Darkness peering (25 page)

"Insulin?"

"Takes too long. Seizures."

"Antidepressants?"

"It's possible. Confusion, hallucinations, and agitation, progressing
to seizures or coma. We should be able to detect liver levels of the
drug."

"Antidepressants combined with alcohol?"

"I didn't smell any alcohol, did you?"

McKissack shook his head. "We'll have to wait for the lab results.
We're dealing with a sophisticated and extremely dangerous man,
somebody we may have already interviewed."

"We interviewed almost two hundred people," she said, overwhelmed by
the implication.

"He needs time alone in a secluded area where he knows he won't be
disturbed." McKissack's eyes glistened with intense speculation. "We
should expect some sort of criminal record. Assaults on women, or at
least obscene phone calls. He's orderly, perhaps obsessively neat."
He cleared his throat, spit on the sidewalk. "Our offender may have a
record, or else there may be an unsolved rape or murder in his
background. Which leads us back to our good friend, Ozzie."

She gave voice to her skepticism. "Ozzie Rudd?"

"Think about it. No evidence of forced penetration in the D'Agostino
case, either, and the body was found just a few miles east of Winnetka
Road." McKissack was wearing dark glasses that reflected only the sky,
and it disappointed her that she couldn't see his eyes. On the far
horizon, storm-strewn clouds appeared to be racing westward.

"I really think you're wrong," she said.

"So who found Claire Castillo?"

"We have to assume it was pure coincidence."

"Fat fucking chance."

"Besides, why go to all that trouble, only to cast suspicion on
yourself by 'rescuing' the victim?"

"Cheap thrills? Hero syndrome?"

"He passed the polygraph eighteen years ago."

"Results were inconclusive," he corrected her. "His alibi was a scared
sixteen-year-old girl, a known shoplifter." He scowled. "So now he
knows he can beat the box. At least we've got the semen stain. If
he's a secretor, we'll be able to match the markers."

"You've got a blood sample?"

"We know his blood type. That'll narrow it down. He'll volunteer a
sample once we bring him in for questioning."

"And if he doesn't?"

"Then he becomes our prime suspect."

"Do you honestly think Ozzie Rudd is capable of something so heinous
and well organized?"

"Three individuals stand out in my mind." McKissack's teeth were
clenched. "Ozzie Rudd, Dinger Tedesco and Buck Folette."

"Buck Folette? I thought you put a tail on him?"

McKissack shook his head. "Local law enforcement refused to cooperate.
We think the family got to them."

"What about the cabin by the ocean?"

"Family refused to sign a consent search." McKissack's eyes scanned
the low-hanging clouds. "Tapper tailed him for about a week, but I
needed him back here. We don't know where the hell Buck Folette was
last night."

Rachel shook her head. "He drives a red pickup truck and his house is
a mess."

McKissack shot her a skeptical look.

"We did profiling at the academy. You said so yourself, the UN SUB is
orderly, organized. He swabbed the injection site in the middle of the
woods. Those stitches were precise. Which means he's compulsive.
Which means his house and car should be fairly well maintained.
Orderly, compulsive perpetrators tend to buy dark-colored cars and
replace them every couple of years. Buck's pickup is at least ten
years old and it's fire-engine red. Also the UN SUB most likely has a
great deal of difficulty with women. BuckFolette collects girlfriends
the way a sheepdog attracts fleas."

"You may be right." McKissack shrugged. "Let's see if he's got an
alibi for last night."

"I'd like to interview Dr. Castillo again," Rachel said. "I'd like to
find out what happened in the ER."

McKissack nodded. "I'll talk to Rudd myself."

Sunlight shot through the clouds in slices, momentarily highlighting
the rugged planes of his face. She wanted to hold him for a moment,
just to keep from shivering to death.

"I never took a profiling course," McKissack said, "but I know what my
gut tells me, and my gut is telling me this was a deliberate act, well
planned and personal."

Rachel nodded. "Whoever did this wanted to depersonalize her. Wanted
to degrade her. That's why he stripped her of her clothes and
mutilated her face."

