Empire of Lies

3

For Sayyid Ramazan Hekim, being summoned away from the family that Friday wasn’t hugely unwelcome. The week had been a dark one, and he knew it would only get worse once Nisreen heard the inevitable confirmation that the execution of her friend Halil Azmi had been carried out.

He would have liked to be with her at that moment. But, at the same time, he knew there was nothing he could do to comfort her. They’d already said all that needed to be said. Better to leave her with the kids. They would distract her.

Ramazan wasn’t as strongly affected by Azmi’s fate as his wife was. He hadn’t even met the man. He didn’t know many of his wife’s law colleagues, and recently he’d purposely avoided them. But Nisreen had on several occasions related their dissenting views on what the state had become, and he knew they would attract trouble, trouble he was fully determined to steer clear of. He and Nisreen had argued about that, of course. It was one thing to disagree with what the sultan and his cronies were doing; it was quite another to be publicly vocal about it. Ramazan felt his primary duty was to his wife, his children, and the patients under his care. Sometimes, late at night, he would wonder if that meant he was reasonable and cautious or a coward. He stoically pushed back against the latter and prided himself on the former. It would all eventually pass—such periods of political strife always did. And when they did, he would have kept his family safe.

Under normal circumstances, this would have been the end of another week of routine, and the next day would have ushered in a new one. Ramazan knew routine all too well. He liked routine. Routine was order. Routine promoted peace of mind. It was the life he’d chosen. After all, being an anesthesiologist wasn’t particularly exciting. It wasn’t particularly glamorous either. In fact, it was quite the opposite: an invisible career. For even though he held his patients’ lives in his hands when they were in the operating room, even though they voluntarily relinquished all control of their bodies and minds to him, he’d long since got used to the fact that, afterward, they always remembered the names of their surgeon, never their anesthesiologist.

In the current climate, being anonymous was probably a good thing.

Today, however, as he walked down the halls of the cardiothoracic wing at the hospital that was part of the Hurrem Sultan Külliye on the Île de la Cité, Ramazan sensed something far from routine was brewing.

“You say he walked in early this morning, alone, in bad shape and coughing blood—but we don’t know anything about him?” he asked, moving briskly alongside Moshe Fonseca, a surgeon he’d worked with frequently.

“Nothing beyond the fact that he needs surgery rather urgently,” Fonseca replied.

The sprawling complex, the largest külliye in Paris, had more humble origins as the Hôtel-Dieu hospital, which dated back to the seventh century. It had grown a lot since the Ottomans had taken over the city. Like all külliyes, it was funded by a voluntary charitable endowment, known as a waqf. Charity was highly encouraged by Islam, and large waqf complexes became a key part of the Ottomans’ colonization of foreign lands. These pious bequests by the imperial family and the ruling class ranged from hostels, mills, factories, and caravanserais to entire villages and included all the revenue that these properties generated.

The Hurrem Sultan had been founded by the wife of a sultan and was named after her. Like the largest külliyes, it also housed a mosque, school, bathhouse, hospice, inn, and public soup kitchen. Its hospital was one of the most advanced in Paris, and Ramazan had a solid reputation as its star anesthesiologist.

“We don’t even know his name?” he asked.

“He hasn’t said a word,” the surgeon replied. “But that’s hardly the most unusual thing about him.”

“What then?”

Fonseca gave him a loaded sideways glance. “You’ll see.”

The surgeon’s reply didn’t just feed Ramazan’s confusion—it worried him. “Has he been reported to the Zaptiye?”

Fonseca stopped. After a quick glance to make sure no one was within earshot, he dropped his voice and said, “There’s no need for the police at this stage. Let’s save the man’s life first. He’s going to be here for a while and he’s going to be pretty helpless. Let’s not make things worse for him before we know what his story is.”

Ramazan held his gaze and considered his words, then nodded. Neither he nor Fonseca were huge fans of the Zaptiye—the city’s police force. Not nowadays.

They rounded a corner and entered the ward, where they made their way past several other patients to reach the man in question.

He was lying in a bed in a far corner by a window, hooked up to several monitors that beeped softly. A nurse by the name of Anbara was checking the drips that snaked into the intravenous cannula attached to his right arm. When she saw the doctors, she bowed slightly and retreated from the bed. The surgeon gave her a small nod back before turning to the patient.

Ramazan couldn’t tell much about the man, given that he was covered by a bedsheet and had a transparent plastic oxygen mask strapped to his face. From what he could see, Ramazan thought the man might be in his late sixties. He had a full head of gray, slicked-back hair.

