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Published simultaneously in Canada
Library of Congress Cataloging-in-Publication Data
Cook, Robin, date. Marker / Robin Cook.
p. cm.
ISBN 0-399-15293-8
I. Title.
PS3553.05545M37 2005 2005045812
813′.54—dc22
Printed in the United States of America 13579 10 8642
This book is printed on acid-free paper.
BOOK DESIGN BY AMANDA DEWEY
This is a work of fiction. Names, characters, places, and
incidents either
are the product of the author’s imagination or are used
fictitiously,
and any resemblance to actual persons, living or dead, businesses,
companies, events, or locales is entirely coincidental.
For Jean and
Cameron
and all they
mean to me
I
would like to acknowledge my medical school, The College of Physicians and
Surgeons at Columbia University in New York. It was an honor and a privilege to
have attended. Both my professional life and writing career have depended
heavily on the foundation of knowledge and experience I learned and enjoyed at
that fine institution.
—R.
C.
prologue
IN THE WEE HOURS OF February 2, a cold, steady drizzle drenched the concrete spires of New York City,
shrouding them in a dense swirl of purplish-pink fog. Save for a few muted
sirens, the city that never sleeps was at a relative standstill. Yet at exactly
three-seventeen A.M., two nearly simultaneous, unrelated but basically similar,
microcosmic events occurred on opposite sides of Central Park that would prove
to be fatefully connected. One was on a cellular level, the other on a
molecular level. Although the biological consequences of these two events were
opposite, the events themselves were destined to cause the perpetrators—all
strangers—to violently collide in less than two months.
The cellular event occurred in a
moment of intense bliss and involved the forcible injection of slightly more
than two hundred and fifty million sperm into a vaginal vault. Like a group of
anxious marathoners, the sperm mobilized quickly tapped into their
self-contained energy stores, and began a truly Herculean race against death: a
remarkably arduous and perilous race that only one could win, relegating the
others to short and frustratingly futile lives.
The first task was to penetrate
the mucous plug obstructing the collapsed uterine cavity. Despite this
formidable barrier, the sperm rapidly triumphed as a group, although it was a
Pyrrhic victory. Tens of millions of the initial wave of gametes were lost in a
form of self-sacrifice required to release their contained enzymes to make the
passage possible for others.
The next ordeal for this horde
of minute living entities was to traverse the relatively enormous uterine
expanse, almost equivalent in distance and danger to a small fish swimming the
length of the Great Barrier Reef. But even this seemingly insurmountable
impediment was overcome as a few thousand lucky and robust individual sperm
made it to the openings of the two oviducts, leaving behind hundreds of
millions of unlucky casualties.
Still, the travail was not over.
Once within the undulating folds of the oviducts, the fortunate ones who’d
entered the correct tube were now spurred on by the chemotaxis of the
descending fluid from a burst ovarian follicle. Somewhere ahead, beyond a
tortuous and treacherous twelve centimeters, lay the sperm’s Holy Grail, a
recently released ovum crowned with a cloud of supporting cumulous cells.
Progressively goaded by the
irresistible chemical attraction, a contingent of the male gametes accomplished
the ostensibly impossible and closed in on their target. Nearly exhausted from
the long swim and from avoiding predatory macrophages who’d engulfed many of
their brethren, the number was now less than one hundred and falling rapidly.
Neck and neck, the survivors bore down on the hapless haploid egg in a race to
the wire.
After an astonishingly short one
hour and twenty-five minutes, the winning sperm gave a final desperate beat of
his flagellum and collided head-on with the egg’s surrounding cumulous cells.
Frantically, he burrowed between the cells to bring his caplike acrosome into
direct contact with the egg’s heavy protein coat to form a bond. At that
instant, the race was over. As his last mortal act, the winning sperm then
injected his contained nuclear material into the egg to form the male
pronucleus.
The other sixteen sperm that had
managed to reach the egg seconds behind the winner found themselves unable to
adhere to the egg’s altered protein coat. With their energy stores exhausted,
their flagella soon fell silent. There was no second place, and all the losers
were soon swept up, engulfed, and carried off by the deadly maternal
macrophages.
Inside the now-fertilized ovum,
the female pronucleus and the male pronucleus migrated toward each other. After
the dissolution of their envelopes, their nuclear material fused to form the
required forty-six chromosomes of a human somatic cell. The ovum had
metamorphosed into a zygote. Within twenty-four hours, it divided in a process
called cleavage, the first step in a programmed sequence of events that
would in twenty days begin to form an embryo. A life had begun.
The nearly simultaneous
molecular event also involved a forcible injection. On this occasion a bolus of
more than a trillion molecules of a simple salt called potassium chloride
dissolved in a shotglass volume of sterile water was injected into a peripheral
arm vein. The effect was almost instantaneous. Cells lining the vein
experienceda rapid passive diffusion of the potassium ions into their
interiors, upsetting their electrostatic charge necessary for life and
function. Delicate nerve endings among the cells quickly sent urgent messages
of pain to the brain as a warning of imminent catastrophe.
Within seconds, the rest of the
potassium ions were streaming through the great veins and into the heart, where
they were propelled with each beat out into the vast arterial tree. Although
progressive dilution occurred within the plasma, the concentration was still
incompatible with cellular function. Of particular concern were the specialized
cells of the heart responsible for initiating the heartbeat, those of the
brainstem responsible for the urge to breathe, and the nerves and muscle
spindles that carried the messages. All were quickly adversely affected. The
heart rate rapidly slowed, and the heartbeats grew weaker. Breathing became
shallow, and oxygenation inadequate. Moments later, the heart stopped
altogether, initiating progressive bodywide cellular death as well as clinical
death. A life had been lost. As a final blow, the dying cells leaked their
store of potassium into the stagnant circulatory system, effectively masking
the original lethal bolus.
one
THE SOUND OF THE DRIPPING was
metronomic. Somewhere out on the fire escape, drops of water, fueled by the
incessant rain, splattered against a metallic surface. To Laurie Montgomery, the
noise seemed almost as loud as a kettledrum in Jack Stapleton’s otherwise
silent apartment, making her wince as she anticipated each splat. The only
competition over the long hours had been the refrigerator’s compressor cycling
on and off, the hiss and thump of the radiator as heat rose, and an occasional
distant siren or horn, sounds so typical in New York that people’s minds
instinctively ignored them. But Laurie was not so lucky. After tossing and
turning for three hours, she’d become hypersensitive to every sound around her.
Laurie rolled over again and
opened her eyes. Anemic fingers of light reached around the window shade’s
edges, allowing her a better view of Jack’s barren and otherwise drab
apartment. The reason she and Jack were there instead of at her apartment was
the size of her bedroom: It was so small that the largest bed it could
accommodate was a twin, which made communal sleeping problematic. And then
there was also Jack’s desire to be near to his beloved neighborhood basketball
court.
Laurie glanced over to the radio
alarm clock. As its digital readout relentlessly advanced, Laurie became
progressively angry. Without much sleep, she knew from sore experience she’d be
a basket case at the medical examiner’s office that day. She wondered how in
God’s name she had made it through medical school and her residency, where
sleep deprivation had been the name of the game. Yet Laurie sensed that her
current inability to fall asleep wasn’t the only thing making her angry. In
fact, her anger was probably why she couldn’t sleep in the first place.
It had been the middle of the
night when Jack had inadvertently reminded her of her upcoming birthday, asking
her if she wanted to do something special to celebrate. Laurie knew it had been
an innocent question, coming as it did in the afterglow of love-making, but it
had shattered her elaborate defense of taking each day at a time to avoid
thinking about the future. It seemed impossible, but she was soon to be
forty-three years old. Somewhere around age thirty-five the cliché about the
ticking reproductive clock had become true for her—and now hers was sending out
the alarm.
Laurie let out an involuntary
sigh. In her loneliness as the hours had slid by, she’d fretted over the social
quagmire in which she found herself ensnared. When it came to her personal
life, things hadn’t gone right since middle school. Jack was content with the
status quo, as evidenced by his relaxed silhouette and the sounds of his
blissful sleep, which only made things worse for Laurie. She wanted a family.
She’d always assumed she’d have one, even during her comparatively wild
twenties and early thirties, yet here she was, almost forty-three, living in a
crummy apartment in a fringe New York neighborhood, sleeping with a man who
couldn’t make up his mind about marriage or children.
She sighed again. Earlier, she’d
consciously tried to avoid disturbing Jack, but now she didn’t care. She had
decided she was going to try to talk with him again, even though she knew that
the issue was something he studiously preferred to ignore. But this time, she
was going to demand some change. After all, why should she settle for a
miserable life in an apartment more suited to a couple of penurious graduate
students than board-certified forensic pathologists, as she and Jack were, in a
relationship where discussions of marriage and children were unilaterally
verboten?
Yet things weren’t all bad. On
the career side, it couldn’t be better. She loved her job as a medical examiner
at the Office of the Chief Medical Examiner of New York, where she’d been
working for thirteen years, and she felt lucky she had a coworker like Jack
with whom she could share the experience. Both of them were awed by the
intellectual stimulation that forensic pathology offered; each day they learned
something new. And they saw eye to eye on a lot of issues: Both had little
tolerance for mediocrity, and both were turned off by the political necessities
of being part of a bureaucracy. Yet as compatible as they were work-wise, it
did not make up for her burgeoning desire to have a family.
Jack suddenly stirred and rolled
over onto his back, his fingers intertwined and hands clasped on his chest.
Laurie looked at his sleeping profile. In her eyes, he was a handsome man, with
closely cropped, gray-streaked light brown hair, bushy eyebrows, and strong,
sharp features, usually sporting a wry smile, even in repose. She found him
aggressive yet friendly, bold yet modest, challenging yet generous, and, most
often, playful and fun. With his quick wit, life was never dull, especially
with his adolescent penchant for risk-taking. On the negative side he could be
aggravatingly stubborn, especially about marriage and children.
Laurie leaned toward Jack and
looked more closely. He was definitely smiling, which aggravated her
irritation. It didn’t seem fair that he was satisfied with the status quo.
Although she was reasonably sure she loved him and believed he loved her, his
inability to make a commitment was literally driving her to distraction. He said
it wasn’t a fear of marriage or parenthood per se, but rather the vulnerability
that such commitment created. At first, Laurie had been understanding: Jack had
suffered the tragedy of losing his first wife and two young daughters in a
commuter plane crash. She knew that he carried both the grief and the
responsibility, since the accident had occurred after a family visit while he
was retraining in pathology in another city. She also knew that after the
accident, he had struggled with severe reactive depression. But now the tragedy
was almost thirteen years in the past. Laurie felt that she’d been sensitive to
his needs and had been patient when they finally did start dating seriously.
But now, almost four years later, Laurie felt that she’d reached her limit.
After all, she had needs, too.
The buzz of Jack’s alarm
shattered the silence. Jack’s arm shot out and swatted the snooze button, then
retracted back into the warmth of the covers. For five minutes, peacefulness
returned to the room, and Jack’s breathing regained its slow, deep, sleeping
rhythm. This was part of the morning routine that Laurie never saw, because
Jack invariably was up before she was. Laurie was a night person who loved to
read before turning out the light, often staying up longer than she should.
Almost from day one of their cohabitation, Laurie had learned to sleep through
the alarm, knowing Jack would get it.
When the alarm went off the
second time, Jack turned it off, threw back the covers, sat up, and put his
feet on the floor, facing away from Laurie. She watched him stretch and could
hear himyawn as he rubbed his eyes. He stood up and padded into the
bathroom, heedless of his nakedness. Laurie put her hands behind her head and
watched him, and despite her aggravation, it was a pleasant sight. She could
hear him use the toilet and then flush. When he reappeared, he was again
rubbing his eyes as he came around to Laurie’s side of the bed to wake her.
Jack reached out to give
Laurie’s shoulder a shake as per usual, and then gave a start when he saw her
eyes open, trained on him, her mouth set in an expression of irritated
determination.
“You’re awake!” Jack
said, his eyebrows arching questioningly. He knew instantly that something was
amiss.
“I haven’t been back to
sleep since our middle-of-the-night tryst.”
