“There are a lot of strange viruses out there these days,” he was saying.
“Yes, there are,” I agreed. “But Hanta, Ebola, HIV, dengue, et al., do not cause the symptoms you have described. That doesn’t mean there isn’t something else we don’t know about.”
“I know smallpox. I’m old enough to have seen it with my own two eyes. But I’m not an expert in infectious diseases, Kay. And I sure as hell don’t know the things that you do. But whatever it might be in this case, the fact is, the woman’s dead and some type of poxvirus killed her.”
“Obviously, she lived alone.”
“Yes.”
“And she was last seen alive when?”
“The chief’s working on that.”
“What chief?” I said.
“The Tangier police department has one officer. He’s the chief. I’m in his trailer now, using the phone.”
“He’s not overhearing this.”
“No, no. He’s out talking to neighbors. I did my best to get information, without a whole lot of luck. You ever been out here?”
“No, I haven’t.”
“Let’s just say they don’t exactly rotate their crops. There are maybe three family names on the whole island. Most folks grow up here, never leave. It’s mighty hard to understand a word they’re saying. Now that’s a dialect you won’t hear in any other corner of the world.”
“Nobody touches her until I have a better idea what we’re dealing with,” I said, unbuttoning my pajamas.
“What do you want me to do?” he asked.
“Get the police chief to guard the house. No one goes in or near it until I say. Go home. I’ll call you later in the day.”
The labs had not completed microbiology on the torso, and now I could not wait. I dressed in a hurry, fumbling with everything I touched, as if my motor skills had completely left me. I sped downtown on streets that were deserted, and at close to five was parking in my space behind the morgue. As I let myself into the bay, I startled the night security guard and he startled me.
“Lord have mercy, Dr. Scarpetta,” said Evans, who had watched over the building for as long as I had been here.
“Sorry,” I said, my heart thudding. “I didn’t mean to frighten you.”
“Just making my rounds. Is everything all right?”
“I sure hope so.” I went past him.
“Is something coming in?”
He followed me up the ramp. I opened the door leading inside, and looked at him.
“Nothing I know of,” I replied.
Now he was completely confused, for he did not understand why I was here at this hour if no case was coming in. He started shaking his head as he headed back toward the door leading out into the parking lot. From there, he would go next door to the lobby of the Consolidated Labs, where he would sit watching a small, flickering TV until it was time to make his rounds again. Evans would not step foot into the morgue. He did not understand how anyone could, and I knew he was scared of me.
“I won’t be down here long,” I told him. “Then I’ll be upstairs.”
“Yes, ma’am,” he said, still shaking his head. “You know where I’ll be.”
Midway along the corridor in the autopsy suite was a room not often entered, and I stopped there first, unlocking the door. Inside were three freezers unlike any normally seen. They were stainless steel and oversized, with temperatures digitally displayed on doors. On each was a list of case numbers, indicating the unidentified people inside.
I opened a door and thick fog rolled out as frigid air bit my face. She was in a pouch, and on a tray, and I put on gown, gloves, face shield, every layer of protection we had. I knew I might already be in trouble, and the thought of Wingo and his vulnerable condition thrilled me with fear as I slid out the pouch and lifted it onto a stainless steel table in the middle of the room. Unzipping black vinyl, I exposed the torso to ambient air, and I went out and unlocked the autopsy suite.
Collecting a scalpel and clean glass slides, I pulled the surgical mask back down over my nose and mouth, and returned to the freezer room, shutting the door. The torso’s outer layer of skin was moist as thawing began, and I used warm, wet towels to speed that along before unroofing vesicles, or the eruptions clustered over her hip and at the ragged margins of the amputations.
With the scalpel, I scraped vesicular beds, and made smears on the slides. I zipped up the pouch, marking it with blaze orange biological hazard tags, almost could not lift the body back up to its frigid shelf, my arms trembling under the strain. There was no one to call for help but Evans, so I managed on my own, and placed more warnings on the door.
