Full Dress Gray

by Lucian K. Truscott

  She handed him the printout from the blood tests and he examined it carefully.

  “She’s got a slightly elevated blood-sugar level here.”

  “Yes sir, I noticed that, and I went back and checked a blood test that was done on her about a year ago, when she had a standard cadet physical exam. Her blood sugar was about the same, slightly elevated, so I didn’t take much notice of it.”

  “Could be significant, and then again, it could be normal for this particular individual. Blood sugar can vary. Mine’s a tad below normal.” He ran his finger down the test results and looked up. “I see you didn’t order a serum cortisol on her.”

  “No sir.”

  “It’s not a standard test, but given the condition of her lungs, I’d say we’d better run one. Did you bring extra blood samples?”

  “Yes sir.” She reached in her briefcase, pulled out a small foam container and removed a test tube of Dorothy’s blood. Colonel Knight called to one of the technicians and handed her the test tube.

  “Run a serum cortisol level on this sample, please,” he said. The technician took the test tube and went through a door into another part of the lab.

  “You want to go for a walk while we wait for the test results?” asked the colonel.

  “Sure.”

  He picked up a paper bag, and they exited the Pathology Institute and wandered down a winding path through Walter Reed’s parklike grounds. Colonel Knight reached into the bag and pulled out a plastic Ziploc of peanuts and shook it. Instantly, three squirrels scampered down the trunk of an oak tree and gathered at his feet, squatting on their hindquarters and making little chirping sounds. He tossed each of them a peanut, and they took off in three separate directions. The two officers sat down on a shaded bench. The colonel tossed another peanut to one of the squirrels. “I come out here to think. It’s quiet, and feeding these guys is just distracting enough to give your mind some time to wander.”

  “I’d forgotten how beautiful it is here,” said Major Vernon.

  “You need time in the day like this in our line of work.” He chuckled. “Contemplating the whys and wherefores of dead folks all day gets a little old after a while.”

  “Did you ever wish you’d taken up another field of medicine?”

  “Nope. This one suits me just fine. After all, it’s the only kind of doctoring you can do where nobody ever dies on you.”

  Major Vernon laughed. “Even dermatologists get an occasional fatal case of melanoma.”

  “Podiatrists have a negligible mortality rate, although I met one guy who lost a patient to a far-gone case of gangrene.”

  “I guess a pretty dark sense of humor comes with the territory,” said Major Vernon.

  “It helps.”

  “Can I ask why the cortisol test occurred to you, sir?” asked Major Vernon.

  “You may,” he smiled.

  She grinned. He had played the same game with her when she was going through training. He was waiting for her to answer her own question. “Okay. We’ve got severe lung inflammation which was present at the time of death and was not merely a contributing factor, but most probably causal. She was reported to be asymptomatic by her fellow cadets before parade. There’s an interview with more than one cadet who reported that she was acting normally in ranks as they formed up in the area of barracks. You’re figuring that the inflammation present at time of death didn’t occur between the formation in the area of barracks and her death at parade maybe thirty minutes later.”

  “Correct.”

  “So some level of inflammation was probably present previously that morning.”

  “Correct.”

  “And if she was asymptomatic, she was treating the condition.”

  “Correct again.”

  “With prednisone, or some other corticosteroid.”

  “Correct. We’ll get some kind of indication if our theory is right with the serum cortisol test results.”

  “If we’re right, and she was treating herself with a corticosteroid, where was she getting it?”

  “An off-post doctor, perhaps. It’s available over the counter in foreign countries.”

  Major Vernon’s eyes widened. “I studied her entire cadet file. She was stationed at Fort Bliss, Texas, over the summer for training. Across the river from Juarez.”

  “There you go.” The cell phone on Colonel Knight’s belt jingled and he unclipped the phone. “You’ve got the results? We’ll be right there.”

