Port Mortuary (18 page)

“We couldn’t see everything he did in there before he left. I figured he might have grabbed his phone on his way out,” Marino supposes. “Or he might have more than one. Who the hell knows?”

“We’ll know when we find his apartment,” Benton says as he prints what he’s found on the Internet. “I’d like to see the scene photos.”

“You mean when I find the apartment.” Marino puts the camera down on a countertop. “Because it’s going to be me poking around. Cops gossip worse than old women. I find where the guy lives, then I’ll ask for help.”

O
n a body diagram, I note that at eleven-fifteen p.m. the dead man is fully rigorous and refrigerated cold. He has a pattern of dark-red discoloration and positional blanching that indicates he was flat on his back with his arms straight by his sides, palms down, fully clothed, and wearing a watch on his left wrist and a ring on his left little finger for at least twelve hours after he died.

Postmortem hypostasis, better known as lividity or livor mortis, is one of my pet tattletales, although it is often misinterpreted even by those who should know better. It can look like bruising due to trauma when in fact it is caused by the mundane physiological phenomenon of noncirculating blood pooling into small vessels due to gravity. Lividity is a dusky red or can be purplish with lighter areas of blanching where areas of the body rested against a firm surface, and no matter what I’m told about the circumstances of a death, the body itself doesn’t lie.

“No secondary livor pattern that might indicate the body moved while livor was still forming,” I observe. “Everything I’m seeing is consistent with him being zipped up inside a pouch and placed on a body tray and not moving.” I attach a body diagram to a clipboard and sketch impressions made by a waistband, a belt, jewelry, shoes and socks, pale areas on the skin that show the shape of elastic or a buckle or fabric or a weave pattern.

“Certainly suggests he didn’t even move his arms, didn’t thrash around, so that’s good,” Anne decides.

“Exactly. If he’d come to, he would have at least moved his arms. So that’s real good,” Marino agrees, keys clicking as an image fills the screen of the computer terminal on a countertop.

I make a note that the man has no body piercings or tattoos, and is clean, with neatly trimmed nails and the smooth skin of one who doesn’t do manual labor or engage in any physical activity that might cause calluses on his hands or feet. I palpate his head, feeling for defects, such as fractures or other injuries, and find nothing.

“Question is whether he was facedown when he fell.” Marino is looking at what Investigator Lester Law e-mailed to him. “Or is he on his back in these pictures because the EMTs turned him over?”

“To do CPR they would have had to turn him faceup.” I move closer to look.

Marino clicks through several photos, all of them the same but from different perspectives: the man on his back, his dark-green jacket and denim shirt open, his head turned to one side, eyes partly closed; a close-up of his face, debris clinging to his lips, what looks like particles of dead leaves and grass and grit.

“Zoom in on that,” I tell Marino, and with a click of the mouse, the image is larger, the man’s boyish face filling the screen.

I return to the body behind me and check for injuries of his face and head, noting an abrasion on the underside of the chin. I pull down the lower lip and find a small laceration, likely made by his lower teeth when he fell and hit his face on the gravel path.

“Couldn’t possibly account for all the blood I saw,” Anne says.

“No, it couldn’t,” I agree. “But it suggests he hit the ground face-first, which also suggests he dropped like a shot, didn’t even stumble or try to break his fall. Where’s the pouch he came in?”

“I spread it out on a table in the autopsy room, figured you’d want to have a look,” Anne tells me. “And his clothes are air-drying in there. When I undressed him, I put everything in the cabinet by your station. Station one.”

“Good. Thank you.”

“Maybe somebody punched him,” Marino offers. “Maybe distracted him by punching or elbowing him in the face, then stabbed him in the back. Except that probably would have been recorded, would be on the video clips.”

“He would have more than just this laceration if someone punched him in the mouth. If you look at the debris on his face and the location of the headphones”—I’m back at the computer, clicking on images to show them—”it appears he fell facedown. The headphones are way over here, what looks like at least six feet away under a bench, indicating to me that he fell with sufficient force to knock them a fair distance and disconnect them from the satellite radio, which I believe was in a pocket.”

“Unless someone moved the phones, perhaps kicked them out of the way,” Benton says.

“That was my other thought,” I reply.

“You mean like somebody who tried to help him,” Marino says. “People crowding around him and the headphones ended up under a bench.”

“Or someone did it deliberately.” There is something else I notice.

Clicking through the slideshow, I stop on a photograph of his left wrist. I zoom in on the steel tachymeter watch, move in close on its carbon-fiber face. The time stamp on the photograph is five-seventeen p.m., which is when the police officer took it, yet the time on the watch is ten-fourteen, five hours later than that.

“When you collected the watch this morning”—I direct this to Marino—”you said it appeared to have stopped. You sure it wasn’t simply that the time was different than our local time?”

“Nope, it was stopped,” he says. “Like I said, one of those self-winding watches, and it quit at some point early in the morning, like around four a.m.”

“Seems it might have been set five hours later than Eastern Standard Time.” I point out what I’m seeing in the photograph.

“Okay. Then it must have stopped around eleven p.m. our time,” Marino says. “So it was set wrong to begin with and then it quit.”

“Maybe he was on another time zone because he’d just flown in from overseas,” Benton suggests.

“Soon as we finish up here, I got to find his apartment,” Marino says.

I check the quality-control numbers in the quality-control log, making sure standard deviation is zero and the noise level of the system or variation is within normal limits.

“We ready?” I say to everyone.

I’m eager to do the scan. I want to see what is inside this man.

“We’ll do a topogram, then collect the data set before going to three-D recon with at least fifty percent overlapping,” I tell Anne as she presses a button to slide the table into the scanner. “But we’ll change the protocol and start with the thorax, not the head, except, of course, for using the glabella as our reference.”

