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The predator picks up his pace, closing the distance between them. He can feel the staccato of his heart kick into third gear, where power wrestles fleetingly with speed. The thing that lives behind the curtain is with him now – has become him. Its breath, wet and heavy and gritty with dirt, slides in and out of his lungs, mixing with his own quick respirations. The incessant march of its pulse thrums along eagerly behind his temples, blanching his vision slightly with each beat. Ahead of him is the boy, his slender frame swinging as he walks, almost dancing, as if his long muscles dangled delicately from a metal hanger. For a moment, watching from behind as he completes the remaining steps between them, the predator is struck by the sheer beauty of that movement, and an unconscious smile falls across his face.
The sound of his footsteps causes the boy to turn, to face him now, arms hanging limply at his sides. As he does, the predator’s left hand swings quickly upward from where it had remained hidden behind his leg a moment before. His hand is curled tightly around an object, its handle connected to a thin metal shaft, long and narrow and tapered at the end to a fine point. It reaches the pinnacle of its arcing swing and enters the boy’s neck, dead center, just below the jaw. A slight jolt reverberates through the predator’s arm as the tip of the rod strikes the underside of the boy’s skull. He can feel the warmth of the boy’s skin pressing up against the flesh of his own hand as the instrument comes to rest. The boy opens his mouth to scream, but the sound is choked off by the blood filling the back of his throat. The predator pulls his arm down and away, feeling the ease with which the instrument exits the neck.
He pauses a moment, watching the boy struggle, studying the shocked confusion in his eyes. The mouth in front of him opens and closes silently. The head shakes slowly back and forth in negation. He leans in closer now, holding the boy’s gaze. The hand gripping the instrument draws back slightly in preparation for the next blow, then he pistons it upward, the long metal tip punching its way through the boy’s diaphragm and into his chest. He watches the body go rigid, watches the lips form the circle of a silent scream, the eyes wide and distant.
The boy crumples to the ground and the predator goes with him, cradling a shoulder with his right hand, his eyes fixed on that bewildered, pallid face. He can see that the boy’s consciousness is waning now, can feel the muscles going limp in his grasp. Still, he tries to connect with those eyes, wonders what they are seeing in these final moments. He imagines what it might feel like for the world to slide away at the end, to feel the stage go dark and to step blindly into that void between this world and the next, naked and alone, waiting for what comes after … if anything at all.
The cool earth shifts slightly beneath his fingers, and in the space of a second the boy is gone, leaving behind his useless, broken frame. ‘No,’ the predator whispers to himself, for the moment has passed too quickly. He shakes the body, looking for signs of life. But there is nothing. He is alone now in the woods. The realization sends him into a rage. The instrument in his hand rises and falls again and again, wanting to punish, to admonish, to hurt. When the instrument no longer satisfies him, he casts it aside, using his hands, nails and teeth to widen the wounds. The body yields impassively to the assault, the macerated flesh falling away without conviction, the pooling blood already a lifeless thing. Eventually, the ferocity of the attack begins to taper. He rests on his hands and knees, drawing in quick, ragged breaths.
Next time, I will do better, he promises the thing that lives behind the curtain. But when he turns to look the thing is gone, the curtain drawn closed once again.
PART ONE (#ulink_75d3fb7e-024b-55d5-a3ec-8b23552a9829)
Chapter 1 (#ulink_ed171f3f-636e-5bb7-9f0a-3d8e572c48ea)
Although it was Friday evening, Ben Stevenson found the traffic along Sunset Boulevard heading west out of Steubenville particularly heavy during his commute home. Dr Coleman’s case had finished earlier than expected, and the last specimen of Mrs Granch’s partial thyroidectomy had been sent to the lab at 4:40 p.m. The surgically resected margins had been clear of cancer cells, and he’d placed a call to the OR.
‘OR Three,’ the circulating nurse’s voice answered at the other end.
‘Marsha, this is Dr Stevenson. Can I speak with Dr Coleman, please?’
