“Then what’s the anomaly?” I asked.
“You can look at every single blood sample-hundreds of them-that we’ve been running these last two days to wind up the investigation. Not one of them-not one drop of blood-matches the DNA of Duke Quillian.”
“You’ve got the man’s skin, but you don’t have his blood?”
“Exactly, Alex.”
“Can you explain-”
“It turns out there is DNA from a fourth person,” Mattie said, wagging her pen in my face. “A different profile that several techs developed. Something that didn’t match to any of the deceased.”
“But there are no other reports of missing persons.”
“Right, there haven’t been any, and it’s actually much easier than that, Alex. It’s the DNA of a woman in this fourth profile,” Mattie said. “One peak only. Again, there’s no Y chromosome.”
“But there were no women working in the tunnel. It’s bad luck-the sandhogs won’t have it.”
“Don’t get ahead of yourself, Coop,” Mike said.
“The blood in the tunnel,” Mattie said, pushing several pieces of paper toward me. “You can see for yourself what I mean. This profile was sitting on my desk last night, right next to my folder on the Hassett case.”
She slid two pieces of paper together-one from Bex Hassett’s file and the other from the water tunnel evidence-and pointed to the alleles that aligned with each other at thirteen loci within the cell to create a distinctive genetic profile.
“You want to talk anomaly, Coop? The DNA in that blood sample from evidence in Water Tunnel Number Three-it’s a perfect match to the DNA of Trish Quillian.”
41
The windows in Anna Borowski’s office overlooked York Avenue, the stretch of East Side real estate from the Queensboro Bridge to Seventy-second Street-once tenements-now known as Hospital Row. It had taken us only twenty minutes to get here from the Office of the Chief Medical Examiner forty blocks downtown.
“What made you think to call me?” the doctor, whose medical specialty was blood cancers, asked Mike.
He had known Anna for several years, he told me on the ride uptown, from the time Valerie was in treatment. Mike had met his fiancée while he was giving blood at the Memorial Sloan-Kettering Cancer Center, where Val had undergone extensive chemotherapy, as well as her surgery.
“Bad blood, Doc. You know more about it than anyone in town.” Mike was looking out at the campus of Rockefeller University on the far side of the street. He turned back to the oncologist and flashed his familiar grin. “I figure I’ve given you a few pints of my best stuff. That maybe you’d go undercover for me. Get me a peek at the patient’s chart, at least.”
The tall, handsome woman, dressed in a lab coat, lowered the tortoiseshell frames of her reading glasses from the top of her head and opened the thick sheaf of medical records. “Am I just easy or does that smile work on everyone?” she asked me.
“The perps don’t go for it,” I said. “Most of the rest of us do.”
“Duke Quillian?” Mike asked.
“On the promise your subpoena will follow shortly.”
“You got it.”
She adjusted her glasses and got to work reading the papers in the blue folder.
“Acute leukemia, Mike. His chart begins with the usual symptoms. Fatigue, frequent fevers and infections. Nosebleeds and bleeding gums. By the second or third round of antibiotics, the local doc-a family practitioner in the Bronx-drew some blood to be tested. Got the result, made the diagnosis, and sent Mr. Quillian to us. That’s the way the disease typically presents.”
“Don’t you have to pull all kinds of strings to get into these digs?” Mike asked.
Anna shook her head. “People think that, I guess. Your friend Duke-looks like he had perfectly good insurance coverage from his union. More important than that, there was no medical facility in the Bronx, where he lived, that did transplants in those days. I’m not sure there’s one now. This would be the only logical place for him to wind up.”
The word transplant caught my attention. “Duke Quillian had a transplant?”
“That was the only curable method of treating acute leukemia back in the days when he was ill, especially when the patients were as young as this guy.” Anna glanced down at the file. “Mid to late twenties.”
“What’s the process?” Mike asked.
“The patient is typed for the human leukocyte antigen-HLA. And all his family members are typed, too. Did he have siblings, this guy?”
“Yes,” we both said.
“There’s a one-in-four chance of matching a family member,” Anna said. “I’ve had cases with eight children, and none of them match the patient, although a few of them match each other. There’s a second reason we start with family.”
“What’s that?” Mike asked.
“Donating marrow is an extremely painful process. It’s hard to imagine how much it hurts,” Anna said, her voice dropping to a whisper. “When you do it for someone you know and love, it’s got to ease some of that.”
“And if the siblings don’t fit?”
“Then we go to the National Marrow Donor Program. Try to find a match from a volunteer donor.”
“Does it tell you what happened here?” Mike asked, ready to grab the file from Anna’s hand.
“Patient as always, Detective Chapman,” Anna said, glancing at me. “Mike would come in every six months to give blood. He’d expect me to have cured someone before he finished his juice and cookies.”
She skimmed the pages to find the information we wanted. “Yes, Mike. There was a perfect match to one of Duke’s siblings-a sister named Patricia. Seems they refer to her in these records as Trish.”
Mike clapped his hands together and flashed me a victory sign. “So Trish was his donor. Duke ended up with her DNA.”
“Not so fast, Mike,” Anna said. “Yes-and no.”
“I’m sorry to say I’m confused, Doctor. I don’t understand this.”
“Was he in the hospital or not? That’s what I want to know,” Mike said.
“Let me back it up. After the match was confirmed and the surgical date was set, the patient-in this case, Duke Quillian-was admitted to the hospital. Usually, about nine days before the surgery, the chemo treatment begins. The point of that is to kill off all the old bone marrow cells completely-the ones causing the disease. So from that time-Day minus 9-Duke was right here in Sloan.”
“What’s the surgery involved?” I asked.
“Two procedures are conducted on the same day, but only one was actually surgical. Trish Quillian would have been in the operating room. Two doctors were harvesting her bone marrow.”
I winced. “Harvesting?”
“She’s anesthetized, of course, Alex. Facedown on the table. Holes are drilled in her iliac crest,” Anna said, pointing to her hip. “A lot of them. Two surgeons go into the holes to draw out three to five cc’s of marrow each time. The procedure can require as many as three hundred needles, filling up a container the size of a coffee can. Do you understand how much that is?”
Mike’s expression was grim. “Yeah.”
“They take what the docs remove directly up to the blood bank for processing, aligning blood types, filtering out the bits of bone from the marrow, and things like that. Runs another hour.”
“And Duke?”
“He would have been resting in his room during that process. Once the marrow was ready to be transfused, the docs just brought it to him, hung it on an IV pole, and sent it on its way, to get to work inside his system.”
Anna made it sound so matter-of-fact.
“I thought you called it a transplant?”
“In the case of bone marrow, transplant and transfusion really mean the same thing. The stem cells are quite amazing. They have some kind of internal homing system. Once they’re transfused to the patient, they find their way-by themselves-right into the marrow. Like we docs say, the healthy stem cells set up ‘housekeeping’ exactly where they belong.”