Excise (Dr. Schwartzman Series Book 2)

by Danielle Girard

  The victim’s legs were splayed slightly, his head toward the far side of the room. There were no obvious contusions on the back of his head, which implied he might have been facing his attacker. She took a series of images of the sculpture and additional images of Posner until she was certain she had captured everything Roger’s team would want from around the victim.

  The camera in her hands, she spent a moment studying the distance from Posner’s head to the wire sculpture. If he had been facing his killer, that person had to have been standing close to the bulky fixture. Although much of the sculpture’s motion was horizontal, it also jutted out into the room—forward and sideways—in a series of wired knots and waves.

  Schwartzman set down the camera and pulled her white light from the kit, approaching the sculpture and examining the sharp wire ends. She moved across the statue’s sharpest points, aiming the wand’s light at the metal and searching for any signs that someone else had gotten cut.

  No sign of blood on the wire. It was possible someone had wiped it clean. She would mention it to the crime scene team. She put the light and goggles away and turned her focus to the body.

  Gloved up, she began with the skull, palpating for contusions and finding none. There were no visible tears in his clothing, no obvious signs of struggle. Posner’s left hand was palm up, and the skin was raw and inflamed, especially along his fingers. She’d seen this type of injury, most commonly in younger physicians. The constant washing of hands—especially with the antibacterial surgical soap the hospital supplied—dried the skin and sometimes caused irritation. She took several close-up images to document the finding.

  The irritation tended to happen along the knuckle line, not the fingers. Finger tissue was thicker and tougher than the skin on the knuckles. She turned the hand in her own and looked at the knuckles, but they didn’t have the same raw appearance. It seemed limited to the fingers. Perhaps some sort of burn. She made a note of it.

  Shifting to the other side of his body, she noticed no irritation at all on his right hand. She photographed that one, as well, front and back.

  As she touched his neck for signs of injury, she found only a bright-red liquid on the skin and the carpet beneath him. She took several swab samples and put on fresh gloves.

  “I want to turn him over,” she told patrol. “Let’s watch the dog. If he reacts, we’ll have to call animal control.”

  The officers gave the dog a cautious glance as they approached the body. She handed each man a pair of gloves. “They’ll be small, but they’ll do.” The dog didn’t even lift his head.

  The officers pulled on the gloves and then positioned themselves on either side of the body, one at Posner’s shoulders and one at his thighs.

  “On three, we roll him toward me,” Schwartzman said. “One, two, three.”

  Schwartzman watched the dog as they rolled Posner. No reaction. As the victim’s back touched the floor, his hand dropped to his side.

  The whole of his face came into view.

  “Oh, God,” one of the patrol officers gasped, reeling away from the body.

  Like the fingers of his left hand, the side of Posner’s face was an angry, mottled red. The center of the affected area was a deeper crimson, as though something had burned through the epidermis to the layers beneath.

  “It looks like someone took a blowtorch to his face,” the other patrol officer said, his voice a raspy whisper.

  The wound stretched across his lower lip and down his chin to his neck, where it eventually disappeared under his white button-down shirt. It looked like a chemical burn. The injuries around his mouth and down his chin suggested that before he’d died, he had been drinking something highly acidic. The wound glistened with blood that hadn’t dried.

  His collar was stained with the same bright-red liquid.

  The chemical burn wasn’t enough to kill him. But it was almost certainly enough to make him want to die.

  2

  The sound of the officer gagging brought back the taste of vomit. She’d thrown up much too recently to listen to someone else get sick. Schwartzman lowered her head and closed her eyes. Breathing slowly, she shut out the noise.

  She would not vomit on a victim.

  “Go on. Get out.” Hal’s voice was urgent. “Don’t puke in here.”

  He was right. She would destroy the evidence. She pushed herself back from the victim to stand as Hal ushered the patrol officer from the room.

  He hadn’t meant her.

  Because she was not going to be sick. She took a tentative swallow and drew another slow, deep breath. Then one more.

