I slowly circle my patient, leaning close, looking. A syringe is still embedded in the crook of his right arm, and second-degree burns blister his upper body. They have bright red margins, and his skin is streaked black with soot that is thick inside his nose and mouth. He is telling me he was alive when the fire started. He had to be breathing to inhale smoke. He had to have a blood pressure for fluid to be pumped into his burns, causing them to blister and have a bright red margin. The circumstances of a set fire and the needle in his arm certainly could suggest suicide. But on his right upper thigh, he has a contusion that is swollen to the size of a tangerine and crimson. I palpate it. Indurated, hard as a rock. It appears recent. How did it happen? The needle is in his right arm, suggesting that if he injected himself, he most likely is left-handed, yet his right arm is more muscular than his left one, hinting he is right-handed. Why is he nude?
"We still don't have an ID on him?" I raise my voice to Jack Fielding.
"No further info." He snaps a new blade into a scalpel. "The detective's supposed to be here."
"Found unclothed?"
"Yup."
I run my gloved fingers through the dead man's thick, carbon-dusted hair to see what color it is. I won't be certain until I wash him, but his body and pubic hair are dark. He is clean-shaven with high cheekbones, a sharp nose and square jaw. Burns on his forehead and chin will need to be covered up with funeral home makeup before we can circulate a pho- tograph of him for identification purposes, if it comes to that. He is fully rigorous, arms straight by his sides, fingers slightly curled. Livor mortis, or the blood settling to dependent regions of the body due to gravity, is also fixed, causing the sides of his legs and buttocks to be a deep red, the backs of them blanched wherever they rested against the wall or the floor after death. I hold him tilted on his side to check for injuries to his back and find parallel linear abrasions over the scapula. Drag marks. There is a burn between his shoulder blades and another one at the base of the back of his neck. Clinging to one of the burns is a fragment of a plastic-like material, narrow, about two inches long, white with small blue type on it, such as you might see on the back of a food product's packaging. I remove the fragment with forceps and hold it up to the surgical lamp. The paper is more like thin, pliable plastic, a material I associate with candy or snack wrappers. I make out the words this product, and 9-4 EST and a toll-free number and part of a website address. The fragment goes inside an evidence bag.
"Jack?" I summon him and begin collecting blank forms and body diagrams, attaching them to a clipboard.
"I can't believe you're going to work with that damn cast on." He walks across the autopsy suite, his bulging biceps straining against the short sleeves of his scrubs. My deputy chief may be famous for his body, but no amount of weightlifting or chocolate cream Myoplex high-protein meals in a glass can stop him from losing his hair. It is eerie, but in recent weeks his light brown hair has started falling out before our very eyes, clinging to his clothing, drifting through the air like down, as if he is molting.
He frowns at the misspelling on the toe tag. "The guy from the removal service must be Asian. John Dooo."
"Who's the detective?" I ask.
"Stanfield. Don't know him. Just don't get a puncture in your glove or you'll be wearing a biological hazard for the next few weeks." He indicates my latex-coated cast. "Actually, what would you do, now that I think of it?"
"Cut it off and put on a new one."
"So maybe we should have disposable casts down here."
"I feel like cutting it off anyway. This guy's burn pattern isn't making sense to me," I tell him. "Do we know how far the body was from the fire?"
"About ten feet from the bed. I was told the bed's the only thing that burned and only partially. He was nude, sitting on the floor, back against the wall."
"I wonder why only his upper body got burned." I point out discrete burns the size and shape of silver dollars. "Arms, chest. One here on his left shoulder. And these on his face. And he has several on his back, which should have been spared if he was leaning against the wall. What about the drag marks?"
"As I understand it, when the fire department got there, they dragged his body out into the parking lot. One thing's for sure, he must've been unconscious or incapacitated when the fire started," Jack says. "Sure as hell don't know why else someone would just sit there getting burned and breathing in smoke. Obviously that happy-holiday time of year." My second-in-command is cloaked in a hung-over weariness that causes me to suspect he had a very bad night. I wonder if he and his ex-wife had another one of their explosions. "Everybody killing themselves. That woman over there." He points to the body on table 1, where Dr. Chong is busy taking photographs from a stepladder. "Dead on the kitchen floor, a pillow, a blanket. The neighbor heard one shot. Mother found her. There's a note. And behind door number two"_Jack stares at table 2_"a motor vehicle death the state police are suspicious is a suicide. She has extensive injuries. Plowed right into a tree."
"Did her clothes come in?"
"Yup."
"Let's X-ray her feet and get the labs to check the bottom of her shoes to see if she was braking or accelerating when she hit the tree." I shade areas of a body diagram, indicating soot.
"And we got a known diabetic with a history of overdose,"
Jack recites our guest list of the morning. "Was found outside in the yard. Question is drugs, alcohol or exposure."
"Or a combination of the above."
"Right. I see what you mean about the burns, though." He leans closer to look, blinking often, reminding me he wears contact lenses. "And it's weird they're all about the same size and shape. You want me to help with this?"
"Thanks. I'll manage. How are you?" I glance up from my clipboard.
His eyes are tired, his boyish good looks strained. "Maybe we can grab some coffee sometime," he says. "One of these days. And I should be asking about you."
I pat his shoulder to let him know I am okay. "As well as can be expected, Jack," I add.
I begin the external examination of John Doe with a PERK. This is a physical evidence recovery kit, a decided unpleasantness that includes swabbing orifices, clipping fingernails and plucking head, body and pubic hair. We PERK all bodies when there is any reason to suspect something other than a natural death, and I will always PERK a body that is nude, unless there is an acceptable reason for the person's not being clothed when he died_in the bathtub or on the operating table, for example. For the most part, I don't spare my patients indignities. I can't. Sometimes the most important evidence lurks in the darkest, most delicate hollows, and clings underneath nails and in hair. During my violation of this man's most private places I discover healing tears of his anal ring. He has abrasions at the angles of his mouth. Fibers adhere to his tongue and the inside of his cheeks.
I go over every inch of him with a lens and the story he tells grows more suspicious. His elbows and knees are slightly abraded and covered with dirt and fibers, which I mundanely collect by pressing them with the adhesive backs of Post-its, which I seal inside plastic bags. Over the bony prominences of both wrists are incomplete circumferential dry, reddish-brown abrasions and minute skin tags. I draw blood from the iliac veins and vitreous fluid from the eyes, and test tubes ride up on the dumbwaiter to the third-floor toxicology lab for STAT alcohol and carbon monoxide tests. At half past ten, I am reflecting back tissue from the Y incision when I notice a tall, older man heading toward my station. He has a wide, tired face and maintains a safe distance from my table, gripping a grocery-size brown paper bag, the top folded over and sealed with red evidence tape. I have a flash of my bagged clothing on my red Jarrah Wood dining room table.