“It’s my burden,” Vinnie complained with a laugh. “Dr. Stapleton doesn’t have a life.”
“What’s more fun than an early-morning autopsy?” Jack questioned in response. Although it was probably impossible to keep a lid on Sue Passero’s identity from in-house chatter, Jack didn’t want to be the direct source.
When the case was finished and after Jack had helped Vinnie move the corpse onto a gurney, he ducked into the locker room to grab a white lab coat to put over his scrubs while Vinnie prepared for the suicide case. Aware that Laurie was desperate for all the details about Sue as soon as possible so that she could provide some answers to the family, Jack wanted to get the samples up to Toxicology and Histology, the two departments that worked the closest with the needs of completing the autopsy. As he knew from experience, the fastest way to get something done was to do it himself.
Clutching all the sample bottles to his chest, Jack first walked into Maureen O’Conner’s recently remodeled domain. As the Histology Department head, she now had a small private office, which was off the lab itself. From Jack’s first days as an NYC ME, he had made a distinct effort to befriend the red-faced Irishwoman with her broad smile and wonderful brogue. As was the situation with the current case, histology and toxicology often provided the critical information required to solve a difficult case, and the faster the microscopic slides were available, the sooner the case could be completed. All the other medical examiners were willing to wait patiently for their slides to be processed, but that had never been the circumstance with Jack, especially with time constraints. Luckily, befriending Maureen had been easy since she was a remarkably outgoing individual.
“Well, glory be!” Maureen said with her charming accent. “This is the earliest hour I have ever had the pleasure of a personal visit from the famous Dr. Stapleton. To what do we owe this distinct pleasure?”
“I can tell you, but with a condition,” Jack said.
“And what might that be?”
“You have to keep it under your hat.”
“My lips are sealed, and my curiosity is heightened. What’s up?”
“The case involves a very close personal friend of the chief’s,” he said, lowering his voice. “And she is eager to have any and all information for the family ASAP.”
“I’m sorry to hear that,” Maureen said, becoming serious. “What is it that you need?”
“Nothing out of the ordinary, other than sooner rather than later,” Jack said. “The friend was a doctor who died yesterday evening sitting in her car in her hospital’s garage. Because of the individual’s lifelong history of diabetes, it was assumed she’d suffered a cardiac issue. But I just found the heart to be grossly normal, and the coronaries looked remarkably clean. So I need to look at the microscopic sections of the coronary arteries and arterioles to see if they can tell us anything.” As he spoke, he separated out the histology sample bottles and arranged them in a line along the front of Maureen’s desk.
“We’ll get right on it,” Maureen said without hesitation.
“When the slides are ready, give a shout, and I’ll pop up here to get them,” Jack said.
“I will call you myself,” Maureen responded, as she leaned forward and began picking up the bottles. “I’ll try for late today but most likely it won’t be until tomorrow morning.”
“I appreciate your help,” Jack said.
Next he headed to the top floor, where John DeVries, chief of the Toxicology Department, had his new office. Toxicology used to be crammed into a tiny area of the fourth floor but had moved up to take over both the fifth and the sixth floors when most of the OCME team moved into the new high-rise quarters on 26th Street. Although the windows had not been upgraded and looked their more-than-a-half-century age, the rest of the laboratory looked sleek and modern and was certainly state of the art. John’s office, which used to be the size of a broom closet and perhaps had once been one, was now spacious and even had windows and a view. Along with the lab’s physical enhancements, John’s personality had undergone a considerable improvement. Previously prickly if not downright surly, John was now decidedly amiable, and to Jack the transition had been nothing short of miraculous. Since toxicology was as critical as histology for complicated forensic cases, Jack had tried to push John as much as he had pushed Maureen on multiple occasions, but instead of being helpful as Maureen was and willing to speed things up on critical cases, John had become progressively passive-aggressive or even outright aggressive. On several occasions Jack and John had nearly come to blows.
“Good morning, Dr. Stapleton,” John said cheerfully as Jack walked in through the open door to the man’s office.
“It’s Jack to you, Dr. DeVries,” Jack responded with a smile. John had a PhD in both chemistry and toxicology.
“Jack it is. What can we do for you today?”
He went through a similar explanation with John as he had with Maureen.
“And what are the results you are possibly looking for?” John asked, becoming serious.
“Well, you know better than I,” Jack said. “First we need to do a general drug screen. The only positive finding at autopsy was mild to possibly moderate pulmonary edema. The chances of it being any kind of drug overdose in my mind is zero, but I’ve been surprised in the past, and it should be ruled out.”
“Of course,” John responded. “That goes without saying. What else?”
“She was a type 1 diabetic, so we need to know as soon as possible and as much as possible about her level of glucose control, insulin levels, and whether any ketoacidosis or hyperglycemia was present when she had her terminal event.”
“Certainly,” John said agreeably. “You are giving us a vitreous sample?”
“Absolutely,” Jack said. He pointed to the specific sample bottle.
“Good,” John said. He quickly glanced through the other sample bottles, nodding as he did so. “What’s this?” he asked, picking up one merely labeled injection.
Jack bent over to take a look. “Ah, yes, thanks for pointing that one out. That’s an en bloc sample of skin and subcutaneous tissue from her last insulin injection site on her thigh. I didn’t know if it was something you ever look at in terms of assessing the amount of insulin.”
“It’s not usual in forensic cases. There are lots of studies on how various insulin preparations are absorbed in the subcutaneous space. Do you think it might have any particular significance in this case?”
“I can’t imagine,” Jack said. “But I’m finding this case troubling. I’m going to need a cause of death for the death certificate.”
“I’ll give it some thought,” John said.
On his way back down to the autopsy room, Jack stopped in his office and left the rest of the sample bottles. They were going to go down to 421, as the OCME high-rise was called. He personally wanted to give them to the DNA laboratory or Forensic Biology Department head, Naomi Grossman, and explain exactly why he wanted to have the lab search for the cardiac channelopathy mutations. Like with Maureen and John, Jack thought it was important to have a personal interaction with the department head. Otherwise, test results got put off, sometimes for weeks.
With all that accomplished, he was about to descend back down to the basement level where the autopsy room was located to get cracking on the supposed suicide case, but as his hand hovered over the basement button in the elevator, he changed his mind. Instead, he pushed the button for the first floor. He decided to stop briefly in Laurie’s office to see if she might be available for a quick chat. Vinnie’s comment about her not appreciating his salute was probably correct, and he thought maybe it would be wise to apologize again for leaving at the crack of dawn. There was no doubt he should have at least left a note.