On the wall to their left was a chart for listing the weight of the brain, lungs, heart, liver, kidneys and spleen of each cadaver examined in here. There was a dash against each item, except for the brain, the only vital organ the cadaver still possessed, and very likely to be the only one that would go to his grave with him.
The pathologist removed his bladder, laid it on the metal dissecting tray, which was on raised legs above the cadaver’s thighs, then made one sharp incision to open it. She carefully bottled and sealed samples of the fluid that poured out, for tests.
‘What’s your assessment so far?’ Grace asked her.
‘Well,’ she said, in her exquisite broken English, ‘the cause of death is not absolute at this moment, Roy. There’s no petechial haemorrhaging to indicate suffocation or drowning, and with the absence of his lungs I can’t say for sure at this point if he was dead prior to immersion. But I think we can surmise, from the fact that his organs were removed, that was pretty likely.’
‘Not many surgeons operate underwater,’ Michael Forman quipped.
‘I don’t have much to go on from the stomach contents,’ she continued. ‘Most of it has been dissolved by the digestion process, although that slows post-mortem. But there are some particles of what looks like chicken, potato and broccoli – so that indicates he was capable of eating a proper meal in the hours preceding death. That is not really consistent with his absence of organs.’
‘In what way?’ Grace asked, conscious of the inquisitive eyes of the Coroner’s Officer and Glenn Branson.
‘Well,’ she said, and waved her scalpel down his opened midriff. ‘This is the kind of incision a surgeon would make if he was harvesting organs from a donor. All the internal organs have been surgically excised, by someone experienced. Consistent with this is the fact that the blood vessels have all been tied off with sutures before being cut through to remove the organs.’ She pointed. ‘The perinephric fat that would have been around the kidneys – the suet, if you are a cook – has been opened with a blade.’
Grace reminded himself not to eat suet for a long time to come.
‘So,’ Nadiuska continued, ‘all this would indicate that he was an organ donor. Now, what directs me even more towards this possibility is the presence of these external indications of medical intervention.’ She pointed again. ‘A needle mark in the back of the hand.’ She gestured at the neck. ‘A puncture mark.’ Then she pointed at the right elbow. ‘Another puncture mark in the antecubital fosse. These are consistent with the insertion of cannulae for drips and drugs.’
Then, taking a small torch, she gently levered open the dead man’s mouth with her gloved fingers and shone the beam in. ‘If you look closely you can see reddening and ulceration to the inside of the windpipe, just below the voice box, which would have been caused by the balloon inflated on the end of the endotracheal ventilator tube.’
Grace nodded. ‘But he ate a meal of solids – he couldn’t have done that with an endotracheal tube, right?’
‘Absolutely right, Roy,’ she said. ‘I don’t understand this.’
‘Perhaps he was an organ donor who was subsequently buried at sea, and then carried by currents away from the burial zone?’ Glenn Branson suggested.
The pathologist pursed her lips. ‘It’s a possibility. Yes,’ she concurred. ‘But the majority of organ donors tend to be on life support for a period of time, during which they would be intubated and on intravenous drip feeds. It is odd to me that there is undigested food in his stomach. When I do the tox screen, that may show up muscle relaxants and other drugs that would be used for the removal of organs for transplant.’
‘Can you give me an approximation of how many hours from when he had eaten until he died?
‘From the state of the food, four to six at maximum.’
‘Couldn’t he have died suddenly?’ Grace asked. ‘A heart attack, or a car – or maybe motorbike – accident?’
‘He doesn’t have injuries consistent with a serious accident, Roy. He has no head or brain trauma. A heart attack or an asthma attack is a possibility, but considering his age – late teens – both, I would say, are a little improbable. I think we could be looking for some other cause.’
‘Such as?’ Grace scribbled a sudden note on his pad, thinking of something that would need following up.
‘I can’t speculate at this stage. Hopefully lab tests will tell us something. If we could get his identity, that might help us also.’
‘We’re working on that,’ he said.
‘I’m sure it is the lab tests that will provide the key. I think it is very unlikely that the tapings are going to produce anything, as he wasn’t in waterproof wrapping,’ the pathologist went on. Then she paused briefly, before adding, ‘There is one other thought. This food in the stomach. In the UK, because there is no automatic organ harvesting without consent, it does often take many hours from brain death for consent to be obtained from next of kin. But in countries where there is just an opt-out, like Austria and Spain, then the process can be much quicker. So it is possible that this man is from one of those countries.’
Grace thought about this. ‘OK, but if he died in Spain or Austria, what is he doing ten miles off the coast of England?’
There was a shrill ring on the doorbell. Darren, the Assistant Mortuary Technician, hurried out of the room. A couple of minutes later he returned with Sergeant Tania Whitlock, from the Specialist Search Unit, gowned and in protective boots.
Roy Grace brought her up to speed. She asked to see the plastic sheeting and weights in which the body had been found, and Cleo took her out into the storage area to show her. Then they returned to the post-mortem room. The Home Office pathologist was busy dictating notes into her machine. Grace, Glenn Branson and Michael Forman were standing near the cadaver. The photographer walked out to the storage area to start working on close-ups of the wrapping and binding.
‘Do you think he could have drifted in the currents from a designated burial-at-sea area?’ Grace asked Tania.
‘It’s possible,’ she said, breathing in through her mouth, trying to ignore the stench. ‘But those weights are pretty heavy, and we’ve had mild weather conditions recently. I can get you a plot done, showing where it might have come from with lesser weights on, if that would be helpful.’
‘It might be. Could it be a burial at sea where they got the position wrong?’
‘A possibility,’ she said. ‘But I’ve checked with the Arco Dee. They found him fifteen nautical miles east of the designated Brighton and Hove burial-at-sea site. It would be a pretty big error.’
‘That’s what I’m thinking too,’ he said. ‘We have a fairly precise position where he was brought up from, right?’
‘Very accurate,’ the Sergeant said. ‘To within a couple of hundred yards or so.’
‘I think we should take a look at what else might be down there, as quickly as possible,’ Grace said. ‘Do you have time to start today?’
Tania looked at the clock on the wall and then, as if mistrusting it, at her chunky diver’s watch. Next she glanced at the window. ‘Sunset is about four o’clock today,’ she said. ‘Ten miles out in the Channel, the sea’s going to be quite choppy – we’d need to rent a bigger dive boat than our inflatable for working out there. We have about three hours of daylight left. What I suggest is we get a dive boat sorted for first light in the morning – this time of year there are a few deep-sea fishing charter boats that don’t have many customers. We can start at dawn. But in the meantime, we can get out to the area in the inflatable and buoy it off, to make sure the dredgers don’t disturb anything else down there.’
‘Brilliant!’ he said.
‘That’s what we’re here for!’ she said, feeling a lot more cheerful than when she had arrived. She could get all that organized and still make it home in time to prepare the meal.