  Hal returned to the room and knelt beside her. “What the hell happened?”

  “Looks like some sort of chemical burn,” Schwartzman said, turning to her kit.

  “That had to hurt like hell.”

  “Yes,” Schwartzman agreed. She studied the burns. Even in the areas with the most damage, the chemical didn’t appear to have penetrated the basal layer, the deepest stratum of the epidermis. Not enough damage to be fatal. “But the burns didn’t kill him.”

  “What do you think it was, Doc?”

  It was too easy to look at the human exterior and guess at how someone died. And sometimes she was right—maybe more often than not. But she didn’t like guessing. Any speculation meant sending Hal’s investigation in one direction. Being wrong meant a waste of time and energy for him. Time they didn’t have to waste. Hal knew all this.

  “Just tell me what you’re seeing,” he said as if reading her mind. Something he did more often since she’d returned from South Carolina.

  Schwartzman pointed to the bluish tint of his lips. “Looks like he was suffering from respiratory failure. It’s possible the toxin affected his lungs. But it’s equally possible that something else killed him before that. I won’t know—”

  “Until the autopsy,” he finished for her. “I hear you. What about those lines in the wound? On his cheek.”

  Schwartzman studied the three horizontal lines on the left side of his face. “You want to know if they’re scratch marks.”

  “I want to know if they’re defensive scratch marks.”

  “More likely he was scratching at the skin himself. The burns would have made the skin more fragile, easily damaged.” She showed Hal the irritated skin of Posner’s left hand. “The chemical burned his fingers, too.”

  “Makes sense if he’s left-handed,” Hal agreed. “I’ll find out. I can’t imagine he drank this stuff on his own.”

  Schwartzman bagged the victim’s hands for transport and then examined the victim’s eyes. No burns there. His pupils were enlarged black disks ringed in a thin circle of brown iris. Pupil dilation was a common response of fight or flight. She studied the burns again.

  “No. If I had to guess, I’d say he was coerced.” She checked his wrists. “No ligature marks.”

  “Maybe someone held a gun to his head,” Hal suggested.

  She studied his temples. No impressions in the skin. A gun wouldn’t necessarily leave a mark. “It’s possible.”

  “On second thought,” Hal said, “maybe I’d risk the gunshot.”

  It was true. The pain of the chemical in his throat had to have been excruciating. What threat would have been strong enough to compel Dr. Posner to drink poison? Schwartzman considered what it would take to convince her. A threat to her family, perhaps? Would she have swallowed poison to save Ava? She wasn’t sure.

  Her father? Probably.

  It was human nature to fight, to survive. Unless someone had convinced Posner that it wouldn’t kill him? But the burning. He must have known that the liquid was a strong chemical. He was a doctor.

  “I’ll use alternate light sources to check for evidence of restraints in the morgue,” she said. “And I’ll swab the wounds. The presence and density of white blood cells will indicate how long before the death the injuries occurred.” Using what looked like a long Q-tip, she took two samples from the center of the wound on Posner’s
chin. “You ever seen this kind of red chemical?”

  “Sure,” Hal said. “Transmission fluid, motor oil—they’re both red.”

  “But darker than this.”

  “Generally,” he agreed. “And more viscous. This is more like tropical punch.”

  She gave him a look.

  “Well, it’s not, obviously. I’m sure there are plenty of red chemicals around.” He studied the stain on Posner’s shirt. “But you’re right. It doesn’t look like automotive chemicals—at least not the ones I’ve seen.”

  “Plus, those chemicals shouldn’t create these kinds of burns,” Schwartzman said. “Not on their own and not so quickly.” She studied the bright color on his white shirt. Hal was right. It was the color of fruit punch.

  “Maybe he didn’t realize it was a poison?”

  “Like he thought he was drinking a Gatorade?” she asked.

  “Is it possible?” he asked.

