Less than one minute later a bald young man rolled a cart through the door.
“Anything else, Dr. Perry?” Baldy avoided eye contact with his boss.
“Stay in touch.”
Baldy bolted.
On the cart lay the following: proximal and distal portions of a left femur; a fragment of proximal left fibula; two fragments of left tibia, one proximal, the other distal, including the mangled malleolus; a portion of left pelvis extending from the pubic bone out into the blade; the talus, navicular, and third and second cuneiforms from a left foot.
Two large brown envelopes occupied the cart’s lower shelf.
“Double-check,” Perry ordered. “Be sure they’re both lefts.”
I did.
They were.
Despite the raucous hair and makeup, the ME’s face looked pallid.
I could imagine the battle playing out in Perry’s mind. The recession had slammed the Hawaiian economy. Air travel was down, and tourism was in the toilet. Close a beach due to shark attack, hotel bookings would vanish like early morning mist. Go the other way, lose a swimmer, mainlanders would opt for the Shenandoah or Disney World. The consequences would be worse than closing a beach.
Guess right, lose dollars. Guess wrong, lose lives as well as dollars.
And Perry had to act quickly.
My hunch? Honolulu’s flamboyant ME would once again piss people off.
I was rotating the new hunk of leg when I noticed an irregularity centered in the shaft approximately five centimeters above the troublesome malleolus. By scraping back tissue, I was able to see that the defect was a hole with a raised outer rim, too perfectly round to be natural.
“This could be helpful,” I said.
Perry snatched the magnifier and held it where I indicated.
“I’ll be damned. You thinking surgical pin?”
I nodded.
“The placement makes sense. Too bad we don’t have the calcaneous.”
“Yes,” I agreed.
“Someone going to educate us nonmedical mopes?” Ryan asked.
I kept my finger in place while Perry handed him the lens.
“That tiny hole?” he asked.
“That tiny hole.”
Ryan passed the lens to Gearhart.
“Everyone familiar with traction?” I asked.
Gearhart nodded.
Ryan shrugged. Not really.
“In orthopedics, traction is used for the treatment of fractured bones and for the correction of orthopedic abnormalities,” I explained for Ryan’s benefit. “Traction aligns the broken ends by pulling a limb into a straight position. It also lessens pressure on the bone ends by relaxing the muscles.”
Ryan snapped his fingers. “The old leg-in-the-air trick. Remember the scene in
I shot a narrow-eyed warning.
Ryan’s face went all innocent. What?
“My nephew got put in traction when he busted his leg.” Gearhart was again peering through the lens. “They drilled a pin right into his femur.”
“Once the hardware is inserted, pulleys and weights are attached to wires to provide the proper pull. Skeletal traction uses anywhere from twenty-five to forty pounds.”
“How long does the pin remain in place?” Ryan now sounded overly proper.
“Weeks, maybe months. This one was removed years ago.”
Gearhart jabbed at her glasses, which had slipped low on her nose. “What’s your take, Doc?”
“I’d guess an unstable tibial shaft fracture. The distal tibia would have been pinned to the calcaneous.”
“Which we don’t have.” Perry.
“Fractured how?” Gearhart asked.
“Skiing? Cycling? Car crash? Without more of the leg it’s impossible to say.”
“Space shuttle wipeout.” Perry began pacing.
