Pathogen Page 8

  Dr. Kellar continued with her official, verbal report.

  “Post-mortem exam of Roberta Sharon Sedlak, female, aged sixty-four. We’ll start with the external physical exam.”

  For a woman who seemed dumpy and unkempt, she was meticulous in her process. Kate watched as Dr. Kellar took photos, weighed the body, and gave a description of the woman’s skin, hair, eyes, and features. She began the physical exam at the crown of the woman’s head, working her way down, taking note of features and appearances, cataloguing this woman’s inconsistencies and imperfections in great detail. She gave a detailed description of the scar on the underside of the woman’s left breast, a result of a four-year-old lumpectomy. Dr. Kellar worked her way quickly down the body, talking only to herself, ignoring her audience. When she attempted to roll the body to examine the back, Kate reached over to assist, getting no acknowledgement. Once the external exam was complete, Dr. Kellar stood at the head of the table and picked up her scalpel.

  “What symptoms did the patient present with upon being admitted to the hospital?” Dr. Kellar said suddenly, addressing no one in particular. Kate looked quickly at Olivia, who merely widened her eyes slightly.

  “Influenza symptoms and respiratory distress,” Kate said.

  “What influenza symptoms? Be more specific,” Dr. Kellar barked.

  “Fever over forty degrees lasting more than four days, complaints of burning in the chest, coughing, muscle aches and pains, and extreme fatigue. Difficulty breathing, including pain when breathing, began at home approximately five hours before being admitted to hospital.”

  “ER treatment?”

  Kate gave a silent thanks for her memory, for her ability to access information quickly.

  “Nasal cannula of forty percent oxygen upon being admitted, chest x-ray confirmed fluid in the lungs, diuretics administered PO initially and then by IV along with steroids as symptoms progressed. Respiratory distress became acute and patient succumbed two days after being admitted. Cause of death ruled as rapid onset pulmonary edema without an identifiable cause.”

  “What was this woman’s occupation?”

  “Teacher, retired.”

  “Who brought her into the ER?”

  Kate quickly scanned the file in her head and came up blank. “I don’t know, but I’m sure I could find out if you think it’s relevant.”

  Dr. Kellar ignored the offer, seeming happier now that she’d found a question Kate couldn’t answer. She still held the scalpel poised over the body, staring at Kate. “And I always assumed she didn’t like people smarter than her.”

  Kate felt a rush of tight anger, hating the way Mona Kellar spoke so familiarly about Andy, still pretending she wasn’t even there. But Kate kept her silence.

  “Beginning internal examination at 9:57 a.m.,” Dr. Kellar said. She immediately sank her scalpel into the patient’s chest, drawing a swift, dark line from shoulder to shoulder, down her chest and stomach with a slight deviance to the left around the navel, stopping at the top of the pubic bone. She then very carefully used her scalpel to peel back the skin, muscle, and soft tissue connecting flesh to bone.

  As Kate watched the forensic pathologist working, she wondered at the woman’s choice of incision. Most coroners preferred the Y cut, giving them better access to the thoracic cavity. The T cut, as Dr. Kellar had just so expertly demonstrated, was used when the coroner was being particularly sensitive to the family. It was much easier to cover once the autopsy was complete. She didn’t have time to speculate on the motives behind the decision because Dr. Kellar was handing her a wicked set of gardening shears.

  “Dr. Morrison, the chest plate.”

  It was not a suggestion. It was a challenge.

  Kate took the shears, opening and closing them in her hand, getting the feel of them. Next she placed her left hand at the bottom of the exposed rib cage. Then she hesitated, hating the thought of asking for help but knowing it would be disastrous to get it wrong.

  “Lateral incision on both sides of the chest, approximately six inches from the centre sternal line?” she asked, keeping her eyes on the rib cage.

  “That’s right.” Dr. Kellar’s voice had changed. It was lower, creepier. “Cut away, Dr. Morrison.”

