“I emailed the report to Turlock yesterday afternoon.”
“To Turlock?”
“He’s still the CIO on that case, is he not?”
“Yes, he is,” said Gurney confidently, trying not to expose any out-of-the-loop uncertainty. “He’ll probably forward your report to the DA’s office, and I’ll get a copy from Sheridan. Is there anything I should pay special attention to?”
“I report facts. Prioritizing them is up to you.”
“And the facts in this instance are . . .”
“Alcohol, midazolam, propofol.”
“Propofol . . . as in the Michael Jackson OD?”
“Correct.”
“Propofol’s administered intravenously, right?”
“Right.”
“I didn’t think it was commonly available on the street.”
“It’s not. It would be a tricky substance for the average addict to deal with.”
“How so?”
“It’s a powerful sedative with a narrow therapeutic window.”
“Meaning?”
“The recommended dosage level is relatively close to the level of toxicity.”
“So it’s easy to OD on it?”
“Easier than with most street drugs. And there’s no antidote—no equivalent to Narcan for opiates—no way to bring you back once you go over the edge.”
“Could a propofol OD have been the cause of death?”
“Direct cause of death for both individuals was strangulation, leading to heart and respiratory failure. I’d say the propofol was administered earlier for its sedative rather than toxic effects.”
“To eliminate the pain of the branding? To keep the victims quiet and manageable?”
“The sedative effect would be consistent with those outcomes.”
“This case gets more interesting every day, doesn’t it?”
“Indeed. In fact, your call caught me on my way from the autopsy table back to my office.”
“Autopsy on who?”
“Officer Loomis.”
“I assume his death was the result of the complications you’d expect from a bullet to the temporal lobe?”
“The temporal lobe was creased but not perforated. He almost certainly would have recovered from that, possibly with some ongoing deficits. Of course, one can never be sure with brain injuries. His death was actually caused by complications arising from tissue destruction, sepsis, and hemorrhaging in critical brain-stem structures, primarily within the medulla oblongata.”
Gurney was puzzled. “What’s the connection between that area and the part of his head where he was shot?”
“No connection relevant to the outcome.”
“I’m confused. Are you saying that his death was not caused by the delayed effects of the gunshot to his temple?”
“His death was caused by the delayed effects of an ice pick driven into his brain stem.”
32
Gurney didn’t have time to ask Thrasher all the questions that came to mind. He settled for three big ones.
First question: How long before Loomis’s deteriorating condition was noted could the stabbing have occurred?
The answer was that it could have occurred anywhere from one to twenty-four hours prior to the onset of symptoms. There was no way of being more specific without a more extensive analysis of the affected area of the brain—which would be undertaken if requested by the WRPD or the office of the district attorney.
Second question: Why hadn’t one of the monitor alarms sounded at the moment of the stabbing itself?
The answer was that the deep sedation brought about by Loomis’s barbiturate coma would have substantially blunted any immediate physiological reaction. The monitors would register the ensuing symptoms of heart and respiratory failure only as they developed during the course of the gradual brain-stem hemorrhaging, deterioration, and sepsis.
Third question: Wouldn’t a crude instrument like an ice pick have produced a bleeding wound that the nursing staff would have noticed?
The answer was that bleeding could be avoided by angling the entry pathway to avoid the principal neck arteries and veins, which is exactly what the autopsy revealed had been done. With some medical knowledge and a good anatomical diagram, it would not be all that difficult. In addition, a small Band-Aid had been applied to the puncture site.
Gurney couldn’t help but be impressed by the simplicity of that last touch.
Thrasher went on to explain that his medical intern would soon be transcribing the audio recording of the detailed comments he’d made during the autopsy procedure. He would review the report, mark it “Preliminary, Subject to Revision,” and send an electronic copy to Mark Torres, the official CIO on the Loomis case.
Gurney knew that Torres would then share it up the chain of command to Turlock, who would in turn share it with Beckert. At some point in that process it would occur to someone to go to the hospital and request a list of all personnel and ICU visitors who could have had access to Loomis during the broad time period in which the stabbing could have occurred.
Gurney’s own goal was to get to the hospital, secure the same list, and get out of there before anyone knew he’d been deprived of his official standing.
The elegant lady with the white permanent and bright-blue eyes was again at the welcome desk, and she remembered him. She smiled, with a touch of sadness. “So sorry about your associate.”
“Thank you.”
She sighed. “I wish more people appreciated the sacrifices made by you people in law enforcement.”
He nodded.
She smiled. “What can we do for you today?”
He spoke in a confidential tone. “We’re going to need a list of hospital personnel and visitors who may have had contact with Rick Loomis.”
She looked alarmed. “My goodness, why . . .”
“Routine. In the event that he may have regained consciousness temporarily and said something in someone’s presence that could be helpful.”
“Oh. Yes. Of course.” She looked relieved. “You’ll need to see Abby Marsh. Let me call to make sure she’s in. Do you have something with your exact title on it?”
He handed her his DA credentials.
She laid them in front of her as she entered an extension number on her desk phone.
“Hello, Marge? Is Abby in? I have a special senior investigator here from the district attorney’s office . . . That’s right . . . Yes, he’s one of the officers who was here before . . . A personnel list . . . He can explain it better than I can . . . All right . . . I’ll send him in.”
She handed back his credentials and gave him directions to the office of Mercy Hospital’s director of human resources.
He was greeted by Abby Marsh at her office door. Her handshake was firm and brief. She was as tall as Gurney, probably in her late forties, thin with brown hair cropped so short it suggested recent chemotherapy. Her harried expression suggested that the days were long gone when a personnel job was a stress-free sinecure. An expanding minefield of regulations, entitlements, resentments, and lawsuits had turned the position into a bureaucratic nightmare.
He explained what he needed. She asked to see his credentials and studied them in a distracted way. She told him she could provide a list of names with addresses, phone numbers, job titles, and dates of employment, but no other file information. As for indicating specific staff members with ICU access, that was impossible since staff access to that area was neither restricted nor monitored.
She looked hurriedly at her watch. Did he prefer a paper printout or a digital file?
Digital.
Did he want it emailed to the DA’s office, or did he want it now on a USB drive?
Now on a USB.