by Robin Cook
“How awful,” Laurie said. “Did they want you to look into it?”
Jack nodded. “It’s quite a story. Do you want to hear it?”
“I’d love to,” Laurie said. “But first maybe I’ll take you up on the offer of something to drink. I’d love a glass of water.”
While Jack went into the kitchen, he started telling the story of his afternoon. Laurie settled back and was instantly entertained. When she heard about Randolph Sanders’s antics, she was indignant. “The nerve of sending the body out!” she said with emotion. “After you went to the effort of going all the way out there.”
Jack shrugged. “To tell you the truth, I wasn’t all that surprised. In my estimation, he’s always had a chip on his shoulder towards us Manhattan MEs.”
“I think he feels as if he’s been unfairly passed over either as the Brooklyn chief or the deputy chief over here,” Laurie said.
“He’s been passed over, all right, but for good reason,” Jack added.
When Jack got to the part about forcing his way into the funeral home to get the body fluid samples from Connie Davydov, Laurie found herself laughing so hard, she choked on her water.
Jack went on to tell Laurie about all the possible causes of death he’d come up with. He ended by admitting that Peter Letterman had found nothing; all the assays were negative, even the stomach contents.
“Interesting,” Laurie said while she pondered all the points Jack had raised. “Too bad you couldn’t have done a quick autopsy.”
“I was lucky to get the skin sample,” Jack said. “But what specifically would you have been looking for, other than the usual?”
“The EMTs specifically said she was cyanotic?” Laurie questioned.
“Yup,” Jack said. “And they found low arterial oxygen when she got to the hospital to confirm it. That’s why I thought the culprit was some drug that had depressed her respiration. I was so sure that when Peter reported he’d come up with zilch, I was stunned.”
“I would have liked to make sure she didn’t have a congenital right-to-left shunt that had reopened.”
“I’ve never seen anything like that,” Jack said.
“Well, it would explain the clinical situation.”
“Any other ideas?” Jack asked. “Does any particular kind of poison or drug overdose come to mind?”
“If Peter didn’t find anything in her stomach contents, I can’t imagine what it could be,” Laurie said. “But did you consider methemoglobinemia?”
“No, but isn’t that rather rare?” Methemoglobinemia was a condition where the hemoglobin was rendered incapable of carrying oxygen.
“Well, you’re asking me for something that causes cyanosis,” Laurie said. “You should at least consider the nitrates and nitrites which can cause methemoglobinemia. Even the sulfonamides.”
“But wouldn’t that only be with someone who was congenitally susceptible?” Jack asked.
“Probably in relation to the sulfonamides,” Laurie said. “But not necessarily with the nitrates and nitrites. Still, if you want to be complete, you have to consider it.”
“Okay, you’re right,” Jack said. “I’ll ask Peter to assay for them in the morning. Anything else?”
Laurie thought for a few more minutes, but then shook her head.
“There’s one more twist to this story,” Jack said. He then went on to tell Laurie about the rat die-off in the same Brooklyn neighborhood where Connie Davydov had lived.
“Do you think there’s an association?”
Jack shrugged. “Your guess is as good as mine, but it is a curious coincidence.” He told Laurie that Connie apparently lived in an old cottage in an enclave of similar buildings. He mentioned his idea about the plumbing being primitive.
“Seems like a far-fetched connection to me. If something deadly leaked up from the sewer, why would it only be in one house?”
“You got me,” Jack admitted. “But let’s go on to my other mystery.” Next, Jack told Laurie about Ted’s further analysis of the tiny glittering star. “It’s as if the star were made of flypaper and dropped into a bowl of anthrax spores.”
“Why is it that you get all the interesting cases?” Laurie teased.
“Come on!” Jack said. “I’m serious. Can you explain it? Remember, I cultured all around the star, including the blotter it was sitting on and the desk itself. The PCR test is so sensitive it can detect as little as just a few spores. Everything was clean.”
