Louisiana Fever

by D. J. Donaldson

  “Want us to get some dental X-rays?” Minoux asked.

  “Eventually, but I’d like to finish the post first,” Broussard replied.

  The two assistants moved the body to the autopsy alcove and transferred it to a long stainless-steel platform welded to a stainless sink.

  “It’ll be a while before you’ll be needing me again,” Minoux said. “I’ve got something next door I have to clean up. I’ll be back.”

  Broussard nodded in agreement, allowing Minoux to leave.

  D’Souza picked up a disposable scalpel and drew the blade deeply through the cadaver’s skin in a long Y that began at the tip of each shoulder and ended at the pubic bone. On the chest, the cut revealed dark red muscle. On the belly, it exposed gobs of bright orange-yellow fat and the glistening gray serpent of intestine. With the penetration of the abdomen, a cloying visceral perfume seeped into the air.

  “Well, he liked his veggies,” D’Souza said, remarking on the bright color of the fat. Broussard said nothing, concentrating on the long, thin knife he was stropping on an oilstone.

  D’Souza began dissecting the skin flaps off the chest, the flashing strokes of her scalpel quickly separating them from the underlying white connective tissue. She did the side flaps first, then moved to the upper one, her swift movements rapidly carrying her dissection to the arch of the mandible, where she draped the loosened skin over the face and cut through the muscles attached to the mandible, thereby entering the mouth. She freed the tongue and pulled it forward, her scalpel slashing at the restraining tissue, liberating the trachea and esophagus.

  Broussard had finished sharpening the long knife he would use to section the organs and had begun arranging the perforated plastic sample containers on his cutting board at the shallow sink under the data blackboard when he heard D’Souza say, “Oh, shit.”

  Turning, he saw her tearing at the tape holding her gloves to her wrists. Obviously, she’d cut herself.

  She pulled off her gloves and Broussard saw that her left index finger was bleeding heavily. To a degree, that was good, as it would wash any potentially infectious organisms out of the wound.

  “How bad is it?”

  “Not deep enough to hit any tendons or need sewing up,” she replied behind her mask.

  “Good. Now get out of here and let it bleed under water for five minutes, then put some Betadine and peroxide on it. When you feel up to it, fill out an incident report.”

  Behind her visor, her eyes were filled with worry. “I’d like to hear that speech again about how unlikely it is to acquire a disease from something like this.”

  “First of all, sudden deaths like this one aren’t caused by infectious disease,” Broussard said. “It’s likely he had a coronary. And even if he did have somethin’ infectious, your chances of acquirin’ it are about like your chances of bein’ struck by lightnin’ today.”

  “Even if he’s HIV-positive?”

  “Even then.”

  “I feel better.”

  “But just to be on the safe side, we’re gonna have the lab check him out. And you’re gonna need to give some blood for a baseline. So, when I’m through here, you can take his samples up to the lab and let ’em draw yours. Now, go on . . . take care of your finger. . . . You’re gonna be fine.”

  As she went into the adjoining room to disinfect her wound, Broussard hailed Minoux on the intercom. “Guy, Natalie’s cut herself. I need you.”

  Broussard then got out a large syringe and five test tubes—three red tops, which contained no chemicals, and two tubes containing viral transport medium. To his test tube collection, he added a bottle containing aerobic and one containing anaerobic bacterial transport medium. Returning to the body, he inserted the needle into the right subclavian vein and drew enough blood to fill the red tops and inoculate the medium in the other containers. The samples would be sent to the Department of Laboratory Medicine, where they would be parceled out to Immunology, Microbiology, and Virology to determine if the deceased was harboring any infectious agents. He really believed what he’d told D’Souza about there being no cause for worry. Still, it was always better not to cut yourself.

  Rather than do nothing while waiting for Minoux, he picked up the dissection where D’Souza had left it. To determine just how far she’d progressed, he checked along the mandible to see if all the tissue had been freed there. Finding that it had, he caught a glimpse of the roof of the mouth, which, to his surprise, was dotted with what appeared to be small hemorrhages, a finding associated with strangulation or choking. But if he’d choked, the scleras should also have shown them.

