Read an Excerpt
Dr. Maura Isles had not smelled fresh air all day. Since seven that morning she had been inhaling the scent of death, an aroma so familiar to her that she did not recoil as her knife sliced cold skin, as foul odors wafted up from exposed organs. The police officers who occasionally stood in the room to observe postmortems were not so stoic. Sometimes Maura caught a whiff of the Vicks ointment that they dabbed in their nostrils to mask the stench. Sometimes even Vicks was not enough, and she’d see them suddenly go wobbly and turn away, to gag over the sink. Cops were not accustomed, as she was, to the astringent bite of formalin, the sulfurous aroma of decaying membranes.
Today, there was an incongruous note of sweetness added to that bouquet of odors: the scent of coconut oil, emanating from the skin of Mrs. Gloria Leder, who now lay on the autopsy table. She was fifty years old, a divorcee with broad hips and heavy breasts and toenails painted a brilliant pink. Deep tan lines marked the edges of the bathing suit she had been wearing when she was found dead beside her apartment swimming pool. It had been a bikini—not the most flattering choice for a body sagging with middle age. When was the last time I had the chance to put on my bathing suit? Maura thought, and she felt an absurd flash of envy for Mrs. Gloria Leder, who’d spent the last moments of her life enjoying this summer day. It was almost August, and Maura had not yet visited the beach or sat by a swimming pool or even sunbathed in her own backyard.
“Rum and Coke,” said the young cop standing at the foot of the table. “I think that’s what she had in her glass. It was sitting next to her patio chair.”
This was the first time Maura had seen Officer Buchanan in her morgue. He made her nervous, the way he kept fussing with his paper mask and shifting from foot to foot. The boy looked way too young to be a cop. They were all starting to look too young.
“Did you retain the contents of that glass?” she asked Officer Buchanan.
“Uh . . . no, ma’am. I took a good whiff. She was definitely drinking a rum and Coke.”
“At nine A.M.?” Maura looked across the table at her assistant, Yoshima. As usual, he was silent, but she saw one dark eyebrow tilt up, as eloquent a comment as she would get from Yoshima.
“She didn’t get down too much of it,” said Officer Buchanan.
“The glass was still pretty full.”
“Okay,” said Maura. “Let’s take a look at her back.”
Together, she and Yoshima log-rolled the corpse onto its side.
“There’s a tattoo here on the hip,” noted Maura. “Little blue butterfly.”
“Geez,” said Buchanan. “A woman her age?”
Maura glanced up. “You think fifty’s ancient, do you?”
“I mean—well, that’s my mom’s age.”
Careful, boy. I’m only ten years younger.
She picked up the knife and began to cut. This was her fifth postmortem of the day, and she made swift work of it. With Dr. Costas on vacation, and a multivehicle accident the night before, the cold room had been crammed with body bags that morning. Even as she’d worked her way through the backlog, two more bodies had been delivered to the refrigerator. Those would have to wait until tomorrow. The morgue’s clerical staff had already left for the evening, and Yoshima kept looking at the clock, obviously anxious to be on his way home.
She incised skin, gutted the thorax and abdomen. Removed dripping organs and placed them on the cutting board to be sectioned. Little by little, Gloria Leder revealed her secrets: a fatty liver, the telltale sign of a few too many rums and Cokes. A uterus knobby with fibroids.
And finally, when they opened the cranium, the reason for her death. Maura saw it as she lifted the brain in her gloved hands. “Subarachnoid hemorrhage,” she said, and glanced up at Buchanan. He was looking far paler than when he had first walked into the room. “This woman probably had a berry aneurysm—a weak spot in one of the arteries at the base of the brain. Hypertension would have exacerbated it.”
Buchanan swallowed, his gaze focused on the flap of loose skin that had been Gloria Leder’s scalp, now peeled forward over the face. That’s the part that usually horrified them, the point at which so many of them winced or turned away—when the face collapses like a tired rubber mask.
“So . . . you’re saying it’s a natural death?” he asked softly.
“Correct. There’s nothing more you need to see here.”
