The Skeleton's knee

Part One
1

“I have a body for you.”

The voice on the line-smooth, cultured, and completely serious-was Beverly Hillstrom’s, Vermont’s chief medical examiner.

I cradled the phone between my shoulder and cheek and poured several packets of sugar into my coffee. Unlike the larger urban charnel houses of New York or Los Angeles, the Brattleboro, Vermont, Police Department did not export corpses to the ME’s office for autopsy every day of the week, nor even once every six months. When we did, it was usually an “unwitnessed death”-an elderly person who’d died alone in bed, and for whose demise the law required an explanation.

Homicides, the only other professional reason for the ME and I to talk, were rarer still, although recently we had given those numbers a boost during a particularly bloodthirsty case. But that was now history; to my knowledge, we hadn’t shipped a body from either category since.

I was, therefore, totally baffled. “It came from here?”

She was suddenly, and uncharacteristically, less sure of herself. “It’s an adverse-occurrence case, sent to me by Dr. Michael Brook. You know nothing about this?”

“I don’t even know what an ‘adverse occurrence’ is.”

“It’s when a patient dies of something other than what he’s being treated for. For example, a cardiac patient dying of undiagnosed cancer.”

“Uh-huh,” I muttered, waiting for the inevitable punch line.

“Or an orthopedic patient dying of an aneurysm caused by a bullet.”

I let out a little puff of air. “Who are we talking about?”

“Someone named Abraham Fuller, age forty-seven. He was sent to me by Brattleboro Memorial Hospital, where he’d checked in with severe back pain and lower-limb paralysis, which X-rays revealed to be acute osteomyelitis. He suddenly up and died in the hospital two days later, and Dr. Brook wanted me to take a look.”

“And you found a bullet wound.”

“Specifically, I found a traumatic aortic aneurysm caused by a bullet crease some time ago.”

I put my feet up on my scarred wooden desk and rocked my chair back, getting comfortable. “Some time ago? How long?”

“I’ll give you the long-winded answer to explain why I have to be a little vague on the timing. When a bone is damaged, as part of Mr. Fuller’s spine was by the same bullet, it undergoes a series of sequential changes before stabilizing, much as the skin does when it scars over. But the process with the skin occurs rapidly, whereas the bone takes its time, five years generally, from start to finish. Technically, all I could say is that since Mr. Fuller’s bone-tissue exhibits having gone through this entire process, his wound is at least five years old.”

I caught her inference. “And not so technically?”

“Between you and me, based on my own experience, I’d say it was easily twice that, and maybe more. But I couldn’t back that opinion up with one shred of scientific data.”

I sighed and closed my eyes. A time-honored policeman’s adage has it that with homicides, if you haven’t nailed your killer inside a week, your chances of ever doing so divide by half for every subsequent week that passes. “So in a nutshell, you’ve just given me one very old, cold homicide.”

“I’m afraid so.”

“The aneurysm could only have been caused by the bullet?”

“I found trace elements of metal and had them sent to Waterbury for analysis under the scanning electron microscope. They were consistent with the lead used in bullets. Also, I have both an entrance and an exit wound, and internal scarring defining the trajectory within the body. So yes, the aneurysm was caused by a bullet and death was due to the aneurysm.”

“What took the aneurysm so long to burst?”

“That’s hard to say. I could venture a few guesses, but none of them would do you any good. Let’s just say he’d reached his time.”

I turned all this over in my mind. “He must have been wounded before he moved to the area. I don’t remember any local ending up in a wheelchair from a gunshot wound.”

“He wasn’t confined to a wheelchair. The paralysis I mentioned was recent, stemming from a sudden infection that formed around the old bone and lead fragments.”

“A sudden infection? Did he reopen the wound?”

There was a pause at the other end. “He might have done something to precipitate it; not reopen it, precisely, but perhaps to cause a shifting of sorts. You see, those fragments were not frozen in place. To a certain extent, the ones that weren’t encapsulated by the healing bone were free to wander a bit. It was one of the fragments that triggered the osteomyelitis, which in turn led to an abscess-a dumbbell lesion, specifically-that expanded into the spinal canal, put pressure on the lower cord, and thereby cut off the use of his legs. This is not so rare, by the way; it’s part of the reason why surgeons are so careful to remove everything they can from a wound. There are dozens of stories of people stepping on shards of glass and having them pop out of the skin years later far from where they entered.”

