"Greetings, Martin," said Reynolds, wiping his hands on his apron. "I'm sorry about that Marino case. I would have liked to have helped you."
"I understand. Thanks for trying. Since there wasn't going to be a post, I tried to run a CAT scan on the corpse. It was surprising. Do you know what I found?"
Reynolds shook his head.
"There was no brain," said Philips. "Somebody removed the brain and sewed her back up so you practically couldn't tell."
"No!"
"Yeah," said Philips.
"God. Can you imagine what kind of blowup that could cause if the press got a hold of it, much less the family? They were definite about no autopsy."
"That's why I wanted to talk to you," said Philips.
There was a pause.
"Wait a minute," said Reynolds. "You don't think Pathology was involved."
"I don't know," admitted Philips.
Reynolds' face reddened, and veins appeared on his forehead. "Well I can assure you. The body never came up here. It went directly to the morgue."
"What about Neurosurgery?" asked Philips.
"Well, Mannerheim's boys are crazy, but I don't think that crazy."
Martin shrugged, then told Reynolds the real reason he'd stopped by was to inquire about a patient by the name of Ellen McCarthy who'd arrived dead at the ER about two months previously. Philips wanted to know if she'd been autopsied.
Reynolds snapped off his gloves and pushed his way through the.doors into the main portion of the department. Using Pathology's terminal for the main computer, he typed in Ellen McCarthy's name and unit number. Immediately her name appeared on the computer screen followed by the date and number of the autopsy as well as cause of death: head injury resulting in massive intracerebral hemorrhage and brain-stem herniation. Reynolds quickly located a copy of the autopsy report and handed it to Philips.
"Did you do the brain?" asked Philips.
"Of course we did the brain!" said Reynolds. He grabbed back the report. "You think we wouldn't do the brain on a head-injury case?" His eyes rapidly scanned the paper.
Philips watched him. Reynolds had gained nearly fifty pounds since they'd been lab partners in med school and a fold of skin on the back of his neck concealed the top of his collar. His cheeks bulged out and just beneath the skin there was a fine network of tiny red capillaries.
"She might have had a seizure before the auto accident," said Reynolds, still reading.
"How could that be determined?"
"Her tongue had been bitten multiple times. It's not certain, just presumptive…"
Philips was impressed. He knew that such fine points were usually only picked up by forensic pathologists.
"Here's the brain section," said Reynolds. "Massive hemorrhage. There is something interesting though. A section of the cortex of the temporal lobe showed isolated nerve-cell death. Very little glial reaction. No diagnosis was advanced."
"How about the occipital area?" asked Philips. "I saw some subtle X-ray abnormalities there."
"One slide taken," said Reynolds, "and that was normal."
"Just one. Damn, I wish there had been more."
"You might be in luck;. It indicates here the brain was fixed. Just a minute."
Reynolds walked over to a card catalogue and pulled out the M drawer. Philips felt some mild encouragement.
"Well, it was fixed and saved but we don't have it. Neurosurgery wanted it so I guess it's up in the neurosurgical lab."
After stopping to watch Denise flawlessly and efficiently perform a single-vessel angiogram, Philips headed over to surgery. Dodging patient traffic in the holding area, he walked up to the OR desk.
"I'm looking for Mannerheim," said Philips to the blond nurse. "Any idea when he'll be out of surgery?"
"We know exactly."
"And what time will that be?"
"Twenty minutes ago." The, other two nurses laughed. Apparently things were going smoothly in the OR for them to be in such good moods. "His residents are closing. Mannerheim's in the lounge."
Philips found Mannerheim holding court. The two visiting Japanese doctors were standing on either side of him smiling and bowing at irregular intervals. There were five other surgeons in the group, all drinking coffee. Mannerheim was holding a cigarette in the same hand as his cup. He'd given up smoking a year ago, which meant he didn't buy any cigarettes, but borrowed them from everybody else.
"So you know what I told this smart-ass lawyer?" said Mannerheim, gesturing dramatically with his free hand. "Of course I play God. Who do you think my patients want screwing around inside their brains, a garbage man?"
The group roared with approval, and then began to disperse. Martin approached Mannerheim and looked down on him.
"Well, well, our helpful radiologist."
"We try to please," said Philips pleasantly.
"Well, I can tell you I did not appreciate your little joke on the phone yesterday."
"It wasn't meant to be a joke," said Philips, "I'm sorry that my comment seemed out of place. I didn't know Marino was dead and I'd noticed some very subtle abnormalities on her film."
"You're supposed to look at the X rays before the patient dies," said Mannerheim nastily.
"Look, what I'm interested in discussing is that Marino's brain was removed from her corpse."
Mannerheim's eyes bulged and his full face turned a dull red. Taking Philips by the arm he led him away from the two Japanese doctors.
"Let me tell you something," he snarled, "I happen to know that you moved and X-rayed Marino's body last night without authorization. And I can tell you this, I don't like anybody fucking around with my patients. Especially my complications."
"Listen," said Martin, shaking his arm free from Mannerheim's grasp. "My only interest is some strange X-ray abnormalities that could result in a major research breakthrough. I have no interest in your complications."
"You'd better not. If there was something irregular done to Lisa Marino's body, it would be on your head. You're the only one known to have taken the body from the morgue. Keep that in mind." Mannerheim waved a threatening finger in Philips' face.
A sudden fear of professional vulnerability made Martin hesitate. As much as he hated to admit it, Mannerheim had a point. If it became known that Marino's brain had been removed, the burden would be on him to prove that he didn't do it, Denise, with whom he was having an affair, was his only witness.
"All right, let's forget Marino," he said. "I found another patient with the same X-ray picture. An Ellen McCarthy. Unfortunately she'd been killed in an auto accident. But she was posted here at the Med Center and the brain was fixed and turned over to Neurosurgery. I would like to get ahold of that brain."
"And I'd like you to stay out of my hair. I'm a busy man. I'm taking care of real patients, not sitting on my ass looking at pictures all day."
Mannerheim turned and started away.
Philips felt a surge of fury. He wanted to shout, "You arrogant provincial bastard." But he didn't. That was what Mannerheim expected, maybe even wanted. Instead Martin went for the surgeon's known Achilles' heel. In a calm, understanding voice Martin said: "Dr. Mannerheim, you need a psychiatrist."
Mannerheim whirled, ready for combat, but Philips was already out the door. To Mannerheim, psychiatry represented the absolute antithesis of everything he stood for. For him it was a morass of hyperconceptual nonessence, and to be told he needed one was the worst insult he could absorb. In a blind rage the surgeon crashed through the door into the dressing area, tore off his bloodstained OR shoes and threw them the length of the room. They crashed into a bank of lockers and skidded under the sinks.