by Robin Cook
“Should we head into the decomposed room and start getting the body out of the body bag?” Vinnie asked as soon as he was ready to go. He was always thinking ahead, which was one of the many reasons Jack liked to work with him.
“Let’s talk over the case before we start,” Jack said while putting his legs into his suit as if he were donning a pair of coveralls. “This is a lot scarier than on Monday. Now we know we could be facing a real subway pandemic.”
“True,” Vinnie said, immediately taking Jack’s lead. “Monday, we worried the case might be contagious, but now with a second case we know for sure.”
“I want to get through this without one or all three of us coming down with the same illness,” Jack said. “What makes it particularly scary is that it’s an unknown virus.”
“Oh, no,” Vinnie said, feigning concern. “Don’t tell me it’s unknown.”
“What difference does that make?” Carlos stuttered.
Jack had to take a deep breath to keep from laughing. For some reason it seemed that tagging a microorganism as an unknown did provide an extra aura of danger. “Unknown viruses are a lot easier to catch than known viruses,” Jack said, now making an attempt at humor. For a moment he worried he’d overdone it, but Carlos quickly proved him wrong.
“Do you think you have to be on a subway to catch it?” Carlos asked.
“Now, there’s a good question,” Jack said. “If we take these two cases as indicative of the nature of the illness, we’d have to say yes.”
“Then we should be okay,” Carlos said. “I mean, as long as we don’t go on the subway.”
“Easier said than done,” Vinnie said. “Besides, we might still be at risk. We’re in the basement here at the OCME. It’s kind of like the subway.”
“Good point,” Jack said. He inwardly smiled as he got his ventilator battery pack and hooked it up. He listened for the hum of the fan to be sure it was functioning normally. “This could be the start of something really big. The only other time people died this quickly on the subway was the 1918 flu pandemic. Back then at the height of the pandemic, New York City saw two to three hundred people dying each and every day.”
“No shit,” Carlos exclaimed.
“I kid you not,” Jack said, as he got his head up into the moon suit. It made his voice sound slightly deeper. “All right, I’m ready. Let’s do it.”
As a group, they walked the short distance from the moon suit locker room to the decomposing room. Carlos lagged behind, using a shuffling gait that made him look like he was walking in wet pants. Once inside the small autopsy room, they first went to the X-ray view box, so Jack could view the film that Vinnie and Carlos had previously taken.
“Well, at least this one surely didn’t have a heart transplant,” Jack said. He didn’t see anything abnormal, like old bone fractures or extensive dental work. “So now we know that having a heart transplant is not a requirement to come down with the subway pandemic.”
Next they got the body out by folding the body bag over the sides of the autopsy table, just as they had done with Carol Stewart. It was obvious Carlos was an unwilling participant.
“I’d guess she’s about the same age as Carol,” Vinnie said. “And nice duds. She looks like she, too, had gotten dressed up for something.”
“Very similar to Carol,” Jack said. “To me it means she was feeling normal when she got on the subway. It’s truly amazing how fast this subway pandemic kills. I hope you are not going on the subway tonight, Carlos.”
“No, not tonight,” he said nervously.
Jack took a series of photographs with the body clothed for identification purposes while Vinnie did the fingerprinting and uploaded the prints into the OCME database. Then Jack removed the woman’s jewelry, which included a watch and a ring, both of which matched what was removed from Carol, further suggesting to him that it was not a coincidence her name was Helen. Although she had pierced ears like Carol, she wasn’t wearing earrings. Jack then told the two mortuary techs to go ahead and start cutting off the clothes while he put the jewelry aside next to the specimen bottles.
Carlos was on the patient’s right, and as soon as Carlos had the right arm exposed, Jack rolled it over to look at the volar surface. As he had anticipated, there was a duplicate of Carol’s puzzle tattoo, with the only difference being the name. In this instance it was Carol.
“Shit!” Vinnie said, looking at the tattoo. “These two women must have been lovers.”
“They might even have been married,” Jack said. “I suspected that they might be a couple the moment Bart said this woman’s given name was Helen.”
“Do you think Helen caught this unknown virus from Carol?” Vinnie asked.
“That’s my fear,” Jack said. “Or maybe the other way around. One way or the other, it means it’s contagious. That is for damn certain.”
“I don’t want to be in here,” Carlos suddenly blurted.
“You’re not having fun?” Jack questioned.
Carlos backed up from the autopsy table. He was still holding the bandage scissors in his gloved right hand. “You people are crazy. I don’t need this.” He tossed the scissors onto the countertop next to the sink as if he no longer wanted to touch them.
“If you are thinking of leaving the party, you have to disinfect yourself,” Jack said, while he pointed to the side door that led into the connecting room designed for that purpose. “I trust you remember how it’s done?”
Carlos didn’t say another word before turning and barreling through the side door.
For a moment Jack and Vinnie paused and stared at each other, even though it was difficult to see their faces through the plastic face guards. When they suddenly heard the shower start in the other room, they high-fived.
