Jillian turned away as he read. It was then Nick realized the man’s suicide attempt was another painful reminder of Belle. How could he be so insensitive? He placed a hand on her shoulder. She in turn reached across her body to take his hand in hers. The moment was brief, but the emotions within it were intense.

“How could somebody shoot themselves like that and not die?” Junie asked.

Nick flashed on one such case he had treated in Afghanistan, but before he said anything about it, he turned to Jillian.

“Talking about this okay?” he asked.

“Yeah, it’s okay,” she said, her tone bittersweet. “Thanks for asking.”

“A self-inflicted gunshot wound to the head is almost always fatal,” he explained, “that is, assuming the victim puts the gun in his or her mouth or presses it hard against the temple. But when a gun-a shotgun especially-is placed under the chin, the recoil can actually redirect the muzzle, causing massive trauma to the face, but avoiding any vital structures in the brain.”

“That’s gross,” Reggie said.

Nick took the mouse from Jillian and continued reviewing the file.

“For this guy, no doubt, fixing him was a massive undertaking. From these reports it looks as though he went through several multi-step reconstructive events, totaling about thirty operations.”

“That’s not the only total that was massive,” Jillian said. “Take a gander at the bill this case generated.”

Nick looked at where she was pointing and whistled.

“Half a million dollars for this work alone. No wonder Shelby Stone formed a partnership with these guys. Even if the patient defaults on their share of the bill, the insurance company owes a hefty six-figure payday for Singh, and a percentage of that goes to the mother hospital.”

“Well, that does explain how Paresh Singh can afford that marble fountain.”

“If they’re so well known for this type of work, I wonder how many shotgun injuries they reconstruct in a year?” Nick asked.

“I can tell you,” Jillian said. “I’ll just look it up by that ICD code.”

Jillian entered the numbers, keeping the scan limited to the twelve months beginning the approximate date Umberto disappeared.

“Keywords shotgun… and… face… and there you are.”

Four seconds after she hit the Enter key, twenty records were identified.

“Amazing,” Nick commented. “Maybe that’s what the J. Geils Band meant when they named their album Blow Your Face Out.”

“Who’s the J. Geils Band?” Reggie asked. “If I ain’t heard of them, they must be old.”

“With you, anything that wasn’t recorded last month is old.”

“Twenty cases in that one hospital doesn’t surprise me very much,” Jillian said. “Between fifty and fifty-five percent of all suicides are caused by guns, but there are over fifteen hundred attempted suicides in the U.S. alone each day.”

“That’s an incredible number,” Junie said.

“Sad, but true,” Jillian said.

Nick thought through the math.

“So, if Paresh Singh is world renowned for his ability to reconstruct faces after a shotgun blast,” he said, “it’s not inconceivable there could be at least a hundred such cases in the U.S. each year-probably more worldwide.”

“One-fifth of them sent to the best of the best makes sense to me.”

“Let’s look at these twenty,” Nick said, “but we’d better move quickly. Sooner or later someone’s going to catch on to the breach.”

Behind them, Reggie kept touching his face, as though trying to visualize how the gunshot wounds Nick described could actually be survivable.

The first five files they reviewed were grisly but also well documented. The skill of Paresh Singh was undeniable, although the residual facial damage in each case was still fairly striking. Nothing in those files jumped out at them as being out of the ordinary. Something troubled Nick about the sixth case, though, a patient named Edwin Scott Price from Plano, Texas.

The majority of suicide attempts with a firearm were males, thirty to fifty years old. Edwin Price was forty-five. But although he fit the profile, there was a feeling Nick could not shake while he was scanning the X-ray images, photos, and CT scans attached to Price’s file. Something about the record was familiar-not possible given that the electronic chart was one he’d never seen before, and the patient one he’d never heard of. The echoing concern nagged at him.

Why?

Nick was about to abandon the CT scans and move on when Reggie leaned over and exclaimed in his ear. “Dang! That dude is just as messed up as the first poor sucker we saw.”

“What do you mean?”

“I don’t know. I’m good at figuring out patterns, and those pieces of bone look almost exactly like that first guy you showed me.”

“That’s it!” Nick exclaimed.

“That’s what?” Jillian asked.

“Why I’ve been feeling like Price’s record was familiar. Let’s go back to that twenty-eight-year-old Caucasian male we looked at first.”

“Giuseppe Renzulli?”

“That’s the one.”

Jillian pulled up Renzulli’s file.

“Can we see both side by side?”

She opened a new window and soon had the two patients’ three-dimensional CT scans displayed next to each other.

“Well, I’ll be…” Junie’s voice trailed off.

“They’re identical,” Jillian said.

“Told you,” Reggie boasted.

Nick studied both pictures intently, his brow knit.

“I’m not a statistician,” he said. “But I’m willing to bet the RV that two identical bone fragment dispersals from a shotgun blast to the face is a statistical impossibility.”

“Are the procedures done on the men the same?” Junie asked.

“Doesn’t look like it to me,” Nick said. “Renzulli had some pretty significant complications that Paresh attributed to his anesthesia and local infection.”

“There’s something else we’re missing,” Jillian said. “I can feel it.”

Nick went back through Price’s and Renzulli’s notes and films. The only thing in common between the two records was the CT scan.

“Didn’t you just say that these procedures cost hundreds of thousands of dollars in hospital billing?” Junie asked.

Nick’s focus was locked on trolling through Price’s file, such that he almost missed the question.

“Yeah,” he said absently. “Why?”

“Well, take a look here,” Junie said, tapping her finger on the screen.

“Hey! Fingers off the monitor,” Reggie scolded.

“Well, I’ll be…” Nick had to blink to make sure he was reading it right. “Jillian, as a joint venture with Shelby Stone, doesn’t that mean Singh operates his medical practice himself, but combines his purchases and billing for supplies with Stone?” Nick asked.

“I think so. That way he gets the benefit of Stone’s purchase power. He probably sends Stone a percentage of his collections for the procedures he performs.”

“Well, according to this, Edwin Scott Price had almost a million dollars of reconstructive work done.”

“And? What am I missing?” Jillian asked.

She turned around in the chair to face both the others.

“What you’re missing and what Junie just pointed out,” Nick said, “is that none of Singh’s profits that were shared with Shelby Stone from Edwin Scott Price’s million-dollar new face came from an insurance company.”

“That would mean Singh didn’t want Price’s insurance company to even know he was doing the work. Why would that be?”

A devilish smile crossed Nick’s face.

“I don’t know. But let’s give our little implanted rootkit a rest and then when Reggie tells us it’s safe, we start looking to find other identical CT scans and take a real close look at Singh’s billing practices when it comes to fixing shotgun wounds.”