Робин Кук - Genesis

Taking care of the direct threat that Aria Nichols presented had been easy, since she lived alone like Kera. It had also been helpful that she’d used a background story with the genealogical company she’d worked with that couldn’t possibly incriminate him. But the most worrisome part of Aria’s involvement, and the one that frightened him the most, was that she’d shown the family trees to Dr. Laurie Montgomery. When Carl had heard that, the clouds truly thickened and threatened a catastrophic storm. But then, as if manna from heaven, he learned that Dr. Montgomery was to have surgery that very day, meaning she’d be in the hospital and undoubtedly have an intravenous line in place, and it all had just been confirmed by her husband. It was this information that had parted the clouds, allowed a bit of sun to shine through, and made him feel like celebrating.

Glancing at the antique wall clock, Carl thought this was an opportune time to pay a quick visit to the Emergency Department. He stood up and got his long white doctor’s coat. He then checked himself in the mirror mounted on the back of his door. Although he had plenty of syringes, he needed more potassium chloride. Like with Madison Bryant, he planned to visit Laurie Montgomery’s hospital room during that same early-morning time interval when the night shift took their lunch breaks. With Laurie, the task would be considerably easier than what he’d had to face with Madison. As a VIP Laurie would undoubtedly be in a private room, especially if she was in the Kimmel Pavilion, which Carl expected she would be. With Madison, he had to worry about nurses and nurses’ assistants in constant attendance. That was not going to be the case with Laurie. And 3:00 to 4:00 was when most hospital deaths occur.

Confident he looked very much the part of a clinical professional, Carl walked out of his office. He informed his private secretary that he had a short meeting he needed to attend but would be back in about a half hour. She said that she would hold all his calls.

May 11th

12:40 P.M.

This is big-time weird,” Vinnie said. He and Jack had paused just after they finished removing the clothes from Aria Nichols’s corpse, which was lying on table #1 in the autopsy room. Since there was only one other case going on at that moment all the way down on table #8, they felt like they were by themselves, facing the unique situation of autopsying the body of a person they had interacted with on a personal level just the day before. “I’ve always wondered what it would be like to autopsy someone I knew, and now I know I don’t like it.”

“Me, neither,” Jack said. “It’s a jolting reminder of the fragility of life. And it’s not just emotionally disturbing. From a professional point of view, it’s going to make it more difficult to maintain the objectivity that is required. It also makes me embarrassed that I’d found her unpleasant to deal with. Now that she’s dead, it seems so petty.”

“Unpleasant wouldn’t be the way I’d choose to describe her,” Vinnie said. “I think ‘snotty entitled bitch’ would be much closer to the truth.”

“Tone it down, big guy!” Jack said. Both Jack and Vinnie heard the door to the hallway burst open, and both turned to see someone coming in their direction. It was Chet McGovern. He’d pulled on a surgical gown over his street clothes and was holding a surgical mask against his face. He walked right up to the table and looked down on the naked corpse.

“Nice body,” he said. “What a waste.”

“Oh, please,” Jack complained at the utter inappropriateness of such a comment. “Let’s show a modicum of respect for the dead, particularly a colleague!”

“Hey, loosen up,” Chet said. “I was only trying to lighten the mood with a bit of black humor.”

“I hope that was the case,” Jack said. “But with a man of your off-hours reputation, who’s to know?”

“Okay, maybe I crossed the line,” Chet said. “I suppose under the circumstances it was out of place and out of line.”

“You got that right,” Jack said.

“Are you guys okay to do this case?” Chet said. “Having just worked with her yesterday, maybe you want me to find someone else to do the autopsy who hasn’t had anything to do with her.”

“We’ve got it under control,” Jack said. “To be honest, Laurie specifically asked me to take care of it, and I said I would. But thanks for asking.”

Once again, the door to the hall banged open, and all three men turned to see who it was. This time it was Marvin Fletcher, one of the mortuary techs, and he, too, came directly to table #1 and looked down at the corpse. “Holy shit, it is her! I heard about this and couldn’t believe it. I had to come and check if it was just a rumor.”

“It’s certainly not rumor,” Jack said.

“Obviously,” Marvin said. “It’s a shame, I guess, but I can’t say I was charmed by her. I also heard that she still had the needle embedded in her arm, just like the case I did with Dr. Montgomery and her just a few days ago.”

“That’s right,” Jack said. “We just removed the syringe, and as expected it tested positive for fentanyl. I assume you are talking about the Kera Jacobsen case?”

“That’s the one,” Marvin said. “We thought it meant she died really fast, probably with a big overdose of fentanyl.”

“That could be the case here, too,” Jack said. “Who knows, maybe they got the drug from the same source since they both worked at the NYU Med Center, and it contained more fentanyl than usual. Part of the overdose problem is that the concentration of fentanyl can vary, and as potent as it is, it doesn’t have to vary too much to be lethal.”

“We wondered the same thing,” Marvin said. Then he added, “Hey, do you mind if I stay and add my two cents?”

“That’s up to Vinnie,” Jack said. Personally he didn’t care if Marvin stayed, but he knew there were some competitive feelings among the mortuary techs, and he didn’t want to be party to it. He knew that Vinnie, as the senior tech, was sensitively possessive about his exclusive relationship with Jack, by far the busiest ME.

“Fine by me,” Vinnie said.

“All right, I’m out of here,” Chet said. “I’ll be interested to hear if you find anything unexpected.”

Ignoring Chet, Jack said to Vinnie and Marvin, “Okay, you guys, let’s knock this one out.”

For a few minutes, Chet stood and watched the sudden burst of activity, but feeling cold-shouldered and a twinge embarrassed at his attempt at black humor, he soon left to prepare for the afternoon conference.

While Jack was doing the external exam, Marvin mentioned that there were other apparent similarities to the Kera Jacobsen case, namely little or no evidence of dried saliva around the mouth, suggesting there had been very little foaming, which is typically seen with pulmonary edema. Jack found this particularly interesting because he was well aware that with fentanyl deaths, pulmonary edema was almost always a primary finding and remnants of foaming were invariably present. Also like with Kera, there was no scarring from previous episodes as usually seen with intravenous opioid, particularly heroin, overdoses. Although there was no scarring, there were signs of other venous punctures, but they all appeared to be new or relatively new, suggesting that Aria’s drug use, at least intravenous drug use, hadn’t been a long-term habit.

Once Jack made the usual Y incision and the internal aspect of the autopsy commenced, any strangeness that existed because of familiarity with Aria on a personal level vanished, and the team functioned with professional celerity. Since Vinnie and Jack had worked together so often, they could anticipate each other’s needs, and often they could go for periods with no conversation. Sensing that he wasn’t really needed, Marvin mostly stayed out of the way and functioned more as a gofer than an integral member of the team.