“What might Kathleen have meant by ‘sleepy’?” I inquired, and the officer seemed to be annoyed by that. “Well, sleepy,” she repeated, as if she was sorry she said it and wanted to take it back. There’s a difference between being sleepy and fatigued, I explained. Physical activity can make one fatigued, as can illness, I pointed out. But sleepiness by my definition indicates feeling drowsy, having difficulty keeping one’s eyes open, and this can occur when someone is sleep-deprived but also when certain conditions such as low blood sugar are to blame.
Officer Slater’s answer was to cut her eyes at Tara Grimm and say to Colin and me that Kathleen complained she wished she hadn’t eaten so close to going outside in the heat and humidity. Eating a big meal might have given her indigestion, and maybe she was having heartburn, she wasn’t sure, but Kathleen was always complaining about the food at the GPFW, Officer Slater let us know.
Kathleen “fussed” about the food whether it was delivered to her cell in Bravo Pod or when she was eating in the chow hall. She talked about food all the time, usually complaining it wasn’t any good or there wasn’t enough, “but it was always something she was unhappy about,” Officer Slater said, and the inflection of her voice and the shifting of her eyes as she continued to talk gave me the same feeling I got when I was talking to Kathleen yesterday. Officer Slater was mindful of the warden and not the truth.
“What’s Benton doing?” I ask Lucy.
“Talking to the Boston field office.”
“Do we have an update?” I want to know about Dawn Kincaid.
“Not that I know of, but he looks intense out there on the ramp, where no one can hear him as usual. You want him?”
“I don’t want to hold you up. We’ll talk when I see you. I don’t know who might be here.” What I’m suggesting is she could run into Jaime Berger, who still hasn’t bothered to return my phone call.
“Maybe it will be her problem,” Lucy says.
“I’d rather it isn’t anybody’s problem. I’d rather you don’t have an unpleasant encounter.”
“Gotta pay for gas.”
I smell creosote and Dumpsters baking in the sun as Colin and I reach the morgue, a windowless pale yellow cinder-block building flanked by HVACs and an industrial backup generator on one side and the bay on another. Beyond the back fence, tall pines sway in the wind, and in the distance, lightning shimmers in blooming black clouds and I can see veils of rain far off to the southwest, a bad storm heading this way from Florida. The huge metal shutter door is rolled up, and we walk through an empty concrete space to another door that Colin unlocks with a key.
“We probably autopsy on average two per year, and then another five or six that we sign out after a view.” He picks up where he left off when Lucy called, explaining the types of cases he typically gets from the GPFW.
“If I were you, I’d review all of them for however many years Tara Grimm has been the warden,” I reply.
“Mostly we’re talking cancer, chronic obstructive pulmonary disease, liver disease, congestive heart failure,” Colin says. “Georgia’s not exactly known for compassionate release if an inmate is terminally ill. That’s all we need. Convicted felons getting out early because they’re dying of cancer and they rob a bank or shoot someone.”
“Unless the inmate died in hospice, in other words, a death that was beyond questioning, I’d go back and look,” I suggest.
“I’m thinking.”
“Any case that gave you even the slightest concern. I’d review it again.”
“No concern at the time, to be perfectly honest, but you’ve got my hindsight kicking in. Shania Plames,” he then says. “A really sad story. Suffered from postpartum psychiatric problems, depressed and delusional, and ended up killing her children, all three of them. Hanged them from a balcony railing. Her husband owned a tile company in Ludowici, was out of town on a fishing trip. Imagine coming home to that?”
He checks the big black log inside the receiving area that has a floor scale, a walk-in refrigerator, and a small office with in-out boxes.
“Good, she’s here.” He means Kathleen Lawler is.
“Shania Plames was a sudden death at the GPFW,” I suppose.
“On death row,” he says. “About four years ago, she asphyxiated herself after she came in from the exercise cage one morning. Used a pair of her uniform pants, wrapped one leg around her neck, the other leg around her ankles, sort of hog-tying herself, and lay on her belly. The weight of her legs hanging over the edge of the bed put just enough pressure on her jugular to cut the oxygen off to her brain.”
