Pointer Club Cadaver (Mandy Bell DVM Series Book 3)

by Abby Deuel

  She had come across an antique white wire basket for the job of egg collection. Every time Mandy gathered eggs with her special basket, she thought of all the eggs that had probably been in that very basket. Although antiques cannot technically talk, Mandy believed that you could hear their stories if you listened hard enough. Some days, Mandy busied herself by making up a new story to explain whose lives had been touched by this basket.

  Today, she was imagining that a large family had used it. The eggs that were collected each day meant the whole family would have full bellies for their hard day’s work ahead of them. The extra eggs were sold to save up money for bolts of fabric with which to make school clothes for the kids. Then when the chicken stopped laying eggs, they would have a chicken dinner. One animal could provide so much for a family.

  Mandy thought of how most people nowadays don’t even have breakfast, much less appreciate how important it is to have a nutritious breakfast. The truth was that many people didn’t know what it would be like to eat what they grew, or to appreciate the importance of gardening for necessity instead of for aesthetics. Many people take life for granted. With her new farm life, she was trying to savor each day and all parts of it so as not to miss a single drop of life.

  In the house, Mandy looked around in her kitchen. She was in the mood for only a light supper or even a snack since she had only just eaten at the clinic. She decided on an old standby, popcorn, to eat while she was going through the papers Gerry had given her. . She placed a bag in the microwave and waited for the familiar popping sound to stop. Anna and Lyle knew the sound and the smell. They both perked up from their nap to position themselves for a front row seat to the impending snack-a-thon.

  The popcorn didn’t take long. To go with it, Mandy made herself some hot herbal tea with lots of honey. She decided to use one of her fancy serving trays to bring it all to the table. It was just her alone most of the time so the fancier items in the kitchen would rarely get used unless she made a point of using them daily. Mandy had promised herself that if she was to hang on to all of Derek’s things, she would have to honor them by using them often. With no living relatives who wanted any of his things, Mandy had been as respectful as possible when she went through them. It was not her place to carry on traditions that she knew nothing about. However, she could tell that some of the pieces had been handed down in a family for generations. She didn’t know if it was his family or him who had collected antiques. Regardless of how the pieces got there, Mandy enjoyed using them. Popcorn and tea was far fancier eaten from a silver tray and china tea set.

  Mandy curled up on the couch with a clipboard and a trusty pencil. She started by putting the papers in date order. She helped herself to a little popcorn, dropping a few pieces for the dogs. The papers were from so many different hospitals and doctors. This man had to have been to all of the health care facilities on the East coast from the looks of his paperwork. The overwhelming theme was that he had some kind of condition, called Loeys-Dietz Syndrome. He had been diagnosed with it in the last ten years of his life, starting with a complaint of easily bruised, velvety skin. He had been adopted as a baby and had no information about his genetic background so there was no family to ask for medical history. The disease would likely have gone undetected had it not been for his persistence that there must be more to it. He went to oodles of specialists until someone finally did a genetic screening test and found the disease.

  Knowing what the disease was now, it was likely that the heart operation Phil had as a baby was related. Apparently, Mandy was reading, Loeys-Dietz Syndrome was associated with congenital heart issues like a patent ductus arteriosis, which would require open heart surgery in an infant. In all likelihood, he had other abnormalities that had been treated when he was young that he could not remember. Mandy thought about how sad it would be to have no family in one’s life. This poor fellow not only had no relatives, but also had to deal with a rare illness.

  Mandy’s tea cup was empty and she needed to stretch. She got up and headed to the kitchen counter. She decided to have some ginger ale instead of another cup of tea. Full from popcorn, Mandy treated herself to a little morsel of chocolate. Anna and Lyle heard the sound of a candy wrapper and made their presence known. Mandy always found it amusing they could hear the sound of a candy wrapper from a farther distance than they could hear their names being called outside. Instead of sharing chocolate, Mandy gave each obedient dog a chew which they chose to enjoy on their cushy beds in the corner of the living room.

