Tomorrow We Die (5 page)

“Yeah.”

She kept her eyes on the car. “Deux Gros Nez happens to be a great café to read in.”

I laughed and then did a double take. She’d just dropped where she hung out.

Her cheeks reddened. Maybe not noticeable to anyone else. But I could tell. My chest swelled.

Victory.

What did she know about Letell? I swung the first-out bag on like a backpack. “It’s been a while since I’ve been to the Deux. Maybe I’ll check it out again.”

The AprisEvac engines throttled up.

Naomi smiled. “Maybe you should, Trestle.”

Firefighters lifted Jeff out on the backboard and set him on the pavement. We walked to the board and helped secure him to it with Velcro Spider-Straps. I knelt low by his head so he could hear me. “Jeff, this is Flight Nurse Naomi from AprisEvac. She’ll take good care of you on the ride to County. All right?”

He grabbed my elbow. “Thank you.”

We lifted the backboard and walked to the bird. Naomi climbed in, and we loaded Jeff onto the helicopter cot. She slid the door closed and positioned the helmet mic by her mouth.

I backed away, watching her as the helicopter lifted, staring as she grew tinier against the blue backdrop, my heart pounding like the pulse of spinning rotor blades.

CHAPTER 07

Trent Matley squinted into the sun, pulling a cigarette from his lips, blowing smoke with purpose. His lanky arms dangled at his sides, short black hair spiked with a firm gel hold. He shook his head and cursed to himself for no apparent reason.

I sat on the bench outside the ER doors, the wood rough but warm, usually a pleasant place to finish up a chart. Trent’s EMT partner redressed the gurney behind their ambulance parked next to ours.

Trent nodded. “ ’Sup, dude.”

“Hey. Busy day, huh?”

“Tell me about it. All bull too.”

I pulled out a pen for the chart’s narrative section.

Medic Two arrived on scene to find a forty-year-old male awake, alert, and oriented, three-point restrained and suspended in the driver’s seat of . . .

A horn blared. Light traffic halted by a crosswalk on Mill Street. I glanced at Trent. “So what’d you guys bring in?”

He stared across the street. “Seizure.”

“And you don’t consider that a bona fide call?”

He turned to me with a condescending look. “Dude. Really? How many seizures do we go on every day? It’s not even an emergency.” He took a pointed drag and shook his head.

Even from the far side of the bench his ego was edging me out. But I expected that attitude from him. I shrugged it off and quipped, “That’s why they pay us the big bucks.”

The glass doors slid open and Bones walked through, Styrofoam coffee cup in hand. I still had half of my charting left.

Rolled-over sedan with moderate damage to the roof and passenger side.

The acrid stench of cigarette smoke wafted past the bench.

Trent watched his partner clean the back of their rig. “And they wonder why they can’t keep medics around here. Pay them scrap to do what? Haul around drunks that aren’t going to pay for the ride anyway.”

I’d given up on coherent reasoning with Trent. A breeze flipped my chart. I flattened it out.

Positive ETOH, complaining of minor cervical and thoracic spinal pain.

The radio beeped. “Medic Two or Medic Nine, can you clear County for a call downtown?”

Nine had arrived a solid ten minutes before us. I waited for Trent to answer. He blew smoke and cracked his neck.

“Medic Two or Medic Nine, Aprisa.”

I shook my head.
Forget it. We’ll take it.
I tossed the chart in the metal clipboard and stood.

Trent flicked the cigarette on the concrete and depressed the transmit button. “Aprisa, Medic Nine’s available.” He ran his tongue under his lip. “See you, Jonathan.” He pounded the side of the ambulance and shouted at his partner, “Dude, come on. Let’s go.”

The Washoe County Morgue was not one of Bones’s favorite establishments.

But several rigs came available after Medic Nine took the downtown call, so I managed to talk dispatch into allowing us an extended stay on the hospital grounds to follow up on Simon Letell and visit an old friend.

The morgue was its own separate but small building, set out on a far corner of the hospital’s parking area. We greeted the receptionist in the lobby and descended the stairs into the basement. A glass wall, interspersed with steel support members, separated a small vestibule from the large exam room. Through the glass at the far end of the room I saw Dr. Eliezer Petrov’s stocky frame operating the crematory oven.

