See No Evil (21 page)

E
lliot arrived at the hospital at nine that morning, late for him, particularly in light of the full schedule of surgeries that had developed over the past couple of days, not the least of which was Ralph Scopo’s. After having been checked in to Mount Sinai, Giuliani’s star witness had been deposited via wheelchair on the third floor of the Housman Pavilion along with two armed members of the NYPD
Mob-Corruption
Unit, who stood guard on a twenty-four-
hour-a-day
vigil and whose job it was to make certain that Scopo made it alive to the operating room.

Once settled into his office, Elliot mulled over the results of the preoperative tests he’d ordered, recorded by Clark Hinterlieter, the resident surgeon, on a patient’s chart. They included an electrocardiogram, blood samples to determine kidney and liver function and cholesterol and mineral
balance
, blood-cell count, and urinalysis. Also there were the
forward
and sideways chest X-rays Elliot had described to Scopo’s wife and son, along with four units of blood cross matched to Scopo’s type that were put aside in the hospital
blood bank.

The case, from a medical standpoint, was routine, Elliot was thinking then, but that was where anything simple ended along with any possible pretense of moral ambiguity along with it. No more faking. No more dodging that treacherous crossroad between good and evil. Scopo would either live or die at his hands. But with a poetic twist that even Shakespeare could not have conceived, in murdering a man, he would be saved. In saving a man, he would risk being murdered. It was enough to give a poor Jewish kid raised in the Bronx Excedrin headache #2321!

From his office, Elliot drifted to the eighth floor of the Annenberg Building where, in a large meeting room, about two dozen attending cardiologists and residents met each morning to talk over cases and compare notes. There, he sat sipping from a cardboard cup filled with Diet Coke, so totally preoccupied with this, the dilemma of his life, that he hardly noticed Clark Hinterlieter as he walked up to the front of the room to present Scopo’s case.

“This fifty-six-year-old white male has a history of heavy cigarette smoking, is obese, sedentary, and has a family
history
of coronary disease and elevated lipid levels. The physical exam showed a heart rate of seventy beats a minute, blood pressure 140/75 in both arms, sitting. He was breathing
comfortably
at fourteen breaths a minute and a febrile …,” Hinterlieter explained to the group as Elliot wondered what had brought him to this juncture in his life. If there was a way out, he didn’t know what it could be at that moment, with
little
prospect for a breakthrough idea between now and the time of the operation.

Elliot looked around the conference room to his
colleagues
including Frank Silvio and could tell as soon as Silvio’s dark eyes met his own, then darted away as quickly, that
Frank knew everything that was going on. “That’s right,” Elliot was thinking, “don’t get too close, Frankie. Not now because for the moment, I’m still something between a
stand-up
guy and damaged goods, with the jury still out.”

His eyes then fell on Dr. Dak as he observed Hinterlieter’s synopsis. “Unusual for him to attend,” he was thinking, “but that’s no accident.” Like nearly every other powerful man he was acquainted with in New York, Simon’s name had been thrown around by Al Rosengarten during their dinner at the Plaza. Maybe Dak’s being here was a message, yet another intimidation piled atop Gotti’s visit and the rest. “Or maybe I‘ve gone over the deep end,” Elliot concluded, “become
totally
paranoid reading meaning into the most innocent
coincidence
.”

Hinterlieter signaled for the angiograms to be shown at the front of the room where the branchlike patterns of Ralph Scopo’s coronaries appeared on the ten-by-twenty-foot white screen. “As you can see, there’s an 85 percent narrowing of the patient’s left main coronary artery just before the vessel divides into its two main branches, the left anterior
descending
and the left circumflex arteries, which were themselves blocked downstream. The LAD was 80 percent obstructed, and there seemed to be another 99 percent lesion of its first diagonal branch. But because these deposits were spread out along the narrow vessel lining, I wasn’t sure whether the artery was bypassable.”