  Kate cut. Her movements were careful but strong, feeling the give of tissue and bone through the instrument into her fingers, her wrist, her arms. She was sweating slightly by the time she’d finished one side. Without asking, she moved to the other side of the table. Dr. Kellar did not give Kate any extra space. Kate tried to ignore the crawling of her skin at having to work so closely to this woman. She focused on the task in front of her, trying not to sigh with relief as she finished, taking her original position across the table.

  She was thankful Dr. Kellar had taken over again, starting the delicate task of removing any soft tissue that had adhered to the underside of the chest plate before removing it all in one piece. Kate looked into the dead woman’s chest cavity. It had been years since she’d seen the heart and lungs so clearly displayed in their predictable, orderly manner. She could see immediately in front of her what she had seen in the x-rays, swollen tissue from fluid build-up and inflammation of the pleural space. A very neat presentation of pulmonary edema.

  Dr. Kellar, however, was frowning down into the chest cavity, her hands still against the table. She bent over the body, seeming to whisper to herself. Kate caught Olivia’s eye. The nurse shrugged imperceptibly. Finally, Dr. Kellar picked up a large gauge needle and a vial, pulling fluid from various spots on the lung, using a sterile swab to pick up the leaking pleural fluid, and dropping that into an encased capsule before handing them all silently to Olivia, who carefully jotted down the appropriate information.

  Kate had a hundred questions, but kept silent. This was not a teaching case, and she knew at the very least she would get the autopsy report. Instead she watched the proceedings, letting no detail go by unnoticed, absorbing every move that Dr. Kellar made and committing it to memory so she could take them out later and sort through relevant information. The only sound was that of the faint, wet tearing of flesh and of Dr. Kellar’s almost constant stream of barely audible self-talk. She spent the most time in the chest cavity, working on the lungs before moving to the heart. After about three hours, as Dr. Kellar was removing and weighing the other vital organs, Kate stretched her back, feeling the strain of standing in one position for so long. She knew immediately it was a mistake.

  “Get out if you can’t handle the physical strain of simply standing up, Dr. Morrison,” Dr. Kellar said, her voice harsh in the silence.

  Kate bit the inside of her cheek, fighting the acid retorts that came quickly to her lips. She didn’t say a word. Dr. Kellar turned to Olivia.

  “Get me some water. From the fridge,” she ordered, and Olivia left the room quickly.

  Kate’s stomach plummeted uncomfortably as Dr. Kellar reached up to turn off the microphone. She could swear she felt Andy tense also, even across the room.

  “Tell me how you met,” Dr. Kellar said, in the same demanding tone she’d just used with the nurse.

  “No.” Kate attempted to infuse as much neutrality as possible into the refusal.

  Dr. Kellar smiled. “You haven’t looked at her once in the last four hours. Why is that?”

  Kate said nothing, wishing Olivia would hurry back. The audience didn’t seem to stop Dr. Kellar from trying to make Kate uncomfortable, but at least she provided some type of outside witness.

  “Did you have sex with her this morning? I know you’re sharing a room. So it would be RCMP-sanctioned sex, wouldn’t it? Though according to my sources, it wouldn’t be the first time.”

  Kate could feel the flush of anger and embarrassment rise in her cheeks and tried to force it back down. She had nowhere to look—not at Dr. Kellar dominating her view and not at Andy, standing by the door. Thankfully, at that moment, Olivia walked back in with three frosted bottles of water. She offered one to Andy, who refused with a shake o
f her head, then another to Kate, and the third to Dr. Kellar, who did not take her eyes off Kate’s face as she opened it and drank half of the contents in one loud gulp. Kate, taking small sips from the water bottle, could see Andy out of the corner of her eye, back ramrod straight, shoulders squared. In her mind’s eye, Kate could also see the tightness of her jaw, the hard lines around her eyes. As Dr. Kellar threw her water bottle into the garbage and picked up her scalpel again, Kate forced her attention away from Andy. There was nothing she could do.

