Chapter 20

May 9th

11:25 A.M.

Disconnecting from the dictation service after finishing Kera’s autopsy report, Aria removed her feet from the corner of the beat-up metal desk that she’d been assigned and let them fall to the floor. That way she was able to tilt forward enough to get her phone out of her back pocket. She’d not felt any buzz of incoming messages, but she was still hopeful. But there were no emails, texts, or voice mail, which confused and aggravated her. She’d left Madison a text to contact her almost four hours ago. As an added inducement she’d added that she was psyched to connect with her. Yet there had been no communication whatsoever. It never failed to amaze her how people were generally unreliable.

With sudden resolve, Aria decided to pay Social Services at the Hassenfeld Children’s Hospital a visit. After Madison’s apparent enthusiasm last night at Nobu for finding Lover Boy, Aria was shocked she’d not gotten in touch that morning even if she was ridiculously busy, which was probably the case. Although Aria knew she could call the Hassenfeld Social Services line, she decided that wasn’t all that different from leaving a message on Madison’s mobile, which had gotten no response. The solution, simply enough, was to walk over there, barge in on whatever she was doing, and talk to her directly. It was only the equivalent of four city blocks away, and having been an NYU pathology resident for almost four years, she knew exactly where the Social Services Department was in the pediatric outpatient clinic.

The weather was again stellar, with a transparent blue sky and bright sunshine that seemed a world away from the windowless OCME autopsy room. Walking north up First Avenue, Aria passed the busy front of the NYU Langone Medical Center with taxis and a few ambulances lined up in the turnout. She continued on, passing the Emergency Services entrance until she arrived at the driveway for the Kimmel Pavilion. Turning right again on 34th Street, she passed the huge, whimsical sculpture of the Dalmatian balancing a full-size yellow cab on its nose and entered the Hassenfeld Children’s Hospital. With her resident white coat and ID card, she wasn’t challenged by the security personnel.

The clinic was packed with children of all ages and their parents. She skirted the reception desk and went directly to the tiny Social Services scheduling office. Inside were two secretaries manning two desks pushed together to face each other. They wore headsets, as they were almost constantly on the phone scheduling visits. Aria had to wait until one of the women looked up and beckoned to her to indicate she was momentarily free. “Can I help you, Doctor?” she asked.

“I’m looking for Madison Bryant,” Aria said. “Can you direct me to her office?”

Instead of answering directly, the secretary looked over at her colleague as if she needed help. The other secretary had heard Aria’s request and in what was clearly a nonverbal exchange between the coworkers, merely shrugged her shoulders.

“Her office is the third door heading down the main hall,” the secretary said. “But she’s not there. She’s in intensive care in Bellevue Hospital.”

“What?” Aria was sure she’d misheard. “Why? What happened?”

“An awful accident from what we have heard,” the woman said. “The poor woman was hit by a train.”

Taken by surprise and without verbally responding, Aria abruptly turned around and walked out into the busy clinic. She knew that subway accidents were not unheard of in New York City. In point of fact they were relatively common, on average of two or three a month with people jumping in front of trains or even being pushed.

Just beyond earshot, she stopped and cursed under her breath: “Damn, fucking, shit!” She had become progressively irritated when Madison hadn’t contacted her all morning. Now she was even more pissed because she had been counting on this woman’s help. Madison had talked her into the idea of using genetic genealogy to find the missing father, and now she’d gone and gotten herself hit by a train. Aria couldn’t believe how inconvenient this was, putting the burden of dealing with these commercial ancestral DNA companies on her shoulders. But then she had another thought, remembering instances when people who’d ended up on the subway tracks managed to hunker down between the rails to allow the train to pass over them with minimal damage, maybe just a broken leg or a few broken ribs. The reality was that Madison wasn’t at the OCME waiting to be autopsied but rather was in critical care in Bellevue, a familiar hospital to Aria because NYU residents were part of the staff just as they were in the NYU hospitals that made up the NYU Langone Medical Center. All that meant that Madison had to be alive. How alive, was the question.

Quickly getting her phone out of her pocket, Aria checked for news of a subway accident by looking at the websites for the Daily News and the New York Post, which loved such stories. As expected, there was reference to a woman having been pushed in front of a Lexington Avenue train at Grand Central Station, but it was a bare-bones piece with no word about the woman’s condition other than that she’d been taken to Bellevue Hospital. With that meager information, Aria decided to do a bit of her own reporting. If Madison wasn’t hurt too badly and could talk, there was still a chance she could contribute to the Lover Boy effort since her experience of dealing with the commercial DNA companies could be critical. After all, there was a mild time restraint for her as she was only scheduled to be on her forensic rotation for another couple of weeks. Once she transitioned back to being a regular pathology resident, she knew she wouldn’t have the time to pursue a paternity investigation regardless of her current emotional motivation.

