Note: For context, this began life as an entry for the NYC Midnight Short Story Competition, which provides entrants with a specific genre, character, and element they must work into their story. My requirements were science-fiction, a plastic surgeon, and a comatose person.
The body on the table was perfect from the neck down. It had taken three days of reconstructive surgery, but no evidence remained of the burns covering the patient’s arms and torso. Her skin was smooth, unblemished; polished bronze. The light spattering of moles across her collarbone had been returned, each exactly in place. Dark hair was already forming stubble across her flawless scalp. All that remained was her face.
Diane always finished with the face.
“Saving the best till last,” she told her patient with a wink. She stood and stretched, feeling the muscles catch in her neck and back.
Once she’d been able to work on patients for hours without stiffness. Another reminder of time’s march, like the gray steadily invading her hair.
Louisa Cortez didn’t answer. Her mouth was in no state to form words, besides which she was in an induced coma until reconstruction was complete. It was considered kinder to patients, when the damage was this severe.
In her Registry headshot, and the photographs supplied by the family, Louisa Cortez was dimple-cheeked, with a Roman nose and perfectly arching eyebrows. Now her face looked like a horror-movie mask. She had spent months in the burns ward for stabilization and wound care, recovery of basic physical functions, and layer upon layer of tissue and skin grafts. Finally she had come to Diane, to be returned to herself.
Once, Diane would have had a team of assistants bustling around. These days her assistants were all computer-driven. Some of her colleagues, old enough – like her – to have experienced the transition, resented this new way of doing things. They complained loudly of jobs lost, of computer incompetence – and, more quietly, of the isolation. But Diane liked being alone with her patients, just the humming of the machines and the two of them. It felt more personal.
Personal, if not private. Diane glanced up at the small, black dome mounted near the ceiling, concealing the room’s camera. Faceless, the dome gave away nothing, but she knew it would be scanning the room, taking silent video, collecting facial data. She sighed and turned her back on it.
Her hand, sheathed in latex, traced the line of Louisa’s face: the nub where her ear should be, the rippled flesh of her jawline. The breathing tube emerging from the woman’s mouth whistled softly.
“Don’t fret, Louisa,” Diane murmured, her hand stopping at the place where angry red mottling met smooth bronze. “I’m taking care of you. Soon you’ll have your own, lovely face back.”
She squeezed her patient’s shoulder. Her training said a comatose individual would be unaware of physical sensations, but Diane felt it reassured her patients to know their surgeon cared about them.
Louisa’s husband was in the waiting room, as he was every afternoon, sometimes with the children, sometimes alone. His overalls were still oily from the mechanic’s floor. Diane wanted to disinfect her hands just looking at them.
The husband hadn’t noticed her yet. He was slumped in a plastic chair, eyes on the inset TV that occupied the top half of the opposite wall. The sound was off, but subtitles tracked the newscaster’s words: -Senate enters its second day of debating the mandatory DNA testing bill, which has been introduced in a bid to curb rising identity theft-
Diane felt her jaw tighten, but forced her expression to remain calm and professional.
The man leapt to his feet. “Dr Martin! Is everything…?”
“Absolutely fine, Mr Cortez. The nurse is taking your wife back to her room now, so you can go and see her. Reconstruction has been straightforward and I expect to be finished tomorrow, after which we can begin waking her up. You should be able to take her home this weekend.”
The smile broke over his face like a sunrise. “Thank you, Doctor. You’ve been… I mean…” He broke off, clearly struggling to hold back tears.
Diane allowed herself a smile in return, though she kept the conversation to purpose. “Tomorrow I’ll be working on your wife’s face. Mr Cortez, I know we’ve been over this, but can you confirm, please, that these images-” she showed him her tablet “-are a true representation of your wife’s likeness?”
He swiped through the photographs, and now the tears escaped and rolled freely down his cheeks. “Yes,” he said. “That’s my Louisa. Please, bring her back to me, just like that. My beautiful lady.” Glancing at the television, he added, “I don’t care what people are saying about you folks, Doctor. You’re one of the good ones.”
Diane’s smile grew forced.
The house was dark when she arrived home. In winter, she could go for days without seeing the sun. The front door unlocked when she turned her face to the camera mounted above it.
Light came on as she walked into the kitchen to take a ready-made meal from the freezer. As it circled in the microwave, she felt disapproving eyes on her.
“Well?” she grunted. “What do you expect, Fi, if you leave me to cook for myself? You know I don’t have the time.”
The silence was oppressive. She returned to the living room, peeling the plastic skin off her dinner, and clicked on the television.
“Next up: identity theft!” the announcer’s voice declared. “The criminals using your face to evade detection – and the plastic surgeons making millions by helping them do it!”
