The Coroner, page 1
THE CORONER
Jennifer Graeser Dornbush
To Ryan, who had the courage to marry this coroner’s daughter despite the human organs in the basement freezer and the body bags drying on the lawn. I love you.
ACKNOWLEDGMENTS
Thank you to Julie Gwinn. When we first met, this novel was just a script and a prayer, but even in that two-minute meet-and-greet in that noisy line at Starbucks, you recognized the potential in the story and me. You stuck with me as I wrote it into novel form and then pitched it relentlessly until it found the perfect home with Crooked Lane. My deepest gratitude for being with me on this journey and for believing in me. I’m pretty sure I still owe you a coffee. Your Starbucks or mine?
Thank you to Anne, Jenny, Jennifer, Matt, Sarah, and the amazing staff and editors at Crooked Lane. It was worth the wait to find you all! You have been a dream to work with and have helped me shape this story into something I’m proud of. You were the perfect finishing flourish on this marathon project. I don’t mean this to sound trite, but let’s be honest: our relationship is the youngest on The Coroner’s literary journey, and you all still need to pass one more test … posing for a selfie in my body bag.
To Barbara N., Chris and Kathy R., Sheryl A., and the many other mentors and writers at the Act One Program in Los Angeles who saw the earliest drafts and the potential in this story when first started as a feature script in 2002. You all did your best to nurture the seed of this story and to nurture me as a newbie writer to tell it. Even after a couple dozen drafts and lots of rejections, I held onto your advice that truly great stories never die. There are not a finer bunch of storytellers that I’ve come across. You are a part of The Coroner’s story. Thank you.
Thank you to Ronald E. Graeser, D.O., and Gail Graeser, the real coroner (ahem … medical examiner), and his wife. Dad, thank you for being part mad scientist, part absent-minded professor, and full-time fan of your family. Mom, thank you for embracing Dad’s quirkiness while showing the utmost level of grace and composure as he de-thawed that dog in the oven and ruined your Tupperware with his experiments. I only hope people don’t read this story and think it’s autobiographical because life in our coroner’s house was sure a lot grittier, messier, and less dramatic than it is depicted here, wasn’t it? I could not be more grateful for the oddities and unique experiences of my childhood. They inspired my imagination. They made me aware of the utter dependence we have on faith, family, and community. And they have stirred me to try to live each day with fullness, gratitude, and vigor … because tomorrow is never guaranteed. Love you both forever.
1
Medical resident Dr. Emily Hartford did her best to shake off the mounting pressure that pulsed through her shoulders, up her neck, and throbbed into the muscles at the base of her skull. Where was that train?
The chondroplasty video looped through Emily’s brain on continuous replay. She had already watched it sixty-seven times. And in ninety-three minutes, she would be doing it for real on a retired professional soccer player who had torn up his knee. Now, recently retired from the sport, he needed the agility and mobility to run after two very active twin toddlers.
Emily, a third-year doctor in her surgical residency, checked the platform ticker for a fifth time. A signal flashed on the overhead monitor. Her train would be two minutes delayed. That was two minutes too late. A warm rain pelted her hood and soaked her running shoes and the pant legs of her scrubs. It would take all morning for them to dry in the highly cooled operation room. Her feet would be numb, with no chance of thawing until lunch. She had forgotten to pack fresh shoes and socks—a deep source of regret.
Her long, blonde hair, wound into a bun on top of her head, was hidden under a wool cap. Her long, lean figure stood a good head above most of the early morning commuters who littered the train stop. With hair down, heels, and makeup, Emily was always turning heads. This morning, in medical garb and hair pulled up, she blended agreeably into the soggy, gray, workaday world around her.
Standing under the platform awning, Emily cracked open her cluttered handbag to search for her phone and headset. Finding them twined around a small notebook and tube of lip gloss, she untangled them and, popping them into her ears, started to search her phone for that video. She wanted to revisit it just once more time.
As she scrolled through her phone to find it, a calendar reminder popped up. Today’s my birthday? Emily tapped the calendar app to double-check the date. Had she really forgotten about her twenty-eighth birthday? September 19th. Sure enough. Day of her birth. Emily had been so busy picking up extra shifts and studying all month, she realized, she hadn’t given a single thought to birthday plans.
The train whizzed into the station, and Emily stuffed her phone back into her handbag. As the train slowed to a stop, the mass of commuters shuffled toward the sliding doors that swooshed open, exchanging a trickle of disembarking passengers for the flock of waiting ones. Emily moved with the herd into the busy train and searched for a seat. A self-absorbed hipster wearing a black hoodie beat her to an aisle spot. She scanned ahead to the one remaining empty seat in the last row of the car but gave it up when an elderly Hispanic woman limped up behind her with a toothless grin and three overstuffed shopping bags. Emily pointed to the vacancy, and the diminutive woman nodded gratefully to her as she slouched into the hard plastic seat. One of the lady’s bags lost its balance and tipped out of her grasp. Emily caught it before it fell, preventing a canned goods avalanche. The woman offered a thankful smile. “Mucho gusto, senorita,” she said.