  Puzzling.

  Could they be Koplik’s spots? He was kind of old for measles, though. And these didn’t have white centers.

  Maybe he did choke. It’s not always possible to tell at the scene whether there’s an obstruction in the airway. But Kit said the deceased hadn’t eaten anything and he hadn’t grabbed at his throat or appeared to gag. Odd . . .

  He pulled the tongue forward to see if the ET tube was in the trachea and not the esophagus. It was.

  After removing the tube, he cut through both sterno-clavicular joints, then severed each rib through its cartilage attachment to the sternum, pleased that he didn’t encounter enough ossification to call for the saw. With that done, he was able to remove the breast plate, revealing the lungs, which cupped the heart in pinkish gray angel wings.

  His scalpel stopped moving.

  He pressed on one lung with a forward motion to see more of it.

  Puzzled at what he saw, he did the same with the other lung. Both were studded with small hemorrhages.

  Very peculiar . . .

  He cut the major vessels entering and leaving the heart, noting there was copious blood flow from them, something commonly seen in heart-attack victims. He removed the tongue, trachea, esophagus, lungs, and heart as a block and dropped them into a stainless pan as Guy Minoux stepped up to the table.

  “Take over, will you, while I work at the sink?”

  Minoux nodded and picked up the scalpel Broussard left for him.

  Broussard took his pan to the sink under the blackboard, poured the contents onto his cutting board, and began separating the organs, prior to close inspection of each one.

  He first examined the tongue, noting there was no indication the deceased had bitten it. With the long knife in one hand and the other pressing on the upper surface of the tongue, he halved it horizontally in the same way he’d slice a bagel. When he separated the two halves, he saw more tiny hemorrhages.

  This was becoming a major mystery, as the emerging pattern of affected organs fit nothing he’d ever seen.

  He took a few thin slices across the long axis of the tongue, trimmed them, and put them in a sample container that he dropped into a waiting bottle of formalin.

  Next, he slit the esophagus, inspected it, then opened the airway and examined the gray lining of the larynx. Close inspection showed there was an area just above the vocal cords in which the small vessels were blanched and devoid of blood, an indication the small balloon used to seal the airway around the ET tube had been inflated properly.

  The heart was in very poor condition, enlarged and with fibrotic streaks all through the muscle. And the coronary arteries were almost completely blocked. Broussard weighed the heart on the hanging pan to his right and chalked the results in the appropriate space on the blackboard.

  Minoux stepped up and put another pan containing the abdominal viscera in the sink. He then went back to the cadaver, slit the scalp from ear to ear across the top of the head, and peeled the skin forward and backward as if husking an ear of corn.

  At the sink, Broussard continued to prowl through the deceased’s organs, weighing, slicing, and adding more sample containers to the jar of formalin, concentrating so intensely he barely heard the sharp whine of the Stryker saw as Minoux turned it on. Nor did he notice the way the sound became labored and dull as the saw cut through the skullcap, throwing bony sawdus
t and bits of flesh into a thin plume of friction smoke.

  Out of a habit arising from the knowledge that defense attorneys often try to make MEs look careless by asking if the victim had an appendix, a totally irrelevant fact, Broussard noted that one was present. Less than a minute later, Minoux plopped the cadaver’s brain into Broussard’s sink and returned to the body to aspirate the blood from its cavities and wash them out.

  As for Broussard, he continued to find hemorrhages—in the lungs, the kidneys, the pancreas . . . and in the brain, where they seemed particularly prevalent in the upper part of the postcentral gyrus. Most likely if this had progressed much farther, the deceased would have experienced sensory deficits in his hands and arms.

