Public Anatomy Page 10

  Fat, fifty, and far from married, Miss Conch guarded her roost like a pissed-off mother hen. And now the rooster had come to peck at her favorite chick, Meg Daily.

  “Hi, Miss Conch.”

  “No, no. Don’t try to smooth talk me. We’ve been working our tails off down here and you haven’t even called her. Not once. Just like every man I’ve ever known.”

  Eli held up his hands in surrender. He wondered how many men that could have been. “Is she back there?”

  “Maybe she is and maybe she ain’t.”

  He tried to think of an appropriate response to this straight-from-elementary-school answer. He went for a direct approach.

  “I need to see her.”

  Miss Conch stared him down. “She’s had a hard month. Margaret’s been sick.” She pointed a stubby finger. “You be especially nice.” With the same finger, she pushed the button on the intercom. “Dr. Daily. Got a surgeon here wants to see you.”

  After a few moments of silence, Eli heard static, then, “Let him back only if he’s carrying an autopsy knife.”

  Miss Conch stopped Eli before he pushed through the autopsy door. “Remember. Extra nice.”

  Meg was in the same position as when he’d first met her, bent over a dead body split stem to stern. She wore a mask, gown, and gloves. Her hair was pulled back and tucked into a surgical cap, though a few errant strands escaped and fell toward her face. So sexy, those unruly strands. For the moment, with so much of her covered, the essence of Meg Daily poured out of intense brown eyes.

  She looked up from her work but said nothing.

  Eli knew the drill. He removed a plastic gown from the corner table and slipped it over his clothes.

  Hard-angled stainless steel on dingy tile floors formed the autopsy room. A single table in the room’s center efficiently removed body fluids, its corners sloping into drains like pockets on a pool table. Even the floor sloped toward a center drain hole. The continuous sound of running water came from a black hose on the autopsy table and another hose that curled like a snake on the floor. Always a drip-drip-drip that made your skin crawl.

  The body on the table was that of an obese male, skin mottled bluish-gray. The breastplate had been removed through a Y incision that extended down the middle of the abdomen. Meg stood on a stool that lifted her over the protuberant belly. She struggled with a pair of heavy Mayo scissors.

  “Hand me that big Richardson.” Meg pointed at the instrument table without looking up.

  Eli slipped on a pair of gloves and removed the right-angled retractor from the instrument set. But rather than give it to her, he stood on the opposite side of the table, inserted the retractor into the incision, and pulled to provide the exposure Meg needed. He immediately saw the problem. Adhesions from a previous operation prevented Meg from eviscerating the abdominal contents, a feat normally accomplished with a few targeted snips.

  With the abdominal wall retracted, Meg could visualize the appropriate plane of dissection, and she quickly removed loops of small intestine and colon. Versed in the sequence of evisceration, the two physicians worked in silence, Eli with gentle pressure on the tip of the spleen, then rotating positions with Meg, both hands on the liver, giving, taking, lost in the void they created, until it was done.

  “Looks like your hand’s much better,” Meg said as she placed the liver in the cradle of a hanging scale.

  “Works well enough for dead people, I suppose.”

  Meg replaced the liver with the spleen, recorded the weight, kept moving.

  “I hear Margaret’s been sick.” Eli felt odd asking about Meg’s five-year-old daughter, a lame way to reacquaint himself.

  “Yes, Eli, she’s sick. Hasn’t been well a day in her life, really.”

  “I’m sorry.”

  To calm herself, Meg stopped and put both hands on the bench in front of her. Then she turned to face Eli. “I haven’t heard a word from you in over two months.” She gestured over her shoulder at the day’s work. “I’ve got six autopsies on the schedule and I’m already behind.”

  “Six weeks,” Eli said, interrupting her.

  “What?”

  “It’s been only six weeks.”

  “What do you want, Eli?”

  “I need your help.”

  “With what, may I ask?”

  Eli motioned to the bank of freezers. “I know things have been crazy, you may not have examined them yet.”