‘Oh, hello, Dr Stevenson,’ she replied. ‘One moment – I’ll put you on speaker.’
There was a brief pause, then Coleman’s voice, sounding slightly distant and metallic over the speakerphone. ‘How does it look, Ben?’
‘Margins are clear, Todd,’ he replied. ‘Looks good from my end.’
‘All right,’ the surgeon responded. ‘That’s all I’ve got for you today. I’m closing now.’
Closing. That was welcome news on any day, but particularly on a Friday when your eldest son’s high school baseball team was scheduled for a game. Thomas had started the season as a center fielder, but the strength of his arm had drawn the coach’s attention and Thomas had quickly proven to be an even greater asset on the mound. Tonight was his turn in the pitching rotation. The game was scheduled for a 6 p.m. start time, and Ben did not intend to miss it.
He spent the next ten minutes closing up the lab. When he was satisfied that everything was in order, Ben grabbed his jacket, locked the door behind him and headed for his car. Pulling out of Trinity Medical Center’s parking lot, he flipped on the XM radio and began to hum along with the Beatles, as John Lennon proclaimed, ‘Nothing’s gonna change my world.’
He passed John Scott Highway, and now the traffic began to slow as he approached Wintersville. Ben had moved his family to this small town from Pittsburgh thirteen years ago. He’d met Susan during medical school at Loyola University in Chicago. They’d graduated together, and had both managed to secure residency positions at the University of Pittsburgh Medical Center. He’d trained in pathology, while Susan had pursued a program in family practice. At the end of their first year, they married – a small ceremony attended by immediate family and a few friends. They’d spent the following week hiking and kayaking through a good portion of upstate New York – Susan’s idea, actually – before returning to the exhausting, gut-wrenching grind of medical residency. The week had suited their needs perfectly, providing unhurried time to spend exclusively with one another, far removed from the constant demands and commotion of residency. It had felt good to exercise their bodies, which had already started to become soft with neglect. The fresh air and vibrant green foliage had rejuvenated their senses, and they’d talked with excitement about their plans for the future. Nights had been mostly cloudless, as he recalled, and they’d made love under the stars nearly every evening before retiring to the thin, nylon shelter of their tent. Ben had finished the week with more than a few mosquito bites on compromising areas of his body. Susan had come away from the week pregnant, although they would not realize it for another six weeks. Thomas was born nine months later.
That had been a difficult time for them, so early in their marriage. Medical residency was not the ideal time to try to raise a newborn, of course, and the hospital didn’t lighten the already exhausting work hours simply because there was a crying three-month-old infant at home to attend to. Neither of them had family in the area, and Susan simply couldn’t bring herself to turn Thomas over to day care after her very brief maternity allowance had ended. Ultimately, she’d decided to take a year off to spend with the baby, which, in retrospect, had turned out to be the right choice for all of them.
Canton Road slipped by on his right, and Ben realized just a little too late that he probably should’ve turned there to detour around some of this congestion. Sunset Boulevard, which had now become Main Street, was the primary connector between the towns of Steubenville and Wintersville, small midwestern flecks on the map, lying just west of the Ohio River. Fifty miles to the east was Pittsburgh, and approximately 150 miles to the west was Columbus. Aside from a parade of small towns with equal or lesser populations, there wasn’t much else in between. Certainly not enough to warrant traffic like this – one of the reasons they’d decided to leave such cities as Chicago and Pittsburgh behind them in the first place.
Must be an accident, Ben thought. A bad one from the looks of this backup. Inconvenient and frustrating, of course – and for one guilty moment he resented its presence in yet another way. An accident causing this much of a standstill could mean fatalities. And that often involved a coroner’s investigation, which meant he might be making a trip to the Jefferson County Coroner’s Office this evening or, by the latest, tomorrow morning to perform an autopsy. Great. Absolutely perfect, he thought to himself, and immediately felt another pang of guilt. Life as a small-town pathologist meant one-stop shopping when it came to coroner investigations. There was him, and then there was the Allegheny County Coroner’s Office and Forensic Lab in Pittsburgh, fifty miles to the east. But he had known that, he reminded himself, when he’d signed on to the job here.
