Hypothermia

23

Erlendur had once developed a condition known as cardiac arrhythmia. At times it was as if his heart took an extra beat, which was very uncomfortable; at others as if his heart rate was slowing down. When, instead of improving, the condition grew worse, he leafed through the Yellow Pages, stopping at a name that caught his fancy in the ‘Heart Specialists’ column: Dagóbert. Erlendur took an immediate liking to the name and decided to make him his doctor. He had hardly been in the doctor’s surgery five minutes before his curiosity got the better of him and he enquired about his moniker.

‘I’m from the West Fjords,’ the cardiologist said, apparently used to the question. ‘I’m fairly resigned to it. My cousin envies me. He got landed with Dósótheus.’

The waiting room in the medical centre was packed with people suffering from a whole range of ailments. A variety of specialists worked there, including ear, nose and throat doctors, a vascular surgeon, three cardiologists, two nephrologists and one eye specialist. Erlendur stood by the entrance to the waiting room, thinking that each of these specialists should be able to find something to suit them in there. He was worried about barging in on his doctor without having made an appointment months in advance. He knew the cardiologist was extremely busy and was presumably booked up far into next year, and that his visit would increase the waiting time of some of the people in here by at least a quarter of an hour, depending when the doctor could fit him in. He had already been standing here for around twenty minutes.

The doctors’ surgeries were on a long corridor off the waiting room, and after forty-five minutes had passed since Erlendur had announced his presence a door opened and Dagóbert came out into the waiting area and beckoned to him. Erlendur followed him into his surgery and the doctor closed the door behind them.

‘Has the problem come back?’ Dagóbert asked, inviting Erlendur to lie down on the bed. His file was open on the desk.

‘No,’ Erlendur said. ‘I’m fine. I’m sort of here on official business.’

‘Really?’ the doctor said. He was a fat, humorous man, dressed in a white shirt, a tie and jeans. He might not have worn a white coat but he did have a stethoscope slung round his neck. ‘Won’t you lie down anyway and let me listen to your chest?’

‘No need,’ Erlendur said, taking a chair in front of the desk. Dagóbert sat down on the bed. Erlendur remembered their previous meetings when the doctor had explained how the electrical impulses that controlled his heartbeat had been disrupted. The problem was generally caused by stress. Erlendur understood little of what he had said beyond the fact that the condition was not life-threatening and would get better in time.

‘Then what can I…?’ Dagóbert asked.

‘It’s a medical matter,’ Erlendur said.

He had been struggling with the wording ever since it had first occurred to him to consult the cardiologist. He didn’t want to talk to anyone involved with the police, such as a pathologist, because he didn’t want to have to explain anything.

‘Well, fire away.’

‘If one wanted to kill a person, but only for a couple of minutes, how would one go about it?’ Erlendur asked. ‘If one wanted to revive him immediately so that nobody could see any sign of what had happened?’

The doctor gave him a long look.

‘Do you know of such a case?’ he asked.

‘Actually, I was going to ask you that,’ Erlendur said. ‘I don’t know of any myself.’

‘I’m not aware of anyone having done it deliberately, if that’s what you mean,’ Dagóbert replied.

‘How would one go about it?’

‘That depends on a number of factors. What are the circumstances?’

‘I’m not sure. Let’s say, for example, that it was done at home.’

Dagóbert looked at Erlendur gravely.

‘Has someone you know been messing around with that sort of thing?’ he asked. Dagóbert knew that Erlendur worked for the CID and thought it obvious that his irregular heartbeat was occupational, as he put it. Otherwise he didn’t often slip into jargon, much to Erlendur’s relief.

‘No,’ Erlendur said. ‘And it’s not a police matter. I’m just curious because of an old report I came across.’

‘You’re talking about how to achieve cardiac arrest without its being discovered and in such a way that the victim would survive?’

‘Possibly,’ Erlendur said.

‘Why on earth would anybody want to do something like that?’

‘I have no idea,’ Erlendur replied.

‘I assume you have some further criteria.’

‘Not really.’

‘I don’t quite follow. As I said: why would anyone want to bring about cardiac arrest?’

‘I don’t know,’ Erlendur said. ‘I was hoping you’d be able to tell me.’

‘The first consideration would be the prevention of damage to the organs,’ Dagóbert said. ‘As soon as the heart stops beating, decomposition begins, immediately endangering the tissues and organs. I expect there are a number of drugs that would do the trick by inducing a coma but, from the way you describe it, this might be a case of hypothermia. Otherwise I’m not really sure.’

‘Hypothermia?’

‘Extreme cold,’ the doctor said. ‘It achieves two goals. The heart stops beating when the body temperature drops below a certain level and you experience clinical death, while at the same time the cold has the effect of preserving the body and organs. Cold slows down all metabolic processes.’

‘How would the person be resuscitated?’

‘Probably with a defibrillator, followed by rapid rewarming.’

‘And you’d need specialist knowledge to do that?’

‘Unquestionably. I can’t imagine any other scenario. There would have to be a doctor present, even a cardiologist. And it goes without saying that no one should meddle with this sort of thing.’

‘How long is it possible to keep someone in a state like that before it becomes irreversible?’

‘Well, I’m no expert when it comes to inducing clinical death by hypothermia,’ Dagóbert said, with a smile. ‘But it’s a question of a few short minutes after cardiac arrest – four to five, tops. I don’t know. You’d have to factor in the facilities available to you. If you’re in hospital with access to all the best technology, it might be possible to go even further. Hypothermia has been used in recent years to keep people in a coma while their wounds are healing. It’s also a good method of protecting the organs of people who have experienced cardiac arrest, for example. In that case the body temperature is held at thirty-one degrees Celsius or thereabouts.’

