“Has anyone called nine-one-one?” Kit asked.
“On the way,” Grandma O said, bending to give the man another breath.
Though the stricken man had said only one word to her, Kit felt a pang of responsibility for him, and here she was standing by, doing nothing to help. . . . But what was there to do? And so she did all she could, silently urging the man to breathe on his own.
The minutes inched by without any encouraging signs. Finally, in the distance, a siren, then closer . . . a green-and-white ambulance outside.
A female white-shirted medic in blue pants charged through the door, her male partner close behind, pulling a stretcher loaded with equipment.
“We’ll take over now,” the female said, helping Grandma O to her feet. “How long’s he been out?”
“Maybe ten minutes,” Grandma O said.
“He eaten anything?”
Learning that he hadn’t, the medic grabbed a shoulder bag from the stretcher and dropped to her knees beside the victim’s head. In seconds, she had a mask strapped to his face. While she gave him air by squeezing a blue bag attached to the mask, her partner grabbed a shoulder bag and a cardiac monitor from the stretcher and hurried to the victim’s other side. He pushed the fallen table away with his foot, knelt, and ripped the victim’s shirt open. He turned on the monitor and clapped two paddles to the exposed skin.
The monitor showed only a flat line, a permanent copy of the bad news issuing from the monitor on a paper tongue.
The medic gave it a name. “He’s in fine v. fib.”
He removed the paddles from the victim’s chest, rubbed a jelly onto their contact surface, and slapped them back against the victim’s skin. He nudged a dial on one of the paddles and pushed a button. The paddles gave off a barely audible buzz that gradually grew louder. A tiny red light on each paddle flicked on.
“Clear.”
The victim bucked under the jolt of current and the air was filled with the smell of burning hair. Seeing the same flat line on the screen, the medic nudged the dial on his paddle. The buzz returned, escalated, and the red lights winked on.
“Clear.”
The victim bucked again, more violently, but the heart refused to kick in.
Another nudge of the dial.
A third, even more powerful shock, lifted the victim off the floor, but still the heart resisted. By now, the smell of singed hair was so sickening, most of the bystanders had moved back. Having smelled far worse odors at crime scenes she’d attended with her boss, and feeling linked to the victim, Kit held her ground. The medic looked up at her, holding out an IV bag. “Take this and stand right here.”
Happy to be helping, Kit moved closer and took the bag from him.
“I need somebody to do chest compression,” the female medic announced, her voice filled with urgency.
Grandma O and a man who wouldn’t take up nearly as much space at the victim’s side as she would stepped forward simultaneously. The medic chose the man, her decision generating a hard look from Grandma O.
The medic working the monitor slipped a needle into a vein in the front of the victim’s elbow. He attached the IV tube and taped it in place. He then discharged the contents of a preloaded syringe into a port on the downstream side of the bag. The heart shock paddles had also been serving as temporary leads conveying the victim’s heart rhythms to the monitor. The medic now switched to the regular leads, sticking them to the victim’s chest.
The monitor showed only the same flat line as before. Continuing to stare at the pattern that wasn’t changing, the male medic said, “Anyone know this man?”
No one spoke up, so Kit said, “We were talking, but I didn’t really know him.”
“What happened?”
“When I approached the table, he stood up, said my name . . . then dropped.”
“You wouldn’t know, then, if he’s had heart trouble or what kind of medication he might be taking?”
“No, I wouldn’t.”
Precious seconds passed, their flight marked by the rubbery squish of the ventilator bag and the volunteer counting off each chest compression. Yet the medic just stared at the monitor. Mesmerized by the struggle playing out before them, no one in the crowd moved. Finally, when Kit was about to suggest he do something, the medic shocked the heart again, still without success.
On the opposite side, the female medic removed the victim’s face mask and passed a long plastic tube into his mouth. She attached the blue bag to that and ventilated him twice while listening to his chest. Apparently satisfied that the tube was properly placed, she taped the tube to the victim’s face and signaled for her volunteer to resume chest compression.
