An ambulance halted near us. Doors slammed and metal grated as attendants quickly lowered the legs of a stretcher to the ground and wheeled an old man through opening glass doors. We followed and in silence walked through a bright, antiseptic corridor busy with medical personnel and patients dazed by the misfortunes that had brought them here. As we rode the elevator up to the third floor, I wondered what trace evidence had been scrubbed away and tossed in the trash.
“What about his clothes? Was a bullet recovered?” I asked Trent as the elevator doors parted.
“I've got his clothes in my car and will drop them and his PERK off at the lab this afternoon. The bullet's still in his brain. They haven't gone in there yet. I hope like hell they swabbed him good.”
The pediatric intensive care unit was at the end of a polished hallway, panes of glass in the double wooden doors covered with friendly dinosaur paper. Inside, rainbows decorated sky blue walls, and animal mobiles were suspended over hydraulic beds in the eight rooms arranged in a semicircle around the nurses' station. Three young women worked behind monitors, one of them typing on a keyboard and another talking on the phone. A slender brunette dressed in a red corduroy jumper and turtleneck sweater identified herself as the head nurse after Trent explained why we were here.
“The attending physician's not in yet,” she apologized.
“We just need to look at Eddies injuries. It won't take long,” Trent said. “His family still in there?”
“They stayed with him all night.”
We followed her through soft artificial light, past code carts and green tanks of oxygen that would not be parked outside the rooms of little boys and girls were the world the way it ought to be. When we reached Eddies room, the nurse went inside and shut the door most of the way…
“Just for a few minutes,” I overheard her say to the Heaths. “While we do the exam.”
“What kind of specialist is it this time?” the father asked in an unsteady voice.
“A doctor who knows a lot about injuries. She's sort of like a police surgeon.”
The nurse diplomatically refrained from saying I was a medical examiner, or worse, a coroner.
After a pause, the father quietly said, “Oh. This is for evidence.”
“Yes. How about some coffee? Maybe something to eat?”
Eddie Heath's parents emerged from the room, both of them considerably overweight, their clothes badly wrinkled from having been slept in. They had the bewildered look of innocent, simple people who have been told the world is about to end, and when they glanced at us with exhausted eyes I wished there were something I could say that would make it not so or at least a little better. Words of comfort died in my throat as the couple slowly walked off.
Eddie Heath did not stir on top of the bed, his head wrapped in bandages, a ventilator breathing air into his lungs while fluids dripped into his veins. His complexion was milky and hairless, the thin membrane of his eyelids a faint bruised blue in the low light. I surmised the color of his hair by his strawberry blond eyebrows. He had not yet emerged from that fragile prepubescent stage when boys are full-tipped and beautiful and sing more sweetly than their sisters. His forearms were slender, the body beneath the sheet small. Only the disproportionately large, still hands tethered by intravenous lines were true to his fledgling gender. He did not look thirteen.
“She needs to see the areas on his shoulder and leg,” Trent told the nurse in a low voice.
She got two packet of gloves, one for her and one forme, and we put them on. The boy was naked beneath the sheet, his skin grimy in creases and fingernails dirty. Patients who are unstable cannot be thoroughly bathed.
Trent tensed as the nurse removed the wet-to-dry dressings from the wounds. “Christ,” he said under his breath. “It looks even worse than it did last night. Jesus.”
He shook his head and backed up a step.
If someone had told me that the boy had been attacked by a shark, I might have gone along with it were it not for the neat edges of the wounds, which clearly had been inflicted by a sharp, linear instrument, such as a knife or razor. Sections of flesh the size of elbow patches had been excised from his right shoulder and right inner thigh. Opening my medical bag, I got out a ruler and measured the wounds without touching them, then took photographs.
“See the cuts and scratches at the edges?”
Trent pointed. “That's what I was telling you about. It's like he cut some sort of pattern on the skin and then removed the whole thing.”
“Did you find any anal tearing?” I asked the nurse.
“When I did a rectal temperature I didn't notice any tears, and no one noticed anything unusual about his mouth or throat when he was intubated. I also checked for old fractures and bruises.”
“What about tattoos?”
“Tattoos?” she asked as if she'd never seen a tattoo.
“Tattoos, birthmarks, scars. Anything that someone may have removed for some reason,” I said.
“I have no idea,” the nurse said dubiously.
“I'll go ask his parents.”
Trent wiped sweat from his forehead.
“They may have gone to the cafeteria.”
“I'll find them,” he said as he passed through the doorway.
“What are his doctors saying?” I asked the nurse.
“He's very critical and unresponsive.”
She stated the obvious without emotion.
“May I see where the bullet went in?” I asked.
She loosened the edges of the bandage around his head and pushed the gauze up until I could see the tiny black hole, charred around the edges. The wound was through his right temple and slightly forward.
“Through the frontal lobe?”
I asked.
“Yes.”
“They've done an angio?”
“There's no circulation to the brain, due to the swelling. There's no electroencephalic activity, and when we put cold water in his ears there was no caloric activity. It evoked no brain potentials.”