‘If it was done at home, what equipment would you need?’

The doctor stopped and thought.

‘I can’t…’ he began, before breaking off again.

‘What’s the first thing that comes to mind?’

‘A good-sized bathtub. Ice. A defibrillator and easy access to electricity. A blanket.’

‘Would it leave any trace? If the person in question was successfully resuscitated?’

‘Signs that it had taken place? I don’t think so,’ Dagóbert said. ‘I should think it’s like getting caught in a blizzard. The cold gradually slows the metabolic processes; the person would become drowsy initially, then fall into a stupor and finally experience cardiac arrest and death.’

‘Isn’t that exactly what happens when people die of exposure?’ Erlendur asked.

‘Exactly the same.’

The woman who had last spoken to the student Gudrún, as far as could be established with any certainty, now worked as a departmental manager at the National Museum of Iceland. They had been cousins and Gudrún’s parents had asked her to keep an eye on their daughter while they were on their extended trip through Asia. She was three years older than Gudrún, short, with thick blonde hair tied back in a ponytail. Her name was Elísabet and she called herself Beta.

‘I find it very uncomfortable raking this up,’ she said once she and Erlendur had taken a seat in the museum café. ‘I was sort of responsible for Dúna, or at least I felt I was, though of course, you know, I couldn’t have prevented anything. She just vanished. It was absolutely unbelievable. Why are you investigating this now?’

‘We’re closing the file,’ Erlendur said, hoping it would do as an explanation.

‘So you’re sure she’ll never be found now?’ Beta said.

‘It’s been a long time,’ Erlendur said, without answering her directly.

‘I just can’t imagine what could have happened,’ Beta said. ‘One day she drives away and – poof! – she vanishes. Her car’s never found, nor any trace of her. She doesn’t seem to have stopped off at any shops or villages, either on the way north or in the Reykjavík area.’

‘People have mentioned suicide,’ Erlendur said.

‘She just wasn’t the type,’ Beta said immediately.

‘What is the type?’ Erlendur asked.

‘No, I mean, she wasn’t like that.’

‘I don’t know anyone who is,’ Erlendur said.

‘You know what I mean,’ Beta said. ‘And what happened to her car? It can hardly have committed suicide!’

Erlendur smiled.

‘We dragged the harbours all round the country. Sent divers to search along the docks in case she’d lost control of the car. We didn’t find anything.’

‘She was incredibly fond of her little yellow Mini,’ Beta said. ‘I’ve never been able to picture her driving it off some jetty. I’ve always found the idea absurd. Ludicrous.’

‘She didn’t reveal anything about her plans in your last conversation?’

‘Nothing. If I’d known what was going to happen it would have been different. She rang to ask me about a hairdresser’s on Laugavegur I’d recommended to her. She was intending to go there. That’s why I’ve never believed in suicide. There was nothing to point to it.’

‘Was there some reason, some special occasion?’

‘For the hairdresser’s appointment? No, it was just time for a haircut, I think.’

‘And you didn’t discuss anything else?’

‘No, not really. I didn’t hear from her again. I assumed she’d gone up north; I called a couple of times but she was never in, or at least that’s what I thought. By then, of course, she had gone missing. I find it so hard to imagine what could have happened. Why should a girl like her, in the prime of life, vanish like that without any reason or warning? What does it tell you? How can you ever be expected to understand?’

‘She’d never been in a relationship, lived with a boyfriend or…?’

‘No, never – she had all that to look forward to.’

‘Where did she go when she used to take trips in the car? I know it’s in the files but one can never ask too often.’

‘Up north, of course. She missed Akureyri at times and used to go there whenever she could. Then there was the area around Reykjavík. The Reykjanes peninsula. Over the mountains to the east. An outing to Hveragerdi for an ice cream. The usual. You know about her passion for lakes.’

‘Yes.’

‘Lake Thingvallavatn was a great favourite.’

‘Thingvallavatn?’

‘She knew it like the back of her hand. Was forever going there and had her favourite spots by the lake. Our uncle down here in Reykjavík had a holiday cottage in Lundarreykjadalur in the Borgarfjördur area, which we used a lot, and she often took the mountain road over Uxahryggir and down to Thingvellir on her way back to town. She’d drive round the eastern shore of the lake and then home. She used to camp at Thingvellir sometimes with her girlfriends. And sometimes alone. She’d drive out of town and stay alone by the lake. She quite liked being alone – she was self-sufficient in so many ways.’

‘There was no sign that she’d visited your uncle’s holiday cottage?’ Erlendur asked, trying to recall the files on Gudrún’s disappearance.

‘No, she hadn’t been there,’ Beta said.

‘Where did this fascination with lakes come from?’

‘No one knew, not even her. Dúna had always been like that, ever since we were small. She once told me that lakes had a strange power, a wonderful tranquillity. That you could commune best with nature beside lakes, with all the birds and the life of the shore. Of course she was studying biology. It wasn’t a coincidence.’

‘Did she ever go out on the lake? Did she own a boat?’

‘No, that was the strange thing about Dúna. She was afraid of water when she was a girl. It was difficult to get her to take swimming lessons and she never much enjoyed trips to the pool. She had no interest in being in the water, only in being near lakes. That was the nature lover in her.’

‘There aren’t many places as beautiful as Lake Thingvallavatn,’ Erlendur commented.

‘That’s true.’