"The mutilation serves two purposes," McKissack said. "One, it caused
her a great deal of pain and humiliation, so you can deduce there's a
tremendous amount of anger there. And two, by sewing her mouth shut,
he prevented us from finding out about his identity immediately."

"It acted like a gag until the drug or poison had time to take
effect."

"He bought himself a little time. He knew she was going to die. He
planned it that way. But why?"

Rachel was quiet a few seconds. "Whoever it is, I can't fathom the
depth of his depravity. To actually sit there and do this meticulous
work with the stitching. It's pure evil."

They locked eyes.

"Things like this aren't supposed to happen here," she said. "I'm
frightened for Nicole ... for her family ... I don't think they can go
through the trauma of losing another child. I don't think Jackie
Castillo can take it."

"We'll find her," he said with determined, angry eyes. "We'll find
them both alive, or I'll quit my fucking job."

All the warmth had drained from her body. She felt as cold as a
corpse. "I won't be able to sleep until they're both home safe," she
said.

A clap of thunder announced a sudden downpour, rain beating on their
uncovered heads. McKissack's umbrella flapped noisily open, and he
drew her close so they could share it, his big arm snaking around her.
Rachel nestled against him, feeling terribly lonely. Most of her
family was gone, her relationship with her brother was strained, all
her friends had left the area years ago--Anne Marie was a lawyer in
Washington, Linda an advertising executive in Manhattan. Everyone had
flown the coop, and yet here she was, turning to a married man for
comfort.

"My breath stinks," McKissack apologized, and she hugged him tight,
needing his warmth.

A HEAVINESS SUFFUSED RACHEL'S LIMBS AS SHE RETURNED TO

the hospital to speak with Dr. Yale Castillo once again. He hadn't
taken off from work despite his daughter's death, and Rachel thought
she understood.

"Why aren't you out looking for my other daughter?" he demanded to
know.

She was seated in the same suffocating leather chair as before, feeling
small and powerless, and that was no good. The case was complicated in
a deep and murky way, and she tried to summon the mental energy she
needed in order to solve it. "I'm here to find out what happened in
the ER," she said, and he nodded in a resigned fashion.

"The call schedule ran twenty-four hours. It was a busy shift, the
usual mix of minor trauma and accidents. Nothing to get the blood
pumping. Then an announcement came over the radio, ambulance with
trauma." He rubbed his hands over his cheeks. "When they wheeled her
in, I didn't recognize her at first. I thought, this isn't my
daughter. This is some monstrous ... mistake. But then the hairs
stood up on the back of my neck and suddenly I knew." His shoulders
sagged. "It's been a singular experience for me, Detective."

Rachel's jaw ached from clenching her teeth, and she forced herself to
relax.

"Claire had a history of asthma," he went on, "moderate, not severe.
There was no prior need for intubation. She'd always responded well in
the past to a treatment of nebulized beta agonists and oral
steroids."

Rachel shifted uncomfortably, sensing the precarious fragility in those
sunken eyes. "So what happened?"

"I assessed airway and breathing. Her skin was cold and clammy and she
was short of breath. I assumed her recent exposure to the cold air and
intense emotional stress had triggered an acute asthma attack. For
moderate cases, I usually give beta-agonists, but for severe attacks, a
dose of subcutaneous epinephrine is used when aerosolized medication
can't reach the target airway. So we administered three systemic
injections of epinephrine, but her condition didn't improve."

Rachel could hear the controlled frenzy of the ER behind her, nurses
and interns running up and down the corridor outside the doctor's
office. "Was that the only medication she was given?"

"No," he continued in a hoarse whisper. "We also gave a bolus of IV
methyl prednisolone When her condition failed to improve significantly,
I ordered an IV administration of magnesium sulfate. But this had
little effect as well, and we had to intubate.

"We used ketamine to provide sedation and bronchodilation. We used
slightly smaller tidal volumes than average on a

volume-preset ventilator. We assessed breath sounds and obtained
arterial blood gas. But by then, her blood pressure was plummeting."
Leaning forward earnestly, he said, "I can't for the life of me figure
out what went wrong."

"So you opened her airway:1"

"Yes." He gave a defeated sigh. "She was fine. She was breathing
normally. She should've been okay. Then her blood pressure dropped to
critical levels, and she lost consciousness."