She stood on the other side of the bed, gloved hands by her sides and expression dispassionate as she continued to relate the various tests conducted and maneuvers instigated to decrease intracranial pressure. I had paid my dues in ERs and ICUs and knew very well that it is easier to be clinical with a patient who has never been awake. And Eddie Heath would never be awake. His cortex was gone. That which made him human, made him think and feel, was gone and was never coming back. He had been left with vital functions, left with a brain stem. He was a breathing body with a beating heart maintained at the moment by machines.
I began looking for defense injuries. Concentrating on getting out of the way of his lines, I was unaware I was holding his hand until he startled me by squeezing mine. Such reflex movements are not uncommon in people who are cortically dead. It is the equivalent of a baby grabbing your finger, a reflex involving no thought process at all. I gently released his hand and took a deep breath, waiting for the ache in my heart to subside.
“Did you find anything?” the nurse asked.
“It's hard to look with all these lines,” I said.
She replaced his dressings and pulled the sheet up to his chin. I took off my gloves and dropped them in the trash as Detective Trent returned, his eyes a little wild.
“No tattoos,” he said breathlessly, as if he had sprinted to the cafeteria and back. “No birthmarks or scars, either.”
Moments later we were walking to the parking deck. The sun slipped in and out, and tiny snowflakes were blowing. I squinted as I stared into the wind at heavy traffic on Forest Avenue. A number of cars had Christmas wreaths affixed to their grilles.
“I think you'd better prepare for the eventuality of his death,” I said.
“If I'd known that, I wouldn't have bothered you to come out. Damn, it's cold.”
“You did exactly the right thing. In several days his wounds would have changed.”
“They say all of December's going to be lik
e this. Cold as hell and a lot of snow.”
He stared down at the pavement. “You have kids?”
“I have a niece,” I said.
“I've got two boys. One of 'em's thirteen.”
I got out my keys. “I'm over here,” I said.
Trent nodded, following me. He watched in silence as I unlocked my gray Mercedes. His eyes took in the details of the leather interior as I got in and fastened my seat belt. He looked the car up and down as if appraising a gorgeous woman.
“What about the missing skin?” he asked. “You ever seen anything like that?”
“It's possible we're dealing with someone predisposed to cannibalism,” I said.
I returned to the office and checked my mailbox, initialed a stack of lab reports, filled a mug with the liquid tar left in the bottom of the coffeepot, and spoke to no one. Rose appeared so quietly as I seated myself behind my desk that I would not have noticed her immediately had she not placed a newspaper clipping on top of several others centering the blotter.
“You look tired,” she said. “What time did you come in this morning? I got here and found coffee made and you had already gone out somewhere.”
“Henrico's got a tough one,” I said. “A boy who probably will be coming in.”
'Eddie Heath.”
“Yes,” I said, perplexed. “How did you know?”
“He's in the paper, too,” Rose replied, and I noticed that she had gotten new glasses that made her patrician face less haughty.
“I like your glasses,” I said. “A big improvement over the Ben Franklin frames perched on the end of your nose. What did it say about him?”
“Not much. The article just said that he was found off Patterson and that he had been shot. If my son were still young, no way I'd let him have a paper route.”
“Eddie Heath was not delivering papers when he was assaulted.”
“Doesn't matter. I wouldn't permit it, not these days. Let's see.”
She touched a finger to the side of her nose. “Fielding's downstairs doing an autopsy and Susan's off delivering several brains to MCV for consultation. Other than that, nothing happened while you were out except the computer went down.”
“Is it still down?”
“I think Margaret's working on it and is almost done,” Rose said.
“Good. When it's up again, I need her to do a search for me. Codes to look for would be cutting, mutilation, cannibalism, bite marks. Maybe a free-format search for the words excised, skin, fresh - a variety of combination of them. You might try dismemberment, too, but I don't think that's what we're really after.”
“For what part of the state and what time period?” Rose took notes.
“All of the state for the past five years. I'm particularly interested in cases involving children, but let's not restrict ourselves to that. And ask her to see what the Trauma Registry's got. I spoke with the director at a meeting last month and he seemed more than willing for us to share data.”
“You mean you also want to check victims who have survived?”
“If we can, Rose. Let's check everything to see if we find any cases similar to Eddie Heath's.”
“I'll tell Margaret now and see if she can get started,” my secretary said on her way out.
I began going through the articles she had clipped from a number of morning newspapers. Unsurprisingly, much was being made of Ronnie Waddell's allegedly bleeding from “his eyes, nose, and mouth.”
The local chapter of Amnesty International was claiming that his execution was no less inhumane than any homicide. A spokesman for the ACLU stated that the electric chair “may have malfunctioned, causing Waddell to suffer terribly,” and went on to compare the incident to the execution in Florida in which synthetic sponges used for the first time had resulted in the condemned man's hair catching fire.
