The Cutting mm-1

by James Hayman

  ‘Did you see her go out the back?’ he asked just as Josie Tenant burst in the front door, cameraman in tow.

  ‘Hey, McCabe, what’s going on?’ she called out.

  McCabe sighed. Hunter chases fox. Hounds chase hunter. Hounds catch hunter. Fox gets away. It wasn’t supposed to work that way, was it?

  ‘Sorry,’ said Summerville. ‘Didn’t really notice.’ McCabe went out the door that led to the parking lot. He scanned the cars in the lot but knew it was over. If she came out here, she was gone. If she didn’t, if she continued down Exchange Street, she was still gone.

  8

  Saturday. 3:00 P.M.

  It was 3:00 P.M. and McCabe and Maggie Savage were both present in the autopsy room at the Maine State pathology lab on Hospital Road in Augusta. Terri Mirabito entered, clad in her blue scrubs, pulling on a pair of surgical gloves. ‘Good afternoon, everybody,’ she called out. ‘Shall we begin?’ Terri was short, perhaps five-one or five-two, a trifle plump but definitely cute, with a round, sunny face and a mop of curly black hair. Before he met Kyra, McCabe seriously considered asking her out on a date. Though he did imagine dinner-table conversation between a homicide cop and a forensic pathologist might tend toward the ghoulish.

  McCabe watched in silence as she took the case chart from Assistant Pathologist Jose Guerrera and began reading aloud. ‘Today is September 17, 2005. This is case number 106-97-4482. Katherine Dubois. Caucasian female. Sixteen years old. Date of birth, July 14, 1989. The body has been positively identified by the deceased’s mother, Joanne Ceglia of 324 Dexter Street, Portland, Maine. Height 5? 3??. Weight 106 pounds, 45.2 kilograms.’ She continued reviewing the preliminaries, recording additional findings on the file as she proceeded. She checked the photographs Guerrera had taken earlier and found them acceptable.

  Terri then began a close examination of the body that had once been Katie Dubois. She identified nine second-degree circular burns, each about half an inch in diameter, that had been randomly inflicted, six on Katie’s chest, three on her inner thighs.

  ‘Was she burned postmortem or ante?’ asked McCabe.

  ‘Ante,’ said Terri. ‘Postmortem tissue doesn’t redden like this.’

  Why on earth did he burn her? McCabe wondered. Why did he have to do that, too? Was it punishment for defiance? Lying there on the autopsy table, Katie seemed so slight, her barely developed body so childlike, so vulnerable in death, McCabe found it hard to imagine that she’d been anything but terrified, anything but compliant.

  McCabe watched Terri closely as she worked. She was humming an old Beatles song, ‘Hey Jude,’ tunelessly, probably mindlessly, to herself. She painstakingly checked every millimeter, looking for hairs or fibers that weren’t Katie’s, for anything that might provide a clue to where the girl had been and whom she’d been with. She found nothing. Terri checked both fingernails and toenails for traces of skin or hair that might have been scratched from an attacker during a struggle. As he watched, McCabe noticed Katie’s toenails were painted an assortment of bright colors, each toe a different color, a smiley face drawn on the big toe where someone, probably Guerrera, had earlier hung an ID tag identifying Katie as case number 106-97-4482. McCabe hadn’t seen the nail polish in the gloom of the scrap yard and chided himself for carelessness. Again Terri found nothing. ‘Clean as a whistle,’ she murmured more to herself than to the cops.

  Terri then swabbed Katie’s vaginal and anal cavities for traces of semen. Though he’d attended dozens of autopsies of women who had been sexually attacked, this time, for the first time, McCabe felt he was intruding in a place he shouldn’t go. He imagined Casey’s body laid out like this on a stainless steel autopsy table, exposed under bright lights to faceless cops and probing pathologists, and he wished he were somewhere else. He forced the image from his mind. He knew he had to be here both for himself and for the girl — in a way, for Casey, too. Terri spoke for the record. ‘There is severe vaginal and anal bruising indicating rough sex or possibly insertion of a dildo or other foreign object. The subject may have been raped multiple times prior to death.’

  Guerrera reported that the swabs came up negative for semen. ‘Either he used a condom or maybe he was just as happy playing with toys.’ He spoke with a soft Castilian accent that seemed somehow out of place in this cold sterile room.

