Робин Кук - Genesis

“How did you end up in Pathology?” Laurie asked. She wanted to get away from Aria’s lurid and depressing family history. Laurie had sometimes felt sorry for herself growing up because her father had been emotionally distant. She couldn’t imagine what it would have been like to be physically abused.

“That’s a good question,” Aria said. “It was by elimination. Maybe I should have given more thought to becoming a doctor, because during medical school I was quick to learn that I hated seeing patients. I mean, it’s pretty pathetic when you think about it. But what can I say? It was what it was. Anyway, pathology is the only real choice if you hate patients. It’s also intellectually stimulating.”

“Well, it’s encouraging to hear you were at least challenged,” Laurie said. She tried to gird herself for an unpleasant afternoon. “Let’s talk about the next hour. My intent here is to get a sense of what you have learned about forensic pathology in the little more than a week you’ve been here. We have an overdose case, and I want you to essentially do it. Are you up for that?”

“I can tell you this: It sounds a hell of a lot more interesting than me just standing around emptying the wastebasket.”

“I hope you find it stimulating,” Laurie said. “Maybe we can even excite you a bit about forensic pathology.”

“That would be a stretch,” Aria said, reverting to her disinterested voice. “Let’s not let expectations get out of hand.”

May 8th

4:15 P.M.

As far as Laurie was concerned, the first part of the autopsy went rather well, and she began to relax and even enjoy to an extent the nostalgia the experience evoked. Although Aria initially mentioned her disgust related to the mild putrid odor and the ghoulish facial appearance of the deceased, she didn’t dwell on it. And Laurie was relieved that the attitude Aria had displayed in the locker room had seemed to melt away once she focused on the actual tasks at hand — Laurie quickly agreed with Chet that she was no dummy.

“The full-body X-ray can potentially help the identification process and will also pick up any foreign bodies that might have contributed to the cause of death,” Aria had correctly said in answer to Laurie’s question of why the film had been taken. Such a response made Laurie feel that Aria had been listening when she’d observed the forensic autopsies, after all.

Laurie had Aria conduct the external exam verbally and was impressed with Aria’s description. Aria talked about why it was best to leave the clothes on the victim, as Kera Jacobsen was still attired in her bathrobe, exactly the way she had been found. She also talked about why the syringe, still embedded in Kera’s left arm, had been left in place and why it had been carefully covered with paper and tape so that it could be examined for DNA and fingerprints. She also mentioned two other significant findings that Laurie herself had noticed — namely, that there wasn’t much evidence of dried foam around Kera’s mouth and nostrils and that although there were signs of other venous puncture marks, they all seemed relatively new.

“My sense is that she had not been a drug user for long,” Aria had said, and Laurie agreed.

After they had removed the bathrobe and examined the livor mortis of the lower extremities, Laurie had quizzed Aria about livor mortis, rigor mortis, algor mortis, and other methods of estimating time of death and why the time of death was important. Laurie also talked about various signs of the body having been moved, which clearly had not been the case with Kera. In all these arenas, Aria displayed reasonably competent knowledge. Although she might have skipped some of the autopsies she’d been assigned, of the ones she had observed, she’d absorbed a considerable understanding of the forensic process.

It wasn’t until they were ready to begin the internal part of the autopsy that Aria’s personality reverted back to what Laurie now feared was her normal inconsiderate self. What seemed to set it off was Laurie merely asking if Aria was familiar with the difference between the forensic or Virchow autopsy technique, which they used at the OCME to determine the cause and manner of death, compared with the clinical or Rokitansky en bloc method that was done to study the pathological effects of disease.

“Yes, for fuck’s sake!” Aria snapped in a loud, irritated tone of voice. She was holding the scalpel, ready to make the initial incision. “Hell, I’ve been a pathology resident for nearly four years. I’d have to be a dumb ass not to know the difference.”

Laurie was shocked and found herself back to having a staring contest with Aria. They were both wearing surgical masks with plastic eye shields, so Laurie couldn’t see much of her face. The transformation in demeanor had been so sudden that Laurie was momentarily speechless. The only thing that had changed prior to the outburst was that Marvin, who had been hovering in the periphery ready to fetch whatever might be needed, had now joined Aria on the right side of the corpse. Since Laurie had intended for Aria to do the case, she had allowed her to be on the right side while Laurie had gone to the left, where she preferred her assistant to stand.

Before Laurie could reboot her brain, Aria broke off staring at Laurie to direct her attention to Marvin. “I don’t like you standing this close to me,” she snapped.

Marvin appeared as shocked as Laurie. He backed up a step and raised his hands, palms out. “Sorry,” he said.

“What’s the problem?” Laurie demanded, finding her voice. “He was just going to lend a hand if needed.”

“I don’t like men I don’t know crowding me,” Aria said.

Shocked anew at this obviously gender-discriminatory tantrum, Laurie was again speechless.

“It’s not personal, it’s just how I feel,” Aria added.

Laurie was dumbfounded and switched her attention to Marvin. “I’m sorry,” she said. “That was uncalled for, inappropriate, and will not be tolerated.”

“As I said, it’s not personal,” Aria repeated. “I need space, is all. Let’s not make a big deal out of it. Maybe he wouldn’t like it if I crowded him.”

“It’s okay, Dr. Montgomery,” Marvin said magnanimously. “I didn’t realize I was crowding anyone.”

“You were,” Aria insisted. “You actually touched up against me, and I responded. Now it’s over. Let’s get this case finished. Go over on Dr. Montgomery’s side if you want to participate!”

Laurie and Marvin exchanged a prolonged glance. They had worked together on so many occasions in the past that they often didn’t even need to talk to be on the same wavelength. Nonverbally they decided that it was best to get the case over with and deal with the incident later.

Meanwhile, Aria started the case by making a modified Y incision from the point of both shoulders, meeting in over the sternum, and then extending down to the pubis. She handled the knife with confidence. It was quickly apparent she was a skilled anatomical pathologist.

Dismayed at the unpleasant and inappropriate personality that Aria was again demonstrating, Laurie said little as Aria worked although she was prepared to intervene if Aria did anything out of the ordinary. But there was no need. Within minutes Aria had both the chest cavity and the abdominal cavity open with the internal organs in full view. Following Aria’s suggestion, Marvin had moved around to the other side of the table to stand next to Laurie.

“I’m going to do the thorax first,” Aria said. Her voice had reverted to the mild tone she’d used at the beginning of the case. Laurie merely nodded at Aria’s announcement, questioning how this woman got accepted to medical school and then a prestigious Pathology residency with that mercurial temperament. If nothing else, she had to have been a hell of a student.