“You can’t test for everything,” Luke said. “There’ve got to be some toxins that aren’t included in your testing methods.”
“That’s always a possibility, but unlikely in this case. Let me show you a section of the lungs, and I think you’ll understand.” Jay removed one slide from the projector and replaced it with another. “This is a section of the upper airways, the trachea. As you can see, it’s virtually normal.” Again he changed slides. “Now we’re looking at—”
“I’ll be damned,” Ben whispered.
“—bronchioles in the lower airways of the lungs. The epithelial cells—see here? For the most part, they’re gone. They’re just not there.”
Ben shot a glance at Luke.
Jay aimed a laser pointer at a specific area on the slide. “Now, look here. There’s an overwhelming infiltration of white blood cells into the surrounding tissues, almost all lymphocytes. I didn’t believe it at first, so I took several additional sections of lung. Every section of lung looks like this.”
Ben leaned forward, grabbed an eyebrow and started playing with it. “That’s not artifact. That’s real.”
Jay nodded. “So Luke, getting back to your question about toxins, it’s difficult for me to imagine a toxin that would spare the upper airways and selectively attack the lower airways. It’s more likely that we’re dealing with a biological agent of some sort.”
“I assume you cultured the lung tissue?” Ben said.
“Yes. Lung cultures were all negative,” Jay said. “Except for the parasites that I already told you about, the only infectious organism we found was in her nasal secretions. It was a garden-variety rhinovirus.”
“This girl wasn’t killed by a head-cold virus,” Ben said.
Jay reached for another slide. “This next slide of the alveolar lung tissue—”
“Let me guess. The alveoli have cellular debris in them, but no specific damage.”
“How did you know that?”
“It doesn’t take a genius to spot a goat in a flock of sheep. This is a carbon copy of our boy’s lungs. Tell us about the pancreas.”
“It’s equally impressive.” Jay slipped another slide into place. “This is a high-magnification view of the pancreas. There’s a heavy infiltration of lymphocytes, just as we saw in the lungs. And note the cells that were destroyed. Again, this was a very selective process, analogous to what we saw in the lungs. Only the exocrine glands of the pancreas were destroyed. The pancreatic islet cells are virtually untouched. In my opinion, this also supports the theory that we’re dealing with some kind of biological agent. A toxin or poison would have caused a more diffuse injury.”
“You mentioned earlier that the bile ducts were also involved,” Ben said.
“That’s correct, and the damage is analogous to what you’ve seen in the lungs and pancreas. Only the bile ducts themselves were destroyed. The adjacent liver tissue was untouched.”
“Have you surveyed any other morgues for similar cases?” Luke asked.
“We canvassed about a dozen coroners’ offices, all of the larger ones between here and Dallas.”
“And?”
Jay shook his head. “Nothing.”
Ben asked, “Can I get some tissue samples to take back with me?”
“I’ll sign out our slides to you.”
“Good, but I’d also like to have a tissue block from each organ. I may want to do some special staining, and I’ll need the tissues to prepare my own slides from.”
“We’re not doing anything on this case right now,” Jay said. “It’s easier for me if I just give you the entire file with all of our tissues. You can return it when you’re done.”
Ben nodded.
Luke asked Ben, “Anything in particular that you’re looking for?”
“Nothing that’s worth a discussion at this point. More of a fishing expedition.”
Jay said, “The truth is, we don’t have the staff to go any further on this case. I appreciate any help you’re willing to give us. I’d like to know what caused this girl’s death. It’s just one of those cases that gnaws at you.”
The M.E. reached over and turned off the projector.
“Before we leave the building,” Luke said, “there’s one other thing I’d like to see.”
20
“How did you know her?” Jay asked.
Luke glanced across the autopsy table at the M.E., then back at Kate Tartaglia’s corpse. “She used to work at our hospital.” The man didn’t need to know any more than that, Luke decided.
