Public Anatomy Read online

  Lipsky approached with more evidence, a glistening tubular-shaped organ held in his gloved hand. From twenty feet, Eli could see that it was the man’s stomach. On closer examination, he noted that the dissection was intricate and precise, the proximal cut made smooth at the junction of the esophagus, the distal transection line just below the muscular pylorus where food empties into the small intestine.

  “Ain’t no hack job, is it, doc?”

  Eli shook his head, part answer, part disbelief. “Whoever did this knows what he’s doing.”

  But exactly what is he doing? Three victims, each with a specific organ removed in its entirety, without damage. He imagined the drawings in the Fabrica, how the sequence of bone to muscle to stomach no longer fit the sequence of Vesalius’s manuscript.

  “On the phone, you guessed that veins were removed from the victim.” Lipsky emphasized the question by rotating the stomach resting in his hands. “What did you mean by that?”

  “Nothing,” Eli conceded. “It was nothing.”

  Basetti announced he was finished taking samples. He held open a plastic specimen container and Lipsky dropped the stomach inside, the image of a steak marinating in a freezer bag. Lipsky and Basetti stared at Eli as though he held the answer.

  “What?”

  Lipsky laid out the prompts. “Over the past three days, we got two doctors and a nurse murdered. Each of them with different body parts cut out, displayed, and sketched on paper.”

  Lipsky waited. Eli said nothing.

  “I been in this business about twenty years now. Seen people gutted, heads cut off, seen one guy doubled over kissing his own ass.”

  Basetti snickered, cleared his throat.

  “Difference is, Doc, those homicides were all from plain meanness, your everyday I’m-pissed-gonna-hack-somebody rage.” Lipsky regarded the victim again. “This is different. There’s some kind of pattern here.”

  “Damn straight,” Basetti said, amen-like, agreeing with the preacher.

  “And frankly, I ain’t got a clue.”

  Basetti agreed. “Damn straight.”

  “Shut up and collect your Baggies, will you,” Lipsky snapped.

  Basetti held the bag to the light, acted like he was reading a message. “There’s got to be some connection, don’t you think? A doctor and two nurses? Maybe they’re friends or work at the same hospital. Or maybe—” Basetti became animated, “it’s a ménage à trois.” He did his best charade to demonstrate. “That’s when three people do it together.”

  Lipsky turned to Eli. “He’s an expert on that sort of thing. Except he has to inflate his partners with an air hose.”

  Eli checked his watch. His ER shift started in one hour. And here he was, listening to this crap.

  “I am a little curious, though, Doc.” Lipsky stroked his bare chin. “How come you happened to be so close to Tunica when I called?”

  When Eli didn’t respond, Lipsky went on.

  “And you didn’t seem very surprised to hear about another death.”

  Eli decided it was time to spill what he knew. Or thought he knew. Maybe Lipsky could use the information and make the whole thing go away.

  “Do you remember the federal agents who visited me in the hospital a couple of months ago?”

  Lipsky nodded. “Yeah, I remember the suits. Said they may be calling on you again for another investigation once your wounds heal.”

  “They called.”

  Lipsky paced a few steps as if considering the implications. “Okay, Mr. Investigator. Want to bring me up to speed?”

  “The first victim had a bone removed,” Eli began. “The second, her tongue cut out.” He stopped, knowing the explanation to Lipsky and Basetti would be difficult to comprehend.

  Check that.

  Damn near impossible.

  “And?” Lipsky asked.

  Basetti raised both hands in the air. “The tongue wasn’t just cut out,” the crime technician said. “It was dissected, the way an anatomist would do it.” Basetti looked at Lipsky. “His dad was an anatomy professor.”

  “I know that, Sherlock,” Lipsky said. “Let him finish.”

  “The specific bone removed, called the navicular, is the same bone, of all the bones in the foot, illustrated separately in a classical text on human anatomy. Even the way the bone was cut open.”

  “Doc, we know you went to medical school,” Lipsky said. “Studied hard, fell in love with your textbooks—”

  Eli interrupted him. “I’m not talking about a modern text. This one was written in the sixteenth century. The first two books of the manuscript describe the bones and muscles, in that order.”

  “Bones and muscles,” Lipsky repeated. “But the second victim had her tongue cut out.”

  Basetti interrupted. “The tongue is a muscle.”

  Lipsky ignored him, turned to Eli for confirmation.

  “He’s right.”

  Basetti stuck his tongue out at Lipsky. Flicked it up and down.

  “Okay,” Lipsky said, trying to piece it together. “The killer gets his ideas from some book.”

  “Not just any book,” Eli corrected him. “This one was written in the year fifteen forty-three.”

  One by one, Basetti flipped up four fingers. “Makes it over four hundred years old.”

  “You said the first two books. I’m betting there’s more,” Lipsky said.

  “There are seven books in all,” Eli informed him. “But the third book is on the vascular system, veins and arteries. The sequence fit, until now.” Eli pointed to the victim. “The stomach is part of the abdomen. That’s book five.”

  “Maybe he’s skipping around,” Lipsky said, laughing at his own next thought. “Maybe he likes to read ahead.”

