Deadly Care, page 4
part #3 of Joanna Blalock Series
Weiderman nodded approvingly. She was smart and thorough. He’d heard that about her too. “I’ll ask the people at Medical Products and Instruments if we can use their data. If they agree, you’ll have to sign a form that forbids you from transferring or copying the NIPI data. And you won’t be able to discuss it at scientific meetings or publish it without their permission.”
“I have no problem with that. But keep in mind this is a murder case and might come to trial. If that occurs, a lot of this information could become public knowledge”
Weiderman hadn’t thought of that possibility, but it didn’t bother him. The publicity would be good for MPI. And most of the methods and technologies were already protected by patent anyhow. “I’ll call the people at MPI today, and if they agree to let you use their data I’ll stop down tomorrow and have a look at your corpse.”
Weiderman got to his feet and Joanna stood up with him. He extended his hand and she shook it firmly. He was tall and slender with tousled brown hair, a strong angular face and eyes so blue that they reminded Joanna of the Sea of Cortez. She thought he looked more like a cowboy than a doctor. “Thanks for your help,” she said.
“I haven’t done anything yet,” Weiderman said.
Joanna waved to Ballernore and left the office. As she closed the door she heard the men speaking in low, muffled tones.
Joanna walked away, thinking that she’d seen Phil Weiderman somewhere in the distant past. Way, way back. For a moment she couldn’t put her finger on it.
Then it came back to her and she smiled to herself. He resembled Mark Elliot, a handsome football star she’d dated when she was a sophomore at the University of Colorado. An old flame who had broken her heart.
How long ago was that? At least twenty years. God! Where does the time go?
Joanna dashed into the elevator just behind a group of interns. They nodded to her deferentially and went on with their discussion of a patient with hemochromatosis. Joanna glanced over at the interns. Two males and two females, all looking young enough to be college cheerleaders. Another sure sign of aging, she thought miserably, when the young look too young.
Joanna tuned out the interns’ chatter and concentrated on the corpse with no face. There were only bits and pieces of his face left, but she was already beginning to form a vague image of what the corpse had once looked like. His hair was light brown, almost blond in places that had probably been bleached by the sun. She knew his eyes were deep brown because she’d found the iris from one eye embedded in the supraorbital ridge. And the top of his forehead seemed broad while the piece of chin Joanna had uncovered was narrow. A triangular face, she guessed, with brown hair and brown eyes. Not much. But it was a start.
Joanna left the elevator on the B level and hurried down a wide corridor, now recalling another feature of the faceless corpse. Although his mandible had been badly smashed, there were ten or so teeth still in place, some with fillings. She wondered if she should take dental X rays and mail them for possible identification to all the dentists who practiced in the cities along the beaches of Los Angeles County. A long shot, she decided. A very, very long shot. Hardly worth the time and effort. But then again, maybe she’d get lucky.
Joanna walked into her office and began to shrug out of her long white coat.
“Lucy O’Hara is set up and ready to go,” said Virginia Hand, a middle-aged secretary with frizzy blond hair and designer glasses. “And Harry Crowe is bitching about Lucy being autopsied out of turn.”
“Too bad,” Joanna said tonelessly.
“And the police have a probable suicide in the midWilshire area they’d like you to look at.”
“No way. Too busy. Tell them to find somebody else to do it.” Joanna went to a file cabinet and reached for a candy bar. Her stomach growled as she pulled the wrapper off.
“Is that lunch?”
“It is.“Very nutritious.”
“Better than no lunch at all.” Joanna chewed into the almonds embedded in chocolate-covered coconut.
“What else have you got?”
“Nothing that can’t wait, except for … The secretary’s voice trailed off as she flipped through a stack of messages. “A phone call from Lieutenant Jake Sinclair in Athens.”
Joanna stopped chewing. “When did he call?”
“About thirty minutes ago. He said to tell you he was fine and that he’ll be back next week.”
“Did he leave a number?”
