by Robin Cook
“Well, no matter,” Laurie said. “Unfortunately, the cases you are interested in won’t be first. I’m sorry.”
“No problem,” Lou said. “I like to watch you work.”
Laurie scanned the material in the folder on the headless woman. Then she perused one of the overdose folders. She’d only got as far as the investigator’s report before she reached for the last folder and scanned its investigator’s report. “This is amazing,” she said. She looked up at Lou. “Dr. Washington said these cases were the same as Duncan Andrews. I had no idea he was speaking so literally. What a coincidence.”
“Are they cocaine overdoses?” Lou asked.
“Yes,” Laurie said. “But that’s not what makes them such a coincidence. One’s a banker, the other an editor.”
“What’s so amazing about that?” Lou asked.
“It’s the demographics,” Laurie said. “All three were successful professionals, actively employed, young single people. Hardly the usual overdose we’re accustomed to seeing around here.”
“Like I said: what’s so amazing about that? Aren’t these people the kind of yuppies who made coke popular? What’s the big surprise?”
“The fact that they took cocaine is not the surprising aspect,” Laurie began slowly. “I’m not naive. Behind the veneer of material success can lie some pretty serious addictions. But as I told you the overdose cases we get in here are usually the truly down and out. With crack you see a lot of very impoverished, lower-class people. We do see more prosperous people from time to time, but usually by the time the drugs kill them, they’ve already lost everything else: job, family, money. These recent cases just don’t strike me as typical overdoses. It makes me wonder if there wasn’t some kind of poison in the drug. Now where did I put that article from the American Journal of Medicine?” she said, talking more to herself. “Ah, here it is.”
Laurie pulled out a reprint of an article and handed it to Lou. “Street cocaine is always cut with something, usually sugars or common stimulants, but sometimes with weird stuff. That article is about a series of poisonings resulting from a kilo of cocaine cut with strychnine.”
“Wow,” Lou said as he scanned the article. “That would be quite a trip.”
“It’d be a quick trip in here to the morgue,” Laurie agreed. “Seeing three rather atypical OD cases with such strikingly similar demographics in two days makes me wonder if they each got the cocaine from the same contaminated source.”
“I think it’s a long shot,” Lou said. “Especially with only three cases. And quite frankly, even if your hunch is right, I’m not that interested.”
“Not interested?” Laurie couldn’t believe what she was hearing.
“With all the problems this city has, with all the violence and street crime going down, it’s hard for me to muster much sympathy for a trio of fancy pants who have nothing better to do with their leisure time than do illegal drugs. Frankly I’m much more concerned about poor slobs like that headless female floater we got downstairs.”
Laurie was stunned, but before she could launch into a rebuttal, her phone rang. She was surprised to hear Jordan Scheffield on the other end when she picked up.
“I finished my first case,” he said. “Went perfectly. I’m sure the Baron will be pleased.”
“Glad to hear it,” Laurie said, glancing self-consciously at Lou.
“Did you get the flowers?” Jordan asked.
“Yes,” Laurie said. “I’m looking at them this very minute. Thank you. They were just what the doctor ordered.”
“Very clever,” Jordan laughed. “I thought it would be an appropriate way to let you know that I’m looking forward to seeing you tonight.”
“The gesture might fall into the same category as your limo,” Laurie said. “A bit on the extravagant side. But I appreciate your thinking of me.”
“Well, I just wanted to check in. I’ve got to get back to surgery,” Jordan said. “See you at eight.”
“I’m sorry,” Lou said once Laurie had hung up. “You could have told me it was a personal call. I would have stepped out into the hall.”
“I usually don’t get personal calls here,” Laurie said. “It took me by surprise.”
“A dozen roses. A limo. Must be an interesting guy.”
“He is interesting,” Laurie said. “In fact, he said something last night that I think you’ll find interesting.”
“That’s hard to believe,” Lou said. “But I’m all ears.”
“The man on the phone is a doctor,” Laurie said. “His name is Jordan Scheffield. You may have heard of him. Supposedly he’s quite well known. At any rate, he told me last night that he has been taking care of the man you are so interested in: Mr. Paul Cerino.”
