including myself. No doctor has the power to cause blood to clot or tissue or bone to regenerate or tumors to shrink. We don’t create, only prompt
biological functions to work or not work properly on their own, and in that regard, doctors are more limited than a mechanic or an engineer who
actually builds something out of nothing. My choice of a medical specialty, which my mother and sister still consider morbid and abnormal, probably
has made me more honest than most physicians. I know that when I administer my healing touch to the dead they are unmoved by me or my
bedside manner. They stay just as dead as they were before. They don’t say thank you or send holiday greetings or name their children after me. Of
course I was cognizant of all this when I decided on pathology, but that’s like saying you know what combat is when you enlist in the marines and get
deployed to the mountains of Afghanistan. People don’t really know what anything is really like until it really happens to them.
I can never smell the acrid, oily, pungent odor of unbuffered formaldehyde without being reminded of how naive I was to assume that the
dissection of a cadaver donated to science for teaching purposes is anything like the autopsy of an unembalmed person whose cause of death is
questioned. My first one took place in the Hopkins hospital morgue, which was a crude place compared to what is beyond this room where I am this
minute folding my AFME field clothes and placing them on a bench, not bothering with the locker room or modesty at this hour. The woman whose
name I still recall was only thirty-three and left behind two small children and a husband when she died of postoperative complications from an
appendectomy.
To this day I’m sorry she was my science project. I’m sorry she was ever put in a position to be any pathology resident’s project, and I
remember thinking how absurd it was that such a healthy young human being had succumbed to an infection caused by the removal of a rather
useless wormlike pouch from the large intestine. I wanted to make her better. As I worked on her, practiced on her, I wanted her to come to and
climb off that scratched-up steel pedestal table in the center of the dingy floor inside that dreary subterranean room that smelled like death. I wanted
her alive and well and to feel I’d had something to do with it. I’m not a surgeon. What I do is excavate so I can make my case when I go to war with
killers or, less dramatically but more typically, with lawyers.
Anne was thoughtful enough to find a pair of freshly laundered scrubs, size medium and the institutional green I’m accustomed to, and I put
them on, then over them a disposable gown, which I tie snugly in back before I pull shoe covers out of a dispenser and cover a pair of rubber
medical clogs Anne dug up somewhere. Next are protective sleeves, a hair cover, a mask, and a face shield, and finally I double-glove.
“Maybe you could scribe for me,” I say to her as I return to the autopsy room, a big, empty vista of gleaming white and bright steel. Only the
three of us are here, if I include my patient on the first table. “In the event I don’t get to dictate my findings directly afterward, and it appears I may
have to leave.”
“Not by yourself,” she reminds me.
“Benton took the car key,” I remind her.
“Wouldn’t stop you, since we have vehicles, so don’t try to fool me. When it’s time, I’m calling him, and there won’t be an argument.” Anne can
say almost anything and not sound disrespectful or rude.
She takes photographs while I swab the entrance wound on the lower back. Then I swab orifices in the off chance this homicide might involve a
sexual assault, although I don’t see how, based on what has been described.
“Because we’re looking for a unicorn.” I seal anal and oral swabs in paper envelopes and label and initial them. “Not your everyday pony, and
I’m not going to believe anything, anyway, since I didn’t go to the scene.”
“Well, nobody did,” Anne says. “Which is a shame.”
“Even if somebody had, I’d still be looking for a unicorn.”
“I don’t blame you. I wouldn’t trust what anybody says if I were you.”
“If you were me.” I lock a new blade into a scalpel as she fills a labeled plastic jar with formalin.
“Unless it’s me who’s talking,” she replies without looking at me. “I wouldn’t lie or cheat or help myself to things that aren’t mine. I would never
treat this place as if it belongs to me. Never mind. I shouldn’t get into it.”
I won’t let her get into it. It isn’t necessary to put her in a position like that, betraying the people who have betrayed me. I know what it feels like
to be put in a position like that. It’s one of the worst feelings there is and promotes lying, overtly or by omission, and I know that feeling, too. An
untruth that lodges intact in the core of your being like undigested corn found in Egyptian mummies. There’s no getting rid of such a thing, of
undoing it, without going in to get it, and I’m not sure I have the courage for that, as I think of the worn wooden steps leading down into the basement
of the house in Cambridge. I think of the rough stonewalls belowground and the fifteen-hundred-pound safe with its two-inch-thick composite triplelock
door.