The young man was already stripping off his gown as he retreated from the table. “I think I need some fresh air . . .”
So do I, thought Maura. It’s a summer night, my garden needs watering, and I have not been outside all day.
But an hour later she was still in the building, sitting at her desk reviewing lab slips and dictated reports. Though she had changed out of her scrub suit, the smell of the morgue still seemed to cling to her, a scent that no amount of soap and water could eradicate, because the memory itself was what lingered. She picked up the Dictaphone and began to record her report on Gloria Leder.
“Fifty-year-old white woman found slumped in a patio chair near her apartment swimming pool. She is a well-developed, wellnourished woman with no visible trauma. External exam reveals an old surgical scar on her abdomen, probably from an appendectomy. There is a small tattoo of a butterfly on her . . .” She paused, picturing the tattoo. Was it on the left or the right hip? God, I’m so tired, she thought. I can’t remember. What a trivial detail. It made no difference to her conclusions, but she hated being inaccurate.
She rose from her chair and walked the deserted hallway to the stairwell, where her footfalls echoed on concrete steps. Pushing into the lab, she turned on the lights and saw that Yoshima had left the room in pristine condition as usual, the tables wiped down and gleaming, the floors mopped clean. She crossed to the cold room and pulled open the heavy locker door. Wisps of cold mist curled out. She took in a reflexive breath of air, as though about to plunge into foul water, and stepped into the locker.
Eight gurneys were occupied; most were awaiting pickup by funeral homes. Moving down the row, she checked the tags until she found Gloria Leder’s. She unzipped the bag, slipped her hands under the corpse’s buttocks and rolled her sideways just far enough to catch a glimpse of the tattoo.
It was on the left hip.
She closed the bag again and was just about to swing the door shut when she froze. Turning, she stared into the cold room.
Did I just hear something?
The fan came on, blowing icy air from the vents. Yes, that’s all it was, she thought. The fan. Or the refrigerator compressor. Or water cycling in the pipes. It was time to go home. She was so tired, she was starting to imagine things.
Again she turned to leave.
Again she froze. Turning, she stared at the row of body bags. Her heart was thumping so hard now, all she could hear was the beat of her own pulse.
Something moved in here. I’m sure of it.
She unzipped the first bag and stared down at a man whose chest had been sutured closed. Already autopsied, she thought. Definitely dead.
Which one? Which one made the noise?
She yanked open the next bag, and confronted a bruised face, a shattered skull. Dead.
With shaking hands she unzipped the third bag. The plastic parted, and she saw the face of a pale young woman with black hair and cyanotic lips. Opening the bag all the way, she exposed a wet blouse, the fabric clinging to white flesh, the skin glistening with chilly droplets of water. She peeled open the blouse and saw full breasts, a slim waist. The torso was still intact, not yet incised by the pathologist’s knife. The fingers and toes were purple, the arms marbled with blue.
She pressed her fingers to the woman’s neck and felt icy skin. Bending close to the lips, she waited for the whisper of a breath, the faintest puff of air against her cheek.
The corpse opened its eyes.
Maura gasped and lurched backward. She collided with the gurney behind her, and almost fell as the wheels rolled away. She scrambled back to her feet and saw that the woman’s eyes were still open, but unfocused. Blue-tinged lips formed soundless words.
Get her out of the refrigerator! Get her warm!
Maura shoved the gurney toward the door but it didn’t budge; in her panic she’d forgotten to unlock the wheels. She stamped down on the release lever and pushed again. This time it rolled, rattling out of the cold room into the warmer loading area.
The woman’s eyes had drifted shut again. Leaning close, Maura could feel no air moving past the lips. Oh Jesus. I can’t lose you now.
She knew nothing about this stranger—not her name, nor her medical history. This woman could be teeming with viruses, yet she sealed her mouth over the woman’s, and almost gagged at the taste of chilled flesh. She delivered three deep breaths, and pressed her fingers to the neck to check for a carotid pulse.
Am I imagining it? Is that my own pulse I feel, throbbing in my fingers?
She grabbed the wall phone and dialed 911.
