Red Mist (30 page)

“It’s not that we didn’t need to.”
I cover my nose and mouth with a surgical mask.
“We just didn’t know any better.”
I put
on a pair of safety glasses to protect my eyes.

“Well, there’s more to worry about now, that’s for sure,” he says, and I can tell he feels terrible.
“I keep waiting for some
God-awful scourge we haven’t heard of or dealt with before.
Weaponizing chemicals and diseases.
I don’t give a damn what anybody
says.
Nobody’s prepared for vast numbers of infectious or contaminated dead bodies.”

“Technology can’t fix what technology destroys, and if the worst happens, nobody’s going to deal with it very well,” I agree.

“That’s something for you to say with the resources you’ve got.
But the fact is, there’s no cure for human nature,” he says.
“No putting the genie back into the damn bottle when it comes to what shitty people can do to one another these days.”

“The genie was never in the bottle, Colin.
I’m not sure there is a bottle.”

We pass the open door of the x-ray room, and I catch a glimpse of a C-arm fluoroscope that I never use anymore.
But advanced
technologies such as computed tomography or magnetic resonance imaging with 3-D software wouldn’t help us if we had it.
Whatever
killed Kathleen Lawler probably wouldn’t be visible on a CT or MRI or any other type of scan, and I hope Sammy Chang already
is receipting documents and swabs to the labs.

Inside the main autopsy room a muscular young man in soiled scrubs and a bloody plastic apron is suturing closed the body
of what I assume is the motor-vehicle fatality from earlier today.
The head is misshapen like a badly dented can, the face
smashed beyond recognition, blood streaking flesh, all of it in stark contrast to sterile cold concrete and shiny metal, to
the lack of color and texture typical of morgues.

I can’t tell the victim’s age, but his hair is quite black and he is lean and well built, as if he went to a lot of trouble
to be physically fit.
I smell the early hints of blood and cells breaking down, of biology giving itself up to decomposition
as a long surgical needle glints in the overhead light with each sweep of white twine, and water dribbles into a sink, tap-tapping
on steel.
On the far side of the room, Kathleen Lawler is on a gurney, a body shape pouched in white.

“Do we know why we posted him instead of doing a view?”
Colin asks the morgue assistant, who has a Marine Corps bulldog tattoo
on the side of his neck and a crew cut.
“Since he doesn’t have much of a head left, almost looks like he got the wrong end
of a shotgun?
Seems like a view would have sufficed.
What exactly was the question in this MV fatality that’s now costing
Georgia taxpayers?”

“If he had a heart attack first and that caused him to swerve into oncoming traffic during rush hour.”
He sutures in long
sweeps and tugs that create a Y-shape of railroad tracks running from the sternum to the pelvis.
“He had a history, had been
hospitalized for chest pain last week.”

“And what did we decide?”

“Hey, not me deciding.
I don’t get paid enough.”

“Nobody around here gets paid enough,” Colin says.

“The Mack truck smashed him to smithereens, and he died of cardiac arrest because his heart quit.”

“What about respiratory arrest?
George, I don’t know if you’ve met Dr.
Scarpetta.”
Colin is grim.

“Yeah, he definitely quit breathing.
Nice to meet you.
I’m just giving him grief.
Somebody has to.”
George winks at me as
he sutures.
“How many times a week do you tell med students rotating
through here that cardiac and respiratory arrest aren’t causes of death?”
He mimics his boss.
“You get shot ten times and
your heart quits and you stop breathing, but that’s not what killed you,” he teases Colin, who’s not laughing, not even smiling.

“I’ll be finished up here in a few,” George says more seriously.
“You need me for the next one?”

He cuts the heavy twine with the sharp, curved tip of the long needle and jabs it into a block of Styrofoam.

“If not, I got supplies that came in this morning and I need to put them away, and I’d like to pressure-wash the bay real
good.
We’re going to have to deal with the stock jars one of these days.
I hate to keep reminding you.
We don’t want the damn
shelves to collapse and formalin and pieces and parts everywhere.
Out of room and out of money.
That’s the country-music song
I’m going to write about this place,” he says to me.

“You know how I am about throwing things out.
Hang around for a bit.
Dr.
Scarpetta and I will get started and see how it goes.”
Colin’s face is hard, and I can see the thoughts in his eyes.

