MAURA PAUSED IN THE ICU CUBICLE DOORWAY, UNNERVED BY THE sight of all the tubes and catheters and wires snaking around Rat’s body, an invasion that no sixteen-year-old boy should ever have to endure. But the rhythm on the cardiac monitor was reassuringly steady, and he was now breathing on his own.
Sensing her presence, he opened his eyes and smiled. “Hey there, ma’am.”
“Oh, Rat.” She sighed. “Are you ever going to stop calling me that?”
“What should I call you?”
You called me Mommy once. She blinked away tears at the memory. The boy’s real mother was almost certainly among the dead, but she did not have the heart to break the news to him. Instead she managed to return the boy’s smile. “I give you permission to call me whatever you want. But my name is Maura.”
She sat down in the chair beside his bed and reached for his hand. Noticed how calloused and scabbed it was, the fingernails still stubbornly stained with dirt. She, who did not easily reach out to touch anyone, took that battered hand in hers, and took it without hesitation. It felt natural and right.
“How’s Bear?” he asked.
She laughed. “You’ll be changing his name to Pig when you see how much he’s been eating.”
“So he’s okay?”
“My friends have been spoiling him rotten. And your foster family promised they’d look after him until you get home.”
“Oh. Them.” Rat’s gaze drifted away from hers, and he looked up listlessly at the ceiling. “I guess I’ll be going back there.”
A place he clearly did not want to go. But what alternative could Maura offer him? A home with a divorced woman who knew nothing about raising children? A woman who was carrying on a furtive love affair with a man she could never acknowledge as her partner? She was a poor role model for a teenage boy, and her life was already troubled enough. Yet the offer trembled on her lips, an offer to take him in, to make him happy, to fix his life. To be his mother. Oh, how easy that offer was to make, and once made, how impossible to retract. Be sensible, Maura, she thought. You can’t even keep a cat, much less raise a teenager on your own. No responsible authority would grant her custody. This boy had already known too much rejection, too many disappointments; it would be cruel to make promises she couldn’t keep.
So she did not make any. She merely held his hand and stayed at his bedside as he drifted back to sleep. The nurse came in to change the IV bottle and whisked out again. But Maura remained, pondering the boy’s future, and what part she could realistically hope to play in it. I know this much: I won’t abandon you. You’ll always know that someone cares.
A knock on the window made her turn, and she saw Jane beckoning to her.
Reluctantly Maura left the bedside and stepped out of the cubicle.
“They’re about to start the first autopsy,” Jane said.
“The Kingdom Come victims?”
Jane nodded. “The forensic pathologist just arrived from Colorado. He said he knows you, and he’s wondering if you’d care to observe. He’s doing it downstairs, in the hospital morgue.”
Maura glanced through the window at Rat, and saw that he was peacefully sleeping. The lost boy, still waiting to be claimed. I’ll be back. I promise.
She nodded to Jane, and they left the ICU.
When they arrived in the morgue, they found the anteroom crowded with observers, Sheriff Fahey and Detective Pasternak among them. The sheer number of victims had made this a high-profile case, and nearly a dozen law enforcement and state and county officials had gathered to witness the autopsy.
The pathologist saw Maura walk into the room and raised a beefy hand in greeting. Two summers ago, she’d met Dr. Fred Gruber at a forensic pathology conference in Maine, and he seemed pleased to spot a familiar face.
“Dr. Isles,” he called out in his booming voice. “I could use another set of expert eyes. You want to gown up and join me in there?”
“I don’t think that’s appropriate,” said Sheriff Fahey.
“Dr. Isles is a forensic pathologist.”
“She doesn’t work for the state of Wyoming. This case is going to be watched closely, and questions could be raised.”
“Why would there be any questions?”
“Because she was in that valley. She’s a witness, and there could be charges of tampering. Contamination.”
Maura said, “I’m only here to observe, and I can do that perfectly well from this side of the window, with the rest of you. I assume we can watch it on that monitor?” She pointed to the TV screen mounted in the anteroom.