The medic at the monitor emptied another syringe into the IV port. He waited a short time, then shocked the heart again. Despite Kit’s wishes, the line on the monitor remained infuriatingly flat. The medic produced a radio.
“Charity Med Control. This is Unit Six-two-oh-one, on the scene. Patient is a white male, approximately sixty years of age, found in full arrest. ACLS protocols implemented and IV going. Patient remains in fine v. fib. Any further orders?”
“Load and go.”
“En route. ETA three to five minutes.”
The medics strapped their patient to a stiff slab of yellow plastic and loaded him onto the stretcher. They put the IV bag Kit had been holding under his head, thanked everybody for their help, and whisked him away.
Kit was ashamed of the relief she felt at his departure.
The knot of people who’d been watching broke up and went back to their tables, buzzing about what they’d seen— all of them except for a woman in a green cotton jogging outfit that, given her age and shape, likely hadn’t been doing much jogging. She came over and shook her finger at Grandma O.
“That was very foolish of you . . . giving that man CPR with your mouth on his. You don’t know what he’s been doing with that mouth or what bugs he might have.”
“Well, it’s like dis,” Grandma O said. “Ah lef’ mah face mask an’ ventilator bag in mah other purse an’ Ah jus’ los’ mah head. Besides, ain’t no bug got the nerve to try anything on me.”
From the look on the woman’s face, she didn’t know what to make of Grandma O. But then, few people did. As the woman moved off, Grandma O turned to Kit.
“When he came in, he said he was waitin’ for somebody, but Ah didn’t know it was you.”
“Someone sent me a yellow rose on Monday with no note attached. The same thing happened Tuesday. Yesterday, one came with a message that the sender would be here today if I wanted to meet him.”
“He looked too old for you. Now, if he’d sent me dose roses . . .”
“But like I told the medic, I’ve never even seen the man before.”
“Child, dis can’t be da first time a man you’d never noticed tried to get your attention.”
“No . . . but this one seemed different.”
“’Cause of his age?”
“More than that.”
“Ah don’ guess anybody ever died on you like dat before.”
“You . . . don’t think he’ll make it?”
Grandma O walked over and picked up the yellow rose Kit’s mysterious admirer had dropped. She came back and handed it to her. “Ah hope Ah’m wrong, but Ah think dis is da las’ rose he’ll ever buy.”
2
Having no appetite for lunch, yet too keyed up to go back to her office in Charity Hospital, Kit lingered at the restaurant, wanting to talk more with Grandma O about what had happened. But Grandma O had customers to deal with. So instead, Kit carried the yellow rose down to the river and watched the ship and barge traffic for a while from a bench in front of the aquarium, spending most of that time reliving those awful moments at the restaurant and wondering what it all meant.
Finally, deciding that enough time had passed for the mystery man to get to the hospital and be checked in, she headed back to her office to see what she could find out about his condition.
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br /> Twenty minutes later, as she got off the elevator on her floor, she ran into her boss, Andy Broussard, chief medical examiner of Orleans Parish, waiting to get on.
Because he was so overweight, if you saw him coming down the street and didn’t know him, you’d probably think he wasn’t very healthy. But when he got close and you could see that above his gray beard, his skin had a robust glow, you might reconsider. And if you’d ever seen him climb a ladder to rescue the odd cat that had become stuck in a tree in his yard or to put a baby bird back in its nest, you’d know you were wrong. Kit hadn’t actually seen one of those ladder rescues firsthand, but Charlie Franks, the deputy ME, had slides of him doing it, so Kit didn’t believe Broussard’s denials that he ever did such things. Aside from his surprising agility, the most remarkable thing about him was his mind, which was so sharp, Kit was still intimidated by him, though she’d played a major role in solving more than one case since she’d arrived.
“Heard you had some excitement,” he said.
“Who told you that?”
“Grandma O.”