“You’ve stumped me again,” Laurie said. She glanced at her watch. “Wow! It’s after midnight, and I’m keeping us both up.” She got to her feet.
“Are you going to be okay?” Jack asked. “You’re welcome to stay here. You can have the bed. Half the time I fall asleep out here on the couch anyway.”
“Thanks for the offer,” Laurie said. “You’ve been very hospitable, but I really should go home. I don’t have clothes for tomorrow or anything else.”
“It’s your call,” Jack said. “You’re more than welcome. But if you do go, at least promise me you’ll give me a buzz when you get home. It’s late to be wandering around even your neighborhood.”
“Will do,” Laurie said. She gave Jack a sustained hug.
Jack accompanied Laurie down the stairs and walked her to the corner. It was much easier to catch a cab on Central Park West.
As Laurie rode downtown she thought about the evening. She was thankful for Jack’s hospitality and friendship. Talking with him—even just about work—had calmed her down considerably and provided her with some perspective. What had disturbed her most about the episode with Paul was her inability to have a dialogue with him. She didn’t think of herself as being so rigid that she couldn’t agree to disagree on certain points, although that didn’t include his possibly selling illegal weapons. But if she and Paul couldn’t communicate, then Laurie saw no future for the relationship irrespective of their apparent day-to-day compatibility.
By the time Laurie got to her own street, her thoughts had turned to the case Jack had told her about, and she smiled anew about his experience in the funeral home. She hoped he’d not get into trouble for it or for the visit to the Brooklyn ME’s office. She was well aware that Harold Bingham and Calvin Washington had little patience for Jack’s maverick methods despite their appreciation of his intelligence and competence.
As Laurie undid the myriad locks on her door, her neighbor’s door creaked open. As per usual, Laurie caught a fleeting glimpse of Debra Engler’s frizzy gray hair and bloodshot eye. Debra saw fit to remind Laurie of the lateness of the hour.
Laurie didn’t respond. Her neighbor’s nosiness at any hour of the day or night was the only thing Laurie couldn’t stand about her living arrangement. She slammed her apartment door in protest and redid all the locks. She’d been directly rude to the woman on several occasions and had even told her to mind her own business, all without success.
Laurie petted Tom-2 and took off her coat in that order. Her affectionate Burmese was insistent and would have climbed up her leg if she’d tried to execute the two moves in reverse order. She even had to put the purring cat on her lap while she phoned Jack.
“Are you still awake?” Laurie questioned when Jack answered with a sleepy-sounding voice.
“Mostly,” Jack answered.
“I’m checking in, as requested,” Laurie said. “I’m home safe.”
“I wish you’d stayed,” Jack said.
Laurie wondered what he truly meant, but from previous experience, she knew better than to try to get him to explain. Besides, it was late. Instead she said, “I thought about Connie Davydov on the way home.”
“Did you come up with any new ideas?”
“I did,” Laurie said. “I thought of something else you could have Peter look for.”
“Good. What is it?”
“Botulinum toxin,” Laurie said. “It would have to be a high level, meaning she’d gotten a big dose.”
There was a silence.
�
��Jack, are you still there?”
“Yeah, I’m here,” Jack said. “Are you serious?”
“Of course I’m serious,” Laurie said. “What do you think about botulism as the cause of death?”
“To use your words, it seems far-fetched,” Jack said. “There were no cranial nerve or bulbar symptoms or, for that matter, any symptoms reported suggestive of botulism. Supposedly she walked into the bathroom and collapsed.”
“But botulinum toxin certainly depresses respiration and would cause cyanosis,” Laurie said.
“Yeah, but how many cases are there in a year?”
“More cases than of anthrax,” Laurie said. “And you just had one of those.”
“Okay, I get your point,” Jack said. “I’ll add it to the list along with the nitrates, nitrites, and sulfonamides that I’ll give to Peter in the morning.”
“Thanks for being there for me tonight,” Laurie said. “It meant a lot to me.”
“Hey, anytime!” Jack said.
