Tess Gerritsen - Vanish

“I understand the woman was pulled out of Hingham Bay yesterday morning,” he said. “Weymouth Fire and Rescue were the first to respond.”

“That’s correct.”

“Why wasn’t the ME’s office called to the scene?”

“We don’t have the manpower to visit every death scene. Plus, this one was down in Weymouth, and there were no obvious indications of foul play.”

“And that was determined by the state police?”

“Their detective thought it was most likely accidental.”

“Or possibly a suicide attempt? Considering the results of her tox screen?”

She saw no point in denying what he already knew. “She may have taken an overdose, yes.”

“A barbiturate overdose. And a body chilled by cold water. Two reasons to obscure a determination of death. Shouldn’t that have been considered?”

“It’s-yes, it’s something one should consider.”

“But neither the state police detective nor the Weymouth Fire Department did. Which sounds like a mistake.”

“It can happen. That’s all I can say.”

“Have you ever made that mistake, Dr. Isles? Declared someone dead who was still alive?”

She paused, thinking back to her internship years before. To a night on call during internal medicine rotation, when the ringing phone had awakened her from a deep sleep. The patient in bed 336A had just expired, a nurse told her. Could the intern come pronounce the woman dead? As Maura had made her way to the patient’s room, she’d felt no anxiety, no crisis of confidence. In medical school, there was no special lesson on how to determine death; it was understood that you would recognize it when you saw it. That night, she had walked the hospital corridor thinking that she would make quick work of this task, then return to bed. The death was not unexpected; the patient had been in the terminal stages of cancer, and her chart was clearly labeled NO CODE. No resuscitation.

Stepping into room 336, she’d been startled to find the bed surrounded by tearful family members who’d gathered to say good-bye. Maura had an audience. This was not the calm communion with the deceased that she had expected. She was painfully aware of all the eyes watching her as she apologized for the intrusion, as she moved to the bedside. The patient lay on her back, her face at peace. Maura took out her stethoscope, slipped the diaphragm under the hospital gown, and laid it against the frail chest. As she’d bent over the body, she felt the family pressing in around her, felt the pressure of their smothering attention. She did not listen as long as she should have. The nurses had already determined the woman was dead; calling in the doctor to make a pronouncement was merely protocol. A note in a chart, an MD’s signature, was all they really needed before a transfer to the morgue. Bent over the chest, listening to silence, Maura could not wait to escape the room. She’d straightened, her face appropriately sympathetic, and had focused her attention on the man she assumed to be the patient’s husband. She’d been about to murmur: I’m sorry but she’s passed away.

The whisper of a breath had stopped her.

Startled, she’d looked down, to see the patient’s chest move. Had watched the woman take another breath, and then fall still. It was an agonal breathing pattern-not a miracle, just the brain’s last electrical impulses, the final twitching of the diaphragm. Every family member in the room gave a gasp.

“Oh my god,” the husband said. “She’s not gone yet.”

“It… will be very soon,” was all Maura managed to say. She had walked out of the room, shaken by how close she’d come to making a mistake. Never again had she been so cavalier about a pronouncement of death.

She looked at the journalist. “Everyone makes mistakes,” she said. “Even something as basic as declaring death isn’t as easy as you’d think.”

“So you’re defending the fire crew? And the state police?”

“I’m saying that mistakes happen. That’s all.” And God knows, I’ve made a few of my own. “I can see how it might happen. The woman was found in cold water. She had barbiturates in her bloodstream. These factors could give the appearance of death. Under the circumstances, a mistake isn’t so far-fetched. The personnel involved were simply trying to do their jobs, and I hope you’ll be fair to them when you write your story.” She stood up, a signal that the interview was over.

“I always try to be fair,” he said.

“Not every journalist can make that claim.”

He, too, rose to his feet and stood gazing at her across the desk. “Let me know if I’ve failed. After you read my column.”

She escorted him to the door. Watched as he walked past Louise’s desk and out of the office.

Louise looked up from her keyboard. “How did it go?”

“I don’t know. Maybe I shouldn’t have talked to him.”

“We’ll find out soon enough,” said Louise, her eyes back on the computer screen. “When his column comes out in the Tribune on Friday.”

Jane could not tell if the news was good or bad.

Dr. Stephanie Tam bent forward, listening through the Doppler stethoscope, and her sleek black hair fell over her face so that Jane could not read her expression. Lying flat on her back, Jane watched as the Doppler head slid across her bulging belly. Dr. Tam had elegant hands, a surgeon’s hands, and she guided the instrument with the same delicacy one might use to pluck a harp. Suddenly that hand paused, and Tam dipped her head lower, in concentration. Jane glanced at her husband, Gabriel, who was sitting right beside her, and she read the same anxiety in his eyes.

Is our baby all right?

At last Dr. Tam straightened and looked at Jane with a calm smile. “Take a listen,” she said, and turned up the volume on the Doppler.

A rhythmic whoosh pulsed from the speaker, steady and vigorous.

“Those are strong fetal heart tones,” said Tam.

“Then my baby’s okay?”

“Baby’s doing fine so far.”

“So far? What does that mean?”

“Well, it can’t stay in there much longer.” Tam bundled up the stethoscope and slipped it into its carrying case. “Once you’ve ruptured your amniotic sac, labor usually starts on its own.”

“But nothing’s happening. I’m not feeling any contractions.”

“Exactly. Your baby’s refusing to cooperate. You’ve got a very stubborn kid in there, Jane.”

Gabriel sighed. “Just like mom here. Wrestling down perps to the very last minute. Can you please tell my wife she’s now officially on maternity leave?”

“You’re definitely off the job now,” said Tam. “I’m going to get you down to Ultrasound, so we can take a peek in there. Then I think it’s time to induce labor.”

“It won’t start on its own?” said Jane.

“Your water’s broken. You’ve got an open channel for infection. It’s been two hours, and still no contractions. Time to hurry junior along.” Tam moved briskly toward the door. “They’re going to get an IV in you. I’ll check with Diagnostic Imaging, see if we can slip you in for a scan right now. Then we need to get that baby out of there, so you can finally be a mommy.”

“This is all happening so fast.”

Tam laughed. “You’ve had nine months to think about it. It shouldn’t be a complete surprise,” she said, and walked out of the room.

Jane stared up at the ceiling. “I’m not sure I’m ready for this.”

Gabriel squeezed her hand. “I’ve been ready for this a long time. It seems like forever.” He lifted her hospital gown and pressed his ear to her naked belly. “Hello in there, kid!” he called out. “Daddy’s getting impatient, so stop fooling around.”