He scanned the common room to make sure everyone was calm and engaged. The key-chain group had abandoned their embroidery floss and were now playing air hockey instead. Isak was still reading with his legs pulled up underneath him.
Sometimes working in health care felt like renovating a fixer-upper with modeling clay. Often he went home from his shift feeling like his work as a social worker didn’t make any difference, that he wasn’t doing enough. Even though he was young and newly qualified, he already felt the impotence crawling under his skin. The system didn’t encourage individuals to take initiative or foster a can-do attitude. But it was impossible for him to accept that conditions weren’t better for the patients and that the beautiful old hospital’s space wasn’t being put to good enough use. More so because he loved the place and appreciated the old buildings that had been built to outlive those who had built them. They reminded him of a bygone era, where solutions lasted and were more than just stopgap measures.
Society had moved on. Now washing machines broke two months after their warranties ended, buildings were made of drywall instead of plaster, and disorders were something managed with painkillers without considering what had caused the pain to begin with.
It was all just symptomatic treatment. Idleness had won; the system was broken.
He got up to go do his rounds.
“Hey, who’s winning?” he asked. “You’re not cheating, are you, Isolde? I’m keeping an eye on you!”
He tweaked Isolde’s arm and walked on with a laugh. One of the upsides of being young was that the patients could relate to him better than to many of his older colleagues. He cleaned up the embroidery floss, even though they were supposed to do it themselves, and found himself next to Isak’s chair again.
“Did you have breakfast?”
Isak nodded absentmindedly.
Simon’s question seemed innocent, but as a matter of fact it was essential. Isak sometimes forgot to eat, and when he did, his antipsychotics caused nausea. The last time he threw up his Seroquel he disappeared on the hospital grounds and was missing for several hours. Later they found four ducks by the pond with their heads ripped off.
Simon had been working with Isak for nearly six months and was getting to know his history. The schizophrenia had emerged in his early teenage years, but because he already had an Asperger’s diagnosis, his family had long thought this was another disorder on the autism specrum. It had taken way too much time for him to get the right treatment. Simon had seen the last of the remaining hope fade slowly but surely from the family’s eyes as Isak’s condition deteriorated and his diagnoses piled up. Now his father mostly came to visit on his own, sometimes with a magazine or a book for Isak, always with a sad smile that broke Simon’s heart. His own father had never shown him that kind of devotion. Isak’s parents were loving people forced to watch helplessly as their son grew sicker and sicker and gradually moved further and further away from the dream of ever living a normal life.
“Do you want to go to the quiet room while the others have their phone time?”
“Yes, please,” Isak said, standing up abruptly.
He knew that Isak liked the little room decorated with floral wallpaper, scented oils, and soothing music, partly because it was a quiet place to read, but also because he didn’t have to see everyone else having fun online. Isak wasn’t allowed to access the internet.
“Do you have your book?”
Isak held up his worn copy of Papillon. He was over six feet tall, skinny as a Masai warrior, and had a wobbly, arrhythmic gait as if the floor sent shocks up through the soles of his feet with every step he took. In the quiet room he sank down into a beanbag chair, pulled his feet up under himself, and went back to reading.
Simon checked that the alarm was in his pocket. Isak was almost eighteen and would soon be transferred in the adult OPUS system, which provided integrated outreach treatment for young adults with psychotic symptoms, a transition that Isak wasn’t ready for at all. The idea was completely untenable. Where was he going to live? In a residential home for mentally ill students with a ratio of one day-shift social worker to ten youths? Or if there wasn’t room, then in a group home or a shelter? Or on the street even? If so he would clock in and out of hospitals and get worse and worse, until… How long would it last until things ended badly?
Simon closed the door with anger bubbling in his blood. It was clear to him that he needed to take drastic measures if he was going to change things.
