“If I’m to make a statement,” he said, “is there anything I should know? Anything you can tell me?”
“You’ll have to speak to Detective Rizzoli. She’s the lead investigator.”
“Do you think this was an isolated attack? Should other parishes be concerned?”
“I only examine the victims, not the attackers. I can’t tell you his motives.”
“These are elderly women. They can’t fight back.”
“I know.”
“So what do we tell them? All the sisters living in religious communities? That they’re not safe even behind walls?”
“None of us is entirely safe.”
“That’s not the answer I want to give them.”
“But it’s the one they have to hear.” She opened her car door. “I was raised Catholic, Father. I used to think nuns were untouchable. But I’ve just seen what was done to Sister Camille. If that can happen to a nun, then no one is untouchable.” She slid into her car. “Good luck with the press. You have my sympathies.”
He closed her car door and stood looking at her through the window. As striking as his face was, it was that clerical collar that drew her gaze. Such a narrow band of white, yet it set him apart from all others. It made him unattainable.
He raised his hand in a wave. Then he looked toward the pack of reporters, who were even now closing in on him. She saw him straighten and take a deep breath. Then he strode forward to meet them.
“In light of the gross anatomical findings, as well as the subject’s known history of hypertension, it is my opinion that this death was from natural causes. The most likely sequence of events was an acute myocardial infarction, occurring within the twenty-four hours prior to death, followed by a ventricular arrhythmia, which was the terminal event. Presumptive cause of death: fatal arrhythmia secondary to acute myocardial infarction. Dictated by Maura Isles, M.D., Office of the Medical Examiner, Commonwealth of Massachusetts.”
Maura turned off the Dictaphone and stared down at the preprinted diagrams on which she had earlier recorded the landmarks of Mr. Samuel Knight’s body. The old appendectomy scar. The blotches of lividity on his buttocks and the underside of his thighs, where blood had pooled during the hours he had sat, lifeless, on his bed. There had been no witnesses to Mr. Knight’s final moments in his hotel room, but she could imagine what went through his mind. A sudden fluttering in his chest. Perhaps a few seconds’ panic, when he realizes that the fluttering is his heart. And then, a gradual fadeout to black. You were one of the easy ones, she thought. A swift dictation, and Mr. Knight could be set aside. Their brief acquaintance would end with the scrawl of her name on his autopsy report.
More reports sat in her in-box, a stack of transcribed dictations needing her review and signature. In cold storage, yet another new acquaintance waited for her: Camille Maginnes, whose autopsy was scheduled for nine o’clock the next morning, when both Rizzoli and Frost could attend. Even as Maura flipped through reports, jotting corrections in the margins, her mind was still on Camille. The chill she’d felt in the chapel that morning had not left her, and she kept her sweater on as she worked at her desk, bundled against the memory of that visit.
She rose from her chair to feel whether her wool slacks, which she’d left hanging over the radiator, were now dry. Close enough, she thought, and quickly untied her waist drawstring and slipped out of the scrub pants she’d worn all afternoon.
Sinking back into her chair, she just sat for a moment, eyeing one of the floral prints on her wall. To counteract the grimness of her job, she had decorated her office with reminders of life, not death. A potted ficus thrived in the corner of the room, the happy recipient of constant fussing and attention by both Maura and Louise. On the wall were framed images of flowers: a bouquet of white peonies and blue irises. Another with a vase of centifolia roses, the blossoms so lush with petals that the stems drooped. When the stack of files grew too tall on her desk, when the weight of death seemed overwhelming, she would look up at those prints and think of her garden, and of the smell of rich soil and the bright green of spring grass. She would think of things growing, not dying. Not decaying.
But on this December day, spring had never seemed so distant. Freezing rain was tapping against the window, and she dreaded the drive home. She wondered if the city had salted the roads yet, or if it would still be an ice rink out there, cars sliding like hockey pucks.
“Dr. Isles?” said Louise over the intercom.
“Yes?”
“There’s a Dr. Banks on the phone for you. He’s on line one.”
