He did not give two hoots about certification by the American Board of Plastic Surgery, or the American Academy of Facial Plastic and Reconstructive Surgery, or the American Society of Plastic and Reconstructive Surgeons. What were a couple more snotty plaques on the wall? His patients could care less. They were rich and vain and impatient. In some exclusive South Florida circles, Rudy’s name carried the glossy imprimatur of a Gucci or a de La Renta. The lacquered old crones at La Gorce or the Biltmore would point at each other’s shiny chins and taut necks and sculpted eyelids and ask, not in a whisper but a haughty bray, “Is that a Graveline?”
Rudy was a designer surgeon. To have him suck your fat was an honor, a social plum, a mark (literally) of status. Only a boor, white trash or worse, would ever question the man’s techniques or complain about the results.
Ironically, most of the surgeons who worked for Rudy Graveline at Whispering Palms were completely qualified to do suction lipectomies; they had actually trained for it—studied, observed; practiced. While Rudy admired their dedication, he thought they were overdoing things—after all, how difficult could such an operation really be? The fat itself was abundantly easy to find. Suck it out, close ‘em up, next case! Big deal.
To be on the safe side, Rudy read two journal articles about liposuction and ordered an instructional video cassette for $26.95 from a medical-supply firm in Chicago. The journal articles turned out to be dense and fairly boring, but the video was an inspiration. Rudy came away convinced that any fool doctor with half a brain could vacuum fat with no problem.
The typical lipectomy patient was not a grotesque hypertensive blimp, but—like Johnny LeTigre—a healthy person of relatively normal stature and weight. The object of their complaint was medically mundane—bumper-car hips, droopy buttocks, gelatinous thighs, or old-fashioned “love handles” at the waist. Properly performed, liposuction would remove localized pockets of excess fat to improve and smooth the body’s natural contour. Improperly performed, the surgery would leave a patient lumpy and lopsided and looking for a lawyer.
On the morning of Reynaldo Flemm’s undercover mission, nothing as sinister as a premonition caused Rudy Graveline to change his mind about doing the nose job first. What changed the doctor’s mind, as usual, was money. Because a lipectomy usually required general anesthesia, it was more labor-intensive (and costly) than a simple rhinoplasty. Rudy figured the sooner he could get done with the heavy stuff, the sooner he could get the anesthetist and her gas machine off the clock. He could do the rhino later with intravenous sedation, which was much cheaper.
That Rudy Graveline could still worry about overhead at this point, with his career crumbling, was a tribute both to his power of concentration and his ingrained devotion to profit.
He grabbed a gloveful of Reynaldo Flemm’s belly roll and gave a little squeeze. Paydirt. Fat city.
Rudy selected a Number 15 blade and made a one-quarter inch incision in Reynaldo’s navel. Through this convenient aperture Rudy inserted the cannula, a long tubular instrument that resembled in structure the nose of an anteater. Rudy rammed the blunt snout of the cannula into the soft meat of Reynaldo’s abdomen, then scraped the instrument back and forth to break up the tissue. With his right foot the surgeon tapped a floor pedal that activated a suction machine, which vacuumed the fat particles through small holes in the tip of the cannula, down a long clear plastic tube to a glass bottle.
Within moments, the first yellow glops appeared.
Johnny LeTigre’s spare tire!
Soon he would be a new man.
In the waiting room, Willie got to talking with some of the other patients. There was a charter-boat captain with a skin cancer the size of a toad on his forehead. There was a dancer from the Miami ballet who was getting her buttocks suctioned for the second time in as many years. There was a silver-haired Nicaraguan man whom Willie had often seen on television—one of the contra leaders—who was getting his eyelids done for eighteen hundred dollars. He said the CIA was picking up the tab.