Laurie hung up the phone and snuggled briefly with Tom-2. The thought went through her mind that Jack would be so wonderful if he ... if he didn’t act like Jack. Laurie laughed at the absurdity of the thought and got up to get ready for bed.
________
SIXTEEN
Wednesday, October 20
5:30 A.M.
Jack could not remember a time in his life when he’d been more preoccupied by so many disparate problems. First, there was Laurie, who confused him both in her behavior and his own reaction to it. After she’d left early that morning, he’d had a devil of a time getting to sleep. He kept mulling over everything she’d said and done in the previous forty-eight hours. He’d still been feeling guilty about his jealous reaction to her engagement news and angry at her response to his attempt at apology, when she’d arrived on his doorstep unannounced. He didn’t know what to make of it all.
And second, there were the two mysterious cases. Try as he might, he’d not been able to come up with an explanation for the grossly contaminated tiny star. As far as Connie Davydov was concerned, his strong suspicion that she’d been poisoned with a respiratory-depressant drug had been shot full of holes by the toxicology department, and despite several hours of reading and even more hours of thinking, he’d not been able to come up with a replacement theory. Laurie’s suggestion of methemoglobinemia was the only idea that he thought had even a slight chance of being correct.
The last problem that was weighing on Jack was the need to come up with some justification for his behavior at both the Brooklyn ME’s office and Strickland’s Funeral Home. Bing-ham had just bawled him out the day before for something that was tame by comparison. If and when Bingham got wind of what had happened in Brooklyn, he’d be livid, and would demand an explanation Jack was ill-prepared to give. For the first time in his career at the Office of the Chief Medical Examiner, he truly thought that come evening, he might be on forced administrative leave.
Not only did Jack have trouble getting to sleep, he also woke up earlier than usual. Still trying to come to terms with his various dilemmas, he bicycled to work just as dawn was breaking. That gave him an hour to work in his office before going down to the ID room.
When he arrived, Vinnie Amendola was in the process of making coffee, and Dr. George Fontworth had just begun looking over the cases that had come in during the night.
“Excuse me, George,” Jack said. “What kind of day does it look like autopsy-wise: heavy or light?”
George’s sleepy eyes ran down his list.
“I’d say the light side of normal.”
“Good,” Jack said. “I’d like to take a paper day if you wouldn’t mind.” A paper day was when one of the medical examiners chose not to do any autopsies, but rather, took the time to catch up on his never-ending paperwork. Normally paper days were scheduled in advance.
“What’s the matter?” George asked. “Are you ill?”
George wasn’t being sarcastic. It was well known around the office that Jack was a glutton for punishment when it came to doing postmortems. He did more than anyone else, and by choice. When anyone asked why, he said that keeping himself busy kept him out of trouble.
“Health-wise, I’m fine,” Jack said. “I’ve just got a lot of things piling up.”
“I don’t see it being a problem,” George said accommodatingly. “Of course, it might be a different story if someone calls in sick at the last moment.”
“If that happens,” Jack said, “just give a shout.”
Jack walked over to the coffeepot.
“Are you finished yet, maestro?” Jack asked Vinnie.
“You can have a cup in two seconds,” Vinnie said.
“Do you have any idea when Peter Letterman usually arrives?” Jack asked.
“The toxicology lab opens officially at nine,” Vinnie said. “But I happen to know that Peter gets in early, usually before eight.”
“Gosh, he spends a lot of time here,” Jack commented.
“You should talk,” Vinnie said.
With coffee in hand, Jack went back to the elevator to return to his office. He was surprised to run into Laurie, who was just arriving. Jack looked at his watch. He was amazed to see her.
“This is early for you, isn’t it?” he asked.
“It is,” Laurie admitted. “I’m turning over a new leaf. I’m going to concentrate on work for a while. It’s something I always do when I’m upset about something.”
“I see,” Jack said. He wasn’t sure if he should ask her what she was upset about or not.