I paused a few seconds, reviewing the little I had. Over the phone, I could hear the faint strains of the classical music she favored in her office. “Could you tell if Fuller was treated at the time he was shot? Were there any suture scars, for instance?”

“None, and I looked carefully. Either the attending physician decided to leave well enough alone or Mr. Fuller never sought treatment. If the latter was the case, I’d say he used to be a very lucky man.”

“Would he have required professional home care, at least?”

“Not necessarily. I followed the scar tissue the bullet left behind. It entered between the navel and the left rib cage, missed the liver, spleen, and left kidney, nicked the aorta and the left transverse process of the spine, and exited. It must have been extremely painful at the time, but neither fatal nor permanently debilitating. Aside from the aorta, nothing vital was hit. He had to have been terribly uncomfortable, and it’s amazing the wound didn’t become infected, but he could have recovered simply by staying put. The irony was that his recovery turned out to be a false one. One millimeter the other way and he would have been dead. As it was, the wound became a time bomb.”

“But wouldn’t he have had a limp, or chronic back pain?”

“You’ll have to confirm this with Dr. Brook, but I doubt Mr. Fuller had much trouble with his spine until recently. His muscular development in the area of the wound indicates a full and normal range of motion. There were also no signs of long-term chronic infection. If I had to guess, I’d say he’d led a perfectly normal life until the abscess developed. In fact, I’ve rarely examined a healthier specimen. He didn’t smoke, wasn’t overweight, his stomach and intestinal contents revealed a vegetarian diet, and his liver was so good-looking, I doubt he drank much alcohol.”

I smiled at her enthusiasm. Despite the derision it attracted from my colleagues, I, too, enjoyed autopsies for the insights they provided. They reminded me of searches I’d conducted through people’s homes, apartments, and luggage, which also were usually rich in personal details.

“You couldn’t guess what the caliber was, could you?”

“Not with any precision, but it wasn’t large. Say anything from a.32 on down.”

I let out a small grunt. “Well, it looks like I better start digging. Could you send me copies of what you’ve got, especially a shot of his face?”

“I have a courier heading to Rockingham in a couple of hours. I’ll ask him to extend his trip a little.”

“Thanks. By the way, who has claim on the body?”

“No one. The record shows no next of kin and no claimant.”

That surprised me. “What about an address? Could he have been a street person?”

“He had none of the outward signs. His teeth, nails, hair, and general hygiene didn’t reflect that kind of life, unless he was new to the street. The hospital probably has all that.”

Familiar sensations were beginning to stir in my mind, the first signs of the case taking hold of my imagination. I knew that, like most homicides, this one probably had an easy and reasonable solution. I was fully prepared to discover that Fuller had been shot accidentally by a.22 pistol ten years ago. But until such a possibility metamorphosed into legal fact, I thought I’d better hedge my bets. “Could you put Mr. Fuller on ice for a few days, until I get a better handle on him, or until someone claims him?”

She hesitated. “It’s a little unusual. We normally don’t do that unless it’s a study cadaver… But sure, I don’t see why not. I have space. If it causes a problem down the road, I’ll let you know. Don’t leave me out on a limb for too long, okay?”

“I promise.”

I hung up and stared out the window that separated my office from the rest of the detective squad, grateful that this was cropping up when our work load was comparatively light. My cubicle, small but well lit, and recently remodeled, along with the rest of the ancient building, was the sole display of rank I could brag of as chief of detectives.

I got up and opened the door. Off to one side of the central cluster of four desks was a fifth one, facing the entrance to the public corridor outside. This was Harriet Fritter’s station, the squad secretary, or clerk, whose frightening efficiency and competence allowed me to duck most of the paperwork that would otherwise have kept me anchored indoors.

