Last to Die

TWENTY-TWO

ARE YOU SURE YOU WANT TO BE HERE FOR THIS, DR. ISLES?”

They stood in the morgue anteroom, surrounded by supply cabinets filled with gloves and masks and shoe covers. Maura had donned a scrub top and pants from the locker room, and she was already tucking her hair into a paper cap.

“I’ll send you the final report,” said Dr. Owen. “And I’ll order a comprehensive tox screen, as you suggested. You’re welcome to stay, of course, but it seems to me …”

“I’m only here to observe, not interfere,” said Maura. “This is entirely your show.”

Beneath her bouffant paper cap, Dr. Owen flushed. Even under harsh fluorescent lights it was a youthful face with enviably smooth skin that had no need for all the camouflaging creams and powders that had started to creep into Maura’s bathroom cabinet. “I didn’t mean it that way,” said Dr. Owen. “I’m just thinking about the fact you knew her personally. That has to make this hard for you.”

Through the viewing window, Maura watched Dr. Owen’s assistant, a burly young man, assembling the instrument tray. On the table lay the corpse of Anna Welliver, still fully dressed. How many cadavers have I sliced open, she wondered, how many scalps have I peeled away from skulls? So many that she had lost track. But they were all strangers, with whom she shared no memories. She had known Anna, though. She knew her voice and her smile and had seen the gleam of life in her eyes. This was an autopsy any pathologist would avoid, yet here she was, donning shoe covers and safety glasses and mask.

“I owe this to her,” she said.

“I doubt there’ll be any surprises. We know how she died.”

“But not what led up to it.”

“This won’t give us that answer.”

“An hour before she jumped, she was acting strangely on the phone. She told Detective Rizzoli that food didn’t taste right. And she saw birds, strange birds, flying outside her window. I’m wondering if those were hallucinations.”

“That’s the reason you asked for the tox screen?”

“We didn’t find any drugs in her possession, but there’s a chance we missed something. Or she hid them.”

They pushed through the door into the autopsy room, and Dr. Owen said: “Randy, we’ve got a distinguished guest today. Dr. Isles is from the ME’s office in Boston.”

The young man gave an unimpressed nod and asked: “Who’s going to cut?”

“This is Dr. Owen’s case,” said Maura. “I’m just here to observe.”

Accustomed to being in command in her own morgue, Maura had to resist the urge to claim her usual place at the table. Instead she stood back as Dr. Owen and Randy positioned instrument trays and adjusted lights. In truth, she did not want to move any closer, did not want to look into Anna’s face. Only yesterday she had seen awareness in those eyes, and now the absence of it was a stark reminder that bodies are merely shells, that whatever constituted a soul was fleeting and easily extinguished. Emma Owen was right, she thought. This isn’t an autopsy I should watch.

She turned instead to the preliminary X-rays hanging on the light box. As Dr. Owen and her assistant undressed the corpse, Maura stayed focused on images that had no familiar face. Nothing in these films surprised her. Last night, just by palpation, she had detected depressed fractures of the left parietal bone, and now she saw the evidence in black and white, a subtle spider’s web of cracks. She turned next to the rib cage where, even through the vague shadows of clothing, she spotted massive fracturing of ribs two through eight on the left. The force of free fall had fractured the pelvis as well, compressing the sacral foramen and cracking apart the ramus of the pubic bone. Exactly what one would expect to see in a body dropped from a height. Even before they sliced open the chest, Maura could predict what they would find in the thoracic cavity because she had seen the results of free fall in other bodies. While a fall might crack ribs and crush a pelvis, what ultimately killed was the force of abrupt deceleration tugging on heart and lungs, ripping delicate tissues and tearing great vessels. When they sliced open Anna’s chest, they would most likely find it filled with blood.

“How the hell did she get these?” Randy said.

Dr. Owen called out: “Dr. Isles, you’ll want to look at this.”

Maura crossed to the table. They had unbuttoned the top of Anna’s dress, but had not yet peeled it off the hips. The corpse was still wearing a bra, a practical white D-cup with no lace, no frills. They all stared at the exposed skin.

“These are the weirdest scars I’ve ever come across,” said Dr. Owen.

Maura stared, stunned by what she saw. “Let’s get the rest of her clothes off,” she said.

With three of them working together, they quickly removed the bra, pulled the dress down. As they peeled the underwear waistband over the hips, Maura remembered the pelvic fractures that she had just seen on X-ray and grimaced at the thought of those bony fragments grinding together. Thought of the screams she’d once heard in the ER from a young man whose pelvis had been crushed in a barge accident. But Anna was beyond pain, and she surrendered her clothes without a whimper. Stripped naked, she now lay exposed, her body bruised and deformed by broken ribs and skull and pelvis.