Maura went very still. “Is it … Dr. Victor Banks?” she asked softly.
“Yes. He said he’s with the charity One Earth International.”
Maura said nothing, her gaze fixed on the phone, her hands frozen on the desk. She was scarcely aware of the sleet hitting the window. She heard only the pounding of her own heart.
“Dr. Isles?”
“Is he calling long distance?”
“No. He left a message earlier. He’s staying at the Colonnade Hotel.”
Maura swallowed. “I can’t take his call right now.”
“It’s the second time he’s called. He said he knows you.”
Yes. He certainly does.
“When did he call before?” Maura asked.
“This afternoon, while you were still at the scene. I did leave his message on your desk.”
Maura found three pink while you were out memos, which were hidden beneath a stack of folders. There it was. Dr. Victor Banks. Called at 12:45 P.M. She stared at the name, her stomach churning. Why now? She wondered. After all these months, why do you suddenly call me? What makes you think you can step back into my life?
“What should I tell him?” asked Louise.
Maura took a deep breath. “Tell him I’ll call back.” When I’m goddamn ready.
She crumpled the slip and threw it into the rubbish can. Moments later, unable to focus on her paperwork, she rose and pulled on her coat.
Louise looked surprised to see her emerge from her office, already bundled up for the weather. Maura was usually the last to leave, and almost never out the door before five-thirty. It was barely five now, and Louise was just shutting down her computer for the night.
“I’m going to get a head start on the traffic,” said Maura.
“I think it’s too late for that. Have you seen the weather? They’ve already closed most city offices for the day.”
“When was that?”
“At four o’clock.”
“Why are you still here? You should have gone home.”
“My husband’s coming to get me. My car’s in the shop, remember?”
Maura winced. Yes, Louise had told her about the car that morning, but of course she’d forgotten. As usual, her mind had been so focused on the dead, she had not paid enough attention to the voices of the living. She watched Louise wrap a scarf around her neck and pull on her coat and thought: I don’t spend enough time listening. I don’t take the time to acquaint myself with people while they’re alive. Even after a year of working in this office, she knew little about her secretary’s personal life. She’d never met Louise’s husband, and knew only that his name was Vernon. She could not recall where he worked, or what he did for a living, partly because Louise seldom shared personal information about her life. Is that my fault? Maura wondered. Does she sense that I’m not a willing listener, that I’m more comfortable with my scalpels and Dictaphone than I am with the feelings of people around me?
Together, they walked down the hall, toward the exit leading to the staff parking lot. No small talk, just two parallel travelers, headed toward the same destination.
Louise’s husband was waiting in his car, its windshield wipers swinging furiously against the falling sleet. Maura gave a goodbye wave as Louise and her husband drove off, and got a puzzled look from Vernon, who probably wondered who that woman was, waving as though she knew them.
As though she
really knew anyone.
She crossed the parking lot, slipping on the glazed blacktop, her head bent under stinging pellets of sleet. She had one more stop to make. One more duty to execute before her day was over.
She drove to St. Francis Hospital to check on the status of Sister Ursula.
Although she had not worked in a hospital ward since her internship years ago, the memories of her final rotation in the intensive care unit remained vividly unpleasant. She remembered moments of panic, the struggle to think through the fog of sleep deprivation. She remembered a night when three patients had died on her shift, and everything had gone wrong at once. She could not walk into an ICU now without feeling haunted by the shadow of old responsibilities and old failures.
The surgical intensive care unit at St. Francis had a central nursing station surrounded by twelve patient cubicles. Maura stopped at the ward clerk’s desk to show her identification.
“I’m Dr. Isles, from the Medical Examiner’s office. May I see the chart for your patient, Sister Ursula Rowland?”
The ward clerk eyed her with a puzzled look. “But the patient hasn’t expired.”
“Detective Rizzoli asked me to check on her condition.”
“Oh. The chart’s in that slot over there. Number ten.”
