by Robin Cook
Laurie’s eyes drifted around her office. There were no Post-its clinging to the tops, sides, or bottom of her computer screen, as there usually were. No stacks of case files on the corner of her desk waiting for information or laboratory results before they could be signed out. In fact, the entire room looked so clean as to be sterile. The microscope standing by itself without slide trays seemed the most lonely, with protective covers on its eyepieces.
Laurie was about to give up trying to read, thinking she would wander down to the autopsy room and at least participate with Jack and Lou on the GSW case. By doing so she hoped she would feel that she was participating, if not contributing. Instead her phone surprised her by filling the room with its persistent jangle. Laurie snapped it up as if it was a desperate emergency, thankful that someone wanted to talk with her.
“Laurie, I have a problem,” a voice said. It took her a moment to recognize that it was Dr. Arnold Besserman, the on-call medical examiner who’d denied her a case that morning and who was thereby guilty of intensifying her anxieties, or so she irrationally and unfairly thought.
“Oh?” Laurie questioned with a glimmer of hope. Maybe a new case had just come in.
“Kevin’s going home sick,” Arnold continued. Kevin was Dr. Kevin Southgate, one of Arnold’s sidekicks. The two argued over everything, particularly religion and politics, despite being quite fond of each other. “I gave him only one post, from the looks of it an easy one at that: an apparently natural death following a collapse on the Fifty-ninth Street platform of the A train. It’s just a routine case. Anyway, he claims he’s coming down with H1N1, and he’s heading home.” Arnold laughed into the phone. “Have you seen Bingham yet, and if you have, could you come down and take over? I know I said I’d give you the day as a freebie, but I’m kinda stuck, and you’re the only one available. What do you say?”
Laurie smiled. Of course she wanted the case, even if it turned out to be a natural death. In fact, she thought a natural death was probably a good way to start; it was hard to screw up a natural death. What made her smile was the fact that Arnold didn’t mention whether he was busy or not. Often when he was the on-call medical examiner, he rarely assigned himself any cases.
“Who’s the mortuary tech on the case?” Laurie asked, more out of curiosity than anything else.
“Marvin,” Arnold said. “That’s another reason I thought you might be willing to take over.”
Arnold was speaking the truth. Marvin Fletcher was Laurie’s favorite tech, and she worked with him as often as she could.
“I’ll be happy to do it,” Laurie said. “I’ll be right down.”
True to her word, Laurie left her office as soon as she’d replaced the receiver, and wasted no time pulling on a Tyvek suit, gloves, and her plastic face mask. So attired, she pushed into the autopsy room and glanced around. All eight tables were in use, and Marvin waved from where he was standing at the head of the fourth table. As luck would have it, Jack and Lou were at the neighboring fifth table. They were just finishing up by closing the autopsy incision, with Lou doing the stitching. He’d become such a frequent visitor that he enjoyed helping. Laurie made a brief stop to say hello.
“Hey, how’s it going?” Jack said, catching sight of her. “I’d heard you were to have a free day, thanks to our fearless leader. What brings you down here?”
“That was before Kevin Southgate fell ill next to you guys.”
Jack glanced at the table just behind him and nodded to Marvin, who was patiently waiting. “I had no idea,” Jack said, returning his gaze to Laurie. “Of course, Arnold couldn’t come down and stand in for his friend.”
“Of course not,” Laurie agreed. “But I’m pleased. I wanted a case, particularly a straightforward case.” Since she didn’t want to get into a discussion of Arnold’s shirking tendencies, which was one of Jack’s pet peeves, she changed the subject and asked how the GSW case had gone.
“I’d say very well,” Jack responded.
“I agree wholeheartedly,” Lou chimed in. “The path of the bullet into the driver’s chest was definitely from the right to the left, meaning he was facing forward when he was shot and not straight on, as he would have been if he was twisted in his seat, backing up, as the accomplices contend. And the core jacket, which separated off as the bullet went through the windshield, did quite a number on the man’s forearm, which couldn’t have happened if he’d had his right arm over the back of the van’s bench seat, as the accomplices also contend.”