  She leaned in and smelled the chemical. The scent was pungent. Posner would have known it was dangerous by the smell. “I don’t think so.” She studied the depth of the burn. Assuming the poison didn’t take hours to kill him, the burn had been rapid. “It would have hurt almost immediately.”

  “Burned his mouth,” Hal clarified.

  “Absolutely.”

  “I think I got some of that on my hand,” the patrol officer said from the corner of the room.

  “Go wash it well—for two minutes at least,” she told him. “Use a mild soap.”

  The officer hurried from the room as his partner, the gagging one, returned.

  Across the room, the dog lifted his muzzle off his front paws and whined. “He’s been doing that since we arrived,” the officer said. The rug was dark in front of him where a puddle of drool had accumulated. The dog yawned, and his tongue uncurled. More drool dripped from his mouth.

  Schwartzman changed to a fresh pair of gloves and patted her leg. “Come here, boy. Come on.”

  The dog lifted his head as if preparing to stand but, within seconds, sank back onto the rug.

  “Anyone know his name?”

  When no one answered, Schwartzman crossed to the dog and checked the collar. “Buster Posey.”

  “Great name,” one of the officers said.

  She stepped back a few feet and called the dog. “Come here, boy. Buster, come.”

  The dog swung his snout into the air and lifted himself onto his front legs, took two tentative steps, and collapsed.

  “He must be old,” the officer said.

  “I don’t think so,” Schwartzman said, opening the dog’s jaw to peer into his mouth. The gums around the front teeth looked swollen and inflamed. “I think Buster ingested whatever killed Posner.” Schwartzman turned to the patrol officer. “We need to get the dog to an emergency vet.”

  “Call animal services,” Hal said to the officer. “Tell them what we’ve got.”

  Schwartzman replaced her gloves with a new pair and shined her flashlight in Posner’s mouth. His tongue was raw and red, his gums inflamed. There were several areas that were raw enough to bleed. Not unlike her own. As she worked, her tongue automatically explored one of the small red wounds in her mouth—a condition called oral mucositis. The chemotherapy damaged the fast-growing cells of the soft tissue, making it difficult for the mouth to fight off germs and heal itself. The result was sores—on the tongue, along the gums, the roof of the mouth, down the esophagus . . . another side effect of the treatment.

  She pushed aside his tongue and spotted something white in the corner of his mouth. Most likely it was sputum, a mixture of saliva and the mucus in the respiratory track. Not uncommon in poisoning victims.

  She reached farther into his mouth to touch it.

  “Dr. Schwartzman.”

  She jumped at the sharp voice.

  Roger entered the room, followed by one of the Crime Scene Unit’s junior techs, Naomi Muir. They were winded, and Roger was frowning.

  Something was wrong.

  “What is it?”

  Roger nodded to Hal. “Your patrol officer found this in the kitchen trash can.” He lifted a plastic evidence bag. Inside was a clear medicine bottle, like the kind that might be filled with cough syrup. At the bottom were dregs of a bright-red liquid. Roger handed the bag to Hal. Schwartzman pulled her gloves off, balling them up inside out.

  “What is it?” Hal asked.

  Schwartzman scanned the label.

  The bright-yellow label read, “Doxorubicin.” Below that in a red box were the words “For Intravenous Use Only. Cytotoxic Agent.”

  Schwartzman was on her feet in seconds. She knew that drug. “Doxorubicin. That’s another name for the drug Adriamycin.”

  “What is that?” Hal again.

  “It’s used for chemotherapy.” She stepped away from the body, motioning the others back. “We need to clear this room until we can mitigate the spill.”

  “She’s right,” Roger said. “We’ll need something alkaline.”

  “Baking soda?” Hal suggested.

  “Not strong enough,” Roger said. “Naomi, see if the victim has any ammonia; then call for a hazmat team. We’ll need full protection and proper disposal equipment.”

  “They call that stuff Red Devil,” Schwartzman added.

  “Red Devil,” Hal repeated, holding up the plastic bag to examine the bottle inside. “It looks like whoever killed him used all of it.” He turned to Schwartzman. “How did you know what it was?”

