Marker

by Robin Cook

  “Tell me why you don’t buy it.”

  “First, the punched-out, depressed fracture is on the top of the head,” Jack said, warming to the conversation. “That’s hard to do if you’re falling in a bathroom, unless you’re a contortionist. Second of all, look at these patterns of bruises on the inside of her upper arms!” Jack pointed to linear groupings of petechiae, which Laurie could see when she looked closer.

  “Next, notice the tan lines on her wrist and ring finger. She’d spent some serious time in the sun on the cruise, with what looks like quite a rock on her finger and a wristwatch. And guess what? No ring and no watch in the stateroom. I have to hand it to the tour doctor. Despite the hour, he was thinking in high gear. They had cleaned up the stateroom and the bathroom, but he still asked the right questions.”

  “So you think it was homicide.”

  “No question, despite the cruise company’s comments to the contrary. Of course, I’ll just be reporting the findings, but if anybody asked my opinion, I’d tell them that this woman was viciously knocked on the head with some kind of hammer, rudely dragged by her arms into her stateroom while still alive, robbed, and left to die.”

  “Sounds like a good case to emphasize that deaths among the elderly are in some respects similar to deaths involving child abuse.”

  “That’s exactly right,” Jack said. “Since the elderly are expected to die, there is less suspicion of foul play than with a younger person.”

  “It’s a good teaching case,” Laurie said, trying to put on a good face before moving on to her table. Although she was leaving the exchange on a reasonable note, its overall character was more evidence of how difficult it was going to be to have any kind of serious discussion with Jack about their relationship even if he was so inclined. But she put the thought out of her mind as she looked down on the body of Rowena Sobczyk.

  “Do you suspect anything out of the ordinary on this case?” Marvin asked.

  “Nope. I believe it is going to be straightforward,” Laurie said as her trained eye began the external exam. Her first impression was that the woman looked considerably younger than the reputed twenty-six years. She was tiny with delicate, almost preadolescent features as well as thick, youthful-appearing curly black hair. Her skin was almost blemish-free and ivory-white, except for areas of dependent lividity. Both feet were bandaged, consistent with her surgery. The bandages were clean and dry.

  Like with McGillin and Morgan, the remnants of the resuscitation attempt were still in place, including the endotracheal tube and the IV line. Laurie checked them carefully before removing them. She looked for signs of drug abuse and found none. She took off the bandages. The surgical incisions showed no signs of inflammation, and only minimal drainage.

  The internal portion of the autopsy was the same as the external: negative for any obvious pathology. In particular, the heart and the lungs were entirely normal. The only finding was several cracked ribs from the resuscitation attempt. As with the other cases, Laurie made certain that she got more than adequate samples from all the usual places for toxicology screening. She was not about to give up hope that Peter would succeed with his magic on one of the cases.

  “Do you want to do the second case right away?” Marvin asked when they had finished sewing the body back together.

  “Absolutely,” Laurie said. To expedite the transition, Laurie helped. As they passed Jack’s table on the way out and again on the way in, Laurie made sure she didn’t hesitate. She didn’t want to be embarrassed again by any of his comments. If he saw her, he did not let on. By that time, the room was in full operation with lots of people coming and going, and in their moon suits, everyone looked rather similar. Thanks to the glare of the overhead lights, it was difficult to see through the plastic face masks.

  As soon as they moved Stephen Lewis onto the table and into position, Laurie began her external exam. Meanwhile, Marvin went to get the specimen bottles and other materials for the case. Laurie forced herself to follow her usual protocol to avoid missing anything. Although her expectations were high that Stephen Lewis would be like the others in the sense of having no significant pathology, she wanted to be thorough, and her methodical approach paid off almost immediately. Barely discernable but definitely present was a small amount of crusted blood under the nails of his right index and ring finger. If she hadn’t specifically looked, she would have missed it. It was something she’d not seen with Sobczyk, Morgan, or McGillin, and George and Kevin had not described it in the autopsy notes on the other two cases.