“No fooling!” Lou said. He was surprised. He was also interested.
“Jordan Scheffield is an ophthalmologist,” Laurie said.
“Wait a sec,” Lou said. He held up a hand while he reached into his jacket and pulled out a tattered pad of paper and a ballpoint pen. “Let me write this down.” While he bit on his tongue, he wrote out Jordan’s name. Then he asked Laurie to spell ophthalmologist.
“Is that the same as optometrist?” Lou asked.
“No,” Laurie said. “An ophthalmologist is a medical doctor trained to do surgery as well as manage medical eye care. An optometrist is trained more to correct visual problems with eyeglasses and contact lenses.”
“What about opticians?” Lou asked. “I’ve always mixed these guys up. No one ever explained it to me.”
“Opticians fill the eyeglass prescriptions,” Laurie said. “Either from an ophthalmologist or an optometrist.”
“Now that I have that straight,” Lou said. “Tell me about Dr. Scheffield and Paul Cerino.”
“That’s the most interesting part,” Laurie said. “Jordan said that he was treating Mr. Cerino for acid burns of the eyes. Someone had thrown acid in Paul Cerino’s eyes to blind him.”
“You don’t say,” Lou said. “That could explain a lot. Like maybe these two gangland-style executions of Lucia people. And what about Frankie’s eye? Could that have been acid?”
“Yes,” Laurie said. “It could have been acid. It will be tough to determine since Frankie was in the East River, but on the whole, the damage to his eye was definitely consistent with an acid burn.”
“Can you try to have your lab document that it was acid? This could be the start of the lucky breakthrough I’ve been praying for.”
“Of course we’ll try,” Laurie said. “But like I said, his having been in the river might make it tough. We’ll also examine the bullet in the present case. Maybe it will match the one from Frankie.”
“I haven’t been this excited for months,” Lou said.
“Come on,” Laurie said. “Let’s see what we can do.”
Together they went down to the lab. Laurie found the director, a toxicologist, Dr. John DeVries. He was a tall, thin man with gaunt cheeks and an academic’s pallor. He was dressed in a soiled lab coat several sizes too small.
Laurie made introductions, then asked if any of the results on the previous day’s cases were available.
“Some might be,” John told her. “You have the accession numbers?”
“Absolutely,” Laurie said.
“Come in my office,” John said. He led them to his office, a narrow cubbyhole filled with books and stacks of scientific journals.
John leaned across his desk and punched a few keys on his computer. “What are the accession numbers?” he asked.
Laurie gave Duncan Andrews’ number and John entered it.
“There was cocaine in the blood and urine,” John said, reading off the screen. “And apparently in high concentration. But this was only by thin-layer chromatography.”
“Any contaminants or other drugs?” Laurie asked.
“Not so far,” John said, straightening up. “But we’ll be using gas chromatography and mass spectrometry as soon as we have time. We got a lo
t of work around here.”
“This was a cocaine overdose case but it’s a little atypical in that the deceased did not appear to be a habitual user. And if he did use drugs—which his family swears he didn’t—it wasn’t interfering with his life. The man was very successful, a solid citizen: the kind of person you do not expect to overdose. So his death was unusual perhaps, but not extraordinary. Cocaine can be an upscale drug. But now I’ve got two more OD’s with similar profiles the very next day. I’m concerned that a batch of cocaine may be poisoned with some kind of contaminant. That’s what may be killing these seemingly casual users. I’d really appreciate it if you ran the samples sooner rather than later. We might be able to save some lives.”
“I’ll do what I can,” John said. “But as I told you, we’re busy. Was there another case you wanted to know about now?”
Laurie gave Frank DePasquale’s accession number and John consulted the screen. “Only a trace of cannabinoid in the urine. Otherwise, nothing on screening.”
“There was a sample of eye tissue,” Laurie said. “Find anything there?”
“Hasn’t been processed yet,” John said.
