Life Support (18 page)

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Authors: Tess Gerritsen

Tags: #Fiction, #Medical, #Thrillers, #General

BOOK: Life Support
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Wallace stood up to shake Vickie's hand but quickly sank back down again, seized by a new fit of coughing.

"Toby, can I talk to you for a minute?" said Vickie, and she turned and walked into the kitchen.

Toby followed her, closing the door behind her.

"What's wrong with that man?" whispered Vickie. "He looks like he's got cancer. Or TB."

"Bronchitis, he says."

"You're not thinking of hiring him, are you?"

"He's the best applicant so far."

"You're kidding. Please tell me you're kidding."

Toby sighed. "Unfortunately, I'm not. You didn't see the others."

"They were worse than him?"

"At least he seems like a nice man."

"Oh, sure. And when he keels over, Mom's going to do CPR?"

"Vickie, I'm not going to hire him."

"Then why don't we send him on his way, before he croaks in your living room?"

The doorbell rang.

"Jesus," said Toby, and she pushed out of the kitchen. She shot an apologetic glance at Wallace Dugan as she walked past him, but he had his head bent over a handkerchief, coughing again. She opened the front door.

A petite woman smiled at her. She was in her midthirties, with trim brown hair in a Princess Di cut. Her blouse and slacks appeared neatly pressed. "Dr. Harper? I'm sorry if I'm early. I wanted to make sure I could find your house." She extended her hand. "I'm Jane Nolan."

"Come in. I'm still talking to another applicant, but�"

"I can interview her," cut in Vickie, pushing forward to shake Jane Nolan's hand. "I'm Dr. Harper's sister. Why don't we go talk in the kitchen?" Vickie looked at Toby. "In the meantime, why don't you finish up with Mr. Dugan?" In a whisper, she added, "Just get rid of him."

Wallace Dugan already knew the verdict. When Toby walked back into the living room, she found him gazing down at the coffee table with a look of defeat. His resume lay before him, three pages chronicling forty-five years of labor. A chronicle that had most likely reached its end.

They chatted a moment longer, more out of politeness than necessity.

They would never meet again, they both knew it. When at last he walked out of her house, Toby closed the door with a sense of relief. Pity, after all, did not get the job done.

She went into the kitchen.

Vickie was alone in the room, gazing out the doorway. "Look," she said.

Outside, in the garden, Ellen shuffled along the brick path. At her side was Jane Nolan, nodding as Ellen pointed to one plant, than another. Jane was like a small, swift bird, alert to every move her companion made. Ellen halted and frowned at something near her feet. She bent down to pick it up�a garden claw. Now she turned it around in her hands, as though searching for some clue to its purpose.

"Now what did you find there?" askedJane.

Ellen held up the claw. "This thing. A brush." At once Ellen seemed to know that was the wrong word and she shook her head. "No, it's not a brush. It's�you know�you know."

"For the flowers, right?" prompted Jane. "A claw, to loosen up the dirt."

"Yes." Ellen beamed. "A claw."

"Let's put it in a safe place, where it won't get lost. And you won't accidentally step on it." Jane took the claw and set it in the wheelbarrow. She looked up and, seeing Toby, smiled and waved. Then she took Ellen's arm, and the two of them continued along the path and vanished around the corner of the house.

Toby felt an invisible burden seem to tumble from her shoulders. She looked at her sister. "What do you think?"

"Her resume looks good. And she has excellent references from three different nursing homes. We'll have to go up on the hourly rate, since she's an LPN. But I'd say she's worth it."

"Mom seems to like her. That's the most important thing."

Vick c gave a sigh of satisfaction. Mission accomplished. Vickie the efficient. "There," she said, shutting the back door. "That wasn't so hard."

Another day, another dollar. Another corpse.

Daniel Dvorak stepped back from the autopsy table and stripped off his gloves. "There you have it, Roy. Penetrating wound to the left upper quadrant, laceration of the spleen resulting in massive hemorrhage.

Definitely not natural causes. No surprises." He tossed the gloves into the contaminated rubbish bin and looked at Detective Sheehan.

Sheehan was still standing by the table, but his gaze wasn't on the hollowed-out body cavity. No, Sheehan was making moo eyes at Dvorak's assistant, Lisa. How romantic. Romeo and Juliet meeting over a corpse.

