problem at post-mortems.
Unknown Male’s flesh was a waxy off-white. It was the colour Roy Grace had long associated with bodies in which the life forces had ceased, but on which decomposition had not yet begun to present, to the naked eye at least, its hideous processes. The winter weather and the cold of the seawater would have helped to delay the onset, but it was clear that Unknown Male had not been dead for long.
Nadiuska De Sancha, her red hair clipped up, tortoiseshell glasses perched on her finely sculpted nose, estimated that death had probably occurred four or five days ago – but she was not able to get closer than that. Nor was she able to establish, for the moment at any rate, the precise cause of death, largely on account of the fact that Unknown Male was short of most of his vital organs.
He was a good-looking young man, with close-cropped, downy black hair, a Roman nose and brown eyes that were fixed open. His body was lean and bony – but from undernourishment rather than exercise, Grace judged from the lack of muscle tone. His genitals were modestly covered by the fleshy triangle of skin from his sternum, which had been removed and placed there by Nadiuska, as if to afford him some dignity in death. The flesh of his chest and stomach, either side of the massive incision running down his midriff, was clamped back, revealing a startlingly hollow ribcage, with the intestines, like shiny, translucent rope, coiled beneath.
On the wall to their left was a chart for listing the weight of the brain, lungs, heart, liver, kidneys and spleen of each cadaver examined in here. There was a dash against each item, except for the brain, the only vital organ the cadaver still possessed, and very likely to be the only one that would go to his grave with him.
The pathologist removed his bladder, laid it on the metal dissecting tray, which was on raised legs above the cadaver’s thighs, then made one sharp incision to open it. She carefully bottled and sealed samples of the fluid that poured out, for tests.
‘What’s your assessment so far?’ Grace asked her.
‘Well,’ she said, in her exquisite broken English, ‘the cause of death is not absolute at this moment, Roy. There’s no petechial haemorrhaging to indicate suffocation or drowning, and with the absence of his lungs I can’t say for sure at this point if he was dead prior to immersion. But I think we can surmise, from the fact that his organs were removed, that was pretty likely.’
‘Not many surgeons operate underwater,’ Michael Forman quipped.
‘I don’t have much to go on from the stomach contents,’ she continued. ‘Most of it has been dissolved by the digestion process, although that slows post-mortem. But there are some particles of what looks like chicken, potato and broccoli – so that indicates he was capable of eating a proper meal in the hours preceding death. That is not really consistent with his absence of organs.’
‘In what way?’ Grace asked, conscious of the inquisitive eyes of the Coroner’s Officer and Glenn Branson.
‘Well,’ she said, and waved her scalpel down his opened midriff. ‘This is the kind of incision a surgeon would make if he was harvesting organs from a donor. All the internal organs have been surgically excised, by someone experienced. Consistent with this is the fact that the blood vessels have all been tied off with sutures before being cut through to remove the organs.’ She pointed. ‘The perinephric fat that would have been around the kidneys – the suet, if you are a cook – has been opened with a blade.’
Grace reminded himself not to eat suet for a long time to come.
‘So,’ Nadiuska continued, ‘all this would indicate that he was an organ donor. Now, what directs me even more towards this possibility is the presence of these external indications of medical intervention.’ She pointed again. ‘A needle mark in the back of the hand.’ She gestured at the neck. ‘A puncture mark.’ Then she pointed at the right elbow. ‘Another puncture mark in the antecubital fosse. These are consistent with the insertion of cannulae for drips and drugs.’
Then, taking a small torch, she gently levered open the dead man’s mouth with her gloved fingers and shone the beam in. ‘If you look closely you can see reddening and ulceration to the inside of the windpipe, just below the voice box, which would have been caused by the balloon inflated on the end of the endotracheal ventilator tube.’
Grace nodded. ‘But he ate a meal of solids – he couldn’t have done that with an endotracheal tube, right?’
‘Absolutely right, Roy,’ she said. ‘I don’t understand this.’
‘Perhaps he was an organ donor who was subsequently buried at sea, and then carried by currents away from the burial zone?’ Glenn Branson suggested.
The pathologist pursed her lips. ‘It’s a possibility. Yes,’ she concurred. ‘But the majority of organ donors tend to be on life support for a period of time, during which they would be intubated and on intravenous drip feeds. It is odd to me that there is undigested food in his stomach. When I do the tox screen, that may show up muscle relaxants and other drugs that would be used for the removal of organs for transplant.’
‘Can you give me an approximation of how many hours from when he had eaten until he died?
‘From the state of the food, four to six at maximum.’
‘Couldn’t he have died suddenly?’ Grace asked. ‘A heart attack, or a car – or maybe motorbike – accident?’
‘He doesn’t have injuries consistent with a serious accident, Roy. He has no head or brain trauma. A heart attack or an asthma attack is a possibility, but considering his age – late teens – both, I would say, are a little improbable. I think we could be looking for some other cause.’
‘Such as?’ Grace scribbled a sudden note on his pad, thinking of something that would need following up.
‘I can’t speculate at this stage. Hopefully lab tests will tell us something. If we could get his identity, that might help us also.’