“I want to thank you again for last night,” Laurie said. “You really helped.”
“But I didn’t do anything,” Jack said.
“You were there and you made me feel comfortable,” Laurie said. “You acted like a friend, and that was what I needed.”
They boarded the elevator. Jack pushed the button for the fifth floor.
“Do you want to tell me what happened at your dinner last night?” Jack asked hesitantly.
Laurie smiled. “Not yet. I’ve got to process it a bit more myself. But thanks for asking.”
Jack smiled weakly He shifted his weight. It was amazing how easily Laurie could make him feel uncomfortably awkward.
“Are you going to work on your mystery cases today?” Laurie asked.
“I’m going to try,” Jack said. “Any other ideas for me about Connie Davydov?”
“Only what I gave you last night,” Laurie said.
“If you think of anything, don’t hesitate to tell me,” Jack said. “I might need it to keep the bounty hunters at bay.”
Laurie nodded. She knew what Jack was referring to.
They walked down the corridor together. When they got to Jack’s door they stopped.
“There is one thing I’d like to say,” Laurie offered. “I want to apologize for the way I acted when you and Lou told me about Paul yesterday afternoon. I wasn’t happy to hear it, but as you suggested, I was taking it out on the messengers. You two were right to tell me, although I’m not sure Lou was right to look it up in the first place.”
“Jealousy makes people do strange things,” Jack said. “And I’m speaking for myself.”
“I’ll take that as a compliment,” Laurie said. “And good luck today.”
“Thanks,” Jack said. “I’ll need it.”
Jack went into his office and got back to work. He concentrated on the prisoner-in-custody case. If nothing else, he hoped to have that done by tomorrow to keep Calvin happy. While he worked, he glanced up at the wall clock repeatedly. When it got close to eight, he put down his pen and descended a floor to the toxicology lab.
As he approached the door, it didn’t look promising. It was closed and the lab appeared dark through the frosted glass. Jack tried the door anyway. It was locked. As he turned around to head back to the stairs, he caught sight of Peter on his way along the corridor from the direction of the elevator. He’d just arrived, as evidenced by his coat over his arm.
“Did you think of something else to test for?” Peter asked as he arrived at the laboratory door. He had his key out.
“I did,” Jack said. “Or actually, Dr. Laurie Montgomery did.”
Jack explained about the methemoglobin idea as he followed the lab tech into the lab and his tiny windowless office. Peter nodded as he hung up his coat.
“That means I should look for things like amyl nitrite, sodium nitrite, and nitroprusside,” Peter said as he donned his white coat. “Did this patient have a history of heart disease?”
“Not that I know of,” Jack said.
“Then I can’t imagine she’d be taking any of those drugs,” Peter said. “But there’s a handful of other substances that can cause methemoglobinemia. Do you want me to test for all of them, whether or not she’d be likely to be taking them as a medication?”
“Please!” Jack said. “I’m desperate.”
“Okay,” Peter said agreeably. He started out of his office. Jack trailed him like a puppy.
“When can you do it?” Jack asked.
“I’ll set it up right away,” Peter said. “It’s better for me to get it going before Dr. DeVries gets here. Otherwise he’d start asking questions.”
“I do appreciate your help, Peter,” Jack said. “I hope I can reciprocate in some way. Speaking about your chief, do you happen to know about the status of David Jefferson’s samples?”
“Is that the prisoner-in-custody case?” Peter asked.
“It sure is,” Jack voiced.
“John was complaining about it yesterday,” Peter said. “As far as I know it’s done. Anyway it was positive for cocaine if that’s what you wanted to know.”
“Thank God for small favors,” Jack said. “Calvin is going to be jubilant. Now if I can only be so lucky with Connie Davydov.”
“I’ll give it my best shot,” Peter promised.
Jack started out of the lab but stopped when he remembered Laurie’s final suggestion. “There’s one other thing that Laurie suggested to test for,” he called back to Peter. “Botulinum toxin.”