“No. He said there was no need for you to call him back.”
Joanna began to chew involuntarily on the candy bar as a picture of Jake Sinclair flashed into her mind. She could still see the deep pain in Jake’s face when he got the phone call about Eleni’s death. She had never seen him that way before. Sad and shocked, straining to keep it together. He made his plane reservations, dressed and left Joanna’s apartment, hardly saying a word as he ran back to a memory, to a lost love that was now dead. Suddenly a dead ex-wife was the most important thing in the world to Jake. What bothered Joanna the most was that Jake had shut her out so completely and pushed her into the background as if she was a casual piece of nothingness. That hurt. That hurt like hell.
“I’d call him back,” the secretary said, breaking into Joanna’s thoughts.
“You said he didn’t leave a number.”
“Cops always leave numbers where they can be reached. With a little digging, I’ll bet I reach him.”
“Maybe later.”
Joanna hurried out and down the hallway, still thinking about Jake. How long had they been together now? Three, almost four years. Off and on, mainly on.
Good and bad, mainly good. The past year had been the best of all. At least that’s what she had thought until he turned around and flew off to Greece for a former wife.
A dead former wife. Jesus Christ! How could she depend on a man like that?
Joanna wondered if their relationship was just running its natural course and was now fading. She had always believed that in most relationships there comes a point where the couple either marry or go their separate ways. She and Jake had passed that point. Maybe it was time to move on.
But Joanna knew that it was a lot easier said than done. She still cared about Jake and liked to be with him. He was strong and bright with some rough edges he made no effort to hide. What you saw was what you got. And she felt comfortable with him. Joanna hated the thought of having to find another man. But she’d do it rather than stay in a relationship where she had to compete with the ghost of an ex-wife.
Joanna passed a group of surgery residents, all tall and attractive. Memorial was full of attractive men.
Like Phil Weiderman. Damn, he was good-looking with those eyes so blue they seemed unreal. A woman could get lost in those eyes. Joanna smiled to herself.
She wondered if Weiderman was as he seemed. Cosmopolitan, confident, bright, refined-all features she admired in a man.
For a moment Joanna’s mind flashed back to Jake and she felt a pang of guilt. But she quickly pushed it aside. He was the one who went to Greece without giving a second’s thought to her or her feelings. Even during the phone call from Greece, all he talked about was Eleni and himself. Joanna decided not to make a final decision on their relationship until Jake returned and they had a chance to talk it out. But something had changed between them and Joanna felt they would never be the same again.
Joanna stopped at the water fountain and took a quick drink. She wetted her hands and rubbed them together absently, removing the last traces of chocolate candy. She wondered if she should return Jake’s phone call. No, better to wait. Nothing would be settled over the phone. They would sort it out face-to-face. Her mind went back to Phil Weiderman and his blue eyes.
She wondered if he was married.
Joanna took another swig of water and cleared her mind, then pushed through a set of swinging doors and entered the autopsy room. She put on a black plastic apron and reached for a pair of latex gloves, then quickly scanned the area. It looked like a scene from MASH, except that the patients were all dead and the cutters were pathologists, not surgeons.
All of the stainless steel tables were filled and busy.
Pathologists were dissecting corpses as quickly as they could, knowing there was no way they could keep up with the flow of bodies from the county morgue. Most of the cases were straightforward with the cause of death obvious-natural causes, gunshot, stabbing. But the majority of pathologists performing the autopsies were not trained in forensics and they were working at breakneck speed. Joanna couldn’t help but wonder how much they were going to overlook.
Her gaze went to the rear of the room where Emily Ryan was leaning against the tiled wall, arms folded across her chest. Joanna walked over. Emily pushed herself off the wall.
“Are we all set?” Joanna asked.
“Just about,” Emily said, motioning with her head.
“Harry is waiting over there for your okay to open the skull.”