  Refreshed, Mandy sat back at the dining room table. So far, she had figured out why Phil had a scar on his chest, what disease had led him to be in and out of doctors for most of his adult life, and what disease may have contributed to his early and untimely death. The main question she needed to answer was whether or not there was a murder after all. She needed more information about Loeys-Dietz Syndrome and what its effects were in adults. It seemed strange that, after all of his doctor visits, there would be anything left untreated in this man.

  Chapter 22

  She started perusing the internet for more information about Loeys-Dietz Syndrome or LDS. While Mandy did not recommend that her clients use the internet for medical information, it did have its place in the hands of a judicious person. All too frequently, a client would come in with their pet’s condition already diagnosed and a list of possible treatments, all based on an internet search. It was astounding how wrong some of these web-based diagnoses could be. One time, a client was completely convinced that her spayed dog was dying of a uterine infection when in fact the frequent urination and loss of appetite was due to diabetes. Instead of surgery, the dog was in need of insulin injections and a change of diet. Luckily, Crestview did not seem to have as much of the doctor google issue that other, larger cities did. Mandy was thankful for her clients’ trust in her knowledge.

  A thorough investigation into Loeys-Dietz Syndrome revealed that it had not been identified in many people. The genes responsible for it had been mapped and identified, so, once suspected, confirming the disease was straight-forward. The hard part was that the condition could manifest as a number of different issues including skull abnormalities caused by cranial fusion issues, long fingers, lax joints, scoliosis, an indented chest wall, and a congenital heart condition. The challenge for doctors was to realize that the disease could have many different manifestations and keep it on a list of differentials for children or adults showing these signs. With the genetic tests available, more people were being found to be carriers of Loeys-Dietz Syndrome. Doctors were always interested in adults living with the disease as they could continue to learn more from them to help others, which explained some of why Phil had been in and out of doctor’s offices.

  One of the main affects of the disease was that it results in weakened connective tissue, which is the tissue that helps to make bones, vessels, joints, and muscles strong yet flexible. The genetic transmission is autosomal dominant, meaning that it is carried on a non-sex chromosome and could be inherited from either the mother or the father, or both. In most cases, however, the disease results from a spontaneous gene mutation as opposed to inheritance of the mutation, making it hard to predict in children.

  There are four types of the syndrome, varying in severity. The diagnosis can be made in childhood or adulthood. The worst of the symptoms of the disease is a weakening of the aortal connective tissues, essentially resulting in a ticking time bomb in the person’s chest. At any point, the tissue could give way, causing an aneurysm, often resulting in death, if not immediately diagnosed and treated.

  “I wonder if that’s what happened to Phil?” asked Mandy out-loud.

  Many patients with the syndrome are screened regularly for aortic integrity to detect an aneurysm before it ruptures. Unfortunately, the connective tissue that allows for the aortic aneurysm can make any vessel weak in the person’s body, including blood vessels in the brain. Echocardiography to monitor heart vessels and real-time angiograms to monit
or other major vessels in the body are the mainstays of surveillance for patients with the disease. This explained why Phil was so frequently in the cardiac specialty centers.

  According to his medical records, Mandy saw no indication that anything was not responding to treatment. He was on beta-adrenergic blockers to reduce the stress on his arteries. He had been undergoing all of the necessary monitoring for a person with his condition. All of the records classed him as a low risk patient. He even underwent special blood culturing after dental cleanings to ensure that he had not contracted a bacteria that might inhabit a heart valve. Patients with LDS developed bacterial endocarditis, or infection of the heart muscle, at a higher rate than those patients without it. Phil was taking all of the necessary precautions to live a normal life despite his potentially deadly disease.

  Mandy would be interested to exchange notes with Gerry the next day. It seemed that there was a huge piece of the puzzle missing. Mandy needed to know more about Phil as a person to help with this case. She thought about how lonely life would be without relatives or close friends. This man had died without anyone noticing. He was living with a terrible disease and no one was there to help him come to terms with it or support him. While Mandy didn’t exactly have a large extended family, she knew she could count on her parents for anything.

