"Mutilated in what way?" I said.
"Extensive abdominal and pelvic cutting. Wrists and ankles bound to a tree with a thick hemp rope. Breasts removed, skin peeled from the inner thighs-your basic sadistic sexual surgery. Subdural hematomas from head wounds that might've eventually proven fatal. But arterial spurts on the tree said she'd been alive while being cut. The official cause of death was bleeding out from a jugular slash. Shreds of blue paper were found nearby and the Ann Arbor investigators matched it, eventually, to disposable surgical scrub suits used at that time at the University of Michigan Medical Center. That led to numerous interviews with med-school staff and students, but no serious leads developed. The surviving girls could only give a sketchy description of the attacker: male Caucasian, medium-size, very strong. He never spoke or showed his face, but one of them remembers seeing white skin between his sleeve and his glove. His modus was to throw a choke hold on them as he hit them from behind, then flip them over and punch them in the face. Three very hard blows in rapid succession." Fusco's fist smacked into an open hand. Three loud, hollow reports. The old woman drinking soup didn't turn around.
" 'Calculated,' one of the surviving victims called it. A girl named Shelly Spreen. I had the chance to interview her four years ago-fourteen years after the attack. Married, two kids, a husband who loves her like crazy. Reconstructive facial surgery restored most of her looks, but if you see pre-attack pictures, you know it didn't do the trick completely. Gutsy girl, she's been one of the few people willing to talk to me. I'd like to think talking about it helped her out a little.
"Calculated," I said.
"The way he hit her-silently, mechanically, methodically. She never felt he was doing it out of anger, he always seemed to be in control. 'Like someone going about his business,' she told me. Ann Arbor did a competent job, but once again, no leads. I had the luxury of working backward-focusing on young men in their twenties, possibly security guards, or university employees who'd left town shortly after, then dropped completely out of sight. The only individual who fit the bill was a fellow named Huey Grant Mitchell. He'd worked at the U. Mich medical school, as an orderly on the cardiac unit."
I said, "Grant Huie Rushton plus Mitchell Sartin equals Huey Grant Mitchell-wordplay instead of a graveyard switch."
"Exactly, Doctor. He loves to play. The Mitchell I.D. was created out of whole cloth. The job reference he gave-a hospital in Phoenix, Arizona-turned out to be bogus, and the Social Security number listed on his employment application was brand-new. He paid for his Ann Arbor single with cash, left behind no credit card receipts-no paper trail of any kind, except for a single employment rating: he'd been an excellent orderly. I think the switch from graveyard hoax to brand-new I.D. represents a psychological shift. Heightened confidence."
Fusco pushed his Coke glass away, then the half-eaten sandwich. "Something else leads me to think he was stretching. Craving a new game. During the time he worked the cardiac floor, several patients died suddenly and inexplicably. Sick but not terminally ill patients who could've gone either way. No one suspected anything- no one realizes anything, to this day. It's just something that turned up when I was digging."
"He cuts up girls and snuffs ICU patients?" said Milo. "Versatile."
Any trace of amiability left Fusco's face. "You have no idea," he said.
"You're talking nearly two decades of bad stuff and it's never come out? What, one of those covert federal things? Or are you out to write a book?"
"Look," said Fusco, jawbones flexing. Then he smiled, sat back. Let his eyes disappear in a mass of folds. "It's covert because I've got nothing to go overt. Air-sandwich time. I've only been on it for three years."
"You said two clusters. Where and when was the second?"
"Back here, in your Golden State. Fresno. A month after Huey Mitchell left Ann Arbor, two more girls were snagged off hiking trails, two weeks apart. Both were found tied to trees, cut up nearly identically to the Colorado and the Michigan vies. A hospital orderly named Hank Spreen left town five weeks after the second body turned up."
"Spreen," I said. "Shelly Spreen. He took his victim's name?"
Fusco grinned horribly. "Mr. Irony. Once again, he got away with it. Hank Spreen had worked at a private hospital in Bakersfield specializing in cosmetic work, cyst removals, that kind of thing. It was a big surprise when three post-op patients had sudden reversals and died in the middle of the night. Official cause: heart attacks, idiopathic reactions to anesthesia. That happens, but not usually three times in a row over a six-month period. The publicity helped close the hospital down, but by then Hank Spreen was long gone. The following summer, Michael Burke showed up at CUNY."
"Long body list for a twenty-two-year-old," I said. "A twenty-two-year-old smart enough to make it through pre-med and med school. He worked his way through by holding down a job as a lab assistant to a biology professor-basically a nighttime bottle washer, but he didn't need much income, lived in student housing. Had Grandma's dough. Pulled a 3.85 GPA-from what I can tell, he really earned those grades. Summers, he worked as an orderly at three public hospitals-New York Medical, Middle State General and Long Island General. He applied to ten med schools, got into four, chose the University of Washington in Seattle."
"Any coed murders during his pre-med period?" said Milo.
Fusco licked his lips. "No, I can't find any definite matches during that time. But there was no shortage of missing girls. All over the country, bodies that never showed up. I believe Rushton/Burke kept on killing but hid his handiwork better."
"You believe? This joker's a homicidal psychopath and he just changes his ways?"
"Not his ways," said Fusco. "His mode of expression. That's what sets him apart. He can let loose his impulses along with the bloodiest of them, but he also knows how to be careful. Exquisitely careful. Think about the patience it took to actually become a doctor. There's something else to consider. During his New York period, he may have diverted his attention from rape/murder to the parallel interest he'd developed in Michigan and continued in Bakersfield: putting hospital patients out of their misery. I know they seem like different patterns, but what they've got in common is a lust for power. Playing God. Once he learned all about hospital systems, playing ward games would've been a snap."
"How is he supposed to have killed all those patients?" said Milo.
"There are any number of ways that make detection nearly impossible. Pinching off the nose, smothering, fooling with med lines, injecting succinyl, insulin, potassium."
"Any funny stuff go down at the three hospitals where Burke spent his summers?"
"New York's the worst place to obtain information. Large institutions, lots of regulations. Let's just say I have learned of several questionable deaths that occurred on wards where Burke was assigned. Thirteen, to be exact."
Milo pointed down at the file folder. "All this is in here?"
Fusco shook his head. "I've limited my written material to data, no supposition. Police reports, autopsies, etcetera."
"Meaning some of your stuff was obtained illegally, so it can never be used in court." Fusco didn't reply.
"Pretty dedicated, Agent Fusco," said Milo. "Cowboy stuff's not exactly what I'm used to when dealing with Quantico."
Fusco flashed those big teeth of his. "Pleased to bust your stereotype, Detective Sturgis.
I didn't say that."
The agent leaned forward. "I can't stop you from being hostile and distrustful. But, really, what's the point of playing uptight-local-besieged-by-the-big-bad-Fed? How many times does someone offer you this level of information?"
"Exactly," said Milo. "When something seems to be too good to be true, it usually is."
"Fine," said Fusco. "If you don't want the file, give it back. Good luck chipping away at Dr. Mate. Who, by the way, began his own little death trip around the same time Michael Burke/Grant Rushton decided to seriously pursue a career in medicine. I believe Burke took note of Mate. I believe Mate's escapades and the resulting publicity played a role in Michael Burke's evolution as a ward killer. Though, of course, Michael had begun snuffing out patients earlier. Michael's main objective was killing people." To me: "Wouldn't you say that applied to Dr. Mate, as well?"