“It was that good,
huh?” Jack said, in hopes that humor could defuse her apparent pique.
“Jack, we have to
talk,” Laurie said flatly, sitting up and clutching the blanket to her
chest. Defiantly she locked eyes with him.
“Isn’t that what we’re
already doing?” Jack questioned. He immediately guessed where Laurie was
coming from, and he couldn’t keep sarcasm out of his voice. Although he knew
his tone was counterproductive, he couldn’t help himself. Sarcasm was a
protective mannerism he’d developed over the last decade.
Laurie started to respond, but
Jack held up his hand. “I’m sorry. I don’t mean to sound insensitive, but
I have a sneaking suspicion where this conversation is headed, and it’s not the
time. I’m sorry, Laurie, but we have to be at the morgue in an hour, and
neither of us has showered, dressed, or eaten.”
“Jack, it’s never the
time.”
“Well, then let’s put it
this way: This might be the worst possible time for some kind of serious,
emotional discussion. It’s six-thirty on a Monday morning after a great
weekend, and we have to get to work. If it had been on your mind, there’d have
been a dozenother times during the last couple of days when you could
have brought it up, and I would have been happy to discuss it.”
“Oh, bull! Let’s face it,
you never want to talk about it. Jack, I’m going to be forty-three on Thursday.
Forty-three! I don’t have the luxury of being patient. I can’t wait for you to
decide what you want to do. I’ll be postmenopausal.”
For several beats, Jack stared
into Laurie’s blue-green eyes. It was clear that she wasn’t going to be
placated easily. “All right,” he said, exhaling noisily as if he was
conceding. He averted his gaze down to his bare feet. “We’ll talk about it
tonight over dinner.”
“I need to talk about it
now!” Laurie said emphatically. She reached out and lifted Jack’s chin to
lock eyes again. “I’ve been agonizing over our situation while you’ve been
sleeping. Putting it off is not an option.”
“Laurie, I’m going to go in
and take a shower. I’m telling you, there’s no time for this at the
moment.”
“I love you, Jack,”
Laurie said after grabbing his arm to restrain him. “But I need more. I
want to be married and have a family. I want to live someplace better than
this.” She let go of Jack’s arm and swept her hand around the room to
point out the peeling paint, the bare lightbulb, the bed with no headboard, the
two night tables that were empty wooden wine cases set on end, and the single
bureau. “It doesn’t have to be the Taj Mahal, but this is ridiculous.”
“All this time, I thought
four stars was adequate for you.”
“Save the sarcasm,”
Laurie snapped. “A little luxury wouldn’t hurt for as hard as we work. But
that’s not the issue. It’s the relationship, which seems fine for you but isn’t
enough for me. That’s the bottom line.”
“I’m taking a shower,”
Jack said.
Laurie gave him a crooked
half-smile. “Fine. You take a shower.”
Jack nodded and started to say
something, then changed his mind. He turned and disappeared into the bathroom,
leaving thedoor ajar. A moment later, Laurie heard the shower start
and the sound of the shower curtain rings scraping across the shower rod.
Laurie exhaled. She was
trembling from a combination of fatigue and emotional stress, but she was proud
of herself for not shedding any tears. She hated when she cried in emotional
situations. How she had avoided it at the moment she had no idea, but she was
pleased. Tears never helped, and frequently put her at a disadvantage.
After slipping on her robe,
Laurie went into the closet for her suitcase. The confrontation with Jack
actually made her feel relieved. By responding just as she’d anticipated, Jack
justified what she had decided to do even before he had awakened. Opening up
her allotted bureau drawers, she took out her things and began packing. With
the task almost complete, she heard the shower stop, and a minute later Jack
appeared in the doorway, briskly toweling off his head. When he caught sight of
Laurie and the suitcase, he stopped abruptly.
“What the hell are you
doing?”
“I think it’s perfectly
clear what I’m doing,” Laurie answered.
For a minute Jack didn’t say
anything, merely watching as Laurie continued her packing. “You’re
carrying this too far,” he said finally. “You don’t have to
leave.”
“I think I do,” Laurie
responded without looking up.
“Fine!” Jack said
after a beat, an edge to his voice. He ducked back through the door to finish
toweling off.
When Jack came out of the
bathroom, Laurie went in, carrying the day’s outfit. She made a point of
closing the door, although on normal mornings, it remained open. By the time
Laurie emerged, fully dressed, Jack was in the kitchen. Laurie joined him for a
breakfast of cold cereal and fruit. Neither took the time to sit at the tiny
vinyl dinette set. Both were polite, and the only conversation was “excuse
me” or “sorry” as they danced around each other to get in and
out of the refrigerator. Thanks to the narrowness of the room, it was
impossible to move without touching.
By seven, they were ready to
leave. Laurie squeezed her cosmetics into her suitcase and closed the lid. When
she rolled it out into the living room, she saw Jack lifting his mountain bike
from its wall rack.
“You’re not riding that
thing to work, are you?” Laurie asked. Prior to their living together,
Jack had used the bike to commute, as well as to run errands around the city.
It had always terrified Laurie, who constantly worried that he was going to
arrive one day at the morgue “feet first.” When they had begun to
commute together, Jack had given up riding the bike, since there was no way
Laurie would consent to doing the same.
“Well, it looks like I’ll
be on my own coming back to my palace.”
“It’s raining, for God’s
sake!”
“Rain makes it more
interesting.”
“You know, Jack, since I’m
being honest this morning, I think I should tell you that I find this kind of
juvenile risk-taking of yours is not only inappropriate but also selfish, like
you’re thumbing your nose at my feelings.”
“That’s interesting,”
Jack said with a smirk. “Well, let me tell you something: Riding my bike
has nothing to do with your feelings. And to be honest with you, your feeling
that it does seems pretty selfish to me.”
Outside on 106th Street, Laurie
walked west to Columbus Avenue to catch a cab. Jack pedaled east toward Central
Park. Neither turned to wave at the other.
two
JACK HAD FORGOTTEN THE
exhilaration of riding his dark purple Cannondale mountain bike, but it came
back to him in a rush as he coasted down one of the hills after entering
Central Park near 106th Street. Since the park was nearly deserted save for the
rare jogger, Jack had let himself go, and both the city and his suppressed
anxieties miraculously disappeared in the misty city-bound forest. With the
wind whistling in his ears, he could remember as if it were yesterday sailing
down Dead Man’s Hill in South Bend, Indiana, on his beloved red-and-gold,
wide-tired Schwinn. He’d gotten the bike on his tenth birthday after having
seen it advertised on the back of a comic book. Mythologized as a symbol of his
happy and carefree childhood, he’d convinced his mother to save it, and it
continued to gather dust back in the garage of his family’s home.
Rain was still falling, but not
hard enough to dampen Jack’s experience, despite his hearing droplets
splattering against the brow of his bicycle helmet. His biggest problem was
trying to see through the moisture-streaked lenses of his aerodynamic bicycling
sunglasses. To keep the rest of himself reasonably dry, he wore his waterproof
bicycle poncho, which featured ingenious little hooks for his thumbs. When he
learned forward with his hands grasping the handlebars, the poncho created a
tentlike covering. For the most part, he avoided puddles, and when he couldn’t,
he lifted his feet off the pedals to coast until he reached drier pavement.
At the southeast corner of
Central Park, Jack entered the Mid-town city streets, already clogged with
morning rush-hour traffic. There had been a time when he loved to challenge the
traffic, but that was when he was, in his words, a bit crazier. It was also when
he was in significantly better shape. Since he hadn’t been riding much over the
last few years, he didn’t have nearly the same stamina anymore. His frequent
basketball playing helped, but basketball didn’t involve quite the same
sustained aerobics that bicycling demanded. Yet he didn’t slow down, and by the
time he coasted down the ramp into the 30th Street receiving dock at the
medical examiner’s office, his quadriceps were complaining. After dismounting,
he stood for a moment, leaning onto his handlebars to let his circulation catch
up with the oxygen demand in his leg muscles.
When the hypoxic aching of his
thighs had been mollified, Jack hefted his bike on his shoulder and started up
the steps to the receiving dock. His legs were still rubbery, but he was eager
to find out what was going on at the morgue. When he’d passed the front of the
building, he’d seen a number of TV satellite trucks parked at the curb with
their generators cranking and their antennae extended. He also had caught sight
of a press of people within the reception area just beyond the front doors.
Something was brewing.
Jack waved a greeting to Robert
Harper through the window of the security office. The uniformed officer popped
out of his chair and stuck his head around the jamb of the open door.
“Back to your old tricks,
Dr. Stapleton?” Robert called out. “I haven’t seen that bike of yours
for years.”
Jack waved over his shoulder as
he carried his bike into the depths of the morgue’s basement. He passed the
small autopsy room used for examining decomposing corpses and turned left just
before the central mass of drawer-shaped refrigerated compartments where bodies
were stored prior to being autopsied. He had to clear a space for his bike in
the area reserved for the Potter’s Field pine coffins, used for the
unidentified and unwanted dead. After stowing his coat and bicycle
paraphernalia in his locker in the changing room, Jack headed for the stairs.
He passed Mike Passano, the graveyard-shift mortuary tech, who was busy
finishing up his paperwork in the mortuary office. Jack waved, but Mike was too
engrossed to notice him.
As Jack emerged into the central
corridor on the first floor, he caught another glimpse of the crowded front
reception area. Even from the back of the building, he could hear the murmur of
excited conversation. Something was up, and his curiosity was piqued. One of
the most exciting aspects of being a medical examiner was that he never knew
from one day to the next what was in store. Coming to work was stimulating, even
exciting, which was a far cry from how Jack had felt in his former life as an
ophthalmologist, when each day had been comfortable but utterly predictable.
Jack’s ophthalmology career had
ended abruptly in 1990, when his practice had been gobbled up by the
aggressively expanding managed-care giant AmeriCare. AmeriCare’s offer to hire
Jack as anemployee was another slap in the face. The experience
forced Jack to recognize that old-school, fee-for-service medicine based on
close doctor-patient relationships, where decisions were based solely on
patients’ needs, was rapidly disappearing. That epiphany led to his decision to
retrain as a forensic pathologist, hopefully freeing himself from managed care,
which he felt was more of a euphemism for “denial of care.” The final
irony was that AmeriCare had resurfaced to haunt Jack despite his efforts to
distance himself. Thanks to a low bid for its premiums, AmeriCare had recently
won a competitive contract for city employees. Jack and his colleagues now had to
look to AmeriCare for their own healthcare needs.
Wishing to avoid the throng of
media, Jack set off on the back route to the ID office, where the morgue’s
workday began. On a rotating basis, one of the more senior medical examiners
arrived early to review the cases that had come in during the night, decide
which ones needed to be autopsied, and make the assignments. It was Jack’s
habit to get to work early as well, even if it wasn’t his turn to be the
scheduler, so he could snoop through the cases and get the most challenging
ones assigned to him. Jack had always wondered why other docs didn’t do the
same thing until he realized that the majority of the others were more
interested in avoidance. Jack’s curiosity invariably caused him to end up with
the largest caseload. But he didn’t mind; work was Jack’s opiate for taming his
demons. While he and Laurie had been practically living together, he’d gotten
her to come in early with him, which had been no mean feat, considering how
hard it was for her to get up in the morning. The thought made Jack smile. It
also made him wonder if she had already arrived.
Jack suddenly stopped in his
tracks. Until now, he had deliberately kept the morning’s confrontation from
his mind. Thoughts of his relationship with Laurie as well as memories of
horrific events of his own past flooded into his consciousness. Irritably, he
wondered why she had felt compelled to end a beautiful weekend on such a downer
note, especially since things had been going so well between them. In general,
he almost felt content, a remarkable state of mind, considering he didn’t feel
he deserved to be alive, much less happy.
A wave of anger spread through
him. The last thing he needed was to be reminded of his smoldering grief and
guilt about his late wife and daughters, which happened with any talk of
marriage or children. The idea of commitment and the vulnerability it entailed,
especially starting another family, was terrifying.
