by Kathryn Fox
Hayden Richards opened the door.
“The head doctor told the triage nurse you could go in now.”
Anya stepped out of the room and tried not to look at Sophie Goodwin’s father.
The triage nurse handed her a white gown, which she pulled on and tied at the back of her neck. “Gloves are on the wall inside.”
“Thanks.” Anya took a deep breath to steel herself before pushing through double plastic doors. A male nurse carrying two bags of blood rushed behind the curtain to the first resuscitation bay.
“Blood warmer’s coming. Group specific is still a couple of minutes away. They’re still working on the full cross-match.”
“Hurry them up,” a male voice boomed. “She’s leaking like a sieve.”
Two paramedics hovered near the central desk area, sipping from paper cups. Judging by their proximity to the cubicle, they were the ones who had brought Sophie in.
Anya peered through the gap in the curtains but could see only the lower part of the girl. Heads and hands moved quickly, each with a specific role.
Inside the cubicle she recognized Mike Monsoor, a surgeon she had trained with, and emergency specialist, Greg McGilvray. The hospital had quickly mobilized the acute trauma team.
A small figure lay on the bed, naked, her flesh covered with mixes of dried and fresh blood. One gloved nurse put pressure on a blood-soaked bandage over the girl’s abdomen.
A woman in blue surgical scrubs was at the head end, with a nurse, squashed between the bed and the wall.
“Doctor Crichton, I heard you’d been called.” Dressed in a sterile procedure gown, Greg McGilvray held a plastic bone-gun in a gloved hand. The gun was used in the army for administering fluids to injured troops in the field. Instead of wasting critical time trying to find venous access, the plastic gun drilled directly into bone. Advocates claimed it could save large numbers of lives.
Anya hoped Sophie Goodwin’s was one of them.
“We’ve just lost the antecubital cannula. It’s tissued,” a younger doctor said, feeling for a groin pulse. “My concern with a femoral line is that any fluid could just fill the abdomen. We need to go in to know what damage is in the belly.”
He had to be a surgical registrar.
“I’m in the humeral head,” Greg announced from the girl’s right shoulder. He flushed the line with saline and attached the blood for immediate transfusion. A nurse stood, arms above her head, squeezing the blood to get it into the body faster.
The monitor beeped seventy-five, a dangerously low blood pressure. Even if the girl survived, there was a chance she could suffer organ damage because of the prolonged poor blood supply.
The number on the monitor slowly increased with each squeeze of the bag. The blood was doing some good.
“Everyone, this is Doctor Crichton, a pathologist and forensic physician,” Greg introduced.
“Aren’t you a bit early? Business must be slow in the morgue,” the surgical registrar muttered and stepped outside the curtain.
Some things in hospitals never changed.
“Don’t suppose you want to put in a subclavian line?” Greg looked up. “Your anatomy is better than all of ours put together.”
“Not today thanks. But I will bag her shirt if anyone knows where it is.”
“Ah, I listened to your last lecture and split it along the buttons so knife cuts stayed intact.”
“Much appreciated.” For the first time, Anya had a clear view of Sophie’s head and neck. The wound gaped from one ear to the other, exposing veins and vital structures.
“I’ve never seen a wound that deep on anyone alive,” Anya thought out loud.
The breathing tube was placed straight into the trachea, bypassing the mouth and upper neck, kept stable by a towel clip attached to the sheet. In this instance, everyone was improvising as best they could. Textbooks couldn’t cover situations this complicated.
No wonder the woman at the top was keeping the head stable. Even a slight movement could tear large veins and prove fatal.
Greg glanced at Anya, then paused to look at his patient. “God knows how she crawled all that way without severing a vessel completely. The ambo officers did a top job getting her here alive.” Gloves on, he wiped his forehead with his forearm. “You know, I’ve got a daughter the same age.”
Moving a piece of hair from the neck area, he paused. “It’s hard to believe someone did this deliberately.”
Blood pressure hovered at eighty to eighty-five.
The surgical registrar returned. “Vascular surgeon’s upstairs prepping. No time for a CT scan. As soon as that other line’s in, we’ll take her straight to theater.”
“What about gynecology?” As the forensic physician, Anya was concerned about Liz’s mention of a bleeding vaginal injury.
Greg explained, “Registrar’s upstairs standing by. You might as well photograph what you can. It’s the best chance for the neck and stab wounds you’re likely to get.”
Anya already had the digital camera in her hand. Any opportunity to examine the wounds would be gone once surgeons started operating. With no time to grab a tape measure, she pulled the lid off a pen and placed it on the skin near the girl’s left shoulder. The lid would be the consistent measure of scale for each wound.
She recorded a number of stab wounds on the chest without interfering with the resuscitation. The woman at the head mentioned marks on the forearms and Anya gently collected images of them as well as of the hands and fingernails with the assistance of another nurse. Classic defense injuries, she thought. Sophie had tried to fend off her attacker, or attackers. She had probably seen whoever stabbed her.
“Thanks, Greg.”
