33

Sunday 9 September

CLASSICAL PIANO MUSIC WAS PLAYING SOFTLY IN the mortuary of St Thomas’s Hospital. The room was modern, but there was something about the arrangement of so much gleaming steel, the careful placement on the counters of jars and dishes, that looked timeless. For all its grim purpose, it felt like a calm room. And given what we were about to see, calm felt good.

The pathologist, a Dr Mike Kaytes, looked at us across the central worktop. ‘Not too much I can tell you,’ he said. ‘They normally send me a bit more to work with.’

As well as Kaytes and his technician, a boy who couldn’t be much more than twenty, there were four police officers in the room: Dana Tulloch, Neil Anderson, Pete Stenning and me. This was my first post-mortem, Stenning’s too, he’d confided on the way over. Anderson and Tulloch must have attended others but they didn’t seem any more at ease. Didn’t have to guess why. The small piece of flesh lying in the centre of the polished steel worktop looked obscene.

I closed my eyes and concentrated on the music for a second. I’m not a great music fan, I’d never think of listening to classical, but there was something about the delicate precision of the notes, the clarity of the sound, that helped.

Kaytes was a tall, barrel-chested man in his late forties. He had thick grey hair and bright-blue eyes. On the third finger of his left hand, beneath the surgical glove, a sticking plaster had been wrapped around where his wedding ring would be. He leaned forward and poked at the upper corner of the specimen. ‘It’s definitely human,’ he said. ‘Look here. See what we’ve got on the fallopian tubes.’ He was pointing to gunmetal-grey, pea-sized objects. ‘These are filshie clips,’ he went on. ‘Not even chimpanzees are that advanced yet; this woman’s been sterilized. And it’s a fresh specimen,’ he finished.

The pianist played a series of notes, pure and clear, interspersed by long silences.

‘Fresh as in …?’prompted Anderson.

‘Recently harvested,’ said the pathologist. ‘We’re running tests to see if we can pick up any of the more common preserving solutions, such as formaldehyde, but, frankly, you can invariably smell the stuff. And this has barely begun to deteriorate. I’d say it’s less than twenty-four hours old, fresh as they come.’

As the music started to build in volume and tempo, I imagined the pianist’s fingers running up and down the keys. And I really hoped Kaytes wasn’t going to use the word ‘fresh’ again.

‘Can you tell us anything about the woman it was taken from?’ asked Tulloch.

Kaytes nodded. ‘Adult,’ he said. ‘From the size of it, I’d say she’d had at least one pregnancy of twenty-four weeks or over.’ He stepped away from the worktop and arched his back. ‘The uterus enlarges in pregnancy as the fetus develops,’ he went on, ‘but then very rarely shrinks back completely to its pre-pregnancy size until some time past the menopause. So this woman wasn’t elderly. She’d also given birth.’

He beckoned us closer and re-angled one of the lights so that it shone directly on the organ.

‘What you’re looking at now is the cervix,’ he said, extending a gloved index finger. ‘And this little hole here is the external os of the cervix, basically the escape route for the emerging infant. Can you see that it’s slit-shaped and a bit distorted?’

I told myself I was back in biology class. I’d never been squeamish then.

‘How is that significant?’ asked Tulloch.

‘Prior to a vaginal birth the os is neat and circular,’ said Kaytes. ‘This isn’t. She’d had at least one vaginal delivery.’

There were pronounced veins on Tulloch’s neck I hadn’t noticed before. The muscles of her jaw seemed tighter than usual. ‘So she was a mother,’ she said. ‘Any idea how old?’

‘Let’s open it up, shall we?’ said Kaytes, taking up a scalpel just as there was a surprisingly cheerful burst of music. Two fingers, tapping down repeatedly on the same keys. I glanced over at Tulloch while the incision was being made. She didn’t flinch.

‘Well, there are some fibroids, but none of them really large enough to distort the uterus,’ said Kaytes. ‘Two or three of them are calcified, which tends only to happen in later life.’

I caught Stenning’s eye. He gave me a tight-lipped smile.

‘I cut a few sections of the vessels before you got here,’ said Kaytes. He stepped away from the table and switched on a microscope on the bench behind him. ‘Bear with me a sec.’

We waited while he adjusted the focus. The microscope was connected to a computer screen and as the screen flickered into life we saw an incomprehensible collage of pink, black and yellow. ‘Here we go,’ Kaytes said, tapping the screen. ‘What you’re seeing now is a segment of uterine artery, with some early signs of atherosclerosis, basically a thickening of the arterial wall. That’s age-driven, although smoking and diet can exacerbate it. The sterilization points to a slightly older subject as well. My educated guess would be that this lady was somewhere from thirty-five to fifty-five.’

‘Is it possible …?’ began Tulloch. ‘Do we … do we have to assume she’s dead?’

At my side, Anderson sucked in a breath. It had never occurred to me that the owner of the uterus might still be … Jesus.