Grimacing, she snatched up the remote and shut the words off. The silence closed in.
Diane laid a gloved hand on her patient’s forehead.
“Today’s the big day, Louisa. Don’t worry – everything’s going to be fine.”
She checked over the lasers and tissue-weavers, then picked up the handheld that let her combine her judgment with that of the AI, guiding the tools in concert to perform this most delicate and vital of reconstructions. The face was paramount. This was the first thing people would see when they looked at Louisa. These were the features that defined her identity. There could be no mistakes.
Diane swiped and tapped. The lasers began their dance.
A warning light appeared on the handheld’s screen. The lasers stilled automatically, micro-cauterizing the tissue before it could bleed. Frowning, Diane accessed the notification.
Scar tissue detected. Proceed?
Pre-existing scars required a different technique; that was no problem. But there shouldn’t be any scar tissue as this level, below the burns. Diane checked the medical history she had been given, but it confirmed: Louisa had no history of facial surgery.
With a deep-tissue scanner, she worked her way across Louisa’s face. There it was: a network of scar tissue, deep and old, underlying her entire face. The marks, unmistakable, of extensive plastic surgery.
A dark feeling began to grow in Diane’s gut.
She left the room, returning a minute later with a small kit containing syringe, alcohol swab, and accu-meter. She took a blood sample, careful not to damage the patient’s perfect forearm, and inserted it in the little machine.
There was a beep. The screen lit up.
DNA Match: Ximena Guerra, registered citizen, age 34, address unknown.
Diane’s hands clenched so hard the bones creaked. Hard-faced, she stared at the woman on her table: this stranger, this fraud. The betrayal felt personal, as if Guerra had deliberately lied to her. Well, hadn’t she? She had lied to the entire world.
“You,” Diane hissed. “This is your fault. Plastic surgery used to be a respected profession. People like you are the reason I have to lie now when someone asks what I do for a living. I make people whole. I am a healer. But thanks to you people think I’m a criminal and a con artist!”
Half a dozen scalpels lay ready on the bench, sterile and razor-sharp. Somehow, she discovered, one had made its way into her hand.
High up on the wall, the black dome sat faceless.
Seconds ticked by as Diane stood, the only motion the heaving of her chest. At last she shuddered and made herself release the scalpel. She would not have used it.
It troubled her that she had been imagining, just for those few seconds, what it might be like to be someone who would.
But there was no need, she realised. She already had all the tools at her disposal to exact revenge. This woman was the criminal, not her – and Diane had the evidence needed to seal her fate.
She turned away, ignoring the twinge in her back that told her she had moved too fast. Picking up the DNA test, damning result still displayed, she walked stiffly out.
The hospital director worked over in the administration block. Diane’s path took her through the waiting room; it was far too early for Mr Cortez to be there, but there he was. She stopped short as he stood to greet her, beaming.
“Dr Martin! I know, I know, it’s too early for you to tell me anything, but I took the day off work so I could be here. This is a special day – the day you bring my wife back to me!”
He took in her expression, and his smile gave way to worry. “Is… is everything all right, Doctor? It’s not Louisa, is it?”
Fear made his eyes dark.
“Mr Cortez…” Diane didn’t know what to say. Everything in the man’s face, in his posture, pleaded for good news.
“How long have you two been married, Mr Cortez?” she found herself asking.
His smile returned, small and uncertain. “Ten years together this August, ten happy years. When I thought I’d lost her, my God… She’s all right, then, isn’t she? Doctor?”
On the wall above the TV, the blank stare of another black dome. Diane’s hand closed over the screen of the DNA meter.
“Your wife is doing fine, Mr Cortez. I… Unfortunately, I won’t be able to complete the work on her face today. Something else has come up, an emergency. I’m sorry.”
She did not go to the director’s office. She returned to her surgery and stared down at the woman on the table.
Plastic surgery had come a long way since she first practiced. It had been possible for years to reconstruct something near-indistinguishable from the original face, on the outside; underneath was where the damage remained. Subcutaneous scarring, often extensive. Modern surgery left barely a trace. The scarring on this woman’s face suggested surgery a decade old or more.
“So, what?” she asked the silent form. “You took Louisa’s identity, stole her face and then- what? Got married, had a couple of babies? Settled down? That’s not what your kind do. What kind of scam are you running?”
The Cortezes were not rich. Diane had seen their file. If it wasn’t for health insurance, they could never have afforded her treatment.
“That is a good man out there,” she hissed at the body. “A loving husband. What do you want with him?”
The woman on the table gave no answer.