* * *
KNIVES HUNG FROM hooks along the tiled wall next to electric oscillating saws and handsaws, heavy and robust work tools made to open rib cages and split skulls, a world of steel and disinfectable surfaces, clinical and precise, to handle the deceased’s waste, decomposition, and chaos. There were spray hoses, nonskid flooring, magnetic bulletin boards, and work lights, and every surface and corner had discreet holes to guide the messy bodily fluids and the final remnants of life away.
Jeppe Kørner snapped up his protective suit and glanced at the oversize grabbing claw that hung from the ceiling. He regretted the chorizo sandwich he had eaten for an early lunch, because the sausage turned out to be a gift that kept on giving. The autopsy hallway in the pathology department was not the place to be reminded of the taste of dead meat.
Next to Jeppe Detective Falck pulled a white scrub cap over his gray hair, which made him look more than ever like a cartoon teddy bear, Paddington perhaps, trapped in a cold world of stainless steel and bodies waiting to be cut open.
“I think they’ve already started.” Jeppe pointed toward the farthest autopsy bay and started walking. Paddington followed.
Professor Nyboe was standing next to a forensic tech and a police photographer by the stainless steel table in the middle of the room. Under the bright lights, they cast shadows over the lifeless body on the examination table, making its skin shine like patches of sunlit snow on a faded gray hill.
“Who do we have there?” Nyboe looked up, his long wrinkly neck evocative of an aristocratic tortoise. “Kørner and Falck, come on over. We’re just finishing up the external examination.”
Jeppe came closer and looked at the dead woman. She lay faceup, her chin raised slightly and the palms of her hands open, still naked with a waxy pallor, her jaw broad and her chin prominent. Her legs were muscular with varicose veins; the hair on both her head and genitals was graying and curly. In this, the very last bodily surrender, she was defenseless, every defect and flaw clearly visible. Still, there was a strange, frail beauty to the dead person lying on the table.
“Has she been definitively identified?”
“As suspected, this is Bettina Holte, fifty-four-year-old health-care aide. She lives in Husum with her husband and is the mother of two grown children. The family positively ID’ed her.”
Jeppe nodded to Falck and said, “Will you just make sure that the search has been completely called off?”
Falck took a couple of steps away and fumbled around with his protective suit, trying to get to his phone.
“And what did she die of?” Jeppe asked.
With concentration, Nyboe rubbed a cotton swab over one of her nipples and then deposited the swab into a sterile bag before replying, “She died of cardiac arrest, Kørner, like everyone else. You want to know more before I’ve done the autopsy?”
“Just tell me what you know now.” Jeppe suppressed a sigh. “If you would be so kind.”
“Kind is my middle name,” Nyboe replied.
Nyboe took a metal stick from the worktable behind him, one of those telescoping pointers that schoolteachers used to use in the old days when they had to point out Djibouti on the world map. Nyboe directed the tip of the pointer to the body’s wrist.
“Do you see those cuts? There, there, and there.” He moved the pointer from arm to arm and then to the hip.
Jeppe leaned forward. Across each wrist and on the top of her left hip, the skin gaped open in centimeter-wide slits, carved completely symmetrically over
each other in two parallel lines. Twelve little cuts in total, meticulously made over three of the body’s major arteries.
“Bettina Holte bled out. I haven’t found any other external injuries apart from those cuts. So I can tell you this with a reasonably high probability.”
“Bled out?” Jeppe actively shut out the sound of Falck’s phone conversation in the background. “Isn’t it usually suicide when someone cuts their wrists and bleeds out?”
“Not in this case. I can assure you that this was not a suicide.” Nyboe moved the pointer back to the pale arm. “Can you see those red marks on her forearms? The woman was restrained with some kind of wide straps, also around the ankles, and maybe around the actual hand as well. The skin is red there at any rate.” He pointed again.
“Why around the hand?”
“So the victim couldn’t do this,” Nyboe said, raising his gloved hand, making a fist, and bending it forward. “That would stop the bleeding. Or slow it down at least.”
Nyboe put the pointer away and adopted a pensive posture, one finger on his chin.
