4.

IN THE CONFERENCE ROOM of the OCME, Scarpetta rolls out a chair at the foot of the table, an outer reach of her former empire that she never visited when she was here. Not once did she sit at the foot of the conference table in the years she ran this office, not even if it was to have a casual conversation over a bagged lunch.

It registers somewhere in her disturbed thoughts that she is being contraire by choosing a chair at the foot of the long dark polished table when there are two other empty seats midway. Marino finds a chair against the wall and sets it next to hers, so he is neither at the foot of the table nor against the wall but somewhere in between, a big grumpy lump in black cargo pants and an LAPD baseball cap.

He leans close to her and whispers, “Staff hates his guts.”

She doesn’t respond and concludes that his source is Julie the clerk. Then he jots something on a notepad and shoves it toward her. “FBI involved,” she reads.

Marino must have made phone calls while Scarpetta was with Dr. Marcus in the library. She is baffled. Gilly Paulsson’s death is not federal jurisdiction. At the moment it’s not even a crime, because there is no cause or manner of death, only suspicion and sticky politics. She subtly pushes the notepad back in Marino’s direction and senses Dr. Marcus is watching them. For an instant, she is in grammar school, passing notes and about to be scorched by one of the nuns. Marino has the nerve to slip out a cigarette and begin tapping it on top of his notepad.

“This is a nonsmoking building, I’m afraid,” Dr. Marcus’s authoritative voice punctures the silence.

“And it oughta be,” Marino says. “Secondary smoke will kill ya.” He taps the filtered end of a Marlboro on top of the notepad that bears his secret message about the FBI. “I’m happy to see the Guts Man is still around,” he adds, referring to the male anatomical model on a stand behind Dr. Marcus, who sits at the head of the table. “Now that’s a thousand-yard stare if I ever saw one,” Marino says of the Guts Man, whose removable plastic organs are present and primly in place, and Scarpetta wonders if he has been used for teaching or explaining injuries to families and attorneys since she was here. Probably not, she decides. Otherwise Guts Man would be missing organs.

She does not know anyone on Dr. Marcus’s staff except Assistant Chief Jack Fielding, who so far has avoided eye contact with her and has developed a skin disorder since she saw him last. Five years have passed, she thinks, and she can scarcely believe what has become of her vain bodybuilding former forensic pathology partner. Fielding was never supremely useful in administrative matters or necessarily respected for having a searing medical mind, but he was loyal, respectful, and caring during the decade he worked for her. He never tried to undermine her or take her place, and he never came to her defense, either, when detractors far bolder than he decided to banish her and succeeded. Fielding has lost most of his hair and his once attractive face is puffy and blotchy, his eyes runny. He sniffs a lot. He would never touch drugs, and she is sure of that, but he looks like a drinker.

“Dr. Fielding,” she says, staring at him. “Allergies? You didn’t used to have them. Perhaps you have a cold,” she suggests, although she seriously doubts he has a cold or the flu or any other contagious disease.

Possibly, he is hungover. Probably, he is suffering from a histamine reaction to something or perhaps to everything. Scarpetta detects the raw edge of a rash peeking out from the v-neck collar of his surgical scrubs, and she follows the white sleeves of his unbuttoned lab coat, over the contours of his arms, to his raw, scaly hands. Fielding has lost considerable muscle mass. He is almost skinny and is suffering from an allergy or allergies. Dependent personality types are thought to be more susceptible to allergies, diseases, and dermatological complaints, and Fielding isn’t thriving. Maybe he shouldn’t thrive, and for him to do well without her would seem to confirm that the Commonwealth of Virginia and humankind in general are better off since she was fired and publicly degraded half a decade ago. The small nasty beast inside her that finds relief in Fielding’s misery instantly crawls back into its dark place, and she is stung by upset and concern. She gives Fielding her eyes again. He won’t complete the connection.

“I hope we’ll have a chance to catch up before I leave,” she says to him from her green upholstered chair at the foot of the table, as if nobody else is in the room, just Fielding and her, the way it used to be when she was chief and so well respected that now and then naive medical students and rookie cops asked for her autograph.

She feels Dr. Marcus watching her again, his stare as palpable as thumbtacks driven into her skin. He wears neither lab coat nor any other medical mantle, and she isn’t surprised. Like most passionless chiefs who should have left the profession years ago and probably never loved it, he’s not the sort to perform autopsies unless there is no one else to do them.