“The eye appeared burned,” Laurie added. “We now suspect acid. Could you look for acid? It might be important if we can document it.”
“I’ll do what I can.”
Laurie thanked John, then motioned for Lou to follow her to the elevator. As they walked, Laurie shook her head. “It’s like squeezing water out of a stone to get information out of him,” she complained.
“He seems exhausted,” Lou said. “Or he hates his job. One of the two.”
“In his defense, he is busy,” Laurie said. “Like everything else here, his funding is limited and getting progressively worse, so he’s stretched thin when it comes to staff. But I hope he can find the time to search for a contaminant in the drug cases. The more I think about it the more sure I am.”
When they got to the elevators, Laurie glanced at her watch. “I have to get a move on!” She lifted her eyes to Lou. “I can’t afford to have Dr. Washington mad at me as well as Dr. Bingham. I’ll be out pounding the pavement, looking for a new job.”
Lou gazed into her eyes. “You really are upset about these overdose cases, aren’t you?”
“Yes, I am,” Laurie admitted. She averted her eyes and glanced up at the floor indicator. Lou’s comment brought up the memory of the nightmare she’d had that morning. She hoped that he wouldn’t mention her brother. Thankfully the elevator door opened, and they boarded.
They changed into scrub clothes and entered the main autopsy room. It was a beehive of activity; every table was occupied. Laurie saw that even Calvin was working at table one. Things were definitely hopping for him to be there; it was not customary for Calvin to do routine cases.
Laurie’s first case was on the table. Vinnie had taken the liberty of getting all the paraphernalia he anticipated she’d need. The deceased’s name was Robert Evans, aged twenty-nine.
Laurie set out her papers and switched into her professional persona, beginning her meticulous external exam. She was halfway through when she realized that Lou was not across from her. Raising her head, she saw him standing to the side.
“I’m sorry I haven’t been including you,” she said.
“I understand,” Lou said. “You do your thing. I’m fine. I can tell that you are all very busy. I don’t want to be in the way.”
“You won’t be in the way,” Laurie said. “You wanted to watch, so come over and watch.”
Lou stepped around the table being careful where his feet touched the floor. His hands were clasped behind his back. He looked down at Robert Evans. “Find anything interesting?” he asked.
“This poor fellow convulsed just like Duncan Andrews,” Laurie said. “He has all the consequent bruises and badly bitten tongue to prove it. He also has something else.
Look here in the antecubital fossa. See that blanched puncture mark? Remember seeing that on Duncan Andrews?”
“Sure,” Lou said. “That was the intravenous site where he mainlined the cocaine.”
“Exactly,” Laurie said. “In other words, Mr. Evans took his cocaine the same way Mr. Andrews did.”
“So?” Lou questioned.
“I told you yesterday that cocaine can be taken lots of ways,” Laurie said. “But sniffing, or the medical term, insufflation, is the usual recreational route.”
“What about smoking?” Lou asked.
“You’re thinking of crack. Cocaine hydrochloride, the salt, is poorly volatile and can’t be smoked. For smoking it has to be converted to its free base: crack. The point is that although the usual form of cocaine can be injected, it usually isn’t. The fact that it had been used that way on both these cases is curious, not that I know what to make of it.”
“Wasn’t it common in the sixties to shoot cocaine?” Lou asked.
“Only when it was combined with heroin in what they call speedball.” Laurie closed her eyes for a moment, took a deep breath, and let it out with a sigh.
“Are you all right?” Lou asked.
“I’m fine,” Laurie said.
“Maybe what we’re seeing is the beginning of a new fad,” Lou suggested.
“I hope not,” Laurie said. “But if it is, it’s much too deadly to be a fad for long.”
Fifteen minutes later, when Laurie plunged the scalpel into Robert’s chest, Lou winced. Despite the fact that Robert was dead and that there was no blood, Lou could not dismiss the idea that the razor-sharp knife was cutting into human tissue just like his own skin.