  Colonel Knight and Major Vernon made their way back to the Pathology Institute and entered the downstairs lab. The specialist who ran the blood test handed Colonel Knight the results. He thanked her and quickly scanned the printout. “Yep. There’s the cortisone, right off the scale. She was loaded up on the stuff.” He handed the printout to Major Vernon.

  “Jeez. How much do you figure she was taking?” asked Major Vernon.

  “It’s just a guess, but I’d have to say sixty milligrams or more.”

  “With a dose like that, why wasn’t it working?”

  “It was. She was asymptomatic an hour before death.”

  “Then she must have suffered a flare-up.”

  “Correct. And now the question is why she was treating herself outside normal military medical channels.”

  “That’s an easy one. A lung condition as chronic as we found would disqualify her for commissioning. She was eight months away from graduation. The pressure she must have felt to make it through her senior year and graduate must have been incredible. She was hiding her condition and self-administering the corticosteroids to keep herself from being medically discharged.”

  “That sounds about right to me.”

  “So what are we going to do about our steroid-popping cadet, sir?”

  Colonel Knight pondered the question for a moment. “It would be nice if we had a diagnosis and could pinpoint exactly what condition she was suffering from. Your slides look an awful lot like asthma, which could account for the sudden flare-up she apparently suffered.”

  “In what way?”

  “An allergic reaction can exacerbate asthma, sometimes greatly so. Let’s say she had an allergy to freshly mown grass, and they had just mowed the parade grounds that morning. That alone might have been enough to cause a flare-up. Then there’s the possibility there was a bacteriological or viral cause of the flare-up.”

  “I ran the standard cultures and found no sign of pneumonia or bronchitis, typical or atypical.”

  “Did you take samples from her nasal passages and sinuses?”

  “Yes sir. There was some mucus, but it was clear and not present in gross quantity.”

  “So the likelihood of her having contracted one of the rhinoviruses is small, but not out of the question.”

  “Yes sir.”

  “There’s the possibility that the corticosteroid she was taking interacted with another drug.”

  “We didn’t find any illicit substances in her blood test.”

  “Wouldn’t have to be illicit. Take Turns, for example.”

  “Turns?"

  “Antacids can bind steroids in the intestine so the drug is not well absorbed.”

  “But she had an incredibly high cortisol level in her bloodstream at the time of death.”

  “Yes, but the level of the drug in her lungs might have been much lower.”

  “I’m not following you, sir.”

  “The adrenal glands are thought to produce most of the naturally occurring cortisol within the body in the morning, which is why steroids are normally taken in the morning, so as to mimic the body’s production. But when you’re on high doses of a steroid like prednisone, the adrenals virtually shut down. Her high cortisol level can be attributed to several factors. Her time of death was what?”

  “Ten A.M.”

  “Let us suppose she took the prednisone, if that’s what she took, about two hours earlier. Suppose she had taken an antacid about the same time. There would be reduced absorption into the bloodstream.
Yet the dose she took the day before could still account for her high blood level if it wasn’t properly eliminated by the body.”

  “How would that happen?”

  “Constipation might do it, along with a reduced intake of fluids and consequent reduced urination.”

  “She had a full bladder at time of death and it appeared that she hadn’t had a bowel movement in more than twenty-four hours.”

  “There you go.”

  “But why would this lead to a lower level of drug in the lungs?”

  “A dose of steroids usually lasts in the body several hours, but the effects are far more long-lasting. Let’s suppose she took a dose the day before and the effects were tapering off the following morning. She takes another dose that morning, but its absorption is blocked or reduced by one or more of the factors we’ve discussed. The cortisol blood level would be fairly high, while the active presence in the lungs, which would come primarily from the most recent dose, could be low, or even negligible. If there was an allergic reaction that tripped the flare-up, a low level of corticosteroids in the lungs would leave them unable to fight the inflammation, and bingo—you’ve got a respiratory emergency, failure to oxygenate the blood stream, and cardiac arrest.”