The upper half of her body was exposed, a thick plastic cover drawn back to her waist. The back of her skull was propped on a wooden block, lifting her head and tilting it forward, as though she were taking in the room.
“I’d like to know what you find on her autopsy,” Luke said.
“I’ll have to run your request by the homicide detectives.” The medical examiner’s voice carried a hint of hesitation. “I’m already stretching the rules by showing you the cadaver. I hope you understand.”
Luke nodded while studying two tightly grouped entry wounds on her chest and a black-rimmed hole in the center of her forehead.
“Those look like some well-aimed shots,” Ben observed, saying aloud what Luke was already thinking.
“Yes, I’d say there’s not much doubt about the cause of death,” Jay said as he pulled the semitransparent covering back over Kate’s head. “Life is full of irony, isn’t it? Just last week I was speaking with Dr. Tartaglia.”
Luke shot an inquisitive glance at the M.E.
“For the past four months,” Jay explained, “we’ve been sending her blood samples. Part of some research study.”
From behind Luke, Ben asked, “What kind of study were you working on?”
“I had nothing to do with the study itself,” Jay said. “She wanted serum samples from Hispanics and Indians who were non-U.S. citizens. She was looking for a comparison group for some vaccine research.”
Luke asked, “Did you send her a blood sample from the Jane Doe case, the one we were just discussing?”
“She met the criteria. So yes, I’m sure we did.”
• • •
“There’re a few more pieces to this story,” Luke said to Ben as soon as they were outside the front door of the Coroner’s Office.
Luke was carrying a cardboard box containing Jane Doe’s slide folders as well as plastic cassettes with paraffin-encased blocks of her tissues. He set it down onto a waist-high brick newel at the top of the steps, then described for Ben his past relationship with Kate, her calls to the E.R. on Friday night, the planned meeting at Kolter’s, and the missing e-mail she’d sent to him just hours before her murder.
The pathologist’s eyes bounced between Luke and the box as he listened.
“So, think about it,” Luke said when he finished. “Kate calls me at the E.R. on the same night that Josue Chaca arrives. Now, her name pops up in connection with a girl whose death looks strangely similar to the Chaca boy.”
Ben’s head rocked up and down like a slow-moving oil derrick, mulling the information.
“Ben, she had to know about both of these cases. It’s the only explanation that makes any sense.”
“And that whole thing about a research study?”
“I think it was a ruse,” Luke said. “She wanted to know about the Jane Doe case, and to do that, she needed a Trojan horse—something to get her inside the Coroner’s Office—so she concocted that story about a research project.”
“If you’re right, the question is—what was she up to?”
“Maybe she was trying to figure this out,” Luke said, “just like we are. That would explain why she asked the M.E. for samples of blood serum. She was probably running her own tests on Jane Doe’s blood.”
“You’re ignoring the other possibility. Maybe she already knew what’d caused the girl’s death. Maybe Kate was a fox in the henhouse.”
“I don’t think so. She came looking for
me, remember? Kate was upset. She had something she wanted to tell me.”
But before she could do that, someone put two bullets through her heart and one through her head.
Luke studied his friend’s eyes, to see if they revealed the same question that was gnawing at him. Ben’s expression revealed nothing, and Luke wasn’t going to proffer a macabre theory about Kate’s murder—at least not yet. He didn’t want to give Ben any reason to back away from their probe into the children’s deaths.
He hadn’t called O’Reilly yet. Just as well, Luke thought. Now he had a lot more to talk about with the detective.
Luke lifted the box. “Let’s go.” He swept the parking lot as they started down the steps. Nothing seemed out of place.
Ben pulled a remote device from his pocket and aimed it at his car. The Cadillac chirped as Luke reached the bottom of the steps.
“Forget about taking me home,” Luke said. “I want to stop by my father’s office and ask him what he knows about Zenavax. I’ll grab a cab home from the hospital.”
As they were getting into the car, Ben said, “I may send some of the girl’s tissue to Caleb Fagan.”
“Immunology? Why?”