“De nada.” Emily settled grocery bags around the woman.
Grabbing a hand strap, Emily tried to block out the musty smell of body odor and rain by breathing shallowly through the bottom of her nose. It was a trick her father, also a physician, had taught her when they worked in the morgue together.
Blaring rap music entered the cab, disturbing everyone’s peace. Emily did her best to ignore a vagrant man squeezing through the center aisle, irreverently blasting his handheld radio. Profanities from the lyrics accosted her and the other riders, many of whom darted dirty looks at the guy. One of the annoyed commuters took courage: “Hey man, turn that thing off. There are children riding.”
The vagrant never even glanced up as he kept trekking toward the back of the car, crossing into the next car to besiege another unsuspecting group of commuters. This was city living. Dense. Unexpected. And fast. Twelve years in Chicago, and Emily was still not completely used to the pace of this world. Although she did love the energy of the city, she didn’t feel the same ease here as her boyfriend, Brandon, did. But then, he had grown up here. Known no other place. They’d met when she was a sophomore and he was a senior in college. On their dates he took her to underground Chicago and exposed her to the real Windy City. The places and people that moved under the surface gave it its texture and toughness. The more he showed her, the more she had come to understand the mysteries of this place. His enthusiasm and loyalty to this city that he loved so much was one of the reasons she had fallen in love with him. He was a fearless explorer, even in his own backyard. There was always something new to see and experience. He approached life with vivacity, curiosity, and thoughtfulness. Which, of course, made him not only a super boyfriend but also a superb surgeon.
She missed him. His schedule as a new surgeon working at Northwestern University Hospital was even more taxing than hers as a resident, and in the past couple of months they had hardly been able to spend a moment together beyond rushed lunches and late-night phone calls. But she was sure he was cooking something up for her birthday. Quite literally, perhaps. He was a foodie and self-taught chef. In his spare time, of course. And when was that exactly? She wasn’t sure. She swore he got by purely on catnaps in the doctor’s lounge.
Emily yawned and looked forward to seeing what surprises Brandon had in store for her day. In the meantime, she needed to focus on prepping for surgery. She pressed “Play” on the video button on her iPhone.
“Create a small incision around the front of the knee. Insert the arthroscope,” the clinical voice from the lecture on her iPod instructed. “This will help you diagnose the problem better and maintain surgery safety protocol.”
The chondroplasty marked an important milestone in her journey as a surgical resident at the University of Chicago Medical School. She would be calling the shots in the operating room under the supervision of the lead doctor and her mentor, Dr. Claiborne, with whom she had been working for three years.
“Expand the joint by pumping fluid into it through the pump hose inserted in one of the incisions. Using the arthroscope, inspect the joint to find the source of the problem, the damaged tissue.” The monotone voice droned as the camera kept an extreme close-up on the procedure. Did these producers purposefully hire monks to record the voiceover?
Emily felt ninety-six percent ready. With this little early morning review, she could pass the surgery with flying colors. In less than two years, Emily would be an employable surgeon, ready to conquer appendectomies, tonsillectomies, or colon resections. She might join a practice or stay on staff at a hospital. She wasn’t sure just yet. One day at a time. Brandon, on the other hand—always the visionary—wanted to open his own surgery center one day. He had also had his sights set on international travel for a few years with Doctors Without Borders. Emily wasn’t sure how she would fit into these plans. But she trusted Brandon had it all figured out.
“With your surgical tools, remove the loose cartilage tissue, which is what ca
Emily’s phone buzzed, cutting off the video. She reached down to silence the call. It was a familiar Michigan number. Cathy Bishop, mortician and lifetime friend of Emily’s family. She had seen this number come up hundreds of times on her family’s caller ID. Cathy and her husband had owned Bishop & Schultz Funeral Home. It was the only funeral home in Freeport, and they had worked closely with Emily’s father. But Emily had spoken to Cathy only a handful of times in the past decade since she’d left home at sixteen.
Emily let the call go to voicemail. She replayed the video, trying to concentrate. But a foreboding nervousness pricked at her like it always did before a surgery. Working on dead people was easy. What’s the worst that could happen? They were already dead.
Keep it together. Today is huge. You need to pass this next step flawlessly. Concentrate. Focus. Listen to the boring monk voice. She notched up the volume and harnessed her concentration for four more stops until the train conductor called out, “Forty-seventh Street Station.” The train jerked to a slow roll. Emily shuffled toward the exit with a couple dozen passengers also jockeying for the door.
Exiting the metro, she jogged down the street toward the university hospital. Her heart rate elevated, and her breathing quickened. Running took away the nerves. Pat, pat, pat, pat, pat, pat. The balls of her feet slapped the wet cement as she darted up the hospital sidewalk.
It was showtime.
2
As Emily entered the surgery center on the fourth floor, her mentor met her with a quick glance and handed her a stack of charts. He had been a surgeon for almost thirty years; he was a loving husband, father of three, a grandfather for the first time last year. She was lucky that he had chosen her from among the seventy-five other surgical interns, to study under him. They had worked together for three years now, and he treated her tough, but fairly.