  “It’s the chemotherapy treatment for breast cancer.”

  “You can’t examine the body without full protective gear,” Roger said.

  Roger was right. There was clear protocol in cases of suspected toxic poisoning. She would follow it, of course. But it was ironic that she would be jumping through bureaucratic hoops to avoid exposure to the same drug that was pumped into her body every three weeks.

  She looked back down at Posner. Some of the sputum in his mouth settled away from his teeth, and the white thing in his mouth took shape. It was not sputum but something small and balled.

  Using a small set of surgical clamps from her kit, Schwartzman extracted the white bolus and laid it on a clean paper evidence bag. There, she used the end of the long tweezers to stretch it out.

  It was blank on one side, but when she flipped it over, it read, “For Sandy, acute myeloid leukemia.”

  Hal squatted beside her so that their shoulders almost touched. “What’s acute myeloid leukemia?”

  “I’m not familiar with it, but myeloid relates to bone marrow or the spinal cord. And leukemia, of course, is a cancer of the blood-forming tissues.”

  Hal put a palm on her shoulder. “Let’s get out of here. You don’t need any more exposure to this Red Devil than you’ve already got, and I need to try to find Sandy with acute what-you-call-it.”

  “Myeloid leukemia,” she said.

  “Right.”

  She stood up and stepped back. As far as she knew, Red Devil was used only for breast cancer. There was no connection between Red Devil and the treatment of other types of cancer. No connection between myeloid leukemia and Red Devil.

  She had cancer.

  Spencer knew that.

  Her cancer was being treated with Red Devil, and Posner had performed her mastectomy.

  Would Spencer connect her to her surgeon? Because he’d performed the surgery to remove her breasts? It sounded absurd. But Spencer’s logic was nothing if not twisted. Then why leave a note about a woman with acute myeloid leukemia, a completely different cancer from her own?

  Was there some connection the killer wanted them to make? Or did the killer not know as much about cancer as he—or she—wanted them to think? That thought brought a brief breath of relief. Spencer was not careless. He would not make a mistake like this.

  Spencer had nothing to do with Posner’s death.

  Maybe.

  She followed Hal from the room, glancing back at Posner’s body.

  Spencer remained at the fr
ont of her mind. Her surgeon dead. On her watch. From the drug being used in her chemo treatments.

  Was that really just a coincidence?

  God, she hoped so.

  But coincidences were for other people. Lucky people. And she wasn’t lucky, not with Spencer still in her life.

  3

  He stopped in the red zone at the end of the block and stared at his house. A white van was parked at the curb in front. No sign of the driver, and his view of the front door was blocked by the gaudy monolith. The van’s pipe rack was painted lime green. A large green-and-yellow emblem on the side was like a neon flashing sign.

  Trent, he thought immediately.

  This was his brother’s doing. This was not staying under the radar. This was not keeping a low profile. His brother was going to blow the whole fucking thing. Months of work—of tiptoeing, of tedious planning, of running interference.

  Not for the first time, his mind shifted to murder.

  His gaze took in the enormous buildings that made up the street. This had been a quiet neighborhood once, small, worn-down homes in an overlooked area of San Francisco. Nothing in San Francisco was overlooked now.

  Investors had swallowed up the neighboring apartment buildings in order to tear them down. People paid millions for a tiny lot and destroyed perfectly good houses to rebuild things two or three times the size of the originals. Triplexes and fourplexes had become single-family homes. But it was responsible building, they all touted. They were working hard for the planet, they said. Not that they said this to him. He didn’t talk to the neighbors.

  The new owners were young dot-commers with more money than God. He’d read about them in the paper—how they were so proud because their houses were solar powered, and they’d bought a thousand acres of forestland in Minnesota to offset their carbon footprint. And since they’d done that, they could justify building end to end on the lots, their greenhouses and decks looking down on his own rotting shingles.