“I’ll turn on the camera, so you’ll all have a good view,” said Dr. Gruber. “And I’m going to ask all the observers to remain in this room anyway, with the door shut. Since there’s a possibility we’re dealing with cyanide poisoning.”
“I thought you had to swallow the stuff to get sick,” one of the officials said.
“There’s the chance of outgassing. The biggest danger is when I cut into the stomach, because that’s when cyanide gas might be released. My assistant and I will be wearing respirators, and I’ll dissect the stomach under the fume hood cabinet. We’ve also brought a GasBadge sensor, which will immediately alert us if it detects hydrogen cyanide. If it’s negative, I may be able to let some of you into the room. But you’ll have to wear gowns and masks.”
Gruber donned dissection garb, including a respirator hood, and pushed through the door into the autopsy lab. His assistant was already waiting, similarly garbed. They turned on the camera, and on the TV monitor, Maura could see the empty autopsy table awaiting its subject. Gruber and his assistant wheeled the plastic-shrouded body out of cold storage and slid it onto the table.
Gruber unzipped the shroud.
On the video monitor, Maura could see that the body was a young girl, only about twelve or thirteen. Since the exhumation from the frozen ground, her flesh had been allowed to thaw. Her face was ghostly pale, her blond hair a crown of damp ringlets. Gruber and his assistant were quietly respectful as they removed the garments. Off came a long cotton dress, a knee-length slip, and modest white briefs. The corpse, now nude, was slender as a dancer’s, and despite days of burial, she was still eerily beautiful, her flesh preserved by the valley’s subfreezing temperatures.
The officials pressed in closer around the monitor. As Gruber collected blood, urine, and vitreous specimens for toxicology, the men’s eyes took in what should never have been revealed to them. It was a violation of a young girl’s modesty.
“The skin is markedly pale,” they heard Gruber say over the intercom speaker. “I see absolutely no residual flush.”
“Is that significant?” Detective Pasternak asked Maura.
“Cyanide poisoning can sometimes cause the skin to appear bright red,” she answered. “But this body has been frozen for days, so I don’t know if that would affect it.”
“What else would you find in cyanide poisoning?”
“If it’s ingested orally, it can corrode the mouth and lips. You’ll see it in the mucous membranes.”
Gruber had already slipped a gloved finger into the oral cavity and he peered inside. “Membranes are dry, but otherwise unremarkable.” He glanced through the window at his audience. “You getting a good view of this on the monitor?”
Maura nodded at him. “There are no corrosive lesions?” she asked over the intercom.
“None.”
Jane said, “Isn’t cyanide supposed to smell like bitter almonds?”
“They’re wearing respirators,” said Maura. “They wouldn’t be able to smell it.”
Gruber carved the Y-incision and picked up the bone cutters. Over the intercom, they heard the crack, crack as he split the ribs, and Maura noticed several of the officials suddenly turn away and stare at the wall. Gruber lifted up the shield of sternum and ribs, exposing the chest cavity, and reached into the chest to resect the lungs. He lifted out one wet and dripping lobe. “Feels pretty heavy to me. And I’m seeing some pink froth here.” He sliced into the organ, and fluid oozed out.
“Pulmonary edema,” said Maura.
“What does that signify?” Pasternak asked her.
“It’s a nonspecific finding, but it can be caused by a number of drugs and toxins.”
As Gruber weighed the heart and lungs, the camera remained fixed on a static view of the torso, gaping open. No longer were they staring at a nubile young girl. What once might have titillated had been transformed to butchered flesh, a mere carcass of cold meat.
Gruber once again picked up his knife and his gloved hands reappeared on the monitor. “This damn face shield keeps fogging up,” he complained. “I’ll dissect the heart and lungs later. Right now, I’m most concerned about what we’re going to find in the stomach.”
“What is your sensor showing?” Maura asked.
The assistant glanced at the GasBadge monitor. “It’s not registering anything. No cyanide detected yet.”
