by Sara Donati
* * *
• • •
THEY FOLLOWED HIM through laboratories, storage and file rooms, a classroom, a small library. Then down a flight of stairs to a part of the morgue that Anna had never seen before. A workspace big enough for five or six people to stand around the slab where a figure lay concealed under a rubber sheet.
It occurred to Anna that if someone were to take a sledgehammer to the far wall the East River would come crashing in. It was the river’s proximity that kept the room cool enough to preserve human remains at this time of year. Soon enough they would start up delivery of ice blocks, but the stench of decomposition would still mount as the summer bore down. By late July it would be thick enough to pierce with a knife.
Lambert folded back the sheet, first from the head to the armpits—he paused to free the arms and place them on top of the sheet—and then from the feet to the thighs.
In her career Anna had seen far more violent deaths—people run down by cabs, trampled by horses, beaten with clubs, burned, hollowed out by cancer or syphilis. The violence of this death was outweighed by its cruelty.
The woman had been young, but she seemed barely human now. The sunken features were as colorless as sand, as were the wounds. And there were so many of them.
“Ligature marks on wrist and ankle on this side,” Sophie said from across the table.
“Here, too,” Anna said. “Very deep abrasions. The onset of gangrene on this lower leg. Strands of oakum in the lesions on her ankle.” She glanced at Lambert.
“This woman was restrained for a very long time. You didn’t mention that to Jack and Oscar.”
“On purpose,” he answered her. “I wanted you to conduct your examination without prejudice.”
Sophie touched the sheet that covered the woman’s torso. “May I?”
Lambert nodded and she drew the covering away. The autopsy incision had been closed neatly, most likely by one of Lambert’s students. The Y shape descended from the shoulders to meet at the diaphragm, where a single stroke continued down to the pubis.
As a new medical student Anna had tried to anticipate what it would be like to perform a dissection. An empty shell, she told herself. A mannequin. Masterfully made, but not a living being. In fact, she learned almost right away that the dead were easy; it was the living who challenged her. The dead required her respect and attention, but the living demanded that she remain both aware and apart, take everything in but show nothing, in order to fulfill her obligations to them. She had learned how to confront the worst wounds, treat the most painful conditions without allowing her emotions to intrude. In the face of unimaginable suffering she could maintain the demeanor her profession demanded of her.
The dead were easy, but this young woman was not just dead. Cold to the touch, no spark of the person she had once been, and still Anna could almost hear how she must have shrieked with pain. Looking at the stab wounds Jack had mentioned to her, it was clear that her death had been very fast, and in comparison to what came before, painless.
The three identical wounds were so exact that they might have been drawn. One was perfectly positioned at the fifth intercostal space and would have pierced the pericardium and then the heart. One between the fourth and fifth ribs, which must have nicked and might have severed the descending aorta, in which case death would be almost instantaneous. The last was between the third and fourth ribs, and alone would have been just as fatal, if not quite so quick a death as a severed aorta.
Sophie said exactly what Anna was thinking: “I’ll guess there was no damage to the ribs.” Soft tissue injuries only meant that if the body had been allowed to decompose until it was only skeletal remains, there would be no evidence of stab wounds at all.
“Let me show you.” Lambert held out two long-sleeved rubber smocks exactly like the one he wore. They were German in design and seldom seen in the States, and for those reasons alone other physicians would almost certainly mock them as fussy and unnecessary. Lambert didn’t seem to care, and Anna approved.
She took a smock. “Murder, without a doubt.”
Sophie wrapped the ties around her waist twice and then tied them, but her eyes stayed focused on the corpse, moving over the stab wounds and then to the abrasions and lacerations, to bedsores that had eaten into the flesh of the hips, the mangled wrists and ankles. “After all this?” She shook her head. “I might call it a mercy killing.”
* * *
• • •
WHEN THEY HAD finished they found Jack and Oscar waiting in Lambert’s office. Oscar came to his feet immediately and moved toward Sophie, his expression open and kind but without any element of pity. Anna had come to like and respect Oscar very much over the last year, and she expected no less of him. More important, she knew that he would be a friend and support to her cousin, someone to call on and to trust.
“You are a sight for sore eyes,” he said to Sophie now.
“Thank you,” Sophie said with a shy smile. “I think. But this is a grim business to meet over.”
Jack touched Anna’s shoulder. “That’s what we feared. So have you come to a conclusion about this Jane Doe?”
Anna said, “I think Dr. Lambert should explain, as it is his case.” She took the chair beside Jack and was glad to have him near. The examination had been unnerving, and this conversation might be just as difficult.
Lambert sat down behind his desk, folded his hands on the desk, and studied them for a long moment.
“We are agreed, the three of us, but I’ll start at the beginning. I trust one of the Drs. Savard will remind me if I forget any details. And I’ll give you a copy of the report, so you needn’t take notes now if you would rather just listen.”
He considered for a long moment. “The body was found at the back entrance of the Northern Dispensary by an orderly, two days ago just after sunrise.”