“Get a grip,” Jack
murmured to himself under his breath. He closed his eyes and roughly massaged
his face with both hands. Behind his irritation and frustration with Laurie, he
felt the stirrings of melancholy, an unwelcome reminder of his past struggles
with depression. The problem was, he truly cared for her. Things were great,
except for the gnawing issue of children.
“Dr. Stapleton, are you all
right?” a woman’s voice asked.
Jack peeked out through his
fingers. Janice Jaeger, the petite night-shift forensic investigator, was
staring up at him while pulling on her coat, on her way home and apparently
exhausted. Her legendary dark circles made Jack wonder if she ever slept.
“I’m fine,” Jack said.
He took his hands away from his face and shrugged self-consciously. “Why
do you ask?”
“I don’t think I’ve ever
seen you standing still, especially in the middle of the corridor.”
Jack tried to think of a witty
retort, but nothing came to mind. Instead, he changed the subject by lamely
asking if she had had an interesting night.
“It was wild around
here!” Janice said. “More so for the tour doctor and even Dr.
Fontworth than me. Dr. Bingham and Dr. Washington are already here doing a
post, with Fontworth assisting.”
“No kidding!” Jack
said. “What kind of case?” Harold Bingham was the chief, and Calvin
Washington was the deputy chief. Generally, neither appeared until well after
eight in the morning, and it was rare for them to do an autopsy before the
normal day began. There had to be political ramifications, which explained the
media presence. Fontworth was one of Jack’s colleagues, and had been on call
for the weekend. Medical examiners didn’t come in at night unless there was a
problem. Pathology residents were hired as “tour doctors” to cover
routine calls requiring a physician.
“It’s a gunshot wound, but
it’s a police case, which is why Font-worth had to take it. As I understand it,
the police had surrounded a suspect in his girlfriend’s care. When they tried
to arrest him, a barrage of shots was fired. There’s the question of
unreasonable force. You might find it interesting.”
Jack inwardly winced. GSW cases
could be tricky with multiple shots. Although Dr. George Fontworth was Jack’s
senior by eight years at the Office of the Chief Medical Examiner, or OCME, he
was, in Jack’s opinion, perfunctory. “I think I’ll stay clear with the
chief involved,” Jack said. “What’d you handle? Anything of
note?”
“The usual, but there was
one at the Manhattan General that stood out. A young man who’d just been
operated on yesterday morning for a compound fracture after a fall while
in-line skating on Saturday in Central Park.”
Jack winced anew. With his
sensitivities aroused, thanks to Laurie, he had a negative response at the mere
mention of the Manhattan General Hospital. Once an acclaimed academic center,
it was now an AmeriCare flagship hospital after having been targeted and taken
over by the cash-rich managed-care giant. Although he knew that the overall
level of medicine practiced at the institution was good, such that if he took a
bad flop on his bike and ended up in their trauma unit, which is where they would
probably take him with the new city contract, he’d be well taken care of. At
the same time it was still a managed-care establishment run by AmeriCare, and
he had a visceral hatred for the company. “What made the case stand
out?” Jack asked, trying to conceal the emotion he felt. Reverting to
sarcasm, he added: “Was it a diagnostic conundrum, or was there some sort
of scurrilous hanky-panky involved?”
“Neither!” Janice
sighed. “It was just the way the case struck me. It was just… rather
sad.”
“Sad?” Jack
questioned. He was taken aback. Janice had been working as a forensic
investigator for more than twenty years and had seen death in all its
inglorious permutations. “For you to say it’s sad, it’s got to be really
sad. What’s the scoop in a nutshell?”
“He was only in his late
twenties and had no medical history— specifically, no heart trouble. The
narrative I got was that he’d rung his call button, but by the time the nurses
got around to him five to ten minutes later—that’s according to the nurses—he was
dead. So it must have been cardiac.”
“There was no resuscitation
attempt?”
“Oh, they definitely tried
to resuscitate him, but with no success whatsoever. They never even got a blip
on the EKG.”
“What made it so sad? The
man’s age?”
“The age was one factor,
but it wasn’t the whole story. Actually, I don’t know why it bothered me so
much. Maybe it has something to do with the nurses not responding quickly
enough and my thinking the poor guy knew he was in trouble but couldn’t get
help. We can all relate to that kind of a hospital nightmare. Or maybe it has
something to do with the patient’s parents, who are very sympathetic. They came
in from Westchester to go to the hospital, then came over here to stay near the
body. They’re really broken up. I get the impression their son was their whole
life. I think they’re still here.”
“Where? I hope they’re not
stuck out there in that mob of reporters?”
“Last thing I knew, they
were in the ID room, insisting on another ID even though it had already been
established. To be considerate, the tour doctor told Mike to go ahead and do
another set of Polaroids, but that was when I was called back to the General
for another case. When I got back here, Mike happened to mention the couple was
still spaced out in the ID room, sort of emotionally adrift, while clutching
the Polaroids. And, as if still hoping the whole affair was a mistake, they
insisted on viewing the body itself.”
Jack felt his pulse quicken. He
knew all too well the emotional devastation of losing a child. “That case
can’t be what has the media people all stirred up.”
“Heavens, no. The kind of
case I’m talking about never reaches the public. That’s part of the reason it’s
so sad. A life wasted.”
“Is it the police case
that’s brought in the media?”
“It’s what brought them
originally. Bingham announced he would make a statement after the autopsy. The
tour doctor told me the Spanish Harlem community is up in arms about the
incident. Apparently, there were something like fifty shots fired by the
police. Echoes of the Diallo case in the South Bronx some years back. But to
tell you the truth, I think what the media is now mostly interested in is the
Sara Cromwell case, which came in after they were already here.”
“Sara Cromwell, the
syndicated psychologist in the Daily News?”
“Yeah, the advice diva,
capable of telling anyone and everyone how to get his or her life back on
track. She was also a TV personality, you know. She hit most of the talk shows,
including Oprah. She was pretty darn famous.”
“Was it an accident? Why the
fuss?”
“No accident. She was
apparently brutally murdered in her Park Avenue apartment. I don’t know the
details, but it was on the gory side, according to Dr. Fontworth, who had to
handle that case as well. I tell you, he and the tour doctor were out all
night. AfterCromwell, there was a double suicide in a mansion on
Eighty-fourth Street, then a nightclub homicide. After that, the tour doctor
had to go out for a hit-and-run on Park Avenue and two overdoses.”
“What about the double
suicide? Old or young?”
“Middle-aged. Carbon
monoxide. They had their Escalade running with the garage door closed and a
couple of vacuum hoses from the exhausts into the cab.”
“Hmmm,” Jack murmured.
“Any suicide notes?”
“Hey, no fair,” Janice
complained. “You’re grilling me about cases I didn’t handle. But as far as
I know there was only one note, from the woman.”
“Interesting,” Jack
commented. “Well, I better get down to the ID room. Sounds like it’s going
to be a busy day. And you better get home to get some sleep.”
Jack was pleased. The
anticipation of an interesting day swept away some of the irritation that had
resurfaced about the morning. If Laurie wanted to go back to her own apartment
for a few days, it was fine with him! He’d just bide his time, because he
wasn’t going to be emotionally extorted.
Jack sped by the forensic
investigators’ office, cut through the clerical room with its banks of file
cabinets, and entered the communications room just beyond. He smiled at the
day-shift telephone operators but got no response. They were preoccupied with
getting themselves organized. He waved to Sergeant Murphy when he passed the
NYPD detective room, but Murphy was on the phone and didn’t respond, either.
Some welcome, Jack mused.
Entering the ID office, Jack got
the same treatment. There were three people in the room, and all three ignored
him. Two were hidden behind their morning papers while Dr. Riva Mehta, Laurie’s
office mate, was busy going over the sizable stack of potential cases to make
up the autopsy schedule. Jack got a cup of coffee from thecommunal pot,
then bent down the edge of Vinnie Amendola’s paper. Vinnie was one of the
mortuary techs and Jack’s frequent partner in the autopsy room. Vinnie’s
regular and early presence meant Jack could start in the autopsy room well
before anyone else.
“How come you’re not down
in the pit with Bingham and Washington?” Jack asked.
“Beats me,” Vinnie
said, pulling his paper free. “Apparently, they called Sal. They were
already going at it when I got here.”
“Jack! How ya doin’?”
A third person emerged from
behind his paper, but the accent gave him away. It was Detective Lieutenant Lou
Soldano, from Homicide. Jack had met him years ago when he had first joined the
Office of the Chief Medical Examiner. Convinced of the enormous contributions
of forensic pathology to his line of work, Lou was a frequent visitor to the
OCME. He was also a friend.
With a bit of effort, the stocky
detective heaved himself out of the vinyl club chair, clutching his paper in
his beefy hand. With his aged trench coat, his tie loosened and the top button
of his shirt open, he appeared like a rumpled character out of an old film
noir. His broad face sported what could have been a two-day growth of beard,
although from experience, Jack knew it was only one.
They greeted each other with a
slapping, modified high-five, which Jack had learned out on the neighborhood
basketball court and had jokingly taught Lou. It made both of them feel more
hip.
“What’s got you up this
early?” Jack asked.
“Up? I haven’t been to bed
yet,” Lou scoffed. “It’s been that kind of night. My captain is
worried sick about this supposed police brutality case, since the department is
going to feel real heat if the involved officers’ story doesn’t hold up. I’m
hoping to get an early scoop, but that’s not looking good with Bingham doing
the case. He’ll probably be in there screwing around for most of the day.”
“What about Sara Cromwell’s case? Are you interested in that, too?”
“Yeah! Of course! As if I
had any choice! Did you see all the media out in reception?”
“They would have been hard
to miss,” Jack responded.
“Unfortunately, they were
already here on the police shooting. Guaranteed there’s going to be a lot of
newspaper and TV hype for that skinny psychologist, probably more than she
would have gotten had they not been hanging around. And whenever a murder gets
a high profile in the media, I know I’ll be getting lots of pressure from above
to come up with a suspect. So, with that said, do me a favor and do the
case.”
“Are you serious?”
“Of course I’m serious.
You’re fast and you’re thorough, both of which fulfill my needs. Also, you’re
okay with me watching, which I can’t say about everybody around here. But if
you’re not interested, maybe I can get Laurie to do it, although knowing her
GSW bent, she’ll probably want to get involved in the police case.”
“She’s also interested in
one of the Manhattan General cases,” Riva said in silky, British-accented
voice, which was in sharp contrast to Lou’s New York twang. “She’s already
taken the folder and said she wants to do that one first.”
“Did you see Laurie this
morning?” Jack asked Lou. He and Lou shared an appreciation of Laurie
Montgomery. Jack knew that Lou had even once briefly dated Laurie, but it
hadn’t worked out. From Lou’s own admission, the problem had been Lou’s lack of
social confidence. Graciously, Lou had become a strong advocate for Jack and
Laurie as a couple.
“Yeah, about fifteen or
twenty minutes ago.”
“Did you talk to her?”
“Of course. What kind of a
question is that?”
“Did she seem normal? What
did she say?”
“Hey! Why the third degree?
I don’t remember what she said; it was something like “Hi, Lou,
wassup?” or something to that effect. And as far as her mental state was
concerned, she was normal, even bubbly.” Lou glanced over at Riva.
“Was that your take, Dr. Mehta?”
Riva nodded. “I’d say she
was fine, maybe a little excited about all the fuss around here. She’d
apparently had a conversation with Janice about the Manhattan General case.
That’s why she wanted it.”
“Did she say anything about
me?” Jack asked Lou, leaning forward and lowering his voice.
“What’s with you
today?” Lou asked. “Is everything copacetic with you guys?”
“Oh, there’s always a few
bumps in the road,” Jack said vaguely. Laurie being “bubbly”
added insult to injury, under the circumstance.
“How about assigning me the
Cromwell case!” Jack called over to Riva.
“Be my guest,” Riva
said. “Calvin left a note saying he wanted it done ASAP.” She took
the folder from the “to be autopsied” pile and put it on the corner
of the desk. Jack grabbed it and opened it, revealing a case worksheet, a
partially filled-out death certificate, an inventory of medical-legal case
records, two sheets for autopsy notes, a telephone notice of death as received
by communications, a completed identification sheet, an investigator’s report
dictated by Fontworth, a sheet for the autopsy report, a lab slip for HIV
analysis, and an indication that the body had been x-rayed and photographed
when it had arrived at the OCME. Jack pulled out Fontworth’s report and read
it. Lou did the same over Jack’s shoulder.