Tucking the news stories inside Waddell's file, I tried to anticipate what pugilistic rabbits his attorney, Nicholas Grueman, would pull out of his hat this time. Our confrontations, though infrequent, had become predictable. His true agenda, I was about to believe, was to impeach my professional competence and in general make me feel stupid. But what bothered me most was that Grueman gave no indication that he remembered I had once been his student at Georgetown. To his credit, I had despised my first year of law school, had made my only B, and missed out on Law Review. l would never forget Nicholas Grueman as long as I lived, and it did not seem right that he should have forgotten me.
I heard from him on Thursday, not long after I had been informed that Eddie Heath was dead.
“Kay Scarpetta?” Grueman's voice came over the line.
“Yes.”
I closed my eyes and knew from the pressure behind them that a raging front was rapidly advancing.
“Nicholas Grueman here. I've been looking over Mr. Waddell's provisional autopsy report and have a few questions.”
I said nothing.
“I'm talking about Ronnie Joe Waddell.”
“What can I help you with?”
“Let's start with his so-called almost tubular stomach. An interesting description, by the way. I'm wondering if that's your vernacular or a bona fide medical term? Am I correct in assuming Mr. Waddell wasn't eating?”
“I can't say that he wasn't eating at all. But his stomach had shrunk. It was empty and clean.”
“Was it, perhaps, reported to you that he may have been on a hunger strike?”
“No such thing was reported to me.”
I glanced up at the clock and light stabbed my eyes. I was out of aspirin and had left my decongestant at home.
I heard pages flip.
“It says here that you found abrasions on his arms, the inner aspects of both upper arms,” Grueman said.
“That's correct.”
“And just what, exactly, is an inner aspect?”
“The inside of the arm above the antecubital fossa.”
A pause. “The antecubital fossa,” he said in amazement.
“Well, let me see. I've got my own arm turned palm up and am looking at the inside of my elbow. Or where the arm folds, actually. That would be accurate, wouldn't it? To say that the inner aspect is the side where the arm folds, and the antecubual fossa, therefore, is where the arm folds?”
“That would be accurate.”
“Well, well, very good. And to what do you attribute these injuries to the inner aspects of Mr. Wadden's “Possibly to restraints,” I said testily.
“Restraints?”
“Yes, as in the leather restraints associated with the electric chair.”
“You said possibly. Possibly restraints?”
“That's what I said.”
“Meaning, you can't say with certainty, Dr. Scarpetta?”
“There's very little in this life that one can say with certainty, Mr. Grueman.”
“Meaning that it would be reasonable to entertain the possibility that the restraints that caused the abrasions could have been of a different variety? Such as the human variety? Such as marks left by human hands?”
“The abrasions I found are inconsistent with injuries inflicted by human hands,” I said.
“And are they consistent with the injuries inflicted by the electric chair, with the restraints associated with it?”
“It is my opinion that they would be.”
“Your opinion, Dr. Scarpetta'?”
“I haven't actually examined the electric chair' I said sharply.
This was followed by a long pause, for which Nicholas Grueman had been famous in the classroom when he wanted a student's obvious inadequacy to hang in the air. I envisioned him hovering over me, hands clasped behind his back, his face expressionless as the clock ticked loudly on the wall. Once I had endured his silent scrutiny for more than two minutes as my eyes raced blindly over pages of the casebook opened before me. And as I sat at my solid walnut desk some twenty years later, a middle-aged chief medical examiner with enough degrees and certificates to paper a wall, I felt my fa
ce begin to burn. I felt the old humiliation and rage.
Susan walked into my office as Grueman abruptly ended the encounter with “Good day” and hung up…
“Eddie Heath's body is here.”
Her surgical gown was untied in back and clean, the expression on her face distracted. “Can he wait until the morning?”
“No,” I said. “He can't.”
The boy looked smaller on the cold steel table than he had seemed in the bright sheets of his hospital bed. There were no rainbows in this room, no walls or windows decorated with dinosaurs or color to cheer the heart of a child. Eddie Heath had come in naked with IV needles, catheter, and dressings still in place. They seemed sad remnants of what had held him to this world and then disconnected him from it, like string tailing a balloon blowing forlornly through empty air. For the better part of an hour I documented injuries and marks of therapy while Susan took photographs and answered the phone.
We had locked the doors leading into the autopsy suite, and beyond I could hear people getting off the elevator and heading home in the rapidly descending dark. Twice the buzzer sounded in the bay as funeral home attendants arrived to bring a body or take one away. The wounds to Eddies shoulder and thigh were dry and a dark shiny red.
“God,” Susan said, staring. “God, who would do something like that? Look at all the little cuts to the edges, too. It's like somebody cut crisscrosses and then removed the whole area of skin.”
“That's precisely what I think was done.”
“You think someone carved some sort of pattern?”
“I think someone attempted to eradicate something. And when that didn't work, he removed the skin.”
“Eradicate what?”
“Nothing that was already there,” I said. “He had no tattoos, birthmarks, or scars in those areas. If something wasn't already there, then perhaps something was added and had to be removed because of the potential evidentiary value.”
Cruel and Unusual ks-4 Page 3