The Beatles had yielded to The Band, who were sailing off into the first stanza of ‘The Weight’ – an ominous sign, Ben thought. He switched off the radio. Traffic had slowed to a crawl and he could now see the entrance to Indian Creek High School just ahead on the right. This seemed to be the source of at least some of the congestion. He could identify two police cruisers, an ambulance and a news truck in the school’s parking lot. On the right-hand shoulder, two cars had pulled off the road to exchange insurance information, apparently the result of a low-speed rear-end collision caused by a little rubbernecking. The drivers were involved in a heated discussion, and a sheriff’s deputy approached to intervene before things escalated further.
Up ahead, the traffic dissipated, and Ben accelerated slowly toward home. There was still enough time to make Thomas’s baseball game, although things would be a little tighter than he’d initially anticipated. He flipped back on the radio and smiled to himself. The Band was finishing the final chorus, and just like that, ‘The Weight’ was over.
Chapter 2 (#ulink_66cd81db-67af-59bd-bcfd-278cfb0b25b0)
The first thing Ben noticed as he approached the house was that Susan had beaten him home, her gray Saab already parked in their driveway. He pulled in behind her, got out, and retrieved his briefcase from the trunk. Having heard him drive up, his wife had stepped out of the house and was walking down the front steps to greet him. Even after all these years she was still beautiful, Ben thought, with dark black shoulder-length hair and chestnut eyes he had difficulty looking away from. Her tall body had remained slim and agile, despite the two children she had carried. And although Ben himself was of similar athletic build, the years, he felt, had taken a harder toll on him, the responsibilities pulling steadily at the corners of his eyes, his brown hair now speckled generously with strands of gray. He smiled up at her, but the smile faded as she drew nearer.
‘Tell me you’ve spoken with Thomas this afternoon,’ she entreated, her hands clutching at the sides of her dress.
‘Why? What’s wrong?’ he asked, his mind automatically flipping through a list of the most catastrophic possibilities. Something was very wrong indeed, he realized as he studied her features. Susan was afraid – but she was much more than that; she was on the brink of hysteria.
‘There’s been a death at the school,’ she blurted out. ‘One of the high school kids, they think.’
Ben looked at her, dumbfounded. ‘What?’
‘Someone was killed this afternoon,’ she advised him. ‘Initial news reports said it was one of the high school kids, but they don’t know for sure.’ Susan’s voice shook. ‘Where in the hell is Thomas?!He should’ve been home an hour ago!’
‘He has a baseball game at Edison,’ Ben reminded her. Edison High was located in the neighboring town of Richmond. A bus was scheduled to transport the team after school. But there were other, more pressing details to be considered. He was still trying to work his mind around what Susan had just told him. ‘What do you mean someone was killed? There was an accident?’
‘An accident?Don’t you listen to the radio?’
‘On the ride home,’ he answered. ‘But they didn’t say anything about—’
‘Honey, it wasn’t a car accident.’ Susan’s voice continued to waver as she spoke, as if it were riding precariously along on one of those small-time roller coasters erected at carnivals. ‘One of the high school kids was murdered on the way home from school – in the woods along Talbott Drive. Ben, he was stabbed to death and just left there to die. They don’t even know who he is yet.’
For a moment, Ben was too stunned to say anything. What his wife had just told him was so implausible that he felt the urge to argue with her, to tell her that she was being ridiculous. Wintersville was a quiet midwestern town of about five thousand inhabitants. The town’s occupants were mostly middle-income conservative families who presumably preferred the sort of small-town life that could be enjoyed here. Golfing, fishing and hunting were popular pastimes, and in early December folks came out for the annual Christmas parade. Tax evasion, shoplifting and the occasional drag race along Kragel Road were the most hardcore criminal activities this town had seen over the past decade. After four years in Pittsburgh, it was one of the things that had initially attracted him. He had decided a long time ago that he did not wish to fall asleep to the sound of sirens. As for the murder of a high school child on his way home from school, it was simply not the type of thing that happened here. Ever.
