Death Rounds (11 page)

“I guess I don’t have to tell you I’m scared,” she sniffled when she spoke again, “especially after what happened to you tonight. God, I’m sorry, Earl, to have been so blind.”

“It’s okay,” I reassured her. “You were the least blind of all. No one else even thought of the Phantom.”

“Yeah, except you warned me about what might happen if we got close.” She pulled away and reached into her lab coat pocket for a tissue. “But if that was the Phantom and my looking at those charts was what brought him down on us, then there must be something in those records that can help us find out who he is,” she said slowly, starting to sound less shaken.

“Hold it. Nancy Drew,” I said. “As your trusty sidekick, I’ve had enough knocks on the head for tonight.”

She smiled, gently ruffled my hair, then laughed and gave me another hug. The closeness felt good, but from my experience in ER I knew the relief we were both feeling at that moment was the kind that always follows a near miss. It was part of the shock, and temporary. Already, as I hugged her back, I was thinking. This guy probably gives out worse things than bumps on the head, things like
Legionella.
“Janet, who besides me knew you were going to look at the old files on the Phantom cases?” I asked, still holding her.

Janet’s expression strained again when she pulled away, and once more her eyes filled with worry.

“No one. I was tired of being scoffed at.”

“So only Cam, Michael, and I heard your Phantom idea?”

She nodded.

“Have you seen a lot of any one person today, someone who could be watching your movements?”

“No,” she answered quietly.

“Then how did he know you were there?” I asked, not expecting an answer. “Or could we be wrong in assuming whoever it was had gone down there tonight to find you? Maybe the person was there for another reason, and I disturbed him, wandering around.”

“Wait a minute,” Janet said. “Are you changing your mind and saying that getting attacked tonight had nothing to do with the
Legionella
deaths, that those crazy excuses I made up might be true?”

“Not at all. Whoever turned out the lights came at me and somehow was waiting back at the elevator for me. And that judo push propelling me into the door was certainly no panicky grab. At the very least the person didn’t want me snooping around. I’m just suggesting that maybe it wasn’t connected to your going over files on victims of the Phantom.”

“So apart from making me feel less guilty about that knock on your head, where does that leave us? You’re not seriously suggesting your figure in the dark has nothing to do with the
Legionella
cases?”

I didn’t answer right away. The menace I’d felt from that hideous encounter was not at all in doubt, but if pressed, I had to admit I’d only assumed the attack was connected to the nurses, especially with Sanders’s death fresh on my mind. But I couldn’t rule out the possibility that I’d stumbled onto a completely unrelated creep.

“It would be a pretty big coincidence, but you’re right. It’s a possibility the attack tonight had nothing to do with the Phantom or
Legionella”

My admission left us looking glumly at each other across a spread of white bedsheets. They reminded me of blank paper—a tabula rasa—waiting for answers that wouldn’t come.

It was an odd sort of letdown. If the attack was an unrelated fluke, then Janet hadn’t threatened anyone, wasn’t in any immediate danger, so far, but might be completely on the wrong track. In that case, we were probably no closer to discovering why two nurses had died and certainly weren’t any nearer to stopping a lunatic who could kill with
Legionella.

Even more frustrating was that we had to live with the other possibility: we somehow had threatened a killer.

After a few moments, Janet raised her head. “I need you here, Earl. You’re the only one who believes me, and I’m certainly not getting anywhere working with Michael. You’ve got to get yourself officially named to his investigation. Then we can start from scratch, together, and maybe you’ll see something I’ve overlooked.”

“Don’t worry,” I told her, trying to sound more confident than I felt. “If Michael doesn’t listen to me, you can tell Donna on him. She’ll make him behave.”

* * * *

We got out of University Hospital’s ER by midnight. The CAT scan and a series of staff doctors declared that apart from an already forming bruise, the blow hadn’t done me much damage. On our way home Janet agreed she’d do no more prowling around until I could be with her. We again considered making a report about the attack to the police and again decided against it. Even if they believed me, which, despite Janet’s skepticism, they might, the crime they’d be investigating would be simple assault and nothing else. Besides, creating a fuss for the hospital would only make it harder for me to get the access I wanted to their records.