We follow a white tiled hallway past locker rooms, bathrooms, various storage rooms, and the decomp autopsy room, with its solitary table and double drawer refrigerator-freezer, and Colin continues to tell me it was an unusually creative way to kill oneself in an environment that is virtually suicide-proof, and he wasn’t really sure if what Shania Plames had rigged up with her trousers would work but he wasn’t about to try it. He gives me every detail he can recall about her and one other case, Rea Abernathy, who was just last year, found with her head in the toilet bowl, the steel rim of it compressing her neck, her cause of death positional asphyxia.
“She didn’t have a ligature mark, but one might expect the absence of that when what she’d allegedly used to strangle herself was a wide, relatively soft fabric,” Colin says, about Shania Plames. “There were no injuries to the internal structures of the neck, and that wasn’t unusual, either, in a suicidal hanging by partial suspension or ligature strangulation by positioning. No injuries or evidence that gave me anything to go on with Rea Abernathy, either.”
As in the Barrie Lou Rivers case, his diagnoses were based mainly on the history, a process of elimination.
“Not at all the way I want to practice forensic medicine,” Colin says darkly, as we enter an anteroom of deep steel sinks, red biohazard trash cans, hampers, and shelves of disposable protective clothing. “Frustrating as hell.”
“Why was Rea Abernathy in prison?” I ask.
“Paid someone to drown her husband in the swimming pool. Was supposed to look like an accident and it didn’t. He had a big contusion on the back of his head, a big intracranial hematoma. Dead before he hit the water. Plus, the guy she paid to do it was someone she was having an affair with.”
“And what about her? She absolutely didn’t drown in the toilet?”
“Wouldn’t have been possible. Prison toilets are shallow and elongated, the water below the level of the bowl. Built to be suicide-resistant, like everything else inside the cell. You’d have to get your face way down inside it to drown or suffocate, and that’s not going to happen unless someone holds you forcibly, and there was no sign of that, no injuries, like I said. The story was she was sick, was gagging. Or maybe was trying to throw up. There was a suggestion she might have had an eating disorder. And she passed out or had an arrhythmia.”
“Assuming she was alive when she ended up in that position.”
“I’m not in the business of assuming,” Colin says unhappily. “But there was nothing else. Negative tox. Another diagnosis of exclusion.”
“The symbolism,” I point out. “Her husband supposedly drowns, and she dies with her head in a toilet and at a glance, at least to the uninitiated, might appear to have drowned. Shania Plames hangs her children and then herself.” I remember what Tara Grimm said about not forgiving anyone who harms a child or an animal, and that life was a gift that could be given or taken away. “Barrie Lou Rivers poisons people with tuna-fish sandwiches, and that’s what she ate for her last meal,” I add.
We pull on splash-proof sleeves and fluid-resistant aprons, then shoe covers, and surgical caps and masks.
“I liked the old days better, when we didn’t have to bother wearing all this shit,” Colin says, and he sounds angry.
“It’s not that we didn’t need to.” I cover my nose and mouth with a surgical mask. “We just didn’t know any better.” I put on a pair of safety glass
es to protect my eyes.
“Well, there’s more to worry about now, that’s for sure,” he says, and I can tell he feels terrible. “I keep waiting for some God-awful scourge we haven’t heard of or dealt with before. Weaponizing chemicals and diseases. I don’t give a damn what anybody says. Nobody’s prepared for vast numbers of infectious or contaminated dead bodies.”
“Technology can’t fix what technology destroys, and if the worst happens, nobody’s going to deal with it very well,” I agree.
“That’s something for you to say with the resources you’ve got. But the fact is, there’s no cure for human nature,” he says. “No putting the genie back into the damn bottle when it comes to what shitty people can do to one another these days.”
“The genie was never in the bottle, Colin. I’m not sure there is a bottle.”