But before setting out, Aria called the main switchboard operator at Bellevue to find out where Madison was since the hospital had a number of intensive-care units. Aria assumed that she’d be in the Shock-Trauma ICU connected to the Emergency Department, but it turned out she was wrong. Madison was in the unit on the second floor of the west wing that had private rooms. In a way that was good news as it suggested that not only was Madison still alive, but she must be in reasonably stable condition and therefore could probably talk. It was all the more reason for her to make the effort to visit.

Leaving Hassenfeld, Aria retraced her steps, now heading south on First Avenue. Moving quickly, she again passed the four-block expanse of the Langone Medical Center and then even OCME as well. Now she was walking along several of the aged brick buildings that had been part of the old Bellevue Hospital and were still standing. As she’d done many times walking between the hospitals, she wondered what kind of horror stories they could tell if they could talk. The new Bellevue was just beyond, and she entered through the front door.

Once again, her NYU Medical Center identification card that hung around her neck on a lanyard was the ticket for uninterrupted access to various portions of the hospital. Pushing her way through the crowds, Aria used an elevator to get to the second-floor west wing, where the ICU was located.

As a pathology resident Aria had had little reason to visit Bellevue ICU except when she’d rotated through the hospital as an anatomical pathology resident. On several occasions she attended teaching rounds, so she was acquainted with how it was set up. The fact that it had private rooms made being an ICU patient a bit more tolerable from the patient’s perspective and was intended to keep them from getting PTSD. It afforded the opportunity to be shielded to a degree from calamities happening to other patients. Until recently, the mental trauma of being an ICU patient had not been given the thought it deserved. The 24/7 full illumination and activity combined with the sounds of the respirators and cardiac monitors were enough to drive someone mad.

From her experience as a sub-intern while she was in her fourth year of medical school, she knew whom to speak with first. The ICU charge nurse essentially ran the unit during her shift even if critical care residents were present, which was usually the case, or even intensivist attendings. As Aria entered the unit, she was surprised to see a number of NYPD personnel standing off to the side and chatting among themselves, both uniformed and some in plainclothes who she guessed were detectives. Aria found the charge nurse at the central desk, which was the equivalent of the brain of the ICU with a bank of monitors showing each of the patients’ vital signs as well as their cardiac function. Each patient had their own intensive-care nurse who spent seventy-five to eighty percent of the time at the bedside. On this particular shift, the charge nurse was Maureen D’Silva, and she was running the show as if she were a conductor of a symphony orchestra. Aria had to wait to get a word in edgewise.

“I’m here to see Madison Bryant,” she said the moment she had an opportunity.

“You and everyone else,” Maureen said. But then her attention was demanded elsewhere, and she had to yell across the room about blood work that needed to be done. A moment later she redirected her attention to Aria. “Who was it you were inquiring about?”

“Madison Bryant,” Aria said.

“Right, the subway victim,” Maureen said. “She’s in room eight.”

“Is she conscious?” Aria asked. “Is she able to talk?”

Maureen held up her hand horizontally and wobbled it in midair. “She’s in and out of consciousness, but reasonably oriented to time, place, and person when she’s with us. Considering what happened to her, she’s one lucky unlucky woman. Medically she is surprisingly stable, which is why they moved her up here.”

“Were you joking about other people coming to see her?” Aria said.

“Not at all,” Maureen said. “All these policemen are here because of her, as well as a bunch of bigwigs, who are in her room right at the moment.”

“Why the fuss?” Aria asked.

“Apparently she was pushed by some homeless guy,” Maureen said. “At least that’s the word.”

“What do you mean by ‘bigwigs’?”

“Try the president and CEO of Langone Health and Hospitals,” Maureen said. She was obviously impressed. “It’s the first time I’ve seen the man in the flesh. Plus, there are some NYU Medical School department heads and the head of Bellevue Emergency Department in there, too.”

“You mean Vernon Pierce is here?” Aria asked. From where she was standing at the central desk, she could see into room 8. The room looked full, and as she watched, people started coming out into the hallway. She even saw someone she recognized: Dr. Carl Henderson.

“That’s Vernon Pierce,” Maureen said, pointing at the first man who had emerged from room 8. He was of a bit more than average height and heavyset, with moderately long black hair slicked back and parted on the left. His face was full but not flabby, with a dark complexion and a five-o’clock shadow. It occurred to Aria that if he weren’t a hospital president, he could have passed for a mob boss.

“What is the extent of Madison Bryant’s injuries?” Aria asked, still wondering about the chances of her helping with Lover Boy’s identity.

“A broken leg, a few broken ribs, a fractured skull, and a broken arm. The worst part is that she lost a foot from just above the ankle. Luckily, she landed between the rails except for the foot.”