“They should know to expect you in theater as well. Any problems, get them to ring me.”
“Give us a few minutes,” said the woman still quietly holding Sophie’s head. “You can meet me in the anesthetic bay. I’m Jenny Rafferty.”
Anya recognized the name of the Director of Anesthesiology and Intensive Care. Sophie was in the best possible hands.
Moving out to let them take the bed away, Anya turned around. The two paramedics were still by the nurse’s station. One was in his thirties, the other in his fifties.
“Excuse me, Doc,” the older man said. “But if you’re going to stay with Sophie, could you give her this?”
In his hand the man held a silver and gold medallion on a thick chain.
“Does it belong to her?”
“No…but, it’s got me this far safely and now I figure Sophie needs it more than I do.”
Anya took the medallion. On it was the image of Saint Jude, the Catholic patron saint of hopeless cases.
“I don’t know if she’s a believer or not, but it might protect her. Can you make sure she gets it?”
Anya nodded. “I’ll do my best.”
An alarm sounded as the bed wheeled past them, Jenny Rafferty clinging to the young girl’s head.
“Blood pressure’s dropping. She’s bleeding again. We need to get to theater now!”
The older paramedic’s face tightened as he closed Anya’s hand around the medallion. “Don’t let it out of her reach. It may be the only thing than can save that poor kid’s life.”
6
Anya left the operating theater an hour and a half later, with three surgical teams still fighting to save Sophie Goodwin’s life. In the change room she took a few minutes to wash her face in cold water and absorb exactly what she had witnessed.
Never before had she seen injuries so severe on a survivor. It was the degree of trauma that might be found following a fatal road trauma or plane crash.
Despite all the years of pathology and examining wounds, it was difficult to accept that a human being had done this to a young girl. She could only imagine the pain the sister had gone through before dying.
She was grateful for the way the gynecologist had not hesitated to take the vaginal swabs while examining Sophie, who remained unaware of the bodi
ly trauma thanks to the anesthetic. Anya had managed to collect important samples while the vascular team tried to repair the massive neck wound. She included clippings and scraping from fingernails along with a short dark strand of hair from Sophie’s sparsely blonde pubic region. Each item was meticulously labeled.
Anya did not want to make any mistake with these specimens.
Unusually, none of the surgeons present objected to a forensic physician’s presence in the theater. Egos appeared to have been temporarily shelved. Each member of the team wanted Sophie to live, but the mood made it clear that everyone present also wanted the perpetrator to be caught.
Silence fell over the group when the gynecologist announced she would have to perform a hysterectomy to stem the hemorrhaging. The knife used to stab her had penetrated Sophie’s young womb. Removal was the only option. If she lived, she would be unable to have children and would have to face a gamut of medical complications related to premature menopause.
Armed with the bags and vials of forensic evidence, Anya headed downstairs. Outside emergency, she dialed Liz who had been with Sophie’s father in a private room.
Within moments of hanging up, Liz appeared from inside, black sunglasses masking her eyes.
“Guess you want a lift to the lab with that lot.”
“Considering you had me chauffeured here this morning…” Anya clutched the bags, relieved that her job was over for the moment.
“Sure, but we need to make a detour first. I want to check out the scene. It might be helpful for you too.”
Anya took an extra breath; visiting the scene would be draining for both of them.
Liz unlocked the unmarked Commodore and Anya placed the bags on the floor in the back before getting into the passenger seat. She buckled her seatbelt as the car left the parking bay and waited until they were in traffic to speak.
“How’s the father?”
“As you’d expect. He’s just lost one kid and the other’s not expected to make it. So what do we do? Treat him like a suspect and interview him as he stares at the doors of ICU for anyone with news of his daughter.” She checked the rearview mirror. “Not the most satisfying part of the job.”
Liz Gould was unusual in Homicide. A new mother and back full-time within weeks of the birth, she had to be under considerable stress. Her usual warmth was understandably lacking today. She seemed shut-down. Sitting with the father would have taken its emotional toll.
“Should he be a suspect?”
Liz stared at the road ahead. “Gut feeling tells me no but the stats aren’t in his favor. His grief seems pretty genuine to me, but that doesn’t always mean much.”
Anya knew the police would need to exclude the father and close family members before they even considered any other suspects. Experience taught them to look at those closest to the victims, then work outward. Unfortunately, that caused even more distress for those already suffering the worst imaginable loss.
“Is the girls’ mother around?”
“Divorced years ago. She died last year from breast cancer and the girls decided to stay on in her house. There’s something I don’t understand. If the slash to the neck was so dangerous, how did Sophie manage to crawl without killing herself?”
“No one knows. The ambulance officers did a hell of a job just transferring her safely.”
Liz Gould’s phone rang a number of times. On speakerphone, a male voice proudly announced that their little boy had just sat up for the first time. He was about to send a photo.
“Honey, that’s great but I’m with someone and can’t talk.”
Liz’s husband sounded deflated when she said she would be home late.
The female detective let out a sigh and glanced over at Anya.
“Sorry about that. He thinks his child came out a genius.”