“I think you accomplished your goal,” Jack said. “Congratulations.”
“Pardon the cliché, but let’s not count our chickens before they hatch,” Vinnie said. “Though it’s looking positive. But it wasn’t me, it was you.”
“All right, enough fun and games,” Jack said as he looked down at the partially exposed Helen VanDam with only her face and arms visible. “Let’s get serious and knock this out. This could be the beginning of a major catastrophe.”
27
WEDNESDAY, 5:35 P.M.
Just as the clinical aspects of Carol Stewart and Helen VanDam corresponded, so did the autopsy results. Except for the heart transplant, the autopsies were mirror images of each other, down to the mild signs of inflammation with extravasation of blood in the gallbladder, spleen, and kidneys. Once again, Jack had been reminded of what was seen with hantavirus, even though he knew it wasn’t hantavirus. But most important were the similarities of the extensive lung pathology, indicating that the victim had essentially drowned in her own body fluids and exudate. Both Jack and Vinnie had been impressed to the point of Vinnie joking that it wasn’t a cytokine storm but rather a cytokine cyclone.
When the autopsy was over, Jack stayed and helped Vinnie clean up and disinfect all the sample bottles and the outside of the body bag with hypochlorite. With that done, Jack left Vinnie to deal with getting the body bag into the cooler and contacting janitorial services to clean the room itself. He also tasked Vinnie to get the viral samples over to Aretha at the Public Health Laboratory. In his mind there was no rush. He was about as sure as he could be that whatever the microorganism was, it was the same in both cases.
After hanging up his moon suit in the hazmat locker room and plugging the ventilator into the charger, Jack went into the main locker room to change back into his street clothes. But first he checked his mobile phone and saw there was a recent text message from Rebecca Marshall. It said that John Carver was on his way in to make a formal identification of Helen VanDam. Jack checked the time of the message. It was 5:11. Quickly he called Rebecca to find out the status. He learned that the man was there an
d had made the identification.
“Is he about to leave?” Jack asked. “As I said, I’d like to talk to him.”
“Yes,” Rebecca said. “We are all done, and I didn’t think I was going to hear from you.”
“Ask him to hold on,” Jack said. “I’ll be right up.”
Instead of changing, Jack grabbed one of the white coats that were available for the MEs to use between cases and pulled it on over his scrubs. A minute later he was in the stairwell. The back elevator that served the basement took forever if the elevator car wasn’t there waiting.
Jack was able to enter the ID area from the back through what used to be Communications before Communications was moved down to 421. The whole area had been greatly expanded over the previous fifteen years, particularly after the identification problems associated with the collapse of the World Trade Center. He found Rebecca Marshall in her cubicle and was told John Carver was waiting for him in the family ID room.
Walking into the family ID room, which was a modestly large space, Jack found the man sitting on a blue couch. He was the only person in the room, the furniture in which consisted of a large, round wooden table with eight wooden chairs in addition to the couch. On the walls were a number of framed posters of the 9/11 disaster with the phrase NEVER FORGET emblazoned across the bottom of each. Jack had wondered for years why the posters were still up. The only explanation he’d come up with was that they would remind grieving families that as bad as they felt, there had been worse times.
As Jack approached, John got to his feet. He was a slightly built, youthful man, probably in his late twenties, with a narrow and handsome face. He was impeccably dressed, wearing a tight-fitting and possibly one-size-too-small blazer. He had a shock of auburn hair with blond highlights that needed to be constantly pushed out of his face or snapped back with a sudden toss of his head. It was painfully apparent from the man’s expression that he had been sorely rattled by the events of the afternoon.
Jack introduced himself and explained that he had done a postmortem examination of Helen VanDam and wanted to ask him a few questions. “I don’t know what you have already told Mrs. Marshall,” Jack added. “So I apologize if there is a certain amount of redundancy.”
“That’s okay,” John said. His voice wavered. It was obvious that Jack had already added to the man’s discomfiture.
Jack gestured toward the table and both men sat. Jack could see that John was trembling.
“I want to personally thank you for making the identification as you did.”
“Thank you,” John said. “I’ve never had to do this before.”
“It’s not easy,” Jack said. “But it is extremely important.”
“I can understand.”
“I want to ask you if you knew Carol Stewart,” Jack said.
“Of course,” John said. “I recently got to know her quite well.”
“Did you know that Carol Stewart had also recently passed away?” Jack asked.
“No, I didn’t,” John admitted with alarm. He took a deep breath and let it out. “When?”
“Monday,” Jack said.
“What did she die of?”
“That’s still to be determined,” Jack said. “Whatever it was, the symptoms and signs were consistent with Helen’s. We are concerned it might be a contagious disease. Strangely enough, both became stricken on the subway.”