With no pathology apparent, Laurie finished the internal aspect of Robert Evans’ autopsy in short order. While Vinnie took the body away and brought in Bruno Marchese, Laurie and Lou went to the X-ray view box to look at Bruno’s X-rays and the one of the headless woman.
“The bullet is in just about the same location,” Laurie said, pointing to the bright dot inside the outline of Bruno’s skull.
“Looks like slightly larger caliber,” Lou said. “I could be wrong, but I don’t think it’s from the same gun.”
“I’ll be impressed if you’re right,” Laurie said.
Laurie put up Bruno’s full-body X-ray. She scanned the film with a practiced eye. When she saw no abnormalities she replaced it with the X-ray of the unfortunate woman.
“It’s a good thing we took this X-ray,” Laurie said.
“Oh?” Lou said, staring at the foggy-appearing shadows.
“You mean you don’t see the abnormality?” Laurie asked.
“No,” Lou said. “At the same time I don’t know how you doctors can see much in these things. I mean a bullet jumps out at you, but the rest just looks like a bunch of smudges.”
“I can’t believe you can’t see it,” Laurie said.
“All right, I’m blind,” Lou said. “So tell me!”
“The head and the hands!” Laurie said. “They’re gone.”
“You miserable slut!” Lou laughed in a forced whisper to keep those at a nearby table from hearing.
“Well, it’s an abnormality,” Laurie teased.
Finished with the X-rays, Laurie and Lou returned to the table just in time to help Vinnie move Bruno from the gurney onto the table. Lou started to help, but Laurie shooed him away since he was not gloved. To save time, Laurie started out with the body prone.
The entrance wound looked much like Frankie’s although the diameter of the stippling was slightly larger, suggesting the gun had been a bit farther away. After taking all the appropriate photographs and samples, she and Vinnie turned the body supine.
The first thing Laurie did then was check the eyes. They were normal.
“After what you said upstairs I was hoping the eyes might tell us something,” Lou said.
“I was hoping as well,” Laurie admitted. “I’d love to give you that break you need.”
“It still might be important,” Lou said. “If Paul Cerino had acid thrown in his eyes, and if Frank DePasqu
ale did too, it’s certainly a link. I think it’s worth my while to take a trip out to Queens and have a chat with Paul.”
After finishing the rest of the external exam, Laurie accepted a knife from Vinnie and began the internal. Again, with no pathology, it went very quickly.
As soon as Bruno’s autopsy was completed, Vinnie rolled him away and brought in the second floater. As Laurie helped Vinnie transfer the body to the table, someone from a nearby table called out: “Where’d that body come from, Laurie? Sleepy Hollow?”
After the laughter died down, Lou leaned over to Laurie’s ear. “That was crude,” he whispered teasingly. “Want me to go over and slug the guy?”
Laurie laughed. “Black humor,” she said. “It has always played a role in pathology.”
Laurie inspected the woman’s severed limbs and neck. “The mutilation was done after death,” she said.
“That’s comforting,” Lou said. He felt his tolerance was getting lower with every case. He was having more trouble dealing with this dismembered body than with the others.
“The decapitation and the removal of the hands was done crudely,” Laurie said. “Look at the rough saw marks on the exposed bones. Of course some of this tissue appears to have been eaten by fish or crabs.”
Lou forced himself to look even though he would have preferred not to. He was feeling slightly nauseated.
“The rest of the torso looks okay,” Laurie said. “No human bite marks.”
Lou swallowed again. “Would you have expected bite marks?” he asked weakly.
“If rape was involved,” Laurie said, “then bite marks are occasionally seen. You have to think about them, otherwise you can miss them.”
“I’ll try to remember that,” Lou said.
Laurie carefully inspected the chest and abdomen. The only finding of note was a right upper quadrant scar following the line of the ribs.
“This could turn out to be important for ID purposes,” Laurie said, pointing at the scar. “I’d guess it was a gallbladder operation.”
“What if the body is never identified?” Lou asked.
“It will stay in the walk-in cooler for a number of weeks,” Laurie said. “If by then we still don’t know who she is, she’ll end up in one of those pine coffins in the hall.”