His curly white hair stuck out from under the surgical cap he wore. He noticed us standing there, waved, and walked over. Pulling off a pair of latex gloves, he opened the door.

“Jonathan, great to see you again.”

I shook his hand and patted his shoulder. “It’s good to see you too, Doc.”

Fog bordered his spectacles. He turned to Bones. “Hello, Thaddeus.”

Bones couldn’t stand that Eli used his proper Christian name. “Hello there, Dr. Petrov.”

Eli wiped beads of sweat from the sides of his nose. “Takes a bit to fire that thing up, but once it gets going . . . You know we’re one of the last morgues to still operate a crematory?” He leaned on the door and exhaled. “What brings you two down to the dungeon?”

My radio squawked. I turned down the volume. “There’s a couple things, actually.”

“Do tell.”

“Well, for one, I’ve been awarded that full-ride scholarship to UNR Med School.”

His face lightened with pride. “Jonathan, that is wonderful news. I am so happy for you.” He pulled me in for a hug.

“Thanks, Doc. I couldn’t wait to tell you. They want me to start with summer school in a month.”

“A month?”

“Yeah.”

“Will you still . . .” He motioned toward my uniform.

“I don’t know. It’s such a commitment. I don’t think I could keep even per diem hours.”

Dr. Eli folded his arms and took a deep breath. “Indeed. Well done.”

“You’ve taught me so much down here.”

“It might’ve helped on those MCATs, huh? What were you?

Ninety-fifth percentile?”

“Ninety-eighth.”

“Outstanding.”

“It’ll be a big challenge.” I pocketed my hands. “But, hey, the other reason we’re here is to check up on a patient.”

“Oh, of course. Here.” He motioned with his hand. “Please, come in.”

The air smelled of bleach, not quite masking the permeating odor of decay. Bones’s pale complexion turned a shade lighter. As many times as I’d been down there, I still felt blood drain from my head and had to focus on steadying myself. But once we dove into the science, the light-headedness mostly passed.

“One moment.” Dr. Eli walked back to the crematory oven and shut down the burners. “So, this patient you had . . . ?”

“His name is Simon Letell.”

“Ah yes. You’re just in time. He’s next up on the list for autopsies I’d ordered.” Dr. Eli walked to a wall lined with oversized refrigeration drawers. He traced his finger down and tapped on a label. “Here we are.” He opened the drawer and unzipped the black body bag that lay in it. “This look like your guy?”

Letell had the same vacant stare he’d had when I’d seen him lying outside his motel room. His skin was waxen and pale, with a clear line demarking pooled lividity.

“Yeah. That’s him. I’m curious about cause of death.”

“Well, all right.” He clapped his hands together. “This will be fun.” He walked to a small office cubicle, squared off by additional glass walls, and picked up a phone receiver. “Tech assistance for autopsy.”

The tech transferred Letell’s body onto a flat exam table. Bones and I donned surgical masks and stood off to the side. Dr. Eli stood at the head of the table, spectacles on and secured under his surgical hat, gloved hands in the air like a surgeon. A microphone hung from the ceiling, and periodically he would use a foot pedal to activate it, verbally recording the exam process.

The tech took a large scalpel and, starting near Letell’s clavicles and extending to his navel, incised a large Y-shaped cut through the layers of skin and adipose tissue. He exposed the sternum, brought out a small circular saw, and wound the cutting blade into high RPMs.

The tech brought it down on Letell’s breastbone with a high-pitched grinding whine and a cloud of bone dust.

Dr. Eli made his own incision over the back of the man’s scalp and peeled the skin forward over Letell’s face, revealing the skull beneath. It was still a strange sight – to see a faceless man with a bare skull. The tech moved to the cranium to begin his next cuts.

Beside me, Bones was as white as a sterile four-by-four dressing.

Eli studied him. “Thaddeus, are you feeling all right?”

Bones stared at Letell, the hint of a gyrating wobble to his stance.

“Remember, son, the body is but a tent.”

Bones pointed at the stairway and managed, “I’m going to – ”

“Sure.” I nodded and smiled.

He took off through the door. Nothing with living people fazed him. But there was something about the dissection of a human body that got to him. Go figure.

It was times like that when I realized I shared a special bond with Eli. And not just with him, but with Vesalius and Da Vinci and Hippocrates. It was in my makeup to be a physician.