Holy shit, Aria thought. Fractured skull meant concussion or worse, which argued against her being in any condition to help, at least on this particular day. Before even trying to talk with her, Aria was now feeling progressively negative about making the effort. Although getting run over by a train was a damn good excuse for not returning a text, Aria couldn’t help but feel irritated that Madison had allowed herself to be victimized. She must have been standing too damn close to the yellow line painted on all subway platforms that people were told to stay well behind. It reminded Aria of New York City pedestrians who always crowded out into the street waiting for the traffic light to change, practically daring the taxis to run them over, which happened on a fairly frequent basis.

“Dr. Nichols!” a voice called out, catching Aria off guard as she was debating whether to attempt to talk with Madison or just leave. Turning in the direction of the voice, Aria saw Dr. Henderson coming in her direction, dragging the mob boss with him. If she could have fled, she would have, but there wasn’t time.

“What a coincidence,” Carl said, crowding close enough to Aria so that she could smell his coffee breath. “I was just talking about you to our president five minutes ago. Vernon, this is Dr. Aria Nichols, who was involved with the autopsy on Kera Jacobsen. Remember, you asked me for her number?”

“Of course I remember,” Vernon said with the mild irritation of a man under stress. He stuck out his hand, which Aria shook against her better judgment. She had an instantaneous dislike for Vernon and his dark beady eyes. To her he seemed inappropriately cast as a hospital president.

“The administration wants to thank you for your understanding of the sensitivity of the Jacobsen tragedy,” Vernon said. Aria nodded. At least the man had a commanding voice. “We hope you will not draw any more attention to it since we’re still concerned it could adversely affect our medical center, especially now with this new, supposedly newsworthy event that is indirectly associated. As you are well aware, we much prefer to stay out of the tabloids.”

Aria chose not to answer, which created an uncomfortable moment.

“Well, that’s it, then,” Vernon said. “I’m glad to meet you, Dr. Nichols, and thanks again. Now, if you’ll excuse me, I have to deal with these detectives here and hopefully keep the fallout of this latest unfortunate episode to a minimum.” With a kind of bow, Vernon moved on. Carl stayed where he was.

“Well, this was an unexpected surprise seeing you,” Carl said. “What brought you here?”

“I wanted to try to talk with Madison,” Aria said. “Is she capable?”

“Oh, that’s right,” he said. “No, she’s not. At least not now. Maybe tomorrow or the next day. She’s been severely traumatized. But on a more positive note, I was going to get in touch with you this afternoon. I checked the literature and there is no information about channelopathies and fentanyl.”

“I’ve kind of lost interest in looking into channelopathies on this case,” Aria told him.

“That’s probably appropriate,” Carl said. “And how is the forensic investigation going about finding the father?”

“I’ve hit the proverbial brick wall,” she said, again borrowing the term from her night’s reading. “But I have a new idea, and that is to see if genetic genealogy can help at all.”

“Now, that is an interesting concept.” Carl nodded several times, obviously giving the idea some thought. “Very creative! That would mean essentially trying to construct the father’s DNA, or at least part of it from the fetus, and then use that like they did with the Golden State Killer.”

“That’s more or less the idea,” Aria said. She was duly impressed that he saw the concept had at least some possible merit, although how much, she really didn’t know herself.

“I can’t imagine it will be easy,” Carl said. “But good luck. As I said yesterday, I think you’re getting more out of your forensic rotation than most pathology residents. I commend you.”

“Let’s see where it leads before offering any kudos.”

“Please, keep me informed of your progress,” Carl said. “I find it fascinating.”

“Yeah, sure,” Aria said. “But I have a sense that Vernon Pierce wouldn’t find it so fascinating.”

“Why do you say that?”

“If the father is located, it could draw general attention to the case,” she said. “Especially if it turns out the father was involved with the drugs Kera Jacobsen was using.”

“I see your point,” he said. “That’s true, but Vernon isn’t trained as a doctor but rather as an administrator. He’s not as aware as he should be of how DNA science is changing medicine and law enforcement. But let’s not worry about his attitude at the moment.”

“Believe me, I’m not,” Aria said.

Carl reached out and gave her shoulder a quick, reassuring squeeze. It happened so fast that she didn’t have time to duck away. She didn’t like to be touched like that.

“Keep up the good work!” Carl said, totally unaware of Aria’s reflex reaction. “Are you going to stay here and try to talk with Madison? I really don’t recommend it.”

“No, I think I’ll come back tomorrow,” Aria said.

“Probably best,” he said. “Anyway, stay in touch.”

With that, he returned to where Vernon was talking with several men. In contrast to Vernon, these men looked perfectly cast as NYPD detectives according to their dress and seen-it-all attitudes. For a beat she watched Carl as he joined the conversation. She briefly wondered if she had been too hasty in her judgment of the man. Perhaps he was acting more like the father figure she’d always wanted but never had.

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