Dvorak shook his head and went to wash his hands in the sink. In the mirror he glimpsed the progress of the incipient romance. Detective Sheehan standing a little straighter, tucking in his gut. Lisa laughing, flicking back her blond bangs. Even in the autopsy room, nature will have its way.

Even when one of the parties is a married, middle-aged, overweight cop.

If Sheehan wants to play lover boy to a pair of blue eyes, it's none of my business, thought Dvorak as he calmly dried off his hands. But I should warn him he's not the first cop whose hormones got tweaked down here. Autopsies had become surprisingly popular events lately, and it wasn't because of the corpses.

"I'll be in my office," Dvorak said, and he walked out of the lab.

Twenty minutes later Sheehan knocked at Dvorak's office door and came in, wearing the sheepishly happy face of a man who's been acting foolish, knows it, knows everyone else knows it, but doesn't care.

Dvorak decided he didn't care, either. He went to his file cabinet, took out a folder, and handed it to Sheehan. "There's that final tox report you wanted. You need anything else?"

"Uh, yeah. The prelim on that baby."

"Consistent with SIDS."

Sheehan pulled out a cigarette and lit up. "That's what I thought."

"Mind putting that out?"

"Huh?"

"It's a smoke-free building."

"Your office too?"

"The smell hangs around."

Sheehan laughed. "In your line of work, Doc, you can hardly complain about smells." But he put out the cigarette, crushing it on the coffee saucer that Dvorak slid across to him. "You know, that Lisa's a nice girl."

Dvorak said nothing, figuring that silence was safer.

"She got a boyfriend?" asked Sheehan.

"I wouldn't know."

"You mean you never asked?"

"No."

"Not even curious?"

"I'm curious about a lot of things. But that's not one of them." Dvorak paused. "By the way, how're the wife and kids?"

A pause. "They're fine."

"So things're good at home?"

"Yeah. Sure."

Dvorak nodded gravely. "Then you're a lucky man."

Face reddening, Sheehan stared down at the tox report. Cops see too much death, thought Dvorak, and they run around grabbing at all the highs in life they can get. Sheehan was struggling, a smart guy, a basically decent guy, dealing with the first glimpse of middle age in his mirror.

Lisa chose that moment to walk into the office, carrying two trays of microscope slides. She flashed Sheehan a smile and seemed taken aback when he simply looked away.

"Which slides are these?" asked Dvorak.

"Top tray's liver and lung sections from Joseph Odette. Bottom tray has brain sections from Parmenter." Lisa stole another glance at Sheehan, then pulled her dignity back together again. In a businesslike tone she said, "You just wanted H and E and PAS stains on the brain, right?"

"Did you do Congo-Red?"

"That's in there too. Just in case." She turned and walked out, pride intact.

After a moment, Sheehan left as well, a temporarily chastened Romeo.

Dvorak brought the trays of new slides back to the lab and turned on his microscope. The first slide was of Joey Odette's lung. Smoker, he thought, focusing on the alveoli. No surprise, he'd already recognized the emphysematous changes at autopsy. He flipped through a few more lung sections, then moved onto the liver slides. Cirrhosis and fatty infiltration. A boozer, too. Had Joey Odette not shot himself in the head, either his liver or his lungs would have failed him eventually.

There are many ways to commit suicide.

He dictated his findings, then set aside the Odette slides and reached for the next tray.

The first slide of Angus Parmenter's brain appeared through the lens.

The microscopic exam of brain sections was a routine part of the autopsy. This slide showed a section of cerebral cortex, stained a hot pink with periodic-acid-Schiff. He focused, and the field came sharply into view. For a full ten seconds he stared through the eyepiece, trying to make sense of what he was seeing.

Artifact, he thought. That must be the problem. A distortion of tissue from the fixing or staining process.

He took out the slide and put in another. Again he focused.

Again, everything looked all wrong. Instead of a uniform field of neuronal tissue stippled with occasional purple nuclei, this looked like pink and white froth. There were vacuoles everywhere, as though the brain matter had been eaten away by microsopic moths.