“Congratulations,” Laurie remarked, and she meant it. It was a good case to demonstrate the power of forensics.
Moving on, Laurie greeted Marvin, who returned the greeting with great enthusiasm. Up until that moment, they’d not yet seen each other since Laurie’s return to work. After a short discussion of the rigors of parenthood, since Marvin had three kids of his own, Laurie directed the conversation to the victim stretched out on the autopsy table.
“So what do we have here?” she asked.
Looking down at the corpse, which had been butterflied with the typical Y-shaped autopsy incision to expose the internal organs, Marvin said, “The victim is an Asian male, which Dr. Southgate estimated to be approximately thirty-five years old, weighing one hundred and forty-two pounds, who collapsed on the subway platform. There is no known medical history, and no prescription drugs were found on his person.”
As Marvin continued his description, Laurie picked up the case file and extracted the MLI’s report. It had been written by Cheryl Meyers. Still listening to Marvin, her eyes scanned the report and immediately picked up on the fact that there had been no identification found on the victim.
“Is this an unidentified individual?” Laurie asked, interrupting Marvin.
“Yup,” Marvin said.
Laurie went back to the case file and pulled out the notice-of-death sheet and the identification-of-body form. The latter was blank and the former barely filled out with the facts that the body was picked up by emergency medical techs who’d responded to the scene after a call to 911. They’d found the victim unresponsive, with no heartbeat, no blood pressure, and without respiration. CPR was instituted and continued until the arrival at the Harlem Hospital Center emergency room, where he was declared dead.
Laurie looked up and locked eyes with Marvin. To her, an unidentified case was a complication, and she was disappointed to a degree. She knew it wasn’t necessarily a rational response, because she could do her forensic work just the same whether the corpse’s identity was known or not known, but on her first case back from her leave, she wanted the case to be definitive, with no loose ends. For her, being unidentified was a loose end, and more important for her, it was a loose end that was largely beyond her control to influence. There would be no medical history to help her confirm her findings.
“Was there anything unique about the external exam?” Laurie questioned.
Marvin shook his head. “No scars or tattoos, if that’s what you mean.”
“How about jewelry?”
“There is a police custody voucher for a wedding band.”
Laurie’s eyes brightened. A wedding band meant a wife, and glancing at the victim’s general appearance, she knew this was no derelict individual, as he was well groomed. “What were his clothes like?”
“Well dressed, with shirt, tie, and jacket under a long overcoat. The overcoat looked new, although it was soiled from the subway platform.”
“Those are all good signs,” Laurie said with relief. From experience she knew that identification of unidentified bodies depended largely on the victim being searched for, and in a situation like the one she was currently facing, a wife starting a search within twenty-four hours or less was the rule, not the exception. In contrast, identifying a body in a situation where there was no one looking for it was a very difficult task, even in this day and age, with tools such as DNA matching.
“Did Dr. Southgate mention if he had any suspicions about the cause of death?” Lauri
e asked.
“Not that he said,” Marvin offered, “but I think he was leaning toward a stroke or something intracranial. One witness—actually, the man who made the nine-one-one call—said that he thought there had been a short seizure involved.”
Laurie glanced back at Cheryl Meyers’s note and saw that she had duly included the suggestion of a stroke, but she’d gotten that from the EMTs and had not spoken with the individual. “What about the X-rays? Anything interesting seen on them?”
“Dr. Southgate said they were negative. But they are still up on the view box, if you care to look at them.”
“I care,” Laurie said. Clasping her hands together, she went over and gave them a look, concentrating on the head and the chest. She saw no abnormalities. She then scanned the abdomen and finally the extremities. Nothing.
“Okay,” Laurie said, returning to Marvin. “Let’s get the show on the road, and we’ll see what we find.”