‘We’re working on that,’ he said.
‘I’m sure it is the lab tests that will provide the key. I think it is very unlikely that the tapings are going to produce anything, as he wasn’t in waterproof wrapping,’ the pathologist went on. Then she paused briefly, before adding, ‘There is one other thought. This food in the stomach. In the UK, because there is no automatic organ harvesting without consent, it does often take many hours from brain death for consent to be obtained from next of kin. But in countries where there is just an opt-out, like Austria and Spain, then the process can be much quicker. So it is possible that this man is from one of those countries.’
Grace thought about this. ‘OK, but if he died in Spain or Austria, what is he doing ten miles off the coast of England?’
There was a shrill ring on the doorbell. Darren, the Assistant Mortuary Technician, hurried out of the room. A couple of minutes later he returned with Sergeant Tania Whitlock, from the Specialist Search Unit, gowned and in protective boots.
Roy Grace brought her up to speed. She asked to see the plastic sheeting and weights in which the body had been found, and Cleo took her out into the storage area to show her. Then they returned to the post-mortem room. The Home Office pathologist was busy dictating notes into her machine. Grace, Glenn Branson and Michael Forman were standing near the cadaver. The photographer walked out to the storage area to start working on close-ups of the wrapping and binding.
‘Do you think he could have drifted in the currents from a designated burial-at-sea area?’ Grace asked Tania.
‘It’s possible,’ she said, breathing in through her mouth, trying to ignore the stench. ‘But those weights are pretty heavy, and we’ve had mild weather conditions recently. I can get you a plot done, showing where it might have come from with lesser weights on, if that would be helpful.’
‘It might be. Could it be a burial at sea where they got the position wrong?’
‘A possibility,’ she said. ‘But I’ve checked with the
‘That’s what I’m thinking too,’ he said. ‘We have a fairly precise position where he was brought up from, right?’
‘Very accurate,’ the Sergeant said. ‘To within a couple of hundred yards or so.’
‘I think we should take a look at what else might be down there, as quickly as possible,’ Grace said. ‘Do you have time to start today?’
Tania looked at the clock on the wall and then, as if mistrusting it, at her chunky diver’s watch. Next she glanced at the window. ‘Sunset is about four o’clock today,’ she said. ‘Ten miles out in the Channel, the sea’s going to be quite choppy – we’d need to rent a bigger dive boat than our inflatable for working out there. We have about three hours of daylight left. What I suggest is we get a dive boat sorted for first light in the morning – this time of year there are a few deep-sea fishing charter boats that don’t have many customers. We can start at dawn. But in the meantime, we can get out to the area in the inflatable and buoy it off, to make sure the dredgers don’t disturb anything else down there.’
‘Brilliant!’ he said.
‘That’s what we’re here for!’ she said, feeling a lot more cheerful than when she had arrived. She could get all that organized and still make it home in time to prepare the meal.
Turning to Glenn Branson, Grace said, ‘You look a bit peaky.’
He nodded. ‘Yeah. Does it to me every time, this place.’
‘You know what you need?’
‘What?’
‘A spot of sea air! A nice cruise.’
‘Yeah. A cruise would be very nice.’
‘Good!’ Grace gave him a pat on the back. ‘You’re going on one tomorrow morning with Tania.’
Branson screwed up his face and pointed at the window. ‘Shit, man, the forecast’s crap! I thought you meant the Caribbean or something!’
‘Start with the Channel. It’s a good place to get your sea legs.’
‘I haven’t even got any yachting gear!’ he moaned.
‘You won’t need any, you’ll be larging it on the first-class deck!’
Tania eyed Glenn dubiously. ‘The forecast’s not great. Are you a good sailor?’
‘No, I’m not,’ he said. ‘Believe me!’
27
There had been no deterioration in Nat’s condition overnight, which was one blessing, Susan thought, trying to find positive things as she sat on her long vigil beside his bed. But there had been no improvement either. He continued to be a silent stranger, propped up at his thirty-degree angle, wired and plumbed into the almost bewildering array of life-support and monitoring apparatus.
The round institutional clock on the wall said ten to one. Nearly lunchtime, which would not mean much to Nat, or to most of his fellow patients here in the ITU. The nutrients entered his body all day and night through a constant trickle down the nasogastric tube. And suddenly, despite her tiredness, Susan smiled at a thought. She was always chiding Nat for being late for meals. His hours as a medic at the hospital were utterly erratic and often, with no prior warning, he had to stay on late into the night. But even when he was at home, he always had
Well, at least you are not late for your meals in here, she thought, and smiled again wistfully. Then she sniffed, pulled a tissue from the pocket of her jacket and dabbed away tears that were rolling down her cheeks.
Shit. This cannot be how it ends. Surely not?
As if in agreement, or to give her reassurance, the baby kicked inside her.
‘Thank you, Bump,’ she whispered.
Since the consultant, dressed in an open-necked shirt and grey trousers, accompanied by a group of gowned medics, had finished his round half an hour or so ago, the ITU seemed eerily quiet.