“Were you at the
scene?” Jack asked Lou.
“No, I was still up in
Harlem when this was called in. The precinct boys handled it initially, but when they
recognized the victim, they called in my colleague, Detective Lieutenant Harvey
Lawson. I’ve since talked with all of them. Everyone said it was a mess. Blood
all over the kitchen.”
“What was their take?”
“Considering she was
seminude, with the apparent murder weapon sticking out of her thigh just below
her private parts, they thought it was a fatal sexual assault.”
“Private parts! So
restrained.”
“That’s not quite how they
described it to me. I’m translating.”
“Thank you for being so
considerate. Did they mention the blood on the front of the refrigerator?”
“They said there was blood
all over.”
“Did they mention blood
being inside the refrigerator, particularly on the wedge of cheese as described
here in Fontworth’s report?” Jack poked the paper with his index finger.
Jack was impressed. Despite his previous experience with Fontworth’s desultory
work, the report was thorough.
“Like I said, they reported
blood was all over the place.”
“But inside the
refrigerator with the door closed. That’s a bit odd.”
“Maybe the door was open
when she was attacked?”
“So then she carefully put
the cheese away? That’s more than odd in the middle of a homicide. Tell me
this: Did they mention footprints in the blood besides those of the
victim?”
“No, they didn’t.”
“Fontworth’s report
specifically says there were none, but quite a few of the victim’s. That’s
odder still.”
Lou spread his hands and
shrugged his shoulders. “So, what’s your take?”
“My take is that in this
case, the autopsy is going to be significant, so let’s get the ball
rolling.”
Jack walked over to Vinnie and slapped
the back of his paper, making the tech jump.
“Let’s go, Vinnie, old
boy,” Jack said happily. “We’ve got work to do.”
Vinnie grumbled under his breath
but stood up and stretched.
At the door into the
communications room, Jack hesitated, looked back at Riva, and called out:
“If you don’t mind, I’d like to do that double suicide as well.”
“I’ll put your name on
them,” Riva promised.
Three
“HOW ABOUT THIS,”
LAURIE suggested. “I’ll call you just as soon as I finish and let you know
what I found. I know it won’t bring your son back, but perhaps knowing what
happened will be some comfort, especially if we’re able to learn from this
tragedy, to keep it from happening to someone else. If by some slim chance we
still don’t have any answers after the autopsy, I’ll call you after I’ve had a
chance to look at the microscopic and give you the definitive answers.”
Laurie knew what she was
suggesting was out of the ordinary and that skirting Mrs. Donnatello in the
public relations office and giving out preliminary information would annoy
Bingham and Calvin, both of whom were sticklers for rules, if they got wind.
But Laurie felt the McGillin case warranted this change of protocol.
After talking with them for only
a short time, she’d learned that Sean McGillin Sr. was a retired physician
who’d had a large internal-medicine practice in Westchester County. He and his
wife, Judith, who’d been his office nurse, were not only fellow medical
professionals but also extremely simpatico. The McGillins projected a salt-of-the-earth
honesty and graciousness that made Laurie like them instantly; it also made it
impossible for her not to feel their pain.
“I promise to keep you in
the loop,” Laurie continued, hoping her reassurances would allow the
McGillins to go home. They’d been at the ME’s office for hours, and it was
obvious that they were both exhausted. “I’ll personally watch over your
son.” Laurie had to glance away after her last comment, knowing it was
deliberately misleading. She again caught sight of the crush of reporters in
the reception area, even though she was trying to ignore them, and heard
muffled cheering as coffee and donuts arrived. Laurie winced. It was
unfortunate that as the McGillins were suffering their private grief, a media
circus was going on in the next room. It had to make it harder for the
McGillins, hearing banter and laughter.
“It just isn’t fair that it
isn’t me who is lying downstairs in that refrigerated compartment,” Dr.
McGillin said with a sad shake of his head. “I’ve had a good run at life.
I’m nearly seventy. I’ve had two bypass procedures, and my cholesterol’s too
high. Why am I still here, and Sean Jr. is down there? It doesn’t make sense;
he’s always been a healthy, active boy, and he’s not even thirty.”
“Was your son’s LDH high as
well?” Laurie asked. Janice hadn’t included anything about that in her
forensic investigator’s report.
“Not in the
slightest,” Dr. McGillin said. “In the past, I made sure he had it
checked once a year. And now that his law firm contracted with AmeriCare, which
requires yearly physicals, I know he’d continue to be checked.”
After a quick glance at her
watch, Laurie made direct eye contact with the McGillins, looking from one to
the other. They were sitting bolt upright on the brown vinyl couch, their hands
folded in their laps, clutching the identification Polaroids of their dead son.
Rain spattered intermittently against the glass. The couple reminded her of the
man and woman in the painting “American Gothic.” They radiated the
same resoluteness and moral virtue along with a hint of Puritanical narrowness.
The problem for Laurie was that
she was organizationally shielded from the emotional side of death, and
consequently had limited experience with it. Dealing with the grieving
families, as well as helping them through the identification process, was done
by others. She was also sheltered by a kind of academic distance. As a forensic
pathologist, she saw death as a puzzle to be solved to help the living. There
was also the acclimatization factor: Although death was a rare event for the
general public, she saw it every day.
“Our son was to be married
in the spring,” Mrs. McGillin said suddenly. She hadn’t spoken since
Laurie had introduced herself forty minutes earlier. “We were hoping for
grandchildren.”
Laurie nodded. The reference to
children touched a tender chord in her own psyche. She tried to think of
something to say but was saved when Dr. McGillin suddenly stood up. He took his
wife’s hand and pulled her to her feet.
“I’m sure Dr. Montgomery
has to get to work,” Dr. McGillin said. He nodded as if agreeing with
himself while collecting all the Polaroids and pocketing them. “It’s best
if we go home. We’ll leave Sean in her care.” He then took out a small pad
of paper and a pen from his inside jacket pocket. After writing on it, he tore
off the top sheet and extended it to Laurie. “This is my personal phone
line. I’ll be awaiting your call. I will look forward to it sometime before
noon.”
Surprised and relieved at this
sudden change of events, Laurie stood up. She took the paper and glanced at the
number to be sure it was legible. It was a 9I4 area code. “I’ll call as
soon as I can.”
Dr. McGillin helped his wife
with her coat before putting on his own. He extended his hand toward Laurie.
She shook it and noticed that it was cold.
“Take good care of our
boy,” Dr. McGillin said. “He’s our only child.” With that, he
turned, opened the door to the reception area, and urged his wife forward into
the press of reporters.
Desperate for news, the
reporters instantly fell into an expectant silence the moment the McGillins
appeared. Anticipating a news conference, all eyes followed their progress. The
couple had advanced halfway across the reception area on their way to the main
door when someone broke the silence by yelling out: “Are you part of the
Cromwell family?” Dr. McGillin merely shook his head without slowing his
progress. “Are you related to the police custody case?” someone else
demanded. Dr. McGillin shook his head again. With that, the reporters switched
their attention to Laurie. Apparently recognizing her as one of the medical
examiners, a number even spilled into the ID room. An avalanche of questions
followed.
Initially ignoring the
reporters, Laurie went up on her tiptoes to see the McGillins exit the OCME.
Only then did she look at the people pressed around her. “Sorry,” she
said, pushing microphones away. “I know nothing of those cases. You’ll
have to wait for the chief.” Luckily, one of the OCME security personnel
had materialized from within the reception area, and he managed to herd the
reporters back to where they’d come from.
Relative silence returned to the
ID room once the connecting door had been closed. For a moment, Laurie stood
with her arms hanging limply at her sides. She had Sean McGillin Jr.’s folder
in one hand and his father’s scribbled phone number in other. Dealing with the
grieving couple had been trying, especially since she wasfeeling
psychologically fragile herself. But there was a positive side. Knowing herself
as well as she did, she knew it was helpful to be involved in an emotionally
wrenching situation, because it put her own problems in perspective. Keeping
her mind occupied was a good hedge against backsliding into what she’d come to
recognize as an unacceptable status quo.
Fortified to a degree, Laurie
headed into the ID office while pocketing Dr. McGillin’s phone number.
“Where’s everybody?” she asked Riva, who was still busy with the
scheduling process.
“You and Jack are the only
ones here so far, besides Bingham, Washington, and Fontworth.”
“What I meant was, where
are Detective Soldano and Vinnie?”
“Jack came in and took them
both down to the pit. The detective asked Jack to do the Cromwell case.”
“That’s curious,”
Laurie remarked. Jack usually shied away from cases that attracted a lot of
media attention, and the Cromwell case certainly fell into that category.
“He seemed genuinely
interested in it,” Riva said, as if reading Laurie’s mind. “He also
asked for the double suicide, which I didn’t expect. I had a feeling he had an
ulterior motive, but I have no idea what it could have been.”
“Do you happen to know if
any of the other techs are here yet? I’d like to get started myself with
McGillin.”
“I saw Marvin a few minutes
ago. He got coffee and went downstairs.”
“Perfect,” Laurie said.
She enjoyed working with Marvin. He’d been on evenings but had recently been
switched to days. “I’ll be in the pit if you need me.”
“I’m going to have to
assign you at least one more case. It’s an overdose. I’m sorry. I know you said
you had a bad night, but we’ve got a full schedule today.”
“That’s fine,” Laurie
assured her. She walked over to get the overdose folder. “Work’s a good way to keep
my mind off my problems.”
“Problems? What kind of
problems?”
“Don’t ask!” Laurie
said with a dismissive wave. “It’s the same old, same old with Jack, but
this morning I laid it on the line. I know I sound like a broken record, but
this time I mean it. I’m moving back to my own apartment. He’s going to have to
make a decision one way or the other.”
“Good for you,” Riva
responded. “Maybe it will give me strength.”
Along with sharing office space,
Laurie and Riva had become good friends. Riva’s boyfriend was as resistant to
commitment as Jack, but for different reasons, so she and Laurie had a lot to
talk about.
After momentarily debating
whether or not to have coffee and deciding not to, for fear that it would give
her a tremor, Laurie started off to find Marvin. Although she was going only
one floor down, she headed toward the elevator. She was exhausted from lack of
sleep, just as she knew she would be when she had been unable to fall back
asleep that morning. But instead of feeling irritated with herself, she was
content. She certainly wasn’t happy, because of her feelings for Jack, and she
knew she was going to be lonely, yet she felt she’d done what she had to do,
and in that way, she was satisfied.
When Laurie passed the forensic
investigators’ office, she leaned in and asked if Janice had left. Bart Arnold,
the chief investigator, told her she had but asked if he could help. Laurie
said she’d talk to her some other time and continued on her way. She had only
wanted to fill Janice in about the conversation she’d had with the McGillins.
She thought Janice would be interested. The fact that the case had penetrated
Janice’s usually thick emotional skin was what had intrigued Laurie in the
first place.
Marvin was in the mortuary
office, attending to his portion of the never-ending paperwork that engulfed
the OCME. He had already changed into green scrubs in anticipation of getting
down to work in the “pit,” the term everyone fondly used in referring
to the main autopsy room. He glanced up when Laurie appeared in the doorway. He
was an athletic-looking African-American with the most flawless skin Laurie had
ever seen. Laurie had been instantly jealous the first time she met Marvin.
Laurie was sensitive about her
complexion. Along with her blond coloring, she had a spattering of freckles
over the bridge of her nose as well as a scattering of other imperfections that
only she could see. Although Laurie had gotten brown hair with auburn
highlights from her father, her almost transparent skin and blue-green eyes
came from her mother.
“Are you ready to rock and
roll?” Laurie asked playfully. She knew from experience that she’d feel
better if she didn’t act tired.
“You’re on, sister!”
Marvin responded.
Laurie handed over the folders.
“I want to do McGillin first.”