  “Can we prove that scenario?”

  “Maybe, maybe not. But we’ve got something to go on. Was there anything else you found that might help us?”

  “Yes sir. I found an abraded area in the labia. I took a vaginal sample and sent it down to Rockville, Maryland.”

  “Did you request DNA analysis?”

  “Yes sir.”

  “We’re backstopping Rockville on DNA these days. Let’s get back to the office. Maybe we’ve got some answers for you.”

  Back in his office, Colonel Knight picked up the phone and quickly dialed an interoffice number. “Ben? Phil Knight. Have you got a minute?” He leaned back and fiddled with the phone cord. “Did you log in a vaginal sample from a Major Vernon at West Point about a week ago?” Listening, Colonel Knight nodded to Major Vernon and gave her a thumbs up. “How far along are you? Two more weeks? Okay, thanks, Ben.”

  “Did I hear you say two weeks?” She sounded shocked.

  “He said the process used to separate out different DNA from a single sample is very complicated. They just developed the process recently, and they’re still feeling their way. He doesn’t want to make any mistakes.”

  “So you’ll call me when the test results are in?”

  “Of course I will.”

  Major Vernon stood. “I think I’d better be getting back to the Academy, sir. They’re chomping at the bit up there. Even though these are only partial results, they are significant, and the authorities are going to want an immediate briefing.”

  They shook hands and Colonel Knight walked her back to her rental car. “I’ll give you a ring the minute I get the DNA results on your sample.”

  “Thanks, sir.”

  CHAPTER 11

  * * *

  EVEN THOUGH temperatures at West Point had reached into the high nineties at Labor Day, only two weeks later there was an icy chill in the night air, and fog had rolled off the Hudson across the Plain and pressed against the barracks threateningly. Every cadet knew what the gray mists outside the windows meant. Within a month or so, cadets would be going to class in overcoats and scarves with their collars turned up against the icy winds that blew down the Hudson.

  An early meeting had prevented the Superintendent from taking his usual morning jog, so he waited until a few hours after supper to pull on a pair of sweats and head up Washington Road. Headlights poked through the fog ineffectually as cars crept along the damp street feeling their way through the soup. He passed a few cadets making their way back to the barracks before taps. They saluted sharply, making the safe assumption that he was probably an officer.

  It comforted Slaight that the rhythms of life at West Point had not changed much since he was a cadet. The day began early, at six A.M., when the “Hellcats,” the Army drum and bugle corps, blew reveille in each of the cadet areas of barracks. Even though cadets mercifully didn’t have to report outside for reveille formation anymore, they were still saddled with making beds and cleaning rooms and preparing their living areas for inspection. Then came breakfast, when the entire Corps sat down together to eat in the mess hall, and then, at 7:15, began the academic day, which was a full one. Most cadets took two classes in the morning and two in the afternoon. The academic system was much the same as it had been when Sylvanus Thayer, the Academy’s first really effective Superintendent, organized it nearly two hundred years ago. Classes were taught in small “sections” of fifteen to twenty cadets, and each cadet was tested and received a grade in every class, every day. This put cadets under intense pressure to study each night and be prepared for class the next day, because they knew beforehand that class performance counted. There was virtually no chance to relax, slough off your studies, and wait until the end of the semester to cram for exams, because you took an exam every day. It was one of West Point’s true oddities that final-exam week at the end of each semester was a time of relaxation for many cadets, who hardly needed to cram for finals when they had crammed every night of the entire semester for daily exams in each of their subjects.

  At the close of the academic day, cadets headed out of the barracks in every direction on their way to various athletic activities. Many participated in Corps Squad sports, like football or soccer or lacrosse or rugby or swimming or wrestling. Anyone not on a Corps Squad played intramural athletics, which ran the gamut from tennis and flag football to canoe racing and orienteering. After athletics came supper, and then back to the barracks for studies and cadet duties until taps at 11:00 P.M.

