“A small right-sided pneumothorax,” she explains right off when she answers my call. “Her scan shows air trapped in the pleural space of the upper lobe, suggesting some type of trauma.”
“I didn’t notice anything here at the scene, no injury to her chest,” I reply. “But it wasn’t the best conditions at the time. Basically, I had a flashlight.”
“Something caused her lung to collapse.”
“Do we have an idea what?”
“I can’t examine her externally unless you want me to unwrap her, Dr. Scarpetta.”
“Not until I get there.” I watch Marino and Machado work on their awkward evidence collection of a fence post. “What about soft tissue damage? Do you see any internal hemorrhage?”
“There’s very minimal bleeding into the upper-right chest,” she tells me as I slowly walk around the parking lot, restless and with too much to think about. “Slightly above and to the left of her breast.”
“You’re not seeing any rib fractures,” I assume.
“No fractures period. I don’t guess we have her clothes.”
“We have one shoe that might be hers. Nothing else so far.”
“That’s too bad. Really too bad. I sure wish we had her clothes.”
“You and me both. Any other radiologic abnormalities?” I can judge the lifting of the overcast by the brightening of the white tennis bubble several playing fields away.
The temperature is in the low fifties, on its way to almost warm.
“There are dense areas of some material inside her nose and mouth,” Anne replies.
“What about in her sinuses, her airway, her lungs? Was any of this material aspirated?”
“It doesn’t appear that it was.”
“Well, that’s significant. If she were smothered with something that has this fluorescing residue on it, I would expect that she aspirated some of it.” The findings are perplexing and seem contradictory.
“Whatever it is, it has a Hounsfield on average of three hundred — or the typical radiodensity of small kidney stones, for example,” Anne says. “I’ve got no idea what it could be.”
“I found high concentrations around her nose and mouth and also in her eyes.” I watch Marino retrieve a pair of heavy-duty wire cutters from his toolbox. “But if she didn’t aspirate any of it, that’s perplexing. It continues to make me wonder if this material was transferred postmortem.”
“I think that’s possible. I can see it inside her nose and mouth. But not very far inside so it may have gotten there after she was no longer breathing. There’s also a fair amount of it between her lips and teeth, what looks like clots of it,” Anne says. “It shows up very clearly on CT.”
“Clots?”
“I don’t know how else to describe it. There are irregular shapes that are denser than blood but not nearly as dense as bone.”
“I didn’t notice any of these clots, as you put it. There was nothing like that externally. The residue that fluoresces is a very fine material like dust that I doubt you can see without magnification. Possibly it’s a trace of the denser material inside her nose and mouth.”
“Like if she was held facedown in something,” Anne suggests.
“There are no abrasions or contusions on her face or neck. Usually when someone has been held facedown in dirt, mud, shallow water, there’s significant injury to the lips, the nose, the cheeks. And there’s aspiration as the person struggles to breathe. Typically, we find the dirt, water inside the sinuses, in the airway, sometimes in the stomach and lungs.”
“All I can tell you with certainty based on what I’m seeing on her scan, Dr. Scarpetta, is her collapsed lung isn’t what killed her.”
“Of course,” I agree. “But if her breathing was already compromised, then she was going to be more vulnerable to asphyxia.”
My suspicions are getting stronger that the fluorescent material all over Gail Shipton was deposited after she was dead. Why? And where was she? And is the residue an accidental transfer of evidence or did her killer want it found? The glittery substance isn’t indigenous to the muddy playing field. It came from someplace else.
“For sure a collapsed lung in isolation didn’t kill her,” I continue to explain. “Right now I don’t know what did but her death isn’t due to natural causes. I’m working this as a homicide and provisionally that’s what I’m calling it, a possible suffocation with contributing complications. I’d appreciate it if you’d pass that along to Bryce to keep him updated but please remind him we’re not releasing anything to the media yet. We need to positively ID her first.”
“That reminds me, Lucy says her dentist is Barney Moore, whom we’ve dealt with once before. That floater from last summer, he told me. As if there was only one.”
“Gail Shipton’s dentist?” I puzzle.
“Right. He’s sending her charts. We should have them any minute.”
“That’s probably the quickest way to confirm her ID,” I agree as I wonder why Lucy would know a detail as personal as who Gail Shipton’s dentist is. “Can you get Bryce to line up Dr. Adams ASAP?”
Ned Adams is a local dentist on call for us, a certified odontologist, an eccentric obsessed with the minutiae of teeth. There’s nothing he likes better than a mouth that can’t talk back, he quips every time I see him.
I search for Benton as Anne and I talk. He’s still inside Simmons Hall, some of its residents emerging, slinging backpacks, grabbing bicycles or walking.
They seem oblivious or only mildly curious now that the body is gone. There is nothing left but two plainclothes cops doing battle with a fence post, a German shepherd puppy barking on and off inside a car, and a woman forensic pathologist on her phone in a parking lot.
“Do you want me to leave her in the scanner until you get here?” Anne asks me.
“No. Let’s move her to my table because I’m going to need to prep her for angiography,” I explain. “I want to see if we can figure out what might have caused her collapsed lung and also check the vessels of her heart since it’s obvious she had a significant rise in her blood pressure that resulted in florid minute hemorrhages. Let’s get the test contrast agent ready. Four hundred and eighty MLs of embalming fluid.”
“Plasmol twenty-five arterial? Hand injection or the machine?”
“By hand. The standard five-F angiocatheters and an embalming trocar, plus the usual thirty MLs of Optiray three-twenty.”
“You’ll be here when?”
“Within the hour, hopefully.” I watch Marino cut through chain link, the metal snapping and jingling. “If they don’t finish up here soon, Benton and I will leave without them. We’ll walk back to the office. I think the two of them might be at it for a while,” I decide as an area of fencing spills loudly to the ground in a metal waterfall. “You’d think they were archaeologists approaching King Tut’s tomb the way they’re deliberating.”
The gouged fence post has proven more stubborn than supposed, set in concrete and buried deep. For the past hour I’ve listened to Marino and Machado debate hacksawing off the area of galvanized steel tubing in question as opposed to uprooting the entire tall pole, and maybe taking the gate with its scratched fork latch while they’re at it. Several times during all this, Marino has let Quincy out for walks involving mini — training sessions that are comical or pathetic, depending on one’s point of view.
These exercises have been going on for weeks, ever since he decided Quincy would be a working dog. Marino hides a bit of cloth saturated with human decomposition fluids that he no doubt got from a CFC refrigerator at some point, and Quincy sniffs out this foul-smelling rag and urinates or rolls on it, a behavior not appropriate for a cadaver dog. Three times this morning I’ve witnessed him darting about, snuffling, digging, rolling, and peeing, while Marino the handler rewards him by blowing a whistle.