  Another two hours, and Kate’s eyes were getting dry. The back of her legs ached from standing for so long, and hunger rolled in her stomach. Dr. Kellar gave her closing observations into the microphone and asked the nurse to close up. Dr. Kellar stretched her back and shoulders, rotated her head, flexed her wrists. Kate resisted the urge to copy her, somehow knowing it would only invite more derision. She waited to be dismissed, feeling a sudden surge of empathy for her med students back at Van East.

  “What’s your conclusion, Dr. Morrison?”

  The question caught Kate off guard. Dr. Kellar hadn’t asked her opinion once in the almost six hours they’d been here. It was another test, another challenge.

  “I saw pulmonary edema from an infection, primary or secondary, I don’t know. I’d want Public Health to run the tests, though.”

  “Assholes,” Dr. Kellar said. “We’ll meet to discuss my findings tomorrow.” She pulled off her gloves, snapping them in the silence, and then removed her apron and gown, tinged brown now with bodily fluid. She then carried them across the room and Kate watched as she approached the door and deposited them into the bypass waste bin. Then she crossed to Andy, turned to make sure Kate was watching them, and whispered something in her ear. Andy kept her eyes ahead, not acknowledging her presence. Dr. Mona Kellar then left the room.

  As the door swung silently closed behind her, Kate let out the first real breath she’d felt since the autopsy started. As she began to remove her own gloves and gown, she studied Andy’s face. Her eyes were guarded, her jaw tense. Kate sighed and turned to the technician.

  “Do you need my help to finish up?” she asked.

  Olivia smiled and looked up from where she was putting in careful stitches. “No, but thanks for asking. That was an interesting autopsy,” she said, her eyebrows raised.

  Kate gave her a knowing smile but said nothing.

  Moments later they were out in the fresh air, leaving the autopsy room and the bodies and the fluid and the awfulness of the last few hours behind them. Kate shuddered, wishing that she could shower, find some way to rid herself of what had just happened. Kate walked as close as possible to Andy, feeling reassurance just from the brush of Andy’s sleeve against hers. They stopped at the hospital coffee shop, ordering overpriced sandwiches and large coffees before carrying them to the small meeting room Kate had taken over as her temporary office.

  Once they were inside, doors closed and blinds drawn, Kate sat down with a loud sigh. It felt amazing to be off her feet. As she unwrapped her sandwich and bit into it, she watched Andy remove the lid of her coffee, her sandwich untouched on the table.

  “Not hungry?” Kate said. It was the first thing she’d said to her since getting out of the car this morning, and it seemed inadequate.

  “Yes and no.”

  In all the chaos of the morning, the phone call to Finns, and the last-minute warnings about Mona Kellar, Kate had forgotten that Andy had just witnessed her first autopsy. And she’d been nervous.

  “You okay?”

  “Shouldn’t I be asking you that?” Andy said. Kate could hear the self-recrimination in her tone.

  “Me? I’m fine. Still hungry though. So, if you’re not going to eat your sandwich, pass it over.”

  Andy shook her head, relaxing her shoulders a fraction. She tossed Kate the sandwich. Kate unwrapped it and took a huge bite.

  Andy laughed. “You’re unbelievable.”

  “Years of practice,” Kate said through her mouthful. “You’ll be hungry in a few hours, trust me.”

  They were silent. Kate made short work of the sandwich while Andy took tentative sips of her coffee.

  “You’ll tell me later, right?” Kate asked, her voice lowered.

  Andy nodded, her eyes darkening. “Yes, everything.”

  With her belly full, and her legs and back no longer screaming their complaints, Kate let her mind free flow with the information from the last two days. She put aside the issues of politics and inflammatory media reports. She put aside, for now, whatever history Andy had with Dr. Kellar. Kate thought about the autopsy, the questions about infection and influenza. She looked at the charts, stacked neatly in the corner.

  “Do you have to be anywhere this afternoon?” Kate asked Andy, relieved to see a small amount of colour returning to Andy’s pale face.

  “No. Why?”

  “Can you help me sort through charts, then?”

  “Is this because you need my help or you think I need to keep occupied?”

  “Both,” Kate said. She stood up and brought the pile of charts over to the table, depositing them in front of Andy before dropping into the chair beside her.

  “Okay, what am I looking for?”

