Foreign Body

by Robin Cook

  “So we are going to need you to be seen by someone in New Delhi the first full day after you arrive. We don’t want to take any risk of hyperstimulation.”

  “That’s the reason I’m calling. Do you know anyone in New Delhi you could recommend?”

  “Lots,” Shirley responded. “Thanks to my having been there for that meeting, I’m in contact with a number. Indian medicine is quite advanced, more than most people realize. I know at least a half-dozen docs I’d feel comfortable recommending for you to see. Any specific requirements, like male or female, or any particular location in the city?”

  “What might be handy is if any of those you recommend are associated with the Queen Victoria Hospital,” Laurie said. “It might be helpful to know someone on the staff when we’re dealing with the administration.”

  “I couldn’t agree more. I tell you what. I’ll make some calls right now. It’s around quarter-to-six in the evening in Delhi, which is a perfect time. I could e-mail, too, but I think telephoning and talking directly will be better, and I don’t seem to have any incoming calls.”

  “Thanks, Shirley,” Laurie said. “I’m certainly going to owe you for all this, but I don’t know how I’m going to repay. I seriously doubt you want any in-kind professional services.”

  “Don’t even joke like that,” Shirley said. “I’m too superstitious.”

  Disconnecting, Laurie reflexively checked her watch. The Indian visa place didn’t open until nine, so she had some time. The first thing she did was call up the airlines and use her credit card to pay for the tickets she had reserved. Next she called Jennifer. The phone rang four or five times, and when it was finally answered, Laurie expected voicemail. It was Jennifer, who sounded out of breath.

  Laurie identified herself and then asked if she were calling at a bad time, because she could easily call back.

  “No, this is fine,” Jennifer said, breathing deeply. “I’m having dinner in a fancy Chinese restaurant here in the hotel, and when the phone rang, I ran out here to the lobby to answer it. Guess who I’m having dinner with?”

  “I couldn’t begin to guess.”

  “A Mrs. Benfatti. She’s the wife of the man who died at the Queen Victoria last night.”

  “That’s a coincidence.”

  “Not really. I looked her up and we had lunch. I have to say his death has some strange parallels with Granny’s.”

  “Really?” Laurie questioned. She wondered if they were real parallels or imagined.

  “Gosh, here I am blabbing away, and you called me. Please tell me you are coming to India.”

  “We are indeed coming to India,” Laurie said, the excitement showing in her voice.

  “Terrific!” Jennifer cheered. “I’m so pleased, you have no idea. Tell Dr. Washington thank you, thank you, thank you.”

  “He did send you his regards,” Laurie said. “Have there been any big changes in the situation there?”

  “Not really. They are still trying to push me to give them the green light. I did tell them that you guys were coming and will be there Friday morning sometime.”

  “Did you mention that we happen to be forensic pathologists?”

  “Oh, yeah, most definitely.”

  “And their response?”

  “Another lecture that there will be no autopsy. They are very adamant.”

  “We’ll see,” Laurie said.

  “I made it a point to talk with the nurse who took care of Granny. She’s this beauty queen you won’t believe with a figure to die for.”

  “Coming from you, that’s quite a compliment.”

  “I’m not in her league. She’s the kind of woman who probably can eat anything, and she just looks better and better. She’s also really nice. At first when I met her she acted weird.”

  “How so?”

  “Shy or embarrassed, I couldn’t tell which. It turns out she was afraid I would be angry at her.”

  “Why would you be angry?”

  “That’s what I asked her. You know what it turned out to be? Granny was the first patient she has lost since she’d graduated from nursing school. Isn’t that touching?”

  “Did you learn anything about your grandmother from her?” Laurie asked. She didn’t comment on Jennifer’s rhetorical question. At first blush, Laurie didn’t understand how Maria being the nurse’s first nursing death meshed with the nurse’s being worried Jennifer might be mad at her. Laurie assumed it had to be a cultural thing.

  “Not really,” Jennifer said, but then corrected herself. “Except she said Granny was cyanotic when she was found.”

