“Look, Mr. Pendergast, get the necessary paperwork and come back. Okay?”
“That will be time-consuming,” said the man named Pendergast. “It will hold you up considerably. I would appreciate your courtesy in letting us observe.”
There was something in the man’s tone that sounded a lot harder than the mellifluous accent and genteel words suggested. Dowson hesitated. “Look, with all due respect—”
“With all due respect, Dr. Dowson, I’m in no mood to bandy civilities with you. Proceed with the autopsy.”
The voice was now cold as dry ice. Dowson remembered the videocam was on. He glanced covertly at the nurse. He had a strong sense that a humiliation at the hands of this man might be just around the corner. This would not look good and it might cause trouble later. The guy was FBI, after all. Anyway, his own ass was covered: he was on record stating the man needed clearance.
Dowson sighed. “All right, Pendergast. You and the sergeant, don scrubs.”
He waited until they returned, then pulled back the sheet with a single motion. The cadaver lay on its back: blonde hair, young, fresh. The chill of the previous night had kept it from decomposing. Dowson leaned toward the mike and began a description. The FBI man was looking at the corpse with interest. But Dowson could see that the uniformed cop was beginning to look uneasy, shifting from one foot to another, lips pressed tight together. The last thing he needed was a puker.
“Is he going to be all right?” Dowson asked Pendergast in an undertone, nodding to the cop.
Pendergast turned. “You don’t have to see this, Sergeant.”
The cop swallowed, glancing from the corpse to Pendergast and back again. “I’ll be in the lounge.”
“Drop your scrubs in the bin on your way out,” said Dowson with sarcastic satisfaction.
Pendergast watched the cop leave. Then he turned to Dowson. “I suggest you turn the body over before making your Y-incision.”
“And why is that?”
Pendergast nodded toward the clipboard. “Page two.”
Dowson picked it up, flipped over the top page. Extensive lacerations . . . deep knife wounds . . .Looked like the girl had been stabbed repeatedly in the lower back. Or worse. As usual, it was hard to make out from the police report what had actually taken place, from a medical standpoint. There had been no investigating ME. It had been given a low priority. This Doreen Hollander didn’t count for much, it seemed.
Dowson returned the clipboard. “Sue, help me turn her over.”
They turned the body, exposing the back. The nurse gasped and stepped away.
Dowson stared in surprise. “Looks like she died on the operating table, in the middle of an operation to remove a spinal tumor.” Had they screwed up again downstairs? Just last week—twice—they had sent him the wrong paperwork with the wrong corpse. But immediately Dowson realized this was no hospital stiff. Not with dirt and leaves sticking to the raw wound that covered the entire lower back and sacrum area.
This was weird. Seriously weird.
He peered closer and began describing the wound for the benefit of the camera, trying to keep the surprise out of his voice.
“Superficially, this does not resemble the random knife slashing, stabbing, or cutting described in the report. It has the appearance of—of a dissection. The incision—if it is one—begins about ten inches below the scapula and seven inches above the belt line. It appears as if the entire cauda equina has been dissected out, starting at L1 and terminating at the sacrum.”
At this, the FBI agent looked at him abruptly.
“The dissection includes the filum terminale.” Dowson bent closer. “Nurse, sponge along here.”
The nurse removed some of the debris around the wound. The room had fallen silent except for the whirr of the camera, and there was a clattering sound as twigs and leaves slid into the table’s drainage channel.
“The spinal cord—more precisely, the cauda equina—is missing. It has been removed. The dissection extends peripherally to the neuroforamen and out to the transverse processes. Nurse, irrigate L1 to L5.”
The nurse quickly irrigated the requested area.
“The, er, dissection has stripped off the skin, the subcutaneous tissue, and paraspinous musculature. It appears as if a self-retaining retractor was used. I can see the marks of it here, and here, and here.” He carefully indicated the areas for the benefit of the video.
“The spinous processes and laminae have been removed, along with the ligamentum flavum. The dura is still present. There is a longitudinal incision in the dura from L1 to the sacrum, allowing full removal of the cord. It has the appearance of a . . . of a very professional incision. Nurse, the stereozoom.”
The nurse rolled over a large microscope. Quickly, Dowson inspected the spinous processes. “It looks as if a rongeur has been used to remove the processes and laminae from the dura.”
He straightened up, running a gowned arm across his forehead. This was not a standard dissection one would do in medical school. It was more like the kind of thing neurosurgeons practiced in advanced neuroanatomy classes. Then he remembered the FBI agent, Pendergast. He glanced at him, to see how he was taking it. He had seen a lot of shocked people at autopsies, but nothing like this: the man looked, not shocked exactly, so much as grim Death himself.
The man spoke. “Doctor, may I interrupt with a few questions?”
Dowson nodded.
“Was this dissection the cause of death?”
This was a new thought to Dowson. He shuddered. “If the subject were alive when this was done, yes, it would have caused death.”
“At what point?”
“As soon as the incision was made in the dura, the cerebrospinal fluid would have drained. That alone would have been enough to cause death.” He examined the wound again. It looked as if the operation had caused a great deal of bleeding from the epidural veins, and some of them had retracted—an indication of live trauma. Yet the dissector had not worked around the veins, as a surgeon on a live patient would have done, but had cut right through them. The operation, while done with great skill, had also apparently been done with haste. “A large number of veins have been cut, and only the largest—whose bleeding would have interfered with the work—have been ligated. The subject might have bled to death before the opening of the dura, depending on how fast the, er, person worked.”
“But was the subject alivewhen the operation began?”
“It seems she was.” Dowson swallowed weakly. “However, it seems no effort was made to keepthe subject alive while the, ah, dissection was progressing.”
“I would suggest some blood and tissue work to see if the subject had been tranquilized.”
The doctor nodded. “It’s standard.”
“In your opinion, Doctor, how professional was this dissection?”
Dowson did not answer. He was trying to order his thoughts. This had the potential of being big and unpleasant. For the time being, no doubt they’d try to keep a low profile on this, try to fly it as long as possible beneath the radar of the New York press. But it would come out—it always did—and then there would be a lot of people second-guessing his actions. He’d better slow down, take it one step at a time. This was not the run-of-the-mill murder the police report indicated. Thank God he hadn’t actually begun the autopsy. He had the FBI agent to thank for that.
He turned to the nurse. “Get Jones up here with the large-format camera and the camera for the stereozoom. And I want a second ME to assist. Who’s on call?”
“Dr. Lofton.”
“I need him within the half-hour. I also want to consult with our neurosurgeon, Dr. Feldman. Get him up here as soon as possible.”
“Yes, Doctor.”
He turned to Pendergast. “I’m not sure I can let you stay without some kind of official sanction.”
To his surprise, the man seemed to accept this. “I understand, Doctor. I believe this autopsy is in good hands. I, personally, have seen enough.”
So have I,thought Dowson. He now felt sure that a surgeon had done this. The thought made him feel sick.