Fatal

CHAPTER 7

Look, officer, I don t want to be a pest, but this woman is really ill and she's running around the city somewhere, certain that some people are trying to kill her. Are you sure word is out?"

"Ma'am, I promise you. This is the fourth day you've called. Everyone here knows about Kathy Wilson. We have every car and every officer on the street looking out for her. We'll call you as soon as we find her."

Four days had passed since Kathy's call, and not another word from her until just now. When Nikki returned home from the office, there was a rambling message from her on their answering machine, but no hint on Caller ID as to the origin of the call. The disjointed, vitriolic message was terrifying as much for its tone as its content. Kathy Wilson was clearly insane.

Joe Keller continued to be as comforting as possible under the circumstances without being patronizing, as the police continued to be. He was, as Nikki would have expected, fascinated with the rapid development of what he assumed from her description were neurofibromas. Twice he began a tutorial teaching session with her on the differential diagnosis of the condition, but when it was apparent she was hearing only a fraction of what he was saying, he set his marker down.

Nikki paced restlessly about their two-bedroom flat, using a remote to change the five-disc CD player from Mahler to Carly Simon to Miles Davis to either of the two Bluegrass Ramblers CDs, and back. Every flat surface in the apartment seemed to hold a half-empty cup of tea or coffee. More than once she had to battle back the urge to go out and buy a pack of Merits — her brand when she quit smoking more than ten years ago. The living room was strewn with textbooks, each open to some aspect of either neurofibromas or acute paranoia. Outside, a steady rain had let up some, but the wind was howling.

Nikki flipped to the Mahler again — a powerful recording of his Symphony No. 7 — and then knelt down by one of her medical textbooks. Tuberous sclerosis, von Recklinghausen's disease, Sturge-Weber syndrome, von Hippel-Lindau Syndrome. The arcane collection of diseases that included neurofibromas were, for the most part, the result of genetic mutations on any one of several different chromosomes. All of them were accompanied by some sort of brain dysfunction, either by way of cancers or the actual growth of neurofibromas in the central nervous system. The best Nikki could come up with was that Kathy Wilson had some sort of variant of von Recklinghausen's disease, the most common of the conditions, reportedly occurring in one out of every 3,500 individuals. Von Recklinghausen's disease — outcome: fatal, sometimes within a few years from diagnosis. Treatment: none.

The jangle of the phone startled her.

"Kathy!" she exclaimed as she scrambled across her pathology text and snatched up the receiver.

"Nikki, Joe Keller here."

"Oh, hi. Thanks for calling. No word yet. Every time the phone rings I jump out of my skin thinking it's her."

For a few seconds there was an uncomfortable silence.

"Nikki, listen, dear," Keller said finally, "Kathy Wilson isn't going to be calling."

Nikki sank back against the sofa, a veil of disbelief already descending over her mind.

"Oh, no," she said.

"I'm sorry to have to tell you this over the phone. I couldn't think of a way to trick you into coming in so I could tell you in person. Nikki, Kathy's dead. She was run down by a truck on Washington Street about an hour ago. Her body's here now."

No, no, no!

"Joe, I… she left a message here just a few hours ago. Oh, this is terrible."

"Nikki, you tried your best."

"I could have done something. I should have said something different when we last spoke."

"Nikki, you've done everything you could do. I know you have. From the looks of her fibromas, I would say Kathy was in for a rapidly progressive illness, visits to doctors, and most likely premature death. If the reports on her behavior immediately before she died are true, this accident may actually have been a manifestation of her disease running its course."

"What happened?"

"I don't know completely yet, but I will. The police will be by any minute. I heard that she was in a bar, disrupting the place. The security people escorted her out, and she suddenly broke away and raced directly into the street. The driver of the truck said he never even had a chance to put on his brakes."

"Oh, God."

"Nikki, I know this is hard, but can you come in to identify her?"