“I’d like Caleb to do some subtyping of the lymphocytes. Find out what type of critters we’re dealing with.” Ben pulled out of the parking lot and merged into traffic on Mission Avenue. “It’s not too often that I run across something I haven’t seen before. Seeing it twice in the same week tells me there’s a connection. The lymphocytes are what connect these two cases. They weren’t just hanging around to pass the time.”
“So, where does this hunch lead you?”
Ben tapped the steering wheel a few times. “Does anything strike you about the organs that were destroyed by…whatever this is?”
“Which case—the boy or the girl?”
“Both,” the pathologist said. “You got the small airways in the lung, the pancreas—”
“Cystic fibrosis?”
“Yep. And we know that Jane Doe’s bile ducts were involved. There’s not much other than CF that selectively attacks those organs.”
“How do you explain the bone marrow findings? And the fact that Adam Smith made a diagnosis of leukemia in my patient?”
“I can’t explain it. But I wish I’d gotten a look at that boy’s marrow myself.”
“You think Adam got the diagnosis wrong?”
“Have to admit, that doesn’t seem likely,” Ben said. “The girl’s bone marrow looks reactive, like it was defending itself against an attack. I can’t imagine Adam confusing that with leukemia. But the similarity between these two cases is too much to ignore. I’m also gonna have Genetics run a chromosome profile on the girl’s tissue to look for CF.”
Luke nodded, but his thoughts were drifting elsewhere. From the moment that Josue Chaca arrived at University Children’s, Barnesdale had been lurking in the shadows of this mystery. The man had thwarted every attempt to investigate the boy’s death.
“Don’t tell anyone about our visit to the coroner,” Luke said. “And if anyone in Immunology or Genetics asks why you want these tests done, make something up.”
“I’m way ahead of you. This time I’m not leaving a trail for Barnesdale or anyone else to follow.”
• • •
Ben slowed to a crawl when, ten minutes later, they passed Kolter’s Deli. “I might as well let you off here. Save you a walk from the parking lot.” He let a bus go by, then made a U-turn and pulled alongside the curb in front of the hospital.
The chaos erupted just as Luke opened his door.
A battered pickup truck filled with gardening equipment swerved in front of them, burnt rubber rising from its rear tires as it screeched to a stop. The passenger door flew open and a thin Latino man leapt from the truck with a small boy in his arms.
The boy’s half-naked body was drenched in blood, his head flopped back. Blood was spurting from a deep gash in his right leg.
Another man leapt from the driver’s seat and ran around the front of the truck, yelling, “Ayúdenos, por favor! Mi hijo, mi hijo!” His screams came between gasping breaths.
Luke had already jumped from the car. He grabbed the boy, clasped his hand over the gaping wound, and laid him on the sidewalk.
Ben started running toward the hospital entrance. “I’ll find a gurney and let the E.R. know.”
“Do either of you speak English?” Luke’s gaze shuttled back and forth between the two men. “Can you tell me what happened?”
One of the men mimicked the sound of a motor while holding his hands as though gripping a chainsaw.
The boy was limp, his carotid pulse thready. Luke ripped off his own shirt and shoved it over the wound. The blood instantly soaked through and began seeping around his fingers. He glanced at the truck, saw a rope with a wooden grab-handle hanging over a lawn mower.
Luke jerked his head toward the rope.
The two men ran to the truck and frantically grabbed at things to the right and left of the rope, looking back at Luke for confirmation. On the third try one of them grabbed the rope and got a confirming nod.
Luke drew the cord around the top of the boy’s thigh and wrapped the free end around the grab-handle. He twisted the handle like a corkscrew and a tourniquet took shape around the boy’s leg.
He glanced around, hoping to see a nurse or doctor. What he saw was a growing crowd of bystanders, their faces struggling to find the right expression for their sickened curiosity.
He also saw a black town car idling across the street, its Asian driver staring intently at him.
“Outta the way. Clear a path.” Ben and a nurse appeared on either side of a gurney, with a security guard behind them.
