“Likewise,” Jack said. “Luckily, I’ve never personally had a case, but I know Dr. Montgomery had one her first year here. Emotionally she found it difficult to handle.” Jack felt a little silly calling his wife Dr. Montgomery, yet he thought it was appropriate under the circumstances.
“Will I find anything at autopsy?” she asked, finally breaking off looking at the X-ray to glance at Jack.
“Probably not,” Jack said. “But it is a diagnosis of exclusion. In that sense it will be like Madison Bryant.”
“Well, let’s get it over with,” Aria said. “I’ve got things to do. Am I still going to be the prosector?”
Jack continued to stare at Aria for a beat while she stared back with a slight smirk. Even though he’d promised himself he’d be the adult, she had already ruffled his feathers by suggesting she had moreimportant things to do than the autopsy on a child who’d died before his life could really begin. It was she who broke off and walked back to the table with a spring to her step. There wasn’t the slightest hint she found the case emotionally upsetting.
Although Aria looked closely at the child’s chest and even palpated the boy’s breastbone, she could not find any evidence of the child’s being hit by a baseball. There was no bruising or abrasion whatsoever. Nor did she find anything on the rest of the external exam. Like with Madison Bryant, Aria was standing on the patient’s right side while Jack and Vinnie were on the opposite side.
“Scalpel,” she said, extending her hand toward Vinnie. Vinnie had the instrument tray next to him.
“What about examining the inside of the mouth just in case the boy choked on something?” Jack said, making an effort to make it sound like a suggestion and not a criticism.
Without responding verbally, Aria did search the mouth and palpate the throat. When she was finished, she then took the knife to start the case with the usual Y incision.
Like with Madison Bryant, Aria worked rapidly but skillfully. Jack helped when he could, especially when she was using the bone shears. When the heart was fully exposed yet still covered by the pericardium, Aria bent down to look closely.
“I don’t see any signs of trauma whatsoever,” she said as she straightened up.
“Nor do I,” Jack said, responding to the first words Aria had said since the case began. He had learned his lesson to stay quiet and not lecture.
“Okay,” she said more to herself than to Jack or Vinnie. Just as she’d done with Madison, she carefully opened the pericardium and then finally removed the heart entirely. Jack watched intently and was convinced that the heart was entirely normal, at least from theoutside. Specifically, there were no signs of bruising. As Aria began opening the heart, Jack caught sight of Laurie coming into the autopsy room for her morning autopsy rounds. Jack was eager to talk with her but was hesitant to leave Aria with the most important part of the autopsy under way. Laurie started at table #8, which was closest to the door to the hallway.
“The interior of the heart is normal,” Aria announced to no one in particular. Jack had been watching over her shoulder. “That leaves coronary vascular abnormalities as the only other possibility.”
“I agree,” Jack said. “The coronary arteries have to be exposed.”
Aria put down the butcher knife she’d been using and picked up more delicate dissecting instruments and began tracing out the coronary system. Jack watched for ten minutes or so to make sure there wasn’t obvious pathology, which there wasn’t, and to make sure she was following the normal protocol. When he was sure things were copacetic, he elected to leave her under Vinnie’s capable supervision and have a few words with Laurie. A moment later he caught up with her as she was moving from table #4 to #3.
“I was on my way down to check in on you two,” Laurie said, practically bumping into him. They stepped back to be out of everyone’s way. “I couldn’t help but notice that things seemed to be going well between you and Dr. Nichols.”
“That’s a bit deceptive. It’s more like the calm after the storm,” Jack said, trying to make light of the situation.
“Was there a problem?” she asked with concern.
“I had to struggle to keep myself under control,” Jack said. “In retrospect, I’m a little embarrassed at my behavior since I was fully warned by you what she was like, and I promised you not to make things worse.”
“What happened?” Laurie asked anxiously. She looked around him to see Aria calmly working at a cutting board.
“Nothing happened,” Jack assured her. “Ultimately, I was able to restrain myself, but it required about as much self-control as I can muster. What was it that Carl Henderson said about her, that she’s not a team player? Well, I can assure you he was correct. And she is definitely antisocial. Whether she has an antisocial personality disorder, I seriously doubt, as she wouldn’t have gotten into or through medical school, but she certainly has zero empathy. To give you a glowing example, it turns out that she knew the first case on a personal basis. Instead of being concerned about the person and the tragedy she suffered, she was irritated the woman had gone and allowed herself to get run over by a train and then die in the Bellevue ICU.”
“She actually was friends with the person you guys autopsied?” Laurie asked with astonishment.
“Well, I don’t know if they were friends,” Jack said. “I’m not sure she’s capable of having what we call friends. I’d say they were acquaintances. She was mad because the victim was supposed to help her with the case that you and she did together the other day.”
“You mean the Kera Jacobsen case?”
“Yes!”
“Then it is a double coincidence,” she said. “What’s the name of the patient?”
“Madison Bryant,” he said.
“That is extraordinary. I remember Dr. Nichols talking about her. She was supposedly Kera’s best friend. Regardless, the point that you’re trying to make is that Dr. Nichols didn’t express any appropriate grief or sadness at all?”
“None, zero, nada. Just irritation, and the language she used to express it was certainly colorful.”