As the resident surgeon droned on, Elliot couldn’t help but ponder his fate now mere hours away. Exactly what were his options? he anguished, remembering something his Uncle Saul had once told him. “There’s a solution to every problem, but most people are either too stupid or too lazy to take the time to figure it out.
Now
go
know!”
Fair enough. He
considered
his options. Clearly there are only two outcomes. Either
Scopo lived or he died. If he survived the procedure, there would be only one conclusion killers like Gotti and Castellano could draw, and that is that he betrayed them. And that meant Elliot was dead. If, however, Scopo was to die during surgery or later from complications, this left a mouse hole for escape because the prosecutors’ conclusions could never be so clear cut. Anyone interested enough to pick up a medical text could read that there are mortality (death) and morbidity (
complication
) rates running somewhere between 1 percent and 3 percent attributed to aortocoronary bypass. Why not Scopo? Who could prove otherwise?

“In summary,” Clark Hinterlieter lectured, “chest X-rays reflect lung disease, but this does not seem too severe. Angiography shows double-vessel disease in addition to a
left-main
lesion, with preserved ventricular function. We suspect recent subendocardial infarction involving the anterior wall related to disease in the diagonal branch of the LAD.”

Yet, deep within Elliot there was something as strong and visceral as his own survival instincts, and that was his love of healing. True, he’d made many mistakes. He gambled too much. He was unfaithful to his wife and had engaged in
questionable
activities that jeopardized himself and his family. But not so many that it had totally blunted his need to save, as opposed to snuffing, human life no matter what the motive. He was a healer, not a murderer. Everything he’d learned and been taught by his father, his mother, and uncles sent him hurtling in one direction while all that he had come to know of life since becoming an associate in the Mafia threw him back again where he was trapped, like in one of those 1950s horror films, in the middle of a locked room with stone walls slowly, inexorably, closing in!

“Elliot, do you have anything to add?” Hinterlieter asked.

“Only that I’m bothered by lack of collaterals in this
fellow
,”
Elliot shot back, surprising himself with the sharpness of the response. “But, one way or the other, there can be no debate about what to do. Mr. Scopo has the most compelling reason for bypass surgery—a major blockage in his left main artery. Statistically, his chances for survival without the
operation
are almost nil.”

No one disagreed. Afterward as Elliot was leaving the darkened conference room, he found Dr. Dak trailing behind him into the corridor.

“Elliot, may we speak for a moment?” the gnomish
seventy-eight-year
-old rumbled with his Romanian accent. “There’s a man from the Federal Bureau of Investigation who’s been asking to see you. His name is Special Agent Hogan. Do you know him?”

Elliot shook his head in the negative, a tingling feeling of dread making its way up from his scrotum to the nape of his neck.

“He says he works with U.S. Attorney Giuliani. I’m sure it has to do with this Scopo fellow, but he wouldn’t say just what it was he wanted to talk about. Is there anything I should be aware of, Elliot. Is there anything you would like to tell me before you meet with Hogan?”

“Not that I can think of, Simon. So far as I can see, the diagnosis is very straightforward, almost routine.”

“As you know, Dr. Litner, no case is ‘routine.’ I suspect Scopo’s is no exception,” Dr. Dak uttered as he ambled down the corridor. “Hogan is waiting in your office. Good luck to you.”

Once Elliot returned to his office, Special Agent Peter Hogan, a strapping, red-haired man in his late thirties, was waiting outside along with two other agents, both shorter and dark haired. Hogan stepped forward and introduced himself as his two subordinates faded to the sidelines.

Inside, Elliot offered Hogan a seat, watching from the
corner
of his eye as the agent studied his diplomas from Syracuse University and Downstate Medical Center, his sharp blue eyes shifting then to family photos of Hanna, the twins, and himself.

“Nice family you have there, Doctor.”

“Thank you, Mr. Hogan, but to be honest, I’m busy as hell. Is there something special you wanted to see me about?”

“Yes, there is. I’m here today to observe the operation you’re going to perform on Ralph Scopo. I’m pretty sure you know who he is and why his good health is so important to Mr. Giuliani and, really, every American citizen.”

