Doctored Death

by P. D. Workman

  “I left some pictures in my office. You want to go get them?” Lorne suggested.

  Zachary nodded. He retrieved Lorne’s latest photographic creations and the two of them put their heads together, discussing perspectives and composition and the various settings on the camera. One thing that Lorne had shared with Zachary was his love of photography. He had given Zachary his first camera when he was living with the Petersons and they had developed pictures together in Lorne’s darkroom over the years. Even at the height of digital photography, the two of them still used analog cameras and developed their own pictures when they could. Zachary used digital cameras for his work, but analog for his art.

  Pat joined them in a few minutes. He rolled his eyes at Kenzie as he sat down. “Just nod and pretend you understand.”

  Kenzie laughed. “Yep.”

  “So, how have things been with you?”

  Kenzie settled into the conversation, sharing what she could with Pat. That was mostly personal stuff because, unlike Zachary, Pat and Lorne were not interested in the nitty-gritty of forensic pathology. So Kenzie said only that things were going well at work and left it at that.

  8

  They went home feeling full and contented. Zachary was more relaxed than usual, all talked out, his eyes fixed on the highway as it spooled out before them. Kenzie listened to the music on the radio and left him to his thoughts. She valued any time he wasn’t visibly depressed or anxious. One reason she liked going to visit Lorne and Pat—besides their company and good food—was that Zachary was usually relaxed and happy after a visit.

  Once home, they vegged in front of the TV, but both knew Kenzie needed to get to sleep to be up for her work without being cranky or tired on the job, so they headed to bed.

  “It was a nice weekend,” Kenzie said as they cuddled.

  “It was,” Zachary agreed. “Good to take time off and just do some things together. Dr. Boyle was right.”

  “I’m sure she’ll be glad to hear it.” Kenzie rubbed Zachary’s back, feeling for the tension he carried in his shoulders and neck, gently prodding and massaging, trying to get him nice and relaxed so he would sleep.

  “You had a good time too?” he asked in a worried tone.

  “Yeah. I did. It was great.”

  He didn’t say anything in response. Kenzie kneaded his shoulders, making him flinch when she hit a tender spot.

  “What is it?” Kenzie asked.

  “Nothing. I just worry about you going back to work. That it’s stressful.”

  “Well... sometimes it’s stressful, yes. But I don’t really mind. I knew when I went into medicine that it was going to be a high-stress job. But at least where I am, I’m not working in the emergency room or in a kids’ cancer ward. I can’t really harm my patients.”

  “I’m sure they’re dying to see you again.”

  Kenzie groaned. She could feel Zachary laughing.

  “You don’t need to worry, though. I enjoy my job. And Dr. Wiltshire is good about letting me get my hands into things so that I can move up the ladder and someday maybe have a morgue of my own.”

  “Just what every little girl dreams of.”

  Kenzie chuckled and molded her body against Zachary’s back, holding him firmly. “I’ll admit it isn’t how I saw my life path when I was a little girl. I guess I thought I’d grow up to be like my mother. A socialite, staying at home with a couple of kids, going to all the important fundraisers and events. But that never particularly excited me.”

  Zachary nodded. “Doesn’t sound like you.”

  “No. She and I are... well, we’re pretty different. I’m not saying that she’s not doing something important. She is involved in a lot of very worthy causes. But it’s not what I want to do. I like the challenge of medicine. I was one of the few girls who was excited about dissecting frogs in school. To actually see all an animal’s insides. In person, not just a diagram in a textbook. To me, that was really interesting.”

  Zachary didn’t respond with what his own experiences in life sciences at school had been like. No anecdotes about dissecting frogs and putting the kidneys down the shirt of the cute girl at the next lab bench. Nothing about being too sensitive to participate, or whether he had even been given the opportunity. Much of his time as a teen had been spent in institutional care, and Kenzie supposed they didn’t like to put scalpels in the hands of kids with poor impulse control and behavioral problems.