  Putting Lewis’s hand back down on the table, Laurie began a careful search for any scratches on the man’s body that might account for the dried blood. There were none. Nor was there any bleeding at the IV site. Next, she removed the bandages covering the right shoulder. The surgical incision was closed and showed no signs of inflammation, although there was some evidence of postoperative bleeding, with a bit of crusted blood along the suture line. Laurie thought there was a chance this blood could have been the source of the blood under the nails although it seemed strange, since it was his right hand.

  When Marvin came back, Laurie asked for a sterile swab and two specimen containers. She wanted to do a DNA fingerprint on both samples just to make sure they matched the victim. When she took the samples, she sensed that there was a small amount of tissue as well. In the back of her mind was the titillating thought that if her serial-killer idea had any merit and if Lewis had had a hint of the killer’s intentions and if he could have gotten hold of him, maybe he could have scratched him. That was a lot of ifs, but Laurie prided herself on being meticulous.

  The rest of the case went quickly. Laurie and Marvin had become accustomed to each other such that they functioned as a well-orchestrated team that required minimum conversation. Each anticipated the other’s motions like tango dancers. Once again, there was almost no pathology. The only findings were minimal atheroma formation in the abdominal aorta and a benign-appearing polyp in the large intestine. There was no explanation for the man’s sudden death.

  “Is this your last case?” Marvin asked after taking the needle holder from Laurie when she had finished sewing up the body.

  “It seems that way,” Laurie said. She looked around the room to see if she could make out Chet, but she couldn’t. “I guess we’re done. Someone would have said something to me by now.”

  “Both these cases this morning remind me of those two we did a month or so ago,” Marvin said as he began cleaning up the instruments and collecting the specimen bottles. “Remember those two when we found nothing significant? I can’t remember their names.”

  “McGillin and Morgan,” Laurie said. “Certainly I remember, and I’m impressed you do as well, considering the number of cases you’re involved with.”

  “I remembered them because of how much they bugged you not finding anything. Hey, do you want to take these specimen samples with you, or do you want them to go up with all the rest?”

  “I’ll take the toxicology and DNA samples,” Laurie said. “The microscopic can go with the others. And thanks for reminding me. I must say, I’m appreciating you more and more.”

  “That’s cool,” Marvin responded. “Likewise from my end. I wish all the docs were like you.”

  “Now that would be boring,” Laurie said with a laugh as she gathered up the samples. She walked past Jack’s table once again without stopping. She could hear him and Vinnie laughing over what had probably been some black humor. Laurie disinfected herself and the sample bottles before emerging into the hallway.

  Not wasting any time, she got out of her protective gear and plugged her battery into the charger. Without even changing out of her scrubs, she headed for the back elevator. She carried the clutch of sample bottles against her chest to keep from dropping them. The two folders were under her arm. As she rode up to the fourth floor, she could feel her pulse in her temples. She was excited. The posts had confirmed Janice’s assessment. Laurie was now confident that her serie
s now stood at six.

  Getting off on the fourth floor, Laurie cautiously peered into the toxicology lab. In her attempt to avoid the temperamental lab director, Laurie was reduced to sneaking around. Luckily, he stayed mostly in the general lab on the floor below. Feeling like a cat with its ears down, Laurie scurried diagonally across the lab and into Peter’s tiny office. She was glad when she didn’t hear someone call out her name. She was even more glad that Peter was at his desk, meaning she didn’t have to seek him out.

  “Oh, no!” Peter moaned teasingly when he looked up from his work and spotted the samples in Laurie’s arms.

  “I know you’re not happy to see me,” Laurie said. “But you are the man! I need you more than ever. I’ve just posted two more patients that are the mirror image of the others. There are now six.”

  “I don’t know how you can say I’m the man, because so far, I’ve come up with a big blank.”

  “I haven’t given up hope, so you can’t, either.” Laurie dumped the samples onto Peter’s desk. Some of them threatened to roll off. Peter grabbed several and righted them. “Now that there are six cases, the idea of skulduggery goes up. Peter, you’ve got to find something. It has to be there.”