  “True cyanosis?” Laurie questioned.

  “That’s what she said, and I asked her specifically. But she was relating this secondhand. Granny didn’t die on her shift but on the evening shift. She had learned it from the nurse who had come upon Granny after Granny had already died.”

  “Maybe you’d better not play medical investigation,” Laurie suggested. “You might ruffle too many feathers.”

  “You’re probably right,” Jennifer agreed, “and especially not with you guys coming. What are your flight details?”

  Laurie gave the flight numbers and the expected arrival time. “Now, you don’t have to come to the airport like you suggested,” Laurie said. “We can just jump in a taxi.”

  “I want to come. I’ll take a hotel car. I mean, my expenses are being covered.”

  Under those circumstances, Laurie agreed for Jennifer to come out to fetch them when they arrived. “Now I better let you get back to your dinner and your dinner companion.”

  “Speaking of Mrs. Benfatti, I offered that you would look into the situation with her husband. I hope you don’t mind. There are parallels, as I’ve said.”

  “We’ll look first at the parallels and then decide,” Laurie said.

  “One more thing,” Jennifer said. “I went to the U.S. embassy this afternoon and spoke to a very nice consular officer who was very helpful.”

  “Did you learn anything?”

  “It turns out that the case manager at the Queen Victoria was giving me the true story about bringing bodies back to the States. You have to jump though a lot of bureaucratic hoops, and it is expensive. So I’m leaning in the direction of cremation.”

  “We’ll discuss it more when I get there,” Laurie said. “Now get back to your dinner.”

  “Aye-aye, sir. See you tomorrow night,” Jennifer said gaily.

  Laurie replaced the receiver. For a moment she kept her hand on it, thinking about a heart attack and general cyanosis. When the heart fails, the pumping action stops, and you don’t get general cyanosis. Cyanosis generally comes from the lungs failing and the pumping continuing.

  The phone under Laurie’s hand rang harshly, causing her to start. With her pulse racing, she snapped the receiver back up and blurted a hurried hello.

  “I am looking for Dr. Laurie Montgomery,” a pleasant voice said.

  “This is she,” Laurie answered with curiosity.

  “My name is Dr. Arun Ram. I just spoke with Dr. Shirley Schoener. She said you were imminently coming to New Delhi and are in the middle of an infertility cycle using hormones. She said you will need to have the size of your follicles followed and your estradiol blood levels checked.”

  “That’s true. Thank you for calling. I expected to hear back from Dr. Schoener with some numbers so I would have to make the calls.”

  “It is no bother. It was my suggestion, since Dr. Schoener said she had been just speaking with you. I wanted to let you know I would be honored to be of assistance. Dr. Schoener told me a little about you, and I am very impressed. There was a time in my early training when I aspired to become a forensic pathologist from watching American TV shows. Unfortunately, I became disenchanted. The facilities in this country are very bad because of our infamous bureaucracy.”

  “That’s too bad. We need good people in the specialty, and India would be well served if the facilities and the field were improved.”

&n
bsp; “Dr. Schoener had first called a colleague of mine, Dr. Daya Mishra, who is obviously a woman, if you would prefer. But Dr. Schoener said you were interested in someone with admitting privileges at the Queen Victoria Hospital, so Dr. Mishra recommended me.”

  “I would be very grateful if you would see me. My husband and I have other business at the Queen Victoria Hospital, so it will be convenient.”

  “When are you coming exactly?”

  “We are leaving this evening from New York and scheduled to arrive in Delhi late Thursday night, October nineteenth, at twenty-two-fifty.”

  “Where are you in this current infertility cycle?”

  “Day seven, but more important, on Monday, Dr. Schoener estimated five days before the trigger shot should be given.”

  “So the last time you were seen was Monday, and everything was fine.”

  “Everything was fine.”

  “Then I believe I need to see you Friday morning. What time would you prefer? Anytime is good since Friday is a research day and my calendar is clear.”

  “I don’t know,” Laurie said. “How about eight a.m.”

  “Eight a.m. it is,” Dr. Arun Ram said.