  “Everybody likes different things,” Kenzie said drowsily, feeling herself starting to slip toward sleep. “The Medical Examiner’s Office really is where I want to be.”

  Zachary said something in response, but Kenzie didn’t catch what it was and couldn’t remember in the morning.

  Despite her assertions of the night before, Kenzie did feel a little stressed as she got ready for work Monday morning. Not because she didn’t like it, just because she knew how busy Mondays could be, catching up with emails and requests that had come in over the weekend, knowing there was likely a backlog of bodies that would take the rest of the week to catch up on. There wasn’t enough action to justify hiring more workers, which meant that sometimes they were overwhelmed when there was a spate of deaths.

  But bodies kept, more or less, and they always caught up again eventually. Dr. Wiltshire was a good boss and Kenzie didn’t dread going into work. It was just a Monday thing.

  When she made it out to the kitchen for breakfast, Zachary already had everything prepared. The coffee was hot. Her toast had been buttered and was awaiting marmalade. The jar was just in front of Kenzie’s plate. And there were a couple of articles that Zachary had printed off from his computer and left on the table for her, their John Doe’s face prominent.

  “I thought you might like to see those so you’re up to speed by the time you get in,” Zachary said. “And you were going to take a closer look at the body and his clothes to see if you think he really is homeless.”

  “I haven’t forgotten.” Kenzie sat down and began slathering marmalade on her toast. She skimmed through the articles, which were pretty generic, with just a few tidbits of information the reporters had managed to get ahold of. Tidbits that Kenzie already knew. She looked at John Doe’s picture in the article. It was small, so she couldn’t see all the details that Zachary had been looking at the day before, but she could see where he was coming from. Doe’s hair did appear to have been shaped by a professional. His teeth didn’t show in the picture, but he didn’t have the shrunken cheeks that many of the homeless did, not just because they didn’t eat enough, but because their teeth had rotted away due to poor oral hygiene or drug addiction. Doe’s skin was relatively smooth and his pores small, even though he did have a five o’clock shadow.

  But his whiskers were not long. It might have been just that, five o’clock shadow because it had been late in the day when he had died. Not because he had been on the streets and had failed to shave for several days or weeks.

  “I’ll look into it when I have a chance,” Kenzie promised. She took a few more bites of her toast. “You look like you’re having a pretty good morning. Sleep well?”

  “Yeah, pretty good.”

  “Good. How’s the calendar look this week?” Kenzie laid her phone down on the table and brought up her calendar app to look at their schedules for the week. Zachary had given her access to his electronic calendar so that she could look at both at the same time and they could adjust if there were any conflicts, which there rarely were. “Couples therapy Wednesday.”

  Zachary nodded. “And ice cream.”

  That had been Kenzie’s suggestion. A reward for both of them for doing something difficult, especially when they couldn’t always see progress from one appointment to the next. Like any kind of therapy or personal development, there were leaps forward and falls back. The falls could be discouraging.

  “And ice cream, of course,” Kenzie agreed with enthusiasm. Zachary gave a little smile and nod.

  9

  Kenzie did her preliminar
y walk-through of the office, ensuring that everything was in order for Dr. Wiltshire’s arrival. She didn’t have a chance to get through the email, but she hadn’t seen any top priority flags, so what was there would wait until she had an opportunity to go through it. Several bodies had been checked in during the weekend. Apparently, people didn’t stop dying just because Kenzie took a couple of days off. Dr. Wiltshire had performed one post on Sunday, but the rest had been left. Kenzie familiarized herself with the check-in sheets, and then returned to her public-facing workstation to process any requests for records or lab reports.