  An important part of the West Point system was to test to the breaking point cadets’ abilities to organize their time and use it as efficiently as possible. That was why each day was so full and there was such precious little free time. Cadets were expected to make hard choices about how to use their time. Those who chose well enjoyed success in their cadet careers. Those who chose poorly could easily end up failing and being expelled from the Academy. The system was ruthless. One failing grade, in one course, one semester, was enough for expulsion. Slaight had known one guy who flunked squash and less than a month later found himself in civilian clothes, headed back to his life in Kansas, or Ohio, or wherever he had come from.

  On an impulse, instead of turning around at Washington Gate and heading straight home, Slaight took a turn and jogged down an alley behind the quarters known as Colonel’s Row along Washington Road. The alley was dark, illuminated only by small light fixtures above each garage door. He had stopped behind a parked car to tie a loose shoelace when he heard the gentle hum of a garage-door opener and looked up. In the darkened garage, he saw two figures kissing passionately. Standing, he slipped and kicked loose gravel against the car’s hubcap. At the sound, the figures inside the garage broke their embrace and ducked out of sight. The light over the garage door went out. For an instant, he thought he should identify himself so they wouldn’t think he was an intruder; then he noticed the car parked inside the garage. It was a Porsche 911, one of only a few he’d seen on the post. He went ahead and jogged past the garage. The people inside must have crouched behind the car in the dark, because he couldn’t see them. But he could see the West Point sticker on the bumper. The Porsche belonged to General Gibson, the Commandant of Cadets.

  Slaight wondered if he had been recognized as he jogged past, but he thought not. He had his sweatshirt hood up, and without the garage light, the alley was totally dark. He hadn’t seen their faces, but he could see enough from the light over the garage door to know that one was a stockily built man of medium height, and the other was a woman with light-colored, possibly blond, shoulder-length hair.

  It was possible that someone else was driving the Com’s car. He had a son who was going to college nearby in Connecticut. But the man kissing the woman in the garage fit the Commandant’s
body shape, and in the dim light, his hair looked just like Gibson’s crew cut. He made a mental note of the quarters number over the garage.

  By the time he got home, he had begun to question his sanity. What was he, anyway? A Peeping Tom? He stripped off his sweats and stepped into a hot shower. So what if Gibson was knocking off a piece? He laughed out loud.

  “What’s so funny, hon?” his wife asked.

  He flipped the shower curtain aside. She was at the sink, brushing her teeth. “You’ll never guess in a million years what I saw while I was out jogging tonight.”

  “I give up.”

  “I was running down the alley behind the quarters on Washington Road, and one of the garage doors opened, and I think I saw Gibson in there making out with somebody.” He turned off the shower, grabbed a towel, and dried off.

  “Gibson? You mean straitlaced-holier-than-thou Jack Gibson?”

  “I couldn’t see his face or hers, but the Porsche parked in the garage was definitely his, and the guy had a crew cut, real short.”

  “Whose quarters was it?”

  “Number One-twenty-five. There wasn’t any name.”

  “It’s the Messicks’. Remember them? They were just down Grant Avenue from us at Leavenworth.”

  “Yeah, Dick is professor of social science. I saw him just the other day at a meeting of the Academic Board.”

  “I happen to know Dick is attending a conference at Princeton this week. He received his Ph.D. from Princeton, submitting some kind of paper he wrote.”

  “How do you know that?”

  “Betty Jones told me at the Officers’ Wives Club Luncheon yesterday. She said they’re encouraging all of the professors to attend these academic conferences. It’s part of the Academy’s certification thing.”

  “Right. The Dean told me all about it when he briefed me a couple of weeks ago,” he said.

  “So you saw goody-two-shoes Gibson in a lip-lock with Helen Messick? Very interesting.”

  “I’m not sure. All I could see was that a man and a woman were kissing. There wasn’t much light, but I think she had blond hair.”