‘They won’t release the victim’s identity until after the family has been notified,’ he heard himself reply numbly. ‘That’s how it’s done.’
Susan came to him then, putting her arms around him tightly. She was trembling, Ben realized, and he hugged her back. He felt sick to his stomach, and his legs were wooden and uncertain beneath him. He was thankful at that moment for someone to hold on to.
His wife looked up at him, and for a moment it seemed as if she was uncertain how to proceed, as if she was struggling with a decision that only partially involved him. Then her eyes cleared and seemed to regain their focus. ‘Honey,’ she said, her voice just above a whisper, ‘we’ve got to find Thomas. I’ll feel better once he’s home. They would’ve canceled the game, don’t you think? Or at least phoned the parents to let them know what was happening?’
Ben thought this was probably true. Whose number had they given the school as an emergency contact, anyway? He separated himself enough from his wife to place his briefcase on the hood of the car, fumbling with the latch. ‘Where’s Joel?’ he asked.
‘Inside,’ she replied. ‘I picked him up from Teresa’s on the way home.’
Ben swung the case open to reveal a haphazard array of documents and medical journals. He reached inside one of the interior pockets and retrieved the phone. The digital display indicated that he had two new messages. He flipped the cell open and punched the button to access voice mail. The first message turned out to be from Susan, asking if he had heard from Thomas, and imploring him to call her as soon as possible. The second message was from Phil Stanner, Thomas’s baseball coach.
‘Ben, this is Coach Stanner,’ the recorded voice announced, and Ben felt a wave of dread rising within him. He put the phone on speaker so that Susan could hear.
‘Listen,’ Phil’s voice floated up to them from the phone’s tiny speaker. ‘You’ve probably already heard, but someone was killed this afternoon in the woods close to the school. The police have the whole area cordoned off, which is making it difficult to get into and out of the school parking lot. All after-school activities have obviously been canceled. Thomas is fine, and I’ve got the entire team here with me in the gymnasium. We’re asking parents not to come up to the school to pick up their kids, but instead to wait at the designated bus stop where their child is usually dropped off after school. Buses will be bringing students home starting around six-thirty p.m., but kids won’t be let off of the bus unless there’s an adult there to meet them. Thanks for your cooperation. If you have any questions, you can contact the school, but even with four people answering phones, the lines have been pretty tied up this afternoon, so don’t call unless you have to.’
The message ended and Ben closed the phone and placed it in his front pants pocket. Susan’s hand was covering her mouth, and she looked up at him with a mixture of relief and sadness. Her other arm had wrapped itself protectively around her waist. It was 5:52 p.m. Ben put an arm around his wife’s shoulders, pulling her body against him. He looked up at the large bay window that marked the front of their house. It offered a limited visual portal into their family room, and he could just make out the top of Joel’s head, his familiar brown cowlick arching upward like an apostrophe, as he sat on their couch watching television – hopefully not the news, Ben thought.
He kissed the top of Susan’s head, wondering if even at this very moment there was a Sheriff’s Department cruiser pulling into someone’s driveway. In his mind, he could see it clearly: the car rolling slowly to a stop, two uniformed officers stepping out and making that long, awful walk to the front door. He imagined them ringing the doorbell and listening to the sound of shuffling feet approaching from the foyer just beyond, a small voice calling through the closed door: ‘Who is it?’
‘Sheriff’s Department, ma’am.’
A momentary pause, followed by the sound of the voice, already afraid, calling out to someone deeper inside of the dwelling: ‘They say it’s the Sheriff’s Department.’