“No problem,” Marvin
said, consulting the ledger for the location of the body.
Laurie first went into the
locker room to change into scrubs, then went over to the storage room to don a
“moon suit.” “Moon suit” was the term used by the staff to
describe the protective gear required while doing autopsies. They were
fashioned of completely impervious material, with attached hoods and full-face
masks. Air was brought into the suit through a HEPA filter by a self-contained
fan, powered by a battery that had to be charged each night. The suits were not
popular, since they made working more difficult, but everyone accepted the
handicap for peace of mind, except Jack. She knew that when Jack was on call on
weekends, he frequently dispensed with the moon suit on certain cases where he
felt the risk of an infectious agent was low. In those circumstances, he
revertedback to the traditional goggles and surgical facemask. The
techs seemed content to keep his secret. If Calvin found out, there would be
hell to pay.
After climbing into her gear,
Laurie retraced her steps to the central corridor, then walked down to the door
of the anteroom, where she washed and gloved. Thus prepared, she pushed into
the autopsy room.
Even after working at the OCME
for thirteen years, Laurie still savored the tingle of excitement she felt as
she entered what she considered to be the center of action. It certainly wasn’t
the visual experience, for in that regard, the tiled, windowless room with its
blue-white fluorescent lighting was cheerless. The eight stainless-steel tables
were dented and stained from countless postmortems. Over each hung an antiquated
spring-loaded scale. Along the walls were exposed piping, dated X-ray view
boxes, old-fashioned glass-fronted cabinets containing an array of grisly
instruments, and chipped soapstone sinks. More than a half century ago, it had
been a state-of-the-art facility and the pride of the OCME, but now it suffered
from lack of funds for both modernization and appropriate upkeep. Yet the
physical plant didn’t faze Laurie. The setting didn’t even register in her
mind. Her response was based on knowing that she would see or learn something
new every time she entered the room.
Of the eight tables, three were
occupied. One supported the corpse of Sean McGillin, or so Laurie surmised,
since Marvin was scurrying around it in his final preparations. The other two,
closest to where Laurie was standing, contained bodies in the middle of their
procedures. Directly in front of her lay a large, dark-skinned man. Four people
attired in moon suits identical to Laurie’s were working over him. Although
reflections off the curved plastic full-face masks made identification
difficult, Laurie recognized Calvin Washington. His six-foot, seven-inch,
two-hundred-fifty-poundframe was hard to conceal. The other one she thought was
Harold Bingham because of his contrasting short, stocky stature. The last two
had to be George Fontworth and the mortuary tech, Sal D’Ambrosio, but because
they were about the same size, she couldn’t tell them apart.
Laurie stepped over to the foot
of the table. Just in front of her was a drain emitting a rude sucking sound.
Water continuously ran down the surface of the table beneath the corpse to
carry away body fluids.
“Fontworth, where the hell
did you learn to use a scalpel?” Bingham growled.
It was now obvious which one of
the suited figures was George. He was on the patient’s right with his hands
somewhere down in the deceased’s retroperitoneal space, apparently trying to
trace the track of a bullet. Laurie couldn’t help but feel a stab of sympathy
for George. Whenever Bingham came into the autopsy room, he liked to assume the
professor role, but he invariably became impatient and annoyed. Even though
Laurie knew she could always learn from him, she disliked the aggravation of
working with him. It was too stressful.
Sensing that the atmosphere
around table one was too charged to ask any questions, Laurie moved down toward
table two. There she had no trouble recognizing Jack, Lou, and Vinnie.
Immediately, she sensed the atmosphere was the opposite, with some
semi-suppressed laughter dying away as she arrived. Laurie was not surprised.
Jack was famous for his black humor. The corpse was that of a thin, almost
emaciated, middle-aged female with brittle, bleach-blond hair. Laurie assumed
it was Sara Cromwell. Of particular note was the handle of a kitchen knife protruding
at an acute, cephalad angle from the upper, outer, anterior surface of her
right thigh. Laurie wasn’t surprised to see the utensil still in place. In such
cases, medical examiners preferred that such objects be left in situ.
“I hope you are showing reasonable
respect for the dead,” Laurie gibed.
“Never a dull moment,”
Lou responded.
“And I don’t know why I
keep laughing at the same jokes,” Vinnie complained.
“Tell me, Doctor
Montgomery!” Jack said in an exaggerated professorial tone. “In your
professional opinion, would you guess this penetrating entry into the thigh was
a mortal wound?”
Bending over slightly so she
could better access the point of entry, Laurie looked more closely at the
knife. It appeared to be a small kitchen paring knife, which she guessed had a
blade about four inches long, which had penetrated to the haft lateral to the
femur. More important, the entrance was inferior to the anterior iliac spine
but in line with it.
“I’d have to say it was not
fatal,” Laurie responded. “Its location suggests the femoral vessels
surely would have been spared, so bleeding would have been minimal.”
“And Dr. Montgomery, what
does the angle of entry of the weapon suggest?”
“I’d have to say it’s a
rather unorthodox way for someone to stab their victim.”
“There you go,
gentlemen,” Jack commented smugly. “We have confirmation of my
assessment by the eminent Dr. Montgomery.”
“But there was blood all
over the place,” Lou whined. “Where the hell did it come from? There
are no other wounds.”
“Ah-ha!” Jack said switching
to an exaggerated French accent, finger raised in the air. “I believe we
shall see in a few moments. Monsieur Amendola, le couteau, s’il vous
plaît!”
Despite the glare of the
overhead fluorescent lights off Vinnie’s face mask, Laurie caught him rolling
his eyes as he passed a scalpel into Jack’s waiting hand. He and Jack had a
curious relationship. Although it was based on mutual respect, they pretended
it was the opposite.
Leaving the three to their own
devices, Laurie moved on. She felt a mild disappointment that Jack could be so
offhand and flippant. She couldn’t help but think it wasn’t a particularly good
sign, as if he didn’t care.
Laurie made an effort to put the
problems with Jack out of her mind as she approached the next table. Stretched out
on its slightly angled surface was the body of a well-muscled male in his
mid-twenties, his head propped up on a wooden block. By reflex, she immediately
began the external exam. The individual appeared healthy. His visible skin,
although marble-white in death, was lesion-free.
His hair was thick and dark, and
his eyes were closed as if in repose. The only visible anomalies were a sutured
incision with a retained drain on his lower right leg, the capped-off end of an
intravenous line running into his left arm, and an endotracheal tube protruding
from his mouth, left over from the resuscitation attempt.
With Marvin still busy putting
labels on specimen jars, Laurie checked the body’s accession number and name.
Confident that she was dealing with Sean McGillin, she continued the external
exam, inspecting the IV site carefully. It looked entirely normal, with no
swelling or other evidence of extravasation of blood or IV fluid. She looked
more closely at the sutured wound on the leg, the site of the operation on the
fractured tibia and fibula. There was no swelling or discoloration there,
either, suggesting that there was no infection. The drain was sutured in place
with a single loose loop of black silk, and there was evidence of a minimal
discharge of serous fluid. The leg itself looked like the other leg, without
any outward signs of venous thrombosis or clotting.
“I didn’t see anything of
note externally,” Marvin said when he returned with a handful of sterile syringes and
specimen jars, some containing preservatives and some without. He placed them
all on the edge of the table to have them immediately available.
“So far, I’d have to
agree,” Laurie responded. There was a lot of give-and-take between the
techs and the doctors, although it varied, depending on the personalities.
Laurie always encouraged comments and suggestions, especially from Marvin. As
far as she was concerned, the techs were a rich source of experience.
Marvin went over to the
glass-fronted cabinets to get the required instruments. Despite the hum of her
ventilation fan, Laurie could hear whistling. He was always cheerful, which was
another thing she liked about him.
After checking for signs of
intravenous drug use and not finding any, Laurie used a nasal speculum to look
inside Sean’s nose. There was no suggestion of cocaine use. With a mysterious
death, drugs had to be considered, despite what his parents had said to the
contrary. Next, she opened the eyelids to examine the eyes. They appeared
normal, with no hemorrhages on the sclera. Opening the mouth, she made sure the
endotracheal tube was in the trachea and not the esophagus. Laurie had seen
that on a few occasions with the predictable disastrous results.
With all his preparations
complete, Marvin came back to the side of the table opposite Laurie and stood
expectantly, waiting for the internal part of the autopsy to begin.
“All right! Let’s do
it!” Laurie said, reaching out with her hand as Marvin handed her a
scalpel.
Although Laurie had done
thousands of postmortems, each time she started another, it gave her a tingle
of excitement. Starting the actual autopsy was akin to opening a sacred book,
the mysteries of which she was about to discover. With her index finger
pressing down on the top of the scalpel, Laurie expertly made the usual
Y-shaped incision, starting from the points of the shoulders, meeting
mid-sternum, and then continuing down to the pubis. With Marvin’s help, she
quickly reflected skin and muscle before removing the breastbone with bone
cutters.
“Looks like a broken rib,”
Marvin commented, pointing to a defect on the right side of the chest.
“No hemorrhage, so it was
postmortem, probably from the resuscitation attempt. Some people go overboard
with the chest compressions.”
“Ouch!” Marvin said
sympathetically.
Expecting blood clots or other
emboli, Laurie was eager to examine the great veins leading to the heart, the
heart itself, and the pulmonary arteries, where fatal clots would usually be
found. But she resisted the temptation. She knew that it was best to follow a
normal protocol, lest something be forgotten. Carefully, she examined all the
internal organs in situ, then used the syringes Marvin had laid out to take
fluid samples for toxicological testing. A fatal reaction to a drug, toxin, or
even an anesthetic agent had to be considered. Less than twenty-four hours had
elapsed since the deceased had undergone anesthesia.
Laurie and Marvin worked
together in silence, making certain that each sample was put into the correctly
labeled specimen container. Once the fluid samples had been obtained, she began
to remove the internal organs. Diligently, she maintained the normal sequence,
and it wasn’t until a bit later that she finally turned her attention to the
heart.
“Here comes the
money!” Marvin quipped.
Laurie smiled. The heart was
indeed where she expected to find the pathology. With a few deft strokes, the
heart came out. She peered into the cut end of the vena cava, but there was no
clot. She was disappointed, since she had already noted that the pulmonary
arteries had been clear when she’d removed the lungs.
Laurie weighed the heart, then
with a long bladed knife, began an internal examination. To her chagrin, there was
nothing amiss. There was no clot, and even the coronary arteries appeared
entirely normal.
Laurie and Marvin’s eyes met
across the opened corpse.
“Damn!” Marvin
exhaled.
“I’m surprised,”
Laurie said. She took a deep breath. “Well, you see to the gut and I’ll
take my micro samples, then we’ll check the brain.”
“You got it,” Marvin
said. He took the stomach and the intestines over to the sink to wash them out.
Laurie took multiple tissue
samples for microscopic study, particularly from the heart and the lungs.
Marvin returned the cleaned gut
to Laurie, who went through it carefully, taking samples as she proceeded.
Meanwhile, Marvin started on the head by reflecting the scalp. By the time
Laurie was finished with the stomach and intestines, Marvin was ready for her
to inspect the skull. She gave him a thumbs-up when she was through, and he
hefted the power-vibrating saw to cut through the bone just above the ears.
While Marvin was busy with the
skull, Laurie took a scissors and opened the sutured wound on the lower leg.
All looked fine within the surgical site. She then opened the long veins of the
legs, tracing them from the ankles all the way up into the abdomen. There were
no clots.
“The brain looks normal to
me,” Marvin commented.
Laurie nodded. There was no
swelling and no hemorrhage, and the color was normal. She felt it with her
practiced finger. It felt normal as well.
A few minutes later, Laurie had
the brain out, and she dropped it into a pan that Marvin held. She checked the
cut ends of the carotid arteries. Like everything else, they were normal. She
weighed the brain. Its weight was within the normal limits.
“We’re not finding
anything,” she said.
“I’m sorry,” Marvin
said.
Laurie smiled. On top of his
other good qualities, he was empathetic. “You don’t need to apologize.
It’s not your fault.”
“It would have been nice to
find something. What are you thinking now? It doesn’t look like he should have
died.”
