt said. “It appears the heart is done. Next, a technician will retrieve the organ and deliver it to the hospital, where the doctor and patient are eagerly waiting for it.” As if on cue, a side door to the printing room opened, and a stocky man entered wearing the standard issue Transplant Unlimited scrubs (also tight, Dr. Abbott noticed), a cap, latex gloves, and a face mask. He carried with him a rectangular blue and white container, holding a handle recessed into the top surface. The corners were square, like a cardboard box, and on the side of the container, in large block letters, were the words “Human Organ.” Seemingly oblivious to his audience, he set the container on a small shelf near the stainless-steel box on the printer, tapped an integrated touchpad on the side of the container, and watched as a thick section of the top slid smoothly back to reveal a darkened interior. Next, he turned to the 3D printer, and set about disassembling the stainless-steel box. Small clamps with threaded fasteners held together the corners of the stainless-steel box, which was roughly the size of a large microwave oven. Using a battery-operated wrench hanging out of sight, the technician began unthreading the fasteners. The four male doctors stepped closer to the glass, and watched with rapt attention as the technician worked. “How long will the organ remain viable before it needs to be transplanted?” Dr. Pena asked. “Oh, roughly a week chilled and stored in the nutrient solution,” Walt replied, “which gives us plenty of time to transport it to other hospitals in our region.” Julie, having seen this demonstration before, found herself standing apart from the group next to Nelson. She turned to him. “So, how have you been?” she asked in a quiet voice, quickly turning back to resume watching the technician as if she didn’t really care about the answer. “Busy, but doing okay. You?” he asked. Nelson also pretended to be interested in the organ removal process, which he’d seen too many times to be impressed. “The same, very busy.” By now, the technician was removing the first panel. As he broke the magnetic seal with the neighboring panels, small rivulets of nutrient bath trickled out into a catch basin. “I like your hair,” Nelson said. “Short hair looks good on you.” Julie broke her stare from the deftly moving technician to face Nelson. “You are a terrible liar. You liked my hair long. As I recall, you didn't want me to get it cut.” Nelson turned to meet her gray-green eyes, now suspiciously studying him under raised brows, and offered a humble smile. “Well, I was wrong. It really works for you.” Her hard stare softened into a contrite smile. “Well, it's a little better now, but just like during my residency, I don't have the time to take care of long hair, or time for much of anything else, for that matter. I feel like I've aged thirty years since college.” “Well, I think you look fantastic.” Although sincere, the compliment tumbled out before he could stop it, and Nelson regretted it the second it left his lips. She smiled at his comment, but her eyes remained suspicious. “Thanks, but you're still a terrible liar. You, on the other hand, don't look a day older than when we were in college. How do you do it?” “Ha, now who's the liar?” he asked with a laugh. “Seriously, you and Walt are the same age. He looks like he hasn’t seen the inside of a gym since graduation, but you haven’t changed a bit.” “I try to exercise when I can.” “It shows.” Julie turned to watch the technician again, mostly to hide the warmth she could once again feel creeping over her face. Three of the four panels were off, but all she could see was the technician’s back. She didn’t mind: she had seen it all before. The technician was visually inspecting the completed organ before moving it from its home location. The repair of tiny visible imperfections such as tears in the surface or ragged edges was relatively simple while the organ remained in the home location, but once moved, repair became much more complex. “So, now you’re Juliette?” Nelson asked quietly. “You hated it when I called you that.” “Since Édouard found out my given name is Juliette, he hasn’t stopped calling me that. He says it sounds more French.” “What it sounds like, is that you have an admirer.” “He’s married,” she said, “but it is nice to speak French again.” “That’s right,” he said, nodding. “You spent a summer in Paris studying abroad.” She nodded. “Studying? I don’t think I got much studying done, but I was in Paris.” They both smiled and pretended to watch the