“Let’s get started,” he announces. “I’m afraid we have a full house this morning, and we have guests. Dr. Scarpetta. And her friend Captain Marino … Or is it Lieutenant or Detective? Are you with Los Angeles now?”

“Depends on what’s going on,” Marino says, his eyes shadowed by the brim of his baseball cap as he fiddles with the unlit cigarette.

“And where are you working now?” Dr. Marcus reminds him that he has not fully explained himself. “I’m sorry. I don’t recall Dr. Scarpetta mentioning she was bringing you.” He has to remind Scarpetta again, this time before an audience.

He is going to take swipes at her in front of everyone. She can see it coming. He will make her pay for confronting him inside his slovenly library, and it occurs to her that Marino made phone calls. Someone he talked to might have alerted Dr. Marcus.

“Oh, of course.” He suddenly remembers. “She did mention you work together, I believe?”

“Yes,” Scarpetta confirms from her lowly spot at the foot of the table.

“So we’re going to get through the cases quickly,” he informs Scarpetta. “Once again, if you and, uh, I guess I’ll just call you Mr. Marino, if the two of you want to get coffee? Or smoke as long as it’s outside. You’re welcome to sit through our staff meeting but you certainly don’t have to.”

His words are for the benefit of those not privy to what has already transpired in less than one rude hour, and she detects a warning in his tone. She wanted to intrude and now she may get an exposure she will find decidedly unpleasant. Dr. Marcus is a politician and not a good one. Perhaps when he was appointed, those in power had deemed him malleable and harmless, the antithesis of what they thought of her, and maybe they were wrong.

He turns to the woman directly on his right, a big, horsey woman with a horsey face and closely shorn gray hair. She must be the administrator, and he nods at her to proceed.

“Okay,” says the administrator, and everyone looks at the yellow photocopies of today’s turndowns, views, and autopsies. “Dr. Ramie, you were on call last night?” she asks.

“I sure was. “Tis the season,” Dr. Ramie replies.

No one laughs. A pall hangs over the conference room. It has nothing to do with the patients down the hall who await the last and most invasive physical examination they’ll ever have with any doctor on earth.

“We have Sissy Shirley, ninety-two-year-old black female from Hanover County, history of heart disease, found dead in bed,” Dr. Ramie says, looking at her notes. “She was a resident of an assisted living facility and she’s a view. In fact, I already viewed her. Then we have Benjamin Franklin. That really is his name. Eighty-nine-year-old black male, also found dead in bed, history of heart disease and nerve failure …”

“What?” Dr. Marcus interrupts. “What the hell is nerve failure?”

Several people laugh and Dr. Ramie’s face heats up. She is an overweight, homely young woman and her face is glowing like a halogen heater on high.

“I don’t believe nerve failure is a legitimate cause of death,” Dr. Marcus plays off his deputy chief’s acute embarrassment like an actor playing off his captive audience. “Please don’t tell me we’ve brought some poor soul into our clinic because he allegedly died of nerve failure.”

His attempt at humor is not meant kindly. Clinics are for the living and poor souls are people in hard times, not victims of violence or random, senseless death. In three words, he has managed to completely deny and mock the reality of people down the hall who are pitifully cold and stiff and zipped inside vinyl and fake fur funeral home pouches, or naked on hard steel gurneys or on hard steel tables, ready for the scalpel and Stryker saw.

“I’m sorry,” Dr. Ramie says with glowing cheeks. “I misread my notes. Renal failure is what I have here. Even I can’t read my writing anymore.”

“So old Ben Franklin,” Marino starts in with a serious face as he plays with the cigarette, “he didn’t die of nerve failure after all? Like maybe when he was out there tying a key to his kite string? Anybody on that list of yours happen to die of lead poisoning? Or are we still calling it gunshot wounds?”

Dr. Marcus’s stare is flat and cold.

Dr. Ramie goes on in a monotone, “Mr. Franklin also is a view. I did view him already. We have Finky … uh, Finder …”

“Not Finky, oh Lordy,” Marino keeps up the straight-man charade in that huge voice of his. “You can’t find her? I hate it when Finky does that, damn her.”

“Is that the proper name?” Dr. Marcus’s voice has the thin ring of a metal triangle, several octaves higher than Marino’s voice.