Ignoring what he’d probably been told, Kit poured out her own version of the story, finishing by saying, “. . . and when they took him away, it didn’t look like he was going to make it.”
Broussard tilted his chin and examined her through the tops of his glasses. “He didn’t.”
“How do you know?”
“He’s downstairs, in the morgue.”
“Who is he?”
Broussard shrugged. “Beats me. I haven’t actually seen him yet, but Guy said he had no ID on him. I told Phillip about the situation. . . .”
Kit briefly wondered which Phillip he meant, then realized it had to be Phil Gatlin, Broussard’s longtime friend in Homicide.
“He went over to the restaurant to see if the victim had come by car, thinkin’ he might get a line on his identity that way, but he just called sayin’ every car in the lot was accounted for.”
“Jesus, you two work fast.”
“We’re old, but we’re good. I’m on my way downstairs now to see what killed this fellow.”
“I’d like to know that myself,” Kit said. “Will you let me know when you find out?”
He nodded and slipped a lemon ball into his mouth from the linty cache in the pocket of his lab coat. He offered her a wrapped one from the other pocket, a ritual that had become so commonplace, the transfer was made without comment. “Should take about an hour and a half.”
Kit went to her office and put the yellow rose in a badly chipped bud vase she’d been meaning to replace for months. She then tried to pick up the project she’d been working on that morning, construction of a psychological autopsy on a nineteen-year-old male who’d shot himself in the head in front of his buddy. They’d bought the gun, a .38 Smith & Wesson, at a pawnshop because his buddy’d had his car hijacked at gunpoint and felt he needed protection to keep it from happening again. The victim had loaded the gun, pointed it at his head, said, “Life sucks,” and pulled the trigger.
But nothing else about the guy sounded like a potential suicide. He had plans for the future and hadn’t been depressed. Something wasn’t right.
She looked at the police report in front of her. Except for an empty chamber at the nine o’clock position, the gun had been fully loaded. Why the empty chamber when there were extra rounds still in the box?
Her concentration wavered as she saw again the pallid complexion of the man stricken at Grandma O’s—his surprised expression before he went down, the flat line on the cardiac monitor.
AS BROUSSARD LEFT THE elevator, he felt a twinge around the knife scar on his side. It’d been a little over a year since that dreadful affair, and except for an occasional sad thought about the cause of it all and an ache in the scar just before a rain, he’d fully recovered.
When he entered the morgue, he found that Guy Minoux and Natalie D’Souza, his two assistants, had already stripped the body. Except for their facial protection, which they hadn’t put on yet, they were each fully turned out in a disposable front-zippered jumpsuit covered by a disposable surgical gown with a Velcro fastener and tie at the back and elastic closures on the sleeves. They had protective booties on their shoes, two pairs of rubber gloves taped at the wrist to the gown, and a disposable hood tied under the chin. This was a bit much for Broussard. After all, there was such a thing as style.
“Afternoon, Your Honor,” Minoux said, bowing. “He’s ready for inspection.”
“Nice to get a clean one once in awhile,” D’Souza added, referring to the fact many of their customers came in bloodied and had to be washed before much could be done.
“We’re gonna need a set of prints,” Broussard said, going to the dressing alcove.
“Already done,” Minoux said, beaming at his own efficiency.
D’Souza stepped over to the stereo. “What’ll it be today— Tchaikovsky, Mozart?”
While he occasionally liked Tchaikovsky during an autopsy, Broussard generally viewed him as a composer better suited to microscopic work. Mozart was a different matter— that was an autopsy composer. “Mozart, disc three.”
She nudged the select button on the stereo, using the knuckle of her gloved hand, then pushed play, warming the cool room with the opening strains of The Magic Flute.
“Delivery crew said he keeled over at Grandma O’s,” Minoux said. “That’s not gonna be good for business.”