“I don’t suppose you’ve heard any rumors about where everybody is,” I then say. “When you were with Marino at McLean.” I begin the Y incision,
cutting from clavicle to clavicle, then long and deep straight down with a slight detour around the navel and terminating at the pubic bone in the lower
abdomen. “Did you get any idea of who is in our parking lot and what’s going on? Since I seem to be under house arrest for reasons no one has
been inclined to make completely clear.”
“The FBI.” Anne doesn’t tell me something I don’t know as she walks to the wall where clipboards hang from hooks next to rows of plastic racks
for blank forms and diagrams. “At least two agents in the parking lot, and one followed us. Someone did.” She collects paperwork she needs and
selects a clipboard after making sure the ballpoint pen attached to it by a cord has ink. “A detective, an agent. I don’t know who followed us to the
hospital, but someone who clearly had alerted security before we got there.” She returns to the table. “When we rolled up at the neuroimaging lab,
there were three McLean security guys, most excitement they’ve had in years. And then this person in an SUV, a dark-blue Ford, an Explorer or an
Expedition.”
Maybe what Benton just drove away in, and I ask Anne, “Did he or she get out of the SUV? I assume you didn’t talk to whoever it was?” I reflect
back soft tissue. The man is so lean he has just the thinnest layer of yellow fat before the tissue turns beefy red.
“It was hard to see, and I wasn’t going to walk right up and stare. The agent was still sitting in the SUV when we left and followed us back here.”
She picks up rib cutters from the surgical cart and helps me remove the breastplate, exposing the organs and significant hemorrhage, and I
smell the beginning of cells breaking down, the faintest hint of what promises to be putrid and foul. The odors emitted by the human body as it
decomposes are uniquely unpleasant. It isn’t like a bird or an opossum or the largest mammal one can think of. In death we are as different from
other creatures as we are in life, and I would recognize the stench of decaying human flesh anywhere.
“How do you want to do this? En bloc? And deal with the metal after we have the organs on the cutting board?” Anne asks.
“I think we need to synchronize what we’re doing inch by inch, step by step. Line things up with the scans as best we can, because I’m not sure
I’m going to be able to see whatever these ferromagnetic foreign bodies are unless I’m looking right at them with a lens.” I wipe my bloody gloved
hands on a towel and step closer to the video display, which Anne has divided into quadrants to give me a choice of images from the MRI.
“Distributed a lot like gunshot powder,” she suggests. “Although we can’t see the actual metal particles because they canceled the signal.”
“True. More blooming artifact, more voids at the beginning than the end. Greatest amount at the entrance.” I point my bloody gloved finger at
the screen.
“But no residue of anything on the surface,” she says. “And that’s different from a gunshot wound, a contact wound.”
“Everything about this is different from a gunshot wound,” I answer.
“You can see that whatever this stuff is, it starts here.” She indicates the entrance wound on the lower back. “But not at the surface. Just
beneath it, maybe half an inch beneath it, which is really weird. I’m trying to imagine it and can’t. If you pressed something against his back and
fired, you’d get gunshot residue on the clothes and in the entrance wound, not just an inch inside and then deeper.”
“I looked at his clothes earlier.”
“No burns or soot, no evidence of GSR,” she says.
“Not grossly,” I correct her, because not being able to see gunshot residue doesn’t mean it isn’t there.
“Exactly. Nothing visually.”
“What about Morrow? I don’t suppose he came downstairs yesterday while Marino had the body in ID, printing him, collecting personal effects.
I don’t suppose someone thought to ask Morrow to do a presumptive test for nitrites on the clothing, since we didn’t know at that time there could be
GSR or that there was even an entrance wound that correlates with cuts in the clothing.”
“Not that I know of. And he left early.”
“I heard. Well, we still can test presumptively, but I’d be really surprised if that’s what we’re seeing on MR. When Morrow or maybe Phillip gets
in, let’s get them to do a Griess test just to satisfy my curiosity before we move on to something else. I’m betting it will be negative, but it’s not
destructive, so nothing lost.”
