splattered with blood, but he didn’t seem to notice it; they had seen so much violence that night, perhaps they could no longer be shocked by the sight of gore. “How’s the girl?” he asked.
“She made it through surgery As soon as her blood pressure’s stabilized, they’ll be transferring her to Bangor.” Claire gave him a tired smile. “I think she’ll be fine, Pete.”
“We brought the boy here,” he said.
“Scotty?”
He nodded. “The nurses put him in that exam room over there. Lincoln thought you’d better take a look at him. There’s something wrong.”
With growing apprehension, she crossed the ER and came to an abrupt halt in the exam room doorway. There she stood staring into the room, saying nothing, a chill rising up her spine.
She almost jumped when Pete said, quietly, “You see what I mean?” “What about his mother?” she asked. “Did you find Faye?” “Yes, we found her.”
“Where?”
“In the cellar. She was still in her wheelchair.” Pete looked into the exam room, and as if repelled by what he saw, he took a fearful step backwards. “Her neck was broken. He pushed her down the stairs.”
10
From the other side of the X-ray viewing window, Claire and the CT technician watched Scotty Braxton’s head disappear into the mouth of the scanner. His limbs and chest were firmly strapped to the table, but his hands continued to twist against the leather restraints and his wrists had already been chafed raw, streaking the leather with blood.
“We’re not going to get any decent shots,” said the tech. “Still too much movement. Maybe you can give him some more Valium?”
“He’s already got five milligrams on board. I hate to obscure his neuro status,” said Claire.
“It’s either that or no CT.”
She had no choice. She filled the syringe and entered the scan room. Through the window, she saw the state trooper watching her. She approached the table and reached for the IV port. Without warning the boy’s hand shot open. She jerked away just as his fingers clamped down like a trap.
The cop stepped into the room. “Dr. Elliot?”
“I’m okay,” she said, heart pounding. “He just startled me.”
“I’m right here. Go ahead and give him the medicine.”
Quickly she snatched up the IV line, plunged the needle in the rubber dam, and injected the full two milligrams.
The boy’s hand finally fell still.
From behind the window, she watched as the scanner began to whir and click, bombarding his head with a shifting sequence of X-ray beams. The first slice, from the top of the cranium, appeared on the computer screen.
“Looks normal so far,” said the tech. “What are you expecting to see?”
“Any anatomical abnormality that might explain his behavior. A mass, a tumor.
There has to be a reason for this. He’s the second boy I’ve seen with uncontrollable aggression.”
They all turned as Lincoln came into the CT room. The tragedy had taken its toll on him; she could see it in his face, in the shadows under his eyes and the sadness of his gaze. For him, the death of Faye Braxton had been only the start of an endless night of press conferences and meetings with state police investigators. He shut the door and seemed to breathe a sigh of relief that he had at last found a quiet, albeit temporary, retreat.
He crossed to the window and gazed at the boy lying on the table. “What have you found so far?”
“The preliminary drug screens were just called back from Bangor. His blood’s negative for amphetamines, phencyclidine, and cocaine. The usual drugs associated with violence. Now we have to rule out other causes for his behavior.” She looked through the glass at her patient. “It’s just like Taylor Darnell. And this boy has never been on Ritalin.”
“Are you sure?”
“I’m their family doctor. I have all Scotty’s records from Dr. Pomeroy’s files.”
They both stood with shoulders propped wearily against the window, conserving energy for the hours that lay ahead. It was the only time they ever seemed to interact, she realized. When they were both tired or scared or distracted by crisis. Neither one of them looking his best. They held no illusions about each other, because they had been through the worst together. And I’ve only learned to admire him more, she thought with surprise.
The tech said, “Here come the final cuts.”
Both Claire and Lincoln stirred from their exhausted daze and crossed to the computer terminal. She sat down to watch as the cross sections of brain appeared on the screen. Lincoln moved behind her, his hands resting on the back of her chair, his breath warming her hair.
“So what do you see?” asked Lincoln.
“No midline shift,” she said. “No masses. No bleeding.”
“How can you tell what you’re looking at?”
“The whiter it is, the denser it is. Bone is white, air is black. As you cut lower in the cranium, you’ll begin to see parts of the sphenoid bone appearing, at the base of the brain. What I’m looking for is symmetry Since most pathology affects only one side of the brain, I check for differences between the two sides.”
A new cut appeared. Lincoln said, “That view doesn’t look symmetrical to me.”
“You’re right, it isn’t. But I don’t worry about that particular asymmetry because it doesn’t involve the brain. It’s in one of the bony sinuses.”
“What are you looking at?” asked the tech.
“The right maxillary sinus. You see? It’s not completely lucent. There seems to be something clouding it.”
“A mucoid cyst, I’d guess,” said the tech. “We see that sometimes in patients with chronic allergies.”
“It certainly wouldn’t explain his behavior,” said Claire.
The phone rang. It was Anthony, calling from the lab.
“You might want to come down and look at this, Dr. Elliot,” he said. “It’s the gas chromatogram on your patient.”
“Has something shown up in his blood?”
“I’m not sure.”
“Explain this test to me,” said Lincoln. “What are you measuring here?”
Anthony patted the boxlike gas chromatograph and grinned like a proud father.
The tabletop instrument was a recent acquisition, a valuable hand-me-down from Eastern Maine Medical Center in Bangor, and he hovered over it protectively.
“What this piece of equipment does,” he explained, “is separate mixtures into their individual components. It does this by making use of each molecule’s known equilibrium between the liquid phase and the gas phase. You remember high school chemistry?”
“It wasn’t my favorite subject,” Lincoln admitted.
“Well, every substance can exist either as a liquid or a gas. For instance, if you heat water, you make steam-which is the gas phase of H-two-oh.”
“Okay, I’m following you.”
“Coiled inside this machine is a capillary column-a very long, very thin tube that, if you laid it out straight, would stretch about half the length of a football field. It’s filled with an inert gas that won’t react with anything.
Now, what I do is inject the sample to be tested into this port here. It gets heated and vaporized to gas, and the different types of molecules travel along that tube at different rates of speed, depending on their mass. That separates them. As they come out the other end of the tube, they pass through a detector and it’s recorded on a strip-chart. The time it takes for each substance to emerge is called ‘retention time.’ We already know the