Since Laurie and Marvin often worked together, the autopsy itself went quickly. The slowest part was when they removed the lungs and the heart en bloc, as cardiac arrest was often involved with sudden death. But the heart was normal and no abnormalities of the vessels were noted, particularly the coronary arteries. The second time they slowed the pace was after Marvin had cut off the crown of the head and gently removed the skullcap. Both had expected to see blood if there had been a fatal event in the brain, but there had been no blood whatsoever, either in the coverings of the brain or within the brain itself.
“Well,” Laurie said after finishing suturing the autopsy incision. “That’s about as normal an autopsy that one can have. Usually there’s some pathology that can be found, but with this unfortunate fellow, he seems to have been entirely healthy and normal.”
“What’s your guess, then?” Marvin asked.
“I suppose I’d have to guess that he suffered some sort of cardiac conduction abnormality despite the possibility of a seizure having been involved,” Laurie suggested with a discouraged shake of her head. “After the heart and great vessels appeared normal, I was surprised when we didn’t come across a solid tumor when we were slicing the brain. So now it will be up to histology—at least I hope histology will help. I don’t want to have to sign this case out as an unknown cause of death of an unknown individual, and especially not as my first case back from my maternity leave. It’s not going to be any help for my confidence.”
“What about the extra fluid we found in the stomach and the beginning of the small intestine?” Marvin questioned. “That seemed to surprise you when you saw it at the time. Any significance you can think of now?”
“Not really,” Laurie admitted. “As far as I know, that’s not associated with any natural cause of sudden death. The man must have drunk and eaten not long before he died. It will be interesting to see what his blood alcohol will turn out to be.”
“What about unnatural cause?”
Laurie paused. Marvin had reminded her that it was always important to keep an open mind, as one could be fooled, for example, by a homicide made to look like a suicide or an accident. Yet the possibility of this case fitting into that scenario seemed very unlikely, with the victim collapsing on a subway platform. At the same time, just to be complete, she had already decided on doing a toxicology screen as well as a BAL, or blood alcohol level test, and had taken the appropriate samples. OCME toxicology screen included some two to three hundred legal and illegal drugs, so she felt confident to be covered in a drug poisoning or overdose situation.
“I’m pretty sure, when all is said and done, this is going to be a natural death,” Laurie predicted. “We just have to wait for histology and toxicology to help us out if there is something else involved.”
“Are you booked for another case?” Marvin asked.
“I doubt it,” Laurie answered. “I wasn’t even booked for this one.”
Laurie helped move the body onto a gurney, then gathered up the toxicology and the histology sample bottles and put them in two brown paper bags. “I’ll carry these up myself,” she told Marvin. “I want to make a personal plea that they get processed quickly. I’ve nothing else to do.”
“Be my guest,” Marvin responded.
On her way out, she stopped at Jack’s table, where he was already starting another case. Lou had long since departed for home and some much-needed sleep.
“How’d it go?” Jack asked, referring to Laurie’s case. When he’d returned to start his second case, he’d decided not to disturb Laurie, who’d appeared to be totally absorbed with the Asian. “What did you find?”
“Unfortunately, nothing,” Laurie responded. “And to make matters worse, it’s an unidentified body.”
“Why the long face?” Jack questioned.
“Don’t ask. I found no pathology whatsoever. And with no medical history, my chances of missing something important go up considerably.”
“So?” Jack questioned. “That happens. Sometimes there’s no pathology whatsoever. Not often, but it happens.”
“Yeah, it happens, but I didn’t want it to happen on my first case PMS.”
“PMS? You have PMS?” Jack was incredulous. Laurie never complained of PMS.
“Post-maternity sojourn.” Laurie said, trying to be funny to buoy her mood, but her would-be joke fell flat. “But I’m not going to give up. I’m going to find some pathology if it kills me. At least I have the time. It’s my only case.”
