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Both detectives nodded, like chastised schoolchildren.
“If you crush the abdomen, it usually results in a massive internal haemorrhage, or bleeding, to the layman, which reduces the amount of blood in your circulation so that the brain cannot be perfused with oxygenated blood. End result, you die. This is called circulatory shock.
“If you are lucky, the bleed may be smaller, which delays death long enough for an emergency operation to prevent shock. If this is possible, it depends on the nature of the damage. Occasionally there may be no noticeable bleeding, but damage to the internal organs may cause them to swell, which results in extreme pain. With all of those organs in your abdomen, there is no room for swelling or even bleeding without pain.
“If the internal bleeding is massive enough and the intestines or stomach are damaged, there may be bleeding from the mouth but it doesn’t often happen despite what you see in war films.
“Jane Carter suffered a massive trauma, which in turn caused internal bleeding, and death soon after, from cardiovascular collapse – in other words, shock; other serious organ damage occurred, including a ruptured kidney.”
Gardener rubbed his hands down his face. He wasn’t quite sure what the pathologist was actually trying to tell him. “I want to come back to something you mentioned on Friday night. You thought that one of the two bruises was down to a footprint. Do you still think that?”
“I wondered if both bruises could be one injury, but they’re not.”
“Are you suggesting it was more than a shoe that caused all of this?” asked Reilly.
“It’s possible. If her attacker had stamped on the stomach repeatedly, I feel sure we would have seen more bruises, and the pattern would almost certainly have been different. Although there were two bruises, only one was major – and very possibly the one that caused all the damage.”
“Any idea what?” asked Gardener.
“I’m afraid that’s up to you two. I believe the ruptured vein and kidney could have been caused by one blow, possibly the result of something like a knee into the abdomen, or maybe a fall against a padded object such as a sofa arm, or perhaps falling down the stairs.”
“We found her in the bedroom, Fitz. Nothing in that room matches your theories.”
“Not unless you count a knee to the abdomen. However, it must have been something pretty solid,” persisted Fitz. “The blow ruptured her kidney, dissecting it across its diameter, and fractured six of her ribs. It’s not unusual for such injuries where someone affected by chronic alcoholism has a fall.”
Gardener thought about that, but he wasn’t convinced. A mental summary of the bathroom with the mess on the floor came to mind. There was a remote chance she could have fallen by the toilet bowl and managed to struggle back to the bedroom.
“Did you find any alcohol in her system?” asked Reilly.
“One unit of white wine was recorded in the toxicity report.”
“That would tie in with what we’ve heard. She looked after herself, ate the right foods, and drank liberally.”
“From what I’ve seen, I would agree with you. Jane Carter was fit and healthy.”
Gardener’s head was close to bursting. He needed a break but judging by what they were hearing, it would be a long time coming. Unlike DCI Briggs who would almost certainly be breathing down their necks before long.
“However, I discovered something that made me think it could have been the result of a natural process, because of a build-up of pressure in the vein as a result of a previous operation.”
“Go on,” said Gardener.
“Whatever it is, involved this little fellow here,” replied Fitz.
“What is it?”
“It’s a small tube. I found it placed between the aorta and the pulmonary artery, but I’ve no idea what it’s doing there. It might be a pump of some description. After following the network around her system, I think it may have something to do with blood pressure. I suspect it might explain the tablets we found. I’ve done a little checking on those. Pentoril Diazanem. She had been taking them to purify her blood, which fits in with the tube being positioned where it was. We’d need her doctor to confirm. I’m curious. I would like to know what’s going on here. I’ve not seen anything like this set up.”
“We dropped by her doctor this morning,” said Reilly.
“He was busy so we had to leave a card,” said Gardener. “There’s obviously a lot more to tell us about your findings.”
“She had some very old injuries. I don’t think Jane Carter is a stranger to pain or accidents. Her doctor will almost certainly confirm something critical – possibly life-threatening – happened in her past.”
“I’m sorry, Fitz, we should have mentioned this,” said Gardener. “Her employer, Matthew Atkinson, did inform us of a serious accident years ago when she lived in Texas but he didn’t know too much about it.”
“Was he able to elaborate?”
“It involved horse riding,” said Reilly. “I think she came off; maybe she ended up underneath the horse.”