“Rigor mortis indicates that the death occurred sometime between midnight and three a.m. last night—the cooling from two hours in the fountain unfortunately makes the calculations a little iffy—and furthermore that the woman was lying completely flat on her back when she died. The killer probably strapped her down, cut her arteries, and then waited for her to bleed out.”
Jeppe noticed that Falck had joined them again and was taking notes. He was humming to himself unknowingly while he wrote, an unwelcome distraction from the music in Jeppe’s own head.
“The killer must have gagged her or used some kind of anesthetic, no? Otherwise surely she would have called for help.”
“Yes, and screamed from the pain,” Nyboe said. He started clipping the body’s fingernails, which were painted with red nail polish, collecting the clippings in a little bag. “Bleeding out is painful. Maybe not for the first ten to fifteen minutes, but once the heart and the vital organs start shutting down, it hurts quite badly. With those cuts it must have taken about a half hour before she died. It would have gone faster if her carotid arteries had been cut.”
“So this was meant to take some time?”
Nyboe nodded thoughtfully and closed the bag of fingernail clippings.
“That was probably the intention, yes.”
“Man!” Jeppe shook off his discomfort. “Then surely the killer didn’t anesthetize her.”
“The toxicology report will obviously confirm that, but my guess is that, no, he didn’t.” Nyboe flipped his headlamp down and forced the body’s mouth open so he could shine the light into it. “No obvious injuries to the teeth, but she could easily have been gagged, maybe with a wadded-up plastic bag or a soft ball. It’s not hard to keep people from screaming.”
Jeppe closed his eyes for a long moment and tried to picture it, the woman undressed and strapped down, bleeding, unable to scream out in pain, while the life slowly and painfully left her.
“Are there signs of anything sexual?” Jeppe asked.
Nyboe stuck a very long cotton swab down into the woman’s throat and then handed it to the forensic tech before responding.
“Nothing obvious,” he said. “Since she was found naked it would be probable, but there are no signs of penetration, resistance, or semen in her orifices.”
“Okay,” Jeppe said, leaning over the table and looking at the woman’s wrist. “Why all these cuts? Why didn’t the killer just cut right across the arteries?”
“Aha! Kørner, a relevant question for once.” Nyboe turned and searched his workbench, picking up a scalpel. “I don’t know. To start, I’d like to know what the cuts were made with.”
The forensic tech lifted the body’s head from the table, Nyboe made an incision across her neck, set the scalpel down, and then peeled the face off the cranium all the way to the chest. Jeppe knew that the next step was to saw the cranium open, so the brain could be removed and weighed, sliced and examined. After it would be placed in her abdomen along with her other organs, and the skin stitched closed. The skull would be filled with cellulose and absorbent paper. If you put the brain back into the cranium there was a risk that fluid would seep out during the funeral.
“Here, give me your hand!” Nyboe instructed.
Jeppe held out his arm so it hovered over the faceless body on the autopsy table.
“Uh, what are you going to do?” Jeppe asked.
“I don’t think I could make cuts as symmetrical as these, no matter how hard I tried.” Nyboe pulled up Jeppe’s sleeve, rotating his palm so it faced up, and rested the edge of a new scalped on the thin skin covering Jeppe’s wrist. “Not even with my smallest scalpel.”
“In other words, we’re looking for a special murder weapon?” Jeppe said, pulling his arm back and tugging his sleeve back down.
“Yes, Kørner, in other words.” Nyboe tipped the scalpel back and forth so it flashed under the bright lights. “We’re looking for a special murder weapon.”
* * *
“SUICIDAL THOUGHTS?” ESTHER de Laurenti repeated, pausing to consider the question.
The psychiatrist regarded her with a learned wrinkle over his frameless lenses, and she wondered yet again whether she, a sixty-nine-year-old woman, could take such a young doctor seriously. How old was he anyway, his early thirties? Esther glanced around the office, skillfully avoiding his questioning gaze. The wall behind him was covered with glass-front cabinets made of polished walnut, filled with professional books about psychiatry and medicine; the other walls were covered with modern art and preserved butterflies in glass display cases.