He’s wondering what he might have missed, wondering what all of us dread, those of us who take care of the dead.
If we misdiagnose
a patient, someone else might die.
Carbon monoxide poisoning or a homicide, if we can catch it, we can prevent more of the
same.
It’s rare we can save anyone, but we must work every investigation as if it’s possible.

“You’ve got the stock jars in those old cases?”
I ask about Barrie Lou Rivers, Shania Plames, and Rea Abernathy.

“Well, I didn’t save their gastric, damn it.
I should have frozen it.”

“Why would you think to?”

“I didn’t.
I wouldn’t have thought of it, had no reason to, but I wish I had.”

“And how many times have people like us said that?”
I try to make him feel better.
“There’s been some success in testing formalinfixed
tissue,” I add.
“Depending on what you’re looking for.”

“That’s the thing.
Screen for what?”

We cross a tan epoxy-sealed floor where three additional tables mounted on columns and attached to sinks are spaced beneath
illuminated fresh-air hoods.
Parked by each station is a trolley neatly arranged with surgical instruments, evidence tubes
and containers, a cutting board, an electric oscillating saw that plugs into an overhead cord reel, and a bright red sharps
container.
Cabinets, light boxes, and ultraviolet air sanitizers are mounted on walls, and there are evidence drying cabinets,
and countertops and metal folding chairs for doing paperwork.

“Not that I’m in charge, but first on my list is what she might have been exposed to,” I say to Colin.
“A grayish chalky residue
that smelled like overheating electrical insulation.
It would be extremely helpful to get an analysis ASAP of whatever was
in her sink.
It certainly didn’t smell like anything indigenous to her cell.
I’m not trying to tell you what to do, but if
you’ve got any influence.”

“Sammy’s got enough influence for both of us, and trace, tool marks, documents, they all like a challenge.
Everything these
days is DNA, and not everything can be solved by damn DNA, but try telling prosecutors that, and especially the police.
My
guess is the folks in trace will get on it right away.
I didn’t smell whatever it is, but I’ll take your word for it, and
you can tell me what to do all you
like.
Offhand, I can’t think of any poison that might smell like overheating electrical insulation.”

“So what was it?”
I ask.
“What did she get hold of, and how?
In the maximum security of Bravo Pod, it’s not as if she could
wander around in common areas and mingle with other inmates and get her hands on something she wasn’t supposed to have.”

“Obviously we have to worry about people who had access to her cell.
Always my concern when it’s a death in custody.
Even
under what may appear to be the most normal of circumstances, and this isn’t in the normal category,” he says.
“Not anymore.”

O
n a countertop are boxes of different-size gloves, and I get two pairs for each of us, and Colin unzips the body pouch.
Plastic
rustles as he opens it all the way.
I help him slide Kathleen Lawler onto the steel table, and he walks to bins mounted on
a wall and begins to collect blank forms, securing them to a metal clipboard as I remove the rubber bands around her wrists
and ankle.
I remove the brown paper bags I placed over her hands and left foot earlier, and fold them and package them for
the trace evidence lab, then I tear off a large sheet of white butcher paper from a dispenser on a counter and cover the autopsy
table beside the one we’re using.

Her body is considerably cooler but still limber and easy to manipulate as we begin to undress it, and we place each article
of clothing
on the paper-covered table next to us.
The button-up white uniform shirt with inmate stamped on the back in large dark blue
letters.
The white trousers with a button fly and the blue initials GPFW down the sides of the legs.
A bra.
A pair of panties.
I find a hand lens on a cart and turn on a surgical lamp, and under magnification I discover a faint area of orange smearing,
as if Kathleen might have wiped her hand on her right pant leg.
I retrieve a camera from a shelf and place a scale next to
the stain, centering it under the light.

“I don’t know where you get food testing done around here,” I say to Colin.
“This looks like cheese, but we should find out.
I’m not going to swab it, will let trace take care of it.
She had something orange under her right thumbnail, too.
Might be
the same thing, something she touched or ate not long before she died.”

“GBI uses a private lab in Atlanta that analyzes food, cosmetics, consumer products, you name it,” he says.
“I wonder if inmates
can buy these cheese sticks or cheese spread in the commissary.”

“Definitely the yellowy-orange color of cheddar or a cheddar spread.
I didn’t see any cheese or cheese sticks in her cell,
but that doesn’t mean she didn’t have something like that earlier.
Of course, we’d know more if her trash hadn’t disappeared.
What about petechial hemorrhages of the eyes, the face, in the Plames case?”
I return to the subject of Shania Plames’s death
as I return to the table bearing Kathleen Lawler’s body.