“He hadn’t had anything to eat, so I don’t think we can blame her,” Broussard replied, slipping a pair of booties over his mesh shoes. While Broussard donned his plastic apron, on which someone had long ago written THE BOSS with a permanent black marker, the two assistants each put on a mask and a plastic visor. Broussard added two pairs of rubber gloves to his meager outfit, walked over to the body, and reached for a Polaroid camera on a nearby bench.
Though he had seen thousands of cadavers, the tenuous nature of life had never ceased to fascinate him. A single puncture wound in the right place and it was gone. . . . Constrict the airway for a few minutes, it was gone—an irrevocable loss far too easy to achieve. And even when it happened without external intervention, as apparently this one had—a death by so-called natural causes—it seemed no less deplorable.
Whenever an endotracheal tube is inserted during attempts at life support and then the patient dies, the tube is left in place so the ME can determine if it was properly placed. That tube and the tape securing it now obscured the man’s features. Even so, it was easy to see he wasn’t young. The gray scalp hair, eyebrows, chest, and pubic hair alone indicated that.
He took a picture of the face with the tube in place, then motioned to Minoux, who cut the end of the tube off with a big pair of scissors and tucked the protruding remains behind the cadaver’s teeth. Broussard photographed the face again and traded the camera for a clipboard holding a sheet of paper depicting front and back views of a sexless human.
He began his superficial exam, starting at the head. After a few seconds of general inspection, he asked Minoux to spread the eyelids, which were half-closed. Using a penlight, he saw that each eye exhibited arcus senilis, a thin white line of deposited lipid circling the cornea near its junction with the sclera—an indicator of heart disease. He noted this on the form.
The next feature of interest was a tattoo lettered on the right wrist, crudely done, like those often acquired in jail. The sentiment expressed, “Think Free,” supported that notion. “Mark it,” he said, noting its location on the diagram.
D’Souza tacked a small adhesive-tape ruler to the skin under the tattoo.
Broussard turned to Minoux and made a twisting motion with his hand. Responding, Minoux rotated the arm so Broussard could examine its posterior surface, the absence of rigor making the task easier than it otherwise might have been.
On the back of that hand, amid a cluster of freckles, Broussard noted a small ecchymosis—a hemorrhage under the skin—probably an injury suffered during his fall in the restaurant. D�
��Souza also marked that.
Minoux then rotated the arm at the shoulder so Broussard could inspect the axilla, which was unremarkable.
There were two more ecchymoses on the back of the body’s left hand. He found patches of brawny edema on both legs, collections of tissue fluid that felt rubbery rather than yielding and soft as in the other major type of edema, further evidence the man was plagued with vascular disease. His sparse leg hair also supported that diagnosis.
“Okay, let’s get him over.”
The two assistants rolled the body onto an adjacent wheeled table and Broussard examined its posterior surface, finding only one item of interest, and that, hardly worth noting—a small reddish brown nodule on the right calf.
D’Souza marked the nodule and Broussard noted it on the diagram. He traded the clipboard for the camera and took a close-up of the nodule. “Time to roll him again.”
The two assistants grappled with the body and returned it to the first table so it again lay on its back. Broussard photographed all the marked areas, then reached for a large syringe. “Let’s get our fluids.”
While Broussard plunged the massive needle on his syringe into the right subclavian vein, Minoux slipped a much smaller needle into the left eye and sucked out the jellylike material that occupied most of the globe, collapsing it. Restoring the eye to full turgor would be a job for the funeral home.
With a syringe and needle the equal of Broussard’s, D’Souza penetrated the skin just above the pubic hair and drove her needle into the bladder.
“I’ll be wantin’ a purple top and a gray,” Broussard said as his syringe filled with dark blood.
D’Souza emptied the contents of her syringe into a plastic bottle and capped it. She then gave Broussard two plastic tubes sealed with colored rubber tops. The tube with the purple top contained EDTA, a chemical that keeps the blood from clotting, allowing this sample to be used for ABO and other antigen typing. Blood in the gray top would be sent to Toxicology, any cocaine in the sample kept intact by the sodium fluoride in the tube.
Louisiana Fever Page 2