  “Or maybe this anatomy book theory is a bunch of shit,” Basetti said. He must have realized he was out of line so he started collecting the specimen bags.

  Lipsky held up seven fingers. “If the doc’s right—” He folded down three fingers. “And if my third-grade math serves me, there are four more deaths on the way.”

  CHAPTER THIRTY

  She had completed the last autopsy of the day. A few moments of dusk light crept through the door as she left the pathology building and walked toward her car.

  “Dr. Daily?”

  A young man approached her. He wore a black, collared shirt, somewhat unusual for this heat. In his hand, he carried a pen and a piece of paper and held them up as though a peace offering, obviously aware that dark parking lots in Memphis were alarming places, especially for women.

  “Are you Dr. Meg Daily?”

  Meg knew what he wanted. She had been through this drill before. Reporters were always looking for the inside story on a homicide. A single murder put them on the scent. But a string of murders? They’d circle like wolves. Interviewing a forensic pathologist was a good place to start.

  It was no use trying to deny her identity. The reporter knew who she was already. A couple of prior interviews on prime-time news and she could no longer hide.

  “Promise to make this brief,” Meg said, “and I’ll answer your questions.”

  Surprised, he waited as if to confirm her offer.

  “I’ve got to get home to my daughter.”

  He put pen to paper. “The two recent murders. Did you examine the bodies?”

  “Yes, I performed the autopsies.”

  He scribbled away. “Can you confirm that the killer left some type of card with drawings at each of the crime scenes?”

  “No. Any evidence at the crime scene, you’ll have to talk with police.”

  He looked disappointed.

  “I only said I would answer your questions. She glanced at her watch. “Clock’s ticking.”

  “Can you confirm that bodily organs were removed from the victims?”

  Meg nodded. “During the organ recital, I remove all the organs from the body, systematically.”

  He stopped writing.

  “Did you say organ recital
?”

  Organ recital was the term her pathology mentor had used in medical school during his autopsy demonstrations, when he would methodically put each organ on display. She liked the term and had adapted it as her own. But she felt regret now for using it.

  “Yes, the autopsy—organ recital.”

  He wrote that down, underlined it.

  “But were specific organs removed by the killer?”

  “Yes.”

  He looked up, eyes wide. “Which organs were removed?”

  “I can’t tell you that.”

  He winced as though he had just been turned down for a date.

  “You’ve got time for one more question.”

  He thought a moment, as though running through a list. “Do you think there will be more murders?”

  Meg smiled. “How long have you lived here?”

  “About, six months.”

  Meg opened the door to her car. “Been busy?”

  The young man rolled his eyes. “Yeah.”

  “There’s your answer.”

  CHAPTER THIRTY-ONE

  At night, Victorian Village is illuminated only by the yellow glow of a few window lamps. The footpaths are dark and anyone can pass through from the medical center to downtown without being seen—unless the moon is full, when the century-old oak trees cast thick shadows.

  Through the parlor window, Layla watched a young man walk back and forth on the sidewalk. She saw him look toward the other houses, as if checking that he had the right one. Liza had told her students of a unique feature to look for—a single third-story window with a Japanese lantern on the ledge.

  There. He saw it, turning with a brisk step up the walk.

  Damn, he’s young, Layla thought. The medical students were getting younger or she was getting older. Probably a first-year. She would know soon enough, cadaver Formalin sweating from his clothes. New to the city, alone, not daring to ignore the request of an attending surgeon who would soon be determining his grade. They all gave the same line after knocking on the door, as though a password.

  “Dr. French told me to come for extra tutoring.”

  Layla smiled.

  Extra tutoring.

  They were all so cute, so innocent. She let him stand outside a few moments. Waited until his eyes drifted down to her leather skirt, black leggings, knee-high boots.

  “Tutoring? Have you not been studying enough?”

  “No ma’am. I guess not.”

  “Well, now, let’s see if we can fix you up.” Layla extended her arm. “Dr. French is waiting for you in her study.”

  Layla led him up the spiral staircase, twitch-twitching her leather skirt at the level of his eyes, warming him up.

  Dr. French sat at her desk, reading glasses on, studying a medical journal, or at least pretending to. When the student entered the room, she took off her glasses, leaned back in her chair, and studied him.

  He thanked her for inviting him, his eyes darting across the room, trying to comprehend the operating table in the center of the room, a modular console in the corner, surgical instruments scattered on a table in between.

  “Have you ever been in an operating room before?”

  “Once, in college,” he said, eyes still searching the room, “but not like this.”

  He looked confused, trying to piece all of it together. Deep wooden bookcases lining the wall, the stainless steel table to finish the décor. Hospital-inspired interior decorating.

  Layla came up behind him, placed her hands on his shoulders. He winced as if he had forgotten she was in the room.

  “So tense, my dear,” she said, messaging his back.

  Liza wore a hooded sweatshirt with a front zipper and no shirt underneath. Green scrub pants. She walked toward him.

  “This is where I practice my skills,” Liza said. “Surgical simulation.”

  “Have you ever been simulated?” Layla asked, moving her hands closer to his hips.

  “You can learn how to operate here, get a leg up on your classmates.”

