Cure

24

March 26, 2010

Friday, 10:50 a.m.

When Laurie got involved in a task, she often became oblivious to the world around her. Such was the situation as she worked through the histology slides of the previous day’s case. Instead of “John Doe,” she’d begun calling the corpse Kenji, given his genealogical resemblance to a medical-school classmate. And giving the man a name seemed to narrow her focus ever further.

The typical starting point when reviewing slides was where there was pathology, but in Kenji’s case there hadn’t been any. Instead, she started with the organ most closely associated with seizures, the brain. Knowing seizures could arise from very small lesions, or even from areas with no lesions at all, Laurie reviewed each slide methodically. Trusting Maureen and her careful supervision of the histology technicians, Laurie was confident she had representative sections from all sections of the brain. Beginning with the frontal cortex, Laurie worked backward into the temporal and parietal lobes. With each slide she’d start with low power, scan the entire slide, then move on to higher power. This took time and attention, so she was surprised when her phone rang, and further surprised it was Vinnie instead of Marvin, and that forty minutes had passed.

“You can come down now,” Vinnie said. “The corpse is on the table.” He spoke in the same perfunctory, emotionless tone that had irritated her earlier.

“Fine!” Laurie responded without sincerity. She was about to hang up when her curiosity got the better of her. “I was looking forward to Marvin calling. Why the change?”

“Marvin is busy on another case with the deputy chief,” Vinnie said. “Besides, Twyla Robinson told me I couldn’t leave until I was finished with you.”

His response had caught her off guard. When the deputy chief was doing a case, it usually meant something interesting was going on; he rarely did autopsies unless there was a political aspect involved. She was also surprised that Twyla Robinson’s name had come up. Twyla Robinson was a petite African-American woman as lithe as a fashion model with high cheekbones and glorious raven hair. As the chief of staff of OCME she was also a woman of steel. Laurie had always been impressed with her ability to run such a tight ship with such a varying mix of personalities.

“Need I ask why Twyla was involved in your helping me repeat an external exam?” Laurie questioned harshly. It was definitely not usual. “And what do you mean by you’re leaving?”

“I’m going on leave for a family emergency,” Vinnie said, now with some emotion.

“I’m so sorry,” Laurie said after a pause. She suddenly felt guilty she’d been selfish in her response to Vinnie’s unusual mood.

“Can I ask you to come down quickly? I really need to leave, and Marvin’s tied up with an added case after the one he’s doing.”

“I’ll be right down,” Laurie said. “Why don’t you just leave? I’m only going to repeat the external exam. I really don’t need any help. I’ll find someone to help me get the corpse on a gurney when I’m done. Really, it’s okay — you should just go.”

“Really?”

“Really,” Laurie said. She was tempted to ask what the family emergency was about, but she didn’t. Vinnie hadn’t given her an in to ask such a question.

“What about Twyla?”

“Don’t worry about her,” Laurie said. “I’ll talk to her if need be. You go and attend to your family emergency.”

“Thanks, doctor,” Vinnie said finally.

“You’re welcome, Vinnie,” Laurie said. For a moment she held the line open, hoping that Vinnie would be more forthcoming, but all she heard was a click. She hung up as well.

Laurie paused with her microscope in front of her, its light source still on. She shook her head. She knew it was human to view the world somewhat selfishly, but she was disappointed in herself for not having given Vinnie a bit of slack rather than immediately taking his behavior personally.

She clicked off her microscope light, leaped to her feet, grabbed a Tyvek coverall suit from the bottom drawer of her file cabinet, pulled it on, and was out the door.

As the aged elevator descended and she watched the numbers reducing, seemingly slower than usual, she banged lightly against the door as if it would speed it up. If she thought she was excited earlier, she was now a quantum leap more excited. The case was suddenly blossoming in unusual complexity, for which she could take credit, credit for persevering even in the face of Jack’s attempt to quell her determination. Of course, she was not going to be critical of Jack, as she knew his motivation was her well-being.