Dr. Ramie’s face is so red that Scarpetta worries the tortured woman is going to burst into tears and flee from the room. “The name I was given is what I just stated,” Dr. Ramie woodenly replies. “Twenty-two-year-old black female, dead on the toilet, needle still in her arm. Possible heroin O.D. That’s the second in four days in Spotsylvania. This was just handed to me.” She fumbles with a call sheet. “Right before staff meeting we got a call about a forty-two-year-old white male named Theodore Whitby. Injured while working on a tractor.”

Dr. Marcus blinks behind his small wire-rimmed glasses. Faces blank out. Don’t do it, Scarpetta silently says to Marino. But he does.

“Injured?” he asks. “He’s still alive?”

“Actually,” Dr. Ramie stammers. “I didn’t take this call. Not personally. Dr. Fielding …”

“No, I didn’t,” Fielding interrupts like a gun hammer clicking back.

“You didn’t? Oh. Dr. Martin did. This is his note,” Dr. Ramie goes on, her hot and humiliated head bent low over the call sheet. “No one seems to be real clear on what happened, but he was on or near the tractor one minute and then his coworkers suddenly saw him badly injured in the dirt. Around half past eight this morning, not even an hour ago. So, somehow, he ran over himself, fell off or something, you know, and ran over himself. Was dead when the squad got there.”

“Oh. So he killed himself. A suicide,” Marino decides, slowly twirling the cigarette.

“Well, it’s an irony that this occurred at the old building, the one they’re tearing down at Nine North Fourteenth Street,” Dr. Ramie adds tersely.

This catches Marino. He drops his not-so-funny act, his silent reaction nudging Scarpetta while she remembers the man in olive-green pants and a dark jacket standing in front of the tractor’s back tire on the pavement near the bay door. He was alive then. Now he’s dead. He should not have been standing in front of the tire, doing whatever he was doing to the engine. She thought that at the time, and now he’s dead.

“He’s a post,” Dr. Ramie says, her composure and authority somewhat restored.

Scarpetta remembers turning the corner as she drove around her old building, and the man and his tractor vanished from sight. He must have gotten his tractor started within minutes of her seeing him, and then he died.

“Dr. Fielding, I suggest you do the tractor death,” Dr. Marcus says. “Make sure he didn’t have a heart attack or some other underlying problem before he was run over. The inventory of his injuries is going to be extensive and time-consuming. I don’t need to remind you of how thorough we need to be in cases like this. Somewhat ironical, in light of our guest.” He looks at Scarpetta. “A bit before my time, but I believe Nine North Fourteenth Street was your old building.”

“It was,” says she, the ghost from the past as she recalls Mr. Whitby from a distance in black and olive green, now a ghost too. “I started out in that building. A bit before your time,” she repeats. “Then I moved to this one.” She reminds him that she worked in this building too, and then feels slightly foolish for reminding him of a fact that is indisputable.

Dr. Ramie continues going through the cases: a prison death that isn’t suspicious, but by law, all prison deaths are medical examiner cases; a man found dead in a parking lot, possibly hypothermia; a woman who was a known diabetic died suddenly while climbing out of her car; an unexpected infant death; and a nineteen-year-old found dead in the middle of a street, possibly a drive-by shooting.

“I’m on call for court in Chesterfield,” Dr. Ramie concludes. “I’m going to need a ride, my car’s in the shop again.”

“I’ll drop you off,” Marino volunteers, winking at her.

Dr. Ramie looks terrified.

Everyone makes moves to get out of their chairs, but Dr. Marcus stops them. “Before you go,” he says, “I could use your help and you could probably use a little mental stretching. As you know, the Institute is running another death investigation school, and as usual I’ve been prevailed upon to lecture about the medical examiner system. I thought I’d try out a few test cases on the group, especially since we are fortunate enough to have an expert in our midst.”

The bastard, Scarpetta thinks. So this is what it’s going to be like. The hell with their talk in the library. The hell with his making the office open to her.

He pauses, looking around the table. “A twenty-year-old white female,” he begins, “seven weeks pregnant. Her boyfriend kicks her in the belly. She calls the police and goes to the hospital. Hours later she passes the fetus and placenta. The police notify me. What do I do?”

No one answers him. It’s obvious that they aren’t accustomed to his mental stretches and just stare at him.