“Every American citizen? That’s a lot of people. What, maybe two hundred fifty million or so?”

“The men his testimony is going to help convict are the leaders of the five Mafia families that run organized crime in New York. They extort, they steal, and they murder, Dr. Litner. Now, I’m not here to tell you about your work as a doctor, but only to ask one small indulgence on your part and that is that you wear a wire during your preop visit. You know, with Scopo under sedation, he’s liable to say things, important things, maybe names, that could be essential to our case.”

“Is this Mr. Giuliani’s idea?”

“Yes, as a matter of fact, it is. I’m making this request on behalf of the U.S. Attorney’s Office.”

Elliot stood up behind his desk just then, feeling the heat rise within him, as he considered Giuliani’s concept of justice, thinking all the while of his family and its harrowing escape from totalitarian Russia. Here was a sick man, dying for all he knew, lying on an operating table undergoing critical surgery, and these ghouls, brains invaded by ambition as rampant as runaway cancer, wanted him, Scopo’s physician, to participate in their mania.

“Mr. Hogan, I won’t wear a wire into Mr. Scopo’s room or
into anyone else’s. I’m a surgeon. I’m not in law enforcement and will not be used by you, the FBI, the U.S. Attorney’s Office, or anyone else in any way that might undermine the
confidentiality
of the doctor-patient relationship. What Scopo says, if anything, while under sedation is no one’s business, not even mine. The last time I looked, this was still the United States of America, not the Soviet Union and not Nazi Germany!”

Hogan’s pale Irish face reddened noticeably as he sucked a stream of air into his lungs and nodded. “Dr. Litner, I have to make a brief phone call. Would you just wait here for a few seconds while I do that?”

“Not a problem,” Elliot said still angry as he glanced to his watch. It was past noon. Ralph Scopo would be prepped and wheeled into Operating Room #2 for surgery in less than three hours.

No more than three minutes had passed when Hogan reentered the room. No question he’d been speaking with the U.S. attorney, who judging by the short time frame, had been standing by for an update.

“Dr. Litner, we’re alone so I’ll speak frankly. I’ve just gotten off the phone with Mr. Giuliani. He asked me to tell you that in his opinion you lead an ‘interesting’ life. We know that you have acquaintances within the Gambino Family. Your name has been mentioned, and you have been referred to, on
government
surveillance tapes. We need Scopo alive to testify against these thugs in the most important Mafia trial of the century. We’d like you to cooperate by wearing a surveillance wire into surgery. If you refuse, that’s your right, but I was asked by Mr. Giuliani to tell you that if anything happens to Ralph Scopo, if, for any reason, he was not to make it through this operation, the full resources of his office will be devoted to a criminal investigation of you, your business dealings, and medical
practice
. Have I made that point clear to you, Dr. Litner?”

O
perating Room #2 in Mount Sinai Hospital is a
twenty-by-twenty-foot
chamber with white tile floors and shiny steel cabinets. Like an altar, the operating table was positioned over a pedestal in the middle of the floor with glass-panel
windows
deep set into the room’s walls on either side. The time was 3:35
P.M
. Coronary patient Ralph Scopo lay motionless on the operating table, chest bare, electrodes attached to the back of his shoulders, intravenous needles inserted into his right arm and left wrist.

Fifty-six-years-old, grossly overweight, and
three-pack-a-day
smoker, Giuliani’s pride and joy had collapsed three weeks earlier, headlines in the morning papers screaming S
COPO
H
EART
A
TTACK
D
ISRUPTS
R
ACKETEERING
T
RIAL
. But there was much more to it than racketeering. This case was an attempt by the FBI and New York City’s Organized Crime Task Force to bring down the Commission, the bosses of the five La Cosa Nostra families that governed New York and
possibly
the nation.