Diane performed no more surgery that day, citing hand cramps; an old complaint that recurred from time to time. She spent the day on paperwork and patient assessments, barely focused on either. In the afternoon, she called a friend who worked at the Registry; a friend who owed her a favor. Once her rostered hours were done and admin closed down for the night, she stayed at her desk, poring over the material she’d been sent.
The first record of Ximena Guerra, beyond the standard birth certificate and DNA profile, was admission to foster care at the age of twelve. There were details provided behind her removal from home; they were not pleasant reading. Repeated foster home placements, none lasting more than two years. Various reasons: “poor integration”, “aggressive behaviour”.
She disappeared from the care system at eighteen, but by that time she was appearing in the criminal justice system. A dozen misdemeanors between ages fifteen and twenty-two: petty theft, public intoxication, disorderly conduct. And then, from twenty-two: nothing. Ximena Guerra became a ghost.
The headshot showed a woman in her early twenties. Her skin tone and hair matched that of Louisa Cortez, but there was no other resemblance. Guerra’s nose was short and snubbed, her brows drawn down, her lips pinched. She looked hostile.
Diane didn’t know what to make of it. The woman in that photograph was a criminal, certainly. But nothing in her early history suggested the kind of criminal mastermind who would steal another woman’s face and wear it for over a decade.
She hunched in her chair, suddenly uneasy. The hallway beyond her door was silent. Nothing moved in the low florescence of the after-hours lighting. Her office had no camera, and Gary had assured her he could transfer the files to her undetected. Perhaps it was just the way Guerra’s dark eyes bored into her own.
As for Louisa Cortez, there was nothing remarkable about her Registry file. Birth certificate, DNA profile, school records, marriage certificate. Birth certificates for her children. Facial data from the last five years placed her living and working locally, the only anomalies being short stays nearby, in the mountains or down by the sea. Her paperwork told the story of an ordinary life. No one looking at her file would have any reason to suspect that life was broken in two. It was possible no one knew save for Diane.
And the woman on her operating table.
It was nearly midnight when Diane got home. The house was dark. The silence waited for her.
“At least you didn’t see what I had for dinner tonight,” she chuckled, feeling no mirth.
A dull throbbing at the base of her neck signaled the beginning of a headache. She popped a couple of painkillers; no need to go into surgery tomorrow with even less sleep.
“You wouldn’t believe what I’m dealing with at work, Fi. This woman, this stupid situation…” She waited for the anger to return, but all she felt was bone-weary. Shedding her handbag and shoes, she shuffled into the bedroom.
A framed screen glowed softly on the bedside table. She picked it up and looked at the two smiling figures displayed. Her own face was younger by a few years, less lined around the forehead and mouth, the gray in her hair streaks rather than swathes. Her wife’s face was thin but soft, with cheekbones that accentuated the crow’s-feet around her smiling eyes.
Diane ran a finger down the side of that perfect face; felt salt water trace a similar path down her own.
“I miss you,” she whispered into the silent dark.
Mr Cortez was not in the waiting room. Perhaps he had no more days to take off work. Diane hurried through nonetheless, trying to quash the feeling she was running away from him.
Closing the surgery door behind her, she stared at the wall-screen covered in photographs of Louisa Cortez. Taking the headshot of Ximena Guerra out of her bag, she taped it to the screen directly beneath the camera, outside its visual range. Only then did she look down at the woman on her table.
Louisa – Ximena – breathed slow and even, chest rising and falling as air whistled through tubes. Diane’s own breath felt ragged, catching in her chest.
“You brought this on yourself,” she told the woman. “You’re the one who chose to wear someone else’s face.”
Her voice sounded rough. Perhaps she was coming down with something. The woman’s mottled flesh was a mask that gave away nothing.
“I have to give you back your real face. You know that, don’t you? If I do anything else, knowing who you really are, I’ll be performing a criminal act. If it was ever discovered, I’d be barred from practicing medicine.”
On the screen, Louisa Cortez and her husband clung together on a beach, eyes squeezed tight with laughter. In another photograph, she crouched, smiling straight at the camera, each arm wrapped around a giggling little boy.
“It won’t last,” Diane whispered. “The government will get DNA testing passed eventually. It’s only a matter of time until you’re found out.”
The woman on the table said nothing. The black dome beneath the ceiling gave nothing away.
For a long minute, the only sound was the humming of machinery. Diane’s fists were clenched, her jaw tight. At last, she reached out a hand and cupped her patient’s face, skin to mottled skin. Her breathing slowed. Her mind settled.
Without looking at the camera, she removed the photograph from directly beneath it, crumpling it and dropping it in her bag. Then she reached for her tools and began her work.