“This is Dr. Isles in the medical examiner’s office. I need an ambulance. There’s a woman here, in respiratory arrest—”
“Excuse me, did you say the medical examiner’s office?”
“Yes! I’m at the rear of the building, just inside the loading bay. We’re on Albany Street, right across from the medical center!”
“I’m dispatching an ambulance now.”
Maura hung up. Once again, she quelled her disgust as she pressed her lips to the woman’s. Three more quick breaths, then her fingers were back on the carotid.
A pulse. There was definitely a pulse!
Suddenly she heard a wheeze, a cough. The woman was moving air now, mucus rattling in her throat.
Stay with me. Breathe, lady. Breathe!
A loud whoop announced the arrival of the ambulance. She shoved open the rear doors and stood squinting against flashing lights as the vehicle backed up to the dock. Two EMTs jumped out, hauling their kits.
“She’s in here!” Maura called.
“Still in respiratory arrest?”
“No, she’s breathing now. And I can feel a pulse.”
The two men trotted into the building and halted, staring at the woman on the gurney. “Jesus,” one of them murmured. “Is that a body bag?”
“I found her in the cold room,” said Maura. “By now, she’s probably hypothermic.”
“Oh, man. If this isn’t your worst nightmare.”
Out came the oxygen mask and IV lines. They slapped on EKG leads. On the monitor, a slow sinus rhythm blipped like a lazy cartoonist’s pen. The woman had a heartbeat and she was breathing, yet she still looked dead.
Looping a tourniquet around one flaccid arm, the EMT asked: “What’s her story? How did she get here?”
“I don’t know anything about her,” said Maura. “I came down to check on another body in the cold room and I heard this one moving.”
“Does this, uh, happen very often here?”
“This is a first time for me.” And she hoped to God it was the last.
“How long has she been in your refrigerator?”
Maura glanced at the hanging clipboard, where the day’s deliveries were recorded, and saw that a Jane Doe had arrived at the morgue around noon. Eight hours ago. Eight hours zipped in a shroud. What if she’d ended up on my table? What if I had sliced into her chest? Rummaging through the receiving in-basket, she found the envelope containing the woman’s paperwork. “Weymouth Fire and Rescue brought her in,” she said. “An apparent drowning . . .”
“Whoa, Nelly!” The EMT had just stabbed an IV needle into a vein and the patient suddenly jerked to life, her torso bucking on the gurney. The IV site magically puffed blue as the punctured vein hemorrhaged into the skin.
“Shit, lost the site. Help me hold her down!”
“Man, this gal’s gonna get up and walk away.”
“She’s really fighting now. I can’t get the IV started.”
“Then let’s just get her on the stretcher and move her.”
“Where are you taking her?” Maura said.
“Right across the street. The ER. If you have any paperwork they’ll want a copy.”
She nodded. “I’ll meet you there.”
A long line of patients stood waiting to register at the ER window, and the triage nurse behind the desk refused to meet Maura’s attempts to catch her eye. On this busy night, it would take a severed limb and spurting blood to justify cutting to the front of the line, but Maura ignored the nasty looks of other patients and pushed straight to the window. She rapped on the glass.
“You’ll have to wait your turn,” the triage nurse said.
“I’m Dr. Isles. I have a patient’s transfer papers. The doctor will want them.”
“The woman they just brought in from across the street.”
“You mean that lady from the morgue?”
Maura paused, suddenly aware that the other patients in line could hear every word. “Yes,” was all she said.
“Come on through, then. They want to talk to you. They’re having trouble with her.”
The door lock buzzed open, and Maura pushed through, into the treatment area. She saw immediately what the triage nurse had meant by trouble. Jane Doe had not yet been moved into a treatment room, but was still lying in the hallway, her body now draped with a heating blanket. The two EMTs and a nurse struggled to control her.
“Tighten that strap!”
“Shit—her hand’s out again—”
“Forget the oxygen mask. She doesn’t need it.”
“Watch that IV! We’re going to lose it!”
