“I’m aware of the policy,” Angie said. “How is she? Can we see her?”
The doctor held her gaze for a moment, then inhaled. “Come this way.” As she took them down the corridor, she glanced over her shoulder. “If you could turn your mobile phones off—they can interfere with equipment in the unit.” Angie and Holgersen powered off their phones as they entered the intensive care ward, and the doc led them to a room. She slid the glass door open.
They stepped inside. Machines beeped and hissed. Angie’s attention shot to the girl lying on the bed. Ventilator tubes were plastered to her mouth, and drips fed into her veins. Monitoring equipment was strapped to her arms, pasted to her chest. A loose dressing covered her brow. She was a brunette, young, and there was a strange tinge to her skin.
“She’s ... blue,” said Holgersen. “What’s with the color? That from cold?”
“Cyanosis,” Dr.Finlayson said quietly, her gaze upon her patient. “It can occur when the blood oxygen level drops too low. She had no heartbeat when she arrived. It’s a miracle she’s even alive. The next twenty-four hours will be telling. However, if she does manage to pull through, there will likely be permanent neurological damage. Of the near-drowning patients who do present without a heartbeat, thirty-five to sixty percent die in the emergency department, while almost all of those who do survive are left with permanent disabilities.”
Both Angie and Holgersen’s attention snapped sharply to the doc.
“Neardrowning?” said Angie. “What do you mean?”
“She’d been submersed in water. Usually when drowning begins, the larynx closes involuntarily, preventing both air and water from entering the lungs. In ten to twenty percent of cases, hypoxemia—a reduced concentration of oxygen in the blood—results because the larynx spasms and stays closed. This is called dry drowning. But in her case, it was wet. Her larynx released, and a small amount of water did enter her lungs.”
Angie stared at the doc, then turned to Holgersen. “Was she found near water?”
“No water bodies in Ross Bay Cemetery that I know of. Just the ocean across the road at the bottom end.”
“It wasn’t seawater,” the doc said. “The physiological mechanisms that produce hypoxemia in wet drowning are different for freshwater and saltwater. Freshwater in the lungs is pulled into pulmonary circulation by osmosis. Diluting the blood this way leads to the bursting of red blood cells. Potassium levels shoot sky-high and sodium levels plummet, which alters the electrical activity of the heart, usually causing ventricular fibrillation. This can cause cardiac arrest in two to three minutes. Saltwater, on the other hand, is hypertonic to blood. It does the opposite of fresh. Osmosis will instead pull water from the bloodstream into the lungs, thickening the blood. Which requires more work from the heart, leading to cardiac arrest in eight to ten minutes. No matter the saline content of the water, either way, technically, she could still drown,” Dr.Finlayson said.
Angie stepped closer to the bed, and her chest tightened. Just a kid. A girl all of maybe fifteen years old. Like Allison Fernyhough. Like Sally Ritter. Except this victim was slightly on the plump side. Her hair had been wiped back from her brow and held traces of dried blood. A loose dressing covered her brow. The skin around her mouth was raw, red.
Angie’s attention moved slowly down the body of the girl. Purplish ligature marks marred her neck and her wrists. Her nails had been ripped, a few torn right off. One of her fingers was in a metal cast. Cuts and contusions patterned her forearms. She’d fought. For her life.
“Can I see the wound on her brow?” Angie said quietly.
The doctor hesitated, and then her mouth tightened. Gently, she lifted the dressing.
The wound had been cleaned and sutured. And it was in the perfect shape of a crucifix, the bottom of the cross ending right between the girl’s eyebrows.
“Carved into her flesh with a fine-edged blade,” said Dr.Finlayson. “Like a razor or scalpel or box cutter. He pressed deep, right down to the brow bone.”
Angie stared, feeling hot. Fernyhough and Ritter had also been marked with a cross on their foreheads. Same size and shape as this one—the base of the cross terminating between the eyebrows. But theirs had been drawn onto their foreheads with red permanent marker ink. Not sliced into flesh.
Angie leaned forward to better examine the girl’s brow and hairline. Her pulse quickened as she found what she was looking for. “She’s had a lock of hair cut off, right at the center of her brow.”
“Dundurn was right,” Holgersen whispered. “He’s back, and he’s escalating.”
“Ifit’s him,” she snapped quickly under her breath. “I prefer to delay any speculation until we have hard evidence.”
“I’ll just keep my ignorant observations to myself, then,” he muttered.
“Signs of intercourse?” she said to the doctor. “This bastard leave any calling card?”
“Semen was not immediately apparent, but it was difficult to see because of the bleeding.” She met Angie’s gaze. “Her genitals were mutilated with a blade.” The doctor hesitated. Her eyes burned brighter. “She was circumcised.”
Angie felt blood drain from her face. “Meaning?”
“Clitoral hood, clitoral glans, and labia minora have been excised.”
Angie’s heart began to pound. “We’re going to need a detailed forensic exam,” she said quickly. “Photographs—”
“We photographically documented the mutilation while in surgery, Detective. We collected the fluids. We’ve taken blood samples, vaginal swabs, saliva, scrapings from under her nails. Now you need to do your job and find her next of kin before we lose her.” Her features tightened as she spoke, and Angie recognized the emotion in the doctor’s face for what it was—a quiet and barely controlled fury. It was an emotion Angie, with her own anger management issues, understood all too well. It was the same aggressive energy that drove her. It’s what had gotten her into the special victims unit. It’s what had her gunning for a promotion to the homicide team. “Promise me,” the doc said softly, almost below audible range. “Promise me that you’ll nail this bastard.”
Angie’s mouth turned dry. And it tasted bad—sour from the vodka she’d consumed earlier in the night.
The door behind them slid suddenly open, and a nurse poked her head into the room. “Dr.Finlayson, Dr.Nassim needs an urgent word.”