Once on the basement level, Laurie ran, not walked, around to the locker room, quickly got herself appropriately attired, and pushed into the pit, which was in full swing.

Pausing just inside the door, she surveyed the scene. All tables were occupied with corpses surrounded by the personnel doing the cases, save for one, which Laurie presumed was her Kenji. Next she picked out Calvin Washington, mostly because of his intimidating size and because there were four people at his table rather than the customary two. The only other person Laurie could pick out from where she was standing was Jack, simply by the way he moved and laughed. Few other people found much to laugh about in the autopsy room, but Jack always seemed to find a way, particularly when he and Vinnie were on a case together.

Rather than going directly to Kenji, Laurie stepped over to Jack’s table. He was working on a relatively young man, in his thirties or forties. Laurie could see that one leg was broken with a compound fracture. There was also a severe head wound and abrasions on his chest. It was clearly an accident of some sort.

“Quick, Eddie!” Jack called out, seeing Laurie approach. “Cover up Henry. Here comes my wife.”

Laurie, with her gloved hands clasped in front of her like a surgeon maintaining sterility, said, “Hurry, Eddie, before I see anything.” Eddie Prince was a relatively new mortuary tech whom she hadn’t met before yesterday. “Well, well,” Laurie continued. “It looks to me like a severe accident. Would it be appropriate to presume this was a bicyclist who’d had a disagreement with a taxicab?”

“Bus,” Jack added.

All Laurie could do was nod. In point of fact, she did not like to joke about the issue. When she and Jack had first met, she’d thought there was something boyishly charming about Jack’s insistence on riding his bike back and forth to work, but now, especially with a child, she thought it was selfishly foolish.

“How are things going?” Jack asked. “I see your case from yesterday is back. Is that a clue?”

“Could be,” Laurie said, recognizing that Jack had immediately steered the conversation away from the bike-bus issue. Even doing cases like the one he was working on or having knowledge of the statistics, about thirty to forty bicycling deaths per year in New York City, did nothing to discourage Jack’s behavior.

“Are we going to have a press conference this afternoon?” Jack inquired.

“It’s not going to be that much of a revelation,” Laurie said with a chuckle. “Although if it turns out to be what I suspect, I’m going to be pleased with myself, and you and Lou are going to be surprised at the very least.”

“Then let’s hope it is what you suspect.”

Laurie moved on to Kenji. She put the papers that she’d brought from her office down on the writing surface. They were copies of outline drawings of the human body from both dorsal and ventral perspectives, where she could indicate any external findings of note. Then she went to get the only equipment she thought she would need: a scalpel, a digital camera, a handheld dissecting microscope, and a stainless-steel probe, which was nothing more than a thin metal stylus with a slightly nodular end used to probe puncture wounds, such as the tracks of bullets or pellets.

With the body supine, Laurie started with the head and face, poring over the scalp, the ears, the face, even the inside of Kenji’s mouth, his ears, and his nose. Having recognized she’d done such a poor job on the external exam the day before, she meant to do an A-plus one today.

Moving on to the upper extremities, Laurie noted every irregularity, including cuts, bruises, moles, hemangiomas, and even calluses. Next were the chest, abdomen, and lower extremities. When she was finished with the ventral surface, she went to find someone to help her turn the corpse over. Jack had finished his case, and Eddie was available. He was happy to give Laurie a hand.

Laurie repeated herself on the dorsal surface. As she worked down the back, her pulse quickened. If there were to be a suspicious break in the skin, she assumed she would find it somewhere on the buttocks or the back or side of the legs. Just because she hadn’t seen anything suspicious with her initial overall glance, Laurie maintained her careful, methodical scrutiny, and her systematic approach paid off. Within the gluteal fold where the buttocks join the leg, Laurie felt she’d found what she was looking for: a possible tiny puncture wound. It was a circular reddened area that required flattening the skin to truly appreciate. She took a digital photograph of the area, showing the puncture.