Jack merely shook his head, and without even smiling questioned, “You’re not using a negative autopsy to fan your professional competency concerns, are you? Because if you are, you’re being”—he paused, trying to find and appropriate word—“silly.”
“I refuse to answer on grounds of incriminating myself,” Laurie offered, and tried to smile.
“You’re impossible!” Jack said with a wave of dismissal. “I’m not even going to respond, for fear of encouraging such nonsense.”
“What’s your second case?” Laurie asked, to change the subject. She was glancing at the body of a young, healthy woman with no obvious abnormalities or trauma. Vinnie was standing at the table, obviously impatient to get under way, nervously shifting his weight from one foot to the other.
“I guess similar to yours: sudden death. Boyfriend saw her walk out of the bathroom as you see her now, completely naked. He described her as looking surprised or confused, and then she just collapsed.”
“Any health problems?”
“Nope, no health problems. She was a cabin attendant for Delta and completely healthy. She had just returned from a trip to Istanbul.”
“You’re right. Sounds like my case,” Laurie suggested.
“Except for one thing,” Jack said. “The boyfriend wasn’t supposed to be there. There was a restraining order against him, as he’d supposedly tried to kill her a month earlier when she started dating a pilot colleague.”
“Uh-oh!” Laurie voiced.
“ ‘Uh-oh’ is right,” Jack agreed.
“Keep me informed,” Laurie said. It did sound like her case, except for the benefit of an identification and history.
Laurie left the autopsy room, carrying bags containing the histology and toxicology sample bottles. In the locker room, she got out of her Tyvek suit and dealt with her headgear. As she rode in the elevator to the fourth floor, she thought about Jack’s case. She was jealous that he would undoubtedly find some nefarious cause of the woman’s death. She wished her case could have been similar in that regard.
“Well, well, ladies!” Maureen O’Conner, the histology lab supervisor, cried out in her famous brogue as she took the brown bag from Laurie. Maureen had spent the first half of her life working at a hospital in Dublin, Ireland, before coming to New York. Vivacity was her middle name, and no one was spared her sharp and humorous tongue, from the chief down to the janitors. Laurie was a favorite, as she was the only medical examiner who made it a point to visit Maureen’s fiefdom regularly. Laurie was always eager to have the histology slides on her
cases sooner rather than later.
“If it isn’t Dr. Laurie Montgomery!” Maureen continued, causing all heads in the department to turn in Laurie’s direction. “Welcome back! How is that little one of yours—well, I hope.” Everyone at OCME had heard the story of JJ’s neuroblastoma, as well as the good news of his miraculous cure.
Laurie took the added attention in stride, even the usual kidding about her frequent requests to have her slides back overnight. Maureen’s usual teasing was to remind Laurie that her patients were all dead, so there was no need for speed, a comment that never ceased to put all employees of the histology lab into fits of laughter.
Next Laurie descended back to the first floor and visited Sergeant Murphy of the NYPD. His tiny cubicle office was situated off the communications room, where operators were on call for reports of deaths twenty-four hours a day. Besides the desk, there was barely enough room for two metal folding chairs and an upright file cabinet. The desktop and the top of the file cabinet were strewn with newspapers, soiled coffee cups, and crumpled Burger King wrappers.
“Did you get word on the unidentified Asian that came in late yesterday afternoon?” Laurie questioned. She’d run into the sergeant earlier, and they’d already gone through their welcome-back greetings.
“I did,” Murphy said. “The transit patrolmen out of District One who responded to the nine-one-one call copied me on their report to the Missing Persons Squad as they were supposed to. Apparently, there was no billfold on the victim or other identification. In fact, there wasn’t anything whatsoever except a wedding band. There wasn’t even a watch.”
“Do you know if there were any witnesses to his wallet being swiped? As well groomed and dressed as he was, it seems unlikely that he’d not been carrying one.”
“None that I know of.”
“What’s the status of the case?”
“It’s been assigned to a missing-persons case detective out of Midtown North Precinct as an unidentified body. It’s being worked.”
