Jack told him about his running the fentanyl test strip on a fluid sample of Aria’s stomach and getting a surprising positive result. “I’m wondering if you might run a speed test for fentanyl on the stomach contents of the first case, Kera Jacobsen. She was autopsied several days ago.”
“I’ll be happy to do so,” John said. He wrote down Kera’s name. “Where will you be in the next half hour or so?”
“I’ll be available,” Jack said. “Just call my mobile number.”
“I or Peter will be back to you shortly,” John said. Peter Letterman was the deputy director of Toxicology.
As Jack walked out to summon an elevator, he had to smile. The change in John DeVries had been nothing short of astonishing. It was now a pleasure to work with the man, whereas prior to his metamorphosis it had been a battle.
Retreating to his office, Jack tried not to think about what was going on in one of the Langone Medical Center’s hybrid operating rooms. He even avoided checking the time for fear he’d start worrying that he hadn’t gotten the call to tell him the procedure was over and there was nothing to worry about. Knowing himself, he needed to keep busy to mentally survive. As sad as it was, the autopsy on Aria Nichols had done the trick, but it was now over.
The growing stack of unfinished cases beckoned as did all the histology slides that needed to be reviewed, but he quickly nixed the idea. That kind of busywork didn’t require enough brainpower to keep him from thinking about things he didn’t want to think about, like Laurie’s biopsy being positive. He needed something else that was more demanding and used more parts of his brain, like the rarely used creative sections. Jack was totally aware that he was a man of action who needed physical exertion to keep himself focused, which was why he still liked to play sports rather than watch them.
Thinking about sports brought up the idea of heading home and getting in a bit of basketball despite his promise to Laurie. He felt his mental equilibrium trumped her worry that he might injure himself. He knew that a good run would surely take his mind off Laurie’s surgery. Jack liked the idea more and more until he checked the time.
“Damn,” he said out loud. It was 2:25P.M., much too early for basketball. People didn’t start showing up on the court until at least 4:30. Unfortunately, checking the time had the negative effect he feared and was trying not to think about, namely that Dr. Cartier had not called him. If Laurie’s surgery had begun around noon, that meant it had been going on for more than two hours, not a good sign.
“Get a grip!” Jack voiced through clenched teeth. He knew he had to think about something else, and the only thing that came to mind was the autopsy he’d just finished on Aria Nichols. As a kind of mental game, he carefully, step by step, went over the entire procedure, forcing himself to remember all sorts of insignificant details from theexternal exam all the way through to the bitter end. Ultimately, he admitted to himself that the only significant finding was the lack of evidence of pulmonary edema, a kind of positive negative. Such a thought at least brought a passing smile to his face since he was a major fan of wordplay and double entendre, which the phrasepositive negativesurely represented. Remembering the lack of pulmonary edema reminded him of the apparent similarities between Aria Nichols’s case and Kera Jacobsen’s and what that might mean beyond the worry that both women possibly had gotten their drugs from the same deadly source. Was it just a weird coincidence or did it presage an even greater rash of overdoses in the city than what they were already seeing? He also found himself pondering the weird irony that Aria had participated in Kera’s autopsy as a further association between the two cases.
The sudden ringing of his phone jarred him out of his thoughts. It was John DeVries. “The Jacobsen gastric sample was positive for fentanyl,” he said. “Was that expected?”
“Yes and no,” Jack said. “As I mentioned, it was positive on the case we did today and there were other similarities between the two cases. I don’t know what it means, if anything.”
“I just thought I’d ask,” John said.
“Let me ask you a question,” Jack said. “Is there a fast test for 3-methylfentanyl?”
“No, the rapid tests don’t differentiate between the various analogues.”
“That’s too bad,” Jack said. “The autopsies on these two women suggest they died very rapidly, which scares me to think it involved one of the super-potent analogues.”
“We’ll know as soon as we have our results from liquid chromatography and mass spectrometry.”
“But that takes time,” Jack moaned. “You know me, I want the results yesterday.”
John laughed. “I can vouch for that, remembering our battles inthe days of yore. Give me the case accession numbers and I’ll see if I can speed things up.”
“I only have handy the accession number of the case I did today,” Jack said. “But I can get the other one easy enough.”
“Don’t bother,” John said. “Just give me the names again and I’ll look them up.”
“Aria Nichols was today,” Jack said. “Kera Jacobsen was the one done a few days ago.”
“I’ll see if I can have the results early next week,” John said.
“Much appreciated, John,” Jack said.
Marveling anew at John’s personality change, Jack went back to going over the details of Aria’s autopsy, and without knowing why, he started thinking about the autopsy he’d let Aria do on Madison Bryant. What came to mind was the vulgar tirade Aria had let loose the moment she’d seen Madison Bryant on the autopsy table, complaining about Madison avoiding helping her on the Jacobsen case by getting hit by a train and dying. At the time, it was Aria’s obscene language and total lack of human warmth or empathy that had caught Jack’s attention. Currently, instead of the profanity, he was stuck on how the three cases were interrelated.
Tipping forward in his desk chair, Jack put in a call to Bart Arnold. Thinking about Madison Bryant reminded him that he’d not seen the hospital chart that he’d called for after the autopsy yesterday. Besides, Bart had asked him to provide a follow-up with Aria’s autopsy.
As was usually the case, Jack got Bart on the phone immediately. As the department head, he rarely did cases himself, with Aria’s being an exception, so contrary to the other MLIs who were out on scene most of the day, Bart spent the vast majority of his workday at his desk.
After identifying himself, Jack said: “I finished Aria Nichols’s autopsy. Except for a lack of the usual pulmonary edema seen in fentanyl overdoses, there was nothing striking about it.”
“Thanks for letting me know,” Bart said. “And from this end, themother didn’t add anything particularly relevant other than insisting she’d had no idea her daughter was a ‘goddamn druggie.’ Those were her words.”
“Like mother, like daughter,” Jack said. “What about the Bellevue hospital records for Madison Bryant? Any luck? I want to see them and not just the digital record.” Jack made no effort to hide his frustration.