“The Grove Street door?” Oscar asked. He lived less than a block from the Northern Dispensary and knew every inch of the neighborhood.
“The paperwork didn’t say,” Lambert told him. “So we have a female about twenty-five years old. Very fair, almost white hair that had been cut off—hacked off, I should say—close to her scalp. In life her eyes were blue. She would have been very pretty.”
Lambert went on with his summary of the victim’s height and weight, what her bones and musculature told them about her early life, namely, that she had had sufficient food as a child and no disabling or disfiguring diseases. No broken or missing or rotting teeth, which was rarely the case even with the well-to-do. Her hands had shown no trace of calluses or the normal burn scars and abrasions common in women who looked after their families. All of which pointed to a young woman born into comfortable circumstances, someone who had never scrubbed floors or butchered a chicken. She had borne three children at least, the last very shortly before her death.
Oscar sat forward, his curiosity getting the better of him.
“The birth was a difficult one and not well attended. If not for the stab wounds to the heart, she would have developed a fatal puerperal infection. But it’s the stab wounds themselves we should talk about.” Lambert paused to look at Anna and inclined his head.
Anna gave him a grim smile. “We’ve all seen more than a few stab wounds. I would say this case stands out because there was nothing really violent about it. There were three surgically precise wounds. It was done in a matter of seconds without any difficulty, as the victim was restrained.”
Jack stiffened. “Restrained? You mean she was kept prisoner?”
“You didn’t see her arms and legs yesterday,” Lambert said. “She was very clearly restrained.”
Anna went on. “For a number of months, I would say. There are deep ligature marks on her ankles and wrists and also on her torso and hips, some of them infected. Rope and wire were both used. And she had ulcerating bedsores.”
I
t was a deeply disturbing image, and it took them all a moment to deal with it.
“How would that be possible, to restrain someone for so long?” Jack wanted to know.
“Opiates,” said Lambert. “I knew it as soon as I opened the abdomen. There was a strong odor.”
“Still quite strong today,” Sophie offered. “More than that, she was dosed by mouth and by hypodermic both. There are dozens of injection sites.”
Oscar said, “Why would that be? Is there a medical reason for more than one kind of dope?”
“If you give someone opium—in any form—for chronic pain, they will develop a tolerance for it,” Lambert answered. “And then you have to increase the dosage to have any effect. At some point the dosage becomes so high that it will bring about death. If she hadn’t gone into labor, she almost certainly would have reached that point very soon.”
“But she wasn’t dosing herself,” Oscar said, his voice coming hoarse. “She couldn’t have injected herself, tied up as she was like a—a sacrificial lamb.”
“She wasn’t administering anything herself,” Anna agreed. “But whoever did this to her let things get to the point of no return. And she did go into labor. Sophie can say more about this. Won’t you?” She looked at her cousin.
Sophie cleared her throat, the way she always did when she had difficult news to share.
“When a woman has taken a lot of opium, birth is very difficult. She can’t do the work she needs to do to expel the child. So, whoever attended her decided to use forceps.” She glanced at Oscar and Jack. “Are you familiar with the term?” And when she got blank looks, she went on.
“Forceps look something like tongs you would use to reach into a fire to grab a coal, but larger, and molded to the shape and size of a newborn’s skull. They are inserted into the birth canal and closed around the baby’s head and then locked so that they can’t close or open suddenly. When a contraction comes the physician helps by pulling—gently—to help move things along. The problem is that forceps are very dangerous when used improperly—”
“Which is almost always the case,” Anna interjected.
“Which is almost always the case,” Sophie echoed. “Forceps births rarely turn out well. In this case they caused a great deal of harm. In fact, there was severe damage to the mother and almost certainly to the child. It’s unlikely that the infant survived. If the mother had survived she would have eventually died of her injuries—”
She broke off, shaking her head.
After a long moment Oscar cleared his throat. “I apologize for my lack of delicacy, but what about the three stab wounds between the uterine horns?”
Anna and Sophie glanced at each other and then together at Lambert.
When Lambert turned his hand palm up as if offering Anna the question, she answered. “There was so much damage, it’s impossible to say.”
“It will be hard to convince anyone this is a multipara case without the three wounds the others had,” Oscar said. “And maybe it isn’t.”
“I’m afraid that’s true,” Jack said. “Unless we have other evidence to offer that establishes a connection.”
“I thought you might feel that way,” Lambert said. “Which is why I wanted to have Anna and Sophie here, in the hope they could make the situation clear.”
Anna turned toward him. “You can call it instinct and dismiss it,” she said. “But I feel that the same person who was responsible for the multipara deaths was behind this—this—butchery.”
“So do I,” Sophie said.
“And I am relatively certain,” Lambert added.
“I would never dismiss your instincts,” Jack said. “But it makes no sense. The multiparas were all women who sought out an abortion, but this woman gave birth.”
“But maybe that’s how it all started. She could have been looking for someone to ‘regulate her courses’ as she most probably phrased it,” Sophie said. “Isn’t it possible that the guilty party changed his methods?”