  Dr. Wiltshire arrived with his Starbucks coffee as usual. He also had a wrapped muffin, which he placed on Kenzie’s desk. She’d never asked him to buy her any baking on his Starbucks run. But every so often, he brought something anyway. Kenzie had noticed a pattern after a while. The days that he brought her treats were generally the days he anticipated to be busy or stressful. She didn’t know if he even realized himself that was what he was doing. He brought her a treat to show her appreciation for her being there and being a diligent employee. Still, apparently the times his mind turned most to his appreciation were those days when he knew he would be putting her through the wringer.

  So Kenzie was forewarned by the chocolate chocolate chip muffin. She smiled and greeted Dr. Wiltshire just like any other day.

  “Good morning, doctor. How was your weekend?”

  “Not bad, Kenzie. Nothing too urgent over the weekend, so I got a bit of a break. Played some golf yesterday.”

  “I didn’t know you’re a golfer.”

  “I’m really not,” he confided. “But it was a nice day and I sensed that my wife wanted me out of the house. So... golf.”

  Kenzie smiled and nodded. Dr. Wiltshire rarely talked about his wife. She wasn’t actually sure whether there was a Mrs. Wiltshire, or whether the doctor just invented her for his stories. There was no picture of a wife or children on his desk or anywhere in his office.

  “I’m glad you had a good rest. We’ve got a few new bodies to be scheduled.”

  “Let’s sit down in my office. I think this is going to take a little longer than usual today.”

  And it had. Kenzie intended to just give him a straight briefing on each of the remains that had been checked in, but he also wanted to know what doctors or police officers were on each of the cases and to evaluate what urgency would be assigned to each of their new guests. Kenzie made suggestions on each of the cases and they set up a schedule. Kenzie stacked the intake sheets in order and promised to add the lineup to Dr. Wiltshire’s calendar so that he could stay on top of it.

  “And if anyone calls to find out where their case is in the pile, you can speak to them with authority,” he advised Kenzie. “No need to guess or pass it back to me. Let them know how many cases there are ahead of them and promise we’ll get to it as soon as we are able.”

  “Sure,” Kenzie agreed. Of course, everyone would want their case to be first on the list, but that wasn’t the way it worked. Potential homicides needed to lead the pack. And the cases where there were religious practices to be adhered to if possible. They would make an effort to process any cases that had to be interred within a certain length of time when they needed to be.

  On returning to her desk, Kenzie found a couple of law enforcement officers waiting for her. She gave them the appropriate request forms to be filled out and started going methodically through her email inbox. Of course, there were a lot of requests to be processed and reports to be printed, reviewed, and filed. She had glanced at the email subjects on her phone a couple of times over the weekend to make sure she was not missing anything important, so she knew she could just start at the top and work her way down through the various emails.

  She nodded when the law enforcement officers left their requests in her inbox, promising that she would get to them as soon as she could. Her laser printer was humming away, spitting out a constant stream of reports as she added them to the queue.

  Kenzie opened one of the imaging files and was startled by what she saw. She looked up at the name of the patient again, just to make sure she had gotten it right, then sent it to the printer. She would have to wait for everything ahead of it to finish printing first, but Dr. Wiltshire would want to see it as soon as possible.

  10

  Kenzie knocked on the door as she entered the surgical suite. Dr. Wiltshire looked up from his work, surprised to see her there.

  “Kenzie. What’s up?”

  Kenzie took a moment to finish suiting up so that she wouldn’t contaminate any evidence and took her printouts over to Dr. Wiltshire. “Sorry, I thought you would want to see this right away.”

  Wiltshire looked curious as he waited for Kenzie to tell him what she had.

  “These are the brain slides for Willis Cartwright.”

  He looked at her for a moment, thinking back. “From the nursing home.”

  Kenzie nodded. “Right.”

  “There was no bleed at the site of the blow to the head. Everything appeared to be normal. A little shrinkage attributable to old age, but gross examination seemed to be unremarkable.”

  Kenzie stood beside him and showed him the image from the first slide.

  Wiltshire’s brows shot up. Kenzie saw his eyes do the same thing as she had initially done. Double-check the name of the patient at the top of the page.

