The first thing he noticed was that the subject was young, perhaps fourteen or fifteen years old. His skin was smooth and slightly freckled around the face. His eyes, still open, were dark brown, interlaced with a touch of mahogany. His hair was also brown, but several shades lighter than his eyes. A long lock hung partially across his forehead, tapering to a point and ending just shy of his left cheek, above the first of several obvious facial wounds. The flesh in this area had been torn completely away, leaving a jagged vacancy.
“Jeeeesus,” Nat commented. “That’s one hell of a chunk gone from his face, Dr. S. What do you think he hit him with?”
Ben studied the gaping wound for a moment, peering closely at its serrated edges. “That’s a bite wound,” he said quietly. “Hand me the camera.”
Nat walked across the room, opened a cabinet, and returned with the lab’s digital camera. “Bit him,” he repeated softly to himself, mulling it over. “Now, that’s messed up.”
Ben snapped off several pictures of the facial wound. “In multiple places.” He pointed to the right side of the boy’s lower neck. “See here?”
A second, wider piece of flesh was missing at the spot Ben was indicating. The boy was still dressed in the clothes he had died in, and the collar of his black, loosely fitting T-shirt was torn in this area and caked with dried blood. Ben inspected the wound carefully, using forceps to pull back a flap of skin that hung limply across the opening, partially obscuring it. A voice-activated recorder hung around Ben’s neck, and he spoke into it in a neutral, practiced tone as he worked:
“Dr. Ben Stevenson; March 29th, 2013; case number—” He looked at the large dry erase board hanging on the wall. “Case number 127: John Doe. Received directly from the crime scene, custody transferred from Jefferson County Sheriff’s Department.” He took a breath. “Subject is a Caucasian male, approximately fourteen years of age, dressed in a T-shirt and blue jeans. Inspection of the face and cranium demonstrates a 3.6-by-4.1 centimeter soft tissue avulsion injury beginning superficial to the left zygomatic arch and extending inferiorly to involve the lateral portion of the orbicularis oris. Avulsions of the zygomaticus major and minor are noted, with wound depth extending through the masseteric fascia.” He lifted the boy’s chin slightly with one gloved finger, using a thin metal instrument to probe a penetrating wound noted there. “Inspection of the submental region demonstrates a puncture wound measuring 0.75 by 0.9 centimeters, which extends through the mylohyoid and hyoglossus muscles, continuing superiorly and dorsally through the body of the tongue, soft palate, and nasopharynx. There are seven—correction, eight—similar puncture wounds to the cranium that extend through the scalp, underlying musculature, and galea aponeurotica. Two of the eight wounds penetrate the skull and enter the cranial vault. A second avulsion injury is noted at the right inferolateral aspect of the neck 5.3 centimeters medial to the acromioclavicular junction and involving the inferior platysma, lateral trapezius, and sternocleidomastoid muscles, as well as the right external jugular vein.”
This part of the examination—the initial inspection and description of the body—was the portion of the necropsy Ben always found most interesting. Every corpse, he found, had a tale to tell, and the details of one’s life were often prominently revealed by the compilation of physical marks collected along the way, like scrapes and gouges on the underside of a boat. Prior scars, both surgical and traumatic; tattoos; track marks from a lifetime of IV drug abuse; burns; calluses; fat and muscle mass distribution; exaggerated spinal curvature from decades of stooped physical labor; tan lines; nicotine-stained fingertips; chewed fingernails; and even the state of a person’s teeth often spoke volumes about the course of their life. In Ben’s opinion, these were not only the most interesting details of the examination, but also the most aesthetically beautiful—strange words to describe the physical blemishes of a corpse, perhaps, but he was a pathologist, after all. These marks and imperfections represented more than simple anatomy. They had been born from action, behavior, and life experiences, and were therefore the most human, the most in touch with the life they had left behind.
In the case of traumatic deaths, however, it was different. One’s eye is inexorably drawn to the fatal injury—that which has extinguished the flame of life so abruptly. Especially in the case of young people, the autopsy ceases to be about discovering the marks left behind from a life richly experienced, and rather is about bearing witness to the end of a life barely begun. Such was the case here, as Ben moved from one disfiguring injury to the other, each one denoting a blatant disrespect for the life of this young man, and for human life in general. It was a tragedy to behold. He wanted simply to stop, to cover the form in front of him with cloth, to save it from this last final disgrace. Instead, he continued, using practiced and precise descriptive terminology like a shield to defend himself from what was real.
“Inspection of the thorax demonstrates puncture wounds to the right fourth and sixth intercostal spaces anteriorly, and to the right fifth, seventh, and eighth intercostal spaces along the midaxillary line. There is a 4.1-by-3.8 centimeter serrated avulsion of the left areola and underlying pectoralis muscle, similar in appearance to those of the face and neck, described above. There is a displaced fracture of the xiphoid process. Inspection of the abdomen demonstrates a 0.8-by-0.9 centimeter puncture wound to the right upper quadrant, and two similar puncture wounds to the right flank. There is a 35-centimeter diagonal incision extending from the right upper quadrant of the abdomen to the suprapubic region, penetrating the rectus abdominus and peritoneal fascia. There is evisceration of the small bowel. The genitalia are… missing.”
He paused for a moment, looking up at Nat, who was positioned across the table on the other side of the body. Most of the color had run out of his round, boyish face as he stood bolt upright and unmoving, eyes transfixed upon the body. Ben was suddenly embarrassed. He should’ve had enough sense to send Nat home as soon as he’d unzipped the bag. This was not something a twenty-two-year-old needed to watch, regardless of his chosen occupation. When Karen Banks had agreed to allow Nat to volunteer at the CO, she had done so with an implicit understanding that Ben would watch out for her son’s physical and psychological welfare, and he regarded the trust and deference Nat’s parents had extended to him seriously. During his time at the CO, Nat had taken part in scores of autopsies, in cases ranging from the ravages of metastatic cancer, to self-inflicted gunshot wounds, to the death of young adults involved in motor vehicle accidents. He had even assisted during pediatric autopsies: cases of SIDS and child abuse. The boy was no novice at witnessing some of the trauma and unpleasantness that could descend upon the human body. But this… well, this was a different matter altogether.
“Listen, Nat. Why don’t you let me finish up here,” he said. “It’s late, and I’m going to need you in the office early tomorrow to help Tanya man the phones. From the look of Brady Circle out there, I don’t think the press is going to give up that easily, and I imagine that Sam Garston from the Sheriff’s Department will be stopping by bright and early looking for the coroner’s report. The rest of this stuff I can just take care of by—”
“Umm… Dr. S?”
“What is it, Nat?”
“This case here is the most interesting, most important thing we’ve had come through these doors over the six years I’ve been workin’ here.”
“I know. It’s pretty—”
“And if you think… if you think I’m goin’ home in the middle of the autopsy just because some nutjob lopped off the guy’s wiener and chucked it into the woods, well… you can forget it.”