Yet it was the marks on her skin that they stared at. Marks that were invisible to the X-ray machine, and revealed only now. The scars were spread across the front of her torso, an ugly grid of knots on her breasts, her abdomen, even her shoulders. Maura thought about the modest Mother Hubbard gowns that Anna wore even on warm days, dresses chosen not because of her eccentric sense of style, but for concealment. She wondered how many years it had been since Anna had donned a bathing suit or sunbathed on a beach. These scars looked old, permanent souvenirs of some unspeakable ordeal.

“Could these be some kind of skin grafts?” asked Randy.

“These aren’t skin grafts,” said Dr. Owen.

“Then what are they?”

“I don’t know.” Dr. Owen looked at Maura. “Do you?”

Maura didn’t answer. She turned her attention to the lower extremities. Reaching up for the light, she redirected it to the shins, where the skin was darker. Thicker. She looked at Randy. “We need detailed X-rays of the legs. The tibias in particular, and both ankles.”

“I already did the skeletal survey,” said Randy. “The films are hanging there right now. You can see all the fractures.”

“I’m not concerned about new fractures. I’m looking for old ones.”

“How does this help us with cause of death?” said Dr. Owen.

“It’s about understanding the victim. Her past, her state of mind. She can’t talk to us, but her body still can.”

Maura and Dr. Owen retreated to the anteroom, where they watched through the viewing window as Randy, now garbed in a lead apron, positioned the body for a new set of X-rays. How many scars were you hiding, Anna? The marks on her skin were obvious, but what of the emotional wounds that never heal, that cannot be closed over with fibrosis and collagen? Was it old torments that finally drove her to step out onto the roof walk and surrender her body to gravity and the hard earth?

Randy clipped a new set of films onto the light box and waved to them. As Maura and Dr. Owen reentered the lab, he said: “I don’t see any other fractures on these views.”

“They’d be old,” said Maura.

“No scar formation, no deformities. You know, I can recognize those.”

There was no missing the irritation in his voice. She was the interloper, the high-and-mighty expert from the big city who’d questioned his competence. She chose not to engage him and focused instead on the X-rays. What he had said was correct: At first glance, there were no obvious old fractures of the arms or legs. She moved closer to study first the right tibia, then the left. The darker skin on Anna’s shins had raised her suspicions, and what she saw on these films confirmed her diagnosis.

“Do you see this, Dr. Owen?” Maura pointed to the outline of the tibia. “Notice the layering and the thickness.”

The young pathologist frowned. “It is thicker, I agree.”

“There are endosteal changes here as well. Do you see them? These are highly suggestive.” She looked at Randy. “Can we see the ankle films now?”

“Suggestive of what?” he asked, still unconvinced by this expert from Boston.

“Periostitis. Inflammatory changes of the membrane covering the bone.” Maura pulled down the tibia X-rays. “Ankle films, please.”

Tight-lipped, he shoved the new X-rays under the clips, and what Maura saw in those films swept away any doubts she’d had. Dr. Owen, standing beside her, murmured a troubled: Oh.

“These are classic bony changes,” said Maura. “I’ve seen them only twice before. Once in an immigrant from Algeria. The second was a corpse that turned up in a freighter, a man from South America.”

“What are you looking at?” said Randy.

“The changes in the right calcaneus,” said Dr. Owen. She pointed to the right heel bone.

Maura said, “You can see them in the left calcaneus, too. Those deformities are from multiple old fractures that have since healed.”

“Both her feet were broken?” said Randy.

“Repeatedly.” She stared at the X-rays and shuddered at their significance. “Falaka,” she said softly.

“I’ve read about it,” said Dr. Owen. “But I never thought I’d see a case in Maine.”

Maura looked at Randy. “It’s also known as bastinado. The feet are beaten on the sole, which breaks bones, ruptures tendons and ligaments. It’s known in many places around the world. The Middle East, Asia. South America.”

“You mean someone did this to her?”

Maura nodded. “And those changes in the tibias that I pointed out are also from repeated beatings. Something heavy was slammed against the shins. It may not be enough to actually fracture bone, but it leaves permanent changes in the periosteum from repeated hemorrhages.” Maura went back to the table, where Anna’s broken body lay. She understood, now, the significance of that grid of scars on the breasts, the abdomen. What she did not understand was why any of this had been done to Anna. Or when.

“It still doesn’t explain why she killed herself,” said Dr. Owen.

“No,” Maura admitted. “But it makes you wonder, doesn’t it? If her death is somehow connected to her past. To what caused these scars.”

“You’re now questioning whether this was a suicide?”

“After seeing this, I question everything. And now we have another mystery.” She looked at Dr. Owen. “Why was Anna Welliver tortured?”