“Good morning, Dr. Claiborne.” Emily broke into a forced smile that covered her frayed nerves.
“Dr. Hartford. Scrub in. I need you in OR five immediately. We have an emergency appendectomy.” He handed her a chart and started to take off down the hall.
“Wait. Dr. Claiborne. But what about my chondroplasty?”
“I’m giving it to Karen Connelly. Don’t be disappointed. You’ll get the next one. I promise.”
“Aren’t you coming in?” Emily said.
“No, it’s just a simple appendix. You got this.”
He scurried down the hall. Emily stood there stunned and unprepared for the sudden change of plans. Five minutes! She racked her brain for appendectomy procedures as she scanned the chart. Her rubber tennies squeaked as she picked up the pace to the operating room.
Everyone was already in the OR, prepping, when Emily entered the dressing area and tossed her bag aside. A nurse was scrubbing in at the sink.
“Jan, is there any chance you could take care of my bag? Claiborne just informed me I have—”
“I know, I know. I got it. I’m assisting you today. Claiborne threw you for a loop, huh?” She smiled at Emily as she secured her face mask.
“Big time.” Emily pushed up her sleeves and turned on the faucet.
“And on your birthday too. Nice gift.”
“What? How did you—?”
“Jackie. The nurse admin. She puts all our birthdays on the master calendar. Happy birthday, Dr. Hartford. See you there in five.” Jan marched off with Emily’s bag.
Emily scoured underneath her fingernails. Her hands were shaking slightly. Nerves and adrenaline and no breakfast. When am I gonna get over these pre-surgery jitters?
Dr. Claiborne had repeatedly told her that her nerves were normal, but Emily thought they would have subsided by year three.
She remembered Dr. Claiborne’s advice and drew in several long, deep breaths from the pit of her belly. As she suited up in her gown and gloves, her body began to relax. The quiver floated out of her fingertips. Through the glass windows, Emily could see into OR number five. The patient was already prepped and under anesthesia. As Emily stepped in, a nurse was calling out vitals.
“Let’s go, people! Dr. Hartford is here.” All eyes fell on Emily.
“Good morning, everyone.” Emily scanned the room and immediately relaxed. “Pleasure to be here with you. Are we all ready?”
Heads nodded and Emily gave everyone a reassuring smile before she slipped her face mask over her mouth. The team moved into position. Jan handed her a scalpel.
The cool metal in her hand triggered muscle memory. This was her realm. Dead or living.
The tip of the knife pressed into the patient’s skin to make the small incision where the scope would enter. Emily could envision the entire system under the layer of flesh. Within a few minutes, she was traveling inside familiar territory.
She scoped the patient’s lower abdomen. “I’m moving the scope to the bottom of the ascending colon. There. A little bit lower. The appendix should be right at the anterior cecum.”
“Patient’s blood pressure is dropping. Eighty-five over sixty,” said a nurse, monitoring vitals.
“Hold it there and keep me posted,” said Emily with her focus on the video monitor as she scoped for the tiny tissue. She was quiet for a few minutes, her gaze moving back and forth between the scope and the monitor.
“Everything okay, Dr. Hartford?” Jan cut the silence.
“I am—it’s just I can’t … it’s not …” Emily glanced up in time to catch worried glances flicker among her team.
“It’s not what? Do you need me to call Dr. Claiborne?” Jan asked.
“I think this little bugger is trying to hide from me.” Only slightly thrown off, Emily continued her laser focus on the monitor, adjusting the scope. “I don’t mean to step on anyone’s toes here, but are we one hundred percent sure this guy has an appendix?”
“Medical history doesn’t indicate any prior surgeries. And he didn’t have any scars on his abdomen or navel that I could see when I prepped him,” said Jan.
“Paramedics said he was complaining of severe nausea and had a high fever when they found him in the park. He passed out on the way to the hospital,” added another nurse.
“Guess I keep looking, then.” Emily glanced up with a playful wink and caught the concerned eye of the anesthesiologist.
“Dr. Hartford, patient is exhibiting masseter muscle contracture. Temp rising. One-oh-three-point-seven … one-oh-three-point-nine …,” said the anesthesiologist. “He’s going into malignant hyperthermia.”
“Get Dantrolene. And ice packs. I can’t get out of here just yet,” said Emily.
Several more team members hustled in with ice packs to cool the patient’s body. Emily’s fingers gripped the scope as she bore onto the monitor with intense concentration. “Where are you, little guy? Don’t be feisty. It’s time to come out.”
The anesthesiologist administered the Dantrolene, and it worked quickly, relieving part of the immediate danger to the patient.
“His muscles are relaxing. But body temp is holding at 104.1,” said the anesthesiologist.
“That’s too high. Get that temp down. More ice packs. I need one more minute to find this thing.”
All eyes were on the monitor as Emily scoped. Meanwhile, the anesthesiologist tried to stabilize the hyperthermia situation when another medical calamity presented itself.
“Where are you at, Dr. Hartford? ’Cause things are not great up here,” said the anesthesiologist.
“Still playing hide and seek. Tell me what you got,” said Emily, never lifting her eyes off the scope.