“Harriet,” I asked her, “could you call Dr. Michael Brook at the hospital and see if he’s available for a quick chat? Also, did you see anything from the town clerk’s office listing the week’s death certificates? I thought we were supposed to get a copy of that as a matter of routine.”

She smiled, already dialing the hospital. “We used to, years ago, but when I told them we were throwing the list out, also as a matter of routine, they quit sending them.”

She turned back to the phone, and I retreated, suitably abashed. Harriet was a grandmother and the leader of an enormous familial clan. That she could run both her family and our office with good humor and no side effects proved she had little tolerance for wasteful habits, and no bashfulness about correcting them.

She buzzed me on the intercom moments later. “You’re in luck. He’s got a free hour right now. Nine Belmont Avenue, second floor.”

Nine Belmont was a remarkably plain red-brick barracks building, attached to the side of the hospital by a narrow corridor like a near-severed limb. A professional building designed to house a variety of medical offices, it had always struck me as the ideal place to receive bad news about a terminal illness: low-slung, cheap-looking, and generally unpromising. I pushed open the glass and aluminum front door, crossed the worn, water-stained foyer carpet, and made for the stairs to the second floor.

Halfway down the dark corridor, I came to a door marked MICHAEL BROOK, M.D.-ORTHOPEDICS. I knocked and walked in.

Brook was standing in his own empty waiting room, leaning on the counter in front of the nurse/receptionist, picking a piece of candy out of a jar to the side of the sliding glass window. He looked up and stuck his free hand out as I approached. “Hi, Joe. I’m test-marketing my reception room. Got to see if I’m invoking the proper element of dread. Want a candy?”

I accepted a blue cellophane-wrapped offering and followed him through the far door into a hallway lined with suitably soothing calendar art. He led the way to an office at the end, stumping from side to side like a land-bound sailor. As ironies would have it, Brook was an orthopedist with one artificial leg, the original having been lost to disease as a teenager. He motioned me into one of two guest chairs, settling into the other one himself.

“What can I do for you?” he asked, unwrapping his candy and popping it in his mouth.

He was a big man, in all dimensions, and had always reminded me of a sheepdog: all bushy gray hair, bearded and uncombed, surrounding two soft brown eyes that hovered above a pair of half glasses like children looking over a fence. I’d met him more than twenty years earlier, when my wife had consulted him for a pain in her shoulder. That hadn’t turned out to be his particular expertise-the pain had been cancer, and Ellen had died within a few months-but Michael Brook had kept by both of us, smoothing the introductions to the many doctors we quickly acquired and translating their incantations into the kind of English we could grasp and digest. While I’d never had to use him professionally since, and our paths rarely crossed socially, his compassion back then had forged a friendship I’d never questioned.

“Mike, I just got a call from Beverly Hillstrom about Abraham Fuller.”

Brook’s face lit up with interest. “Right. What the hell was that, anyway? We were all stunned when he died; didn’t make any sense.”

“She called it a traumatic aortic aneurysm, caused by the creasing of a bullet years ago.”

His mouth fell open and he pulled his glasses off his face. “Damn. That scar he had. He said he got it falling against a tree branch when he was a kid.”

“Apparently, there was an entrance wound near his belly button-a small one. Hillstrom guesstimates a.32 caliber at most.”

He shook his head in wonder. “Christ. It never even crossed my mind. Did this guy have a record, too?”

I smiled at the imaginative leap. “Not everyone with a bullet scar is a crook, Michael. Although, for all I know so far, you may be right. I’m just starting to look into his past. I thought I’d start with you.”

Brook waggled his shaggy eyebrows at me and pushed himself forward in his chair. “You’re not going to get too far. He wasn’t a great historian.” He twisted his phone console around to face him and pushed one of its many buttons. “Bernice? Could you pull everything we have on Abraham Fuller and bring it in? Thanks.”

He settled back in his seat with a small grunt. “I was called in by the Emergency Department a few days ago. Rescue, Inc. had transported a middle-aged male with back pain resulting in paraplegia. The X-rays revealed vertebral osteomyelitis, complicated by an abscess, all stemming, I thought, from the patient’s decades-old encounter with a tree branch…”

“Did he pinpoint the time of the injury?”