  After terminating the call with Dr. Ram, Laurie called Shirley back and thanked her for the referral.

  “You’ll like him,” Shirley said. “He’s very smart, has a great sense of humor and good stats.”

  “One can’t ask for much more than that,” Laurie said before ringing off.

  With all the calls out of the way, Laurie glanced briefly at her watch. It was time to head over to the company to which India had outsourced its visa service. She got out her and Jack’s passports from her briefcase and wedded them with the photos they’d had taken that morning.

  With the passports and photos tucked into her shoulder bag along with her mobile phone, Laurie stepped back out of her office and headed for the elevators. When she heard the elevator door open ahead, she quickened her step to catch it and bumped head-on into her officemate, Dr. Riva Mehta, exiting. Each apologized. Laurie actually laughed.

  “My, you are in a good mood,” Riva commented.

  “I guess I am,” Laurie responded cheerily.

  “Don’t tell me you are pregnant,” Riva said. Not only were Riva and Laurie officemates, they were also confidantes. Riva was the only person other than Shirley with whom she had shared all the stresses of the infertility treatment.

  “I wish,” Laurie said. “No, Jack and I are making an emergency trip to India.” Laurie struggled with the elevator door that desperately wanted to close.

  “That’s terrific,” Riva said. “Where in India?” Riva and her parents had emigrated to the United States when she was eleven.

  “New Delhi,” Laurie said. “Actually, I’m on my way over to get our Indian visas. I’ll be back in a half-hour or so. I’d love to talk to you about it and maybe get some tips.”

  “By all means,” Riva said with a wave.

  Laurie ducked into the elevator car and let the insistent door close. As she descended, she thought about Riva’s comment regarding her mood and realized that she was truly on a high, magnified by the low she’d been on over the last two to three months. Vaguely, she hoped that the strain of infertility wasn’t making her bipolar.

  Getting off at the basement level, Laurie hurried down to the autopsy room. Knowing she was going to be in there for only a few moments, she grabbed just a gown and a hat, and pushed in through the main double doors. Although it was almost eight-forty-five, Jack and Vinnie were the sole team working. Several other mortuary techs were preparing cases and putting out bodies, but the associated docs had yet to appear. Jack and Vinnie were well along. The body they were working on already had the large Y incision over the chest and abdomen sutured. At the moment, the individual’s skull cap was off and they were working on the brain.

  “How’s it going?” Laurie asked, coming up alongside Jack.

  “We’re having a ball as usual,” Jack responded, straightening up and stretching.

  “A typical gunshot suicide?” Laurie asked.

  Jack let out a short laugh. “Hardly. At this point, it’s pretty clear it was homicide.”

  “Really?” Laurie questioned. “How so?”

  Jack reached over to the corpse and grabbed the reflected and inverted scalp and pulled it from covering the face back into its original position. High on the side of the head and in the center of a shaved area was a sharply defined circular deep-red entrance wound surrounded by a number of two-to-three-inch black speckles.

  “My word,” Laurie exclaimed. “You are right. This is not suicide.”

  “And that is not all,” Jack said. “The path of the bullet is steeply downward such that it ended up in the subcutaneous tissues of the neck.”

  “How can you guys read so much into this?” Vinnie asked.

  “It’s easy,” Laurie said. “When someone shoots themselves, they almost always place the barrel against the skin. What happens then is the explosive gases go into the wound along with the bullet. The resultant entrance wound becomes raggedly stellate as the skin blows away from the skull and tears.”

  “And you see this stippling?” Jack said, pointing with the handle of a scalpel to the ring of black spots around the wound. “That’s all gunpowder residue. In a suicide, all that goes into the wound.” Then, turning back to Laurie, he asked, “How far away do you think the barrel was when the gun was fired?”

  Laurie shrugged. “Maybe fifteen to twenty inches.”

  “That’s exactly my thought,” Jack agreed. “And I think our victim was lying down when it happened.”

  “You’d better let the boss know as soon as possible,” Laurie advised. “This is the kind of case that invariably has political fallout.”