“I haven’t the slightest
idea. I’ll hope the microscopic can shed some light, but I’m not optimistic.
Everything looks and feels so normal. Why don’t you start winding things up
while I section the brain. I can’t think of anything else to do.”
“You got it,” Marvin
said cheerfully.
As Laurie anticipated, the
interior of the brain looked like its exterior. She took the appropriate
samples, then joined Marvin to suture up the body. With both of them working,
it took only a few minutes.
“I’d like to get my next
case up as soon as possible,” Laurie said. “I hope you don’t
mind.” She was afraid that once she sat down, her fatigue would return
with a vengeance. At the moment, she was feeling better than expected.
“Not at all,” Marvin
said. He was already straightening up.
Laurie looked around the pit.
She’d been so engrossed that she hadn’t seen all the activity. At that point,
all eight tables were in use, with at least two and sometimes more people
clustered about each. She glanced toward Jack’s table. He was bent over the
head of another woman’s body. Apparently, he’d finished with Sara Cromwell, and
Lou had left. Beyond Jack’s table, Calvin was still at work with Fontworth on
the same body they were working on before. Bingham had apparently left to give
his news conference.
“How long will the
turnaround take?” Laurie asked Marvin as he carried the specimen bottles
away.
“Not long at all.”
Laurie wandered toward Jack with
mixed feelings. She was notprepared for more of his levity, but after the earlier
tease about Cromwell, she was curious about what he’d discovered. Laurie
stopped at the foot of the table. Jack was concentrating intently on making a
mold of a lesion on the woman’s forehead, just within the hairline. Laurie
stood for a moment, waiting for him to acknowledge her presence. Vinnie had
looked up immediately and had at least given a restrained wave.
“What did you find on your
first case?” Laurie asked finally. It seemed unlikely that he hadn’t seen
her, but it had to have been the case. She didn’t want to think otherwise.
Another few minutes went by
without Jack responding. She glanced back at Vinnie, who spread his hands out,
palms up, and shrugged his shoulders as if to indicate that there was no accounting
for Jack’s behavior. Laurie stood for another beat, uncertain of what to do
before moving on. Although she was aware that Jack could become so engrossed as
to be oblivious of his surroundings, it was demeaning for her to stand there.
Things were not much better at
Fontworth’s table. Even though Bingham had left, Calvin was riding poor
Fontworth with equivalent venom as the case dragged on interminably. After a
quick glance at the other five tables, Laurie gave up on socializing and
returned to lend Marvin a hand.
“I can get one of the other
techs to help,” Marvin said. He’d brought in a gurney and positioned it
next to the table.
“I don’t mind,” Laurie
said. There had been a time not too long ago that between cases, the examiners
would go upstairs either to the ID room or the lunchroom for a quick coffee and
impromptu discussions. But with the more elaborate protection apparatus they
were required to wear, it was too much effort.
Once Sean McGillin’s remains had
been placed in the walk-in cooler, Marvin led Laurie to the appropriate
compartment for the next case, a man named David Ellroy. The moment Marvin
pulledout
the drawer to reveal the body of thin, undernourished, middle-aged
African-American, Laurie remembered that it was a presumed overdose. Her
trained eye immediately took in the scars and tracks on the man’s arms and legs
from his intravenous habit. Although Laurie was accustomed to overdose cases,
they still had the power to evoke an emotional reaction. With less than the
usual control over her thoughts, her mind yanked her back to a crisp, clear,
flag-snapping October day in I975 when she’d rushed home from her high school,
the Langley School for Girls. She lived with her parents in a large, prewar
flat on Park Avenue. It was the Friday before the long Columbus Day weekend,
and she was excited because her brother, Shelly, her only sibling, had come
home the night before from Yale, where he was a freshman.
As Laurie had gotten off the
elevator in their private lobby, she sensed a disturbing stillness. None of the
usual sounds issued forth from the laundry room door vent. Entering the
apartment proper, she called Shelly’s name while she stashed her books on the
console table in the foyer before cutting through the kitchen. When she didn’t
see Holly, she was momentarily relieved, remembering it was their maid’s day
off. Yelling out Shelly’s name again, she glanced in the den beyond the family
room. The TV was on without sound, which heightened her uneasiness. For a
moment, she watched the antics of a midday game show, wondering why the TV
would be on without sound. Resuming her tour of the apartment, she called out
Shelly’s name yet again, convinced that someone had to be home. As she passed
the formal living room, she began to move faster, sensing a secret urgency.
Shelly’s door was closed. She
knocked, but there was no answer. She knocked again before trying the door. It
was unlocked. She pushed it open only to see her beloved brother stretched out
on the carpet, clad in only his briefs. To her horror, bloody froth oozed from
his mouth, and his overall color was as pale as the bone china in thedining-room
breakfront. A tourniquet was loosely looped about his upper arm. Near his
half-open hand was a syringe. On the desk was a glassine envelope, which Laurie
guessed contained the speedball, a mixture of heroin and cocaine he’d bragged
about the night before. Laurie had taken it all in instantly before dropping to
her knees to try to help.
With some difficulty, Laurie
pulled herself back to the present. She didn’t want to think about her vain
attempt to resuscitate her brother. She didn’t want to remember how cold and
lifeless his lips felt when she touched them with her own.
“Can you help move him over
onto the gurney?” Marvin asked. “He’s not very heavy.”
“Certainly,” Laurie
said, glad to be of use. She put down David’s folder and lent a hand. A few
minutes later, they were on their way back to the autopsy room. Inside, when
Marvin maneuvered the gurney next to the table, one of the other techs helped
Marvin get the body onto the table. Laurie could see the dried remains of a
bloody froth that had issued from David’s mouth, and the image drew her back
into her disturbing reverie. It wasn’t her failed attempt to resuscitate her
brother that occupied her thoughts, but rather the confrontation she had to
endure with her parents a number of hours later.
“Did you know your brother
was using drugs?” her father had demanded. His face was purple with rage
and was mere inches away from Laurie’s face. His thumbs dug into her skin where
he held her upper arms. “Answer me!”
“Yes,” Laurie blurted
through tears. “Yes, yes.”
“Are you using drugs,
too?”
“No!”
“How did you know he
was?”
“By accident: I found a
syringe he’d gotten from your office in his shaving bag.”
There was a momentary silence as
her father’s eyes narrowed and his lips stretched out in a thin, cruel line.
“Why didn’t you tell us,” he growled. “If you told us, he’d be
alive.”
“I couldn’t,” Laurie
sobbed.
“Why?” he shouted.
“Tell me why!”
“Because …” Laurie
cried. She paused, then added: “Because he told me not to. He made me
promise. He said he’d never talk to me again if I did.”
“Well, that promise killed
him,” her father hissed. “It killed him just as much as the damn
drug.”
A hand gripped Laurie’s arm and
she jumped. She turned to look at Marvin.
“Anything special you want
for this case,” Marvin asked, motioning toward David’s corpse. “It
looks pretty straightforward to me.”
“Just the usual,”
Laurie said. As Marvin went to get the necessary supplies, Laurie took a deep
breath to get herself under control. Intuitively, she knew she had to keep her
mind busy to keep it from dredging up other bad memories. Opening the folder
she had in her hand, she searched through the papers to find Janice’s forensic investigator
report and began reading. The body had been found along with drug paraphernalia
in a Dumpster, suggesting that David had died at a crack house and had been
thrown out with the rest of the trash. Laurie sighed. Dealing with such a case
was the negative side of her job.
An hour later and back in her
street clothes, Laurie stepped into the back elevator. The overdose case had
been routine. There had been no surprises; David Ellroy had shown the usual
signs of asphyxial death with a frothy pulmonary edema. The only mildly
interesting finds were multiple, tiny, discrete lesions in various organs,
suggesting that he had suffered numerous episodes of infection from his habit.
As the antiquated elevator
clunked upward toward the fifth floor, Laurie thought about Jack. When she’d
finished with David Ellroy, he had already started his third case. Between his
second and third, he’d gone out of the room, pushing the gurney with Vinnie
steering. Even from where she was standing, Laurie could hear the usual banter.
Five minutes later, they’d both reappeared, bringing in the new case while
carrying on with the same wisecracking behavior. They then proceeded to
transfer the body to the table and go through the setup before starting the
post. At no time through any of this did Jack make an attempt to come over to
Laurie’s table, engage her in conversation in any way, or even look in her
direction. Laurie shrugged. Whether she wanted to admit it or not, it was
becoming obvious that he was actively ignoring her. Such behavior was
uncharacteristic. For the nine years she’d known him, he’d never been
passive-aggressive.
Before Laurie went to her
office, she stopped in the histology lab. In addition to the case folders, she
was carrying a brown paper bag containing the tissue and toxicology samples
from McGillin. It didn’t take her long to locate the supervisor, Maureen
O’Conner. The full-bodied, busty redhead was sitting at a microscope, checking
a tray of slides. She looked up as Laurie approached. A knowing smile spread
across her heavily freckled face.
“Now, what have we
here?” Maureen questioned with her heavy brogue. She looked from Laurie to
the bag Laurie was carrying. “Let me guess: tissue samples whose slides
you desperately need yesterday.”
Laurie smiled guiltily. “Am
I really that predictable?”
“With you and Dr.
Stapleton, it’s always the same story. Whenever you two come in here, you’ve
got to have the slides immediately. But let me remind you of something, sister:
Your patients are already dead.” Maureen laughed heartily, and a few of
the other histology techs who’d overheard joined in.
Laurie found herself chuckling
as well. Maureen’s ebullience was infectious, and it never varied, despite the
lab being chronically understaffed due to OCME budgetary restraints. Laurie
opened the bag, took out the tissue samples, and lined them up on the counter
next to Maureen’s microscope. “Maybe if I told you why I’d like these
sooner rather than later, it might help.”
“As busy as we are around
here, a few extra hands would be more helpful than talk, but fire away.”
Laurie pulled out all the stops,
knowing there was no professional reason for what she was asking. She started
by describing how sympathetic Dr. and Mrs. McGillin were, and how their
deceased son seemed to have been their whole life. She even mentioned the son’s
imminent marriage and the parents’ hope for grandchildren. She then admitted
that she had promised to provide the couple the cause of their son’s death that
morning to help their grieving. The problem was that the autopsy had failed to
confirm her clinical impression. Thus, she needed the slides in hopes the
answers would be forthcoming. What she didn’t explain were her personal
reasons for taking on this mini-crusade.
“Well, that’s quite a
touching story,” Maureen said softly. She took a deep breath and then
gathered up the samples. “We’ll see what we can do. I promise you we’ll
give it a go.”
Laurie thanked her and hurried
out of histology. She glanced at her watch. It was already after eleven, and
she wanted to call Dr. McGillin before noon. Taking the stairs, she descended a
floor and walked into the toxicology lab. Here, the atmosphere was different
than in the histology lab. Instead of a babble of voices, there was the
continual hum of the sophisticated and mostly automated equipment. It took
Laurie a few moments to locate anyone. To her relief, she saw Peter Letterman,
the assistant director. If it had been the lab director, John DeVries, Laurie
would have walked out. She and John had gotten off on the wrong foot back when
Laurie desperately needed quicker results on a series of cocaine overdose cases
and had badgered the man. That was thirteen years earlier, when Laurie had
first started at the OCME, and John had held on to his animosity like a dog
with a bone. Laurie had long ago given up trying to make amends.
“My favorite ME,”
Peter said happily, catching sight of Laurie. He was a thin, blond man with
androgynous features and almost no beard. He wore his long hair in a ponytail,
and although he was pushing forty, he could still pass as a teenager. In
contrast to John, he and Laurie got along famously. “You have something
for me?”
“Indeed I do,” Laurie
said. She handed over the bag while warily looking around for John.
“The Führer is down in the
general lab, so you can relax.”
“It’s my lucky day,”
Laurie commented.
Peter glanced in at the sample
bottles. “What’s the scoop? What am I looking for and why?”
Laurie told a shorter version of
the same story she’d related to Maureen. At the end, she added: “I don’t
really expect you to find anything, but I’ve got to be complete, especially if
the microscopic doesn’t show anything.”
