“It all looks normal to me,” she said to no one in particular as she proceeded to run the balls of her fingers over the heart still covered by its pericardium. Without looking up at Jack, she asked him if he wanted to feel it as well.
“It’s not necessary,” Jack said. “I trust your judgment, and it looks normal to me, too.”
Wasting no time, Aria took a couple of clamps and dissecting scissors from Vinnie and opened the pericardium to expose the heart itself. Using her right hand, she palpated the softball-size organ and commented that it, too, seemed entirely normal. After she pulled her hand away, Jack reached in and did the same, with the same conclusion. Taking a large syringe outfitted with a fourteen-gauge needle, Aria lifted the base of the heart high enough to get a look at the posterior aspect of the left atrium. After inserting the needle through the atrial wall, she took a sizable blood sample for Toxicology.
With that job out of the way, she double-clamped all the major cardiac veins and arteries and cut them, freeing up the heart. While she did this, she used the opportunity to look for any large clots, particularly in the veins. “So far no emboli,” she announced. She then lifted the heart out of its bed, where it had been nestled between the two lungs. She weighed it and then put it on a cutting board that Vinnie had brought over along with a standard butcher knife. During the next fifteen minutes Aria carefully opened the heart to peer at the various heart valves. Then using fine dissecting scissors, she began painstakingly tracing out each coronary artery.
Around 8:15 other medical examiners and mortuary techs started to appear in the autopsy room to begin their cases. A number of them detoured to take a peek at the subway case because of its morbid appeal. Those who did asked a few questions, and some even indulged in a bit of dark humor. But each interaction was short-lived as Jack made it plain that he was intent on watching Aria. That was the case until Chet showed up when she was busy with the coronary arteries. Sensing it was an opportune moment, Jack pulled Chet to the side, out of her earshot.
“My God,” Jack said under his breath. “She is a trip!”
“I told you so,” Chet said with apparent satisfaction.
“I almost lost it when we first started,” Jack said. “In retrospect, I’m embarrassed my reaction was so over the top. I came close to literally throwing her out of the pit. Her language would make the proverbial sailor blush.”
“Tell me about it.” Chet chuckled behind his hand.
“You won’t believe this, but she knew the patient personally,” Jack said. “That was what keyed off her orgy of profanity. She was mad the person got hit by a train and died because she was supposed to help her. I don’t think I’ve ever witnessed a worse case of self-centered lack of empathy in my life.”
“I can tell you that she’s not been concerned about my feelings,” Chet said. “I’ve been victimized by her profanity, too. I mean, I’m not as bothered by profanity as you are, but in my case it was specifically directed at me.”
“Did you really ask her to have a drink sometime?” Jack said. “You should have your head examined. Especially in this day and age and you essentially being her boss. What were you thinking?”
“Hey, I wasn’t thinking,” Chet confessed. “I’d just met her, she said she was single, and there was something vaguely appealing about her before she opened her foul mouth.”
“You must be more desperate than I realized,” Jack said. “She’s the last person you should have a drink with, so in some ways maybe she did you a favor. Anyway, Laurie asked me to help you with her, God knows why, with my short fuse. So how can I help?”
“You’re already helping, bro,” Chet said. “You’ve kept her entertained two days in a row. I owe you.” Chet glanced around Jack and watched Aria for a beat as she was examining the heart. “Are you letting her do the case like Laurie did?”
“I am,” Jack said. “I hadn’t necessarily planned it, but after what Laurie said yesterday, I thought it might be best for everyone. She’s got good hands, and she’s definitely savvy.”
“I’m running out of people to ask to let her assist,” Chet said. “She pretty much turns everybody off.”
“I’ve got another case that I know of after this one,” Jack said. “Why don’t you let her stay with me. I’ll offer her that case, too. At least that will let you get through today. And who knows, if she continues to act like she has during this case, I can tolerate her.”
“You got her,” Chet said. “Have fun!”
“Yeah, sure,” Jack said. He turned away and walked back to where she was working on the heart. He could tell she was nearly finished.
“I’m surprised, but this is a normal heart,” Aria said when she became aware of Jack’s presence. She stepped to the side so Jack could take a look at the opened organ. “There are absolutely no signs of any heart disease or congenital abnormalities like I expected. Of course, we can’t rule out a channelopathy, but if she had a channelopathy, chances are there would have been a history of cardiac rhythm problems. The MLI report says there was none, so we’re back to square one.”
“I’m surprised, too,” Jack said as he picked up the heart and quickly glanced at its interior and at the coronary vessels. A moment later he put the organ back on the cutting board. “I agree. The heart’s clean. I would have put money on some anatomical cardiac abnormality. I guess we’ll have to wait for Toxicology to provide us with some answers, or Molecular Biology concerning the possibility of a channelopathy. We are certainly going to need to get her entire hospital record for this latest Bellevue admission and any other hospitalization she’s had while growing up in Missouri. Meanwhile, why don’t you go ahead and finish this case?”
The rest of the autopsy proceeded rapidly as there was no pathology to speak of except for the skull portion, where it was important to expose the fracture lines. As soon as Aria was finished, she stripped off her double-layered gloves, tossed them onto the cadaver, and started for the door. Jack, who was finishing a diagram of Madison’s external injuries, had been planning on making sure that she didn’t do a repeat of her disappearing act like she’d done the previous day, but she again took him by surprise.
“Hey!” Jack called out. “Dr. Nichols! Hold up.”
Still holding the diagram and the pencil he was using, Jack caught up with Aria, who had gotten halfway to the exit. “This is not how we MEs end autopsies here at the OCME,” he said. “It’s customary to help get the body off the table as well as organize the specimen jars, decontaminate them, and make sure they are all labeled properly.”
She went up on her tiptoes to see over Jack’s shoulder. She could see that Vinnie was guiding one of the gurneys next to the autopsy table. She looked at Jack. They were both still wearing plastic facial shields, and neither could really see the other’s expression. “I’m not an ME nor am I a mortuary technician,” Aria declared as if the issue wasn’t up for discussion. “And I’ve got something more important to do. I have to check my phone about getting information on the case I did with Dr. Montgomery.”
“You’re scheduled to be with me for the next autopsy,” Jack said. “I’m going to suggest you do that one, too, but I expect you to carry your own weight, which means helping out.”
“I’ll be back,” Aria said. “I appreciate you letting me actually do the case rather than having me just standing around sucking my thumb. And it is damn appropriate, considering in a month I’ll be in my last year as a pathology resident. But I’m not a mortuary technician, nor a janitor.”
“This isn’t an argument,” Jack said. “Vinnie needs some help because all the other mortuary technicians are busy, which you could see if you just looked around. And I have to go upstairs to see the chief in between cases.” Jack was dying to find out if Laurie had heard from her surgeon about when her surgery was to take place. He was afraid it was going to be as soon as tomorrow.