  “That’s my plan,” Jack said. “It’s amazing, isn’t it, how many cases we see where the manner of death is different after the autopsy than what it was thought to be before.”

  “It’s what makes our job so important,” Laurie said.

  “Hey!” Jack voiced. “Did you get to see Calvin yet?”

  “Oh, yeah!” Laurie said remembering her mission. “That’s why I popped down here. I’m on my way to Travisa to get our Indian visas. Calvin has given us the green light for a week.”

  “Damn,” Jack said, but then he laughed before Laurie could get miffed.

  Chapter 20

  OCTOBER 17, 2007

  WEDNESDAY, 7:40 P.M.

  NEW DELHI, INDIA

  Raj Khatwani cracked the door from the stairwell and peered out into the wedge of the third-floor corridor of the Aesculapian Medical Center hospital that was visible. There was no one in his line of sight, but he could hear a medication cart approaching with its characteristic rattling of glass against glass. He let the door close. Through its fire-resistant thickness, he heard the cart roll past.

  Leaning back against the concrete-block wall, he tried to control his breathing. With the tension he was experiencing, it was difficult. Sweat dotted the upper part of his forehead. All he could think of was his new respect for Veena and Samira. Now that he was in the middle of putting his first patient to sleep, he realized it was a lot more stressful than he had anticipated, especially after Samira had told him it was a breeze. Some breeze, he thought grudgingly.

  When an adequate amount of time had passed, he cracked the door again. Not seeing anyone or hearing anything, he opened the door farther and slowly stuck his head out, looking up and down the hallway. The only people he saw were two nurses a distance down the main corridor at the central desk, talking to an ambulatory patient. They were far enough away so that Raj could just barely hear them. In the opposite direction, there were only three more patient rooms on either side of the corridor before a terminal conservatory. There were conservatories at both ends of the long corridor, each filled with plants and chairs for those patients able to use them.

  In his mind, Raj could hear Samira’s advice: Don’t be seen, but if you are, act
normally. Let your nurse’s uniform do the talking. Don’t be seen! Raj scoffed silently. Since he was a big man, slightly more than two hundred pounds, not being seen was particularly difficult, especially on a full hospital floor with nurses and aides scurrying about on any one of myriad possible errands.

  Raj had gone to Samira and Veena’s room to seek advice that evening before he’d left for the Aesculapian Medical Center. He didn’t think he’d really need help and did it more out of respect for his female colleagues, but now that he was there, he was glad he did. Samira had finally admitted she had been nervous, which was good to know, since he, too, was definitely nervous. Veena, however, had said nothing.

  Of the twelve nursing employees of Nurses International, as the only male, Raj provided a stark foil for the other eleven attractive and quite feminine females. He had medium-dark flawless skin, very dark closely cropped hair, darkly penetrating eyes, and a pencil-line mustache beneath a slightly hooked nose. But his most characteristic physical feature was his physique. He had broad shoulders, a narrow waist, and bulging muscles. He looked every inch the enthusiastic weight lifter and black-belt martial arts expert he was. But despite his appearance, Raj was not a masculine-acting individual, but nor was he feminine, at least in his mind. Nor was he gay. He thought of himself as just Raj. The seemingly out-of-character weight lifting and martial arts had originally been his father’s idea. Recognizing early his son’s social proclivities, his father had wanted him to have some protection in a socially cruel world. As he got older, Raj liked the weight lifting, as looking buff had become enjoyable because of the attention it engendered from his mostly female friends, and he liked the martial arts because, in his mind, it was more like dance than an aggressive sport.

  Suddenly Raj heard loud footsteps against bare concrete. To his horror, he realized that someone was behind him in the stairwell, descending from above. From the proximity of the noise he could tell the person was imminently going to reach and round the landing between the third and fourth floors, at which point Raj and his loitering would be in full view! Raj knew he had two choices if he didn’t want to be seen: either he could run back down the stairs, maybe as far as the basement, or he could exit onto the third floor and take the risk of being seen there.