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Wendell Black, M.D. by Gerald Imber Coming 2-11-14 Spotlights Important Contributions of Police Surgeons...

 I had the feeling I was getting set up, but I answered seriously. "Well, I'm not sure what's in the report. It was the usual failed resuscitation. She was agitate, and then she tanked. There was a rapid, thready pulse before her pressure dropped through the floor and she flatlined. Two unusual things, though, pinpoint pupils and bilateral inframammary dressing, like from breast implants. Could be an OD, but otherwise I'm in the dark. Did I miss something?"
"You got most of the fine points, but perhaps you didn't notice that she is a he."
As my face reddened, I could imagine the assistant MEs around the chief getting ready for the big laugh. "Shit. Don't tell me that. Why do you have that?"

What can you say when you feel like a fool. There was no
reason to pull her...his pants down during CPR, but still I felt well beyond foolish. I said nothing. Defending myself would feed the laughter. I could already hear over the speaker. I suffered through ten or fifteen seconds of snickers until Benson spoke again.
"You were half-right, at least."
"What does that mean?"
"Your patient was a genetic and partially anatomic male with a normal penis and almost no body hair. His testicles have been surgically removed. You were right about the breast implants, three hundred cc silicone bags, but then it gets strange..."
The deceased was definitely a man, and it wouldn't have shocked me if Benson and company had tied a ribbon around his organ, but they'd resisted...
~~~



Wendell Black, M.D.
By Gerald Imber


I don't know about you, but if I had been giving CPR to a body with breasts, I would never have considered that it might be a man... and that he might have both breasts and a penis...in transition. So the fact that Police Surgeon Wendell Black didn't immediately identify the body as a male, in my opinion, was not his fault... even the scars under the breasts would not have been evidence of which sex...

A 19-year-old transgender patient...
Close examination of Azul Capinpin's face--
that was the name on his passport--
showed no evidence of a beard. 
His cheeks were smooth and free of the telltale
 enlarged pores where hairs had been removed. 
These days laser hair removal does the job
 without the ugly side effects of electrolysis.
 This was smooth, female looking skin. 
There were traces of hair follicles on the
 upper lip that had previously been hidden
 by makeup. The body was clean. No hair. 
The pubis had been shaved, or waxed, 
or lasered clean. The rest of the
 body was hairless as well...Benson talked me
 through his findings, and doctor or not, 
I would have missed the boat. The
 distribution of body fat was feminine,
with a fairly soft belly and hips. 

Even without the implants, which
had been removed to a stainless-steel pan

 hanging from a scale over the table, 
there were hints of breasts.
~~~