  Terri looked up at McCabe. ‘Are you alright?’ she asked. ‘You don’t look so good.’

  ‘Yeah, I’m okay.’ He didn’t elaborate.

  Terri nodded and then went back to her work. She examined the incision that had been made in Katie’s abdomen. She carefully removed the small ornament that decorated Katie’s navel. Using a scalpel, Terri then cut diagonally from each of Katie’s shoulders down toward the opening that already existed in her chest and abdomen. She continued the cut down beyond the navel to the pubis. She reopened the already sawn sternum and began removing, examining, and weighing each of the girl’s organs, excepting, of course, her missing heart. With the body opened, the stench of decomposing flesh filled McCabe’s nostrils, and he felt a rising nausea. This was the moment in each autopsy where, for McCabe, the corpse lost its connection with the living, its human identity becoming once and for all time a memory. McCabe’s mind let go of Katie and now shifted to planning the next steps in the Dubois investigation. At the same time, he found himself wondering if Lucinda Cassidy might still be alive and, if she was, how on earth he’d ever find her before she, too, ended up on a table like this.

  An hour later the autopsy was over. Terri, removing her gloves, walked McCabe and Maggie to the door. She looked at McCabe. ‘Like I said last night, someone surgically removed this girl’s heart. Underline surgically. Removing a heart is not a difficult procedure, especially if you don’t care if the patient — victim — dies, or if you actually want the patient to die.’

  ‘How could you remove someone’s heart and not have the person die?’ asked Maggie.

  ‘It’s done all the time,’ said Terri.

  ‘What do you mean?’ Maggie was genuinely confused.

  ‘It’s called a transplant. A sick heart is removed from a person and a healthy heart put in. In most cases, the patient who receives the heart goes on to live a perfectly normal life. At least for some period of time.’

  A transplant was something McCabe hadn’t considered. He found the notion intriguing. He looked at Terri. ‘Do you think that’s even remotely possible?’ he asked. ‘That Katie’s heart was removed as part of a transplant procedure?’

  ‘I suppose it’s possible, but damned unlikely. There’s certainly a shortage of hearts available for transplant. Someone might even kill for one. Many have died for want of one. The thing is, a successful transplant can’t be done outside a modern OR, and I can’t imagine any American transplant center accepting a donor heart without knowing exactly whose it was or where it came from. It just wouldn’t happen.

  ‘Even so,’ Terri continued, ‘this extraction was done skillfully. The incision was clean, most likely made with a scalpel. I’d guess the sternum was cut with a Stryker surgical saw. Like the one I use for autopsies. Hard to find outside a hospital. Or someplace like this. Anyway, I’d say you might — underline might — be looking for a murderer who trained as a doctor. Probably, but not necessarily, a surgeon. Possibly, but not necessarily, a cardiac surgeon. Again possibly, a pathologist. That’s the best lead I can give you. Katie Dubois was alive, her heart was beating, when the surgery — and I’m going to call it that — began. The removal of her heart was the immediate cause of death. What I’m really curious about is whether or not she was either anesthetized or brain dead at the time the heart was removed.’

  ‘If not?’

  ‘If not, she would have suffered horribly.’

  Maybe our boy got off on that, thought McCabe. ‘Your blood tox results will tell you that?’ he asked.

  ‘Yes. I’ll let you know as soon as I do. It’ll be a while, but I’ll try to hurry the lab along as much as I can.’
/>   9

  Saturday. 6:00 P.M.

  McCabe’s cell phone rang on the return trip from Augusta. ‘This is McCabe.’

  ‘Sergeant McCabe? This is Dr. Spencer. Phil Spencer. My wife said you called?’

  ‘Yes, Dr. Spencer, I was hoping you could spare me half an hour.’

  ‘Hattie said you wanted to talk to me about the Dubois girl,’ said Spencer. Without waiting for a response, he continued. ‘I’m not sure how I can help, but I’ll be happy to talk with you. I keep an office in the hospital, in the Levenson Heart Center. It’s one of the luxuries the hospital affords me. If you can come up in an hour or so, say seven o’clock, I can spare you some time. I should warn you, though, I may have to run out midconversation. I’m waiting on a harvest.’

  ‘A harvest?’

  ‘Yes. We’re harvesting a heart. For a transplant. Or, more accurately, a surgeon in New Hampshire is harvesting a heart.’

