Laurie went into her e-mail and scrolled through all the hospital records Cheryl had amassed for her. One by one, she queued them up and sent them to the printer down in administration. For ease of reading, she wanted hard copies. Next, she organized the cases by hospital. Considering case files and hospital records, she had a lot of information, which made her wonder if she should computerize her matrix. Although the idea had merit, she decided to stick with the simple legal-pad variety for the time being.
When she thought she'd allowed enough time to pass she made a rapid trip down to the computer room and retrieved the stack of printed hospital records.
On the way back up in the elevator, she noticed it was nearing five, and wondered if and when Jack would be returning. As she got out on the fourth floor to stop in and see Agnes in the microbiology lab, she pulled out her cell phone to make sure it was turned on in case Jack called. It was conceivable he might be closer to home than to the OCME on his field trip, as Chet had called it, and head home afterward rather than return to the office.
"We're making headway," Agnes said. Laurie had caught her in the process of putting on her coat to go home. It had been another of her normal ten-hour days. Agnes went over everything she had done, which included reaffirming that all the cases in Laurie's series were definitely methicillin-resistant staphylococcus aureus. She then ticked off where she had sent David Jeffries's samples for more definitive subtyping: the state reference lab, the CDC, and Ted Lynch in the OCME DNA lab. She advised Laurie that the CDC would be more efficient than the state reference lab and that Laurie could expect to hear from them in two to three days – four, tops.
Agnes's comment about the CDC reminded Laurie that she had meant to call Dr. Ralph Percy about Chet's case, but a glance at her watch suggested she might be too late. After quickly thanking Agnes for everything she was doing, Laurie dashed up a flight to save time. Since she'd not gotten the number from Chet, she had to call directory assistance for the main CDC switchboard. When the CDC operator connected her to the doctor's line, Laurie got voice mail.
"Damn!" she murmured before Dr. Percy's outgoing message had terminated. The doctor had already left for the day, and Laurie was irritated at herself for not having called the moment she'd returned from Chet's. After the beep, Laurie gave her name, her direct-dial number, the patient's name, and the fact that she was interested in the MRSA typing he'd done for Dr. Chet McGovern. Then, as an afterthought, she mentioned she was a medical examiner and a colleague of Dr. McGovern.
"What's going on?" Riva asked. She'd returned to the office while Laurie had retrieved her printed documents and had overheard Laurie's voice-mail message.
"It's been one busy day," Laurie complained. "I wanted to talk to someone at the CDC, but he's left for the day."
"There's always tomorrow," Riva said.
"I hope you are not trying to aggravate me," Laurie said. Such a patronizing comment reminded Laurie of her mother.
"Oh, no. If anything, I was trying to calm you down. You look frazzled. I know you've been preoccupied most of the day."
"That's an understatement," Laurie said. She then told Riva what she'd been up to all day and why she wanted to talk with the doctor from the CDC.
"What about the woman at the CDC I dealt with?" Riva suggested. "Did you call her?"
"I did. She was helpful and said she'd get back to me."
"Why not try her? I'm certain she'd have access to Chet's case."
"Good idea," Laurie said. She had Silvia Salerno's number on a Post-it stuck to the edge of her monitor. As the direct-dial connection went through, she glanced at her watch. It was now significantly after five. Once again, she got voice mail. On this occasion, she didn't leave a message since the woman had already agreed to call her back. Laurie hung up the phone and shook her head.
"Two for two!" Riva said lightly. "They must have a curfew at the CDC!"
Laurie laughed. Riva's comment about the world-renowned CDC amused her, as unlikely as it was, and laughing for possibly the first time all day made her realize how tense she was.
Riva stood up and took her coat from behind the door. "I think I will follow the CDC's example and head home. Working with Bingham this morning on the police custody case exhausted me."
"Oh, yeah!" Laurie said. "As preoccupied as I've been, I forgot to ask you what the outcome was."
"Not good for the police or the city," Riva said, "although it could turn out to be a windfall for the family. The hyoid bone was fractured in several places, so there was obviously excessive force."
"The only good part is that Bingham will take over the inevitable political and legal fallout."
"That's true," Riva said. "We pathologists can only say it was a homicide. Whether justified will be up to a jury."
With her coat on, Riva said good-bye, but before she left Laurie asked, "If there are any more MRSA cases over the next week while you're assigning cases, would you give them to me?"
"I certainly will," Riva said before leaving.
Laurie turned back to her desk with the three stacks of case files from the three Angels Healthcare hospitals and the stack of printed hospital records. Over the next three minutes, she combined the case files with their hospital records. There were still a few hospital records missing, as Cheryl had indicated.
Putting her matrix in front of her, Laurie picked up David Jeffries's hospital record and began reading. As she read, she filled in the boxes that she'd not been able to do without the hospital record. Since she still felt the operating room had to be where he was infected, she read through the anesthesia record, paying attention to the detail. When she did so she came up with some additional categories that she had not thought of earlier, namely the OR room number, how long the operation took, duration of time spent in the PACU, and which drugs were given in the PACU. Reading through the nurses' notes, she found the names of the scrub nurse and the circulating nurse. With a ruler, she made more vertical lines to create boxes for this additional information.
When she finished with David Jeffries's hospital record, she reached for another. It happened to be one of Paul Plodget's patients: a forty-eight-year-old man named Gordon Stanek. Like Jeffries, he was a patient of Angels Orthopedic Hospital. And as she'd done with Jeffries, she used the hospital record to fill in the boxes of her matrix. As she'd noticed earlier with Riva's two cases, the anesthesiologists were different. Unsurprisingly, she recorded that the other people involved with the patient, including the surgeon and the nurses, were also different, as was the operating room itself. Even the anesthesia was different. Although both patients had general anesthesia, the agents employed were different. There was also a difference in the way the anesthesia was administered. Jeffries had had an endotracheal tube, while Stanek had had a laryngeal mask airway.
Laurie sat back and glanced first at her matrix, then at all the case files and hospital records. It was going to be a long process. In the end, what she hoped to find was some kind of commonality they all shared.
Laurie was about to pick up another hospital record when a rhythmic thumping coming from the hallway caught her attention. It was low in pitch and distant, and had the building not been as quiet as it was, since it was after five, Laurie might not have heard it. Straightening up in her chair, Laurie cocked her head to try to hear better. Although the beat stayed the same, it was becoming progressively louder. It was as if someone was beating on the floor with a rubber mallet and coming closer and closer.