Mike shook his head. “No. That’s what I meant when I said he was a poor historian. He just said it happened when he was a kid. I asked him the usual background questions, so I could rule out any underlying congenital or genetic causes for his problem, but every time I wanted specifics, he got vague. Maybe that’s why I thought he was a crook just now.”

There was a knock on the door and a nurse handed Brook a slim folder before retiring. Brook leafed through it cursorily and handed it over to me. “No date of birth, no place of birth, no names of parents, no address, no phone number, no Social Security number, no family physician, no prior records at the hospital. No nothin’, when you get down to it.”

I glanced over the admission sheets at the front, not bothering with the treatment pages, which were indecipherable scrawls, in any case. They were virtually blank. “Hillstrom told me he stayed several days.”

“That’s right. I wanted to do a biopsy on the abscess, and I was planning surgery regardless.” He paused. “If that damned aneurysm had held on a little longer, we might have caught it in surgery and saved his life.”

“Why did it blow, after all this time?”

He shrugged, much as I’d guessed Hillstrom had earlier to the same question. “That kind of aneurysm acts like a stretched-out water balloon. If either the pressure inside increases too much or the outer envelope weakens, it goes pow.” He retrieved the file from my lap and flipped it open. “His blood pressure was on the high side, probably due to the pain and anxiety. That alone might have been enough to do the trick.”

I let my eyes wander across the walls before me, registering but not reading the various diplomas and citations. A secretive man, admitting to no past, is forced by medical necessity to come out of his hole and then dies. I shook my head. This was turning out darker than I’d feared… and more intriguing.

“How did the Accounting Office deal with him? I notice he didn’t list any insurance.”

Brook chuckled. “Normally, I wouldn’t know, since it ain’t my department, as they say, but this guy really made history on that one. The whole hospital heard about it-unofficially, of course. He paid cash, and I mean real cash: greenbacks. At some point, after I’d started talking surgery, someone in Accounting got nervous-Fuller didn’t even have a Medicaid number, after all-and they went up to talk to him. He asked them how much they needed, told them to leave the room for a minute, and then handed them five thousand bucks. He told them to regard it either as a down payment or an amount to draw on, depending on the final amount due. They didn’t argue, and from what I heard, they didn’t ask for explanations.”

“Where was he keeping it? Did he have a bag or something?”

“Yeah, one of those small backpacks. I think the hospital still has it, along with his clothing and whatever else he left behind, unless somebody’s claimed them by now.”

My mind was humming with possibilities, most of them far from innocent, but I wanted to play out at least one straightforward angle before assuming the worst. “Maybe he was a hermit. Did you see him clothed, or did the ER staff have him stripped already?”

Michael paused before answering, thinking back. “He was still partly dressed. They were work clothes-standard JCPenney-type stuff. His hands were rough; he had the typical workingman’s suntan-forearms as black as walnut, the rest of him lilywhite. I don’t know… I guess initially I took him for what he looked like. Not a backwoods type, though. His speech didn’t fit that at all. He was pretty well educated, beyond high school. When I described what I’d found out about his back, he had no trouble following it, even asked some fairly sophisticated questions…”

“As if he’d had medical training?”

“No, nothing that fancy, but definitely a college background. He was also a health nut. A lot of construction workers and whatnot are tough as nails, but their eating habits are lousy. It usually shows up in their waistlines. This guy was as thin and hard as cable wire. Described himself as a lacto-vegetarian: no eggs, no meat, no fish, and no poultry. He gave strict instructions to the dietitian.”

“You think he took care of himself because he knew he had a touchy back?”

Brook shook his head. “I don’t know. He denied it to me-said he’d never had any trouble with it except when he’d fallen on the tree branch years ago, but who’s to know? The guy was obviously not too intimate with the truth.”

I thanked him and moments later passed through the umbilical-like corridor between the hospital and the office building, in search of the head of Accounting. I found her beyond a moderately crowded waiting room in a small, windowless, but cheery cubbyhole decorated with framed Georgia O’Keeffe posters and unusually healthy green plants.