Nikki swiped at her tears with her sleeve. Off and on over the past week she had feared, even expected, the worst. Now it had happened.

"I'll be there in ten minutes," she said.

Babies beaten and shaken to death, total body burns, shotgun blasts to the face, long-term submersions, accidents of almost every imaginable kind — over her years in the coroner's office, Nikki had encountered them all. But nothing prepared her for the horrible anguish of seeing Kathy Wilson's battered corpse, stretched out on the stainless-steel table right next to the one where Roger Belanger had been autopsied just days before.

From several feet away, it appeared from the unnatural angle of her head as if her neck had been broken. Above the sheet that covered her body, her pale face with its features already deformed by the multiple lumps was surprisingly spared. But there was a trickle of drying blood wending down from the corner of her mouth — a mouth that would never sing again. Feeling as if her chest were being compressed in a vise, Nikki stepped forward and gingerly pulled back the sheet. The police or the autopsy technician had stripped away Kathy's clothes. Like Nikki, Kathy was a runner, although she was broader across the shoulders than Nikki and more heavily muscled. In fact, the two of them ran together when their schedules permitted. Now Kathy's body looked frail and bony. It had clearly taken a high-speed, high-impact hit from the left. Her arm was ripped nearly off at the shoulder, and the entire chest wall on that side was caved in. It was a blessing of minuscule proportions, but given the angle of her head and the likelihood of her aorta being sheared by the blow to her chest, death had probably been instantaneous.

For a few moments, the sound of Kathy's mandolin filled Nikki's head. It was the soaring, looping, breathtaking solo from "Nik the Quick," a piece Kathy had written for her and recorded on the band's second album.

Thank God for the CDs. A part of Kathy Wilson would live on as long as her music did.

Nikki set the sheet back gently, then bent down and kissed her friend on the forehead.

"I'm done, Joe," she managed.

She led Keller back to his office and sank down in the chair across from him.

"You should have heard her play and sing, Joe. People would be standing and cheering when she finished, screaming for more. Eighty-year-olds would be up in the aisle dancing. She was daz-zling."

"Thanks to the recording you gave me, I can truthfully say I agree with you. Hers is not music I am used to, but it is music I en-joy."

"I'm pleased to hear that. Joe, if it's possible, could you do the post?"

Don't let Brad Cummings near her!

"I was intending to," Keller replied. "In fact, I will probably do it tonight."

Over the years since the death of his wife, Keller had become married to his job. He could be found in the office at almost any hour, weekend or not, hunched over his microscope, asking questions of cells and their groupings, and far more often than not, receiving the answers. It was hardly unusual for him to spend the night in the on-call suite.

"And Joe?"

"Yes?"

"I have one other favor to ask of you. Even if it appears completely normal, will you do her brain?"

Keller looked at her quizzically.

"Even if I see no problem, you still want me to dissect, fix, and stain her brain?"

Unlike most other tissues, the brain required specialized, time-consuming, and expensive fixation and staining. The microscopic examination could not be performed for days, sometimes as long as two weeks. Because of the cost, unless there was specific evidence of an anatomic brain problem on gross examination, the microscopic part of the autopsy was never done.

"Please do it no matter what," Nikki said. "Do whatever special stains you can think of to look for toxins. She became insane, Joe. She kept talking about people trying to kill her. In just a few months she went from being one of the most creative, enchanting, centered women who ever lived, to being a paranoid lunatic, frightened that even I was out to get her."

"How can I say no to you."

"Thanks, Joe."

"Urn… I don't want to make this day any more difficult for you than it has already been, but nobody has notified her family yet."

"I expected you would want me to do that. Both her parents are alive. Kathy hasn't been that close to them in recent years, but they were in touch, and when she could, she booked the band to play near there."

"Where is she from?"

Nikki fished out her tattered address book from her bag.

"She's from a coal town in Appalachia. I have the number and address there. The place is called Belinda. Belinda, West Virginia."