In the background “The Wanderer,” a 1961 hit by Dion was playing in place of Verdi or Puccini, Elliot’s usual fare.
The anesthesiologist jerked Scopo’s head back so the blunt blade of the L-shaped laryngoscope could be put in his throat and a one-half-inch endotracheal tube inserted past his vocal chords. A balloon on the tube’s lower end inflated creating an airtight seal as Clark Hinterlieter inserted a Foley catheter through Scopo’s penis into his bladder, then nodded to Elliot Litner.

Elliot glanced to his right where outside operating room #2 the Giuliani team of three federal investigators led by Special Agent Peter Hogan awaited the operation’s outcome like vultures. Then, to his left where John Gotti’s right hand, Sammy “the Bull” Gravano, and two of his underlings loomed nearby the patients’ waiting room pacing the floor with equal intensity. “The Brooks Brothers Ivy Leaguers versus the
polyester
suit
gumbas
,” he mused sardonically, the voice in his head sounding like a cross between Woody Allen and a manic Jerry Lewis.
“How
the
hell
did
a
nerdy,
Jewish
kid
from
the
Bronx
get
caught
up
in
a
mess
like
this
?” The feds want Scopo alive to
pros
ecute
and “twist” into a government witness. The goodfellas don’t want him leaving this operating room alive. Either way, it’s understood, Elliot was a dead man.

Dion warbled in the background about Flo on the left, Mary on the right, and Janie being the girl he’ll be with tonight. When Janie asks who he loves the best, Dion tears open his shirt to show Rosie on his chest.

The chest was open; the heart-lung machine ready to go. It was impossible to stall any longer. It was time for Elliot Litner, a man who could have been the poster boy for moral
ambiguity
to choose between life or death: loyalty to La Cosa Nostra or devotion to his Hippocratic oath.

“Fifty cc’s going in to test the line,” the technician announced.

“On bypass,” Elliot commanded, “start cooling.”

Almost immediately, Scopo’s heart slowed.

Judy Harrow, his surgical nurse, held the shiny
stainless-steel
needle up in the air. She depressed the syringe plunger, and a stream of clear liquid potassium spurted from it.

She handed it to Elliot.

This was it. The moment of truth, for if ever there was a time to see to it that Scopo never awakened from his
drug-induced
sleep to testify, this was that time.

Elliot took the syringe into his right hand, clamped the aorta, then injected the icy fluid directly into the vessels below the blockages in Scopo’s lower aorta.

Ralph
Scopo’
s
heart
had
stopped
beating
!

The heartbeat indicator read 0. The organ had stopped. Bloodless, motionless, and rubbery, it was the ideal target.

With a Number-15 blade, Elliot cut into the muscle to expose a pale yellow streak on the back of the heart where the major posterolateral branch of the circumflex artery ran. Then, he looked at the front of the heart.

“The distal LAD looks pretty good. We’ll put the graft there,” he told Hinterlieter. “What’s the temperature?”

“Twenty-five,” he replied.

“And the flow?”

“Three liters per minute.”

Elliot nodded holding a surgical needle at the tip of
long-handled
forceps, then sewing a series of tiny stitches with
near-invisible
filament, first in the vein, then in the artery. Still,
concentrating
with all of his will, Elliot couldn’t shake the images that passed through his mind, some related to childhood, most having to do with Hanna, Samantha, and Rachel. Whatever the outcome, he knew his life would never be the same.

“
Focus,
focus
,” he repeated to himself like a mantra, his thoughts drifting despite those efforts, back to the events that had led him to this nightmare.

Even as he worked, he could envision the twins frolicking in the water on the lake where they vacationed. He pictured himself and Hanna, early in their marriage, making love, totally consumed with desire for one another. He
remembered
their family dinners, Hanna singing songs with the kids while Mort cooked burgers on the grill. All of them laughing, savoring the joy and innocence of the children. Then it occurred to Elliot that this must be what it’s like just before death as a man’s life flashes before him. And, in a way, Elliot was dying because he knew that after today, everything he’d built and worked for would cease to exist. More, he
understood
that these “friends” of his were no friends at all, but monsters who sucked the marrow from society, threatening and killing everyday people, exploiting their greed and avarice, then subjugating them with mortal terror.