Maura lunged toward the stretcher and grabbed the patient’s wrist before she could pull out the intravenous catheter. Long black hair lashed Maura’s face as the woman tried to twist free. Only twenty minutes ago, this had been a blue-lipped corpse in a body bag. Now they could barely restrain her as life came roaring back into her limbs.
“Hold on. Hold on to that arm!”
The sound started deep in the woman’s throat. It was the moan of a wounded animal. Then her head tilted back and her cry rose to an unearthly shriek. Not human, thought Maura, as the hairs stood up on the back of her neck. My god, what have I brought back from the dead?
“Listen to me. Listen!” Maura commanded. She grasped the woman’s head in her hands and stared down at a face contorted in panic. “I won’t let anything happen to you. I promise. You have to let us help you.”
At the sound of Maura’s voice, the woman went still. Blue eyes stared back, the pupils dilated to huge black pools. One of the nurses quietly began to loop a restraint around the woman’s hand.
No, thought Maura. Don’t do that.
As the strap brushed the patient’s wrist, she jerked as though scalded. Her arm flew and Maura stumbled backward, her cheek stinging from the blow.
“Assistance!” the nurse yelled. “Can we get Dr. Cutler out here?”
Maura backed away, face throbbing, as a doctor and another nurse emerged from one of the treatment rooms. The commotion had drawn the attention of patients in the waiting room. Maura saw them eagerly peering through the glass partition, watching a scene that was better than any TV episode of ER.
“We know if she has any allergies?” the doctor asked.
“No medical history,” said the nurse.
“What’s going on here? Why is she out of control?”
“We have no idea.”
“Okay. Okay, let’s try five milligrams of Haldol IV.”
“Then give it IM. Just do it! And let’s get some Valium in her, too, before she hurts herself.”
The woman gave another shriek as the needle pierced her skin.
“Do we know anything about this woman? Who is she?” The doctor suddenly noticed Maura standing a few feet away. “Are you a relative?”
“I called the ambulance. I’m Dr. Isles.”
Before Maura could answer, one of the EMTs said: “She’s the medical examiner. This is the patient who woke up in the morgue.”
The doctor stared at Maura. “You’re kidding.”
“I found her moving in the cold room,” said Maura.
The doctor gave a disbelieving laugh. “Who pronounced her dead?”
“Weymouth Fire and Rescue brought her in.”
He looked at the patient. “Well, she’s definitely alive now.”
“Dr. Cutler, room two’s now empty,” a nurse called out. “We can move her in there.”
Maura followed as they wheeled the stretcher down the hallway and into a treatment room. The woman’s struggles had weakened, her strength giving way to the effects of Haldol and Valium. The nurses drew blood, reconnected EKG wires. The cardiac rhythm ticked across the monitor.
“Okay, Dr. Isles,” said the ER physician as he shone a penlight into the woman’s eyes. “Tell me more.”
Maura opened the envelope containing the photocopied paperwork that had accompanied the body. “Let me just tell you what’s in the transfer papers,” she said. “At eight A.M., Weymouth Fire and Rescue responded to a call from the Sunrise Yacht Club, where boaters found the subject floating in Hingham Bay. When she was pulled from the water, she had no pulse or respirations. And no ID. A state police investigator was called to the scene, and he thought it was most likely accidental. She was transferred to our office at noon.”
“And no one at the ME’s noticed that she was alive?”
“She arrived while we were swamped with other cases. There was that accident on I-95. And we were still backlogged from last night.”
“It’s now nearly nine. And no one checked this woman?”
“The dead don’t have emergencies.”
“So you just leave them in the refrigerator?”
“Until we can get to them.”
“What if you hadn’t heard her moving tonight?” He turned to look at her. “You mean she might have been left there until tomorrow morning?”
Maura felt her cheeks flush. “Yes,” she admitted.
“Dr. Cutler, ICU has a bed available,” a nurse said. “Is that where you want her?”
He nodded. “We have no idea what drugs she might have taken, so I want her on a monitor.” He looked down at the patient, whose eyes were now closed. Her lips continued to move, as though in silent prayer. “This poor woman’s already died once. Let’s not have it happen again.”