“Nothing.
But you don’t always have that, either, in suicidal hangings with full vascular compression.”

“Based on the rig you’ve described, the way her uniform trousers were tied around her neck and legs, I’m not sure I would
expect
the full vascular compression associated with full—not partial— suspension or with complete ligature strangulation.”

“It was unusual,” he agrees solemnly.

“Possibly staged?”

“Never entered my mind at the time.”

“Why would it?
I doubt it would have entered mine.”

“I’m not going to say it couldn’t have been staged,” he continues.
“But I would have expected evidence of a struggle, of some
means of incapacitating her.
Not so much as a bruise.”

“I’m just wondering if it’s possible she was already dead when she was tied up and placed in the position she was found.”

“Right about now I’m wondering a lot of things,” he says grimly.
I measure a tattoo on the lower-right abdomen, a Tinker Bell–
like fairy that is six and a half inches from wing to wing.
Based on the way the image is stretched, I estimate that Kathleen
got the tattoo when she was thinner.

“And if she already was dead when she was positioned on her bed,” I add, as I continue to think about Shania Plames, “the
question is, dead from what?”

“Dead from what and with no indication of foul play or anything out of the ordinary.”
Colin pushes up the mask loose around
his neck, covering his nose and mouth.
“Something that doesn’t show up on autopsy or on a tox screen.”

“There are countless poisons that don’t show up on a standard drug screen,” I contemplate, as we hold the body on its side,
checking the back.
“Something fairly fast-acting, causing symptoms that remain largely unreported because either witnesses
aren’t reliable or
the victim is isolated and out of sight or all of the above.”
I measure another tattoo, this one a unicorn.
“And most important,
something not survivable.
The person doesn’t live to tell.
There are no failed attempts that anybody ever reports.”

“None that we know of, at any rate,” he says.
“But we wouldn’t know.
If someone gets extremely ill in prison and survives,
we’re not going to find that out.
We don’t get near-deaths reported to us.”

He presses his fingers against an arm, a lower leg, and makes a note of moderate blanching.
He opens the eyelids and with
a plastic ruler measures the pupils.

“Dilated equally, six millimeters,” he says.
“Theoretically, with opiates you can see constricted pupils postmortem.
I never
have.
Other drugs cause dilation, but dead pupils are dilated anyway.”
He makes swift incisions with the scalpel from clavicle
to clavicle and down the length of the body.
“We’ll PERK her.
Work her up for sexual assault.
Work her up for every damn thing
we can possibly think of.”
He begins reflecting back tissue, guiding the scalpel with his right index finger and manipulating
with his thumb as he holds forceps in his left hand.

“Which cabinet?”
I ask, and he points a bloody gloved finger.

I find the Physical Evidence Recovery Kits and examine the body for sexual assault, swabbing every orifice and photographing,
labeling each evidence bag.

“I’m going to swab the inside of her nose and mouth for toxicology while I’m at it,” I let Colin know.
“And submit hair.”

He removes the breastplate of ribs and drops it in a plastic bucket by his feet as the morgue assistant, George, walks in
with films.
He attaches them to light boxes, and I walk over to have a look.

“An old fracture of her right tibia.
Nothing recent.
Typical arthritic changes.”
I move from one light box to the next, scanning
bright white bones and the shadowy shapes of organs.
“She does have a fair amount of food in her stomach.
I wouldn’t expect
that if she ate at five-forty this morning and died at around noon, or some six hours later.
Delayed gastric emptying.”
I
return to the autopsy table and pick up a scalpel.
“Something that’s causing the digestion basically to quit.
Barrie Lou Rivers’s
last meal was undigested.
What about the other two?”
I refer to Shania Plames and Rea Abernathy.

“I vaguely recall.
And yes.
Undigested food.
Certainly in Barrie Lou Rivers’s case, and I figured it was stress,” Colin says.
“I’ve seen it before in executions.
The inmate eats his last meal and it’s mostly undigested because of anxiety, of panic.
Although go figure how any of them eat.
If I was about to be executed, I don’t think I would.
Just give me a bottle of bourbon
and a box of Cuban cigars.”

I cut a slit in the stomach and empty its contents into a carton.
“Well, she certainly didn’t have what we were told was delivered
to her cell early this morning.”