Anya remembered what those early few months were like. As she was struggling with exhaustion after a marathon labor and delivery, Martin would brag to anyone who would listen about how great their child was, how well behaved and what a perfect sleeper. Her recollections of Ben as a newborn were very different from her former husband’s. Instead of time mellowing those images, they had been permanently etched onto her memory.
“What is your son-six months?”
“Four and a half. He probably pulled himself up and waited a second before tipping over. To his father, that counts.”
It triggered memories of Anya’s experience. Just when she thought she could not cope any longer with sleep deprivation and motherhood, Ben looked at her with huge blue eyes and beamed a smile. One relaxation of a few facial muscles and she thought her heart would burst. From that moment on, she was tied to motherhood and adored her only child.
Liz paused at the lights. “How old is your little one?”
“Ben just turned five and started school.”
With one hand, the new mother fiddled with her bra strap beneath the collar of her shirt. “Please tell me it gets better.”
Anya grinned. “Every day. Once the overnight feeds stop, everything becomes easier. Can I make a suggestion?”
The lights turned green and the car accelerated forward.
“Sure.”
“Check out YouTube. Search for laughing baby. There’s a clip on there of a baby laughing at some noise. Just hearing it makes you want to keep going.”
“I’ll do that.”
The car pulled up at a bend along Rosemount Place, a quiet suburban street. The crime scene had been cordoned off with tape. Up a long, sloped driveway was the house. A uniformed constable stood guard to direct any traffic around the scene. The detective removed a nail file from the middle console and slipped off both shoes.
“New leather soles,” she said, scraping the bottoms of her shoes with the file into a backward “G.” “Now if I stick my hoof in the wrong place, everyone will know it’s my print, no one else’s.”
Anya preferred the disposable shoe covers pathologists wore in the morgue and at scenes.
The pair climbed out and the car beeped when the doors locked. The evidence bags would be safe with a policeman standing guard nearby.
Liz pointed to an area of dirt at the bottom of the drive.
“This is where she was found.”
Anya surveyed the ground. Numerous footprints and the wheel tracks of what had to be the ambulance gurney made impressions in the soil.
“Has your photographer been through?”
Liz nodded and the pair squatted to look more closely at a blackened area on the sloped driveway.
“Sophie must have laid here for a while. Allowing for absorption, it’s a significant amount of blood loss. If she crawled along, her head was pointing downhill the whole time, which might have just saved her life.”
“The trail goes back up to the house.”
The women slowly stepped along the drive, careful not to disturb the bloodstains soaked into the white gravel.
“She must have been on her stomach for most of the way.”
Anya thought of the blackened fingernails and the samples she had taken from beneath the fingernails.
“I’d say she stopped at least three times for a rest, judging by the pools concentrated at various intervals.”
The neck and abdominal wounds would have oozed and been further traumatized by the driveway. “What was the temperature overnight?”
Liz Gould pulled out her notebook. “Your colleague asked the same thing, apparently. Got down to four degrees Celsius. Sophie’s lucky she didn’t die of exposure.”
“Or the cold slowed the blood loss and her metabolic rate long enough for her to be found alive.”
“Barely-she’s not out of the woods yet.”
Anya knew that even if the young girl survived theater, there was the possibility of kidney, lung and brain damage. For the moment, she kept those thoughts to herself.
As she and Liz approached the house, the photogram-metry team appeared with their array of digital equipment. One crime scene officer held a
vertical stand supporting two cameras mounted on either end of a crossbar. The other held a computer bag and recorded findings. By combining the two images taken of the one object or area, the police would establish a 3-D image and from that calculate distances and depths of objects without touching and disturbing them any more than was necessary for the pictures.
The one with the computer offered Anya disposable gloves and shoe covers. She took them gratefully.
Despite the warmth of the midmorning sun, Anya felt a shiver as she crossed the threshold into the house.
Two crime scene officers swabbed separate patches of living room floor in silence. They looked up at the sound of footsteps on the polished wooden boards.
“Anyone from Homicide here?” Liz asked.
“Try the bedroom. Third door on the left.”
With a narrow frontage, the cottage was surprisingly large, extending down the block. Exposed wooden beams gave the place a country feel. Dried flower arrangements and wallpaper friezes at hip height were dated but homely. Anya suspected the mother had been crafty and, since her death, the daughters had kept things as she’d left them.
Until last night.
Broken mugs lay alongside the coffee table along with a pool of water and fresh flowers. The petals had been crushed, presumably by shoes. Anyone in bare feet or socks would have been cut by the shards of vase.
“Sophie was out here, we think. Her sister was in the bedroom.”
Either someone had smashed the items to scare the girls, or Sophie had fought her attacker. Judging by the strength the girl had shown by crawling for help, there might have been a significant struggle.
“We’ve bagged a small pair of underwear from under the coffee table,” offered one of the officers, “and a pair of jeans from just near the door. There are some smears of blood on the outside, so we assume her attacker removed them, then assaulted her. If the blood came from the older sister, then the younger girl was stabbed second.”