  Broussard cut small pieces from several of the affected organs and parceled them out to bacterial and viral transport media. He then sliced the brain into sections like a loaf of bread, chose a few to trim and add to the formalin jar, and he was finished. He photographed the data on the blackboard and carried all the pictures he’d taken and the fingerprint cards to the old desk in the adjacent room, where he filled out the various autopsy and lab forms, then called the dictaphone upstairs and recited his report, drawing no conclusions about the widely disseminated hemorrhages he’d found, because he didn’t know what they meant. Death was surely caused by his bad heart and those blocked coronaries. The other . . . who knows?

  His failure to understand the hemorrhages was like an alligator in a chicken coop. It disturbed things. And he did not enjoy being disturbed.

  He gathered up all the samples for the lab, labeled them with the case number, and put them on the desk alongside the form that would accompany their delivery.

  “Guy, Natalie’s gonna take care of everything from this case that needs to go to Laboratory Medicine. When you finish in there, would you see that the rest gets on its way? I’ll leave the forms on the desk.”

  “Sure thing.”

  “I’d also appreciate it if you’d take care of those X-rays and let Dr. French know that we need the teeth charted.”

  On the desk was a grocery bag and a big tan envelope stamped with the case number of the individual they’d been working on. After changing out of his autopsy gear, Broussard picked those items up along with the autopsy photos and the fingerprint cards and went into the hallway. Before going to the office, he stepped into the room where the morgue assistants each had a desk. D’Souza was at hers, filling out the incident report required when anyone cut themselves or was injured, which fortunately didn’t happen often.

  “How’s your finger?”

  She looked up. “It throbs, but it’s on my left hand, so that’s good. You didn’t find any signs he was suffering from some horrible infectious disease, did you?”

  Broussard hesitated before answering. He didn’t know what he’d found, so it was hard to answer. And without knowing what was going on, there wasn’t anything she could do until the tests on the blood came back. They’d just have to wait. Most likely, it was some kind of physical deterioration unrelated to any causal organism.

  “Looks like he died of a weak heart.”

  “I’m glad—not that he died. I mean . . .”

  “I know. The samples for the lab are on the desk in the next room. Be sure and give Margaret that report when you’re finished.”

  Reaching the office, he called Kit, then emptied the bag of clothing he’d brought up from the morgue onto his desk. Half a minute later, he heard Kit’s knock, and she came in.

  “So what was it?” she said. “Bad heart?”

  Broussard leaned back in his chair and laced his fingers over his belly. “Pretty bad. Is that for me?” He was referring to the file folder in Kit’s hand.

  “Yeah . . . my report on that kid who shot himself.” She put the folder in front of him.

  “Suicide?” he asked.

  She shook her head. “Misadventure. The gun was a recently purchased Smith & Wesson thirty-eight, fully loaded except for an empty chamber two to the left of the spent round under the hammer. The victim had owned a Colt thirty-eight for several years. . . .”

  “Ha.” Broussard rocked forward. “Misadventure. I agree.”

  “You don’t even want to hear my reasons?”

  Broussard shrugged. “The Colt cylinder rotates clock-wise, the Smith counterclockwise. I assume the deceased was known to play pranks from time to time. . . .”

  “Yes,” Kit said, unable to keep exasperation out of her voice.

  “This was meant to be another one,” Broussard said. “He loaded the Smith with an empty chamber just to the left of the firin’ position, thinkin’ the cylinder was gonna rotate the empty chamber under the hammer and he’d have a good laugh on his friend. But it rotated the other way. . . .”

  Kit was hugely disappointed. She knew little about guns and had developed this explanation on instinct and a call to the police firing range. And, damn it, that called for a “Well done.” Obviously, today wasn’t going to be the day she’d hear that phrase for the first time from him. But someday . . .

  “Okay, let’s talk about the man downstairs,” Broussard said. “These are his clothes—expensive labels and so new, they still smell like it.” He opened the manila envelope he’d also brought up, then dumped out its contents—a ring, a wristwatch, a wallet, some coins, and a pocketknife. Kit pulled one of the visitor’s chairs closer, sat down, and leaned forward, her folded arms on the desk.

  Broussard picked up one of the coins and examined it through the bifocal part of his glasses. “African, if I’m not mistaken,” he said, passing it to Kit.