Breast augmentation: cross-sectional schemes o...
Breast augmentation: cross-sectional
schemes of a subglandular breast prosthesis
 implantation (1) and of a submuscular
 breast prosthesis implantation (2).
 (Photo credit: Wikipedia)
"And last, the implant pockets." Here Benson
insisted we move in closely to see the smooth, lined
pocket between the underside of the breast and the
muscles of the chest wall. Benson had separated
the skin and breast along the sternum and folded it
back for observation. "This smooth capsule is
something the modern pathologist has seen a
thousand times; our colleagues of a few generations
ago would have no idea what of make of it. Under
the microscope the white lining you see is made up
of a thin fibrous tissue layer spotted with foreign-
body giant cells and silicone residue. It effectively
separates the implants from the body. That's its
job. It develops quickly and matures over time.
Take the implants out and after a time it
disappears or at least dissipates, but as long as
implants are in-situ, it remains."
"What are you telling me?" I asked, pointing
to the tissue scale alongside of the autopsy table.
"Maybe."
"Maybe? Maybe what?"
"Maybe there were there all the while, and maybe
they had been replaced. The old capsule and the
new scar don't go together..."
~~~


I don't mind telling you that this was a disturbing book in relation to the breast implants. Whether or not an individual chooses to have such surgery is, in my opinion, a very personal and private decision. However, as with so much of today's world, what the thrust of this thriller reveals is that, if there is a way to make money on personal desires, somebody is going to do it!

But Wendell Black, NYPD Police Surgeon had fallen into a situation he'd never have been able to imagine. Coming back home during a very rough flight had led something even worse... He was just beginning to settle back when the plane had smoothed out when they asked for a doctor if on flight. Remembering that one time he had even got lucky enough to end up with someone nice with whom he spent a few months, he stood up and identified himself.  

The attendant explained what had happened and eased a wet towel from the woman's eyes...her young face with a broad, high forehead, and flaring cheekbones, was pale--"a kind of odd, pasty look of pigmented skin gone white." Breaths were shallow and rapid, barely enough to keep her alive. They tried oxygen first.  And continued to work on her, but the individual didn't make it...

There wasn't any reason for Dr. Black to have recognized the cause of death...

But once the investigation started, and the autopsy completed, not only did they discover that the man was in the process of transgender change,
the implants had contained drugs!

And then Dr. Black got deeply involved through his surgeon lover anmeeting Dr. Farzan Byarshan, a plastic surgeon, socially, and then privately. Farzan explained that he thought he knew something about the person who had died on the plane...

He thought his partner might be involved... 

But Farzan soon was murdered...
http://www.allvoices.com/





"These people, the Asians...like your person from the plane...they are mostly Filipinos and Indonesians working in Saudi Arabia We see some of them in the clinic. They come to the Saudis and Kuwaitis from advertisements and agencies, by the thousands. They come to earn money for families at home. They hire out as domestics...They take any work that the spoiled, oil-rich Bedouins don't want to do themselves. In Saudi Arabia these people earn perhaps seven-eight hundred riyals per month...less than a hundred and forty euros. There is nothing to save or send home, and to add insult to injury they are treated like cattle...
"How does the person from the plane fit into this?" I asked, trying not to show my impatience.
"He may have been one of them."
"Why in the world would you jump to that conclusion? These are poor people. They can't afford plastic surgery. They can barely afford to eat, and they..."
Farzan held up a hand. "A moment, Wendell, if yu please, I am getting to the point...Some of these unfortunate people are homosexual, a few are transsexual or wish for surgical gender change, just as in the Western society. In fact, Muslim societies have always been tolerant of homosexuality." I started to interrupt, but Farzan headed me off at the pass. "Sodomy...homosexuality, these are capital offenses, but not if you look the other way. In my country, my old country, there is a thriving gay community... A smaller subset have gender issues. It is not difficult to identify them. They will do almost anything to find their surgical release from the bonds of gender misidentification...but with menial work and no way to pay for the multiple procedures, they become desperate. Enter the drug traffickers. To gain control of these workers, they are known to use both threat of exposure...punishment by death is a heavy threat among the unsophisticated, and then dangling the carrot of gender-altering surgery. Your man fits into the pattern..."
~~~

Needless to say, this was quite a twist to the normal investigations, but what it did do was place even Wendell and his lover, Alice under suspicion by the drug officers since they could perform the opening of the breasts and retrieve the drugs... Which, of course, led Dr. Black to begin his own investigation. Even though he was the police surgeon... he had no authority to participate in the actual case.

When most had decided that drugs were probably not the goal for this procedure, drug enforcement kept on the medical personnel who could handle the needed insertions and extractions. 

And then there were questions about Alice and he knew he really had to find out what was going on in order to keep suspicion away. But then she surprised him by saying she was CIA! And...it was believed that there was more to this than drugs, since it would be a very expensive activity to bring much quantity into the country. What else could it be? Soon they had arrived at a very possible alternative substance being carried...

While the plausibility of this story may be questionable, so also are suicide bombers to me... I don't know whether the facts as used are correct, but I can tell you that the story is a fun investigation to follow and is suspenseful enough, with a surprise ending that I certainly didn't anticipate, even for a second... Although there are medical (plastic surgery) issues included, and ably described by the author/plastic surgeon, I wouldn't consider it a true medical thriller--more a police procedures crime novel. 

Actually, I had not known that the police even had surgeons on staff, but then I've never seen a police officer hurt except on television... Just figured they went to the same hospitals that all of us do, even for a cold or fever... So, even though Dr. Imber is a Plastic Surgeon, and "only" an honorary police surgeon, I appreciated very much his spotlight on this group "who perform critical work and are integral to the functioning of a police force..." Check this one out...story line may be a little weird, but the potential reality of it all? Let's pray not!


GABixlerReviews


Dr. Gerald Imber is a well-known New York City plastic surgeon. He has published a number of beauty books and a well-received biography. In addition to directing his private clinic in Manhattan, Dr. Imber is on the staff of the New York Presbyterian Hospital, and is an assistant clinical professor of surgery (plastic) at the Weil Cornell Medical Center. He has been an honorary police surgeon for many years.
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