Maura crossed to the row of cubbyholes and pulled out the aluminum cover containing Bed #10’s hospital chart. She opened it to the preliminary operative report. It was a handwritten summary, scrawled by the neurosurgeon immediately after surgery:
“Large subdural hematoma identified and drained. Open right parietal comminuted skull fracture debrided, elevated. Dural tear closed. Full operative report dictated. James Yuen, M.D.”
She turned to the nurses’ notes, and skimmed the patient’s progress since surgery. The intracranial pressures were holding steady, with the help of intravenous Mannitol and Lasix, as well as forced hyperventilation. It appeared that everything that could be done was being done; now it was a waiting game, to see how much neurological damage would result.
Carrying the chart, she crossed the unit to Cubicle #10. The policeman sitting outside the doorway gave her a nod of recognition. “Hey, Dr. Isles.”
“How is the patient doing?” she asked.
“About the same, I guess. I don’t think she’s woken up yet.”
Maura looked at the closed curtains. “Who’s in there with her?”
“The doctors.”
She knocked on the doorframe, and stepped through the curtain. Two men were standing by the bed. One was a tall Asian man with a darkly piercing gaze and a thick mane of silver hair. The neurosurgeon, she thought, seeing his name tag: Dr. Yuen. The man who stood beside him was younger—in his thirties, with robust shoulders filling out his white coat. His long blond hair had been pulled back into a neat ponytail. Fabio as M.D., thought Maura, regarding the man’s tanned face and deep-set gray eyes.
“I’m sorry to intrude,” she said. “I’m Dr. Isles, from the Medical Examiner’s office.”
“The M.E.’s office?” said Dr. Yuen, looking baffled. “Isn’t this visit a little premature?”
“The lead detective asked me to check in on your patient. There is another victim, you know.”
“Yes, we’ve heard.”
“I’ll be doing that postmortem tomorrow. I wanted to compare the pattern of injuries between these two victims.”
“I don’t think there’s much you’ll be able to see here. Not now, after surgery. You’ll learn more by looking at her admission X rays and head scans.”
She gazed down at the patient, and could not disagree with him. Ursula’s head was encased in bandages, her injuries by now altered, repaired by the surgeon’s hand. Deeply comatose, she was breathing with the aid of a ventilator. Unlike the slender Camille, Ursula was a woman of large proportions, big-boned and solid, with the plain, round face of a farmer’s wife. IV lines coiled over meaty arms. On her left wrist was a Medic Alert bracelet, engraved with “Allergic to Penicillin.” An ugly scar tracked, thick and white, over the right elbow—the aftermath of an old injury, badly sutured. A souvenir from her work abroad? Maura wondered.
“I’ve done what I could in the O.R.,” said Yuen. “Now let’s hope Dr. Sutcliffe here can head off any medical complications.”
She looked at the ponytailed physician, who gave her a nod, a smile. “I’m Matthew Sutcliffe, her internist,” he said. “She hasn’t been in to see me for several months. I didn’t even know she was admitted to the hospital until a little while ago.”
“Do you have her nephew’s phone number?” Yuen asked him. “When he called me, I forgot to get it from him. He said he’d be talking to you.”
Sutcliffe nodded. “I have it. It’ll be easier if I’m the one who stays in touch with the family. I’ll let them know her status.”
“What is her status?” asked Maura.
“I’d say she’s medically stable,” said Sutcliffe.
“And neurologically?” She looked at Yuen.
He shook his head. “It’s too early to say. Things went well in the O.R., but as I was just telling Dr. Sutcliffe here, even if she regains consciousness—and she very well may not—it’s likely she won’t remember any details of the attack. Retrograde amnesia is common in head injuries.” He glanced down as his beeper went off. “Excuse me, but I need to get this call. Dr. Sutcliffe can fill you in on her medical history.” In just two quick strides, he was out the door.
Sutcliffe held out his stethoscope to Maura. “You can examine her, if you’d like.”