We pass the open door of the x-ray room, and I catch a glimpse of a C-arm fluoroscope that I never use anymore. But advanced technologies such as computed tomography or magnetic resonance imaging with 3-D software wouldn’t help us if we had it. Whatever killed Kathleen Lawler probably wouldn’t be visible on a CT or MRI or any other type of scan, and I hope Sammy Chang already is receipting documents and swabs to the labs.
Inside the main autopsy room a muscular young man in soiled scrubs and a bloody plastic apron is suturing closed the body of what I assume is the motor-vehicle fatality from earlier today. The head is misshapen like a badly dented can, the face smashed beyond recognition, blood streaking flesh, all of it in stark contrast to sterile cold concrete and shiny metal, to the lack of color and texture typical of morgues.
I can’t tell the victim’s age, but his hair is quite black and he is lean and well built, as if he went to a lot of trouble to be physically fit. I smell the early hints of blood and cells breaking down, of biology giving itself up to decomposition as a long surgical needle glints in the overhead light with each sweep of white twine, and water dribbles into a sink, tap-tapping on steel. On the far side of the room, Kathleen Lawler is on a gurney, a body shape pouched in white.
“Do we know why we posted him instead of doing a view?” Colin asks the morgue assistant, who has a Marine Corps bulldog tattoo on the side of his neck and a crew cut. “Since he doesn’t have much of a head left, almost looks like he got the wrong end of a shotgun? Seems like a view would have sufficed. What exactly was the question in this MV fatality that’s now costing Georgia taxpayers?”
“If he had a heart attack first and that caused him to swerve into oncoming traffic during rush hour.” He sutures in long sweeps and tugs that create a Y-shape of railroad tracks running from the sternum to the pelvis. “He had a history, had been hospitalized for chest pain last week.”
“And what did we decide?”
“Hey, not me deciding. I don’t get paid enough.”
“Nobody around here gets paid enough,” Colin says.
“The Mack truck smashed him to smithereens, and he died of cardiac arrest because his heart quit.”
“What about respiratory arrest? George, I don’t know if you’ve met Dr. Scarpetta.” Colin is grim.
“Yeah, he definitely quit breathing. Nice to meet you. I’m just giving him grief. Somebody has to.” George winks at me as he sutures. “How many times a week do you tell med students rotating through here that cardiac and respiratory arrest aren’t causes of death?” He mimics his boss. “You get shot ten times and your heart quits and you stop breathing, but that’s not what killed you,” he teases Colin, who’s not laughing, not even smiling.
“I’ll be finished up here in a few,” George says more seriously. “You need me for the next one?”
He cuts the heavy twine with the sharp, curved tip of the long needle and jabs it into a block of Styrofoam.
“If not, I got supplies that came in this morning and I need to put them away, and I’d like to pressure-wash the bay real good. We’re going to have to deal with the stock jars one of these days. I hate to keep reminding you. We don’t want the damn shelves to collapse and formalin and pieces and parts everywhere. Out of room and out of money. That’s the country-music song I’m going to write about this place,” he says to me.
“You know how I am about throwing things out. Hang around for a bit. Dr. Scarpetta and I will get started and see how it goes.” Colin’s face is hard, and I can see the thoughts in his eyes.
He’s wondering what he might have missed, wondering what all of us dread, those of us who take care of the dead. If we misdiagnose a patient, someone else might die. Carbon monoxide poisoning or a homicide, if we can catch it, we can prevent more of the same. It’s rare we can save anyone, but we must work every investigation as if it’s possible.
“You’ve got the stock jars in those old cases?” I ask about Barrie Lou Rivers, Shania Plames, and Rea Abernathy.
“Well, I didn’t save their gastric, damn it. I should have frozen it.”
“Why would you think to?”
“I didn’t. I wouldn’t have thought of it, had no reason to, but I wish I had.”
“And how many times have people like us said that?” I try to make him feel better. “There’s been some success in testing formalinfixed tissue,” I add. “Depending on what you’re looking for.”