  ‘You call removing a heart “harvesting”?’ McCabe found the term a little creepy.

  ‘Yep. Organ recovery is more politically correct these days, but I’ve said harvesting for fifteen years, so I guess I always will. Anyway, once I get word the heart’s on its way, I won’t have much time to talk.’

  McCabe glanced at his watch. Five after six. He could make it by seven if he drove straight through to the hospital. ‘See you at seven,’ he said.

  It was a warm, pleasant evening, and he drove with the Bird’s retractable hardtop down, catching as much of the sunset as he could. There wasn’t much traffic, and he picked up his speed, taking 95 to 295. He reached the Congress Street exit for the hospital with time to spare.

  He pulled the Bird into the crowded visitors’ parking lot and headed for the hospital. An oversized revolving door led into the main lobby. Spotting an information desk manned by elderly volunteers, McCabe lined up behind a gaggle of other visitors and, as he waited, studied the comings and goings of a wounded humanity. An old woman, legs wrapped in bandages, hobbled painfully toward a bench, where she sat heavily. A girl, no more than fifteen, perhaps as young as Casey, rode in a wheelchair, a dazed expression on her face, a newborn in her arms. An aide was pushing the chair toward the exit. A middle-aged couple, the girl’s parents, McCabe supposed, walked behind. White-coated students and residents scurried importantly around them, stethoscopes stuffed in pockets, badges pinned to chests.

  Finally an elderly woman sporting a fluffy halo of white hair smiled up from behind the desk. ‘May I help you, sir?’

  ‘I’m here to see Dr. Spencer. Dr. Philip Spencer.’

  ‘Yes, of course,’ she said. Her tone suggested Spencer was someone she held in high regard. ‘Dr. Spencer’s office is in the Levenson Heart Center in the Harmon Wing. Is he expecting you?’

  ‘Detective Michael McCabe.’ He opened his badge wallet. ‘Yes, he is expecting me.’

  She phoned to announce McCabe’s arrival. She nodded, apparently to the person at the other end of the phone, and looked up again. ‘Walk down this hall as far as you can go, take a left, and then your first right. Take the elevator to the seventh floor. You’ll see the sign for the heart center. They’ll direct you from there. Shall I draw you a map?’

  ‘No, thank you, ma’am. I can remember your directions.’

  McCabe found Spencer’s office without difficulty. At seven o’clock on a Saturday evening no assistants manned the outer office, but Spencer’s door was open. McCabe poked his head in and gently knocked. Philip Spencer was on the phone. Smiling, he waved McCabe in and directed him to a wing chair at the side of his mahogany desk. Covering the bottom of the phone, he mouthed the words, ‘Just take a minute.’

  McCabe nodded and sat down. The furniture was conservative and expensive. Standard issue, he supposed, for senior executives of every stripe including, it seemed, the medical stripe.

  Spencer looked even younger than McCabe expected and handsome enough to play a doctor on TV as well as in real life. He was tall and slender, his straight dark hair beginning to turn gray. His face and manner exuded WASP breeding. His deeply tanned skin suggested a lot of time spent either outdoors or in tanning salons, and McCabe didn’t see him as a tanning salon kind of guy. He was dressed in surgical scrubs.

  McCabe glanced around. There was nothing out of place. The items on Spencer’s desk were precisely arranged. Medical journals on the coffee table were stacked in date order, no untidy edges sticking out. Photographs of Spencer, sometimes alone, sometimes with others, lined one wall. In several he was wearing scrubs, as he was today, standing with people McCabe assumed were grateful patients, happy to be leaving the hospital alive, new hearts beating, their leases on life, at least for the moment, renewed. In one photo Spencer was dressed in black tie and flanked by former president George H. W. Bush, Barbara Bush, and Maine’s Senator Olympia Snowe. A banner behind them indicated they were celebrating the twenty-year anniversary of the Levenson Heart Center.

  To McCabe, the most interesting of the photos showed Spencer, maybe ten years younger, dressed in climbing gear, posing for the camera with a group of three other men all about the same age. A hand-lettered sign in front of them read DENALI SUMMIT. ALT: 20,320 FEET. WE MADE IT! Three of the climbers were smiling proudly into the camera, but Spencer’s face was turned away. He was standing second from the left, his eyes focused on the man standing next to him. McCabe thought there was something unexpected about Spencer’s expression. He couldn’t quite figure out what it was.