“Have you had suicidal thoughts?”
Apparently Esther had considered the question for too long. She noticed that this time around he spoke louder, in case she simply hadn’t heard him, and decided on the spot that she didn’t like him. Seeking his help had been a long shot in the first place. Some of her old friends from academia recommended him warmly, others couldn’t distance themselves enough from his methods. Young Peter Demant was a psychiatrist his patients either loved or hated.
“No…,” Esther said. “Uh, that is, no, not for a long time.”
“But you have had them?” He pointed at her with his Montblanc pen like some lawyer in a courtroom movie.
“As I said, I went through something really devastating a year ago. I lost two people who were close to me. In the wake of that episode… well, after that…” Esther reached for her glass of water, drank a sip, and put the glass back. “I moved out of my childhood home, and that was hard for me as well. I did go through some very dark spells, but it is a long time ago now. So, to answer your current question, no, I’m not having suicidal thoughts.”
He wrote something on his notepad and regarded her over the top of his eyeglasses.
“And yet you’ve come to see me,” he said. “Why?”
Yes, why had she?
Esther wasn’t depressed per se. Her life was pleasant enough without being stellar. She had retired from her job as associate professor of comparative literature at the University of Copenhagen and lived with her old friend and tenant, Gregers, and her two pugs, Dóxa and Epistéme, in a beautiful, centrally located apartment on Peblinge Dossering, overlooking the Lakes, less than a mile from Rosenborg Castle. She had been able to buy the place outright after selling her building on Klosterstræde, in the heart of Copenhagen’s old medieval core. She had money, was in relatively good shape physically, and had tons of time to pursue her writing ambitions.
She just didn’t get any writing done. The murder mystery she had dreamed of writing up until a year ago, she had now abandoned for good, and she couldn’t seem to start on anything else. Inspiration had long faded, and every time she sat down to the keyboard, she was overcome by fatigue and complete apathy. Instead, the days were spent on basic maintenance and mundane tasks like grocery shopping, walks, reading the paper, dinner parties, and so on. She didn’t accomplish anyt
hing. The days just passed.
“It’s like I’m sort of numb on the inside, like I’m stuck,” she said. “I’m not doing badly. I’m just not really doing well, either. Does that make sense?”
“That absolutely makes sense, and you’re far from the only one who feels that way.” The psychiatrist thoughtfully tilted his round, clean-shaven face to one side and smiled fleetingly. “Depression is a widespread disease.”
“Oh, but I’m not depressed,” Esther said, shaking her head in surprise so her earrings jingled against her neck. “I’m just… stuck.”
“Stuck in what sense?”
She weighed her words carefully before responding. He really wasn’t getting it.
“Like I said, my life sort of fell apart the summer before last, and it’s been hard to pick up the pieces. It’s not that I feel depressed the whole time, just…”
“How about insomnia? How have you been sleeping at night?”
“Well, I do wake up around three or four most nights.”
“And how’s your appetite?”
Esther shrugged. She had actually lost nearly ten pounds in the last couple of months; she just didn’t really feel like eating.
The psychiatrist took off his glasses in a rehearsed motion, which was meant to radiate authority, and regarded her seriously. Esther saw through his agenda but also noted with irritation that it was working.
“You’ve experienced an upheaval in your life, from retiring and then from the two deaths. You’re having a hard time eating and sleeping, and you walk around with a general sense of despondency. Have I understood that correctly?”
“Yes, I suppose that’s it.”
“To me it sounds as if you’re traumatized. Maybe the situation doesn’t feel urgent to you and you are not actually feeling depressed. My guess is that your coping strategy is to clench your teeth and struggle through the day. At the same time, you are what I would call emotionally immature. The type who doesn’t dwell on the difficult and the unhappy, and who refuses to be a victim. A survivor, someone who bounces back up.”
The Butterfly House Page 3