“That’s the thing. Screen for what?”
We cross a tan epoxy-sealed floor where three additional tables mounted on columns and attached to sinks are spaced beneath illuminated fresh-air hoods. Parked by each station is a trolley neatly arranged with surgical instruments, evidence tubes and containers, a cutting board, an electric oscillating saw that plugs into an overhead cord reel, and a bright red sharps container. Cabinets, light boxes, and ultraviolet air sanitizers are mounted on walls, and there are evidence drying cabinets, and countertops and metal folding chairs for doing paperwork.
“Not that I’m in charge, but first on my list is what she might have been exposed to,” I say to Colin. “A grayish chalky residue that smelled like overheating electrical insulation. It would be extremely helpful to get an analysis ASAP of whatever was in her sink. It certainly didn’t smell like anything indigenous to her cell. I’m not trying to tell you what to do, but if you’ve got any influence.”
“Sammy’s got enough influence for both of us, and trace, tool marks, documents, they all like a challenge. Everything these days is DNA, and not everything can be solved by damn DNA, but try telling prosecutors that, and especially the police. My guess is the folks in trace will get on it right away. I didn’t smell whatever it is, but I’ll take your word for it, and you can tell me what to do all you like. Offhand, I can’t think of any poison that might smell like overheating electrical insulation.”
“So what was it?” I ask. “What did she get hold of, and how? In the maximum security of Bravo Pod, it’s not as if she could wander around in common areas and mingle with other inmates and get her hands on something she wasn’t supposed to have.”
“Obviously we have to worry about people who had access to her cell. Always my concern when it’s a death in custody. Even under what may appear to be the most normal of circumstances, and this isn’t in the normal category,” he says. “Not anymore.”
24
On a countertop are boxes of different-size gloves, and I get two pairs for each of us, and Colin unzips the body pouch. Plastic rustles as he opens it all the way. I help him slide Kathleen Lawler onto the steel table, and he walks to bins mounted on a wall and begins to collect blank forms, securing them to a metal clipboard as I remove the rubber bands around her wrists and ankle. I remove the brown paper bags I placed over her hands and left foot earlier, and fold them and package them for the trace evidence lab, then I tear off a large sheet of white butcher paper from a dispenser on a counter and cover the autopsy table beside the one we’re using.
Her body is considerably cooler but still limber and easy to manipulate as we begin to undress it, and we place each article of clothing on the paper-covered table next to us. The button-up white uniform s
hirt with inmate stamped on the back in large dark blue letters. The white trousers with a button fly and the blue initials GPFW down the sides of the legs. A bra. A pair of panties. I find a hand lens on a cart and turn on a surgical lamp, and under magnification I discover a faint area of orange smearing, as if Kathleen might have wiped her hand on her right pant leg. I retrieve a camera from a shelf and place a scale next to the stain, centering it under the light.
“I don’t know where you get food testing done around here,” I say to Colin. “This looks like cheese, but we should find out. I’m not going to swab it, will let trace take care of it. She had something orange under her right thumbnail, too. Might be the same thing, something she touched or ate not long before she died.”
“GBI uses a private lab in Atlanta that analyzes food, cosmetics, consumer products, you name it,” he says. “I wonder if inmates can buy these cheese sticks or cheese spread in the commissary.”
“Definitely the yellowy-orange color of cheddar or a cheddar spread. I didn’t see any cheese or cheese sticks in her cell, but that doesn’t mean she didn’t have something like that earlier. Of course, we’d know more if her trash hadn’t disappeared. What about petechial hemorrhages of the eyes, the face, in the Plames case?” I return to the subject of Shania Plames’s death as I return to the table bearing Kathleen Lawler’s body.
“Nothing. But you don’t always have that, either, in suicidal hangings with full vascular compression.”
“Based on the rig you’ve described, the way her uniform trousers were tied around her neck and legs, I’m not sure I would expect the full vascular compression associated with full—not partial— suspension or with complete ligature strangulation.”