technician. “You have a good group with you today,” Nelson said. “Yeah, they’re all great. Most of the docs next door are stiffs, but these guys get my humor. You looked surprised to see me this morning. I guess Walt didn't tell you we were coming.” “Yeah, a little surprised, and no, he didn’t tell me. He's been busy, too, it seems.” From the corner of her eye, Julie noticed Walt leaning down to whisper into the console technician’s ear. She was a pretty Latina that Julie didn’t know, but she was well-acquainted with Walt’s wife, Lillian. “I hope you're okay with this,” she said. Nelson turned to face her and she met his look. “Of course,” he said. “Perfectly fine with it. I'm an adult. There's no reason we can't have a working relationship just because we can't have a personal one.” “You're taking this pretty well. The last time I talked to you, you told me I broke your heart.” “Well, I printed myself a new one.” He managed to keep a straight face for only two or three seconds before the mischievous grin appeared. The brief confusion on her face melted into a smile, and she playfully hit him on the arm. “I do miss that goofy sense of humor, but only sometimes,” she said, smiling, and then turned serious. “I am sorry. I—” Nelson interrupted. “Julie, it's okay. I'm okay. It's in the past and we're friends. I'm good with that, really.” They locked eyes and looked at each other while all around them, the minutiae of that moment in time—the incessant buzzing from the second printer, the group of awe-struck doctors, the technicians, the freshly printed human heart—all faded into the background. As he looked once again into those familiar gray-green eyes, he thought he saw something, something he used to see when they were dating. As much as he enjoyed seeing it, he knew he could not encourage her. He kept his eyes passive and lifeless as he stared back at her. “Okay,” she said finally, “okay.” She turned back to watch the technician behind the glass, but Walt’s interest in the attractive girl at the console drew her attention once again. “Is there something going on there?” She nodded in their direction. Nelson shifted his gaze to look at them. Walt said something to Erika, and she gave him a playful smack to the arm, just like the one Julie had delivered to Nelson moments ago. “Funny you should say something, that's the rumor going around, but I don't think so. He and Lillian are pretty solid. Besides, Erika’s got to be ten years younger than him.” “Or more. Maybe she likes older guys,” Julie said. “Of course. Everyone knows that hot, young, big-boobed girls are attracted to overweight, out of shape, balding, middle-aged guys. It's like a natural law or something.” “Okay, smart-ass, maybe she likes older guys’ bank accounts.” Nelson nodded in agreement. “That would seem more likely.” “I don't know. Something just looks out of place there.” While Nelson and Julie watched, Erika wagged an accusatory finger at Walt as he held up his hands in mock surrender. “Poor Lillian,” Julie said. “She can be a little rigid, but she's such a good person.” A small commotion from the doctors shook Nelson and Julie from their discreet observations. The technician now gripped the heart in both latex-covered hands, and held it close to the glass to afford the doctors a better view. About the size of two small fists held together, the freshly printed muscle was pinkish auburn-red with pale white streaks of collagen running randomly throughout. The superior and inferior vena cavas, the aorta, and the pulmonary artery all protruded from the organ with crisp, perfect edges. “Wow, look at that,” said Dr. Pena. “It looks like it just came out of a chest cavity.” “Put a defibrillator on it, and it would start beating,” Walt said proudly. “The aorta and pulmonary arteries look out of proportion,” Abbott said. Walt said, “Good eye. We print them slightly longer to make the transplant process easier. The surgeon can use the extra length or trim them as needed.” Leaving his audience and turning to the blue container, the technician lowered the heart down into it and tapped the touchpad. The lid glided effortlessly back, sealing the heart inside. Glancing up at a digital clock integrated into a display screen in the front of the printer, he tapped the screen on the container a few more times. “Right now, he's comparing the digital time stamp on the storage vessel with the machine time,” Walt said. “He’s also just wirelessly transferred all the information from the electronic file folder on the console to the storage vessel. Before the