“I hope you didn’t get all dressed up for us,” Jack quipped. Lots of sarcastic barbs was the bulk of their normal verbal interaction.
“Let me guess,” Vinnie said as he collapsed into one of the chairs. “Problems on the home front? In-law difficulties? Am I getting close?”
Jack grimaced. Vinnie knew him much too well. “Things could be better,” Jack admitted without elaborating. “What I need is a challenging case.”
Vinnie immediately got the message and didn’t tease further. Instead, he changed his tone and said, “Okay! Anything promising?”
“I haven’t yet had a chance to look,” Jack responded. “How about getting the communal coffee ready?” Making coffee in the morning was one of Vinnie’s self-imposed jobs, as he was usually one of the first people on the day shift to arrive.
“All right, already!” he said, pretending to be irritated.
Jack redirected his attention to the stack of folders, hoping to hit pay dirt, but his optimism quickly dimmed. As Jennifer had warned, the first three were run-of-the-mill overdoses. Although he was certainly aware each was its own personal tragedy, particularly the third case, which involved a fifteen-year-old boy, none of them would be enough to dominate his mind at least for a few days or even for a week, which was what he was hoping to find. But then, like an unexpected slap in the face, the name on the fourth folder jolted him. It was Susan Passero, the name of Laurie’s oldest and closest friend, who also served as her general medical practitioner. Jack also knew her, and he certainly respected her as a first-rate internist as well as personable, socially committed, and a dutiful mother. Although Laurie usually saw Susan solo, mostly for lunch at least once a month, Jack and her husband, Abraham, known as Abby, had on occasion had been included with the women for dinner or to attend some sort of cultural event.
With his pulse quickening, he emptied the folder and hurriedly searched through the contents for the MLI’s investigative workup. As he did so, he hoped that the body downstairs in the cooler would turn out to be a different Susan Passero. As he snapped up the workup, Jack’s worst fears were realized when he read that the deceased was a physician on the staff of the Manhattan Memorial Hospital who had died suddenly in apparent good health, which was the reason it was deemed a medical examiner case.
Jack sighed loudly and involuntarily stared off into the middle distance, already worried about having to call Laurie and give her this disturbing and shocking news. With all the stresses and strains that were happening at home and those associated with her relatively new role as the chief medical examiner — running the largest ME office in the country, with more than six hundred employees and a yearly budget of $75 million — this added emotional burden was potentially going to be horrendous.
“Something wrong?” Jennifer asked, sensing Jack’s reaction.
“I should say,” he answered. He glanced at Jennifer, who knew Laurie well. Jennifer was the daughter of Laurie’s late nanny, and Laurie was largely responsible for Jennifer’s career choice as a physician and a forensic pathologist. Jack held up the MLI report. “I’m afraid this autopsy case is one of Laurie’s closest friends.”
“Good lord,” Jennifer said. “What happened?”
He went back and read more of the workup. “She apparently died in her car in the MMH’s garage. She was found slumped over the steering wheel by a nursing supervisor named Ronald Cavanaugh, who was coming on shift. He described finding no pulse, and with the help of another arriving nurse alerted the ED while starting CPR.”
“Cardiac, probably,” Jennifer said.
“That’s what the ED physician ultimately thought,” he said. He looked back at Jennifer and shook his head. “Wow! What a tragedy! This is going to be one hell of a blow for Laurie. Besides being a friend, the woman was a committed doctor, a doctor’s doctor, as I’m sure Laurie would agree.”
“Who was the MLI?” Jennifer asked.
“Kevin Strauss,” Jack said as he went back to reading.
“He’s good.”
“I agree,” he mumbled.
“If you are going to have a heart attack, I guess a hospital is a good place to have it,” Vinnie said as he was making the coffee.
“But not in your car in the garage,” Jack said.
“Did the ED send a resuscitation team?” Vinnie asked.
“Within minutes,” Jack said. “Apparently they made a lot of effort because the nursing supervisor and the other nurse said that the patient initially showed some signs of improvement when they started CPR.”
“Did they ever get a pulse?” Jennifer asked.
“No, no pulse was obtained either in the garage or in the ED where she was moved while the CPR was continued.”
“I wonder what they thought were signs of improvement.”
“It doesn’t say,” Jack said.
“Any history of cardiac issues?”
“Apparently not,” he said. “What she did have is type 1 diabetes, which I didn’t know, and I don’t believe Laurie knew, either, which is surprising for as long as she and Sue knew each other.”
“Well, sudden cardiac death is certainly not unknown with type 1 insulin-dependent diabetes,” Jennifer said. “And I actually did hear about this case last night.”
“How did that come about?” Jack asked, looking up from his reading.
“One of the ID team called me with a problem,” Jennifer said. “The husband of the patient was the one who came in to make the ID, and he was understandably very upset and let it be known that he was firmly against an autopsy. He demanded the body be released immediately to his designated funeral home. I ended up talking to him and tried to calm him down. When he would finally listen, I explained to him that it was not possible for the body to be released because his wife had died suddenly, in apparent good health, and that we were required by law to determine the cause and manner of death. I made sure he understood that an autopsy was needed.”
“I find all this really surprising. Was the name of the husband Abraham Ahmed?” For a few seconds, he entertained the idea that maybe this case involved a different Susan Passero, but the idea was dispelled when Jennifer confirmed the husband’s name.
“Good grief,” Jack said. “I’m shocked. Did he offer a reason for not wanting an autopsy?”
“Yes. He said he was Muslim and that he didn’t want to delay burial.”
“My word! You live and learn. I’ve spent some social time with the man and had no idea Abby, as he likes to be called, is Muslim. What did you tell him?”
“I told him most likely an autopsy would have to be done, but I assured him it would be done quickly and with full respect for the body. Because of a previous case I read up on Islamic attitudes and sensitivities toward autopsies. I knew that in this day and age, it is not as clear cut as he was suggesting. I read it’s not mentioned in the Koran.”
“Was he satisfied?”
“Not particularly,” Jennifer admitted. “He was obviously put out about the situation. I encouraged him to call back this morning, saying he could talk to whoever does the case.”