image.
When all the tests were done, Dr. Ruddock summoned Victor and Marsha back to his office. VJ was left outside in the waiting room. Victor was plainly nervous, crossing and uncrossing his legs and running his hand through his hair.
Throughout the testing neither Dr. Stevens nor the technician made any comment. By the end, Victor was almost paralyzed with tension.
“Well,” Dr. Ruddock began, fingering some of the print-outs and images from the tests, “not all the results are back, specifically the blood work, but we do have several positive findings here.”
Marsha’s heart sank.
“Both the PET and the NMR scans are abnormal,” Dr. Ruddock explained. He held up one of the multicolored PET scan images with his left hand. In his right hand he held a Mont Blanc pen. Carefully pointing to different areas, he said, “There is a markedly elevated but diffuse uptake of glucose in the cerebral hemispheres.” He dropped the paper and picked up another colored image. “In this NMR scan we can see the ventricles quite clearly.”
With her heart pounding, Marsha leaned forward to get a better look.
“It’s quite obvious,” Dr. Ruddock continued, “that these ventricles are significantly smaller than normal.”
“What does this mean?” Marsha asked hesitantly.
Dr. Ruddock shrugged. “Probably nothing. The child’s neurological exam is entirely normal according to Dr.
Stevens. And these findings, although interesting, most likely have no effect on function. The only thing I can think of is that if his brain is using that much glucose, maybe you should feed him candy whenever he’s doing much thinking.” Dr.
Ruddock laughed heartily at his own attempt at humor.
For a moment both Victor and Marsha sat there numbly, trying to make the transition from the bad news they’d expected to the good news they’d received. Victor was the first to recover. “We’ll certainly take your advice,” he said with a chuckle. “Any candy in particular?”
Dr. Ruddock laughed anew, enjoying that his humor was so well received. “Peter Paul Mounds is the therapy I recommend!”
Marsha thanked the doctor and ran out the door. Catching VJ unaware, she had him in a bear hug before he could move away. “Everything is fine,” she whispered in his ear. “You’re okay.”
VJ extracted himself from her grasp. “I knew I was fine before we came. Can we go now?”
Victor tapped Marsha on the shoulder. “I’ve got some other business here and then I’ll go directly to work. I’ll see you at home, okay?” Victor said.
“We’ll have a special dinner,” Marsha said, turning back to VJ. “We can leave but you, young man, are not finished. We are going to my office. I have a few more tests for you.”
“Oh, Mom!” whined VJ.
Marsha smiled. He sounded just like any other ten-year-old.
“Humor your mother,” Victor said. “I’ll see you both later.” He gave Marsha a peck on the cheek and tousled VJ’s hair.
Victor crossed from the professional building to the hospital proper and took the elevator to Pathology. He found Dr. Burghofen’s office. The man’s secretary was nowhere to be seen so Victor looked inside. Burghofen was typing with his two index fingers. Victor knocked on the doorjamb.
“Come in, come in!” Burghofen said with a wave. He continued to peck at the typewriter for a few moments, then gave up. “I don’t know why I’m doing this except my secretary calls in sick every other day, and I’m constrained from firing her. Administering this department is going to be the death of me.”
Victor smiled, reminding himself to remember that academia had its own limitations the next time he got fed up with office problems at Chimera.
“I was wondering if you had finished the autopsies on the two children who died of cerebral edema,” Victor said.
Dr. Burghofen scanned the surface of his cluttered desk.
“Where’s that clipboard?” he asked rhetorically. He spun around in his chair, finding what he was searching for on the shelf directly behind him. “Let’s see,” he said, flipping over the pages. “Here we are: Maurice Hobbs and Mark Murray.
Are those the ones?”
“Yup,” Victor said.
“They were assigned to Dr. Shryack. He’s probably doing them now.”
“All right if I go look?” asked Victor.
“Suit yourself,” he said, checking the clipboard. “It’s amphitheater three.” Then as Victor was about to leave, he asked, “You did say you were a medical doctor, didn’t you?”
Victor nodded.
“Enjoy yourself,” Dr. Burghofen said, returning to the typewriter.
The pathology department, like the rest of the hospital, was new, with state-of-the-art equipment. Everything was steel, glass or Formica.
The four autopsy rooms looked like operating rooms. Only one was in use and Victor went directly inside. The autopsy table was shining stainless steel, as were the other implements in sight. Two men standing on either side of the table looked up as Victor entered. In front of them was a young child whose body was splayed open like a gutted fish.
Behind them on a gurney was the small, covered body of another.
Victor shuddered. It had been a long time since he’d seen an autopsy and he’d forgotten the impact. Particularly when viewing a child.
“Can we help you?” the doctor on the right asked. He was masked like a surgeon, but instead of a gown, he wore a rubberized apron.
“I’m Dr. Frank,” Victor said, struggling to suppress nausea. Besides the visual assault, there was the fetid odor that even the room’s modern air conditioning could not handle. “I’m interested in the Hobbs baby and the Murray baby. Dr. Burghofen sent me down.”
“You can watch over here if you like,” the pathologist said, motioning Victor over with his scalpel.
Tentatively, Victor advanced into the room. He tried not to look at the tiny eviscerated body.
“Are you Dr. Shryack?” asked Victor.
“That’s me.” The pathologist had a pleasant, youthful voice and bright eyes. “And this is Samuel Harkinson,” he said, introducing his assistant. “These children your patients?”
“Not really,” Victor said. “But I’m terribly interested in the cause of their deaths.”
“Join the group,” Dr. Shryack said. “Strange story! Come over here and look at this brain.”
Victor swallowed. The child’s scalp had been cut and pulled down over the face. Then the skull had been sawed around the circumference of the head, and the crown lifted off. Victor found himself looking at the child’s brain, which had risen out of its confinement, giving the child the appearance of some sort of alien being. Most of the gyri of the cerebral cortices had been flattened where they had pressed against the inside of the skull.
“This has to be the worst case of cerebral edema I’ve ever seen,” Dr. Shryack said. “It makes getting the brain out a chore and a half. Took me half an hour with the other one.”
He pointed toward the shrouded body.
“Till you figured out how to do it,” Harkinson said with a faint Cockney accent.
“Right you are, Samuel.”
With Harkinson holding the head and pushing the swollen brain to the side, Dr. Shryack was able to get his knife between the brain and the base of the skull to cut the upper part of the spinal cord.
Then, with a dull, ripping sound, the brain pulled free.
Harkinson cut the cranial nerves, and Dr. Shryack quickly hoisted the brain and placed it in the pan of the overhead scale. The pointer swung wildly back and forth, then settled on 3.2.
“It’s a full pound more than normal,” Dr. Shryack said, scooping the brain back up with his gloved hands and carrying it over to a sink that had continuous running water. He rinsed the clotted blood and other debris from the brain, then put it on a wooden chopping block.
With experienced hands, Dr. Shryack carefully examined the brain for gross pathology. “Other than its size, it
