close to the bone we run the office as is, but death investigation still doesn't come cheaply enough for the budget cutters.'
It was an all-too-familiar lament among forensics experts. 'I'm sorry to hear it, Karl.' She sounded like a person giving condolences to a friend who'd contracted an incurable disease, but she didn't know what else to say.
Repasi shrugged and said, 'There's the usual complaint about lack of money, which has led to inadequate staffing and salaries, and we struggle along with antiquated operations and equipment.'
'Resistance to acquiring new technology, resistance to change,' she sounded the mantra. 'And a failure to appreciate, even understand, the M.E.'s mission. I got the same nonsense when I was M.E. in Washington, and when I was an assistant M.E. in Baltimore before that.'
Finally, something she did understand. It made sense for Repasi to have shown up uninvited here. 'How many ways do we have to show people that the coroner system produces inferior and inaccurate results?' she rhetorically asked. 'Nonphysicians can't make accurate medical decisions, no matter how many weeks of training you give them.'
'Nor can general pathologists in many cases. Sure, they can mull their way through most common cases, but the difficult ones, the cases they often don't even recognize as difficult… Fools in Phoenix are taking the death stats to heart, you see. They say only twenty percent of our cases involve suspicious deaths, so a pathologist could handle the eighty percent that we do not need to investigate.'
Jessica understood the enormous hole in this logic, and she nodded knowingly.
'How does a pathologist know which is the twenty percent if he isn't trained to recognize that twenty percent? What judge would take his pregnant wife to a dermatologist for obstetrical care? But the same politician will permit an individual with zero forensic training to testify in a case involving life-and-death decisions.'
'Yeah, agreed,' began Jessica. 'A major characteristic of the unqualified expert in forensics is that rare ability to interpret a case in absolute and exquisite detail when there are no forensic details to be had in a case.'
'Worse still is the practice of contract pathologists.'
'Yes, the very notion sets my teeth on edge.' Jessica's mind fumed at the idea of a pathologist paid by the case, so that the more cases he or she put away, the more money the pathologist made. 'What about the local coroner here in Page? How does he work?'
'Modified coroner, M.E. system. Sends a lot of his cases up to Salt Lake City, others to me in Phoenix.'
'Oh, so you two know each other well.'
'Yes.'
'So, he's okay with you taking charge, Karl?'
We've talked at length. He's happy for the interference.'
'That's a refreshing change. I usually meet with resistance with the natives. Good for you.'
'Perhaps I'm better with my people skills than you, Jessica?''
She let this pass, saying, 'Well then, let's get to work, shall we?' She returned to the body, what remained of Mel Martin: a greasy, soot-covered, creosoted lump of charred flesh an autopsy could do little or nothing for. This they all knew, but protocol mandated an autopsy be performed.
And so, Jessica, how do you approach a fire victim such as this? She heard Dr. Holcraft's voice, her mentor, now long dead, filling her thoughts.
She inwardly, silently answered, The same way that any physician approaches any patient. In medical school, Jessica was taught that to make a correct diagnosis, she must first take a history, perform an examination, and order relevant laboratory tests. They'd gotten only a smattering of Martin's history, knowing much less about the man than they had Chris Lorentian in Vegas. But there were no family members at hand, and time was fleeting. They were prepared to make their examination now and order necessary tests.
'I suppose you've seen your share of burn cases, Dr. Coran,' said Repasi, 'but have you ever seen anything worse than this?'
She paused, considered his question, and replied, ''Yes, I have.'
'Oh, really? Explosion victims? Lightning victims?'
'A woman who was scalded to death.'
Both doctors appreciated the severe nature of burns from boiling water, knowing that water heated to 158 degrees Fahrenheit caused a full-thickness burn in adult skin in one second of contact.
'Ahhh, bathroom shower injuries I've seen, but nothing approximating this.'
'This was no bathroom shower accident. It was a victim of murder whose body was placed in a scalding hot spring in Yellowstone National Park, held under by her ankles as she thrashed. The scalding was uniform, not showing any burn variation, no multiple splash bums, just all-over fourth-degree burns. The killer hoped to cover up a rape-murder by completely scalding the body in a two-hundred-five-degree hot pool. She was scalded over her entire body, save her ankles and feet, which were only mildly burned by comparison. Sloppy oversight on the killer's part, but then he didn't know a medical examiner was in the park at the time. The murderer was a young park ranger who'd come up on the victim where she was hiking alone in the park. That was some ten or eleven years ago.'
'Sounds like an interesting case,' he granted.
'It was the first murder case I ever solved.'
While Page's hospital was an adequate, modern facility, the death room and the forensic equipment in Page left a great deal to be desired; still, Jessica was glad to see that they had at least the rudiments for a pathology lab and that it was not placed in the subbasement of the hospital or the back of a funeral home, as was the case in hundreds of thousands of small towns all across America. There was just sufficient enough space along with appropriate lighting, plumbing, and cooling facilities. The instrumentation included an X-ray machine for the pathology lab and coroner's office to share, a luxury, it appeared, despite the fact that an X-ray machine was basic equipment in any autopsy suite. Page also had its own small toxicological lab capable of accurate, precise analysis for the presence of drugs.
In getting the autopsy under way, Jessica spoke into a microphone that recorded her autopsy for later transcription. Back at Quantico, nowadays, the entire autopsy was put on videotape, and Jessica had learned to choose her words with extreme care, for anything said now could come back to haunt the medical examiner. She announced the purpose of their coming together, the name of the deceased, age, height, weight, sex, race, condition of the body upon discovery. This led her to add, 'On gross examination of such a victim, it is virtually impossible to distinguish antemortem from postmortem burns. Microscopic examination of the body tissue offers no help, unless the victim has survived long enough to develop an inflammatory response. Wouldn't you agree, Dr. Repasi?'
Repasi promptly agreed, saying, 'Yes, lack of such a response doesn't necessarily indicate that the burn was postmortem. I have had occasion to view third-degree burns incurred by Vietnam veterans in which the patients died two and three days later. In some of these cases, there was no inflammatory reaction whatsoever.'
Jessica agreed now, adding, 'Due, presumably, to heat thrombosis of the dermal vessels.'
'Such that inflammatory cells could not reach the area of the burn and produce a reaction to begin with,' finished Repasi.
Jessica thought that perhaps J. T. ought to have remained; he might well have learned something about the irregular nature of burn pathology.
'In Mr. Martin's case, it is presumed he was alive when he died due to witness testimony, namely Dr. Coran,' said Repasi for the record.
'It may also be of interest that the skin has split open, revealing exposed muscle across the upper torso and upper extremities, while skin over the back is perfectly preserved. Where the skin is completely burned away, underlying muscles have ruptured due to the intensity of the heat,' added Jessica.
Burned bone shone as gray-white with a fine, superficial network of fractures on the cortical surface. Repasi noted this for the shoulder bone and collarbone as well as the skull. With his gloved hand, he put slight pressure on a section of skull thus discolored, and it crumbled at his touch. He noted this for the record. 'The outer table of the exposed cranial vault,' he said, pausing, 'reveals a network of fine, crisscrossing heat fractures.'
Both examiners knew that it was extremely hard to burn a body, due to its high water content, and that to do the damage the Phantom had inflicted on Martin required a superheated energy source. Portions of the abdominal wall were burned away as well, exposing the viscera. The internal organs appeared charred, seared.