With the stylus in her right hand, Laurie flattened the skin with her left. Gently she applied the smaller end of the stylus to the reddened patch of skin, and with a slight pressure the nodular end popped inside. It was definitely a puncture wound.

Pressing a little harder but not so much as to create an artifact, Laurie advanced the nodular end of the stylus until it hit the end of the track. Laurie took another photograph of the stylus in the track. Then, placing her fingers around the stylus where it disappeared into the skin, she drew it out and measured. The track was two and a half centimeters deep.

Laurie disposed of her gloves and left the autopsy room. Using the case’s accession number, she found the X-rays, brought them back into the pit, and snapped them up onto the view box. Carefully she scanned the area in question on both the frontal and lateral views, in hopes of seeing a possible pellet of some sort, but there was nothing. That meant that either a pellet was used that was capable of being dissolved by the body or whatever toxin was used was injected directly. Either way, Laurie assumed the greatest concentration of the poisonous agent had to be at the end of the track.

Returning to Kenji with a new pair of gloves, Laurie picked up the scalpel and fell to work. What she wanted was the track itself, encased in a core of muscle tissue about the size of a wine cork. It sounded easy enough, but Laurie struggled. With the tissue being easily compressible, it was difficult to avoid cutting into the track. She wanted the sample to be en bloc. The handheld dissecting microscope was a help, but it precluded the use of her left hand, and in the end, she didn’t use it.

As Laurie worked with the scalpel, and having now ascertained that Kenji had been murdered, presumably with an umbrella air gun, her thoughts naturally drifted back to what agent might have been involved. She already knew it could not be ricin, as was used in the infamous Bulgarian’s case. Although she did not know the specific poison, she did know some things about it. It had to be extraordinarily toxic, as the security tapes indicated. According to what she saw on the tapes, the poison had been almost instantly effectual. She also knew it had to be neurotoxic, because of the seizure, as a number of snake and fish venoms were. She eventually decided to go on the Net and check out seizure-inducing reptilian and aquatic neurotoxins.

Laurie struggled for almost half an hour, but the final sample approximately an inch and a half long and an inch thick looked very close to what she’d envisioned.

Laurie removed her gloves yet again and went into the supply room for a sample bottle and a sample custody tag. Back at the autopsy table, she put the sample in the bottle and completed the tag, which included the case’s accession number, the date, and the location from the body where the sample had originated, and then signed it. She was being exquisitely careful: If there was to be a trial concerning the case, which she now considered a distinct possibility, the sample she was holding would be a key piece of evidence.

With her last chore finished, Laurie went looking for an available mortuary tech to lend a hand. With practiced ease she and the tech got Kenji off the autopsy table and onto a gurney. Wheeling the corpse herself out of the autopsy room, Laurie deposited him and his gurney back in the cooler, where the corpse would stay for the next several months, unless he was lucky enough to be identified and shipped off to his next of kin. “I know you’re trying to tell me some things, Kenji,” Laurie said out loud in the heavy stillness of the cooler, “and I’m trying to listen. We already have the person who killed you, but unfortunately we don’t yet know who you both are. Be patient!” She stepped out of the cooler and closed its heavy insulated door, causing it to emit a final-sounding reverberant click.

Laurie had planned to take the sample directly up to toxicology on the fifth floor, but a glance at her watch changed her mind. She was aware that John DeVries was one of the most compulsive people she knew, and one of the ways he manifested his compulsive-ness was to stop whatever he was doing at exactly noon, and take his old-fashioned lunch box with a thermos mounted in its vaulted top to OCME’s sad excuse of a lunchroom on the second floor. The room was windowless, with cement-block walls. All that was in the room were a bank of vending machines filled with unhealthy food, plastic-topped tubular steel tables, and plastic chairs. Although Laurie could have stopped to say hello, she was reluctant to interrupt his lunch. It was also true that the room depressed her. Instead she went directly up to her office so as not to waste time. As punctual as John was about getting to the lunchroom at noon, he was just as punctual about returning to work at twelve-thirty, and Laurie planned to take the sample to him then.