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“Okay. No, wait. First I want to show you something on these ribs.” I helped her up from the steps, picked up her things, and held the door for her, seeing as she was wounded and all. Back in the lab, she made a beeline for the tray of b
ones and picked up a rib with her left hand. “Look at this,” she said, pointing with her right index finger. “Yow!” She laid the curved, ivory-colored bone down on the counter and pointed with her left hand. It was easy to see what she was excited about.
The bone — rib seven or eight, I guessed from the size — was a comma-shaped arc roughly ten inches long. Its curve was asymmetrical, though that wasn’t the odd part: ribs arc sharply near the spine, but the curve flattens out near the sternum. There’s a slight sideways warp to the curve, too, which keeps the bones from lying flat on a desk or examination table. With all those compound curves, students sometimes have trouble telling which way is up on an individual rib, until they learn to look at its cross-section. In cross-section, the rib is shaped like an upside-down teardrop; in other words, the rounded part is the top surface. The lower, more pointed edge is a bit lopsided — it’s actually slightly concave on its inner surface, to make room for the artery, vein, and nerve that nestle beneath each rib. The architecture and engineering of the human body never cease to amaze me.
What had gotten Miranda excited enough to ignore her throbbing arm was a region about midway along the shaft of the rib. A ring of thicker material, maybe half an inch wide and an eighth-inch thick at its midline, encircled the rib. Several other ribs in the tray had similar features. “Recently broken,” she said proudly. “But already healing. Definitely not perimortem.”
She was right; it couldn’t have been broken at the time of death. “Got a guess on how long before death?”
She swung the lamp with the built-in magnifier down over the bone and switched on the doughnut-shaped light. “Well, the hematoma at the break would have turned into this healing callus within a week to ten days, so I’d say the fracture occurred at least a couple of weeks prior to death. But the callus is still more cartilaginous than bony, so it’s got a ways to go yet. Just a guess — I’d need to search the literature to pin it down — but I’d say this break was two or three weeks antemortem.”
“Would you say it’s consistent with injuries sustained in a barroom brawl eighteen days before death?”
She swiveled her head to look at me. “Well, yeah. Would you say our friend participated in a barroom brawl eighteen days before he died?”
“Got the shit kicked out of him, according to the defendant, who also came out a little the worse for wear. Happened in one of those windowless cinder-block beer joints in Morgan County that practically shout, ‘Enter and die!’ Couple other locals corroborate the story. Apparently Mr. Ledbetter here got stomped by some bad hombres wearing combat boots.”
She laid down the first rib and picked up another. “Here’s the really interesting one. See the callus? Not a nice, neat ring around the bone. I’ve never seen one shaped like this.” Neither had I. The patch of new bone was long and irregular; instead of encircling a cross-section of rib, it extended for several inches in a lumpy, wavy path. “Weird, huh?” I nodded. “Must be a comminuted fracture, with multiple fragments,” she went on. “But that’s not all. Look at the distal end of the break. Something’s missing.”
I leaned closer to the lens. Sure enough, extending beyond one end of the healing callus was a gouged-out groove in the underlying bone. “I’ll be damned,” I said. “Looks like a piece splintered off.”
Miranda nodded excitedly. “So where’s the missing piece?”
“Maybe somewhere in the right lung,” I said.
“Exactly what I was thinking,” she grinned. “Let’s go see.”
“No. I’ll go see,” I said. “You’ll go get your arm fixed.”
She made a face, then brightened. “This is a great case!”
“Yeah. I’m mighty glad to have your help. Good work, Miranda. Thanks.” I caught and held her eyes. They glistened and filled — damn, was she going to cry again? — and then she smiled and nodded briskly. Thank you, God, I thought, and nodded back.
I let her out at the service entrance to the health service. We were regulars there, what with our frequent trips for quick X-rays when we didn’t want to drive clear across the river to the morgue. Miranda hipped the door of the truck shut and waved me on with her good arm.
I crossed the river — our own River Styx, one of my colleagues had once joked, but that made me death’s boatman, and I wasn’t sure I liked the label — then threaded behind the hospital and angled in beside the morgue’s loading bay. Punching the combination code for the adjoining door, I hurried inside. My first stop was the X-ray room. I found Ledbetter’s file and clipped his films to a light box. His ribs were a mess: six ribs on the right side were fractured, three of them in two or more places. The seventh rib — the last of the “true ribs,” so-called because they joined the breastbone, while the “false ribs” below them did not — had one of the worst comminuted fractures I’d ever seen; it looked like one end had been fed through a KitchenAid garbage disposal before being patched back together with Bondo. I couldn’t believe Dr. Hamilton’s autopsy report had failed to mention the injuries — and I couldn’t believe I’d neglected to check the X-rays weeks ago. I studied the multiple bone fragments, which were denser and paler on the negative than the healing callus, trying to determine if any of the pieces were so displaced as to have pierced the lung. It was hopeless: the ribs themselves could easily have blocked the camera’s view of any wayward fragments, unless the fragments happened to align with the intercostal spaces. I’d have to revisit the corpse.