Slowly he lifted his head from the eyepieces. Then he looked down at his finger�the finger he'd cut with the scalpel. The laceration was healed now, but he could still see the fine line on the skin, where the wound had recently closed. I was working with the brain when it happened. I've 7oeen exposed.

The diagnosis would have to be confirmed. A neuropathologist consulted, electron microscopy performed, the clinical record reviewed.

He should not be planning his own funeral quite yet.

His hands were sweating. He turned off the microscope and released a deep breath. Then he picked up the telephone.

It took his secretary only a moment to locate Toby Harper's number in Newton. The phone rang six times before it was answered by an irritated "Hello?"

"Dr. Harper? This is Dan Dvorak at the ME's office. Is this a good time to talk?"

"I've been trying to reach you all week."

"I know," he admitted. And could think of no excuse to give her.

"Do you have a diagnosis on Mr. Parmenter?" she asked.

"That's why I'm calling. I need some more medical history from you."

"You have his hospital record, don't you?"

"Yes, but I wanted to talk to you about what you saw in the ER. I'm still trying to interpret the histology. What I need is a better clinical picture."

Over the line, he heard what sounded like water running from a faucet, and then Toby called out, "No, turn it off! Turn it off, the water's getting all over the floor!" The phone clattered down and there were running footsteps. She came back on the line. "Look, this isn't a good time for me right now. Can we discuss this in person?"

He hesitated. "I suppose that's a better idea. This afternoon?"

"Well, it's my night off, but I have to make arrangements for a sitter.

What time do you leave work?"

"I'll stay as late as I need to."

"Okay, I'll try to get there by six. Where are you located?"

"Seven twenty Albany Street, across from City Hospital. It'll be after hours, so the front door will be locked. Park around in back." "I'm still not sure what this is all about, Dr. Dvorak."

"You'll understand," he said. "After you see the slides."

10 tt was nearly six-thirty when Toby pulled into the parking lot behind the two-story brick building at 720 Albany Street. She drove past three identical vans, each labeled on the side with COMMONWEALTH OF MASSACHUSEtITS, CHIEF MEDICAL EXAMINER, and she parked in a stall near the building's rear door. The rain, which had threatened all day, was finally beginning to fall in a gentle sprinkling that silvered the gloom. It was late October, and darkness fell so early these days, already she missed the long warm twilights of summer. The building looked like a crypt walled in by red brick.

She stepped out of the car and walked across the lot, head bent under the rain. Just as she reached the rear entrance, the door swung open.

Her head snapped up in surprise.

A man was standing in the doorway, his tall frame silhouetted against the hall light. "Dr. Harper?"

"Yes."

"I'm Dan Dvorak. They usually lock the doors by six, so I was watching for your arrival. Come in."

She stepped into the building and wiped the rain from her eyes.

Blinking against the light, she focused on Dvorak's face, reconciling the mental image she'd formed from his telephone voice with the imposing man who stood before her. He was about as old as she'd expected, in his mid-forties, his black hair generously streaked with silver and tousled, as though he'd been nervously running his fingers through it. His eyes, an intense blue, were so deeply set they seemed to gaze at her from dark hollows. Though he did manage a small smile, she sensed it was forced, it flickered only briefly but attractively across his lips, and then was gone, replaced by an expression she could not quite fathom. Anxiety, perhaps. Worry.

"Most everyone's gone home for the day," he said. "So it really is as quiet as a morgue in here right now."

"I tried to get here as soon as I could, but I had to make arrangements with the sitter."

"You have children, then?"

"No, the sitter's for my mother. I don't like to leave her alone."

They took the stairs up, Dvorak slightly in the lead, white lab coat flapping at long legs. "I'm sorry to ask you here on such short notice."

"You've been refusing all my calls, and then suddenly you have to talk to me tonight. Why?"

"I need your clinical opinion."

"I'm not a pathologist. You're the one who did the autopsy."

"But you examined him while he was still alive."

He pushed through the stairwell door onto the second floor and started up the hall, moving with such nervous energy that Toby had to trot to keep up.

"There was a neurologist consulting on the case," she said. "Did you talk to him?"

"He didn't perform his exam until after the patient became comatose. By then there were few signs and symptoms to go on. Other than coma."

"What about Wallenberg? He was the attending physician."

"Wallenberg maintains it was a stroke."

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