Faye Kellerman - Double Homicide

Change spread four Polaroids on his desktop. “These are the gunshot wounds: two that coalesced into each other and skimmed the right temple region, the two holes in the arm, and one through the shoulder. The last one had the highest probability of being fatal until I saw that the bullet went through muscle only.”

He laid out two more Polaroids, both of them gruesome. Dorothy drew her head back.

McCain screwed his lips up in disgust. “What’re we looking at, Doc?”

“The interior of Mr. Van Beest’s thoracic cage. This is what I saw when I opened him up. There’s nothing discernible anatomically because the entire region is swimming in blood.” Change looked up from the photographs. “After I cleaned up the area, I can say with authority that the boy died of a burst in the subclavian artery where it comes off the arch of the aorta. And by my estimation, the cause of the burst was an aneurysm, which is a fancy word for a weakness in the vessel wall. Because the wall is weak, it eventually forms an out-pouching-a sac, if you will. It’s like a balloon. And you know what happens when the balloon inflates. The walls get thinner and thinner until you blow too much air in and, bingo, it pops.”

The detectives were speechless. Finally, McCain said, “How’d that happen? The aneurysm?”

“Usually, it’s a preexisting condition. But I could postulate that the paramedics may have inadvertently brought about a vascular accident as they attempted CPR. A real Greek tragedy, when you think about it.”

Dorothy couldn’t draw words from her throat.

“From your point of view,” Change went on, “you need to keep in mind that you may not be able to charge your suspect with premeditated murder. Only attempted murder, because the gunshot wounds weren’t the direct cause of death.”

“But”-Dorothy cleared her throat-“why would the paramedics do CPR unless his heart had stopped?”

McCain picked up on her question. “There you go: Shock from being shot stopped his heart in the first place. So you could give us a direct link to Delveccio, right, Doc?”

“His heart had to have stopped,” Dorothy insisted.

“It’s a thought,” Change admitted. “Even so, the defense could argue that the gunshot wounds combined with a preexisting arterial defect might have been enough for a precipitous drop in blood pressure. He could’ve had a pulse, but a very faint one, and the EMTs missed it.”

“But still, there’s a direct link to the gunshot wounds.”

“Unfortunately, Detective Breton, that’s all theory. In a medicolegal context, the gunshot was not the cause of death. Mr. Van Beest expired due to a burst artery. And we have no way of knowing precisely when that occurred. The defense could even argue that the paramedics made it worse, that without their compressions the victim would’ve survived. Each downward motion against the sternum could have caused the wall to stretch wider and wider until it ripped open. The area is right below the clavicle near where the aorta splits into the carotid artery that feeds the head and the subclavian artery that feeds the upper body. These are major vessels that transport lots of blood.”

“That’s ridiculous,” said McCain.

“Perhaps, but it’s more than reasonable doubt.”

The room fell silent.

McCain cleared his throat. “The stress of getting shot had to make his heart beat faster, which would put stress on that sac, right?”

Change didn’t speak.

“Isn’t that so, Doc?”

Change picked up a pencil and waved it like a wand. “Yes, the sympathetic nervous system kicks in under stress. I’m sure at some point his heart was beating very rapidly.”

“So would that increase the likelihood of the aneurysm tearing open?”

“That’s more than speculative. I could surmise, but I wouldn’t know how fast his heart had been beating. The defense would seize on that. If I were Delveccio’s lawyer, I’d keep focusing on the compressions.”

Dorothy said, “There is no way the burst artery could have been caused by one of the gunshot wounds?”

Change shook his head. “No hole was found in the area.”

“What about a deflected bullet?”

“That’s not what happened, Detective.”

“Julius fell on his chest when he was shot,” Dorothy said. “Maybe the thump on his chest burst open the aneurysm.”

Change thought about that. “It’s a possibility. But then again, I heard he got hit pretty bad across his chest at last night’s game. The defense could argue that that was the triggering event.”

“We were there,” Dorothy said. “It looked to me like he got hit in the neck.”

Change said, “A long arm fouling him like that probably impacted his neck, face, and chest. Must’ve been a severe blow to knock such a large man down. I hear he was out on the floor for quite a while.”

“He came back and played the game of his life,” Dorothy said.

“That doesn’t mean damage wasn’t done. Perhaps the fouling did exacerbate an arterial tear. Combine that with chest compressions…” Change threw up his hands.

McCain said, “Defense this, defense that. How about giving us something to work with?”

“I just want to tell you what you could be up against- what the DA will consider when you plead your case. On attempted murder, Detectives, you’ve got a cakewalk. But I couldn’t say beyond a reasonable doubt that the aneurysm burst because of anything the shooter did.”

“That’s crazy,” McCain said.

“Attempted murder is still jail time,” Change said.

“It’s not the same as premeditated murder,” McCain said. “That would be life without parole, and that’s what the asshole deserves-shooting up a club like that.”

“Can I go back to something?” Dorothy said. “You said you thought it was a preexisting condition.”

“Almost certainly. If it was an aneurysm.”

“If?”

“Theoretically,” said Change, “it could have been a stress tear. But I’d consider that highly unlikely, and I’d have to say so on the stand.”

“Still,” said Dorothy, “it’s not impossible, right? And couldn’t a stress tear have resulted from a bad fall onto the table after he got shot? Which would put us right back to the shooting as the main cause.”

“I don’t think a fall on the table would do it.”

“But how about if it wasn’t a preexisting condition?”

Change said, “But how would you know that unless you had prior X-rays of the region?”

Dorothy smiled. “At Boston Ferris, all athletes are required to have yearly checkups, including chest X-rays. I know that from my own baby. Since Julius was on the team going on his fourth year, that means four X-rays. This aneurysm, it would show up on a chest X-ray, right?”

Change nodded. “If it was large enough, yes.”

“And the doctor seeing this… they certainly wouldn’t have let him play with it, right?”

Again, Change nodded. “ If it was big enough and if someone saw it. The artery runs behind the clavicle. The aneurysm could’ve been hidden by bone.”

“But maybe it wasn’t. And they let him play. And he played for four years with no problem.”

Change shrugged.

“I think Dorothy’s onto something,” McCain joined in. “It’s worth taking a look at the X-rays. ”Cause if it didn’t show up, maybe it was hidden by bone, sure. But maybe it just wasn’t ever there in the first place. Meaning that maybe falling on the table caused the artery to burst, Doc.“

“Detective, arteries don’t just explode.”

“But you can’t tell me what did happen at a hundred percent certainty, right?”

“I can tell you that a bullet hole didn’t cause the artery to burst,” Change said. “There was no puncture wound from any external cause. Nor were there any bone fragments that could have pushed through. Ergo, the cause has to be idiopathic-something internal, unique to Mr. Van Beest.”