Joanna glanced over at Harry Crowe, the diener of the morgue, the keeper of the corpses. He was a short, stocky -man in his late fifties, balding, with a round face that had BBs for eyes. Joanna nodded to him and he nodded back, almost imperceptibly. They exchanged cold stares.
Joanna looked down at the corpse of Lucy O’Hara.
Her skin was a ghostly gray-green color under the fluorescent light, her silky blond hair appearing much lighter than it was in life. Joanna leaned forward and examined the young woman’s scalp. There were no cuts or lumps or abrasions, nothing to suggest any trauma. The hair smelled clean, as if it had just been shampooed. Across her lips and skin were scattered petechiae, little hemorrhages caused by a lack of platelets.
Joanna motioned with a finger to Harry Crowe.
“Open her skull.”
Harry walked over slowly and picked up a scalpel.
He lifted the corpse’s head and expertly made an incision across and through the scalp. Working his fingers between the scalp and bone, he pulled the scalp forward and off the bone, exposing the skull.
“It ain’t right,” Harry grumbled loudly, “and it ain’t good to do autopsies out of order. It throws everything off schedule. We got a schedule to keep down here, you know.”
“Well, she’s an exception,” Joanna said evenly.
“Why?” Harry snapped. “Because she’s rich and her father is a big-time lawyer?”
Joanna narrowed her eyes, disliking him even more than usual. “Just open the head, Harry.”
Harry turned on the electric saw, testing it, then turned it off. He touched the blade with a finger, measuring its sharpness, knowing he was taking up valuable time and irritating Joanna.
Emily watched the two, enjoying the tension between them. Harry Crowe had been at Memorial for over thirty years and was accustomed to having his own way and pushing others around, even the senior staff. But he was very careful around Joanna Blalock.
She didn’t tolerate his boorishness and arrogance, not even for a moment. And when he tried to push her in public, she pushed back. Harder.
Harry turned on the electric saw and carefully sawed through Lucy O’Hara’s skull. When he was done, he slowly coiled the wire around the saw and walked away.
“Enough time wasted,” Joanna said impatiently.
“Are you ready to begin, Emily?”
“Yes.”
“Give me a brief history.”
“Lucy O’Hara was a twenty-four-year-old law student with acute myeloblastic leukemia that had become refractory to chemotherapy. She was admitted to Memorial for a bone marrow transplant and died suddenly thirty minutes after admission. She was found dead in bed.”
Was she infected or bleeding at the time of admission?”
“No. And her vital signs were all normal.”
Joanna glanced down at the corpse’s arm and saw venipuncture marks in the antecubital fossa. They were at least a week old. She gently palpated the area, feeling for thrombosed veins. There weren’t any. Sudden death in a young leukemic, she was thinking. Sepsis’and hemorrhage were far and away the most likely causes, but leukemics could die very quickly from a hundred other things, just like everyone else.
Joanna looked over at Emily. “I take it that you’ve examined her.”
“I have.”
“Tell me the positive findings.”
Emily shrugged. “There weren’t any.”
Joanna groaned her disapproval. “There’s no such thing as a corpse without a positive finding.”
“Let me rephrase that,” Emily said quickly. “There were no positive findings that could explain her death.”
“Well, we’ll see.”
Joanna picked up her magnifying glass and began examining Lucy O’Hara’s toes and feet. There were scattered calluses and a bunion from wearing pointed shoes. A large number of petechiae were present around the ankles, as would be expected. Hemorrhages into skin were most likely to occur in dependent parts of the body. The thighs and groin were clear. Joanna spotted the small abdominal incision and palpated the metal device that was implanted in the subcutaneous tissue.
“Is this a morphine pump?” Joanna asked.
“Right.”
“Do we have any information on it?”
Emily reached for an index card. “I called her doctor at Health First, a Dr. Amanda Black. The pump was inserted several months ago because of bone pain. It holds ten doses of morphine sulfate-eight milligrams in each dose. The pump is refilled externally and this can easily be done by the patient.”
“So the most she could give herself at once was eighty milligrams?”
