"But this coincidence has to give you pause," Laurie said. She knew it would certainly give her more than pause if the situation were reversed and she was slated to have the surgery.
"Frankly, it doesn't," Jack said. "First, I'm not superstitious, and second, I specifically asked Dr. Anderson what his postsurgical infection rate was. He told me that the only postoperative infections he'd had over his entire career involved compound-fracture repairs, which are a totally different situation. Besides, this case you're showing me involved University Hospital." Jack tried to return the file to Laurie, but she wouldn't take it.
"If you'd read further, you'd see that's not the case."
"What do you mean?" Jack asked. He felt himself getting irritated about the surgery issue all over again. Laurie could be like a dog with a bone, which he found frustrating at times, although he knew people often accused him of having the same trait.
"The patient had had his surgery eleven hours earlier at Angels Orthopedic Hospital, not University Hospital. The reason he ended up at the University Hospital was to treat his septic shock and fulminant staphylococcal pneumonia."
"Really?" Jack's eyes went back to the PA's note. Although he trusted that Laurie would never make such a thing up he had to read it himself.
"This has to worry you," Laurie said. "The fact that they had to transfer a critically ill patient at all doesn't speak very highly for the Angels Orthopedic Hospital. What kind of hospital outsources its dirty laundry? The patient apparently died in the ambulance. That's crazy!"
"New treatments for septic shock require specialized personnel," Jack said. He was distracted by what he was reading. The rapidity with which the patient's infection progressed was shocking. Jack, as the OCME's putative infectious-disease guru, from having made several – what he called lucky – diagnoses on cases of infectious disease ten years ago, couldn't help but be impressed. In fact, he started to wonder if Mr. Jeffries had had a more truly infectious disease like Rocky Mountain spotted fever.
"Was the infectious agent unequivocally proved to be staph aureus?" Jack asked. He tried to remember what other known diseases caused such a rapidly fulminant course.
"Not by culture but by a monoclonal-based automate diagnostic system. Both the incision site and the lungs tested positive for methicillin-resistant staph, and interestingly enough, it was a strain associated with what they call 'community-acquired staph,' not the kind of antibiotic-resistant staph that has been plaguing hospitals over the last ten or fifteen years."
"Which means the patient probably brought the bug in with him rather than acquired it in the hospital."
"Could be," Laurie agreed. "But there's no way to know. Doesn't this bother you at all? I mean, the victim was roughly your age, had suffered the same injury, and was going to have the same operation at the same hospital. It would sure make me think twice. That's all I can say."
"To be honest, a postoperative infection had been one of my concerns," Jack said. "Maybe even the biggest, which is why I asked Dr. Anderson about his record and why I have been using antibacterial soap ever since the accident. I'm going to be damn sure I'll not be bringing any bacterial hitchhikers into the hospital if I can help it."
Jack flicked the back of Vinnie's newspaper hard enough to startle the man.
"Quit it!" Vinnie groused when he'd recovered from his shock and saw who was the culprit. "Please, God, don't let the self-proclaimed super forensic sleuth insist on breaking the rules by starting early," Vinnie added sarcastically and with seeming disrespect. In point of fact, there was enough mutual respect between Vinnie and Jack to allow for such teasing banter, and technically they were breaking the rules. By decree from Chief Bingham, autopsies were supposed to start at seven-thirty sharp, although they never did. Jack was always early, thanks in part to Vinnie's willingness to cut short his coffee break while all the other medical examiners, including Laurie, were always late because Bingham or the deputy chief, Calvin Washington, were rarely there to enforce the edict.
"The supersleuth wants the super mortuary tech down in the pit," Jack said to the back of Vinnie's paper. Defiantly, Vinnie had gone back to his reading.
Laurie asked Riva if she could do David Jeffries's autopsy.
"Of course," Riva said. "But it's going to be a busy day. You'll have to take at least one more. Do you have a preference?"
"Sure," Laurie said absently. She was back to rereading David Jeffries's history.
"Come on, Vinnie," Jack called, leaning on his crutches at the doorway leading into the communications room. Vinnie had become reabsorbed in his paper.
"I'm here!" a voice called out. "The day can now officially begin."
All eyes turned to the door leading out to the main part of the ID room. Even Vinnie, who was passive-aggressively avoiding Jack, lowered his paper to see who had arrived. It was Chet McGovern, Jack's office mate. "Have you guys left anything mildly interesting? Hell, I'd have to camp here overnight to avoid getting your rejects." After ditching his coat on an empty chair, he stepped behind Riva to paw through some of the folders. Jokingly, as if a schoolmarm, Riva hit his hand using a foot-long wooden ruler.
"You're in a good mood, sport," Jack said. "What's the occasion? How come you're here so early?"
"I couldn't sleep. I met a woman last night at my health club who's an impressive businesswoman. I had the feeling she's a CEO or something. I woke up this morning early, trying to figure out how to get her to go out with me."
"Ask her," Laurie suggested.
"Oh, sure, in case I hadn't thought of that."
"And she said no?"
"Sort of," Chet said.
"Well, ask her again," Laurie said. "And be direct. Sometimes you men can be rather vague to protect your fragile egos." Chet saluted, as if Laurie were his superior officer.
"Come on! You lazy good-for-nothing," Jack said after returning to where Vinnie was sitting and snatching his paper out of his hands. Vinnie scrambled after Jack, who managed to keep the newspaper away from Vinnie until they reached the clerical room beyond communication. There was a brief tug-of-war amid laughter.
The battle for the newspaper over, Jack gave Vinnie the John Doe case file and asked him to put up the body, meaning prepare the body for the autopsy. Meanwhile, Jack stuck his head into Sergeant Murphy's closet-like NYPD office. The aging, amiable cop looked up from his computer screen. He'd been assigned to the OCME forever. Jack was fond of the man, as was everyone else. Murphy was one of those rare individuals who managed to get along with everyone. Jack admired the trait and wished some of it could rub off on him. Over the years, he'd become progressively intolerant of perfunctory bureaucrats with mediocre administrative or professional skills, and he was unable to hide his feelings, as much as he tried. In his mind, there were too many such tenured people hiding out in the OCME.
"Have you seen Detective Soldano?" Jack asked.
"He was here earlier but left to go down to the morgue," Sergeant Murphy said.
"Did he ask you about the unidentified floater that came in last night?"
"He did, and I told him the only missing-person report filed overnight was for a woman."
Jack thanked the sergeant and managed to catch up to Vinnie, who'd summoned the back elevator. Downstairs, Jack found Lou in the locker room, already suited up in a Tyvek coverall, which had replaced the far more bulky protective moon suits except for known exceptionally infectious cases.
As Jack quickly changed into scrubs, Lou couldn't help but notice the swelling and discoloration of Jack's injured knee.