The emergency entrance was around the corner and down the block. The boy would bleed to death before they reached the ambulance bay. They loaded the patient onto the gurney and raced toward the hospital entrance with the guard jogging in front of them to clear a path.
Several onlookers gasped as Luke pushed the gurney through the hospital entrance, his forearms covered in blood. A middle-aged man swooned, his eyes rolling back as he dropped to the floor in front of the security desk.
Luke and his ragtag team sprinted toward the E.R.
• • •
Calderon connected a thin cord from his cell phone to the recorder, then pressed the PLAY button. A harmonic flutter distorted the distant-sounding voices:
“It turns out that the coroner had a case with similar lung findings—a Jane Doe case. It was a few months back.”
“A woman?”
“A young girl.”
“Did they ever identity the body?”
“He doesn’t think so. Oh, and by the way, the only similarity with our boy seems to be the lung tissues, so don’t get your hopes up. He was sure their girl didn’t have leukemia. Like I said, it’s a long shot, but I think I’ll stop by and take a look at what they have.”
Calderon pulled the wire from his phone and lifted it to speak. “Could you make out the words?” he asked.
The laser microphone had captured the minute window vibrations caused when sound waves, even whispered words, strike glass. A computer had done the rest, reconstructing McKenna’s conversation with that pathologist by feeding the laser’s return signal through specialized software. It was hardly high fidelity, but it had worked.
“I understood most of it,” his client said. “So, now we know what happened to that girl.”
She had been the only test subject who was unaccounted for, and while it seemed obvious that she might have crossed into the U.S. from Tijuana, Mexico—where the local police had found her parents’ bodies—Calderon’s men had failed to pick up her trail.
“It can’t be a coincidence—the girl ending up in L.A.,” Calderon said. “Tartaglia probably had something to do with her getting here.”
It annoyed him that he hadn’t thought to ask the Tartaglia woman about their stray test subject.
After a me
dical examiner in Tijuana had contacted Guatemalan Health Ministry officials—one of whom was on his client’s payroll—about two deceased persons with Guatemalan identifications, Calderon had dispatched a team to retrieve the bodies and search for the girl. The local Mexican officials were only too happy to release the disease-ridden corpses to the custody of his men, who were carrying IDs and paperwork furnished by their mole in the Health Ministry. Before returning to Guatemala, his team had spent a week looking for the girl before finally deciding that the trail had gone cold.
“McKenna and that pathologist were at the Coroner’s Office this morning,” Calderon said.
“Ironic, isn’t it—that Dr. McKenna led us to the girl?”
“I’m telling you, McKenna and that pathologist are too persistent. They’re gonna keep pushing this until we stop them.” Calderon worked to keep the emotion out of his voice. His had to be the words of a dispassionate professional.
“I’m afraid you’re right.”
Calderon hadn’t felt this kind of rush since he buried a knife in the neck of the German banker, the one whose house his mother had cleaned, the one whose bed his mother had shared—though not of her choice. He was twelve years old at the time, and though his mother had never told him, Calderon knew that he was killing his father.
He fingered the scarred remnant of his left ear. The piece he’d lost in that struggle had always been a source of pride, his rite of passage into manhood.
“How do you propose that we handle this?” his client asked.
His client had an unhealthy need to meddle in things he knew nothing about. “Leave that to me.” Calderon clenched his fist and watched the veins in his forearm fill with blood.
“We need to do this in a way that doesn’t draw attention to ourselves,” his client said. “Let’s give the police something else to focus on. Here’s what I want you to do…”
• • •
“Here.” Ben tossed a towel to Luke.
Luke glanced down at himself. He was a bloody mess.
He wiped a red sheen from his arms and hands while watching the trauma team finish its work.
The boy was going to live. They had poured four units of fresh frozen plasma and six units of blood into him, and in a few minutes the team would take him up to the O.R., where vascular surgeons would patch together his blood vessels.
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