heart goes to St. Joseph, he’ll run it through a small MRI scanner to make sure the interior geometry is correct, but so far our success rate is one hundred percent.” Apparently satisfied that all was well, the technician picked up the storage vessel, and, giving the crowd a small wave, exited through the same door he previously entered. “Okay folks,” Walt said, running his hand through his hair. “I guess the show's over. There’s coffee and doughnuts in the conference room, and we can answer any other questions you have.” The small crowd followed as Walt headed toward the exit. He held the door open as they filed through. “Do you run these machines around the clock?” asked Dr. Abbott. “We typically just staff a day shift, although depending on the organ print schedule, we sometimes stretch that to ten or twelve hours. The equipment will run twenty-four seven, so we may start a lung at five p.m., and it will be here waiting for us the next morning. In fact, we'll be closed Monday for the Labor Day weekend, but the machines will be humming along while we—” Walt’s voice faded away as the door closed behind him. Julie and Nelson stood unnoticed as Erika busily tapped screens on the control panel. In the print room, a second blue-scrubbed technician was now cleaning the print platform to prepare for the next job. “It was nice seeing you again, Nelson,” Julie said. “I'm sorry it worked out this way.” “I know, Julie. It was nice seeing you, too.” She hesitated, as if she had more to say, but looked at the floor and turned quickly toward the exit. Nelson watched as she hurried toward the door, the tails of her white lab coat flapping behind her. As the seconds ticked by unnoticed, he stood motionless, staring at the door after it closed. With a brief shake of his head to break the mental trance, he turned, retrieved his briefcase from the floor, and made his way out of the control room.
© Kyle R. Fisher
Transplant Unlimited Excerpt

Prologue

No one could deny that Walt Bartell was dead. Of course, in the twenty years that Nelson Taft had known Walt, he’d seen him dead before: dead serious, dead certain, dead tired, even dead drunk, but this was a dead that not even a stiff Bloody Mary or a twelve-hour binge coma could cure. This dead was of the permanent variety. The police found Walt’s prized possession, a 2008 Chevrolet Corvette with the 7.0-liter, 505 horsepower gasoline engine, twelve coats of OEM Atomic Orange Metallic paint, and Ebony leather interior at the bottom of a steep ravine outside the town of Corona, smashed into a twisted, burning fusion of antique aluminum, magnesium, and fiberglass. Not even the white historic vehicle vanity license plate escaped unscathed. Where it once read “ORNGCRSH” in crisp, red letters was now an illegible smear of blackened, bubbled paint on a warped rectangle of aluminum. What was once a museum-quality, vintage sports car was now a smoldering monument to the inherent flammability of hydrocarbon fuels. The police found his body—at least what remained of it— amid the wreckage of the Corvette he loved so much. The personal effects found at the scene were Walt's, and his wife made a positive identification of his face, which had, through happenstance, survived the petrochemical’s thermal event relatively intact. Even the compulsory DNA testing, performed by police for all questionable deaths, confirmed it was Walt. No one could logically refute this was Walt’s corpse, and in fact, nobody did. Walt’s funeral was moving; a tribute to the impact he made in his short life. Nelson gave a speech about Walt that was overflowing with praise, and, yes, even love: brotherly love. Tears flowed in abundance from those whose lives Walt had touched. He was well known and well loved for his selfless concern for the clients, and his quirky sense of humor. He would be missed. Everyone, from his wife, Lillian, to his life insurance company, accepted as fact, like gravity or string theory, that Walt Bartell died in that crash. Yet there he stood, only weeks later, brandishing a pistol pointed unerringly at Nelson’s chest, and wearing the desperate look of a strung-out junkie. At that instant, a sick feeling of panic finally settled into Nelson’s core, previously present, but pushed forcibly into the background, waiting for this confirmation, this proof, before getting intimate with his awareness. He knew exactly what Walt had done, to what depths his best friend would plunge. What he didn’t know, despite the twenty- year history, was how the next few minutes were going to play out.