  Eli watched her pull out a freezer drawer on the bottom row. As the drawer opened, the feet presented first and Eli immediately recognized the extremity wound he had seen in Lipsky’s photo.

  “This who you’re looking for?”

  The horizontal incision across the foot had dried but the missing bone was obvious. Eli looked over the rest of the body. There was no obvious trauma on the anterior half of the nude male.

  “How did you know?” Eli asked.

  “Only two bodies have been interesting, one male, one female. There have been a lot of heat-related deaths, two straightforward gunshot wounds, a stabbing, one strangling—you know, the usual stuff.” Meg pointed to the foot wound. “But not this.”

  Eli stepped closer to the body.

  “What do you know about this?” Meg asked.

  Eli shook his head. “They’re dead.”

  Meg glanced at him as though peering above eyeglasses. “Damn. You must have gone to one of those Ivy League medical schools.”

  “No. I was lucky to be accepted here in Memphis. Lots of dead patients to work with.”

  “Anything else about these patients,” Meg asked, “that a ditchdigger couldn’t figure out?”

  “No, not much. Detective Lipsky asked me to look at the photos. He thought these were a weird combination of wounds, and the fact they were both medical personnel.”

  “Medical?”

  “Yeah. The guy’s an anesthetist and the female victim you refer to is a nurse.”

  “That is strange,” Meg agreed. “What did you tell him?”

  “I didn’t tell him anything. He thought there might be some connection between the two victims.”

  “And?”

  “And what?”

  “Is there a connection?”

  “Hell if I know. Why is it that all of a sudden I know what makes people kill each other?”

  Meg closed the drawer and returned to the autopsy Eli had interrupted.

  “I’m sorry,” he said, following her.

  “Something made you come here, Eli,” Meg said, facing him now. “Something about those deaths, I presume.” She grabbed the hem of her protective gown and curtsied. “Or maybe you just wanted to see me in my new yellow dress?” She bellied up to the head of the autopsy patient.

  Eli didn’t know how to start. Why exactly the sequence of foot bone, then tongue removal, bothered him. Before he could speak, Meg pressed the Stryker saw into the man’s scalp, and the high-pitched circular saw spit a line of bone on the table. She finished the 360-degree cut and pulled the skull off by the hair.

  “What was the cause of death?”

  Meg laid the saw on the table. “I’m running behind in the autopsy schedule so I haven’t started on the first victim yet, but I did find an external wound that is telling.”

  Eli knew it had to be a finding other than the foot wound; that insult alone would not kill a person. “Telling for what?”

  Meg placed her hand at the back of the victim’s neck. “A single hole, tiny, like an ice pick.” Meg pointed to another body drawer, yet to be opened. “Same with this one. Whoever did this knows their anatomy.”

  Eli reacted by cupping the back of his neck with his hand. “Speaking of anatomy,” he said, “the bone from the foot, was it the navicular?”

  Meg turned and stared at him. “Yes, as a matter of fact, the excised bone was the navicular.”

  Eli felt the room turn cold. He knew what she was thinking. The navicular is one of many bones in the foot, and not the only one that could have been removed throu
gh the wound.

  “You’ve got a reason for asking that, don’t you, Eli?” She pointed a blood-stained finger at him. “Now, tell me what the hell is going on.”

  “Can I see the next victim, the woman?”

  “Sure,” Meg said. She maneuvered herself away from the table and pulled out the top drawer. “Would you like fries with that?”

  The drawer rolled forward easily to reveal the body. Eli had been so focused on examining the first victim’s foot, he had not even glanced at the man’s face. With the second victim, he would focus his initial exam on the victim’s face and the absence of her tongue.

  Meg folded back the sheet. Eli stepped toward the head and froze. The corpse’s mouth was swollen, old blood smeared across her lips like a bad lipstick application. Her tongue lay beside her head in a transparent plastic bag.

  The possibility that he would know the victim had not occurred to him. Her mouth was contorted; perhaps her jaw had been broken during the assault. But her identity was unmistaken. He stared at the face of Virginia Brewer, a respected operating room nurse who had been at Gates Memorial Hospital for years.