‘Not necessarily,’ replied the pathologist. ‘Hysterectomy is still one of the most common elective operations in this country. But without medical support, there’d be a huge amount of bleeding, the pain would be close to unmanageable and there would be a massive risk of infection.’

It was getting harder, by the second, to persuade myself that this was nothing more than a biology class.

‘Is it possible this was the by-product of a hysterectomy?’ asked Tulloch, who seemed the only one of us with her brain fully engaged. ‘Removed in the last twenty-four hours and then smuggled out of the operating theatre as a joke.’

Kaytes looked bemused. ‘Not even medical students would try that nowadays,’ he said.

‘Are you sure?’ said Tulloch. ‘Because the alternative is a whole lot worse.’

Kaytes made a resigned face and bent down to the worktop again. After a few seconds he shook his head. ‘There are no clamp marks across the residual uterine and ovarian vessels,’ he said. ‘Also a surgeon would use diathermy to control the small vessels, particularly around the cervix. There are no coagulation burns to suggest that. The incision around the cervix is by no means neat, in fact I’d say there’s some evidence of pretty amateurish hacking. And you’ve got this piece of tissue here, which is a small segment of the ureter, indicating this was done in a hurry.’ He stood upright again and let the scalpel dangle in his fingers. ‘This wasn’t the result of a legitimate operation,’ he said.

‘But he would still have to know what he was doing, right?’ asked Stenning. ‘I mean, there’s no way I could cut a woman open and take out her uterus.’ He looked round at the rest of us almost defensively. ‘I wouldn’t know where to begin. I wouldn’t even know what it looked like.’

Anderson nodded. Tulloch gave Stenning a small half-smile.

‘Well, that’s true,’ replied Kaytes. ‘Whoever did this would need some basic knowledge of anatomy. Maybe someone who’s worked in medicine without actually being a surgeon. Possibly even a butcher, someone used to cutting up large animals.’

Tulloch’s eyes closed and I had a pretty good idea what she was thinking. Exactly the same conjectures had been made about the original Ripper. Someone with rough anatomical knowledge. For a while suspicion had fallen on the numerous slaughterhouse workers who lived around Whitechapel and Spitalfields.

‘To be honest, though,’ continued Kaytes, ‘you can research just about anything on the internet these days. I wouldn’t want to send you off on a wild goose chase, looking for a psychotic doctor when it’s just someone who’s read a couple of textbooks.’

No one answered him.

‘Any truth in what I’ve been hearing?’ asked Kaytes. ‘Have we got a wannabe Ripper?’

Tulloch was about to answer when her mobile beeped. Excusing herself, she stepped to the corner of the room and took the call.

‘What’s the music?’ I asked, after a second.

Kaytes looked at me properly for the first time. ‘Beethoven,’ he said. ‘One of the piano sonatas. Les Adieux, in fact, played by Alfred Brendel.’

‘He saves the symphonies for when the detective superintendent comes down,’ said the technician in a voice that was pure estuary. ‘When we get a bad one, he puts on the Fifth.’

‘Gets him every time,’ agreed Kaytes.

Over in the corner, we heard Tulloch take a deep breath. Then she ended the call, turned back and nodded to the pathologist.

‘Mike, thank you,’ she said. ‘That was very helpful.’ Then she looked at the rest of us and her eyes were gleaming. ‘We have to get back,’ she said. ‘That print they found on Emma’s phone. They’ve managed to trace it.’

I rode back with Stenning. For a while, neither he nor I spoke.

‘It seems clumsy,’ I said at last. ‘Leaving a print behind.’

‘Only a partial print,’ Stenning reminded me.

I nodded. ‘How are the Jones family doing?’ I asked, because I didn’t want to spend the entire trip back obsessing about possible evidence and who it might point to.

Stenning shrugged. ‘Not great,’ he said. ‘The youngest son is home now. He should have gone back to university but he’s put it off a couple of weeks. The au pair thinks they’re still in shock. They want answers, of course. They’re starting to blame us.’

‘We haven’t given up on the family angle though, have we?’ I said, as the lights changed and we pulled away. ‘We’re still talking to them, trying to find any connection she may have had with Kennington.’

‘Yeah, but there isn’t anything there, Flint. No financial motive that we can find, no dodgy goings-on, everyone close to her had a good alibi, husband isn’t having an affair that we know of.’

‘There was nothing on the bag we found the uterus in,’ I said. ‘If he was careful enough to keep that clear, why leave something on the phone?’

‘They get careless,’ said Stenning. ‘That’s how we catch them. If they’d had fingerprinting and forensics back in 1888, they’d have caught the Ripper.’

I didn’t argue, but I wasn’t so sure. Nineteenth-century Whitechapel had been densely populated. Watching eyes were everywhere and at the time of the Ripper murders there was a heavy police presence on the streets. The Ripper had managed to act and escape each time undetected. I was inclined to think that whatever tools the police had had at their disposal, he’d still have stayed one step ahead.