With sutures joining vein to artery, Elliot turned his
attention
to Scopo’s distal LAD, his next and in many ways most important target. “There’s a lot of disease in this vessel. But this will turn out to be good for the internal mammary,” he observed, picking up the LIMA, which he had left clamped. “See how big it is?”

Judy handed him the finest 7-0 sutures. Once the
connection
was complete, he undamped the LIMA, and on the
surface
of Scopo’s heart, branch after branch of tiny vessels immediately turned bright red.

“What time is it?” he asked.

“Four fifty-six,” Hinterlieter replied. The heart had been deprived of blood for twenty-one minutes.

“Right on schedule,” Elliot calculated, beginning to sew the upper ends of the saphenous vein graphs to Scopo’s aorta.

He applied a half-moon-shaped clamp to the massive
vessel
, isolating a quarter-sized area where the veins would be attached, then punched two circular holes into the vessel through which blood would flow into the new conduits to the heart. Then, eyes focused like lasers, he began attachment, the most critical phase of the procedure, as images of Marie and Joey Scopo flooded his mind.

How could he murder this woman’s husband and the young man’s father? he anguished. What kind of man would he be to allow Scopo to pay for the bad decisions he’d made during his life? He thought about what Uncle Saul might have advised and the core of the stories he’d told based upon the value and dignity of human life. No, Elliot decided as the final minutes of the bypass surgery approached, he could not be party to another man’s murder. Even if it meant one of the family’s hit men taking his own life, he would do everything in his power to keep Ralph Scopo alive.

Judy Harrow dabbed a skein of perspiration from Elliot’s forehead as he completed his stitching, leaving only the detachment of the heart-lung machine as the final hurdle for the surgical team. He double-checked the grafts. Bulging with blood, there were no kinks or leaks. All had gone smoothly. He could feel the sense of relief in the room as spirits buoyed and “Walk Like a Man,” a Four Seasons song began playing over the speaker system.

“Did anyone ever tell you that you had lousy taste in music?” Judy Harrow asked.

Elliot glanced from his patient to the monitor over the table that tracked the state of Scopo’s cardiovascular system. The mean arterial pressure was fifty-eight millimeters of
mercury
; the left arterial pressure was four.

“That’s a little low,” he told Hinterlieter, who added more fluid to the pump as the blood pressure began to rise. “But to
answer your question,” Elliot said, attaching pacemaker wires to the right atrium and ventricle, “no. No one has ever told me that I have lousy taste in music. Terrible, yes. Lousy, not until today, but you know what, Judy? Sometimes a man’s gotta do what a man’s gotta do!”

Then, Elliot sang along with the tape, the surgical team unaware of the incredible sense of freedom he was
experiencing
at that moment. No one knew what to make of it, but he did because when the chips were down, it was his
judgment
, his ethics that prevailed, and that was a high the likes of which he’d never experienced before. He reveled, as Frankie Valli crooned the words to his 1963 hit record.

Valli was absolutely right.

Finally, Elliot picked up the Bovie and reaching inside the wall of the chest, cauterized any vessels that were still bleeding.

“I think it’s pretty dry,” he said watching as clear plastic tubes a half-inch in diameter were placed over the front
surfac
e of the heart and in the left chest cavity to drain any bloody fluid after the incision was closed.

And that’s when an intriguing thing happened. Dr. Hinterlieter reached across to him. “Congratulations, Doctor,” he said shaking Elliot’s hand. Then Judy Harrow offered her hand. Then Dr. Falk, the anesthesiologist, and Rick Whittaker, the technician, followed by every member of his surgical team.

“Congratulations,” “Congratulations,” each of them said as they clasped his hand into their own. And, oddly, if this was going to be the last day of his life, Elliot had to admit that, in many ways, it was also his proudest.