  Layla wrapped her leg around his. “Yeah, a leg up.”

  Liza handed him a long pencil-thin telescopic grasper, one that would be placed through small ports during laparoscopic surgery. The grasper had a finger hole grip at one end, fine pincers at the other.

  He held the instrument, worked the grip, watched the pincers open and close.

  “Very good,” Liza said. “You’re ahead of the curve already.”

  He smiled.

  She pulled the instrument toward her until the tip nearly touched the zipper on her sweatshirt.

  “Open,” she instructed him.

  He complied.

  “Now, close.”

  The instrument grabbed the zipper.

  He looked at her for the next set of instructions.

  She waited.

  Using the instrument, he inched the zipper up, toward her neck.

  “No,” she said. “Wrong way.”

  With her index finger, Liza pushed the shaft of the instrument down.

  With more of her skin exposed, the student’s hand began to shake and the grip of the instrument released the zipper.

  Liza shook her finger. “We’ll have to work on that tremor before you operate on real patients.”

  Layla pulled his arms behind him, slowly, and held his hands as though cuffed. “Needs a bit more practice, does he, Dr. French?”

  “A lot more practice.”

  Layla tugged his hands, pulling him backward, step-by-step, until he was at the edge of the operating table.

  “Do you know what empathy means?” Liza asked.

  The student looked behind him at the table, glanced at Layla, then back at Liza. “Empathy?”

  “Yes, what does it mean?”

  “It’s … it’s when you understand how another person feels.”

  “That’s right,” Liza said. She pressed down on his shoulders until he met the table, leaning on the edge with his feet on the floor, unwilling to commit.

  “Before you become a physician—a surgeon, certainly—you have to know how the patient feels.”

  From the other side of the table, Layla pulled him back, gradually, until his head rested on the hard surface. Liza lifted his feet, rotating the lower half of his body until he was completely supine.

  Layla moved to the head of the table, taking the position of surrogate anesthesiologist. She leaned over him to reach the leather strap, her full chest covering his face.

  As Layla secured the strap over the student’s waist, Liza asked, “Do you want to know how it feels?”

  His voice full with fear and excitement, he whispered, “Yes.”

  CHAPTER THIRTY-TWO

  Eli reported for his ER call shift in Whitehaven at seven p.m. The off-call doc gave him a report on patients waiting for test results. Routine blood work on a diabetic patient with a toe infection, urinalysis on a nursing home patient with mental status changes, and a head CT on a seventy-year-old man who lived alone and was found unconscious next to his porch swing by his neighbors—but who was now only complaining that the nurses had stolen his clothes. Nothing too exciting, which suited him fine because he’d brought along some homework that he desperately needed to complete. All the awaited test results came back within the hour, and after Eli treated an additional case of noncardiac chest pain, he retreated to the call room with a stale but hot cup of coffee.

  His homework consisted of two texts.

  The first was Andreas Vesalius of Brussels, the definitive biography of the master anatomist by O’Malley. The second, an account of Vesalius’s first public anatomy dissection at Bologna in 1540.

  If the killer was so intent on imitating the work of Vesalius, Eli felt he needed to know more about the anatomist himself.

  Vesalius was born in 1514 and died in 1564. During those fifty years, he brought an era of enlightenment to the study of anatomy, as he refuted the teachings of Galen whose knowledge of anatomy was largely based on dissections of animals
a century before. Vesalius brought a literal hands-on approach to anatomical dissection. Rather than orate his observations after delegating the cutting to a prosector, Vesalius took his place beside the body and became the center of attention. And the center of attention he was.

  Vesalius’s public dissections became legendary. Often, he performed them outdoors on a makeshift stage constructed for the purpose of hosting an audience. A visual collage of this audience is depicted in the title page of the Fabrica. The elaborate sketch shows a motley crew of townspeople: politicians, scholars, and curious onlookers lusting after a gruesome sight. At the center lies the body, abdomen opened, with Vesalius not only performing the dissection himself, but also teaching the spectators, their necks craning for a better view.

  The voices of a couple of nurses talking in the hallway drifted through the door. Eli assumed they were about to summon him with a knock on the door. Their voices faded. He continued to read.

  Obtaining a body for these dissections was far from easy, it seemed. Vesalius had no cadaver donation program, so beneficial to medical schools today. If he wanted to dissect a body, he had to find it and steal it himself. The most ready source were the bodies of executed criminals. At night he went in search of a gibbet, the inverted L-shaped structure on which the bodies of the executed were hung.

  While in Paris, Vesalius traveled to Montfaucon, passing the Cemetery of the Innocents, where multitudes of plague victims were interred. At Montfaucon, a gibbet had stood on the mound since the twelfth century. Near it was a charnel house, its colonnade of thirty-foot-high stone pillars joined by wooden beams, where the executed bodies hung until arrangements for their disposal were completed. Crows and outcast dogs held vigil nearby, waiting for a chance at the rotting meat.

  When robbing a gibbet, timing was important. For both dissector and audience, a fresh body was preferable to one in which organ decay had begun. This made a public anatomy a spur-of-the-moment event, announcement spreading by word of mouth, spectators scrambling for position near a recently erected stage.