It’s a simple, quick procedure involving desensitized photographic paper that is treated with a solution of sulfanilic acid, distilled water, and
alpha-naphthol in methanol. When the paper is pressed against the area of clothing in question and then exposed to steam, any nitrite residues will
turn orange.
“Of course, we’re going to do SEM-EDX,” I add. “But these days it’s a good idea to do more than one thing, since slowly but surely lead is
going to disappear from ammunition, and most of these tests are looking for lead, which is toxic to the environment. So we need to start checking
for zinc and aluminum alloys, plus various stabilizers and plasticizers, which are added to the gunpowder during manufacturing. Here in the US, at
any rate. Not so much in combat, where poisoning the environment with heavy metals is considered a fine idea, since the goal is to create dirty
bombs, the dirtier the better.”
“Not our goal, I hope.”
“No, not ours. We don’t do that.”
“I never know what to believe.”
“I do know what to believe, at least about some things. I know what comes back to us when our service people are returned to Dover,” I reply. “I
know what’s in them. I know what isn’t. I know what’s manufactured by us and what’s manufactured by others, the Iraqi insurgency, the Taliban, the
Iranians. That’s one of the things we do, materials analysis to figure out who is making what, who is supplying it.”
“So when I hear these things about weapons or bombs made in Iran…”
“That’s where it comes from. It’s how the US knows. Intelligence from our dead, from what they teach us.”
We leave it at that, our talk of the war, because of this other war that has killed a man who is too young to be finished. A man who took an old
greyhound for a walk in the civilized world of Cambridge and ended up in my care.
“They’ve developed some really interesting technology in Texas that I want us to look into.” I return to gunshot residue because it is safer to talk
about that. “Combining solid phase micro-extraction with gas chromatography coupled with a nitrogen phosphorus detector.”
“As Texas should, since it’s a state law that everybody carry a gun. Or is it that firearms are tax-deductible, like farming and raising livestock is
around here?”
“Well, not quite,” I reply. “But we’ll want to look into doing something similar at the CFC, since of all places I would expect a growing prevalence
of green ammunition.”
“Of course. Don’t pollute the environment while you’re doing a drive-by shooting.”
“What scientists have come up with at Sam Houston can detect as little as one gunpowder particle, which isn’t relevant in this case, since we
know this man has metal in him, almost at a microscopic level but plenty of it. Preliminarily, at any rate, Marino should have used a GSR kit on the
hands at least. Since this man was armed.”
“I do know that he did that much before he printed him,” Anne says. “Because of the gun, although no sign it had been fired. But I saw him using
a stub on the hands when I walked into ID at one point.”
“But not the wound, because you discovered it later. It wasn’t swabbed.”
“I haven’t done anything. I wouldn’t have. Not my department.”
“Good. I’ll take care of it when I get to it, when we turn him over,” I decide. “Let’s take out the bloc so I can blot the raw surfaces of the injured
track. I’m going to use the MRI as my map and blot as much of the metal material as I can, in hopes that even if we can’t see it, we’re getting some
of it. We know it’s metal. The question is, what kind of metal and what is it from?”
In wall-mounted steel cabinets with glass doors I find a box of blotting paper while Anne lifts the bloc of organs out of the body and places it on
the dissecting board.
“I can’t tell you what a problem it is these days, people with metal in them,” she comments as she collects organ fragments from the chest
cavity, which is opened and empty like a china cup, the ribs gleaming opaquely through glistening red tissue. “Including old bullets of the non-green
variety. We get these research subjects in after the hospital’s advertised for volunteers, and of course I mean the normals, right? All these people
who come in and they’re just as normal as the day is long, right? And have nothing to report. Uh, right. Like it’s real normal to have an old bullet in
you.”
She returns fragments of the left kidney, the left lung, and the heart to their correct anatomical positions on the bloc of organs as if she’s
piecing together a puzzle.
“Happens more often than you think,” she says. “Well, not more often than someone like you would think, since we see things like that in the
morgue all the time. And then you get the old routine that bullets are lead, and lead isn’t magnetic, so it’s fine to scan the person. Usually, one of the
