To: Jeffrey Baldwin
From: Dan Wallace
Re: Analysis of KidneyNow Operation


I’m sorry if this assessment comes across a bit harsh, but after all, you did hire me to “shake things up,” as you put it in your first e-mail. Nobody brings a professional ass-kicker like me aboard unless they have major concerns about their company. And after analyzing your operation, let me put it as bluntly as I can: Your business model is insane.

Since the beginning, your operation has rigidly followed the same plan: Your point man identifies a target at a hotel bar, engages, and makes them compliant through the use of Rohypnol in their drink. The target is taken to a hotel room, the kidney is harvested, the donor is fitted with a drainage tube in their lower back and placed in a bathtub filled with ice, with a phone and instructions nearby to call 911 when they awaken.

As you know, the company created incredible word-of-mouth buzz after just a few snatches. As an outsider, I can vouch for this—everyone I met, it seemed, knew someone who knew someone whose hairdresser, or son-in-law, or neighbor, had it happen to them. It was brilliant viral marketing, even if it occurred on its own. No wonder the organ trade was beating a path to your door.

But instant success has its downside. You got on everyone’s radar because no company had done anything like it. But nobody in the organization scrutinized the process closely or had the backbone to tell you when something is being run poorly. (I know how it is; nobody wants to spoil the party.) I guess that’s where I come in.

This procedure is plagued with inefficiencies at every step. It’s no wonder KidneyNow is hemorrhaging money. And they all can be traced to a huge, fundamental flaw in your business model.

But first, let’s look at the specific problems:

  • Your point men are taking their damn sweet time moving in on targets. When I look at their expense sheets, I see appetizers, cocktails, and whiskey shots. Are they camping out for a few hours to catch a game or chat up women? Their bar tabs routinely get up to $70 or $80. And I don’t understand why they’re using Rohypnol instead of the cheaper generic, flunitrazepam.
  • Your people have been renting their own hotel room in case they can’t get their target to reveal his room number before the drug kicks in. I know those card keys make it impossible to identify the target’s room just by looking at them, but this is a colossal waste. I don’t understand why they don’t make sure they learn the room number before they give the target the drug. If they can’t get it, move on to someone else.
  • The ice in the bathtub is a fiasco. Your people don’t fill it ahead of time because they’re afraid it will melt. Instead, they start once the target’s in the room and the cutters are prepping him. I don’t know the last time you were in a hotel, but it’s not like the old days. You can’t take a big cooler to the ice machine and fill it all at once—you have to use your room’s tiny bucket and push down a plunger. Your people are making 25 trips to the machine, turning a 20-minute operation into a two-hour ordeal. This seriously limits your number of harvests per night.
  • The phone is also a financial drain. The cord on the hotel-room phone is not long enough to stretch into the bathroom, so your people have to use something else. Sometimes they use the target’s own phone, but not everyone carries one, so the company ends up buying a cell phone that will be used exactly one time.
  • I don’t mean to nitpick, but the cutters have been irrigating the incision with water from the minibar. They should buy bottled water ahead of time and take it in with them. There’s nothing suspicious about carrying bottled water. That’s just laziness.

Correcting these faults would help, but you could sweep most of them away with one decision. Let’s talk about the elephant in the room, the big flaw that’s ruining your business.

Jeff, have you thought about, oh, I don’t know, LETTING THE TARGET DIE? I’m pretty confident what you’re doing is illegal in the first place. And yet you’re spending time and money to keep these people alive, giving them a chance to ID your employees later.

I confess, when I first heard of your operation, I thought it was one of those legends, because it didn’t make any sense—the ice, the tube in the back, the phone, it all sounded ridiculous. But when your Houston team got busted (fingered by a target, of course), I realized it was for real.

This can’t work. I know it’s hard to scrap an original model for doing things, especially one that gave such a jolt to the organ industry. You have an emotional attachment to it. You’re also being held back (forgive me) by your patrician upbringing, which saddled you with that humane impulse. But it’s time to let go if you want to continue chasing your dream. Do you really want to go back to working at McKinsey & Company?