“Oh my God, it was terrible,” John confessed. He closed his eyes for a moment and shook his head at the memory. “When we got on the subway, Helen was fine. She’d been fine. She hasn’t been sick at all. We were having fun. We were coming into the city to shop. Then, before we crossed to Manhattan, she had a chill and soon started having trouble breathing. I didn’t know what to do. Somebody called the conductor. It was awful.”
Jack paused in his questioning for a moment, trying to figure out how to continue. “I’m sorry,” he said empathetically. “I know this is not easy, but because it might involve a contagious disease, I need to ask some personal questions. From the matching tattoos on both women, I’m assuming they were romantically involved. Is that fair to say?”
“Yes, they were a couple,” John said. “As far as I know, they had been living together for at least a year and at one point were thinking about getting married.”
“What was your relationship with these women?”
“It’s all rather complicated,” John said.
“It might be important for us to know the details,” Jack said.
“For the last three and a half months I’ve been roommates with Helen.”
“And before that?” Jack asked.
“I had been living on and off with a girlfriend in SoHo but mostly off,” John said. “But I’ve known Helen forever. We went to school together in Seattle, and from grammar school all the way through high school we’d been an item. We’d been in touch when we both found out we were here in the city. But then when Carol started getting really sick and was going to have her heart transplant, Helen more or less insisted I move in with her to keep her company and help her get through a difficult period. She thought Carol was going to die.”
“That was three and a half months ago?”
“That’s right,” John said. “I wasn’t getting along all that well with my girlfriend, so I took Helen up on her offer. And then we kinda hit it off remembering old times.”
“You mean you and Helen started an affair?”
“I guess you could say that,” John said. “It was more a reawakening. She was needy, and I was needy, so there you have it. It surprised both of us.”
“What happened when Carol came home?”
“Well, we ended up telling her what was happening. She seemed all right with it because she was limited in what she could do after her operation. Then, when she got better, she even tried to participate. She didn’t want to lose Helen, and I was kind of a package deal by then. And she gave it a good go, but ultimately she told Helen she couldn’t handle it. She actually got pretty angry about it all and moved out a couple months ago to an apartment in Sunset Park.”
“Did you guys see her after she moved?”
“Yeah, for the first month. We made an effort. We hoped she’d change her mind, so we spent lots of evenings at her place. But it was clear it wasn’t going to work.”
“Do you mean neither you nor Helen saw Carol for about a month before she died?” Jack asked.
“That’s right,” John said. “We got into an argument the last evening we spent together. Helen and I got pissed. I mean, we didn’t force her or anything. Carol was acting so bitchy and self-righteous, like she was better than us.”
“To me it sounds like Carol decided she preferred a monogamous relationship,” Jack said, treading carefully.
“Maybe, but I think it was more that by making the attempt, she only grew more sure she wasn’t bisexual,” John said. “I mean, she tried, and there’s nothing wrong with being bi, but I don’t think she liked it. She was a lesbian and just didn’t get turned on by the opposite sex. That’s what I think she realized. But you could be right that she wanted all or nothing with Helen.”
“Okay,” Jack said. “I appreciate your time, and I want to thank you for being so open. I know this has been a difficult day for you.”
“The worst,” John said without hesitation. “Now, let me ask you a question. If this is a contagious disease like you’re saying, do I have to worry about catching it?”
“That is a very good question,” Jack said. “The problem is, we just don’t know. But we have your contact information, so we’ll be in touch if we need to be.”
“Is that it, then?” John asked. “Can I go?”
“One more question,” Jack said. “If it is a contagious disease, we don’t know who gave it to whom. As far as you know, did either woman travel recently outside the U.S.?”
; “No. I mean, Helen didn’t for sure. I suppose Carol could have, but I doubt it. She had been so sick and was always going back to see her doctor out in New Jersey someplace. And she wasn’t excited about travel. She thought she’d gotten her heart condition on a business trip to South America.”
“What about pets?”
“No pets,” John said with an expression of disgust. “I won’t live with animals, and both Helen and Carol felt the same way.”
“What about pests, like mice around the apartment. Anything like that?”
“Yuck,” John said. “No way.”
“Thank you for your cooperation,” Jack said. He pushed back from the table and stood. “If and when we discover what killed your friends and we think your health is at all at risk, we’ll call you.”
Leaving the family ID room, Jack intended to go back downstairs to change into his street clothes, but halfway to the stairwell he remembered his promise to Laurie to see to the police custody case. Instead of going to the basement, he beelined to the front elevators with the idea of heading up to the sixth floor to see if anyone was still in Toxicology.
As it turned out, Jack was lucky. Peter Letterman, the assistant director, who was an extraordinarily dedicated civil servant, was still in his tiny office despite the time. It was after six. Peter was more than happy to check on the case, and when he did, he reported to Jack that the blood cocaine level was 1.52 mg/l and the cocaine metabolite was 1.84 mg/l.
“These are high,” Jack commented.
“Very high,” Peter said.
“Dr. Montgomery is going to be happy,” Jack said. “The police commissioner has been on her case in trying to prove forceful restraint was necessary. I think this does the trick.”