“Why?” Jack said. “Just to drag out the pain for a longer period of time?”
Sophie looked each of the men in the eye. “Consider that Dr. Cameron is dead. This may be his accomplice, who might have had other priorities than just punishing the mother.”
“Yes,” Anna said. “The idea might be to save the child.”
Sophie went on. “The child could be the reason they didn’t kill the mother straight off. She might have been kept alive only as a living container, something like a bitch in a kennel, kept close until she whelps.”
“You wouldn’t treat a bitch the way this young woman was treated,” Oscar said. “Certainly not if you wanted a healthy litter of pups.”
“That’s the sticking point for me,” Jack agreed. “Any physician would have known that subjecting the mother to extended torture—I think we have to use that word—was likely to result in a stillbirth. If the child was the goal, why would he—or she—have allowed it?”
Anna said, “Assume for the moment that we’re not dealing with the original surgeon. The person who kept this woman prisoner either didn’t realize the repercussions, or—what seems more likely to me—he or she is delusional. If this is a multipara case, the guilty party might have decided that it is morally acceptable to kill the mother, but not the child. So he or she decided to hold the mother prisoner until the child was born. The contempt or hatred for the mother would explain the terrible treatment she received while waiting to go into labor.”
“And then kill her mercifully, instead of letting her die of infection, as the others did?” Oscar asked.
“The original plan was likely to let her die as the others did,” Anna said. “But I can think of many reasons it might have been abandoned for a quicker solution. Fear of discovery, for example. Curious neighbors showing too much interest. Panic, once the child was stillborn. Or it could be the simple recognition that she had already suffered enough.”
And that was the question that disturbed Anna most. She turned to Lambert. “What will you tell the coroner?”
“I’ll send you a copy of the report, but it’s what you’d expect. An unidentified woman, murdered by person or persons unknown. Primary cause of death is severing of the descending aorta, but the rest of the damage is of equal importance. Will the chief of police let you open the investigation again?”
“It will have to be investigated,” Jack said. “But to use this crime as a reason to reopen the multipara investigation, that will be tricky.”
Anna said, “If this is a multipara case, the guilty party might try again. There could be another victim. Another woman might be lying tied to a table somewhere, half-insane with pain and fear.” She couldn’t curb the anger in her voice, even if she had wanted to. “Will it take finding her body to convince them?”
“Let’s hope not,” Jack said. But his expression was familiar to Anna. There was a truth they both dealt with in their work, one he didn’t need to say aloud, but it was there on his face: who could not be saved, must die.
* * *
• • •
ON THE WAY back downtown Jack said, “Even keeping one woman prisoner for the duration of a pregnancy would take a lot of arranging.”
Oscar bit off the end of a cigar and spat it into the street. “I’ve been trying to imagine it. If he’s got more than one woman locked up it would look like a hospital ward.”
He plugged the unlit cigar into the corner of his mouth. “But maybe that’s just how he’s doing it. He’s got a clinic someplace, it looks from the outside like it’s set up to handle difficult maternity cases. All the mothers insane or sick unto death. And all of them in a morphine haze. They would need a nursing staff.”
“Not a lot of nursing done in her case,” Jack said.
Oscar shifted the cigar and frowned, squinting into the sunshine while he thought. After a long moment he said, “You re
member the rumors about Max de Peyster?”
It took Jack a minute to pull the memory up. The family had made its considerable fortune in iron starting back before the Revolution.
“Locked in battle with his sisters about the father’s estate,” Jack said.
Oscar nodded. “He was married almost twenty years, no heirs, and then a fine healthy son appears out of nowhere. Born while they were touring Europe. The sisters raised hell, but there wasn’t anything they could do.”
“You can’t compare that situation to this one,” Jack said. “De Peyster is a rich man who adopted a child and passed it off as his own. He had to have connections to do that. Doctors who agreed to help, who knew where to find healthy infants. They’d have no reason to abduct a pregnant girl and keep her locked up. I think Sophie was likely right, they wanted to kill the mother but balked at killing the child. And then ended up killing it anyway by mistreating the mother.”
“If it is dead.”
Jack thought about that for a moment. They were both too familiar with the things that happened to abandoned children to dismiss the scenario—and it was not a pretty one—out of hand.
“So where to start?” Jack said.
“Maybe it’s time we had another talk with Graham,” Oscar said. “Wouldn’t want him to think we’ve forgotten about him.”
Oscar was following some vague instinct that Jack couldn’t quite figure, but it didn’t matter. It was the way they operated; it often worked out well in the end to humor each other’s hunches.
Jack said, “You want to interrogate Graham because you just can’t believe he’s immune to your powers to terrify.”
“Interesting theory,” Oscar said. “But wrong. He’s not immune, I just haven’t found the right thread to pull, just yet.”
10
IT WAS ALMOST midday by the time Anna and Sophie took their leave from Nicholas Lambert and found a cab. Sophie looked like she had just worked a double shift, so worn down that she could fall asleep standing up.