She was an angular, white-haired woman with a flame-red dress and an animated face. The nameplate on her tidy desk read KATHY PARKER. She half rose from her chair as I entered and shook hands. “The receptionist said you’re from the police?”

I smiled and placed my credentials before her. “Yes. Lieutenant Joe Gunther.” She looked at me carefully then. “Oh, I’ve heard of you. My goodness, weren’t you almost killed a couple of months ago?” I smiled at the reference to a recent headline-grabbing case. “A dubious claim to fame. Yes, that was me.”

She returned my badge and gestured to me to sit. “Well, it’s an honor.” Her face acquired a carefully neutral cast. “I take it you’re here in a professional capacity?”

“Yes. I want to know about a small backpack belonging to a patient who died here a couple of days ago, an Abraham Fuller.” Kathy Parker’s eyebrows shot up. “Oh yes. I inventoried that myself. Would you like it?”

“I’d like to take a look at it.”

She turned toward a small floor safe behind her, opened its door, and retrieved an old red canvas bag, laying it on her desk. “I’m not surprised you’re here, actually. I mean, we’re obviously delighted when a patient pays for his treatment on the barrel, but using a bagful of cash did stir up a few comments.”

I picked up the knapsack and rested it in my lap for the moment. “Did anyone know him, or about him?”

“Mr. Fuller? Not that I heard. That’s what made it even more mysterious; paying cash is the kind of thing you see drug-runners do on TV.” She smiled at the soiled, much-used bag between my hands. “Of course, on TV they usually carry it around in a fancy briefcase. I guess that’s the Vermont touch.”

I smiled and fingered the material. “I know you didn’t mean it literally, but was there anything indicating he was into drugs?”

She shook her head emphatically. “No, no, this was all just gossip; you know how it is, especially in a small place like this. People were also asking if Fuller was a pseudonym for an Italian name, as in Mafia. I never even saw the man.” She nodded toward the pack. “I didn’t get that until after he’d been shipped off to Burlington for autopsy. It was just… Well, open it and see for yourself. It is a little weird.”

I undid the knot at the throat of the bag and drew it open, taking a look before I reached in. There were some odds and ends: a toothbrush and paste, a comb, a paperback edition of A Connecticut Yankee in King Arthur’s Court, a balled-up pair of socks, some underwear, and a single change of clothes. But the attention grabbers were the banded bundles of hundred-dollar bills.

I gingerly pulled one out, holding it by the edges. “Did you count it all?”

“Yes. There’re five of them, a thousand dollars each.”

“And he’d already paid five thousand for his treatment, is that right?”

She nodded. “We deposited part of what he gave us, for services rendered. The difference is still in escrow, pending retrieval by next of kin.”

I looked at the bundle in my hand. The inner bills were new and crisp; the outer ones were unwrinkled but grimy, and the edges of all of them were faintly soiled. They also had an odd feel to them-almost slippery. I held it up to my nose and smelled.

“Mildew,” Kathy Parker suggested.

“Yeah. I think you’re right.” I lifted the knapsack to my nose and detected the same pungent odor. I looked at the face side of one of the cover bills and let out a small grunt, flipping through the others for confirmation.

“What?” Parker asked, presumably keen for more gossip.

I hesitated, then dropped the money back into the bag. “Nothing; I was just wondering about the mildew. If you could draw up a receipt, I think I’ll take this down to the Municipal Building and lock it in our evidence room.”

She did as I requested, half-curious and half-relieved to be rid of a potential headache. By proxy, I was allowing her to jerk her thumb down the line at us, should anyone later ask about the cash.

Not that I was paying much attention to her quandaries, in any case. As I thanked her, took a copy of the receipt and the bag, and worked my way back to my car, I was mulling over what I’d discovered in glancing at those bills. Not all the bundles were of mint notes-in fact, only two of them were-but those two were utterly pristine, with their serial numbers in perfect chronological sequence. The kicker was, new or old, none of them had been printed more recently than 1969, nearly twenty-five years ago.