Chapter 14
14
“A call just came from the ER.”
Cora looked over as Janice walked to the board on the wall and wrote the name of the body heading to the morgue. Her hospital cell phone rang almost immediately. “Mortuary. Dr. Wadsworth speaking.”
“Cora? It’s Dan Lyles in the ER. We’ve got a situation with the body being sent to you. Sixty-nine-year-old man. Farmer. According to the wife, her husband was dead in the kitchen when she got home from shopping in Virginia Beach with her daughter. He was transported here by ambulance. He was declared DOA by me. According to his wife, there was no documented history of cardiac abnormalities or dysfunction. The wife is distraught, and the son has already called the funeral home. The man’s sister came in and approached me privately. She wants an autopsy. She says there’s something fishy going on. And those were her words.”
“Thanks, Dan. I’ll deal with it. I know you’ll document the sister’s concerns. Once he gets down here—” Her attention darted to the door where a gurney was being rolled in. “Looks like he’s here.”
“Christ,” the ER doctor groaned. “The sister and wife have just started yelling in the ER waiting room. Security is stepping in.”
“Tell security to deal with them and keep them away from my area. We won’t open the door to anyone without an invite. I’ll check the medical records and talk to his physician.”
It didn’t take long to get the local general practitioner on the phone. He verified that the patient didn’t have a history of heart disease. “But then he was sixty-nine. His wife kept telling him the farm would kill him.”
“Do you have any concerns about the cause of death?” she asked.
The physician hesitated. “Well, there was a ruckus when they were here last month.”
“A ruckus?”
“When I gave him a clean bill of health based on just an annual physical exam, he told his wife that he was going to keep farming. She got angry and started yelling about him going back on his word to sell the farm. It got so bad that my receptionist had to threaten them to take their argument somewhere else or she’d call the police.”
After obtaining a little more information, she thanked the doctor and disconnected the call. Dialing Dan, she said, “I’ll start the postmortem immediately.”
“You can get to him now?”
“I have no other postmortem on the board now. I won’t be able to say that if I wait. I’ll let you know what I find.”
“Thanks, Cora. My notes are now in the electronic chart.”
Disconnecting, she typed on her keyboard to pull up the records. Dan and she had gone out to dinner several times after she’d moved to the shore, but there was no spark for either of them. They remained friends, and they worked efficiently together.
Scanning through the information, she absorbed the notes. Possible myocardial infarction. Dan added that the man’s sister claimed he’d never felt better when he celebrated his birthday last month. She stated someone wanted him dead because he’d also said he was keeping the farm instead of retiring and selling it. The sister also claimed that news upset his wife.”
Cora looked at the blood work, and while nothing showed up on the typical panel, she knew secrets wouldn’t stay hidden from the toxicology she ran.
Dan was an excellent ER physician, and she understood his position. He wasn’t able to say definitively that there was a suspicious death, but with a family member voicing her concerns, he easily turned the decision over to Cora. And she had never shied away from doing what was necessary to ensure the questions surrounding death were answered.
“What do you think?” Carl said, moving to stand beside her as she looked over the results an hour later.
She scooted her chair back and clipped, “Suit up.”
He grinned, and she shook her head with a rueful understanding. It was hard to explain to someone not in the field, but investigating the human body and searching for indications of how they lived and died was what they had studied for, trained for, and worked for.
“Janice, get the body prepped. We’ll begin now.”
An hour later, she had removed organs, examined the entire body, given tissue for Janice to prepare slides, and run lab tests. As she examined his heart, it was obvious to her that the ventricles and septum were enlarged and thick with scarred tissue.
Cora dictated her findings as she completed the autopsy. It allowed her to work hands-free and gave her assistants instructions. “The septum has bulged into the left ventricle and partially blocked the blood flow to the body. The left ventricle is smaller and stiff.” She looked at David, her intern, and then handed the organ to him. “Can you feel that?”
“Yes,” he acknowledged, his eyes never leaving his task.
“You will also note the fluid buildup in the lungs. That’s because hypertrophic cardiomyopathy can also affect how the mitral valve works, increasing ventricular pressure. This can cause fluid to build up in the lungs.”
David looked at the large computer screen mounted on a rolling cart nearby. “His family doctor didn’t note any abnormal heart rhythms.”
“True, therefore the patient wasn’t referred for any in-depth cardiology tests,” Cora said while nodding.
“So…” David said slowly as though weighing his words. “His death could be entirely natural based on the information we have.”
She didn’t respond but held his gaze with an impassive expression, wanting to see what he would conclude.
He licked his bottom lip and added, “But the sister’s concerns cannot be dismissed, and we don’t have the toxicology report. That would give us the information needed to see if the HCM was the cause of death or something that hastened the process.”
A smile graced her lips even though no one would see it behind her surgical mask. “That’s right. In a case like this, the simplest answer may not be correct. The labs will give us what we need.”
She detected a sigh of relief escaping his lips from how his mask puffed slightly, and her smile widened. She loved having an intern or resident who felt the tickle of suspicion and the desire to investigate thoroughly.
After they completed the postmortem, she stepped back and snapped her gloves off. Jerking her mask down, she inhaled deeply. The cold air in the mortuary was welcome after breathing through the mask. She moved to see her dictated recordings already printed for her to review.
“What about the family?” Carl asked. “They’ve called down several times.”
“Have security send them down. Separately. I want to speak to the sister first.”
“Will do.” Carl moved away to place the call while Cora shed her PPE suit and pulled on her white lab coat. She went to the ladies’ room, returned, and sipped her now-cold coffee. When Carl gave her a nod, she went down the hall to the conference room.
Entering the room, Cora noticed the woman sitting at the table didn’t appear nervous. Instead, her red-rimmed eyes held a hard glint. She steadily held Cora’s gaze. “I’m Dr. Wadsworth, the medical examiner, and this meeting is being recorded?—”
“Did you do an autopsy?”