She took the stethoscope and moved to the bedside. For a moment she just watched Ursula’s chest rise and fall. Seldom did she examine the living; she had to pause to call back her clinical skills, acutely aware that Dr. Sutcliffe was a witness to just how out of practice she felt when examining a body whose heart was still beating. She had worked so long with the dead that she now felt clumsy with the living. Sutcliffe stood at the head of the bed, an imposing presence with his broad shoulders and intent gaze. He watched as she shone a penlight into the patient’s eyes, as she palpated the neck, her fingers sliding across the warm skin. So different from the chill of refrigerated flesh.
She paused. “There’s no carotid pulse on the right side.”
“What?”
“There’s a strong pulse on the left, but not the right.” She reached for the chart and opened it to the O.R. notes. “Oh. The anesthesiologist mentions it here. ‘Absent right common carotid artery noted. Most likely a normal anatomical variation.’ ”
He frowned, his tanned face flushing. “I’d forgotten about that.”
“So it’s an old finding? The lack of a pulse on this side?”
He nodded. “Congenital.”
Maura slipped the stethoscope onto her ears and lifted the hospital gown, exposing Ursula’s large breasts. The skin was still pale and youthful despite her sixty-eight years. Decades of protection beneath a nun’s habit had spared her from the sun’s aging rays. Pressing the diaphragm of the stethoscope to Ursula’s chest, she heard a steady, vigorous heartbeat. A survivor’s heart, pumping on, undefeated.
A nurse poked her head into the cubicle. “Dr. Sutcliffe? X-ray called to say that the portable chest film’s ready, if you want to go down and see it.”
“Thanks.” He looked at Maura. “We can look at the skull films too, if you’d like.”
They shared the elevator with six young candy stripers, fresh-faced and glossy-haired, giggling among themselves as they shot admiring glances at Dr. Sutcliffe. Attractive though he was, he seemed oblivious to their attention, his solemn gaze focused instead on the changing floor numbers. The glamour of a white coat, thought Maura, remembering her own teenage years working as a volunteer in St. Luke’s Hospital in San Francisco. The doctors had seemed untouchable to her. Unassailable. Now that she herself was a doctor, she knew only too well that the white coat would not protect her from making mistakes. It would not make her infallible.
She looked at the c
andy stripers in their crisp uniforms, and thought of herself at sixteen—not giggly, like these girls, but quiet and serious. Even then, aware of life’s dark notes. Instinctively drawn to melodies in a minor key.
The elevator doors opened, and the girls spilled out, a sunny flock of pink and white, leaving Maura and Sutcliffe alone in the elevator.
“They make me tired,” he said. “All that energy. I wish I had a tenth of it, especially after a night on call.” He glanced at her. “Do you have many of those?”
“Nights on call? We rotate.”
“I guess your patients don’t expect you to rush in.”
“It’s not like your life here in the trenches.”
He laughed, and suddenly he was transformed into a blond surfer boy with smiling eyes. “Life in the trenches. That’s what it feels like sometimes. The front lines.”
The X rays were already waiting for them on the clerk’s counter. Sutcliffe carried the large envelope into the viewing room. He slid a set of films under the clips and flipped on the switch.
The light flickered on through images of a skull. Fracture lines laced across bone like lightning strikes. She could see two separate points of impact. The first blow had landed on the right temporal bone, sending a single fine crack downward, toward the ear. The second, more powerful, had fallen posterior to the first blow, and this one had compressed the plateau of cranium, crushing it inward.
“He hit her first on the side of the head,” she said.
“How can you tell that was the first blow?”
“Because the first fracture line stops the propagation of an intersecting fracture from a second blow.” She pointed to the fracture lines. “You see how this line stops right here, where it reaches the first fracture line? The force of impact can’t jump across the gap. That tells me this blow to the right temple came first. Maybe she was turning away. Or she didn’t see him, coming at her from the side.”
“He surprised her,” said Sutcliffe.
“And it would have been enough to send her reeling. Then the next blow landed, farther back on the head, here.” She pointed to the second fracture line.
The Rizzoli & Isles Series 11-Book Bundle Page 67