Gruber said, “Okay, here’s where things could get interesting.” He looked through the window at his audience. “Because we could be dealing with cyanide, I’m going to proceed a little differently. Normally I’d just resect, weigh, and open up the abdominal organs. But this time I’m going to clamp off the stomach first, before I resect it in toto.”
“He’ll place it under the fume hood before he slices it open,” Maura explained to Jane. “Just to be safe.”
“Is it really that dangerous?”
“When cyanide salts are exposed to gastric acid, they can form toxic gas. Open that stomach and you release the gas into the air. That’s why they’re wearing respirator hoods. And why he’s not going to cut into that stomach until it’s under a fume hood.”
Through the window, they watched Gruber lift the clamped and resected stomach out of the abdomen. He carried it to the fume hood cabinet and glanced at his assistant.
“Anything showing up on the GasBadge?”
“Not a blip.”
“Okay. Bring that monitor closer. Let’s see what happens when I start cutting.” Gruber paused, staring down at the glistening organ, as though bracing for the consequence of what he was about to do. The fume hood blocked Maura’s view of the actual incision. What she saw was Gruber’s profile, his head craned forward, his shoulders hunched in concentration as he sliced. Abruptly he straightened and looked at his assistant.
“Well?”
“Nothing. It’s not reading cyanide, chlorine, or ammonia gas.”
Gruber turned to the window, his face obscured by the fogged mask. “There are no mucosal lesions, no corrosive changes in the stomach. I have to conclude that we’re probably not dealing with cyanide poisoning.”
“Then what killed her?” asked Pasternak.
“At this point, Detective, I’d be guessing. I suppose they could have ingested strychnine, but the body shows no lingering opisthotonos.”
“What?”
“Abnormal arching and rigidity of the back.”
“What about that other finding, in the lungs?”
“Her pulmonary edema could be due to anything from opiates to phosgene. I can’t give you an answer. I’m afraid this is all going to come down to the tox screen.” He pulled off his fogged respirator hood and heaved out a sigh, as though relieved to be free of that claustrophobic mask. “Right now, I’m thinking this is a pharmaceutical death. A drug of some kind.”
“But the stomach’s empty?” said Maura. “You didn’t find any capsule remnants?”
“The drugs could have come in liquid form. Or death could have been delayed. Sedation, followed by assisted asphyxiation.”
“Heaven’s Gate,” Maura heard someone say behind her.
“Exactly. Like the Heaven’s Gate mass suicide in San Diego,” said Gruber. “They ingested phenobarbital and tied plastic bags over their heads. Then they went to sleep and never woke up.” He turned back to the table. “Now that we’ve ruled out any danger of cyanide gas, I’m going to take my time. You’ll all have to be patient. In fact, some of you may find the rest of this tedious, if you’d like to leave.”
“Dr. Gruber,” one of the officials said, “how long is this first autopsy going to take? There are forty other bodies waiting in the deep freeze.”
“And I’m not thawing any more of them until I’m satisfied I’ve done justice to this young lady.” He looked down at the girl’s corpse, and his gaze was mournful. Entrails glistened in her gaping abdomen, and her freshly thawed flesh dripped pink icemelt into the table drain. But it was her face that seemed to hold his attention. Staring up at the monitor, Maura, too, was transfixed by the face, so pale, so innocent. A snow maiden, frozen on the threshold of womanhood.
“Dr. Gruber?” the assistant said. “Are you okay? Doctor?”
Maura’s gaze shot back to the viewing window. Gruber swayed and put his hand out to catch himself against the table, but his legs seemed to dissolve away beneath him. A tray toppled and steel instruments clattered across the floor. Gruber collapsed, his body landing with a sickening thud.
“Oh my God!” The assistant knelt down beside the body. “I think he’s having a seizure!”
Maura grabbed the nearest telephone and dialed the operator. “Code Blue, autopsy lab,” she said. “We have a Code Blue!” As she hung up, she saw to her dismay that three observers had already pushed through the door into the lab. Jane was about to follow them when Maura grabbed her arm and stopped her.