“I’ll see what I can
do,” Peter said.
“I appreciate it,”
Laurie responded.
After climbing back up the
single flight of stairs, Laurie walked down the corridor toward her office. She
passed Jack’s office, with its door ajar, but neither Jack nor his officemate,
Chet McGovern, were inside. Laurie assumed that they were both still down in
the pit. Coming into her own office, she immediately caught sight of her
suitcase that she’d brought from Jack’s. Although she hadn’t forgotten the
morning’s confrontation, seeing the suitcase brought it back with unpleasant
clarity. It also didn’t help that she felt let down by not finding a smoking
gun during Sean McGillin’s autopsy. The more she thought about it, the more
surprising it was.
How could an ostensibly healthy
twenty-eight-year-old man die and the cause not be apparent from a combination
of a detailed history and the autopsy? In some respects, the case was mildly
shaking her belief in forensic pathology.
“That microscopic better
come through!” Laurie voiced out loud as she sat down at her desk. She was
emphatic but didn’t quite know how she would act on the threat if the
microscopic failed to live up to her expectations. Leaning over, she added the
folders from the morning’s cases to her sizable unfinished pile. It was
Laurie’s job on each case to collate all the material from the autopsy, from
the forensic investigators, from the laboratories, and from any other source
she needed to come up with a cause and manner of death. The meaning of
“cause” was obvious, whereas “manner” referred to whether
the death was natural, accidental, suicidal, or homicidal, each with specific legal
ramifications. Sometimes it took weeks for all the material to be available.
When it was, Laurie had to make her decision about the cause and manner on a
preponderance of evidence, meaning she had to be at least fifty-one percent
certain. Of course, in the vast majority of cases, she was close to or at one
hundred percent certain.
Laurie took the sheet of paper
containing Dr. McGillin’s phone number from her pocket and smoothed it out on
the blotter in front of her. Although she was reluctant to call him, she knew
she had to make good on her promise. The problem was, Laurie was not good at
any type of confrontation. It was a given that he was going to be even more let
down, as there was, as of yet, no ostensible cause for his son’s untimely
death.
With her elbows on her desk, she
leaned forward to massage her forehead while staring at the Westchester number.
She tried to think of what to say in hopes of mitigating the impact. For a
fleeting moment, she considered handing the situation over to the public
relations department as she was supposed to do, but she quicklyruled that out,
since she had specifically offered to make the call herself. While her mind was
struggling over her prospective wording, she found herself thinking about the
victim’s first name, Sean, since it was the name of a college boyfriend.
Sean Mackenzie had been a
colorful fellow Wesleyan University student who’d appealed to Laurie’s
rebellious side. Although he wasn’t exactly a hoodlum, he’d been a bit over the
edge with his motorcycle, artistic craziness, and outlaw behavior, including
mild drug use. At the time the whole package had excited Laurie and driven her
parents to distraction, which was part of the attraction. But the on-again,
off-again relationship had been unhealthily mercurial from the start, and
Laurie had finally put an end to it just before joining the OCME. Now, with her
relationship with Jack in question, she vaguely thought about calling Sean,
since she knew he was living in the city and had become a rather successful
artist. But she quickly nixed the idea. There was no way she wanted to reopen
that Pandora’s box.
“A penny for your
thoughts?” a voice asked.
Laurie’s head popped up. Filling
her doorway was Jack’s athletic, six-foot frame. He was the picture of relaxed
informality in his lived-in chambray shirt, knitted tie, and faded jeans.
“Let’s up that to a
quarter,” he added. “There’s been significant inflation since I
learned that phrase, and I know how valuable your thoughts are.” An impish
smirk dimpled his cheeks. His lips were pressed together into a thin line.
Laurie regarded her friend of at
least a decade and lover of nearly four years. His irreverent gaiety and
sarcasm could at times be wearing, and this was one of them. “So you’re
deigning to speak with me now?” she questioned with an equally affected
tone.
Jack’s smile faltered. “Of
course I’m going to talk with you. What kind of question is that?”
“Except for that brief
professorial game when I first came into the autopsy room, you’ve been ignoring
me all morning.”
“Ignoring you?” Jack
questioned with knitted brows. “I think I should remind you we came to
work separately, which was more your decision than mine, arrived at different
times, and since then, we’ve been working on our own cases.”
“We work most days, and
most days we communicate almost continuously, particularly when we are in the
same room. I even went over to your table during your second case and asked you
a direct question.”
“I didn’t see or hear you.
Scout’s honor.” Jack held up his index and middle finger in the form of a
V. His smile returned.
Laurie arched her eyebrows and
shrugged. She was being provocative by suggesting that she didn’t believe him,
but she didn’t care. “Fine and dandy, and now I have more work to
do.” She turned her attention back to the sheet with the Westchester phone
number.
“No doubt,” Jack said,
refusing to rise to the bait or be dismissed. “How were your cases this
morning?”
Laurie looked up but not at
Jack. “One was routine and rather uninteresting. The other was
disappointing.”
“In what regard?”
“I’d promised a couple
whose son died at the Manhattan General to find out what killed him and let
them know immediately, but the autopsy was clean; there was no gross pathology
whatsoever. Now I’ve got to call and say we have to wait for the microscopic to
be available. I know they are going to be disappointed, and I am, too.”
“Janice briefed me on that
case,” Jack said. “You didn’t find any emboli?”
“Nothing!”
“And the heart?”
Laurie looked back at Jack.
“The heart, the lungs, and the great vessels were all completely
normal.”
“I’ll wager you find
something with the heart’s conduction system or maybe micro emboli in the
brainstem. You took adequate samples for toxicology? That would be my second
thought.”
“I did,” Laurie said.
“I’d also kept in mind he’d had anesthesia less than twenty-four hours
ago.”
“Well, sorry your cases
were a letdown. Mine were the opposite. In fact, I’d have to say they were
fun.”
“Fun?”
“Truly! Both turned out to
be the absolute opposite of what everybody thought.”
“How so?”
“The first case was this
well-known psychologist.”
“Sara Cromwell.”
“Supposedly, it was a
brutal murder during a sexual assault.”
“I saw the knife,
remember?”
“That was what threw
everybody for a loop. You see there was no other wound, and she hadn’t been
raped.”
“How could all the blood
that was described come from that single, nonfatal stab wound?”
“It didn’t.”
Jack stared at Laurie with a
slight smile of anticipation. Laurie stared back. She was in no mood to play
games. “So where did it come from?”
“Any ideas?”
“Why don’t you just tell
me?”
“I think you’d be able to
guess if you thought about it for a minute. I mean, you did look at how gaunt
she was, didn’t you?”
“Jack, if you want to tell
me, tell me. Otherwise, I have to make my call.”
“The blood was from her
stomach. It turns out there was a fatal engorgement of food, causing a rupture of her stomach
and the lower part of her esophagus. Obviously, the woman had bulimia, and
pushed herself over the edge. Can you believe it? Everybody was convinced it
was homicide and it turns out to be accidental.”
“What about the knife
sticking out of her thigh?”
“That was the real teaser.
It was self-inflicted, but not on purpose. In her final moments, while she was
puking blood and putting away the cheese, she slipped on her own blood and fell
on the knife she was holding. Isn’t it too much? I tell you: This is going to
be a good case to present at our Thursday conference.”
For a moment, Laurie stared at
Jack’s satisfied face. The story had touched a chord in her inner life. There
had been a time when she’d had self-esteem problems after her brother’s death,
causing her to have a brush with anorexia and bulimia. It was a secret she
hadn’t shared with anyone.
“And my next two cases were
equally intriguing. It was a double suicide. Did you hear about it?”
“Vaguely,” Laurie
responded. She was still thinking about bulimia.
“I tell you, I have to give
old Fontworth credit,” Jack said. “I’d always considered him less
than meticulous, but last night he seemed to have done a bang-up job. With the
double suicide, he found a heavy Mag-Lite flashlight on the front seat of the
SUV along with the victims and was smart enough to bring it with the bodies. He
also noted the driver’s-side door was ajar.”
“What was important about
the flashlight?” Laurie asked.
“Plenty,” Jack
replied. “First of all, let me say I was a bit suspicious when there was
only one suicide note. In double suicides, it’s usual to have two notes or one
that is written by both parties. I mean, it makes sense, since they are doing
it together. Anyway, that put up a red flag. Since the note was presumably from
the woman, I elected to autopsy her first. What I expected to find after the
factwas
something toxicological, like a knock-out drug or the like. I didn’t expect to
find anything on gross, but I did. She had a literal indentation on her
forehead just above the hairline that was curiously curved.”
Jack paused. His smile returned.
“Don’t tell me the
flashlight and the indentation matched.”
“You got it! A perfect match!
It seems that the whole affair was an elaborate setup by the husband, who had
prepared the scene and probably even wrote the note. After he knocked out his
wife, got her into the passenger seat of the SUV, and started the engine, he
probably went back in the house to wait. When he thought enough time had
passed, he returned to check that his wife was dead, but didn’t realize how
quickly one can succumb to carbon monoxide if the level is high enough.
Climbing behind the wheel, he rapidly fell unconscious and ended up joining his
wife.”
“What a story!” Laurie
commented.
“Isn’t it ironic? I mean,
it was supposed to be a double suicide, and instead the manner of death turns
out to be homicidal for the wife and accidental for the husband. Forensic
pathology certainly can surprise.”
Laurie nodded. She distinctly
remembered having the same thought before she started her overdose case.
“Even the police case is
turning out to be opposite of what was expected.”
“How so?” Laurie
asked.
“Everybody has been
assuming it was a case of justifiable homicide by the police, since the police
acknowledged shooting him a number of times, but Calvin just told me that as
near as they can determine, it was suicide. They’ve been able to ascertain that
the victim shot himself through the heart before he was hit by any of the
police rounds.”
“That should help quiet the
neighborhood.”
“We should hope,” Jack
said. “Anyway, it was an interesting morning, to say the least, and I just
thought you’d like to hear that we’ve had a rash of cases this morning where
the manner of death was the opposite of what was expected. With that said, are
you going to pop down for some lunch soon?”
“I don’t know. I’m not
terribly hungry, and I’ve got a lot to do.” “Well, maybe I’ll catch
you down there. If not, I’ll see you later.” Laurie waved at Jack as he
disappeared down the hall. She turned her attention back to Sean McGillin Sr.’s
phone number. She thought about what Jack had said about forensic surprises and
considered what that could mean for Sean McGillin Jr. She’d expected his manner
of death to be natural, a fatal clot or fat emboli or even a congenital
anomaly. Since she’d not found anything of the kind, at least so far, she was
now entertaining the idea that the cause of death could’ve been accidental,
such as an unexpected late complication with anesthesia. But if the cause of
death were to be truly opposite, like the cases Jack had just described, it
would have to have been homicidal.
Laurie mulled the idea. It
seemed far-fetched, but then she thought about Sara Cromwell and how only
minutes earlier, she would have thought it totally far-fetched that her manner
of death was accidental. Sean Jr.’s autopsy had already surprised her with its
lack of findings. Could the case surprise her once more? She doubted it, but
then again, she couldn’t rule it out completely.
four
DESPITE LAURIE’S CONCERNS to the
contrary, the phone conversation with Dr. McGillin turned out be surprisingly
civil. He had accepted that the autopsy had failed to show any pathology with
unexpected equanimity. It was as if he had taken the information as a
compliment about his adored son, corroborating the idea that the boy was indeed
perfect, inside and out.
Having expected to be angrily
chastised for not delivering on her promise, or at the very least anticipating
having to weather passive-aggressive disappointment, Laurie felt even more
beholden to the man when he maintained his composure. He had even gone to the
extent of thanking her for her efforts on his son’s behalf and for spending
time with them in their hour of need. If she had beenwilling before to
bend the rules by providing the man with the cause of his son’s demise, she’d
now become determined to get him that information.
After hanging up the phone with
Sean Sr., Laurie spent some time pondering the case while staring blankly ahead
at her cork-board with its various notes, reminders, and business cards. She
tried to think of a way to speed up the process, but her hands were tied. She
had to wait for Maureen and Peter, and hope that they would respond to her
appeal.