Later, in bed, I lay awake listening to Janet’s breathing and pictured that sinister figure in the hallway. Despite our second-guessing why he’d turned out the lights and come after me, I couldn’t stop thinking he was down there because Janet was checking into the
Legionella
cases and digging out the old files on victims of the Phantom. What would he have done to her if I hadn’t come along? Possibilities out of a nightmare flooded into my thoughts and burned away all possibilities of sleep. I got up, went downstairs to the living room, and paced to control my fears. No one, I swore, not Michael, not Cam, not anyone at University Hospital, was going to keep me from protecting my wife.

But after putting a few miles on the carpet and tripping innumerable times over Muffy, by 3:00
A
.
M
. I still had no plan. That was when I remembered Phyllis Sanders’s autopsy was scheduled for 7:00.

* * * *

During twelve hours on a slab in the morgue the flesh of the dead becomes yellowed and white as the blood slowly drains toward the back and pools in the skin behind the head, shoulders, and hips. There it clots, suffusing those resting spots with large purple blotches—a telltale pattern of how the body was initially lying after death. Pathologists call this pattern dependent lividity, and it can reveal whether a body subsequently was moved into a different position and, if so, suggest foul play.

Phyllis Sanders had obviously spent an undisturbed night on her back. She now lay naked on the dissecting table under the harsh light of the operating lamp, awaiting her final medical procedure and hopefully a definitive diagnosis as to the cause of her death, if the purely medical cause of death could be called definitive. In her case, the possible cause of the cause—a dim figure in the shadows— wouldn’t be discovered here.

Her eyes were closed, her cheeks were slack and hollow, and her mouth was a gaping hole. Her gray hair lay splayed out over the glistening steel of the table’s surface and hung off its end, reminding me of how she’d looked in ER. I found myself wondering how they’d protect those long strands for the mortician if they planned to include her brain in the post. The standard cutting procedure would involve an incision around the back of her head from temple to temple and pulling the front half of her scalp forward over her face to expose the skull.

I was dressed in greens, mask, and gloves and pacing impatiently, having been in the chilled room for ten minutes and wondering what the delay was. On the steel counters surrounding me were the rows of tubes and glass beakers that would hold specimens of her various bodily fluids. Other bottles filled with colored liquids stood waiting to receive tissue samples from her major organs. Spread out near the deep sinks at the end of one of these counters was an array of large Tupperware containers, each half filled with formaldehyde, where the major organs themselves would be placed once they were removed in their entirety. The overhead vents hummed and did their best, but even through my mask the familiar fumes of the preservative stung my eyes and bit into my nose. Every now and then I also got a whiff of the unmistakable odor of early rot.

Scalpels, probes, pickups, forceps, bone cutters, and a rotary saw lay neatly arranged on a steel cart placed near the woman’s chest. This being an ID case, a plentiful supply of swabs and culture sets were on a separate tray within easy reach. All that was needed was a pathologist.

Finally I heard the sound of approaching voices coming from the changing room on the other side of the doors to the autopsy suite. As the conversation grew louder, I realized a heated argument was taking place.

“I don’t give a goddamn about whatever juice you managed to pull from upstairs! Down here you’re on my turf, this is my case, and it’s my policy that any attending physician or resident not only can be present but should be encouraged to be present at an autopsy of his or her patient—”

The doors swung open and the thin figure of Len Gardner, already in full protective gear, strode into the room. Of medium height and build, he was in his early fifties. He should have been chairperson of his department but was far too frank and honest to have any political support at St. Paul’s. “Oh, hi. Earl,” he commented cheerfully, winking at me over the top of his mask. He gave his head a little nod in the direction of whoever was following him, the corners of his eyes wrinkling merrily with the smile I couldn’t see. Then he suddenly stared at my forehead. “Hey, that’s quite a bruise. What happened?”

“I hit a door in the dark,” I mumbled.