I swung open the heavy cooler door and switched on the light. Ledbetter’s remains — what remained of them — were on a gurney in a far back corner, wedged behind two other bodies. One was an immense young white woman who filled the gurney’s flat surface almost entirely, the dimpled flesh of her hips and thighs lapping up the rim around the table’s perimeter and drooping over the edge. The other was her exact opposite, an ancient, scrawny black man.
Ledbetter’s decapitated head lay on its right side, propped in place by folded-up paper pads. Three inches of neck still clung to the head; below that, a messy eighteen-inch swath of stainless steel gurney divided the neck from the pelvis and legs.
The bag of organs wasn’t on the gurney.
I jockeyed the two other corpses out of the way and looked closer.
Up close, it still wasn’t on the gurney. Or under the gurney. Or anywhere in the same room with the gurney.
Damn. I raced out of the cooler and down the hall, sticking my head in every door along the way. In one of the autopsy suites, a young pathology resident of indeterminate gender was bending low over a body, the gooseneck light pulled down close. When I barged in, the resident straightened abruptly, whacking the light. “Son of a bitch,” moaned a strangled voice, still of indeterminate gender.
“Sorry,” I called, beating a hasty retreat.
I made my way up the long hallway toward the front desk, a part of the morgue where I seldom ventured. The receptionist sat behind a bulletproof glass window. On the other side was a small waiting room, which was entered — generally by grieving family members, arriving for the grim task of identifying a son or daughter, sibling or spouse — from a corridor in the hospital’s basement. The morgue was, by design, as far off the beaten track as possible. People had to work pretty hard to find it, and once they found it, things generally got a lot harder for them. Then there were the other people who might come in the front way — the ones the bulletproof glass had been put up to defend against: the pissed-off brother of a guy who’d been shot by a cop. The boyfriend in a love triangle, trying to make sure that the ME’s autopsy wouldn’t find a bullet from the wife’s purse gun inside her dead hubby. Far as I knew, the glass had never been put to the test, but then again, its mere presence might have deterred some borderline crazies.
As I approached the desk from the morgue’s inner recesses, I struggled to dredge up the name of the young woman perched there. She was the latest in a long line of short-lived receptionists. Short-tenured, anyway. Tiffany? Kimberly? Tamara? As I got closer, I decid
ed I hadn’t even met this one yet. That meant the last one had come and gone in less than a month.
“Good morning, young lady, I don’t believe we’ve met,” I said, extending my right hand to introduce myself. We both noticed my purple rubber glove at the same instant. “You really don’t want to shake my hand right now. I’m Dr. Brockton.”
She shook her head and sighed. “Hi, Dr. B., I’m Katie. We have met. Twice. You’re looking better, by the way.”
Okay, perhaps we had met after all. What was wrong with my memory, and what had been wrong with me last time she saw me? I didn’t have the time or the heart to pursue either question. I asked if she’d seen the morgue tech I needed, hoping I wasn’t too late. “Joey? I think he’s doing a burn.” Not good, I thought. I spun on my heel and sprinted down the corridor that led out one side of the morgue, where the medical waste incinerator was tucked into an out-of-the-way angle of the hospital complex.
Joey Weeks, the lowest-ranking morgue assistant, stood beside the incinerator’s open hatch, a gurney parked beside him. I saw him toss a bag into the burner, then grab another off the cart. “Wait!” I yelled.
“Hey, Doc,” he said as I skidded to a stop. “What’s up?”
“Joey, I’m looking for some tissue that came from an exhumation a couple of days ago.”
“Exhumation? Oh, you mean that one autopsied by Dr. Carter from Chattanooga? The guy that ain’t got nothin’ between the head and the waist? That’s creepy, man.”
“Yeah, that’s the one. You know anything about that? There was a biohazard bag with some tissue in it with the body in the cooler.”
“Sure. Dr. Hamilton told me it was waste. Said to incinerate it. Probably going up in smoke right now.”
Hamilton? “Damn.”
“Problem?”
“I was hoping to take one last look at something.”
He motioned toward the cart. “Well, I got a few bags left here. Maybe it’s not too late. Let’s take a look. Do you know the number?”