  “But Mr. Cartwright hadn’t shown any overt symptoms.”

  “No.”

  “Well... those are clearly amyloid plaques and tau tangles.”

  Kenzie nodded her agreement and flipped to the next page. She held a couple of images side by side for Dr. Wiltshire. He chewed his lip and nodded.

  “Well, there have been cases of amyloid plaques being found in the brains of people who showed no symptoms of Alzheimer’s Disease before death.”

  “I’ve heard of that. And I guess... that’s what we’ve got here. But does that mean that he did or did not have Alzheimer’s Disease?”

  “We’ll need to discuss it in more detail with his doctor and the nursing staff. He may have shown mild symptoms. But if he didn’t have any...” He shook his head as he mused over the problem. “I’m reluctant to say that a patient had Alzheimer’s Disease if he showed no signs of dementia.”

  “Even with the size and number of these plaques and tangles?”

  “If you brought me this brain with no other information, I would say that it is a patient who had advanced Alzheimer’s Disease. But we have to realize that what we know about the human body is really just a freckle on the backside of science. We don’t know more than we do know.”

  “So then... it’s just an anomaly?”

  “If you add up all of the anomalies in Alzheimer’s Disease—or any disease—eventually you will have a new pattern. We may be able to use cases like this to find a way to protect people against the ravages of the disease. We may find something in this man’s biology that could be used as a vaccine in the future. He appears to be resistant, in some way, to the progression of the disease. If we have the correct information from the nursing home and his family. And if this isn’t a case of a sample being mislabeled or saved to the wrong file. We need to explore all of the possibilities before declaring this to be a case of a man being immune to the effects of amyloid plaques spreading throughout his brain.”

  Kenzie had her work cut out for her. She retrieved the slides from the Cartwright case and checked the label on the box in her own writing, as well as the individual bar codes on the slides. She put the slides under a microscope to view them directly. After adjusting the focus, she saw the same results as shown on the processed images.

  That was pretty clear.

  Just to be sure, Kenzie retrieved Cartwright’s remains. She made another examination of the brain, which did not show the deterioration she would expect in a case of advanced Alzheimer’s disease. She prepared additional slides of the brain tissue and took them directly to the microscope. There could be no doubt that Car
twright’s brain was full of the amyloid plaques and tau tangles normally associated with Alzheimer’s disease.

  11

  Kenzie didn’t usually do any fieldwork, so it was exciting to go to Champlain House to follow up on the Willis Cartwright case. She pictured herself as a private investigator like Zachary, going out to interview subjects and ferret out the truth. She was experienced in the lab work and in understanding and interpreting test results. Actually going out and talking to people about a case was something that she hadn’t done in... well, since Amanda had died. She had succeeded in digging up the truth in that case, or as much of it as she could, but there had been serious and long-lasting consequences that she preferred not to think about.

  She told herself that wasn’t her fault. But it was going to take a lot of convincing, because she didn’t believe it, even after all the intervening years.

  She pushed thoughts of that long-past case aside and pulled into the parking lot of Champlain House. She managed to find a parking space marked for visitors and pulled in. If there weren’t any free visitor slots, she would have taken one of the reserved places. She was, after all, there on official Medical Examiner business. But it was probably better not to get people’s backs up the instant she arrived.

  There was still a chill in the air as she got out of the car. She had hoped that it would warm up more during the day, but she suspected it wasn’t going to get much warmer. It was early afternoon, the sun already on its descent. She loved fall in Vermont, with all its gorgeous riot of colors, but she was sorry to see the summer go.

  The reception area of Champlain House was quiet and comfortable. Dark wood, well-upholstered furniture that didn’t look like it got a lot of use, the ringer on the phone at the reception desk set to a low murmur so that it didn’t echo all the way through the room. The older woman at the desk, maybe a nurse but maybe just an administrative clerk, gave her a warm smile as she approached.