He couldn’t see much else.

“My name is Moshe Fonseca, effendi,” Fonseca told the man in his customary upbeat, confidence-inspiring tone. “I’m in charge of the hospital’s cardiothoracic unit. How are you feeling today?”

The man’s eyes narrowed as he seemed to study the surgeon for a brief moment. Then he replied with a slow, gentle nod, closing his eyes as he did.

“Good. Well, you’ll be relieved to know your case doesn’t present anything we can’t fix,” Fonseca continued. “Basically, you’ve got what we call mitral valve stenosis. We all have four valves in our heart. The mitral is one of them, and sometimes, for any number of reasons—age maybe, or you might have been born with it, or maybe you had a bad case of rheumatic fever at some point—this valve gets narrower, and it stops opening properly. Which means there’s less blood flowing into your left ventricle, which is the main pumping chamber of your heart. I imagine you’ve been feeling very tired and short of breath lately, yes?”

The man nodded.

“All these symptoms—coughing blood, the heart arrhythmia—they’re all because of this. Your lungs are severely congested; your heart has clearly been strained for quite some time. Frankly, I’m surprised you haven’t had this treated until now. It can easily cause clots that lead to a transient ischemic attack, which is a kind of ministroke, or even a full stroke and—well, that’s not something we want, is it?”

Fonseca studied the man, but the patient said nothing.

After a moment, Fonseca just nodded and said, “The main thing: you’re here now, and we’re going to fix this. The way we do this is by replacing your valve with a bioprosthetic one that will do the job your valve hasn’t been doing. That’s going to be my job.” He gestured at Ramazan. “And this here is Sayyid Ramazan Hekim, one of our finest anesthesiologists. He’ll be the one putting you to sleep. As your condition is rather urgent, I’d rather not wait any more than we have to before doing this, so we’ve scheduled you in this afternoon. I trust you have no problems with that?”

The man shook his head.

“Ramazan Hekim will answer any questions you might have,” Fonseca continued, “and he also has some pre-op questions to ask you, although I’m not sure how fruitful that’s going to be given your”—he hesitated—“condition.”

The man didn’t react.

“Very well then,” Fonseca said. “All you need to do now is relax. You’re in good hands and you have nothing to worry about. I’ll see you in the recovery room.” He turned to Ramazan. “He’s all yours.”

Ramazan looked a question at him, still wondering about what the surgeon had meant by his earlier comment.

“It might be a good idea for you to examine his breathing again,” the surgeon told him. “The fluid level in his lungs is quite high.”

Fonseca lingered for a second with a telling look, as if to make sure his message had sunk in, then wandered off.

Ramazan stood there, confused. He glanced at Anbara, who didn’t react. Then he looked at the patient, wondering what Fonseca was talking about. Examine his breathing? The man was connected to monitors that gave far more information than anything he could glean from a simple stethoscope. Still, the surgeon had been noticeably pointed about it.

He reached into the tray unit by the bed, picked up a stethoscope, and moved in closer.

“All right, let’s see how your lungs are doing, shall we?”

The man’s eyes tightened, visibly uncomfortable about this, which Ramazan noticed as he folded down the sheet covering him. Then he pulled the man’s hospital gown up to expose his chest.

And froze.

The man’s chest was covered in tattoos. All of it, all the way down to his waist. Ramazan had never seen anything like it. He couldn’t see them as clearly as he would have liked, since some of them were obscured under the man’s chest hair, but from what he could see, they didn’t seem ornamental or symbolic. Rather, they were words and numbers written in the same Arabic-Persian alphabet that Ramazan used, only they were written the wrong way, from left to right. The letters were small, the technique intricate. He thought some looked like they might be names and dates, but it was hard to tell. They were difficult to read, given that they were mirror images of normal writing.

There were also several drawings and diagrams, images that looked technical that Ramazan didn’t recognize at all.

Still rigid with surprise, he glanced up at the patient. The man was watching him, his cold, impassive eyes clearly probing him. Ramazan felt a deep-seated unease—and, oddly, he felt scared. He wasn’t sure why, but something about the man’s unwavering gaze, coupled with the tattoos and the strong torso they covered, made him very uncomfortable.

He glanced furtively at the tattoos again, then forced his attention away from them and did his best to sound casual and seem unperturbed by what he’d seen.

“This might feel a bit cold,” he said as he placed the stethoscope’s resonator on the man’s chest. “Take a deep breath, please.”