  “Laurie, I did everything I could think of with the other four cases. I looked for every known agent that affects cardiac rhythm.”

  “There has to be something you haven’t thought of,” Laurie insisted.

  “Well, there are a couple of other things.”

  “Okay, like what?”

  Peter made a face and scratched his head. “I mean, this is way out in left field.”

  “That’s okay. We need some creativity here. What are you thinking about?”

  “In the back of my mind, I remember reading something when I was in graduate school about a poison frog from Colombia called Phyllobates terribilis.”

  Laurie rolled her eyes. “I’ll say you’re getting a bit far afield. But it’s okay. What about these frogs?”

  “Well, they contain a toxin that’s one of the most toxic substances known to man. If I remember correctly, it’s capable of causing cardiac arrest.”

  “Sounds interesting! Have you tested for it?”

  “Not really. I mean, so little of the toxin is needed, like millionths of a gram. I don’t know whether it would show up with the sensitivity of our machine. I’ll have to find out where to look.”

  “That’s the spirit. I’m sure you are going to find something, especially with these two additional cases.”

  “I’ll go online and see what I can learn.”

  “I appreciate it,” Laurie said. “And keep me posted!” She picked up the DNA samples and started to leave, but then she stopped. “Oh, by the way, there was something slightly different with one of these cases. Let me check which one it was.” She opened Sobczyk’s folder and checked the accession number against the sample bottles. Finding the correct one, she held it up, then put it directly in front of Peter. “It’s this one. This was the only patient out of the six who apparently had some cardiac and respiratory activity when she was found. I don’t quite know what to make of that, but I thought you should know. If it were an unstable toxin, maybe it would have the highest concentration of all the cases.”

  Peter shrugged. “I’ll keep it in mind.”

  Laurie looked out into the lab proper. Seeing that the coast was clear, she waved to Peter and quickly dashed out into the hallway. She used the stairs on her way up to the sixth floor. Halfway up, she stopped. All of a sudden, the right lower quadrant abdominal discomfort she’d had that morning reappeared. Once again, she used her fingers to press over the area. At first, it made the discomfort worse, reaching the threshold of what she would call pain, but then, as quickly as it had appeared, it vanished. Laurie felt her forehead to make sure she didn’t have a fever. Convinced she didn’t, she shrugged and continued on her way.

  The sixth floor housed the DNA laboratory. In contrast to the rest of the building, the DNA lab was state-of-the-art. It was less than a half dozen years old and sparkled with white tiled walls, white cabinetry, white composite flooring, and the newest instrumentation. Its director, Ted Lynch, was a former Ivy League football jock. He wasn’t in Calvin’s league in terms of size, but not far behind, though he had a personality the opposite of Calvin’s. Ted was an even-tempered, friendly individual. Laurie found him hovering over his beloved sequencer machine.

  Laurie gave Ted a bit of background on the case and then asked him if he’d do a rush screen. Along with the samples from under Lewis’s nails, she gave him a sample of Lewis’s tissue.

  “Yeah, yeah, yeah!” Ted voiced with a laugh. “You and Jack are quite a pair. Every time you bring me something, it’s got to be stat, like the sky is going to fall if you don’t get it. Why can’t you two be more like the rest of the lazy gang? Hell, they hope they don’t hear from me, because when they do, it creates work for them.”

  Laurie couldn’t help but smile. She and Jack had created a reputation for themselves. Laurie told Ted just to do the best he could. She then descended a floor and walked quickly down toward her office. She couldn’t wait to get to the phone. The person to whom she was most excited about giving the news of the two new members of her series was Roger.

  Sitting at her desk, Laurie dialed Roger’s extension at the Manhattan General. She drummed her fingers as she waited for the call to go through. Her heart was beating even faster than it had been earlier. She knew Roger would want to know about the two new cases if he didn’t already. Unfortunately, when the line was picked up, it was Roger’s voicemail. Laurie silently cursed. Of late it seemed that all she ever got was people’s voicemail, never a real person.

