A surgeon in the UK lost his medical license after authorities discovered he had branded his initials into two patients' livers using an argon beam machine.
The grisly signatures were exposed when another surgeon operated on a failed transplant.
Turning this into a story, what if a state coroner discovers a series of messages etched onto transplanted organs that point to a cold-case serial killer?
The story begins in the first week of her new job as city coroner, maybe somewhere like Philadelphia—big, but not what most people consider a significant city. Like the zodiac killer, she discovers a cipher etched onto a liver.
She brings it to her superiors, but they dismiss it, saying the scarring isn't deliberate. So she investigates herself, discovering that the organ was transplanted, and finds out the doctor is retired. After a visit, she doesn't believe he did it but can't prove it.
Months go by, and she forgets about the strange marking until another one shows up—this time, on a kidney. The problem? A different doctor performed the surgery.
Bringing the issue to her superior again leads nowhere, so when the third symbol shows up, she doesn't even bother taking it to the authorities. Finally, a third doctor performed the transplant; she still can't figure out who etched their name into the organs.
By now, she suspects that the people showing up with etched organs—all of them too young to die of natural causes—are being murdered, despite their death's seemingly accidental nature.
She figures out the cryptic clues which point to a decades-old serial killer. But they're an homage to the killer, not divulging who the murderer was all those years ago.
She can't figure out who has access to the organs until she's driving to work one day and sees a medical transport ambulance. Then, she realizes: the murderer is one of the drivers (Red Dragon, anyone?). After some investigating, she discovers the company which transported the organs and figures out which driver it was.
But, they're on vacation—overseas. The night before she meets the police, the murderer shows up at her house and takes her hostage. He reveals that his father was the cold-case serial killer from years past and that he's carrying on his legacy.
She escapes and kills the man. With help from the authorities to figure out all of the organs he helped transport, they place guards over the recipients.
They relax the security measures when it appears the people with the transplanted organs are all safe, and one of them shows up with another message on their liver. "I'm still here," written in plain English.
Other books could follow Patricia Cornwell's Kay Scarpetta novels, a mix of CSI and murder mystery.