Chapter 6 - The Dermatologist's Bill

By the fourth week of November, the frost had turned the grass outside the Cornell Medicine Burn Center in Manhattan into stiff, silver needles that cracked beneath the tires of the ambulances.
Dr. Richard Okonkwo sat across from me in a private examination room on the sixth floor. He was sixty-two, with silver hair, skin the color of dark roast coffee, and hands that were so light, so steady, that when he peeled the silicone dressing from my cheek, I felt only a faint, cool breath of air against the scar tissue.
He held a magnifying loupe to his eye, switching on a high-intensity white LED examination light.
"The re-epithelialization is ninety percent complete, Sloan," Dr. Okonkwo said, his voice quiet, carrying the deep, melodic cadence of a man who spent forty years putting burned children back together. "The lateral border—near the zygomatic arch—has formed a hypertrophic band. It will stay pink for twelve to eighteen months. It will be tight when the humidity drops, and you will need three rounds of pulsed-dye laser therapy to reduce the vascular erythema."
I held up a small hand mirror.
The face looking back at me was no longer the face of the twenty-nine-year-old actuary who had arrived at that conservatory in Westchester with a spreadsheet in her head.
A four-inch, jagged crescent of pale, smooth, hairless skin stretched from my left temple down to the corner of my jaw. It was slightly raised, the texture like thin, antique vellum, contrasting sharply with the olive undertone of my natural skin.
"Will it ever look like it did before?" I asked.
Dr. Okonkwo set his loupe on the stainless-steel tray.
"No," he said, with the honest, unsparing mercy of a real surgeon. "The chemical destroyed the basal layer of the epidermis and twenty percent of the reticular dermis. We can soften the texture. We can take the redness out with the laser. But when you look in the glass at seventy, Sloan, you will see the line where the acid hit the bone."
He picked up a blue billing folder from the counter.
"This is the comprehensive surgical and dermatological projection for the next five years," he said, handing it to me. "Laser reconstruction. Silicone sheeting. Micro-needling with platelet-rich plasma. Physical therapy for the facial nerve branches that were inflamed by the burn."
I glanced at the total at the bottom of page three: $184,600.00.
"Send it to Marcus Vance," I said, handing the folder back. "He has an account waiting for it."
"Whose account?"
"Dr. Jonathan Croft," I said. "And the Lumière Aesthetics Group."
Thirty minutes later, I walked into the lobby of the Lumière Aesthetics Clinic on East 64th Street.
The clinic was an exercise in Madison Avenue narcissism: white Italian marble, minimalist orchids in bronze urns, and a faint, synthetic scent of lavender and expensive moisturizer hanging in the climate-controlled air. Behind the curved glass reception desk sat Chloe Miller—the aesthetician who had handed an Aperol bottle filled with acid to an assistant through a fire exit for two thousand dollars in cash.
Chloe looked up as the glass doors clicked shut behind me.
When she saw the black wool coat, the dark glasses, and the four-inch vellum scar running down my cheek, her hands froze over her keyboard.
Her face went from professional indifference to absolute, paralyzing terror in three seconds.
"Miss Whitmore," Chloe whispered, her voice cracking. "I... Dr. Croft is in a consultation—"
"Dr. Croft is currently in the lower conference room with two investigators from the State Attorney General’s Medicaid Fraud Unit, Chloe," a voice said behind me.
Marcus Vance stepped through the glass doors, accompanied by two process servers carrying cardboard legal storage boxes.
Marcus didn't look at Chloe. He set an eight-page legal summons on the white marble counter, right over the promotional display for forty-percent fruit-acid peels.
"Chloe Miller," Marcus said, his voice flat as a carpenter's rule. "You are served with an individual civil complaint for Gross Negligence, Battery as an Accessory, and Violation of the New York State Public Health Law. The State Board for Medicine received our petition to revoke your aesthetician license sixty minutes ago, accompanied by the ATM withdrawal logs from the bank across the street."
Chloe began to cry—a ragged, silent stream of tears that ran down her pristine, chemical-peeled cheeks, ruining her fifty-dollar foundation. "I didn't know she was going to throw it... she told me it was for a private facial party... she told me she’d tag the clinic—"
"You took two thousand dollars in cash to dispense an unbuffered chemical compound from a medical refrigerator without a chart, Miss Miller," Marcus said, without looking back as he held the inner office door open for me. "You can tell the grand jury about your marketing strategy next Tuesday."
We walked into Jonathan Croft’s corner office.
Dr. Croft was forty-eight, with dyed black hair, an eight-thousand-dollar Brioni suit, and the greasy, desperate posture of a man who had realized his liability insurance policy was an empty piece of paper.
Sitting across from him were two federal investigators and an attorney from the New York State Department of Financial Services.
Croft looked up as I entered. His gaze hit the scar on my cheek, and his hands began to twitch rhythmically against his mahogany desk blotter.
"Sloan," Croft croaked, his voice cracking into a dry rattle. "We can settle this. I have three million in personal liquid assets. I can write you a check today. We can sign an off-market settlement—"
"The time for writing checks was forty minutes before my sister walked onto that dance floor, Dr. Croft," I said, sitting in the leather armchair across from his desk, keeping my hands folded calmly over my purse.
Marcus Vance laid a sixty-page asset forfeiture agreement between Croft’s trembling hands.
"Under the civil settlement terms approved by the court receiver thirty minutes ago," Marcus said, "you will surrender all commercial real estate holdings associated with this clinic, including the leasehold on East 64th Street, to the Whitmore Foundation for Reconstructive Trauma."
Croft blinked, his mouth falling open. "The foundation? What foundation?"
"The non-profit foundation my father established fifteen years ago," I said, my voice dead and cold as winter iron. "The one my mother defunded so Blair could spend three thousand dollars a night at the Four Seasons in Milan. You are going to fund it, Dr. Croft. For the next ten years. Every dollar of profit generated by this clinic will provide free reconstructive surgery for domestic burn victims across this state."
Croft looked at the investigators sitting beside him. Both men looked straight ahead, their expressions carved out of gray slate.
"And if I refuse?" Croft whispered.
"Then the Department of Justice files the criminal healthcare fraud indictment at two o'clock," Marcus said. "And you spend the next eight years practicing aesthetic medicine on the inmates at Otisville Federal Correctional Institution."
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Croft looked at the pen in his shaking fingers.
He signed his name on the line.