“Ken?” Marissa called timidly. Both men looked up. They were in the process of eviscerating the corpse.
“Marissa, how are you!” Ken answered through his mask.
“Come on over here and meet the worst junior resident the Memorial has ever seen.”
“Thanks a lot,” Greg said.
Marissa advanced to the foot of the autopsy table. Ken formally introduced Greg to Marissa, changing his joking evaluation to one of high praise. Greg waved at Marissa with his scalpel.
“Interesting case?” Marissa asked to make conversation.
“They are all interesting cases,” Ken said.
“If I didn’t feel that way I would have gone into dermatology. Is this a social visit?”
“Hardly,” Marissa said.
“I was told you did a post on a woman by the name of Rebecca Ziegler.”
“Was that the woman who couldn’t fly?” Ken asked.
Spare me the pathology humor,” Marissa said.
“But yes, she was, the one who jumped from a sixth-story window.”
I did the post,” Greg said.
“Ken watched.”
“It was an interesting case-” Ken said.
“You just said they were all interesting,” Greg interrupted.
“All right, wise guy,” Ken said to Greg. Then to Marissa he said: “This was a particularly interesting case. The woman ruptured her aorta.”
“Did you look at the fallopian tubes?” Marissa asked. She wasn’t interested in gross injuries.
I looked at everything,” Greg said.
“What do you want to knol?”
“Did you look at the slides yet?” Marissa asked.
“Of course,” Greg said.
“She had granulornatous destruction of both tubes. I sent a bunch more slides off to be processed with various stains, but last time I looked they weren’t back yet.”
“If you’re curious whether they looked like those slides you showed me months ago,” Ken said, “they did. Exactly the same.
So our tentative diagnosis of her problem in her fallopian tubes was an old, resolved TB lesion. But of course, that was just an incidental finding. It didn’t have anything to do with her death.”
“You going to tell her about the other stuff?” Greg asked.
“What other stuff?” Marissa asked.
“Something that Greg and I have been mulling over,” Ken said.
“I’m not sure we should tell you.”
“What are you talking about?” Marissa insisted.
“Why wouldn’t you tell me? Come on, you’re making me curious.”
“We can’t make up our own minds,” Greg said.
“There are a couple of things that are bugging us.”
“Give me a try,” Marissa pleaded.
“Well, don’t say anything to anybody,” Ken said.
“I might have to discuss it with the medical examiner, and I don’t want him to hear it from anyone else first.”
“Out with it,” Marissa demanded.
“You can trust me.”
“Everybody thinks pathology is cut and dry,” Ken said evasively.
“You know, the last word, the final answer. But it ain’t so.
Not always. There are times when your intuition is telling you something even though you cannot document it categorically.”
“For chrissake, tell her,” Greg said.
“All right,” Ken said.
“We noticed that Rebecca Ziegler had a recent venipuncture in one of her arm veins.”
“Oh, for goodness’ sake!” Marissa said with exasperation.
“The woman was undergoing in-vitro fertilization. She was getting hormones and blood tests all the time. Is that what you’ve made this big buildup for? Please!”
Ken shrugged his shoulders.
“That’s part of it,” he said.
“If it were only that, we wouldn’t be concerned. We know she’d been stuck a lot of times over the last months. There were marks all over her body. But this stick gave the appearance of being done just before she died. That makes it suspect. So we decided to expand our toxicology screen to look for drugs other than the usual hormones. As pathologists we’re supposed to be suspicious.”
“And you found something?” Marissa asked with horror.
“Nope,” Ken said.
“Toxicology was clean. We’re trying a few other tricks, but so far nothing has turned up.”
“Is this some kind of joke?” Marissa said.
“No joke,” Ken said.
“The other part of the puzzle is that she only had a few hundred cc’s of blood in her chest.”
“Meaning..
“When someone ruptures an aorta there is usually a lot of blood in the chest,” Ken said.