  As a medical student, he had known her a decade ago. He saw flashes of her helping him through that awkward time of learning to gown and glove when he scrubbed in for his first operation. And just six weeks ago, she had welcomed him back to the hospital in the midst of a gory operation that had begun the spectacular derailing of his career. Now, he looked upon her in death, less of a colleague, more as a mother figure.

  Eli was paralyzed by the memories of this gentle nurse. “I knew her,” he said. He couldn’t quit staring at her disfigured face. “She was an OR nurse.”

  Lipsky had told him her body was found in an old wrestling arena. He thought that was odd, a portion of her life he knew nothing about.

  Meg said, “I’m sorry.” Then, she pulled the sheet, slowly this time, until the body of nurse Virginia Brewer was covered.

  CHAPTER TWENTY

  Liza French cut her course short of the usual three miles. It was too damn hot and she was too fatigued after a near-sleepless night. When she returned from her early evening run, Liza found medical student Cate Canavan waiting for her in the living room. Layla sat beside Cate, trying to console her with a cup of tea. Cate was too upset to drink.

  Liza was not surprised to see Cate. As her mentor, Liza knew the death of any patient could be traumatic for health care providers, even when it is expected. But no one, especially not a medical student, is prepared for the death of an otherwise healthy woman on the operating room table. Cate had witnessed the event firsthand. The blood, the shouting, the chaos as robotic instruments were frantically removed and the patient’s abdomen sliced open.

  As attending surgeon, Liza did not have a chance to speak with Cate after the operation. At least not in a consoling way. Liza remembered yelling at the resident, the nurses, even Cate, trying to determine what had gone so horribly wrong.

  Cate stood when Liza entered the room. Her eyes were puffy and red.

  “Dr. French, I’m so sorry to bother you.”

  “I’m glad you’re here, Cate. Please, sit down.”

  Liza asked Layla to bring her a bottle of water. Sweat continued to run down her back as she sat beside Cate.

  “What happened in the operating room,” Cate said, “I can’t quit thinking about it.”

  “I know. It was a terrible complication. I’m sorry you had to see it.”

  “But everything was going so well. We were almost finished.”

  Layla brought the water. Liza held the bottle without opening it.

  “I know, Cate. I thought the same thing.”

  Cate shook her head. “I feel like I should have done something to stop it. I just stood there. Paralyzed.”

  “There was nothing you could have done. And that’s a normal reaction at first, to feel paralyzed.”

  Merely talking about the case, Liza felt the empty pit return to her stomach. She had pored over the facts of the case, each step, each movement of the operation. But now, the emotional response returned. She too had felt paralyzed, as if the blood had drained from her as well.

  “Panic in the OR,” Liza said. “That hurt us.” She stood and took several gulps of water. “In your own practice—” Liza put her hand to her mouth, belched. “You’ll find that experience keeps you calm and allows you to act.”

  Cate shook her head. “I can’t do it.”

  “What do you mean, you can’t do it?”

  “Be a surgeon, like you. I don’t think I can do it anymore.”

  Liza knelt in front of Cate. “Sure you can, I’ve seen you. You’re wonderful with the patients, Cate. And your technical skill will come naturally during your fellowship.”

  Cate took a sip of tea.

  Liza stood again.

  “Come. I want to show you something.”

  Cate followed Liza up the spiral staircase. They stopped on the second floor landing.

  “Remember the robotic simulator I told you about?”

  Cate turned to see Layla several steps below them. “The one the company donated to your program?”

  Liza continued up the stairs to the single room on the third floor.

  “Wasn’t it supposed to go to the OB Department?” Cate asked.

  Liza looked over her shoulder. “I had them drop it off here, first.” She smiled. “On a trial basis.”

  The upper staircase ended at a single door. Liza opened it and motioned for Cate to enter.

  CHAPTER TWENTY-ONE

  Cate stopped just inside the door. An operating table occupied the center of what appeared to be an office. Bookcases lined the dark-paneled room. A large wooden desk sat beneath the room’s single window. And off to the side, near the far corner, a sleek gray robotic console looked completely out of place.