“Come on, come on,” he says with a smile. “Let’s say I just got such a phone call, Dr. Ramie.”

“Sir?” She turns red again.

“Come, come. Tell me how to handle it, Dr. Ramie.”

“Process it like a surgical?” she guesses as if some alien force has just sucked away her long years of medical training, her very intelligence.

“Anybody else?” Dr. Marcus asks. “Dr. Scarpetta?” He says her name slowly, making sure she notices that he didn’t call her Kay. “Ever had a case like this?”

“I’m afraid so,” she replies.

“Tell us. What’s the legal impact?” he asks quite pleasantly.

“Obviously, if you beat up a pregnant woman, it’s a crime,” she answers. “On the CME-1, I’m going to call the fetal death a homicide.”

“Interesting.” Dr. Marcus looks around the table as he takes aim at her again. “So your initial report of investigation would say homicide. Perhaps a bit bold of you? Intent is for the police to determine, not us, correct?”

The sniping son of a bitch, she thinks. “Our job as mandated by code is to determine cause and manner of death,” she says. “As you may recall, in the late nineties the statute changed after a man shot a woman through the belly and she lived but her unborn child died. In the scenario you’ve put before us, Dr. Marcus, I suggest you have the fetus brought in. Autopsy it and give it a case number. There’s no place on a yellow-bordered death certificate for manner of death, so you include that with cause, an intrauterine fetal demise due to an assault on the mother. Use a yellow-bordered death certificate since the fetus wasn’t born alive. Keep a copy with the case file because a year from now that certificate won’t exist anymore, after the Bureau of Vital Records compiles its statistics.”

“And what do we do with the fetus?” Dr. Marcus asks, not quite so pleasantly.

“Up to the family.”

“It’s not even ten centimeters,” he says, his voice getting tight again. “There’s nothing left for the funeral home to bury.”

“Then fix it in formalin. Give it to the family, whatever they want.”

“And call it a homicide,” he says coldly.

“The new statute,” she reminds him. “In Virginia, an assault with the intent of killing family members, born or unborn, is a capital crime. Even if you can’t prove intent and the charge is malicious wounding of the mother, that carries the same penalty as murder. From there it tracks down through the system as manslaughter and so on. The point is, there doesn’t have to be intent. The fetus doesn’t even have to be viable. A violent crime has occurred.”

“Any debate?” Dr. Marcus asks his staff. “No comments?”

No one responds, not even Fielding.

“Then we’ll try another one,” Dr. Marcus says with an angry smile.

Go ahead, Scarpetta thinks. Go ahead, you insufferable bastard.

“A young male in a hospice program,” Dr. Marcus begins. “He’s dying of AIDS. He tells the doctor to pull the plug. If the doctor withdraws life support and the patient dies, is it an ME case or not? Is it a homicide? How about our guest expert again? Did the doctor commit homicide?”

“It’s a natural death unless the doctor put a bullet through the patient’s head,” Scarpetta answers.

“Ah. Then you’re an advocate of euthanasia.”

“Informed consent is murky.” She doesn’t answer his ridiculous charge. “The patient is often dealing with depression, and when people are depressed, they can’t make informed decisions. This is really a societal question.”

“Let me clarify what you’re saying,” Dr. Marcus replies.

“Please do.”

“You have this man in hospice who says, ‘I think I’d like to die today.’ Should you expect your local doc to do it?”

“The truth is, the patient in hospice already has that capacity. He can decide to die,” she replies. “He can have morphine when he wants it for pain, so he asks for more and goes to sleep and dies from an O.D. He can wear a Do Not Resuscitate bracelet and a squad doesn’t have to resuscitate him. So he dies. Chances are there will be no consequences to anyone.”

“But is it our case?” Dr. Marcus insists, his thin face white with rage as he glares at her.

“People are in hospices because they want pain control and want to die in peace,” she says. “People who make informed decisions to wear DNR bracelets basically want the same thing. A morphine O.D., a withdrawal of vital support in a hospice, a person wearing a DNR bracelet isn’t resuscitated. These are not our issues. If you get called about a case like that, Dr. Marcus, I hope you turn it down.”

“Any comment?” Dr. Marcus asks tersely, shuffling paperwork and ready to leave.

“Yeah,” Marino says to him. “You ever thought of writing Q-and-A’s for Jeopardy?”

[“_Toc93039621”]