Time melted away effortlessly.
Riva came in and said hello as she dumped folders on her desk and took her
seat. Laurie returned the greeting by reflex without turning around. Her mind
by then had switched to Jack and his irritatingly insouciant joviality, and
what that meant about their relationship. Although she hated to admit it, it
was becoming progressively apparent that he was happy she’d decided to leave.
In a circular fashion, thoughts
of Jack brought her back to Sean Jr.’s case as she recalled Jack’s comments
about forensics occasionally revealing that the causation and manner of death
were the opposite of what was assumed. Laurie again considered the possibility
that Sean’s death could have been a homicide. She couldn’t help but remember
several infamous episodes of serial homicides that had occurred in healthcare
institutions, particularly one rather recently that had continued undetected
for an unconscionably long time. Such a scenario had to be considered, although
she recognized that all the involved patients in those series were aged,
chronically ill individuals and that there was an inkling of an imaginable,
albeit sick motive. Not one of the victims had been a vigorous, healthy
twenty-eight-year-old whose whole life was still ahead of him.
Laurie was certain that homicide
was extremely implausible, and she wasn’t going to worry about it, especially
since Peter’s toxicology screen would pick up an overdose of insulin or digoxin
oranother
potentially lethal drug akin to those implicated in the previous institutional
murders. After all, that was what the toxicology screen was all about. In her
mind, Sean Jr.’s death had to be either natural, which was most probable, or
accidental. Yet what was she going to do if the microscopic and the
toxicological turned out to be negative? Such a concern seemed reasonable,
considering the autopsy itself had been so surprisingly clean. From her
experience, it was rare not to find some pathology, even in a twenty-eight-year-old,
and even if the abnormalities were not associated with the demise.
To prepare for such an
eventuality, Laurie needed as much information as possible. Although the usual
course of action in such a case would be to wait for the microscopic and the
toxicological to come back, she decided to be proactive to save time.
Impulsively, she snatched the receiver and called down to the forensic
investigator’s office. Bart Arnold picked up on the second ring.
“I posted a Sean McGillin
this morning,” Laurie said. “He was an inpatient over at the
Manhattan General. I’d like to get a copy of his hospital chart.”
“I’m aware of the case. Did
we not get what you need?”
“The forensic
investigator’s report is fine. To be honest, I’m on a fishing expedition. The post
was negative, and I’m a little desperate. There’s kind of a time
constraint.”
“I’ll put the request in
immediately.”
Laurie replaced the receiver
while racking her brain in hopes of coming up with something else that would be
useful if everything turned out to be negative.
“What’s wrong?” Riva
asked. She had swung around in her desk chair after overhearing Laurie’s
conversation with Bart. “Knowing how tired you are, I thought I’d given
you straightforward cases. I’m sorry.”
Laurie assured her officemate
that she needn’t apologize. Laurie admitted that she was creating a problem
when there really wasn’t one, probably to keep from obsessing about her social
life.
“Do you want to talk about
it?”
“You mean my social
life?”
“I mean Jack and what you
did this morning.”
“Not particularly,”
Laurie responded. She waved a hand as if swatting a nonexistent fly.
“There’s not much to say that you and I haven’t hashed over before ad
nauseam. The reality is that I don’t want to be stuck in a never-never-land
relationship, which is what I’ve been settling for over the last couple of
years. I want a family. It’s that simple. I guess what’s really irking me is
that Jack is being such an ass by acting so blasted cheerful.”
“I’ve noticed,” Riva
agreed. “I think it is an act.”
“Who’s to know,”
Laurie responded. She laughed at herself. “I’m pathetic! Anyway, let me
tell you about the McGillin case.” Quickly, Laurie related the whole
story, including the details of the conversations she’d had with the parents
and then subsequently with Jack.
“It’s not going to be a
homicide,” Riva said emphatically.
“I know!” Laurie
agreed. “What’s bothering me at this point is not being able to live up to
the promise I made to the parents. I was so sure I’d be able to tell them today
what killed their boy, and now I have to sit on my hands and wait for Maureen
and Peter. My compulsiveness is driving me batty.”
“If it’s any consolation,
my opinion is that Jack was right about the microscopic being the key. I think
you’ll find the pathology in the heart, especially with a strong family history
of elevated LDH and heart disease.”
Laurie started to concur, but
her phone rang. Twisting around, she answered it, expecting some quick tidbit
of information on one of her cases, which is what the vast majority of her
calls were about.
Instead, her eyebrows arched in
surprise. Covering the mouthpiece, she looked back at Riva and whispered.
“You’re not going to believe it! It’s my father!”
Riva’s face reflected equal
disbelief. She hastily motioned for Laurie to find out the occasion for the
call. Phone contact was restricted to Laurie’s mother, and that was rarely at
work.
“I’m sorry to disturb
you,” Dr. Sheldon Montgomery said. He spoke in a resonant voice with a
hint of an English accent, despite his never having lived in Great Britain.
“You’re not disturbing
me,” Laurie answered. “I’m sitting here at my desk.” She was
intensely curious why her father was calling, but resisted the temptation to
ask directly, fearful such a question would sound too unfriendly. Their
relationship had never been anything special. As a self-absorbed, workaholic
cardiac surgeon who’d demanded perfection from everyone, including himself,
he’d been emotionally distant and generally unavailable. Laurie had tried
vainly to break through to him, constantly pushing herself to excel at school
and in other activities, which is what she thought he wanted. Unfortunately, it
never worked. Then came her brother’s untimely death, which Sheldon blamed on
her. What little relationship they’d had deteriorated even further.
“I’m at the hospital,”
he said. His tone was matter-of-fact, as if he was telling her the weather.
“I’m here with your mother.”
“What is Mother doing at
the hospital?” Laurie asked. For Sheldon to be at the hospital was not out
of the ordinary. Although he was retired from private practice now that he was
in his early eighties, he still frequently went to the hospital. Laurie had no
idea what he did. Her mother, Dorothy, never went to the hospital despite being
active in various hospital fund-raising activities. The last time Laurie
remembered her mother being in the hospital was for her second facelift fifteen
years earlier, and even then, Laurie had learned of the admission after the
fact.
“She had surgery this
morning,” Sheldon said. “She is doing fine. In fact, she is rather
chipper.”
Laurie sat up a bit straighter.
“Surgery? What happened? Was it an emergency?”
“No. It was a scheduled
procedure. Unfortunately, your mother had a mastectomy for breast cancer.”
“My word!” Laurie managed.
“I had no idea. I just spoke with her on Saturday. She didn’t mention
anything about surgery or cancer.”
“You know your mother, and
how she likes to ignore unpleasant issues. She was particularly insistent on
shielding you from unnecessary concern until this was behind her.”
Laurie looked at Riva with
disbelief. As close as their desks were in the small office, Riva could hear
both sides. Riva rolled her dark eyes and shook her head.
“What stage was the
cancer?” Laurie asked solicitously.
“A very early stage with no
apparent nodal involvement,” Sheldon said. “Things are going to be
fine. The prognosis is excellent, although she’ll have to undergo further
treatment.”
“And you say she is doing
well?”
“Very well indeed. She’s
already taken some nourishment orally, and she’s back to her old self by being
genuinely demanding.”
“Can I speak with
her?”
“Unfortunately, that would
be rather difficult. You see, I’m not in the room at the moment. I’m at the
nurses’ station. I was hoping you’d be able to come over here to see her this
afternoon. There is an associated aspect to all this that I would like to
discuss with you.”
“I will be right
over,” Laurie said. She hung up the phone before turning back to Riva.
“Is it true you had no idea
about any of this?” Riva asked.
“Not a clue. There wasn’t
even the slightest hint. I don’t know whether to be angry, hurt, or sad.
Actually, it’s pathetic.
What a dysfunctional family! I
can’t believe it. I’m almost forty-three and a doctor, and my mother still
treats me like a child about illness. Can you imagine, she wanted to shield me
from unnecessary concern?”
“Our family is just the
opposite. Everybody knows everything about everybody. It’s the opposite
extreme, but I don’t advocate it, either. I think the best is somewhere in
between.”
Laurie got up and stretched. She
waited for a moment of dizziness to pass. Her fatigue had come back with a
vengeance after sitting at her desk. She then got her coat from behind the
door. When she considered the differences between her family and Riva’s, she
thought she would pick Riva’s, although she certainly wouldn’t choose to live
at home like Riva did. She and Riva were the same age.
“Want me to answer your
phone?” Riva asked.
“If you won’t mind,
especially if it’s either Maureen or Peter. Leave any messages on my
corkboard.” Laurie got out a package of Post-its and plopped them on her
blotter. “I’ve got to come back here. I’m not going to take my suitcase
with me.”
Laurie stepped into the hall and
briefly considered going down to Jack’s office to tell him about her mother,
then decided to skip it. Even though she was certain he’d ultimately be
sympathetic, she had had quite enough of his levity and didn’t want to risk
having to deal with anymore.
On the first floor, Laurie took
a quick detour into the administration office. Calvin’s door was ajar.
Unchallenged by the two busy secretaries, Laurie glanced in to see the deputy
chief hunched over his desk. A standard-sized pen looked like a miniature in
his huge hand. She knocked on the open door, and Calvin raised his intimidating
face and drilled Laurie with his coal-black eyes. There had been times when
Laurie had clashed with the deputy chief, since he was both a stickler for
rules and a politically savvy individual willing to bend those rules on
occasion. From Laurie’s perspective, it was an untenable combination. The
occasional political demands of being a medical examiner were the only part of
the job Laurie didn’t like.
Laurie mentioned that she was
leaving early to visit her mom in the hospital. Calvin waved her away without a
question. Laurie didn’t have to clear such a thing with him, but she had been
trying of late to be a little more politically sensitive herself, at least on a
personal level.
Outside, the rain had finally
stopped, making it easier to hail a taxi. The ride uptown went quickly, and in
less than a half hour she was deposited at the front steps of the University
Hospital. During the drive, she had tried to imagine what her father had meant
by “an associated aspect” of her mother’s illness that he wished to
discuss. She truly had no idea. It was such an oblique statement, but she
assumed he meant some limitations of her mother’s activity.
The hospital’s lobby was in its
usual afternoon uproar with visiting hours in full swing. Laurie had to wait in
line at the information booth to find out her mother’s room number, castigating
herself for failing to get it earlier. Armed with the information, she took the
proper elevators up to the proper floor and walked past the nurses’ station,
where a number of people were busy at work. No one looked up at her. It was the
VIP wing, which meant the corridor was carpeted and the walls were hung with
original, donated oil paintings. Laurie found herself glancing into the rooms
as she passed like a voyeur, reminding her of her first year of clinical
residency.
Her mother’s door was ajar like
most of the others, and Laurie walked right in. Her mother was in a typical
hospital bed with the guardrails up, an intravenous running slowly into her
left arm. Instead of the usual hospital garb, she was wearing a pink silk robe.
She was sitting up with a number
of pillows behind her. Her medium-length, silver-gray hair, which normally
billowed on top of her head, was pressed down like an old-fashioned bathing
cap. Her color was gray without her makeup, and her skin seemed to be pulled
tighter than usual over her facial bones, and her eyes had retracted as if she
was slightly dehydrated. She appeared fragile and vulnerable, and although
Laurie knew she was petite, she looked particularly tiny in the large bed. She
also looked older than she did less than a week before, when Laurie had seen
her for lunch. There had been no conversation about cancer or imminent
hospitalization.
“Come in, my dear,”
Dorothy said, waving with her free hand. “Pull a chair over. Sheldon told
me he had called you. I wasn’t going to bother you until I was home. This is
all very silly. It’s just not worth getting all upset over.”
Laurie glanced over at her
father, who was reading The Wall Street Journal in a club chair by the
window. He glanced up, gave a little wave and a wan smile, and then went back
to his paper.
Advancing to the side of the
bed, Laurie took her mother’s free hand and gave it a squeeze. The bones felt
delicate and the skin cool. “How are you, Mother?”
“I’m just fine. Give me a
kiss and then sit down.”
