“Why not wait for the regular fixed sections?” Chet said. “These frozen sections are so limiting.”
“I’ve asked Maureen to get them out as soon as she can,” Jack said. “But meanwhile this is all I have. What do you think of the area under the pointer?”
Chet played with the focus. One of the many problems with frozen sections was they were often thick and the cellular architecture appeared fuzzy.
“I’d say it looks like a granuloma,” Chet said. A granuloma was the cellular sign of chronic, cell-mediated inflammation.
“That was my thought as well,” Jack said. “Now move the field over to the right. It will show a part of the liver surface. What do you see there?”
Chet did as he was told, while worrying that if he was late to the gym, there wouldn’t be a spot in the aerobics class. The instructor was one of the most popular.
“I see what looks like a large, scarred cyst,” Chet said.
“Does it look at all familiar?” Jack asked.
“Can’t say it does,” Chet said. “In fact, I’d have to say it looks a little weird.”
“Well said,” Jack remarked. “Now, let me ask you a question.”
Chet raised his head and looked at his office mate. Jack’s domed forehead was wrinkled with confusion.
“Does this look like a liver that you’d expect to see in a relatively recent transplant?”
“Hell, no!” Chet said. “I’d expect some acute inflammation but certainly not a granuloma. Especially if the process could be seen grossly as suggested by the collapsed surface cyst.”
Jack sighed. “Thank you! I was beginning to question my judgment. It’s reassuring to hear you’ve come to the same conclusion.”
“Knock, knock!” a voice called out.
Jack and Chet looked up to see Ted Lynch, the director of the DNA lab, standing in the doorway. He was a big man, almost in Calvin Washington’s league. He’d been an all-American tackle for Princeton before going on to graduate school.
“I got some results for you, Jack,” Ted said. “But I’m afraid it’s not what you want to hear, so I thought I’d come down and tell you in person. I know you’ve been thinking you’ve got a liver transplant here, but the DQ alpha was a perfect match, suggesting it was the patient’s own liver.”
Jack threw up his hands. “I give up,” he said.
“Now there was still a chance it was a transplant,” Ted said. “There are twenty-one possible genotypes of the DQ alpha sequence, and the test fails to discriminate about seven percent of the time. But I went ahead and ran the ABO blood groups on chromosome nine, and it was a perfect match as well. Combining the two results, the chances are mighty slim it’s not the patient’s own liver.”
“I’m crushed,” Jack said. With his fingers intertwined, he let his hands fall onto the top of his head. “I even called a surgeon friend of mine and asked if there would be any other reason to find sutures in the vena cava, the hepatic artery, and the biliary system. He said no: that it had to be a transplant.”
“What can I say?” Ted commented. “Of course, for you I’d be happy to fudge the results.” He laughed, and Jack pretended to take a swipe at him with his hand.
Jack’s phone jangled insistently. Jack motioned for Ted to stay, while he picked up the receiver. “What?” he said rudely.
“I’m out of here,” Chet said. He waved to Jack and pushed past Ted.
Jack listened intently. Slowly, his expression changed from exasperation to interest. He nodded a few times as he glanced up at Ted. For Ted’s benefit he held up a finger and mouthed, “One minute.”
“Yeah, sure,” Jack said into the phone. “If UNOS suggests we try Europe, give it a try.” He glanced at his watch. “Of course it’s the middle of the night over there, but do what you can!”
Jack hung up the phone. “That was Bart Arnold,” he said. “I’ve had the entire forensics department searching for a missing recent liver transplant.”
“What’s UNOS?” Ted asked.
“United National Organ Sharing,” Jack said.
“Any luck?” Ted asked.
“Nope,” Jack said. “It’s baffling. Bart’s even checked with all the major centers doing liver transplants.”
“Maybe it wasn’t a transplant,” Ted said. “I’m telling you, the probability of my two tests matching by chance is very small indeed.”
“I’m convinced it was a transplant,” Jack said. “There’s no rhyme or reason to take out a person’s liver and then put it back.”
“You’re sure?”
“Of course I’m sure,” Jack said.
“You seem committed to this case,” Ted commented.
Jack gave a short derisive laugh. “I’ve decided that I’m going to unravel this mystery come hell or high water,” he said. “If I can’t, I’ll lose respect for myself. There just aren’t that many liver transplants. I mean, if I can’t solve this one, I might as well hang it up.”
“All right,” Ted said. “I’ll tell you what I can do. I can run a polymarker which compares areas on chromosome four, six, seven, nine, eleven, and nineteen. A chance match will be in the billions to one. And for my own peace of mind, I’ll even sequence the DQ alpha on both the liver sample and the patient to try to figure out how they could have matched.”
“I’ll be appreciative whatever you can do,” Jack said.
“I’ll even go up and start tonight,” Ted said. “That way I can have the results tomorrow.”
“What a sport!” Jack said. He put out his hand and Ted slapped it.
After Ted left, Jack switched off the light under his microscope. He felt as if the slide had been mocking him with its puzzling details. He’d been looking at it for so long his eyes hurt.
For a few minutes, Jack sat at his desk and gazed at the clutter of unfinished cases. Folders were stacked in uneven piles. Even his own conservative estimate had the figure somewhere between twenty-five and thirty. That was more than usual. Paperwork had never been Jack’s forte, and it got worse when he became enmeshed in a particular case.
Cursing under his breath from frustration at his own ineptitude, Jack pushed back from his desk and grabbed his bomber jacket from the hook on the back of his office door. He’d had as much sitting and thinking as he was capable of. He needed some mindless, hard exercise, and his neighborhood basketball court was beckoning.
The view of the New York City skyline from the George Washington Bridge was breathtaking. Franco Ponti tried to turn his head to appreciate it, but it was difficult because of the rush-hour traffic. Franco was behind the wheel of a stolen Ford sedan on the way to Englewood, New Jersey. Angelo Facciolo was sitting in the front passenger seat, staring out the windshield. Both men were wearing gloves.
“Get a load of the view to the left,” Franco said. “Look at all those lights. You can see the whole freakin’ island, even the Statue of Liberty.”
“Yeah, I’ve seen it already,” Angelo said moodily.
“What’s the matter with you?” Franco asked. “You’re acting like you’re on the rag.”
“I don’t like this kind of job,” Angelo said. “It reminds me of when Cerino went berserk and sent me and Tony Ruggerio all over the goddamn city doing the same kind of shit. We should stick to our usual work, dealing with the usual people.”
“Vinnie Dominick is not Pauli Cerino,” Franco said. “And what’s so bad about picking up some easy extra cash?”
“The cash is fine,” Angelo agreed. “It’s the risk I don’t like.”
“What do you mean?” Franco questioned. “There’s no risk. We’re professionals. We don’t take risks.”
“There’s always the unexpected,” Angelo said. “And as far as I’m concerned, the unexpected has already occurred.”
Franco glanced over at Angelo’s scarred face silhouetted in the half light of the car’s interior. He could tell that Angelo was dead serious. “What are you talking about?” he questioned.