Eli pulled off the top of Letell’s skull, set it aside on a stainless steel tray, and waved me over. Sliding his hands into the cranium, he made a few careful cuts with a scalpel and then cradled Letell’s brain up into the light to examine it.

He depressed the foot pedal. “Cerebral surface tissue appears intact and undamaged.”

He set the curled gray mass on a tray and used a blade to cut it into one-centimeter-thick slices. He stopped every minute or so to record an observation.

The areas of the brain echoed in my head as I watched every transection and incision. MCAT flash cards flipping through my mind – coronal, midsagittal . . . Colored-pencil images from my anatomy drawing book.

He progressed down to the neck and removed the entire windpipe. He handed me the trachea, all dangly and fleshy with ribbed cartilage up around the voice box.

Holding it up like a telescope, I stared past Letell’s epiglottis and through his vocal cords. “It looks like there was some trauma around the larynx.” I thought of how Bobbi the nurse said he’d yanked out his endotracheal tube.

Eli smiled. “Atta boy. Knowing your anatomy will save you.”

He moved on to the heart, the lungs, each major organ – excising them one by one and verbally documenting his findings. Letell’s coronary arteries were coated with a fine layer of plaque, yellow like a hamburger bun. There was a bit of blackened alveoli in the lung tissue, likely from a prior history of smoking. Letell’s gall bladder sac spilled out a host of white BB-shaped stones when lacerated.

Dr. Eli finished up, bagging a few specimens for pathological testing. “Nothing obvious yet, I’m afraid. Definitely no other blatant trauma. I expect we’ll learn more from this man’s liver and kidneys than anything else.” He peeled off his gloves and nodded to the tech. “Let me know when our next one is ready, if you would, Steve.”

My radio chirped traffic again.

Eli raised his eyebrows. “Do you need to go?”

“No. It’s for another unit.”

“Care to join me in the office?”

We washed up and sat down in the glass-walled office adjacent to the exam area. Outside, Steve the tech sewed up the Y cut in Letell’s torso with a pen-sized needle and thick thread. Eli set the bagged samples in a specimen refrigerator beneath a microscope on the far wall of the office.

“You still do most of your work down here?” I said.

“Hmm?” Eli looked up. “Oh, instead of in that closet-sized office in the old hospital wing?” He smiled and sat on the edge of a desk chair. “You know, my father always thought I’d be a family physician.” He pulled a chain out from his scrub shirt. Two flat round pendants dangled at the end of it. He unclasped the necklace and held the brass circles out to examine them. “This was a gift from him when I made it into medical school.” He pulled one off of the chain and handed it to me. “The Hippocratic Oath is inscribed on it.”

I ran my thumb over the etchings.

“Do no harm.”

He rested his forearms on his knees. “Even though I work with the dead, I still endeavor to fulfill that oath.”

I handed it back. “It’s a special gift.”

He put up a palm. “I would like for you to have that one.”

“Doc, I can’t take this.”

“Jonathan, you are the closest thing to a son that I have. I am so proud of your accomplishment. I want you to have it.”

“Eli,” I looked at the pendant. “I am honored. This means a lot. Are you – ”

“I insist. He gave me two for just this reason.”

I clenched it in my fist. “Thank you.”

He sat back in the chair and propped up his glasses. “So tell me – what was it about this patient?”

I took a seat and told him the story of getting Letell back from cardiac arrest, the strange things he had said, his last request to give a note to someone named Martin, and how I’d finally found him dead outside of his motel room.

Eli rested his chin on his thumb, his forefinger stretched across his lips, his eyes searching in thought. “What do you know about his Arepo comment?”

I shared what Bones and I had found on the Internet that morning.

He straightened. “Well, for one thing, he sure was determined to tell you that. So much so that he fought off the grave to say it.”

I hadn’t thought of it that way. “It’s just so out of left field. I’m probably making too much out of nothing.”

He nodded. “Perhaps.” He took his glasses from his head and examined them. “When searching for the unknown, it is best to start with what we know.”

“But where do you go from there?”

He sat back in his chair. “I’ve often found that when answers elude me, I need to cut deeper to see the story. Simon Letell related to you a message that coincides with an ancient Latin palindrome square.”