Michael Crichton - A Case of Need

But I was bothered by the size. It just didn’t look like a pregnant uterus to me, particularly if the girl was four months’ pregnant. At four months, the fetus was six inches long, with a pumping heart, developing eyes and face, and forming bones. The uterus would be markedly enlarged.

Weston thought the same thing. “Of course,” he said, “she probably got some oxytocin [16] A drug to contract the uterus, useful for initiating birth and for stopping uterine bleeding. at the EW, but still, it’s damned peculiar.”

He cut through the uterine wall and opened it up. The inside had been scraped quite well and carefully; the perforation was obviously a late development. Now, the inside of the uterus was filled with blood and numerous translucent, yellowish clots.

“Chicken-fat clots,” [17] See Appendix I: Delicatessen Pathologists. Weston said. That meant it was postmortem.

He cleaned away the blood and clots and examined the scraped endometrial surface carefully.

“This wasn’t done by a total amateur,” Weston said. “Somebody knew at least the basic principles of curettage.”

“Except for the perforation.”

“Yes,” he said. “Except for that.”

“Well,” he said, “at least we already know one thing. She didn’t do it to herself.”

That was an important point. A large proportion of acute vaginal hemorrhages are the result of women attempting self-abortion, with drugs, or salt solutions, or soaps, or knitting needles and other devices. But Karen couldn’t have done this kind of scraping on herself. This required a general anesthetic for the patient.

I said, “Does this look like a pregnant uterus to you?”

“Questionable,” Weston said. “Very questionable. Let’s check the ovaries.”

Weston incised the ovaries, looking for the corpus luteum, the yellow spot that persists after the ovum has been released. He didn’t find one. In itself, that proved nothing; the corpus luteum began to degenerate after three months, and this girl was supposedly in her fourth month.

The deaner came in and said to Weston, “Shall I close up now?”

“Yes,” Weston said. “You might as well.”

The deaner began to suture the incision and wrap the body in a clean shroud. I turned to Weston. “Aren’t you going to examine the brain?”

“No permission,” Weston said.

The medical examiner, though he demanded an autopsy, usually did not insist on brain examination unless the situation suggested possible neuropathy.

“But I would have thought a family like the Randalls, medically oriented…”

“Oh, J. D. is all for it. It’s Mrs. Randall. She just refuses to have the brain removed, absolutely refuses. Ever met her?”

I shook my head.

“Quite a woman,” Weston said dryly.

He turned back to the organs, working down the GI tract from esophagus to anus. It was completely normal. I left before he finished everything; I had seen what I wanted to see and knew that the final report would be equivocal. At least on the basis of the gross organs, they would be unable to say that Karen Randall was definitely pregnant.

That was peculiar.

I HAVE TROUBLE BUYING LIFE INSURANCE. Most pathologists do: the companies take one look at you and shudder—constant exposure to tuberculosis, malignancies, and lethal infectious disease makes you a very poor risk. The only person I know who has more trouble getting insured is a biochemist named Jim Murphy.

When he was younger, Murphy played halfback for Yale and was named to the All-East team. That in itself is an accomplishment, but it is amazing if you know Murphy and have seen his eyes. Murphy is practically blind. He wears lenses an inch thick and walks with his head drooping, as if the weight of the glass burdened him down. His vision is barely adequate under most circumstances, but when he gets excited or tight, he walks into things.

On the surface it would not seem that Murphy had the makings of a halfback, even at Yale. To know his secret, you have to see him move. Murphy is fast. He also has the best balance of anyone I know. When he was playing football, his teammates devised a series of plays especially designed to allow the quarterback to point Murphy in the proper direction and send him on his way. This usually worked, though on several occasions Murphy made brilliant runs in the wrong direction, twice charging over the goal line for a safety.

He has always been drawn to unlikely sports. At the age of thirty, he decided to take up mountain climbing. He found it very agreeable, but he couldn’t get insured. So he switched to sports-car racing and was doing very well until he drove a Lotus off the track, rolled it four times, and broke both clavicles in several places. After that, he decided he’d rather be insured than active, so he gave it all up.

Murphy is so fast he even speaks in a kind of shorthand, as if he can’t be bothered putting all the articles and pronouns into his sentences. He drives his secretaries and technicians mad, not only because of his speech, but also because of the windows. Murphy keeps them wide open, even in winter, and he is an unrelenting opponent of what he calls “bad air.”

When I walked into his lab in one wing of the BLI [18] Boston Lying-in Hospital. I found it filled with apples. There were apples in the refrigerators, on the reagent benches, on desks as paperweights. His two technicians, wearing heavy sweaters under their lab coats, were both eating apples as I entered.

“Wife,” Murphy said, shaking hands with me. “Makes a specialty. Want one? I have Delicious and Cortland today.”

“No, thanks,” I said.

He took a bite from one after polishing it briskly on his sleeve. “Good. Really.”

“I haven’t got time,” I said.

“Always in a rush,” Murph said. “Jesus Christ, always in a rush. Haven’t seen you or Judith for months. What’ve you been up to? Terry’s playing guard on the Belmont first eleven.”

He lifted a picture from his desk and held it under my nose. It showed his son in a football uniform, growling into the camera, looking like Murph: small, but tough.

“We’ll have to get together soon,” I said to him, “and talk about families.”

“Ummmm.” Murph devoured his apple with remarkable speed. “Let’s do that. How’s bridge game? Wife and I had an absolutely devastating time last weekend. Two weekends ago. Playing with—”

“Murph,” I said. “I have a problem.”

“Probably an ulcer,” Murph said, selecting another apple from a row along his desk. “Nervous guy I know. Always in a rush.”

“Actually,” I said, “this is right up your alley.”

He grinned in sudden interest. “Steroids? First time in history a pathologist’s interested in steroids, I bet.” He sat down behind his desk and propped his feet up. “Ready and waiting. Shoot.”

Murphy’s work concerned steroid production in pregnant women and fetuses. He was located in the BLI for a practical, if somewhat grisly, reason—he needed to be near the source of supply, which in his case was clinic mothers and the occasional stillbirths [19] Stillbirths, abortuses, and placentas are in hot demand at the BLI for the dozen or so groups doing hormone research. assigned to him.

“Can you do a hormone test for pregnancy at autopsy?” I asked.

He scratched his head in swift, nervous, fluttery movements. “Hell. Suppose so. But who’d want to?”

“I want to.”

“What I mean is, can’t you tell at autopsy if she’s pregnant or not?”

“Actually, no, in this case. It’s very confused.”

“Well. No accepted test, but I imagine it could be done. How far along?”