  He scanned the rest of the framed photos. Interestingly, there were no shots of the doctor’s wife. None of family vacations. None of Spencer children, if any such children existed.

  McCabe turned away from the photos and looked through the windows behind Spencer’s head. Far in the distance, he could see the distinctive triangular shape of Mount Washington silhouetted in the last of the sun’s setting rays. ‘Pretty spectacular, isn’t it?’ Spencer said, hanging up the phone. ‘One of the rewards of being on the top floor.’

  He pushed some papers into a folder, flicked on his desk lamp, and leaned back in his chair. The light accented the shadows of Spencer’s deep-set, nearly black eyes as they studied McCabe. ‘Sorry about the delay,’ he said. ‘Now, how can I help you, Detective?’

  ‘What do you know about Katie Dubois’s death?’

  ‘Not much. Basically what I read in the paper last week after her disappearance. Katie Dubois was a sixteen-year-old high school girl from Portland. She was a good athlete. A pretty blond. She vanished after a night out in the Old Port. Last night Tom Shockley told me she’d been murdered.’

  McCabe stiffened. ‘How do you know Shockley?’

  ‘We go to the same parties. That’s where we were last night. At a fund-raiser for Kids with Cancer at the Pemaquid Club.’

  The Pemaquid Club was a tony in-town watering hole for Portland’s rich and well connected. It was housed in an elegant redbrick Georgian mansion on the city’s West Side. McCabe doubted there were many cops among its membership rolls.

  ‘What else did he tell you?’

  ‘Not much. We were having a drink together at the bar when he got a call about the murder. I could only hear his end of the conversation, so I asked him what’d happened. He said the girl’s body was found in that scrap yard on Somerset. Naked. Cut up. Maybe raped. Then he took out his phone again and called you and left a message. He said you’d be running the investigation and that he had a lot of confidence in you. That’s it. All I know.’

  ‘Did you watch Shockley’s news conference this morning?’

  ‘Afraid not.’

  ‘What I’m about to tell you is confidential.’

  ‘I understand.’

  ‘Katie Dubois died because her heart was cut out of her body.’ As he spoke, McCabe watched Spencer’s face for signs of reaction. All he saw was a mild curiosity.

  ‘Removing the heart was the cause of death? It wasn’t done postmortem?’

  ‘No.’ McCabe told Spencer most of what Terri Mirab
ito had said about the cause and manner of Katie’s death, leaving out any mention of ligature or burn marks. Or of rape.

  ‘Dr. Mirabito’s right. Removing a heart is not that difficult. Not if you’ve got the proper tools — a scalpel, a reciprocating saw to cut the sternum, a retractor to spread the ribs. Pretty much any surgeon could do it, certainly any cardiac surgeon.’

  ‘Why do you think the murderer — whoever it was — might have wanted to cut out her heart?’

  ‘Me? I haven’t a clue. We both know there are all kinds of crazies in the world. I suppose some of them could be doctors. It was probably something sexual. From her picture, Katie was an attractive girl. People express their sexual fantasies in strange ways, but psychiatry’s not my field of expertise.’

  ‘You’re a transplant surgeon, right?’ asked McCabe. ‘You remove hearts for a living?’

  ‘Not exactly. I’m head of the transplant program here at Cumberland. The goal is to give people new hearts. In each case to save a life. That’s what turns me on. Harvesting — organ retrieval — is more often than not somebody else’s task.’

  ‘What’s it like? Cutting a heart out of a living human being? For a heart surgeon, is it simply all in a day’s work, or is it something somebody might get off on?’

  ‘You mean sexually?’

  ‘Yes.’

  ‘I don’t know. I can tell you it’s never all in a day’s work. Even when you know the heart will be used to save another life. On one level, the human heart is nothing more than a muscle that works like a small pump. Weighs less than a pound. Only a little bigger than your fist. Yet it beats a hundred thousand times a day. Pumps a couple of thousand gallons of blood. Unless we go out of our way to screw it up, it will, most likely, keep on doing that every day for seventy, eighty, even ninety years, often without routine maintenance. Show me another machine that can do anything like that.’ Spencer sounded genuinely excited.