  She continued to research what it was like to have LDS as a child since she had already learned as much as she could about what Phil’s adult life had been like. She found countless stories of innocent infants born with no fighting chance at life. The parents were completely unaware of their child’s issues until they had delivered them into the world. Some were whisked off to surgery straight after deliver to have the first of a series of open heart surgeries to correct weak vessels or heart defects. Others had to undergo multiple surgeries to repair joint abnormalities or skull defects, including cleft palates.

  Mandy could not help but find it so hard to read stories about children. On the one hand, she could not imagine having a child only to find out that it was born with an undetected genetic disease. On the other hand, if everyone lived in fear of what their child might have when it was born, no further children would be born. In the case of LDS, most went on to lead normal and happy lives, largely due to the love of their parents. Phil, on the other hand, did not have that in his succession of foster homes. Mandy felt more determined than ever to find the truth about Phil’s life and death to set his soul at rest, even if no one else had even known that he passed away. For the time being, she needed to get some rest. Her research had kept her up way past her bedtime.

  Chapter 23

  “When will that arrive? Oh, that’s great news. Let’s plan on having some dinner tonight at my place while we go through it,” said Mandy. She had called Gerry first thing in the morning to relay the information she had gleamed from the medical records, in particular about Loeys-Dietz Syndrome. Gerry was delighted to have more information and he too had been busy. He had arranged for the personal effects of the deceased to be overnighted to Gerry’s house to arrive that afternoon. The landlord was all too eager to have somewhere to send the items since he was interested in renting the apartment as soon as possible.

  “Maybe we should re-visit the post mortem to ensure that they did not miss the cause of death, now knowing that he had a high risk of aneurysm in any vessel,” said Mandy. “Please let me know what they find out.”

  Mandy drank her coffee and read through the medical records one last time to make sure that she had not missed anything. Anna and Lyle played a game of tag around the house. Although it was getting much colder outside, Mandy let them out to burn off some steam. They would need to become somewhat acclimatized to the cold as they would still need periodic jaunts outside even in the dead of winter to be able to relieve themselves. They did not even seem to notice the beginning of a light sprinkle of snow falling from the sky.

  “It’s here. It’s finally here,” said Mandy. “I love winter!” Mandy ran outside with the dogs, only clothed in her robe and pajamas. She had been so preoccupied that she had not been watching the weather This little flurry had caught her by surprise entirely. Being in charge of the welfare of an entire farm of creatures meant that she got lucky this time since it was only a few snowflakes that didn’t stick to the ground. She would have to keep better tabs on the weather to ensure that she had the proper preparations in place for the first real snow fall.

  For today, she could enjoy the chill in the air and watch her dogs play with the falling flakes. Anna, the Pyrenees, had not seen flakes yet. She was galumphing in her awkward, giant puppy way, following a flake until it melted away on the ground. She was visibly bemused when the flake disappeared before her very eyes. Luckily another one caught her eye to take her mind off of the mourning of the previous flake. It appeared that she could keep herself busy for hours with this task as she did not appear to remember from one flake to the next that the game was eerily familiar.

  Lyle, on the other hand, realized that the flakes would melt upon reaching the ground. Her tactic was to catch them in her mouth like she did everything else. She tried to turn her rendition of flake watch into a game of fetch. Once she caught a snowflake, she bounced over to Mandy to drop the flake at Mandy’s feet only to find that somewhere along the way, she had dropped it. She retraced her steps to find where her mouth had carelessly let go of the loot. A new snowflake would catch her eye, enabling her to cover up her carelessness of dropping the last flake by catching a new one. Unfortunately, the flakes seemed much harder to keep hold of than a ball or stick as she just kept losing them by the time she had reached Mandy’s feet.