  He briefly looked at the watch, front and back. “Hmm, expensive, and not very old.” He passed the watch to Kit and picked up the ring, whose primary feature was a large stone of black onyx. Inside, where the thin gold surface had worn away, he could see silver beneath. Though it was a cheap ring, Broussard valued it highly, for it bore an inscription.

  “If this ring has always belonged to him, we’ve got his first name,” he said, handing Kit the ring.

  Inside the band she read, “To Jack, with affection.”

  “So he’s now Jack Doe,” Broussard said.

  Broussard opened Jack Doe’s wallet, checked the money compartment, and whistled. Minoux had said the guy was loaded, but Broussard wasn’t expecting this. He pulled out a sheaf of crisp new hundreds and counted them. “. . . thirteen, fourteen, fifteen. That’s a lot of walkin’-around money.” He put the bills back in the wallet and looked into the pocket for credit cards, but he found nothing. He moved on to the plastic photo sleeves and his shaggy eyebrows lifted. “Look at this. . . .”

  He turned the wallet, and Kit saw one of those photos of a pretty young woman that come with a new wallet.

  “What’s that?” Kit said, pointing to a folded piece of paper in the opposite sleeve.

  Broussard extracted the paper and unfolded it. He looked at it and handed it over.

  In a scrawled hand, written in ink, was the cryptic message: “Schrader, Wed., 11:00 A.M.”

  “Well . . .”

  Kit looked up to see what else Broussard had found.

  “This fellow’s clothes are new; the watch is new; the wallet is new. . . . Here’s somethin’ that isn’t.”

  He slipped a worn photograph free and passed it to Kit, who looked at it and felt her jaw drop.

  It was a photograph of her parents and herself when she was a teenager, coming out of their house in Speculator, New York.

  3

  The man in the morgue and the picture they’d found in his wallet remained center stage in Kit’s consciousness the rest of the afternoon. It was still there as she pulled up to the wrought-iron gates on Dauphine Street in the French Quarter and signaled for them to slide open.

  Her life had certainly taken some unexpected turns lately. Who could have predicted that shortly after she’d bought a great little house uptown, she’d find the skeleton of a murdered young woman buried in the backyard, then be attacked in her own b
edroom? She shuddered when she thought of it. There was no way she could have remained there after that.

  And then this opportunity: a rich friend of Teddy’s looking for someone to occupy and care for his house for three years, rent-free, while he supervised construction of a series of desalination plants somewhere in the Middle East. That was a godsend. Three years in which she could get back on her feet financially after the beating she’d taken on the sale of her place.

  And what a house this new one was. . . . She guided the car through the gates and came to a stop a few inches from the back wall of the detached brick alcove that gave the house privacy from the street. She signaled the gates to close, then got out and gathered up the mail from its wicker basket under the mail drop.

  It was all throwaway stuff—a waste of a tree.

  Between the portico and the house was a wonderful courtyard floored with gray brick. On each side of the patio the brick was interrupted by a small rectangular pool. The pools were connected by a narrow channel, open except for a short section that ran under the brick, allowing easy access to the front door.

  Everywhere, there were signs of spring. On the winter-darkened ivy covering the concrete lady at the bubbling origin of the pools, hundreds of bright green accents had appeared almost overnight. In the pools, snow-white flowers with a blush of pink on their tips poked bravely between the lily pads, their perfection coaxing the eye from the pool edges, where long green stems with furled leaves thrust upward from taller water plants that were growing inches a day. The tree hibiscuses populating the large flower beds fronting the house and against the portico struggled under a load of deep red blooms with yellow tongues, clusters of yellow irises and clumps of yellow pincushions at their feet. From the side walls of the courtyard, which were formed by neighboring houses, a million jasmine blossoms poured their heady perfume into the air.

  All this renewal caused Kit to reflect more deeply on the death of Jack Doe. She might also have thought about the young man who’d accidentally shot himself, but her name hadn’t been the last word he’d ever speak. Nor did he possess a photograph of her and her parents.