I headed upstairs to the third floor, and unlocked a small lab that would have looked like most were it not for various instruments used only in the microscopic study of tissue, or histology. On a counter was a tissue processor, which fixed and dehydrated samples such as liver, kidney, spleen, and then infiltrated them with paraffin. From there the blocks went to the embedding center, and on to the microtome where they were shaved into thin ribbons. The end product was what kept me bent over my microscope downstairs.
While slides air-dried, I rooted around shelves, moving aside stains of bright orange, blue and pink in coplin jars, pulling out Gram’s iodine for bacteria, Oil Red for fat in liver, silver nitrate, Biebrach Scarlet and Acridine Orange, as I thought about Tangier Island, where I’d never had a case before. Nor was there much crime, so I had been told, only drunkenness, which was common with men alone at sea. I thought of blue crab again, and irrationally wished Bev had sold me rock fish or tuna.
Finding the bottle of Nicolaou stain, I dipped in an eye dropper and carefully dripped a tiny amount of the red fluid on each slide, then finished with cover slips. These I secured in a sturdy cardboard folder, and I headed downstairs to my floor. By now, people were beginning to arrive for work, and they gave me odd looks as I came down the hall and boarded the elevator in scrubs, mask and gloves. In my office, Rose was collecting dirty coffee mugs off my desk. She froze at the sight of me.
“Dr. Scarpetta?” she said. “What in the world is going on?”
“I’m not sure, but I hope nothing,” I replied as I sat at my desk and took the cover off my microscope.
She stood in the doorway, watching as I placed a slide on the stage. She knew by my mood, if by nothing else, that something was very wrong.
“What can I do to help,” she said in a grim, quiet way.
The smear on the slide came into focus, magnified four hundred and fifty times, and then I applied a drop of oil. I stared at waves of bright red eosinophilic inclusions within infected epithelial cells, or the cytoplasmic Guarnieri bodies indicative of a pox-type virus. I fitted a Polaroid MicroCam to the microscope, and took instant high-resolution color photographs of what I suspected would have cruelly killed the old woman anyway. Death had given her no humane choice, but had it been me, I would have chosen a gun or a blade.
“Check MCV, see if Phyllis has gotten in,” I said to Rose. “Tell her the sample I sent on Saturday can’t wait.”
Within the hour, Rose had dropped me off at Eleventh and Marshall streets, at the Medical College of Virginia, or MCV, where I had done my forensic pathology residency when I wasn’t much older than the students I now advised and presented gross conferences to throughout the year. Sanger Hall was sixties architecture, with a facade of garish bright blue tiles that could be spotted for miles. I got on an elevator packed with other doctors I knew, and students who feared them.
“Good morning.”
“You, too. Teaching a class?”
I shook my head, surrounded by lab coats. “Need to borrow your TEM.”
“You hear about the autopsy we had downstairs the other day?” a pulmonary specialist said to me as doors parted. “Mineral dust pneumoconiosis. Berylliosis, specifically. How often you ever see that around here?”
On the fifth floor, I walked quickly to the Pathology Electron Microscopy Lab, which housed the onl
y transmission electron microscope, or TEM, in the city. Typically, carts and countertops had not an inch of room to spare, crowded with photo and light microscopes, and other esoteric instruments for analyzing cell sizes, and coating specimens with carbon for X-ray microanalysis.
As a rule, TEM was reserved for the living, most often used in renal biopsies and specific tumors, and viruses rarely, and autopsy specimens almost never. In terms of my ongoing needs and patients already dead, it was difficult to get scientists and physicians very excited when hospital beds were filled with people awaiting word that might grant them a reprieve from a tragic end. So I never prodded microbiologist Dr. Phyllis Crowder into instant action on the occasions I had needed her in the past. She knew this was different.
From the hall, I recognized her British accent as she talked on the phone.
“I know. I understand that,” she was saying as I knocked on the open door. “But you’re either going to have to reschedule or go on without me. Something else has come up.” She smiled, motioning me in.
