Blow Fly

61

BEYOND THE WINDOW IN FRONT of Scarpetta's desk, shadows crawl over sand dunes as the sun moves.

Palm fronds rattle lightly, and a man walking his yellow lab on the beach leans into a headwind. Far off on the hazy blue horizon, a container ship forges south, probably to Miami. If Scarpetta is too caught up in her work, she will forget the time and where she is and soon will miss another flight to New York.

Dr. Lanier answers his phone and is hoarse as he says, "Hello."

"You sound terrible," Scarpetta says sympathetically.

"I don't know what I caught, but I feel like hell. Thanks for getting back to me."

"What meds are you taking? I hope it's decongestants and a cough suppressant with an expectorant, and that you're staying away from anti-histamines. Try the daytime or nondrowsy formulas that don't list antihistamines or doxylamine succinate on the label-unless you want to dry yourself out and get a bacterial infection. And stay away from alcohol. It lowers your immunities."

He blows his nose. "I'm a real medical doctor, just so you know. And an addictionologist, meaning I do know a thing or two about drugs." He says this without a trace of defensiveness. "Thought you might be relieved to hear that."

Scarpetta is embarrassed for making assumptions. Coroners are elected officials and unfortunately, nationwide, many of them are not physicians.

"I didn't mean to insult you, Dr. Lanier."

"You didn't. By the way, your sidekick Pete Marino thinks you walk on water."

"You checked me out." She is nonplussed. "Good. Now hopefully we can get down to business. I've been through Charlotte Dards case."

"An oldie but goodie, and I don't mean that literally. There's nothing good about it. Hold on. Let me get something to write with. Unquestionably, there's a Bermuda Triangle for pens, and in my home it's my beloved wife. All right."

"Mrs. Dard's case is definitely perplexing," Scarpetta begins. "As you know from her tox reports, oxymorphone-the metabolite of OxyContin-is only four milligrams per liter of blood, which puts her in the low lethal range. Her gastric is negative, and the level in her liver's no higher than the level in her blood. In other words, death from an overdose of OxyContin is equivocal. Clearly, her drug level isn't as critical as her clinical findings."

"I agree. My thought all along. If you interpret her tox in light of the histological findings, it's possible she didn't need as high a level for an accidental overdose. Although her reports and body diagrams don't indicate any cutaneous stigmata of past intravenous drug abuse," he adds. "So I'm guessing she was a pill-popper but didn't shoot up."

"Certainly she was a chronic drug abuser," Scarpetta says. "Her heart tells us that. Patchy necrosis and fibrosis of varying age, and chronic ischemia, plus an absence of coronary artery disease or cardiomegaly. Basically, a coke heart."

It is a catch-all phrase that does not necessarily mean the person was a cocaine addict. Drugs such as narcotics, synthetic narcotics, OxyContin, hydrocodone, Percocet, Percodan and whatever else the addict can get his or her hands on will destroy the heart just as completely as cocaine will. Elvis Presley is a sad example.

"I need to ask you about blackouts," Dr. Lanier says, after a pause.

"What about them?" This must be what he so urgently wanted to talk to her about. "I saw nothing in the case file you sent me that mentions blackouts."

She checks her irritation. As a private consultant, she is limited by the medicolegal information presented to her, and the absence of pertinent findings-or the presence of incorrect findings-is intolerable. Until she gave up working her own cases or supervising those worked by her other forensic pathologists throughout the Commonwealth of Virginia, she did not have to rely on the competence or veracity of virtual strangers.

"Charlotte Dard suffered occasional blackouts," Dr. Lanier explains. "Or at least this is what I was told at the time."

"Who told you?"

"Her sister. It appears," he goes on, "or let me qualify this by saying it is alleged, that she suffered from retrograde amnesia…"

"I certainly would think her family would know that, unless no one was ever home."

"Problem is, her husband Jason Dard's a rather shady character. Nobody around here knows much, maybe nothing about him, except he's rich as hell and lives on an old plantation. I wouldn't call Mrs. Guidon a reliable witness. Although she certainly could be telling the truth about her sisters condition prior to her death."

"I've read the police narrative, which is brief. Tell me what you know," Scarpetta says.

