“I’m afraid not,” Melanie said. “The afternoon patients started arriving just after we got back from lunch. But we’ve only one more patient to see this afternoon, and I’ll start on it after she’s been seen. I did have an opportunity to find an assessor’s map of the township online and downloaded it, so I’ll be able to print it out. At some point I’ll get around to marking where each of the dementia patients live, for whatever that might be worth.”
“That sounds perfect,” Jack said. “I have another request, too, and hoping not burden you unreasonably, I’d like to take a peek at each of the patients’ records. I assume you are aware that being a New York medical examiner, I have the legal right to do so.”
“I am aware,” Melanie said. “I can print those out easily as well.”
“Terrific,” Jack said. “I appreciate it. What about the two patients that were seen this afternoon that you felt would possibly be added to the series? What were the names again?”
“I don’t believe I mentioned the names,” Melanie said. “They are George Rogers and Gloria Hosbrook.”
“What’s the consensus after they were seen?”
“They definitely need to be added to the series, at least according to their symptoms and timing. It was the parents who brought in the young man, who’s only twenty-four. His muscle spasms and gait problems were immediately apparent just coming into the examination room. Pretty much the same with the woman, who is only ten years older. She was brought in by her husband.”
“That’s remarkably young for Alzheimer’s symptoms,” Jack said. “What did you do for them?”
“The same as we did with the previous cases,” Melanie said. “Both were referred to the Clinton Hospital for MRIs and neurology consults. We’re really at a loss of what else to do, to be honest.”
“Were the histories essentially the same?” Jack asked.
“They were almost identical,” Melanie said. “With both patients the symptoms began abruptly only a little more than a week previously and have rapidly progressed. Prior to that, according to their family members, they had been entirely normal. It’s frightening. As I said to Bob and can admit to you, dealing with these patients has become the first time in my clinical life as a nurse that I’m feeling concerned about my own health. I was reluctant to ask this question of Bob but I’ll ask it of you: Do you think we are all at risk?”
“Do you mean contracting the illness from these patients?” Jack asked.
“Exactly,” Melanie admitted. “Having been trained as a nurse, it embarrasses me to admit it! But after our lunch conversation, it has been difficult for me to think of much else other than an untreatable, fatal brain disease is spreading in our community, and Bob and I are dealing directly with each one of these unfortunate patients.”
“You shouldn’t be embarrassed,” Jack said. “It is a natural response. But my answer is no. Following current medical theory andwhat we found on autopsy, I’m pretty confident we’re dealing with a prion disease. We’ll get confirmation from the samples we sent today down to the OCME. Unfortunately, the test takes a few days. But assuming we are dealing with prion disease, these victims themselves are not contagious, except possibly by the autopsy tools we used this morning on Stanley Kramer’s brain. They could possibly be contaminated. I meant to bring this up, but those instruments should be soaked in sodium hydroxide for several hours just to be safe. Prion protein is remarkably resistant to denaturation except by sodium hydroxide. It is why it accumulates in infected patients’ brains and ultimately kills them.”
“Oh, my goodness,” Melanie said. “Thank you for telling me. I’ll be sure to see to it.”
“Although the patients themselves are not contagious,” Jack continued, “the way they became infected could possibly infect us and others. That’s why we have to try to figure it out, if we possibly can. This could very well turn into an epidemic of sorts if the source is not found and dealt with.
“Surely New York State will be sending an epidemiological team here in response to Bob’s filings, and they can take over. Unfortunately, the state’s medical bureaucracy has significant inertia, so there will undoubtedly be a delay. How long of a delay, who’s to know? In the meantime, I’d like for us to learn what we can. What about the missing corpse; has there been any follow-up?”
“Do you think the dementia cases and the missing corpse are related?” Melanie asked with shocked surprise.
“At least they’re temporally related since we discovered the missing corpse this morning,” Jack said. He shrugged his shoulders. “At the moment I don’t have any reason to think they are otherwise related. The only reason I’m bringing up the missing corpse isbecause it’s a problem I take personally. As a medical examiner, I can’t help but do so because it is specifically meant to prevent me from doing my job. When a body purposefully vanishes before an autopsy it is usually for one of two reasons. It’s either because someone thinks that the procedure is a violation of the victim’s personage, which is misguided, as the procedure does the opposite by allowing the dead to tell his or her story, or more commonly the body is taken because someone doesn’t want something possibly discovered, which is usually to cover up some sort of criminal behavior.”
“There hasn’t been any explanation of what happened to the body so far,” Melanie said. “We’re waiting on Chief Hargrove’s investigation. We’ve yet to hear from him.”
“Perhaps I’ll run by and ask him if he’s made any progress.”
“Good idea! I’m sure he’ll be willing to fill you in with whatever progress he’s made. The police station is behind the post office on Washington Avenue.”
“Thank you. I think I know where it is. Besides talking with Chief Hargrove, I’d also like to chat with Ethan Jameson’s family. I gather they live here in town.”
“They certainly do,” Melanie said. “His parents and the paternal grandparents live together less than two blocks away from here, Twenty-two Cutter Lane.” She pointed over Jack’s shoulder in the general direction. “I lived for a time directly across the street from the grandparents before I moved out to the countryside.”
“The parents live with the grandparents?” Jack questioned. “Or is it the other way around?”
“The parents live with the grandparents,” Melanie said. “It’s been a sad family saga. Edward Jameson, Ethan’s father, still struggles with the alcoholism brought on by losing his job at the shoe factory. His wife, Alice, and Ethan and his older sister trulysuffered. Why Alice stayed married is one of those unknowns, but to survive they ended up moving in with her husband’s parents.”
“Good Lord,” Jack said. It was the kind of story he hated to hear. It also suggested that the probability someone from such a family managing to abduct Ethan Jameson’s body without leaving a trace for whatever reason was close to zero. Still, he felt obligated to be certain. “I’m thinking of stopping unexpectedly at the house to see what I can learn, although it doesn’t sound like any of them could be involved.”
“I can’t imagine,” Melanie agreed.
“How is it you know so much about the family?”
“It’s one of the benefits or disadvantages, depending on your point of view, of living in a small town,” Melanie explained. “We all know everybody’s secrets, which means they aren’t secrets. I grew up here and only left for my professional training.”