I had known her during my residency days, and had always believed that kind words from faculty like her had everything to do with why I had come to mind when the chief’s position had opened in Virginia. She was close to my age and had never married, her short hair the same dark gray as her eyes, and she always wore the same gold cross necklace that looked antique. Her parents were American, but she had been born in England, which was where she had trained and worked in her first lab.
“Bloody meetings,” she complained as she got off the phone. “There’s nothing I hate more. People sitting around talking instead of doing.”
She pulled gloves from a box and handed a pair to me. This was followed by a mask.
“There’s an extra lab coat on the back of the door,” she added.
I followed her into the small, dark room, where she had been at work before the phone had rung. Slipping on the lab coat, I found a chair as she peered into a green phosphorescent screen inside the huge viewing chamber. The TEM looked more like an instrument for oceanography or astronomy than a normal microscope. The chamber always reminded me of the dive helmet of a dry suit through which one could see eerie, ghostly images in an iridescent sea.
Through a thick metal cylinder called the scope, running from the chamber to the ceiling, a hundred-thousand-volt beam was striking my specimen, which in this case was liver that had been shaved to a thickness of six or seven one-hundredths of a micron. Smears like the ones I had viewed with my light microscope were simply too thick for the electron beam to pass through.
Knowing this at autopsy, I had fixed liver and spleen sections in glutaraldehyde, which penetrated tissue very rapidly. These I had sent to Crowder, who I knew would eventually have them embedded in plastic and cut on the ultramicrotome, then the diamond knife, before being mounted on a tiny copper grid and stained with uranium and lead ions.
What neither of us had expected was what we were looking at now, as we peered into the chamber at the green shadow of a specimen magnified almost one hundred thousand times. Knobs clicked as she adjusted intensity, contrast and magnification. I looked at DNA double-stranded, brick-shaped virus particles, two hundred to two hundred and fifty nanometers in size. I stared without blinking at smallpox.
“What do you think?” I said, hoping she would prove me wrong.
“Without a doubt, it’s some type of poxvirus,” she hedged her bets. “The question is which one. The fact that the eruptions didn’t follow any nerve pattern. The fact that chicken pox is uncommon in someone this old. The fact that you may now have another case with these same manifestations causes me great concern. Other tests need to be done, but I’d treat this as a medical crisis.” She looked at me. “An international emergency. I’d call CDC.”
“That’s just what I’m going to do,” I replied, swallowing hard.
“What sense do you make of this being associated with a dismembered body?” she asked, making more adjustments as she peered into the chamber.
“I can make no sense of it,” I said, getting up and feeling weak.
“Serial killers here, in Ireland, raping, chopping people up.”
I looked at her.
She sighed. “You ever wish you’d stayed with hospital pathology?”
“The killers you deal with are just harder to see,” I replied.
The only way to get to Tangier Island was by water or air. Since there wasn’t a huge tourist business there, ferries were few and did not run after mid-October. Then one had to drive to Crisfield, Maryland, or in my case, go eighty-five miles to Reedville, where the Coast Guard was to pick me up. I left the office as most people were thinking about lunch. The afternoon was raw, the sky cloudy with a strong cold wind.
I had left instructions for Rose to call the Centers for Disease Control and Prevention (CDC) in Atlanta, because every time I had tried, I was put on hold. She was also to reach Marino and Wesley and let them know where I was going and that I would call as soon as I could. I took 64 East to 360, and soon found myself in farmland.
Fields were brown with fallow corn, hawks dipping and soaring in a part of the world where Baptist churches had names like Faith, Victory and Zion. Trees wore kudzu like chain mail, and across the Rappahannock River, in the Northern Neck, homes were sprawling old manors that the present-generation owner couldn’t afford anymore. I passed more fields and crepe myrtles, and then the Northumberland Courthouse that had been built before the Civil War.