  Liza put her hand on top of the console and stroked the smooth surface as if it were the hood of a Mercedes-Benz. The front of the console was cut out to accommodate a screen, robotic hand controls, and a bucket seat.

  “This simulator is like the real thing, Cate. I want you to come here and practice on it any time you wish.”

  Cate approached the machine. Not because she wanted to, but because her mentor insisted. She looked at a pair of leather straps that crossed the operating table. In this room, the simulator looked more like a device for torture than a means to save lives.

  “I can’t believe you have all this in your house,” Cate said.

  “It doesn’t exactly fit with the Victorian décor, does it?” Liza laughed. “So I keep all the high-tech stuff in this third-story office. Here,” she said, pointing to the console, “have a seat.”

  Standing between the console and the operating table, Cate had a flashback from the operation. How she’d glanced at Dr. French when the anesthesiologist announced the plummeting blood pressure. How the video screen had filled with the image of spurting blood.

  Cate took a seat inside the console. Cold sweat beaded on her forehead. Her hands shook as Dr. French told her to take the controls.

  “I want you to feel comfortable with the instruments.”

  Cate felt Liza lean over her shoulder.

  “By the time you start residency, you will be well above your peers.”

  Cate sensed the delicate positioning of the hand controls, felt Liza’s breath on her hair, smelled the sweat soaked into her teacher’s running clothes.

  Cate wanted to be the good medical student, to show her utmost appreciation and dedication to what Dr. French was offering her. She knew this opportunity was afforded to few students. But her pulse was pounding, and for the first time in her life she felt claustrophobic. Cate stepped out of the console and bumped into Liza, knocking her back. She crossed the room and opened the door to the staircase.

  “I’m sorry.” Cate tried to slow her rapid breathing. “It’s too soon. I’m just not ready.”

  Liza followed her down the stairs. “It’s okay. I shouldn’t have shown
you this yet. It was inconsiderate of me.”

  Layla met them in the parlor. “What’s wrong, darling?”

  “Nothing. I just need some fresh air,” she said. “Thank you, Dr. French.”

  “You will overcome this, Cate,” Liza called from the doorway. “You will be a fine surgeon. I hope you know that.”

  Cate ran from the house down the walkway. Relieved, she took in a full breath of the humid night. She looked back at her mentor’s stately mansion. The front door was closed, the porch light already turned off.

  CHAPTER TWENTY-TWO

  Secret Lives of Doctors.

  The newest in reality-based television shows. The premise: What former lives had doctors given up to pursue a career in medicine? World-class cellist, Broadway actress, pitcher in triple-A minor league baseball, lingerie model?

  The doctors chosen for each episode of this show were in their first years of training for specialties such as OB/GYN and surgery. Only a few years before, each had faced the decision to pursue the professional life of an artist, an athlete, or the profession of medicine. One more performance, another competition, could have pushed them into celebrity status.

  So what happened?

  Do they still hold to these dreams once pursued through obsessive hours of practice and training? Or did the stress and demands of medical school and residency force them to drop their preoccupying desires? Or had they simply replaced these activities with something less admirable? A vice, perhaps?

  This is what the producers were hoping for. The hook. The dirty laundry. They were looking for someone like Thomas Greenway. The man was six foot three, had the body of a swimmer: broad shoulders, trim waist. In fact, he was a swimmer, spent his evenings and weekends, when he wasn’t on call for OB/GYN service, training for triathlons. He had been paying his way through college and medical school working as a model for magazine ads.

  He was handsome enough, but his main attribute had not been captured through facial photography. That was part of the deal. No pictures of his face. He thought he would never get into medical school if his identity in the pictures was known. The photos that had paid for an expensive medical education were pure torso shots. He had a rolling set of abs that led the eyes below the waist. What started as advertisements for men’s boxer shorts soon went to men’s briefs, and then the Speedo-like mini briefs in which his abdominal muscles were not the only prominent organ displayed.