Tess Gerritsen - Ice Cold

“What about that other finding, in the lungs?”

“Her pulmonary edema could be due to anything from opiates to phosgene. I can’t give you an answer. I’m afraid this is all going to come down to the tox screen.” He pulled off his fogged respirator hood and heaved out a sigh, as though relieved to be free of that claustrophobic mask. “Right now, I’m thinking this is a pharmaceutical death. A drug of some kind.”

“But the stomach’s empty?” said Maura. “You didn’t find any capsule remnants?”

“The drugs could have come in liquid form. Or death could have been delayed. Sedation, followed by assisted asphyxiation.”

“Heaven’s Gate,” Maura heard someone say behind her.

“Exactly. Like the Heaven’s Gate mass suicide in San Diego,” said Gruber. “They ingested phenobarbital and tied plastic bags over their heads. Then they went to sleep and never woke up.” He turned back to the table. “Now that we’ve ruled out any danger of cyanide gas, I’m going to take my time. You’ll all have to be patient. In fact, some of you may find the rest of this tedious, if you’d like to leave.”

“Dr. Gruber,” one of the officials said, “how long is this first autopsy going to take? There are forty other bodies waiting in the deep freeze.”

“And I’m not thawing any more of them until I’m satisfied I’ve done justice to this young lady.” He looked down at the girl’s corpse, and his gaze was mournful. Entrails glistened in her gaping abdomen, and her freshly thawed flesh dripped pink icemelt into the table drain. But it was her face that seemed to hold his attention. Staring up at the monitor, Maura, too, was transfixed by the face, so pale, so innocent. A snow maiden, frozen on the threshold of womanhood.

“Dr. Gruber?” the assistant said. “Are you okay? Doctor?”

Maura’s gaze shot back to the viewing window. Gruber swayed and put his hand out to catch himself against the table, but his legs seemed to dissolve away beneath him. A tray toppled and steel instruments clattered across the floor. Gruber collapsed, his body landing with a sickening thud.

“Oh my God!” The assistant knelt down beside the body. “I think he’s having a seizure!”

Maura grabbed the nearest telephone and dialed the operator. “Code Blue, autopsy lab,” she said. “We have a Code Blue!” As she hung up, she saw to her dismay that three observers had already pushed through the door into the lab. Jane was about to follow them when Maura grabbed her arm and stopped her.

“What the hell?” Jane said.

“You stay right here.” Maura snatched an autopsy gown off a shelf and thrust her arms into heavy rubber dissecting gloves. “Don’t let anyone else into that room.”

“But the guy’s having a seizure in there!”

“After he took off his hood.” She glanced around frantically for another respirator, but she saw none in the anteroom. No other choice, she thought. I have to be quick. She washed out her lungs with three deep breaths and pushed through the door, into the lab. Gruber had left his respirator lying on the fume hood cabinet. She snatched it up and pulled it over her head. Heard a clang and turned to see one of the men sag against the sink.

“Everyone, get out of here!” she yelled as she grabbed the wobbling man and helped him toward the door. “This room is toxic!”

The morgue assistant shot her a stunned look through his mask. “I don’t understand! The GasBadge monitor didn’t register a thing!”

She bent down to grab Gruber under his arms, but he was too heavy, an immovable deadweight. “Take his feet!” she ordered.

Together she and the morgue assistant dragged Gruber away from the table and across a floor littered with instruments. By the time they pulled him into the anteroom, the Code Blue team had arrived and was strapping oxygen masks onto three pale-looking men.

Maura looked down at Gruber, whose face was tinged with blue. “This man’s not breathing!” she yelled.

As the code team converged on the patient, Maura backed away to let them do their jobs. Within seconds they were forcing oxygen into his lungs, slapping cardiac leads on his chest. On the monitor, an EKG tracing appeared.

“He’s got a sinus rhythm. Rate of fifty.”

“I’m not getting a blood pressure. He’s not perfusing.”

“Start compressions!”

Maura said, “He was exposed to something. Something in that room.”

But no one seemed to hear her through her respirator hood. Her head was pounding. She pulled off the hood and blinked against lights that suddenly seemed too bright. The medical team was in full Code Blue mode now, and Fred Gruber’s torso was completely bared, his bloated abdomen humiliatingly exposed and jiggling with each cardiac compression. The stench of urine rose from his soaked scrub pants.

“Do we have any history on this man?” the doctor called out. “What do we know about him?”

“He collapsed while doing an autopsy,” Jane said.

“He looks about a hundred pounds overweight. I’m betting he had an MI.”

“He wet himself,” said Maura.

Again, her voice went ignored. She was like a ghost hovering at the periphery, unheard and unheeded. She pressed a hand to her head, which was pounding even worse, and struggled to think, to focus. Somehow she managed to push her way into the throng of personnel and kneel down near Gruber’s head. Lifting one of his eyelids, she stared at the pupil.

It was barely a pinprick of black against the pale blue iris.

The stench of urine wafted up from his body, and she looked at his soaked scrub pants. Suddenly aware of the sound of retching, she glanced across the room and saw the morgue assistant was vomiting into a sink.

“Atropine,” she said.

“I got the IV in!” a nurse called out.

“I’m still not getting a blood pressure.”

“You want a dopamine drip?”

“He needs atropine,” said Maura, louder.

For the first time, the doctor seemed to notice her. “Why? His heart rate’s not that slow.”

“He has pinpoint pupils. He’s soaked with urine.”

“He also had a seizure.”

“We all got sick in that room.” She pointed to the morgue assistant, who was still leaning over the sink. “Give him the atropine now, or you’re going to lose him.”

The doctor lifted Gruber’s eyelid and stared at the constricted pupil. “Okay. Atropine, two milligrams,” he ordered.

“And you need to seal that lab,” said Maura. “We should all move into the hallway now, as far from that room as possible. They need to call in a hazmat team.”

“What the hell is going on?” said Jane.

Maura turned to her, and just that sudden movement made the room seem to whirl. “They’ve got a chemical hazard in there.”

“But the GasBadge readings were negative.”

“Negative for what it was monitoring. But that’s not what poisoned him.”

“Then you know what it is? You know what killed all those people?”

Maura nodded. “I know exactly why they died.”

ORGANOPHOSPHATE COMPOUNDS ARE AMONG THE MOST TOXIC OF pesticides used in the agricultural industry,” said Maura. “They can be absorbed by almost all routes, including through the skin and by inhalation. That’s how Dr. Gruber probably got exposed in the autopsy room. When he removed his respirator and breathed in the fumes. Fortunately, he received the appropriate treatment in time, and he’s going to recover.” She looked around the table at the medical and law enforcement personnel who had gathered in the hospital conference room. She did not need to add the fact that she was the one who’d made the diagnosis and saved Gruber’s life. They already knew it, and although she was an outsider, she heard a tone of respect when they addressed her.