“And you are…?”
The woman tucked a wayward strand of hair behind her ear. “Debra. Debra Marshall. I’m Roy’s sister.”
“I’m sorry for your loss, Ms. Marshall. And, yes, I performed the postmortem.”
“Oh, thank God,” Debra said, a long exhalation releasing from her lungs.
“I understand that Mr. Parker’s wife and you disagreed on the situation surrounding his death.”
“She’s all religious, claiming God just took Roy when it was his time. Now, I’m religious, too, mind you. But I don’t… I just… something isn’t right. He wasn’t on medication for his heart and felt great. He decided not to retire from farming and wanted to keep working the farm that’s been in the family. His wife, Sharon, was livid. She kept saying he was ruining their chance to take the money from selling and finally live without having to scrimp and save all the time.”
“And he had no physical complaints at the time?”
“Nope. Said he felt strong as a horse. He even brought their preacher over to pray about the situation since his Sharon was pouting somethin’ fierce. I thought he looked ill about a week ago, but Sharon just said that God was reminding Roy that he wasn’t taking his health seriously. Since then, he’s felt poorly.”
“And you suspect something caused his ill health besides normal conditions?”
Debra’s lips pinched together momentarily, and then her shoulders slumped as her whole body seemed to curl inward. “I don’t know. I really don’t. Maybe I’ve watched too many damn cop shows. Or maybe Sharon has gone from a good friend of mine many years ago… someone I loved being with my brother, to a person I hardly know. When I talk to her about her bitchy moods, she claims it’s just menopause.” She rubbed her hand over her face, swiping at the tears running down her cheeks. “Maybe it is. Maybe I’m the crazy one.”
“Well, along with your suspicions, I talked to his physician, who concurred that he didn’t have a diagnosed heart condition. I have completed a postmortem. When you say your brother was feeling poorly, what did you mean? Can you give me specific symptoms?”
“He’s always had a strong constitution, but his stomach was increasingly upset. Sharon said it was stress from working the farm too much. Sometimes he’d come in complaining of feeling dizzy or lightheaded. And when he’d be out working, he sweat a lot more than he used to. Other times, he felt weak.”
Cora continued questioning the sister, documenting her concerns and noting her observations. With sympathies given again, she watched as the sister was escorted out of the mortuary before asking to see the wife.
Sharon Parker walked in with fire in her eyes and a rigid set to her jaw. She had the slightly disheveled appearance of someone who had rushed to the emergency room, but instead of a devastated, grieving widow, the woman before her was ready for a fight.
Cora had barely expressed her condolences and informed Sharon that their session was being recorded when the woman slammed her hands down on the table.
“What did you do to my Roy? Did you cut him up?”
“Mrs. Parker, a postmortem was conducted?—”
“I’m going to contact my lawyer! No one gave you the right to do that to my husband! I’ll have your medical license and sue this hospital!”
“Mrs. Parker, I understand you’re upset. As the medical examiner, I have the authority to order an autopsy if the death is deemed suspicious, sudden, or unexplained.”
“What on earth was suspicious about a man his age having a heart attack? This was just an effort for the hospital to get more money! Well, I’m not paying for it. And I’ll tell my insurance company not to pay for it either! And then I’m going to contact my attorney!”
“Your husband did not have documented heart disease. I spoke with his physician and the attending ER physician. With a family member stating to the attending ER physician that they suspected something else was wrong, I deemed it necessary for an autopsy to give us an understanding of his death.”
The woman burst into tears as her hands clasped together as they pressed against her chest. “I can’t believe you did this to my husband. He was a good man. Kind. And you… you… I can’t even say it. What you did to him was so horrid!”
“It is my and my office’s duty to treat your husband’s body with the utmost respect and care. We have finished the postmortem and will wait for any lab results to give us the information we need.”
“What did you find?” she demanded.
“We found evidence of heart damage.”
“See! See! I knew it! There was no reason for this!”
“There are other tests, such as the toxicology report, that we’ll have to wait on. Once pathology is done, then we will have a clearer picture of precisely what caused your husband’s death.” Cora kept her voice calm and her words succinct.
Sharon glanced at Cora and quickly dropped her gaze to the table, where her clasped hands were now clenched so tightly that the skin around her knuckles was white.
Cora continued, “While you are certainly within your rights to request a review of the procedures and consult your attorney, you will find that the law protects my duty as the medical examiner to ensure we understand what has happened.”
Sharon stood quickly and mumbled as she threw open the door and walked out.
Cora sighed heavily, clicked off the recording device, and stood. She had barely reached the door when she stopped suddenly and looked up at the man standing so closely.
“Dan! I’m sorry. I didn’t hear you.”
He placed his hands on her shoulders and bent slightly to hold her gaze.
“I just wanted to make sure you were okay. I had a break and thought I would come down. I saw the wife leave, so I suppose that was an unpleasant conversation.”
“Not the first unpleasant conversation I’ve ever had, and certainly not as bad as a few others. I interviewed the sister first, who agreed that the postmortem was necessary.”
“Is there anything I can do? I need to head back up to the ER, but I’d like to keep tabs on what’s happening with this case and you.”
She shook her head. “I’m good. But thanks for checking on me.”
His hands dropped from her shoulders, and he smiled. A throat clearing near the end of the hall caused them to turn to see who was there. Her eyes widened at the sight of Jeremy. She smiled, then her gaze dropped to the spark in his eyes and the tic in his jaw. She tilted her head to the side. “Detective Pickett. What brings you here today?”
His gaze moved from Dan down to her, and she could have sworn the fiery spark softened, and his lips quirked upward on one side.
“Well, Dr. Wadsworth. How about lunch?”