After a coughing bout, Dr. Lanier replies, "The hotel where she died is in a not-so-nice part of the city, in my jurisdiction. A housekeeper found her body."

"What about blood tests? In the paperwork you sent me, all I got were postmortem levels. So I don't know whether she might have had the elevated GGTP or CDT associated with alcohol abuse."

"Since I first contacted you, I have managed to track down premortem blood test results, because she was in the hospital about two weeks before her death. Misfiled, I'm embarrassed to say. I've got a particular clerk I'd pay heaven and earth to get rid of. But she's the sort to sue for one thing or another. The answer to your question is no-no elevated GGTP or CDT."

"In the hospital for what?"

"Tests after her most recent blackout. So, obviously, she had one of these blackouts two weeks before she died. Again, I say allegedly"

"Well, if she didn't have elevated GGTP or CDT, it would seem to me that we can rule out alcohol as the cause of her blackouts," Scarpetta replies. "And Dr. Lanier, I can't offer you a second opinion if I'm not supplied with all of the information."

"Be nice if I was supplied all the information, too. Don't get me started on the police down here."

"What was Mrs. Dard s behavior during her blackouts?"

"Supposedly violent, throwing things, trashing the house or wherever she was staying. On one occasion, she vandalized her Maserati by smashing the windows, doors and hood with a hammer. She poured bleach all over the leather seats."

"A record of this with a body shop?"

"It happened in May of 1995 and required two months to repair the damage, then her husband traded it in on a new one for her."

"That wasn't her last blackout, though." Scarpetta flips to another page in her legal pad, writing quickly and illegibly.

"No, the last one-two weeks before her death-was in the fall. September first, 1995. On that occasion, she took a razor of some sort to paintings valued at more than a million dollars. Supposedly."

"This was in her home?"

"In a parlor, as I understand it."

"Witnessed?"

"Only the aftermath, based on what I'm told. Again, this is according to what her sister and husband said way back when."

"Certainly her drug abuse could cause blackouts. Another possibility is temporal lobe epilepsy. Any record of her having suffered a head injury?"

"None that I'm aware of, and no old fractures or scarring showed up on X ray and gross examination. Hospital records indicate that after her second blackout, which, as I've said, was September first, 1995, she went through the gamut of tests: MRI, PET scan and so on. Nothing. Of course, temporal lobe epilepsy doesn't always show up, and maybe she did suffer some sort of head injury and we just don't know about it. Hard to imagine. I'm inclined to think her drug abuse was to blame."

"Based on the information I have, I agree. Her findings correlate with chronic abuse and not from one single overdose of OxyContin. Sounds like the only answer as to manner of death is investigation."

"Jesus God. That's the problem. The cops who worked the case didn't do shit and sure as hell aren't going to do shit now. Hell, everything's a problem down here. Except the food."

"Mrs. Dard is probably a heart death with chronic drug abuse as a contributing factor," Scarpetta tells him. "That's the most I can offer you."

"Doesn't help that we've got an idiot of a U.S. Attorney, Weldon Winn," Dr. Lanier continues to complain. "Since this damn serial killer's been on the loose, a lot of people are sticking their noses in everything. Politics."

"I presume you're on the task force," Scarpetta interrupts him.

"No. They say I'm not needed, since no bodies have turned up."

"And if a body does turn up, you don't need to know anything about the investigation? Even though it's believed that each of the women was murdered? Everything you're telling me goes from bad to worse," Scarpetta says.

"You're absolutely right. I haven't been invited to look at the scenes of their abductions. I haven't looked at their homes, cars, not a single crime scene."

"Well, you should have," Scarpetta replies. "When a person is abducted and assumed to be a homicide, the police should ask you to look at everything and know every detail. You should be fully informed."

"Should doesn't mean crap down here."

"How many of the abducted women are-or were-from your parish?"

"So far, seven."

"And you haven't been to a single scene of an abduction? I'm sorry to keep asking you the same questions. But I'm incredulous. And now those scenes no longer exist, am I right?"

"Cases are as cold as an ice block," he replies. "I guess the cars are still impounded, and at least that's a good thing. But you can't secure a parking lot or house forever, and I have no idea what's happened with their homes." He pauses to cough. "It's going to happen again. Soon. He's escalating."