  “Any mention of fatigue or muscle ache unrelated to injury goes in this pile. Everything else goes over here.”

  The next hour was quiet, a relaxed quiet, a stress-free quiet. They sorted through paperwork, through charts, scanning pages of symptoms and complaints, searching for commonalities. As she picked up one of the last charts, she noticed something. She looked at the piles in front of them, each chart neatly labeled with the patient’s name.

  “I need you to do something for me,” Kate said suddenly.

  “What?”

  “I need a circle of people. If this is truly influenza, then those closest to the patients are at the highest risk of getting sick. That includes siblings, parents, partners, and coworkers. I want to know if any of them got sick, even an unreported illness.” Kate watched Andy pull out her notepad and scrawl some notes. “I don’t need it now, not even today. Maybe tomorrow, with Ferris?”

  “Sure, I can do that. Anything else?”

  “We’re going to need to put pressure on Public Health. Failing that, do you think the hospital or Cardiff could get some kind of independent lab to take results?”

  Andy rolled her eyes. “I’m sure he’d be delighted at the opportunity to throw his weight around.”

  “Let’s wait and see what Kellar says tomorrow.”

  The name brought instant tension back into the room, and Kate shook her head, annoyed at herself. “Sorry.”

  “Don’t be. I’ll feel better once you know what’s going on.”

  Kate looked at the stacks in front of them. “Three more charts, then we’re out of here.”

  The day outside had gone from cool to warm and was heading back down to cold again when Kate and Andy pulled into a deserted rest stop at the side of the highway. They’d stopped at a posh little grocery store in town and picked up some food, including breakfast for the next morning. They made their way back through the trees until they found a damp wooden picnic table where they set down their food. Andy opened her take-out container of squash and cheese ravioli, and as the smell hit her, Kate kicked herself for saying she wasn’t hungry. She was. Again. Andy popped two in her mouth and chewed slowly. Apparently her appetite was back.

  “Good?” Kate asked.

  Andy only nodded as she scooped up two more. Kate looked around, the trees swaying above them, the sky darkening into twilight. They probably only had another forty-five minutes until sunset. Kate wondered if it was enough time to hear Andy’s story. She tried not to stare at Andy’s dinner.

  “I shouldn’t tease you.” Andy pulled a second fork out of the bag and pushed the oversized container into the centre of the table. “I have no idea how you can eat so much and not gain weight.”

  Kate stuffed two of the raviolis into her mouth. God, they wer
e good. “High stress job and a sexy girlfriend. You should try it.”

  “I do. Daily,” Andy said.

  They ate in silence, listening to the wind, happy to be alone together.

  “Should I start?” Andy finally asked, putting down her fork.

  “Yes.”

  “I had just graduated Depot and had been a rookie with E-Division about three months when I first came across Mona Kellar. She was consulting on a high profile double homicide. The investigation was long and involved, so she was around headquarters a lot. I wasn’t on the case because I was too new, but my mentor, Lincoln, was connected to it. I was shadowing him most of the time.” Andy stopped and took a sip of water and Kate watched her eyes darken. “After Dr. Kellar and I were first introduced, she started talking to me all the time, seeking me out at work, waiting for me in the parking lot after my shift. I was twenty-four, she was in her forties. Time hasn’t improved her all that much.”

  “Did she know you were gay?”

  “Yeah, I guess. It wasn’t something I ever hid.”

  “Is she gay?”

  “She’s a predator,” Andy said. “She’ll jump on anything that moves.”

  Kate got a mental image of this, and she shuddered reflexively.

  “Exactly,” Andy said. “Her attention got worse, people started talking, and I just tried to avoid her as much as possible. One night I’d stayed late trying to finish something for Lincoln, and she was waiting for me at my car. She came onto me strong and tried to kiss me. When I stopped her, she got angry. Really angry. Told me if I didn’t sleep with her, she would lodge a sexual harassment complaint against me, saying I had made inappropriate advances. Mona Kellar made it perfectly clear that if I didn’t have sex with her, my career would be over before it had started.”