“Correct.”
“Not exactly a lethal dose.” Joanna reached for a scalpel and cut through the skin. She extracted the pump device and examined it carefully. It was black and round, about the size and width of a woman’s compact. Joanna pried it open and studied the calibration on the clear plastic holding vial. “It’s still half filled, so the most she could have gotten just prior to death was forty milligrams.”
“Enough to put her to sleep, but not enough to kill.”
“Assuming it’s morphine sulfate in the vial.”
Emily’s eyes widened. “You think she might have committed suicide?”
“I don’t think anything. But I’m not going to exclude that possibility either. We’ll analyze the contents of the holding vial and then we’ll know for sure.”
Joanna methodically examined the corpse’s chest and neck and head and found only scattered petechiae and a small hemorrhage on the hard palate. Nothing else. Nothing to point to the cause of death.
Joanna stepped back. “Let’s open her up.”
She watched Emily make a long incision, sternum to pubis. The skin and muscles were folded back and the abdomen opened. Joanna took another step back and viewed the corpse as a whole, sensing that she’d overlooked something. Something simple. But what? Not the toes or feet or ankles or thighs or pubis. Not the arms where she’d seen the venipuncture marks from needle sticks-all fresh, no tracks or thrombosed veins, nothing to suggest she was shooting drugs intravenously. And the pump had been examined, its contents to be analyzed thoroughly.
Emily asked, “How is it going with the man with no face?”
“Slowly,” Joanna said absently.
“I’d really like to work with you on that.”
Joanna nodded and moved closer to the table. She reached into Lucy O’Hara’s abdominal cavity and began studying the viscera, concentrating as she searched for clues to explain the girl’s sudden death.
But she still had a gnawing sensation that she’d already overlooked something important.
“Sally Wheaton,” said the voice over the public address system.
Sally didn’t hear her name being called. She was lost in her own thoughts, remembering back to when the world was a better and kinder place. When kids didn’t carry guns to school. When people didn’t lock their front doors at night. When her children weren’t grown and still at home and her husband was still alive. When she didn’t have breast cancer. A thousand years ago, or so it seemed.
“Sally Wheaton!”
Sally came out of her reverie and pushed herself up from the chair. She walked slowly across the waiting room of the outpatient clinic, passing rows of women sitting quietly in uncomfortable Naugahyde-covered chairs. There was no idle chatter or laughter in the advanced breast cancer clinic at Memorial Hospital.
At the receptionist’s window, Sally gave her name.
The receptionist didn’t even bother to look up. She reached for a thick chart and handed it to someone Sally couldn’t see and the chart disappeared. The receptionist gestured to the left with her thumb.
Sally walked into the clinic. A young nurse’s aide with very blond hair that still smelled of peroxide weighed Sally and commented, “Well, at least you’re not losing weight.”
Then the aide took Sally’s temperature, pulse and blood pressure. She actually took the blood pressure recording twice. The second time the aide measured the blood pressure she wrinkled her brow up as if she didn’t believe it.
“What’s my blood pressure today?” Sally asked.
“You’ll have to ask the doctor,” the aide said.
But I’m asking you, Sally wanted to shout. And you should be able to tell me my blood pressure because it’s not a national secret and it really doesn’t matter a damn to anybody but me. And your hair smells awful, Sally wanted to add, and you don’t know how to deal with patients because you’re both young and stupid.
Sally wanted to say all these things, but she didn’t. She held her temper and her words because that was the way she’d been trained to behave. That was the way ladies behaved.
Sally was led into an examining room and told to undress, taking off everything except her panties, and to put on a paper gown. She waited for the door to close, then slowly disrobed, carefully folding sweater and skirt over the back of a chair. Compared to the stuffy waiting room, the examining room was cold and Sally felt goose bumps popping up as she removed her bra. She glanced into the mirror over the basin and briefly studied herself, now rubbing her shoulders with her hands and generating a little heat.