  After listening to Roger’s outgoing message, Laurie merely said it was she who was calling and to call her back. She couldn’t help but feel a twinge of disappointment at not getting hold of him right away. As she hung up the phone, she left her hand on the receiver as she thought about Roger being the only person who seemed to share her concern about the possibility of a grim reaper stalking the halls of the Manhattan General, which was the derogatory way Sue Passero had referred to her suspicions. Yet with her new self-honesty, she wondered how sincere his support really was. After the marriage revelation, she didn’t know how much to trust him. As Laurie thought back over the last five weeks, she had to admit that he’d been almost too solicitous at times. She hated to be cynical, but that was the consequence of his dishonesty.

  Laurie jumped as the phone rang under her hand, and snatched up the receiver in a mini-panic.

  “I’m looking for Laurie Montgomery,” a pleasant female voice said.

  “Speaking,” Laurie responded.

  “My name is Anne Dickson. I’m a social worker here at the General, and I’d like to make an appointment with you.”

  “An appointment?” Laurie questioned. “Can you tell me what case this is about?”

  “Your case, of course,” Anne said, confused.

  “My case? I’m not sure I understand.”

  “I work here in the genetics lab, and I believe you came in a little more than a month ago for a genetic screen. I’m calling to arrange for you to come back in so we can schedule a meeting.”

  A complex array of thoughts flashed through Laurie’s mind. The BRCA1 test was yet another example of her putting unpleasant things out of her mind. She’d completely forgotten about having given the blood. This woman calling her up out of the blue brought back the whole disturbing issue like an avalanche.

  “Hello? Are you still there?” Anne questioned.

  “I’m still here,” Laurie said as she tried to organize her thinking. “I suppose this means the test was positive.”

  “It means that I’d like to see you in person,” Anne said evasively. “It’s our normal procedure for all our clients. I’d also like to apologize. Your folder has been on my desk for a week or so, but it mistakenly got put in the wrong basket. It’s my fault entirely, so I’d like to see you sooner ra
ther than later.”

  Laurie felt a wave of impatient irritation. She took a deep breath and reminded herself that the social worker was only trying to do her job. Still, Laurie would have preferred just to be told the results than suffer some drawn-out protocol.

  “I’ve had a cancellation for one o’clock today,” Anne continued. “I was hoping that might work. If it’s not convenient, the next opening is a week from today.”

  Laurie closed her eyes and took another deep breath. She wasn’t going to allow herself to be in limbo for a week. Although she expected that the phone call meant the test was positive, she wanted to know for certain. She looked at her watch. It was eleven forty-five. There was no reason she couldn’t run over to the General. Maybe she could have lunch with Roger or Sue. “One is fine,” she said with resignation.

  “Wonderful,” Anne said. “My office is in the same suite where you came for the blood to be drawn.”

  Laurie hung up the phone. With her eyes again closed, she bent over her desk and ran her fingers roughly through her hair, scratching her scalp. All the nasty consequences of the BRCA1 gene flooded into her consciousness, along with a wave of sadness. What particularly bothered her was the acknowledgment of the upcoming need to make what she called “an end decision,” a decision that eliminated options, such as having children.

  “Knock, knock!” a voice called out.

  Laurie glanced up to find herself looking at the smiling face of Detective Lieutenant Lou Soldano. He appeared particularly dapper with a clean, pressed shirt and a new tie. “Hey, Laur,” he said cheerfully. Laur was a nickname that Lou’s son, Joey, had given Laurie back when Laurie and Lou had briefly dated. At that time, Joey was five. Now he was seventeen.

  Laurie and Lou had not had a falling out but rather a mutual understanding that a romantic relationship wasn’t appropriate. Although they continued to have great respect, understanding, and admiration for each other, the passion part didn’t work. Instead of romance, a close friendship developed and blossomed over the years.