“No eggs and grits?”
Colin glances at what I’m looking at as he uses both hands to lift the liver out of the electronic scale’s
stainless-steel bowl.
He picks up a long-handled, wide-bladed autopsy knife.

“Two hundred and eighty MLs, with pieces of what looks like chicken, pasta, something orange.”

“Orange as in the fruit?
Supposedly an orange was on the breakfast tray.”
He cuts sections of liver as if he’s slicing bread.

“Not that kind of orange,” I answer.
“I’m not seeing evidence of fruit.
Orange as in the color orange.
Cheeselike, and the
same color as the orange material I found under her thumbnail and on her
trousers.
Where might she have gotten chicken, pasta, and cheese this morning?”

“Moderate fatty changes in the liver but not bad, considering.
But about one out of three livers are normal in alcoholics,”
he says, starting on the lungs.
“You know what makes you an alcoholic.
You drink more than your doctor.
So they lied about
what she ate this morning.
Chicken and pasta?
I got no idea.”
He grabs a lung out of the scale and wipes his bloody hands
on a towel.
“If they somehow killed her, wouldn’t you think they’d be smart enough to know she’s going to end up here and
we can tell what she ate?”
He jots down weights on the clipboard.

“Not everyone is that astute, especially if she really did eat between five-thirty and six this morning, when breakfast apparently
is served in Bravo Pod.”
I label a carton for toxicology.
“The assumption might have been that her food would be digested
by the time she died.
Under normal circumstances, it would have been.”

“She’s got some congestion, mild edema.”
He slices sections of a lung.
“Engorgement of alveolar capillaries, pink foamy fluid
in the alveolar spaces.
Typical of acute respiratory failure.”

“And typical in heart failure.
Hers is surprisingly good.”
I begin cutting sections of her heart on the large cutting board.
“Looks a little pale.
No scarring.
Vasculature widely patent.
Valves, chordae tendineae, papillary muscles are without note,”
I dictate as I dissect.
“Ventricular wall thicknesses, chamber diameters are appropriate.
Exiting great vessels widely patent.
No lesions in the myocardium.”

“I sure wouldn’t have guessed that.”
Colin wipes his hands again and writes it down.
“Nothing to make us think an MI, then.
All roads keep leading to toxicology.”

“Not seeing anything at all to indicate an MI.
You can check for histologic evidence, the theory that cardiac myocytes divide
after myocardial infarction.
But generally if I don’t see anatomic evidence, I’m skeptical.
And I’m seeing no evidence.
Aorta
has minimal atherosclerosis.”
I look up as the doors to the autopsy room swing open.
“Nothing whatsoever to indicate she died
from anything cardiac-related, in my opinion.”
I hear familiar voices as George walks back in.

I recognize Benton’s calm, mellow baritone, and my mood is lifted by the sight of him in creased khaki pants and a green polo
shirt, lean and handsome.
His silver hair is slicked back, probably from sweating in a van with no air-conditioning, and it
doesn’t matter that we are in a stark autopsy room that smells like death or that my white gown and gloves are bloody and
Kathleen Lawler is opened up, her sectioned organs in a bucket on the floor beneath the table.

I’m happy to see Benton, but our being in a morgue in the middle of an autopsy isn’t why I don’t want him close, and then
Lucy appears, slender and foreboding in a black flight suit, her auburn hair loose around her shoulders and streaked rose
gold in the overhead lights.
Both of them stay where they are, on the other side of the room.

“You need to stay over there,” I tell them anyway, and I sense from Benton’s demeanor that something is wrong.
“We don’t know
what she’s been exposed to, but a tox death is first on our list.
Where’s Marino?”

“He didn’t want to come in.
Probably for the same reason you don’t want us getting close,” Benton says, and something absolutely
is wrong.

I can see it on his face, in the tense way he is standing and the imperviousness of his face.
His eyes are locked on mine,
and he looks quietly agitated, the way he gets when he is intensely worried.

“Dawn Kincaid’s in a coma,” he then says.

An alarm begins to sound at the back of my thoughts.

“I got the latest update when we landed, and they’re saying that she’s brain-dead but they’re not entirely sure.”
He projects
his voice so Colin and I can hear him.
“You know how that is.
They’re never really sure even when they are.
Whatever’s the
cause, it’s very suspicious,” he adds, and I envision Jaime Berger’s face last night right before I left her apartment.

She looked sleepy, and her pupils were dilated.