Chapter 1

The small group of doctors stood in the control room at Transplant Unlimited, and watched the intricate machine in awed silence. They peered through a floor-to-ceiling glass wall as the delicate, coffee-cup-sized mechanism traversed rapidly back and forth above the stainless-steel tank. Accompanying each graceful movement across was a persistent, high-pitched, electronic whine that, although muted by the glass, was still pervasive almost to the point of irritation. The stereo effect from the second machine, located twenty feet away and running a half second behind in period, only served to increase the irritation. Intermittent blue light peeked out indirectly from between the mechanism and the tank, reminiscent of the light emitted from a welder joining molten metal. The twin machines behind the glass nearly filled the small room, and represented the height of modern medical engineering. These two in particular, built as much for presentation as for function, shined with gleaming stainless steel, crisp white engineering-grade polymer nanocomposites, and multicolored medical-grade tubing everywhere the doctors looked. When he built them, Walt went to great efforts to ensure the visual presentation of these two machines was every bit as impressive as the products they generated. The room, and in fact, the entire suite of offices, conveyed a faint hospital sterilization smell that was only partially disguised by the abundant application of cream-colored Steelcase and HON. Dressed in their stereotypically appropriate white lab coats, the group of five doctors crowded in front of the glass next to the control console. All but one watched the flickering blue light as if a religious miracle would soon occur. A mocha- skinned technician wearing tight-fitting, navy blue surgical scrubs with the Transplant Unlimited logo over her left breast sat at the console monitoring the process. She was a stunning Latina with carefully placed deep auburn streaks radiating through her long, black hair, currently pulled back into a sensible ponytail. Next to her stood Walt Bartell in a blue lab coat, similar in design to the doctors’ but bearing the Transplant Unlimited logo. “Our timing is good. The heart should be emerging soon,” Walt said. He gave a quick glance at the stunning technician, attempting, with limited success, to keep from looking at her chest, which was barely contained in scrubs at least a size too small. “How long, Erika?” Erika tapped the screen on the control panel, and gave Walt a large smile. “Thirteen more minutes.” “Our timing is not good,” he said, smiling to the MDs. “Looks like I’ll have to ad-lib for a while. It's not a successful tour unless you see an organ come out.” “Said the actress to the bishop,” muttered one of the doctors in a heavy, French accent. The other doctors in the group attempted to quell their high- school-like giggles and titters, mostly unsuccessfully. “I’m sorry, what?” Walt said. “Oh, nothing,” came the French-accented reply from a short, heavyset doctor wearing wire frame glasses and a thin goatee. “It is a British thing. I could not resist.” Walt’s brow rose in confusion as the laughter faded, and with a puzzled grin and a slight shake of his head, he removed the tablet-sized electronic file folder from the control panel’s docking bay. He tapped the screen a few times and studied the display, his eyes shifting over the surface. “Okay,” he said, reading from the screen. “This is the Meir heart being printed for a thirty-four-year- old woman with advanced extrinsic cardiomyopathy. She was scanned about a week ago, and is currently being prepped at St. Joseph next door to receive her heart today at ten a.m.” Walt ran a calming hand through his thick head of brown hair, which fell rakishly back where it started. Although he looked ten years older than his current mid-thirties, partly due to the slight paunch where his middle-aged spread started early, he still carried the remnants of striking, almost aristocratic good looks from his youth. Now, however, the fine lines on his face and dark circles under his puffy eyes betrayed his late nights and general lack of healthy upkeep. He replaced the electronic file folder into its docking station with a glance at Erika. She looked up to catch Walt staring at her, but rather than surprise or indignation, she responded with a