In huffed Gary Rossit, also fully garbed, but the visible portions of his face and neck were deeply flushed. The effect made his head look like a round beet enclosed in a cap and mask. “Garnet’s handling of this case is under review, and I insist you comply with my wishes and bar him—” He broke off when he saw me, his forehead flushing even redder.

I felt my own face grow warm. “You wouldn’t be trying to keep me away from the post, would you Dr. Rossit?” I snapped. Having caught him in the act of doing exactly that, I was furious. But I gritted my teeth knowing my mask at least partially kept him from seeing how well he’d succeeded in making me livid.

He glared back up at me, his pupils widening as I watched.

“You are both welcome to stay,” Len interjected sternly, giving us a precautionary glance that made it clear he wouldn’t tolerate his domain being used as a battleground. He reached overhead and snapped on the microphone to record his running commentary of the autopsy. Rossit eyed the device, the blacks of his eyes growing even bigger, but kept silent. Whatever he had to say against me, I guessed he still preferred it said behind my back and off the record.

Apparently satisfied that we would behave, Len stepped to the business side of the table, picked up his scalpel, and looked down at his subject. “The patient is a fifty-seven-year-old female with no external markings except needle punctures at the documented IV sites—the right and left forearms—below the junction of the lateral and middle thirds of the right clavicle, and at an arterial line inserted in her left wrist. The central line has been left in place for verification of position.”

This initial inspection included documentation that the various lines had been properly inserted in her veins. Antibiotics injected outside a vessel would simply collect in the surrounding tissue where they’d pool and fail to reach the site of the infection.

“Likewise the endotracheal tube has been cut and the lower end left in place...”

Len grasped her windpipe between his thumb and third finger at the thyrocricoid—a tiny area in the upper end of the trachea covered by a thin membrane—and brought the tip of his scalpel blade down to make a vertical slice. As the skin and tissue parted, the orange tube so expertly inserted by Michael two days ago came into view. I recalled my own hesitancy trying to intubate her, which had necessitated his taking over.

“...incision through the cricothyroid membrane reveals a properly positioned endotracheal tube...”

And so it went: the preliminary to what we were all here to see— her lungs.

Len’s scalpel made a sweeping cut from her upper right chest across to her sternum and down to her pubis. Her flesh pouted open along the path of the blade, the cleanly sliced edges forming a bloodless trench the color of sushi. He made a similar cut above her left breast, joining his initial incision and completing a Y that would allow him access to both thoracic cavities and the abdomen. His expert use of the blade had penetrated not only dermis but also more than half an inch of glistening subcutaneous fat. Abandoning the knife for a large pair of tissue spreaders—an instrument resembling scissors with curved blunt probes instead of blades—he deftly widened and deepened the fleshy trench along its length. In the thoracic region it took him seconds to reveal the white striations of sinew and the pearl gray sheen of underlying bone. Working lower down over her belly, he brought into view the darker gray of peritoneum—a fibrous sheath holding back her intestines and other contents of her abdominal cavity. He continued to give succinct explanations of all he did, the easy flow of technical jargon consistent with his years of experience.

“Double glove if you haven’t already. I’m going through the chest wall,” Len advised us.

Both lungs were liable to be full of pus. The extra layer of latex was protection against an incidental tear midst such septic material. Rossit and I complied, reaching for the dispenser box at the same time; then we both impatiently insisted the other hurry up and use it first. I caught a glimpse of us struggling to pull rubber over rubber in our reflection from the glass doors of a nearby cabinet. Positioned back to back, we looked like dualists gloving up to mark off twenty paces. I heard Len muttering behind his mask—something about rectal orifices.

Len picked up the rotary bone saw—a hand-sized tool fitted with a two-inch round saw blade—and switched on the motor. He bent over his patient again and touched the top of each rib with the whirling saw blade, making only a partial cut so as not to disturb the structures underneath. At each contact with bone there came a high-pitched whine, not unlike a dentist’s drill, that made me cringe.

While Rossit and I watched, he reached for his rib cutters, stainless steel shears any florist or chef would die for, and finished snipping completely through the ribs. Their freed ends sprang upward, allowing access to the lungs.