"What happened next?"

Lowering his head, he cradled his broad, damp forehead in his hands.
"Full cardiac arrest."

"Is it possible," she asked, "something could've gone wrong with the
intubation?"

He shook his head. "I've done it a million times. I could intubate in
my sleep."

They sat in stony silence. She could almost count each inky strand of
hair combed across his bald spot. "My hands were shaking by that
point. My hands never shake."

"You administered CPR yourself?"

"Her vital signs were pre terminal I called a Code Blue." His voice
trailed off. He stroked his head as if he were petting a dying animal.
"I tried to resuscitate for about twenty minutes. I refused to give
up. I refused to call it. Hurley had to do it."

"Who's Hurley?"

"One of my residents." He straightened up, eyes red-rimmed and
gleaming like surgical equipment. "There's an old joke. The procedure
was a success, but the patient died."

"I'm so sorry about your loss," she said, getting up. "I want you to
know we're doing everything we can to find your other daughter."

His face contorted, caught between a sob and his effort to control it,
and he confessed, "I wake up in the middle of the night sometimes and
don't know if that's me screaming."

She didn't know how to respond to such incalculable grief.

SHUTTING THE DOOR TO DR. CAST ILLO OFFICE BEHIND HER,

Rachel felt a cold finger on her arm. She spun around and recognized
the nurse from the waiting room, the one who'd brought them Nicole's
necklace. She had an experienced grace about her, her eyes honest and
direct.

"Detective Storrow? Can we talk?"

"Of course."

"Not here."

Rachel followed her out into a barren-looking alleyway between two
cinder block buildings where they stood shivering beside a dumpster
overflowing with IV bags and crumpled paper gowns.

"My name's Casey," the nurse said. "Casey Angstrom. I don't feel
particularly great about what I'm about to tell you, the patient being
his daughter and all ... but I just can't keep it to myself anymore."

"Keep what to yourself?"

Casey's face was a slab of candor. "It wasn't an asthma attack."

"What?"

Casey paused for a moment, her moist eyes scanning the turnip-colored
sky. "During the assessment period, we're supposed to provide critical
interventions, including positioning and supplemental oxygen. What
should've been done immediately is, we should've removed those sutures
from her mouth. If we'd removed them immediately, I could have
administered one hundred percent oxygen through the bag and it may not
have been necessary to resort to any other interventions. Her color
was good, her temp was up. She had good vital signs."

"Can you explain how you knew it wasn't asthma?"

"My brother has asthma. I know what it sounds like, those attacks. I'd
know them in my sleep. The patient presented none of the symptoms of a
severe attack, outside of frantic breathing. She was agitated and she
was hyperventilating, hut in my opinion, she wasn't wheezing. There's a
difference. She was scared to death. Panic-stricken." She squinted
at Rachel with extremely alert, intelligent eyes as if trying to
impress upon her the gravity of this information. "The patient came to
us with generalized swelling and trauma to the face and upper chest,
but she had good vitals. She had good pressure. One-thirty over
ninety. Pulse eighty-five."

"So you're saying ... ?"

"Who wouldn't panic with your eyes, ears and mouth sewn shut? Who
wouldn't have trouble breathing? It must've been terrifying."

"Are you telling me that Dr. Castillo didn't need to intubate? That
he didn't have to use the procedures he used?"

"Oh no," she said, "no, something happened. I don't know what. After
we administered the third injection of epinephrine, shortly after the
third injection, there was a sudden, rapid decrease in blood pressure
amplitude. She went into shock."

"Dr. Castillo made a mistake?"

"I don't mean to question the doctor's decisions."

Rachel was confused. "But you are questioning the doctor's
decisions."

"All I'm saying is, there was a lot of panic in that room."

"So he misdiagnosed her original condition?"

"Gosh, I suddenly feel like I'm on the witness stand." She edged
toward the exit door. "I don't know what went wrong. But I think the
whole thing could've been avoided if we'd all kept our heads. When
they wheeled her in, she was okay. Scared, but okay. I tried to tell
the doctor."