Робин Кук - Genesis

“Damn,” he said out loud. It was 2:25 P.M., much too early for basketball. People didn’t start showing up on the court until at least 4:30. Unfortunately, checking the time had the negative effect he feared and was trying not to think about, namely that Dr. Cartier had not called him. If Laurie’s surgery had begun around noon, that meant it had been going on for more than two hours, not a good sign.

“Get a grip!” Jack voiced through clenched teeth. He knew he had to think about something else, and the only thing that came to mind was the autopsy he’d just finished on Aria Nichols. As a kind of mental game, he carefully, step by step, went over the entire procedure, forcing himself to remember all sorts of insignificant details from the external exam all the way through to the bitter end. Ultimately, he admitted to himself that the only significant finding was the lack of evidence of pulmonary edema, a kind of positive negative. Such a thought at least brought a passing smile to his face since he was a major fan of wordplay and double entendre, which the phrase positive negative surely represented. Remembering the lack of pulmonary edema reminded him of the apparent similarities between Aria Nichols’s case and Kera Jacobsen’s and what that might mean beyond the worry that both women possibly had gotten their drugs from the same deadly source. Was it just a weird coincidence or did it presage an even greater rash of overdoses in the city than what they were already seeing? He also found himself pondering the weird irony that Aria had participated in Kera’s autopsy as a further association between the two cases.

The sudden ringing of his phone jarred him out of his thoughts. It was John DeVries. “The Jacobsen gastric sample was positive for fentanyl,” he said. “Was that expected?”

“Yes and no,” Jack said. “As I mentioned, it was positive on the case we did today and there were other similarities between the two cases. I don’t know what it means, if anything.”

“I just thought I’d ask,” John said.

“Let me ask you a question,” Jack said. “Is there a fast test for 3-methylfentanyl?”

“No, the rapid tests don’t differentiate between the various analogues.”

“That’s too bad,” Jack said. “The autopsies on these two women suggest they died very rapidly, which scares me to think it involved one of the super-potent analogues.”

“We’ll know as soon as we have our results from liquid chromatography and mass spectrometry.”

“But that takes time,” Jack moaned. “You know me, I want the results yesterday.”

John laughed. “I can vouch for that, remembering our battles in the days of yore. Give me the case accession numbers and I’ll see if I can speed things up.”

“I only have handy the accession number of the case I did today,” Jack said. “But I can get the other one easy enough.”

“Don’t bother,” John said. “Just give me the names again and I’ll look them up.”

“Aria Nichols was today,” Jack said. “Kera Jacobsen was the one done a few days ago.”

“I’ll see if I can have the results early next week,” John said.

“Much appreciated, John,” Jack said.

Marveling anew at John’s personality change, Jack went back to going over the details of Aria’s autopsy, and without knowing why, he started thinking about the autopsy he’d let Aria do on Madison Bryant. What came to mind was the vulgar tirade Aria had let loose the moment she’d seen Madison Bryant on the autopsy table, complaining about Madison avoiding helping her on the Jacobsen case by getting hit by a train and dying. At the time, it was Aria’s obscene language and total lack of human warmth or empathy that had caught Jack’s attention. Currently, instead of the profanity, he was stuck on how the three cases were interrelated.

Tipping forward in his desk chair, Jack put in a call to Bart Arnold. Thinking about Madison Bryant reminded him that he’d not seen the hospital chart that he’d called for after the autopsy yesterday. Besides, Bart had asked him to provide a follow-up with Aria’s autopsy.

As was usually the case, Jack got Bart on the phone immediately. As the department head, he rarely did cases himself, with Aria’s being an exception, so contrary to the other MLIs who were out on scene most of the day, Bart spent the vast majority of his workday at his desk.

After identifying himself, Jack said: “I finished Aria Nichols’s autopsy. Except for a lack of the usual pulmonary edema seen in fentanyl overdoses, there was nothing striking about it.”

“Thanks for letting me know,” Bart said. “And from this end, the mother didn’t add anything particularly relevant other than insisting she’d had no idea her daughter was a ‘goddamn druggie.’ Those were her words.”

“Like mother, like daughter,” Jack said. “What about the Bellevue hospital records for Madison Bryant? Any luck? I want to see them and not just the digital record.” Jack made no effort to hide his frustration.

“I got the hard copy here on my desk,” Bart said. “Sorry! I can have someone run them over to 520 within the hour if you’d like. Are you in your office?”

“I am,” Jack said. “Send them over!”

“Any word from Dr. Montgomery yet?” Bart asked.

The innocent question felt like a stab in the back for Jack, who had been actively trying to avoid thinking about Laurie. He had to clear his throat to steady himself mentally. “Not yet, but soon.”

“Give her my best when you speak with her,” Bart said.

“I will,” Jack said. As he hung up the phone, he felt suddenly irritable. He wasn’t angry with Bart but rather angry that Laurie had had the bad luck to inherit the mutated BRCA1 gene. If that hadn’t happened, at that very moment she would have been down in her office taking care of business instead of being on one of the NYU Langone Medical Center’s operating tables.

“Hey partner, wassup?”

Jack looked up to see Chet’s silhouette filling the doorway to the hallway.

“Not much,” Jack said, purposefully avoiding the truth that he was desperately trying not to think about Laurie.

“I wanted to apologize for my flippancy down in the pit,” Chet said.

“It’s already been forgotten,” Jack said with a wave of dismissal.

“Thanks,” Chet said. “Find anything of note on Aria’s autopsy?”

“No, unless you think finding no pulmonary edema on a fentanyl overdose is noteworthy.”

“Since it is found in ninety-six percent of fentanyl overdoses, I’d say it is noteworthy,” Chet said. “Interestingly enough, it was the same on the Jacobsen case. Are you aware of that?”

“Yes, Marvin reminded us,” Jack said. “It makes me worry both were killed with one of the extraordinarily potent fentanyl analogues. I think the explanation for the lack of pulmonary edema is that both died so rapidly there wasn’t time for it to develop.”

“That’s an interesting supposition,” Chet said.

“As long as you’re here, let me run something by you,” Jack said. “There’s an interesting association between the Jacobsen, Bryant, and Nichols cases.”

“How so, other than Jacobsen and Nichols being overdoses?” Chet asked.

“There’s a curious tangled web of sorts,” Jack said. “Or at least there might be a tangled web. Jacobsen and Bryant were coworkers and fast friends. Nichols did the Jacobsen autopsy and, according to Laurie, was motivated to find the father of the unexpected fetus. Apparently, Bryant was going to help her but ended up getting hit by a train and dying in the hospital. All this happened over three days.” Jack fell silent, staring at his former office roommate.

Chet shifted his weight. “Are you thinking that there is some underlying connection here?” he said.