I refer to the space between the eyebrows above the nose that we use for spatial orientation.

“A cross-sectional of the chest exactly correlating with the region of interest you’ve marked.” I go down the list as we return to the control room. “An in situ localization of the wound; we’ll isolate that area and any associated injury, any clues in the wound track.”

I seat myself between Ollie and Anne, and then Marino and Benton pull up chairs behind us. Through the glass window I can see the man’s bare feet in the opening of the scanner’s bore.

“Auto and smart MT, noise index eighteen. Point-five segment rotation, point-six-two-five detector configuration,” I instruct. “Very thin slice ultra-high resolution. Ten-millimeter collimation.”

I can hear the electronic pulsing sounds as detectors begin rotating inside the x-ray tube. The first scan lasts sixty seconds. I watch in real time on a computer screen, not sure what I’m seeing, but it shouldn’t be this. It occurs to me the scanner is malfunctioning or that some other patient’s scan is displayed, the wrong file accessed.
What am I looking at?

“Jesus,” Ollie says under his breath, frowning at images in a grid, strange images that must be a mistake.

“Orient in time and space, and let’s line up the wound back to front, left to right, and upward,” I direct. “Connect points to get the penetration of wound track, well, such as it is. There is a wound track and then it disappears? I don’t know what this is.”

“What the hell am I looking at?” Marino asks, baffled.

“Nothing I’ve ever seen before, certainly not in a stabbing,” I reply.

“Well, for one thing, air,” Ollie announces. “We’re seeing a hell of a lot of air.”

“These dark areas here and here and here.” I show Marino and Benton. “On CT, air looks dark. As opposed to the brighter white areas, which show higher density. Bone and calcification are bright. You can get a pretty good idea of what something is by the density of the pixels.”

I reach for the mouse and move the cursor over a rib so they can see what I mean.

“CT number is one thousand one hundred and fifty-one. Whereas this not-so-bright area here”—I move the cursor over an area of lung—”is forty. That’s going to be blood. These dullish dark areas you’re seeing are hemorrhage.”

I’m reminded of high-velocity gunshots that cause tremendous crushing and tearing of tissue, similar to injury caused by the blast wave from an explosion. But this isn’t a gunshot case. This isn’t from a detonated explosive device. I don’t see how either could be true.

“Some kind of wound that travels through the left kidney, superiorly through the diaphragm and into the heart, causing profound devastation along the way. And all this.” I point to murky areas around internal organs that are displaced and sheared. “More subcutaneous air. Air in the paraspinal musculature. Retroperitoneal air. How did all this air get inside of him? And here and here. Injury to bone. Rib fracture. Fracture of a transverse process. Hemopneumothorax, lung contusion, hemopericardium. And more air. Here and here and here.” I touch the screen. “Air surrounding the heart and in the cardiac chambers, as well as in the pulmonary arteries and veins.”

“And you’ve never seen anything like this?” Benton asks me.

“Yes and no. Similar devastation caused by military rifles, anti tank cannons, some semiautomatics using extreme shock fragmenting high-velocity ammunition, for example. The higher the velocity, the greater the kinetic energy dissipates at impact and the greater the damage, especially to hollow organs, such as bowel and lungs, and nonelastic tissue, such as the liver, the kidneys. But in a case like that, you expect a clear wound track and a missile or fragments of one. Which we aren’t seeing.”

“What about air?” Benton asks. “Do you see these pockets of air in cases like that?”

“Not exactly,” I reply. “A blast wave can create air emboli by forcing air across the air-blood barrier, such as out of the lungs. In other words, air ends up where it doesn’t belong, but this is a lot of air.”

“A hell of a lot,” Ollie concurs. “And how do you get a blast wave from a stabbing?”

“Do a slice right through those coordinates,” I say to him, indicating the region of interest marked by a bright white bead— the radio-opaque CT skin marker that was placed next to the wound on the left side of the man’s back. “Start here and keep moving down five millimeters above and below the region of interest specified by the markers. That cut. Yes, that’s the one. And let’s reformat into virtual three-D volume rendering from inside out. Thin, thin cuts, one millimeter, and the increment between them? What do you think?”

“Point-seventy-five by point-five will do it.”

“Okay, fine. Let’s see what it looks like if we virtually follow the track, what track there is.”

Bones are as vivid as if they are laid bare before us, and organs and other internal structures are well defined in shades of gray as the dead man’s upper body, his thorax, begins to rotate slowly in three-dimension on the video display. Using modified software originally developed for virtual colonoscopies, we enter the body through the tiny buttonhole wound, traveling with a virtual camera as if we are in a microscopic spaceship slowly flying through murky grayish clouds of tissue, past a left kidney blown apart like an asteroid.

A ragged opening yawns before us, and we pass through a large hole in the diaphragm. Beyond is shattering, shearing, and contusion.
What happened to you? What did this?
I don’t have a clue. It’s a helpless feeling to find physical damage that seems to defy physics, an effect without a cause. There’s no projectile. There’s no frag, nothing metal I can see. There’s no exit wound, only the buttonhole entrance on the left side of his back. I’m thinking out loud, repeating important points, making sure everyone understands what is incomprehensible.

“I keep forgetting nothing works down here,” Benton comments distractedly as he looks at his iPhone.

“Nothing exited, and nothing is lighting up.” I calculate what must be done next. “No sign of anything ferrous, but we need to be sure.”

“Absolutely no idea what could have done this,” Benton states rather than asks as he gets up from his chair, making rustling sounds as he unties his disposable gown. “You know the old saying, nothing new under the sun. I guess, like a lot of old sayings, it’s not true.”

“This is new. At least to me,” I reply.

He bends over and pulls off his shoe covers. “No question he’s a homicide.”

“Unless he ate some really bad Mexican food,” Marino says.