“No.”
“Did you ask him?”
“Yes, but he didn’t know.”
“How could he not know?”
Her face clouded over since Greg wasn’t going to let go. “Well, I don’t know,” she said reluctantly. “Unless it was some kind of procedure he had at a young age.”
“Have you ever seen scars like those before?”
Porter glanced at the others. “Well, not really.”
“They were very unusual,” Budd added, and Doria shot him a hard look.
“Can you at least tell me how old he was?” Greg asked.
Cindy looked at Doria who made a half-nod to end the discussion. “Eighteen.”
Greg conspicuously wrote down on his pad: “Male—eighteen.”
“White?”
“Mmm.”
“And what did he come into the ER for?”
“Excuse me, Officer,” Doria cut in. “But we can’t do this.”
“Do what?”
“Try to get around protocol by playing twenty questions. I mean, if you had a crime and a court order, that would be different. But you don’t, and we’re not at liberty to discuss the case. Patients have their rights.”
The others nodded.
“Then can you tell me what kind of medical procedure these holes might have come from?” He spread out the skull photos and moved them closer to them.
“I don’t think we can continue,” Doria announced, backing away.
“Why not?”
“Because you’re indirectly asking us to disclose a patient’s condition by having us diagnose these remains. And we can’t do that.”
“But you may help solve a crime.”
“What’s to say those holes had anything to do with a crime?” Doria asked.
“Because nobody knows what they were for. So I’m suspicious.”
“Well, if you think there’s a connection,” Doria said, “then get a subpoena.”
That was a legitimate option, but it could take days, even weeks. And that would alert Lieutenant Gelford, who would go ballistic to know Greg was still pursuing this. There was another option.
Greg stood up so he was eye to eye with Doria. “You worked on this patient, correct?”
“You know that.”
“And you were aware that this eighteen-year-old had scars on his head that he himself was not aware of, correct?”
“So?”
Greg picked up the photocopy of the newspaper article on the mystery skull and held it to Doria’s face. “This is child abuse as far as it can go—kidnapping and murder.”
“What’s your point, Officer?” Doria asked.
“My point is that in the state of Massachusetts, as doctors and nurses you are mandated reporters of child abuse. By penalty of law, it is incumbent upon you to report directly to the DSS any suspicions you have that a minor has been wrongfully injured. Failing to do so can result in your arrest and incarceration.”
“But we had no such suspicions,” Doria protested. “The kid had old scars.”
“But you said the kid didn’t know he had them.”
Doria’s face turned red. “Many adults walking the streets have scars from appendectomies, but they didn’t get them from abuse as children.”
“You’ve treated a patient with very unusual scars in his head similar to those of a murdered child. Did you notify the DSS?”
Doria looked at Dr. Budd who both looked at Nurse Porter. Sheepishly, Porter said, “Well, I called you.”
“That’s not what I asked you,” Greg said. “Did you file a report with the DSS as mandated by law?”
“No.”
“Wait a minute,” Doria said. “Are you threatening us, Officer?”
“No, I’m offering you an option to jail.”
“I don’t believe this,” Doria said.
“Believe it.”
“So what are we supposed to do?” Nurse Porter asked. She looked scared.
“Show me the X rays.”
“And if we don’t?” Doria asked defiantly.
“Then I will file a complaint with the attorney general’s office, and you’ll be arrested.”
Doria gave Greg a scathing look. “Give me a break.”
“I am.”
There was a moment of prickly silence. Then Dr. Budd said, “I have no problems with your seeing the films.”
“Me, neither,” Nurse Porter said.
Doria glowered at Greg like an angry schnauzer. “This is coercion, Officer, and you know it,” he said. “You can see them, but I’m drawing the line on revealing the patient’s name.”
“Fair enough.”
Doria left, and returned a few minutes later with a large envelope containing duplicates he had made without the patient’s name or ID number on them. He handed them to the radiologist.
Budd pulled out the X rays and slid them onto the light board. He studied them for a moment, then with a pen he pointed to faint impressions on the top and side images. “These are the holes. There’s a cluster of eight here above the left ear each about a millimeter and a half in diameter—and ten more above the eyebrow, just behind the hairline—here.”
The holes appeared on the images as white dots on the left profile, and tiny transect lines in the top views. “Can you tell how they were made?”
“Since they’re so sharply incised, my guess is a cranial drill,” Budd said.
“As the result of some medical operation or procedure?”
“Yes.”
The holes appeared to be clustered almost identically to those on the Sagamore and Dixon boys’ skulls.
“The ones in front I noticed while working on him,” said Cindy Porter. “But I didn’t know about the others until I saw the films.”
Budd continued. “What’s even odder are the three holes just behind the temple about where the left ear begins.” He tapped them out with the pen.
Not wanting to influence their interpretations, Greg held back on Joe Steiner’s speculations. “What do you make of them?”
“Well, I’m not really sure,” said Budd.
“Have you ever seen clusters of holes like these before?”
“No,” Budd said. “It’s possible he’d been treated for multiple tumors.”
“Except that the surgeon wouldn’t have to make so many holes,” Doria added.
Greg could see that he was warming up again. The threat of jail does that. “Why not?” Greg asked.
“Well, if you’re going to drill so many holes—whatever the reason—it’s a lot easier to pull back the skin first, then drill.” He put his fingers to his forehead and rotated the flesh. “The scalp moves around easily. It makes more sense to do a line incision and push the skin back, then close the incision after boring.”
“So you’re saying that this is an unusual technique.”
“Very,” Doria said. “Why go to this length to make all these little incisions when it’s easier to make a clean slice?”
“Unless he wanted to hide them,” Cindy suggested.
“Why hide them?” Greg asked.