wry smile. Walt returned the smile, and turned back to his guests. “Can I ask a question?” said a distinguished looking, gray haired doctor. “Sure, Dr. Abbott.” Walt said. “How does your technician stand listening to this noise day after day?” Walt smiled. “Let’s ask her.” He turned to Erika. “How about it, Erika. How do you stand listening to this noise all day?” “I’m sorry,” she replied, with a well-rehearsed cadence. “Did you say something?” The group was slow to catch on, but aided by Walt’s wide grin and Erika’s duplicitous laugh, they got the joke. “Same old Walt,” mumbled Dr. Julie Mills, the only female doctor in the group. “The annoyance factor goes away pretty quickly,” Erika said, more serious this time, “but I swear Walt could turn it off in a second if he wanted to. I think he leaves it there so people ask that question and he can make me do that joke.” “Nope, just a happy coincidence,” he said. “That sound is an unavoidable part of the printing process.” “Walt,” said Dr. Mills. “We all have a basic understanding of how the organic printing process works, but since we have a few extra minutes, can you go into a little more detail on it?” “Sure thing,” he replied. “Good idea.” Walt stepped closer to the doctors. “We begin with—” A door behind them opened, and all eyes turned to see a man in his mid-thirties enter the room. He carried a briefcase and wore a wide-eyed look of surprise at seeing the group of doctors. “Excellent,” Walt said. “Our resident genius has arrived. Nels, come and meet everyone. Everyone, this is Nelson Taft, the brains of our organization.” Nelson’s look of surprise quickly faded, replaced by a large smile until his eyes fell on Dr. Julie Mills. Her dark brown hair was much shorter now, just about shoulder length, but she was still as beautiful as when they dated in college, perhaps more so, if that were possible. Gone from her face was the roundness and smoothness of youth, replaced with confidence and a sharpening of features that only enhanced her beauty. Hoping no one noticed his faltering smile, he mustered a new one and stepped toward the group. “Good morning, folks.” “Julie,” Walt said, “I think you’ve met Nelson before, haven’t you?” Nelson looked once again into those gray-green eyes that were so familiar, made more enchanting by the contrasting black eyeliner surrounded by that perfect, alabaster skin. “Hi Julie, it’s been a long time.” She smiled at Nelson as if they were just old friends from college. “Hi, Nelson. I see Walt’s still an ass.” Walt was smiling broadly. “Sorry, I couldn’t resist.” “Well, same old Walt,” Nelson said. She turned to the other doctors and their puzzled expressions. “Sorry, guys. I’ve known these two for years. We went to college at UC Irvine together. It’s how I’m able to get these tours on such short notice.” “Well,” Walt broke in, “If you’re finished insulting me, why don’t you introduce everyone to Nelson.” “All right, but I doubt I’m done insulting you.” Turning to the first doctor, a curly-haired Hispanic man, she said, “This is Dr. Pena. Nelson Taft.” Nelson turned to Pena and shook his hand. “He's in his first year of residency, so feel free to completely ignore anything he says,” Julie said. “Wow,” Nelson said to Pena, “She’s really softened up over the years.” Pena laughed. “And she’s one of the nice ones.” He shrugged. “Everyone treats the first-years that way.” “Sorry, it’s a rite of passage,” she said, smiling. “Have to cull the weak from the herd, you know.” “I'm fascinated by your operation here,” Pena said. “Can't wait to see the finished product.” Nelson turned to the next doctor, a slight, dark haired Asian man. “This is Dr. Wong,” Julie said. “He's been at St. Joseph for—” Julie looked at Dr. Wong for confirmation. “—Five years?” “Yes, five years. Nice to meet you.” “He's transplanted quite a number of your organs, but never had the chance to come over and look around.” “You're right next door, but I’ve just never found the time,” Dr. Wong said. “You don’t have to tell me twice. I know the life of a transplant surgeon is a busy one.” Julie shot Nelson a sideways look but continued. “Next is Dr. Abbott.” Nelson turned to the next white-coated doctor and offered his hand. “Good to meet you,” he said. Although easily the oldest person in the room, Dr. Abbott carried a youthful look that made it difficult to guess his age.