“What the hell?” Jane said.
“You stay right here.” Maura snatched an autopsy gown off a shelf and thrust her arms into heavy rubber dissecting gloves. “Don’t let anyone else into that room.”
“But the guy’s having a seizure in there!”
“After he took off his hood.” She glanced around frantically for another respirator, but she saw none in the anteroom. No other choice, she thought. I have to be quick. She washed out her lungs with three deep breaths and pushed through the door, into the lab. Gruber had left his respirator lying on the fume hood cabinet. She snatched it up and pulled it over her head. Heard a clang and turned to see one of the men sag against the sink.
“Everyone, get out of here!” she yelled as she grabbed the wobbling man and helped him toward the door. “This room is toxic!”
The morgue assistant shot her a stunned look through his mask. “I don’t understand! The GasBadge monitor didn’t register a thing!”
She bent down to grab Gruber under his arms, but he was too heavy, an immovable deadweight. “Take his feet!” she ordered.
Together she and the morgue assistant dragged Gruber away from the table and across a floor littered with instruments. By the time they pulled him into the anteroom, the Code Blue team had arrived and was strapping oxygen masks onto three pale-looking men.
Maura looked down at Gruber, whose face was tinged with blue. “This man’s not breathing!” she yelled.
As the code team converged on the patient, Maura backed away to let them do their jobs. Within seconds they were forcing oxygen into his lungs, slapping cardiac leads on his chest. On the monitor, an EKG tracing appeared.
“He’s got a sinus rhythm. Rate of fifty.”
“I’m not getting a blood pressure. He’s not perfusing.”
“Start compressions!”
Maura said, “He was exposed to something. Something in that room.”
But no one seemed to hear her through her respirator hood. Her head was pounding. She pulled off the hood and blinked against lights that suddenly seemed too bright. The medical team was in full Code Blue mode now, and Fred Gruber’s torso was completely bared, his bloated abdomen humiliatingly exposed and jiggling with each cardiac compression. The stench of urine rose from his soaked scrub pants.
“Do we have any history on this man?” the doctor called out. “What do we know about him?”
“He collapsed while doing an autopsy,” Jane said.
“He looks about a hundred pounds overweight. I’m betting he had an MI.”
“He wet himself,” said Maura.
Again, her voice went ignored. She was like a ghost hovering at the periphery, unheard and unheeded. She pressed a hand to her head, which was pounding even worse, and struggled to think, to focus. Somehow she managed to push her way into the throng of personnel and kneel down near Gruber’s head. Lifting one of his eyelids, she stared at the pupil.
It was barely a pinprick of black against the pale blue iris.
The stench of urine wafted up from his body, and she looked at his soaked scrub pants. Suddenly aware of the sound of retching, she glanced across the room and saw the morgue assistant was vomiting into a sink.
“Atropine,” she said.
“I got the IV in!” a nurse called out.
“I’m still not getting a blood pressure.”
“You want a dopamine drip?”
“He needs atropine,” said Maura, louder.
For the first time, the doctor seemed to notice her. “Why? His heart rate’s not that slow.”
“He has pinpoint pupils. He’s soaked with urine.”
“He also had a seizure.”
“We all got sick in that room.” She pointed to the morgue assistant, who was still leaning over the sink. “Give him the atropine now, or you’re going to lose him.”
The doctor lifted Gruber’s eyelid and stared at the constricted pupil. “Okay. Atropine, two milligrams,” he ordered.
“And you need to seal that lab,” said Maura. “We should all move into the hallway now, as far from that room as possible. They need to call in a hazmat team.”
“What the hell is going on?” said Jane.
Maura turned to her, and just that sudden movement made the room seem to whirl. “They’ve got a chemical hazard in there.”
“But the GasBadge readings were negative.”
“Negative for what it was monitoring. But that’s not what poisoned him.”
“Then you know what it is? You know what killed all those people?”
Maura nodded. “I know exactly why they died.”