“Don’t believe everything you hear,” Aria said.
“The part I want to believe is about your exceptional forte with surgical pathology.”
“That’s my major interest,” she said. “But could you get to the point here? As I said, I’m busy.”
“Yes, of course,” he said. “First, I’d like to be perfectly open with you.”
“That’s a start,” Aria said. Now that she was sitting reasonably close to the man, she realized that his projected persona reminded her of her father. It had nothing to do with the similarities of the respective offices nor their personal appearances, but rather it was a sense of male cockiness that she despised. The self-satisfied way he had his arms folded was exactly a posture her father would often assume before giving her unwanted advice, and it rubbed Aria the wrong way. She had to resist standing up and walking out.
“First, I want you to know I spoke with Dr. Montgomery twice today. On one of the calls, I’m sorry to say, she implied that your attitude and performance at the OCME had not been up to standard. Are you surprised to hear that?”
“Not at all,” Aria said. “I was open with her. I told her I felt I was wasting my time at the OCME. Forensic Pathology should be an elective, not a requirement. In just a few days over there, I believed I had gotten all that I wanted or needed, so I chose to come back over here in the afternoons to go over the day’s surgical pathology cases. The OCME’s director of education had the nerve to follow me back here one day and bawl me out, the creep.”
“That’s unfortunate,” Carl said. “But Dr. Montgomery also had some good things to say. She told me that she did a case with you this afternoon and was extremely complimentary about how you handled it.”
“It wasn’t difficult,” Aria said. “And in my experience, forensic autopsies are a hell of a lot easier than clinical autopsies. But then again, I haven’t done any gunshot wounds yet, which I’m told can be a bear.”
“She also mentioned that there was a surprise finding,” Carl said. “The patient was about ten weeks pregnant.”
“That’s correct,” she said. The sound of the vacuum cleaners through the open door reached a crescendo and then began to fall off.
“Dr. Montgomery also said that this finding seems to have turned your attitude about forensics around a hundred and eighty degrees. She told me that you are seriously committed to look into it almost on an emotional level.”
“She said that? ‘On an emotional level’?”
“Yes, she did,” Carl said. “And this is why I felt I needed to talk with you. The president and CEO of the hospital, Vernon Pierce, and I are concerned about this case, as is the dean. You do know that the patient, Kera Jacobsen, was part of our NYU Medical Center family?”
“Yes, I’m aware,” Aria said.
“And I assume you are aware that our community has made a big commitment to doing whatever we can to stop this opioid overdose scourge.”
“I suppose,” she said. From her perspective it was more lip service than commitment.
“Even before knowing about the pregnancy, we were concerned enough to offer to do the autopsy here in our theater to make sure that it doesn’t become fodder for the city’s tabloids. As you undoubtedly know, they love this kind of lurid stuff because it sells papers and encourages conspiracy theories in an age when conspiracy theories are in vogue. If this story does come out in the tabloids, it could put the medical center in a very bad light and negate advertising efforts we’ve been making over the last couple of years. Are you aware that on occasion privileged information has leaked out of the OCME?”
“I suppose,” Aria repeated yet again. She’d gotten the message that NYU was concerned about publicity and wondered why Carl was beating a dead horse. It wasn’t rocket science.
“What is it about this case that has caught your interest? I mean, I’m glad you’re suddenly taking advantage of the fabulous experience the NYC OCME affords our residents, but why has it been this case particularly? Vernon Pierce asked me to ask you. He’s even more afraid this unfortunate overdose of one of our own will turn into a publicity nightmare than I.”
She started to respond, but he interrupted her by saying: “I should warn you that Mr. Pierce might be contacting you directly, so you should be prepared. Have you ever met him?”
“No, I haven’t,” Aria said. Nor did she want to, but it certainly begged the question of why the hospital president would be so concerned about the passing of one social worker out of the thousands of people who worked in the medical center.
“Well, he might call. He even went so far as to ask me for your number. As you can imagine, he’s also taken an interest in this social worker’s death for obvious reasons,” Carl said. “Sorry to interrupt earlier! What were you about to say?”
“Regardless of possible publicity implications, I think the father has to be found,” Aria said with rising anger. “The goal of forensics is to determine the manner and cause of death. Because of the opioid crisis, it’s natural to think that the cause of Kera’s death was a drug overdose, particularly an overdose of fentanyl. And fentanyl was already found on a rapid test of the drugs found at the scene. Yet there was little or no pulmonary edema at autopsy, which is, as I understand it, always found with a fentanyl overdose. There was also no scarring on Kera’s arms that would indicate a long-term drug problem. In fact, before we stumbled onto the fetus, I was thinking of a channelopathy as the cause of death, even if it wasn’t related to fentanyl. I mean, is there an association with fentanyl and exacerbation of a channelopathy?”
“I have no idea,” he said. “I’m not sure if anyone would know the answer to that.”
“So, the cause of death in my mind is up in the air,” she said. “And now let’s think about the manner of death. Obviously, there’s a knee-jerk reaction to calling an opioid death accidental. Most drug users don’t want to kill themselves, which is why overdoses are labeled accidental. But with Kera I’m not so sure I’m willing to jump on the accidental bandwagon. Here was an unmarried, educated woman having a covert love affair. Why the need for the big secrecy? In all likelihood it was the father who insisted on keeping the relationship hushed up. It just stands to reason. If that is the case, and I believe it is, why wasn’t Kera’s body found earlier than it was? To me, that’s not a rhetorical question. Why didn’t the boyfriend find the body instead of letting it rot for two or three days?”
“Are you asking me?” Carl questioned. He was clearly impressed with her line of reasoning. After being at the OCME for just over a week she was sounding like an experienced forensic pathologist.
“What I’m doing is asking myself,” Aria said. “How was this unknown boyfriend involved in this drug overdose? Did he supply the drugs? Did he participate in some way? I think these are reasonable questions because maybe Kera’s death wasn’t accidental. Hell, it could have been homicide.”
“You’ve convinced me,” Carl said without hesitation. “Wow! It sounds to me that you are getting a lot more out of your forensic rotation than most pathology residents, myself included. Now you have me personally engrossed in the case, whereas before I just wanted it to go away. However, it also makes it even more imperative for you to keep it all close to your chest and tell no one of your suspicions and progress except, of course, Dr. Montgomery. She told me on the phone that she asked you to keep her informed of what you’re up to. I’d like you to do the same for me since I’ll need to keep Vernon Pierce up to speed. If your worst fears are realized, this case could be a true publicity nightmare for the medical center, and I’d like to be able to brief the head of our publicity department as well as the president before the press gets wind of it. If it turns out this overdose wasn’t accidental, there is no way to keep the press from becoming involved.”