  Mandy, meanwhile, was almost out of breath from laughing at her duo of dogs. A person just could not take the world seriously with dogs around. The flurry was over almost as soon as it had arrived. Nothing stuck to the ground so there was no evidence that it had even come through. Mandy was so thankful that she had followed the dogs outside and not missed winter’s first sign of arrival. She also had filled her quota of laughing for at least a few days. The dogs would be able to rest while Mandy finished the remainder of the chores.

  Warm inside, the dogs ate their breakfast on the hearth. Mandy had lit a fire to take the chill off and make sure that the fireplace worked before the true snow started. The dogs took their rightful place on the hearth, protecting their domain from anyone who might come along. Mandy always wondered what people without dogs did with their hearth. They probably had to buy silly props and statues to make it not look so empty on a winter’s day with the fire roaring. Mandy would not have to worry about that.

  After chores, Mandy worked up an appetite for breakfast. She decided to make herself an omelet with some of the fresh eggs. Today would likely be busy and she would need lots of fuel to keep her going. She mixed up the eggs and milk, placing them on her favorite cast iron skillet which she had had so long that it had become more non-stick than a fancy store-bought non-stick skillet. As she waited to add the filling to the pan, she smelled something dreadful. It smelled almost like burnt hair. She figured there must had been some dust on the burner and waited to see if it went away. She filled the omelet with cheese, scallions, and mushrooms before folding over the egg to make a pouch. The smell did not go away.

  Anna nuzzled her leg, which Mandy thought meant that she wanted some omelet. This was the crucial time for the omelet so Mandy could not look away.

  “Just a second, Anna. I promise that I will share. It’s almost done,” said Mandy.

  Anna’s tail came into Mandy’s peripheral vision. It was on fire at the tip and moving its way toward the base.

  “Aggh. Anna, hold still,” said Mandy, using a kitchen towel to suffocate the flame on Anna’s tail. Her fur was so thick and fluffy for winter that it took a few swats before the flames died down. Meanwhile, the omelet started to smoke on the stove. Mandy transferred her energy from the tail to the omelet, putting out another fire. Once the second fire was out, Mandy took a closer look at Anna’s
tail. Luckily, none of the flesh had been damaged. The abundance of white fur had saved Anna’s tail from even being harmed in the small flame.

  “I’m so sorry, Anna. You did a good job telling me that there was something wrong. I wasn’t paying enough attention. We sure learned a lot about how close to sit to the fire on the hearth, didn’t we?” said Mandy. Anna was watching Mandy’s mouth as if trying really hard to file away the lesson so she wouldn’t have to go through that again. Once Mandy stopped talking, Anna’s focus redirected to the stove. “We will have to make another one. That one is a bit ruined. It will have to be another day, though, we will be running late if we start again.”

  She stuffed a granola bar, grabbed her coat, and headed out to the Jeep with the dogs close behind.

  Chapter 24

  “What on earth happened to Anna?” asked Gillian when Mandy reached the clinic with the dogs.

  “We learned about fire today. Right after we learned about snowflakes melting and right before we learned about omelets burning on the stove,” said Mandy. “Today was a busy day in the life of a puppy.”

  “I should think so. Let’s at least cut away the burnt fur so she doesn’t smell so bad,” said Gillian.

  “We simply ran out of time. We didn’t get to eat any breakfast today either. We just loaded up and headed out,” said Mandy.

  “We have just enough time to remedy that before our appointments start arriving,” said Gillian, starting to gently trim around Anna’s tail. “You go put a waffle in the toaster or something. I can handle this.”

  Anna sat patiently while Gillian trimmed away the evidence. The advantage of a Pyrenees’s fur is that is so plentiful that there is no way a person could tell if a huge section was cut out. The tail in particular is a fountain of long, semi-crimped fur. A happy or excited Pyrenees flaunts its feathered tail by flipping it up in a curl over its back. Gillian waited until Anna did this to make sure she had not butchered the attractive fluff of her tail. No harm was done. Mandy appeared with several waffles, which she shared with Gillian and the dogs.