In Heathsville were cemeteries with plastic flowers and cared-for plots, and an occasional painted anchor in a yard. I turned off through woods dense with pines, passing cornfields so close to the narrow road, I could have reached out my window to touch brown stalks. At Buzzard’s Point Marina, sailboats were moored and the red, white and blue tour boat, Chesapeake Breeze, was going nowhere until spring. I had no trouble parking, and there was no one in the ticket booth to ask me for a dime.
Waiting for me at the dock was a white Coast Guard boat. Guardsmen wore bright orange and blue antiexposure coveralls, known as mustang suits, and one of the men was climbing up on the pier. He was more senior than the others, with dark eyes and hair, and a nine-millimeter Beretta on his hip.
“Dr. Scarpetta?” He carried his authority easily, but it was there.
“Yes,” I said, and I had several bags, including a heavy hard case containing my microscope and MicroCam.
“Let me help with those.” He held out his hand. “I’m Ron Martinez, the station chief at Crisfield.”
“Thanks. I really appreciate this,” I said.
“Hey, so do we.”
The gap between the pier and the forty-foot patrol boat yawned and narrowed as the surge pushed the boat against the pier. Grabbing the rail, I boarded. Martinez went down a steep ladder, and I followed him into a hold packed with rescue equipment, fire hoses and huge coils of rope, the air heavy with diesel fumes. He tucked my belongings in a secure spot and tied them down. Then he handed me a mustang suit, life vest and gloves.
“You’re going to need to put these on, in case you go in. Not a pretty thought but it can happen. The water’s maybe in the fifties.” His eyes lingered on me. “You might want to stay down here,” he added as the boat knocked against the pier.
“I don’t get seasick but I am claustrophobic,” I told him as I sat on a narrow ledge and took off my boots.
“Wherever you want, but it’s gonna be rough.”
He climbed back up as I began struggling into the suit, which was an exercise in zippers and Velcro, and filled with polyvinyl chloride to keep me alive a little longer should the boat capsize. I put my boots back on, then the life vest, with its knife and whistle, signal mirror and flares. I climbed back up to the cabin because there was no way I was going to stay down there. The crew shut the engine cover on deck, and Martinez strapped himself into the pilot’s chair.
“Wind’s blowing out of the northwest at twenty-two knots,” a guardsman said. “Waves cresting at four feet.
”
Martinez began pulling away from the pier. “That’s the problem with the bay,” he said to me. “The waves are too close together so you never get a good rhythm like you do at sea. I’m sure you’re aware that we could get diverted. There’s no other patrol boat out, so something goes down out here, there’s no one but us.”
We began slowly passing old homes with widow’s walks and bowling greens.
“Someone needs rescuing, we got to go,” he went on as a member of the crew checked instruments.
I watched a fishing boat go past, an old man in hip-high boots standing as he steered the outboard motor. He stared at us as if we were poison.
“So you could end up on anything.” Martinez enjoyed making this point.
“It wouldn’t be the first time,” I said as I began to detect a very revolting smell.
“But one way or another, we’ll get you there, like we did the other doctor. Never did get his name. How long have you worked for him?”
“Dr. Hoyt and I go way back,” I said blandly.
Ahead were rusting fisheries with rising smoke, and as we got close I could see moving conveyor belts tilted steeply toward the sky, carrying millions of menhaden in to be processed for fertilizer and oil. Gulls circled and waited greedily from pilings, watching the tiny, stinking fish go by as we passed other factories that were ruins of brick crumbling into the creek. The stench now was unbearable, and I was certainly more stoical than most.
“Cat food,” a guardsman said, making a face.
“Talk about cat breath.”
“No way I’d live around here.”
“Fish oil’s real valuable. The Algonquin Indians used cogies to fertilize their corn.”
“What the hell’s a cogy?” Martinez asked.
“Another name for those nasty little suckers. Where’d you go to school?”
“Doesn’t matter. Least I don’t got to smell that for a living. Unless I’m out here with schleps like you.”
“What the hell’s a schlep?”
Unnatural Exposure Page 14
