Робин Кук - Genesis

“Has this ever happened to you?” Aria asked. “I mean, discovering a pregnancy during an autopsy when you had no clue whatsoever?”

“Yes, once,” Laurie said. “It was similar to this case. Yet we shouldn’t be all that surprised. As medical students we were all taught that whenever you are confronted with a female patient ranging in age from menarche to menopause, you should consider them pregnant until proven otherwise. It’s to avoid doing anything untoward to the pregnancy, like a simple X-ray or an inappropriate medication.”

“It’s different with a live patient,” Aria said.

“I know what you mean,” Laurie said. “The beginning of life is so different than death.”

“How old do you think it is?” Aria asked. She looked closer at the tiny fetus huddled against the wall of the uterus with its bulging, oversize forehead and tiny hands.

“Marvin, get us a ruler, please,” Laurie said. To Aria she added: “My guess is in the ten-to-eleven-week realm. The hands are quite well developed.” She took the small ruler that Marvin handed her and measured. “Thirty-eight millimeters, or an inch and a half,” she said. “So yes, I’d estimate ten weeks, meaning it had just changed its designation from an embryo to a fetus.”

“Was the victim found by her boyfriend?” Aria asked while continuing to stare at the fetus. Her tone had changed yet again. Now she sounded irritated, almost angry.

“No, she was found by a female coworker,” Laurie said.

“That doesn’t compute,” Aria snapped.

“I’m not sure what you mean,” Laurie said. “What doesn’t compute?”

“She should have been found by the boyfriend,” Aria said emphatically. “The bastard, whomever the hell he is, gets this woman pregnant and then lets her sit around and rot for two or three days. That’s not right.”

“That’s a mighty big leap of faith,” Laurie said. “At this point there’s no way of knowing the relationship between this woman and the father. For all we know it could have been donor sperm.”

“Give me a break,” Aria commented derisively. “This wasn’t a sperm-donor pregnancy. Some bastard had his way with this woman and then abandons her. I can just feel it. Hell, he might have even supplied the drugs or been the reason she decided to take them.”

“Those are rather wild assumptions,” Laurie said. “In forensic pathology we have to stick with the facts and avoid value judgments. We also have to finish this autopsy. Let’s continue.”

Going back to work, Aria followed Laurie’s directions for dealing with the fetus and the ovaries. As they expected but hadn’t noticed, there was a sizable corpus luteum in the left ovary. For a time, Aria was quiet as she dealt with the rest of the abdominal organs, but it didn’t last. Soon she was back to railing against the unknown boyfriend. Laurie listened but didn’t respond as she was nonplussed at Aria’s apparent anger, making her question if there had been some similar pregnancy event in her life.

Finally, Aria said: “You know, coming across this fetus has really caught my attention. I never expected this kind of surprise twist. I think it deserves to be looked into.”

“I would encourage you to do so,” Laurie said. “But I need you to do it for the right reasons and with an open mind. I don’t want to think that it’s your apparent animus toward men or personal history that’s motivating you.”

“In the locker room you bragged that forensic pathology provided an opportunity to listen to the dead tell their stories. I’m hearing this woman,” Aria said, “and she’s telling me loud and clear that something is not right in Camelot, and I mean to find out what it is. Someone has to find and talk to the father.”

“Okay, I’ll encourage it with a couple of caveats,” Laurie said. Despite Aria’s inappropriately emotional carryings-on about the woman’s boyfriend, Laurie couldn’t help but be pleased something had caught her attention. “First, you must keep me fully apprised of what you’re doing and what you’re learning on a concurrent basis. I need this for a variety of reasons but mostly because I am responsible for the death certificate, so be sure to leave me your number so I can get in touch if need be. And second, you do your investigative work under the supervision of our MLI who is already involved with the case. His name is David Goldberg, and he has legal clearance to investigate. As a pathology resident rotating through the OCME, you don’t. Is this all understood and agreed to?”

“I suppose,” Aria said without a lot of enthusiasm about being forced into a collaboration. She couldn’t have cared less whether she had legal clearance. If the boyfriend had been the one who’d found the body, she wouldn’t have been so suspicious.

“Those are the stipulations,” Laurie said. “Can I get a more definitive reply than ‘I suppose’?”

“All right, whatever you say,” Aria answered.

“And there is another restraint you have to be aware of,” Laurie said. “Because of HIPAA there are restrictions about the patient’s pregnancy until fifty years after the individual’s death. It’s privileged information. I want to be sure you understand. We will not be telling the family even though it will be part of the autopsy record, which the next of kin can request.”

“Yeah, yeah, I know,” Aria said.

“Okay, good,” Laurie responded. “Let’s do the neck and the brain quickly and finish up.”

The rest of the case went rapidly, with no more surprises. There was no cerebral edema or swelling of the brain. Laurie continued to be impressed with Aria’s technical skills even if she found the woman’s personality a hard pill to swallow. Toward the very end of the autopsy, Laurie began to sense that Aria was becoming progressively eager to leave and seemed to be rushing, which was a recipe for disaster. Thoughtful and careful progress during the autopsy was the way to avoid accidents like cuts or puncture wounds with instruments. When Laurie mentioned it, Aria dismissed her concern by saying she was always careful.

As Aria was finishing the final labeling of the specimen jars, Laurie snapped off her gloves and said: “Well done, Dr. Nichols. That was a terrific forensic autopsy, and I’m impressed with your technical skills. Now, before you dictate the case, I’d like you to help Marvin clean up and get the body into the cooler. As for me, I need to get up to my office.”

“Sorry, but I don’t have time,” Aria said. She imitated Laurie by snapping off her own gloves, but unlike Laurie, she tossed them on top of the closed corpse.

“What did you say?” Laurie asked, even though she had clearly heard.

“I said I don’t have time,” Aria repeated. She was already walking away from the table, heading to the door to the hall. Calling out over her shoulder, she added, “Besides, it’s not my job. And I want to see if I can catch David Goldberg before he leaves for the day.”

Dumbfounded, Laurie watched the swinging doors that led to the hall close after Aria had passed through. Laurie shook her head in disbelief at Aria’s insouciance.

“I’ll give you a hand,” Laurie said, turning back to Marvin, who’d overheard the exchange.

“It’s okay, Dr. Montgomery,” Marvin said. “I’m sure you have better things to do. And Vinnie’s here. He’ll help me get the body on a gurney.”

“Are you sure?” Laurie said. In the past she’d always made it a point to help after autopsies.

“No problem,” Marvin said.

“I’m sorry about Dr. Nichols’s behavior,” Laurie said. “Any kind of discrimination, gender or otherwise, has no place here at the OCME and won’t be tolerated.”

“She’s something else,” Marvin said, as he gathered up all the specimen jars to take them out of the autopsy room. “I wasn’t all that surprised. I’d heard a few of the guys have had run-ins with her.”