“Is there a problem?” Vinnie asked. He’d stuck his head through the door.
“I’ll be there in a second,” Jack said.
Vinnie let the door close.
As long as he was there, Jack washed and regloved his hands. When he was finished he returned to the table.
“Let’s get this show on the road,” he said.
“I’ve looked the body over,” Clint said. “I don’t see anything that looks like an insect bite, do you?”
Jack had to restrain himself from subjecting Clint to a lecture like the one Clint had given to him. Instead, he merely proceeded with his external exam. Only after he’d finished did he speak.
“No gangrene, no purpura, and no insect bites as far as I can see,” Jack said. “But by just looking at her I can see some of her cervical lymph nodes are swollen.”
Jack pointed out the finding to Clint, who then nodded in agreement.
“That’s certainly consistent with plague,” Clint said.
Jack didn’t answer. Instead he took a scalpel from Vinnie and quickly made the typical Y-shaped autopsy incision. The bold cruelty of the move jolted Clint. He took a step back.
Jack worked quickly but with great care. He knew that the less the internal organs were disturbed, the less chance that any of the infecting microbes would be aerosolized.
When Jack had the organs out, he turned his attention first to the lungs. Calvin had drifted over at this point and towered behind Jack as he made his initial cuts into the obviously diseased organ. Jack spread open the lung like a butterfly.
“Lots of bronchopneumonia and early tissue necrosis,” Calvin said.
“Looks pretty similar to Nodelman.”
“I don’t know,” Jack said. “Seems to me there is an equal amount of pathology but less consolidation. And look at these nodal areas. They almost look like early granulomas with caseation.”
Clint listened to this pathological jargon with little interest or comprehension. He remembered the terms from medical school, but had long since forgotten their meaning. “Does it look like plague?” he asked.
“Consistent,” Calvin said. “Let’s look at the liver and the spleen.”
Jack carefully pulled these organs from the pan and sliced into them.
As he’d done with the lung, he spread open their cut surfaces so everyone could see. Even Laurie had stepped over from her table.
“Lots of necrosis,” Jack said. “Certainly just as virulent a case as with Nodelman or with the case I did earlier.”
“Looks like plague to me,” Calvin said.
“But why was the fluorescein antibody negative?” Jack said. “That’s telling me something, especially combined with the lung appearance.”
“What’s with the lungs?” Laurie asked.
Jack moved the liver and the spleen aside and showed Laurie the cut surface of the lung. He explained what he thought of the pathology.
“I see what you mean now that you mention it,” Laurie said. “It is different from Nodelman. His lungs definitely had more consolidation. This looks more like some sort of horribly aggressive TB.”
“Whoa!” Calvin said. “This isn’t TB. No way.”
“I don’t think Laurie was suggesting it was,” Jack said.
“I wasn’t,” Laurie agreed. “I was just using TB as a way of describing these infected areas.”
“I think it is plague,” Calvin said. “I mean, I wouldn’t if we hadn’t just had a case from the same hospital yesterday. Chances are it is plague regardless of what their lab said.”
“I don’t think it is,” Jack said. “But let’s see what our lab says.”
“How about double or nothing with that ten dollars,” Calvin said. “Are you that sure?”
“No, but I’ll take you up on it. I know how much the money means to you.”
“Are we finished here?” Clint asked. “If so, I think I’ll be going.”
“I’m essentially finished,” Jack said. “I’ll do a little more on the lymphatics, and then I’ll be obtaining samples for the microscopic. You won’t be missing anything if you take off now.”
“I’ll head out with you,” Calvin said.
Calvin and Clint disappeared through the door to the washroom.
“If you don’t think this case is plague, what do you think it is?” Laurie asked, looking back at the woman’s corpse.
“I’m embarrassed to tell you,” Jack said.