A man’s voice, descending down the interior stairs: ‘Well, what do they want? Jesus, Martha, open the door!’
The sound of the dead bolt sliding back within its metallic housing. The door slowly swinging open to reveal a man and a woman, roughly the same age as Susan and himself, standing just inside the open threshold and looking out onto the cold, gray world and the unfortunate messengers standing in front of them. In this image he has conjured, the couple suddenly appear frail beyond their given years, as if this moment itself has weakened them. In a timorous glance, they take in the grave faces of the two unwelcome men standing before them, who have arrived with news the parents do not want to hear, and whose expressions carry within them all of the information that really matters: I’m terribly sorry. Your boy is gone. He was left dead in the woods, and he lies there still while we try to figure out who might have done this to him. He will never walk through this door again.
In that moment, standing in their own driveway with familiar gravel beneath their feet, Ben offered a silent prayer of gratitude – God forgive him – that he and his wife had not been selected at random to receive that horrible message. It was a prayer of relief and thankfulness for the safety of his family, and a prayer of compassion for the ones who waited even now for the messengers to come.
‘Let’s go inside,’ he whispered to Susan, and the two walked up the steps together.
Chapter 3 (#ulink_98446bcd-a7e1-5165-b442-6aef679c5c08)
An hour later, the three of them stood on the sidewalk, impatiently awaiting the arrival of the Indian Creek High School bus. A block to the east, the sound of passing vehicles could be heard as they traveled along Canton Road on their way north toward Route 22. Beside him, Susan fidgeted restlessly. Ben shared the sentiment. A recorded message from the high school baseball coach, after all, could only go so far in placing a parent’s mind at ease.
Ben glanced at his watch. It was seven o’clock. Shouldn’t the bus be here already? he wondered. Perhaps not, considering the traffic and events of the day. Rounding everyone up and making sure that all of the kids were accounted for would take longer than expected. Some of the parents would just now be arriving home from work, and there would be no one waiting to receive the kids at certain stops. It could be another hour, he realized.
Dusk was already beginning to settle upon the neighborhood. In another forty minutes they’d be standing here in the dark. Under the circumstances, he reflected, it was probably not the best plan the school could have come up with; a bunch of families standing around outside in the dark waiting for their kids to be dropped off while somewhere out there a psychopath roamed the streets. He thought about returning home for the car, even though they lived only two blocks away. He didn’t want to leave Susan and Joel standing here alone, however, and he was afraid that if they all went back together the bus would arrive during the time they were gone. Instead, they waited, watching their shadows grow long and lean as the sun continued its rapid descent toward the horizon.
Something the size of a large cicada moved against Ben’s upper leg with a soft buzzing sound, startling him. He nearly cried out, but in a moment it was gone. He shuddered involuntarily, imagining its crunchy, crackling exoskeleton flitting up against him.
Suddenly, it came again, nestling up against his right thigh with a muffled burring noise. He leaped backward. ‘Shit!What was that?’
Susan looked over at him inquisitively, eyebrows raised. ‘What’s wrong with you?’
‘A giant bug just hit me in the leg,’ Ben advised her. ‘Twice!’
No sooner had he uttered these words than he realized two things. The first was that he had just cursed in front of his highly impressionable eight-year-old son, who would now most assuredly walk around his home, his school, and the local playground for the next week yelling ‘Shit!’ at the top of his lungs. The second was that the flying cicada creature that had struck him – twice! – in the right thigh was nothing more than his own cell phone, which he’d left on vibrate in his front pants pocket. Feeling now like a complete idiot, he reached into his pocket and brought out the phone.
‘Shit!That’s no giant bug, Dad. That’s your phone,’ Joel pointed out enthusiastically.
‘Thank you, Joel,’ he said, looking at the phone’s digital display, which simply read: ‘CO.’ It was his assistant calling from the Coroner’s Office, which meant that the body was either on its way to the CO, or it had already arrived and would soon be ready for autopsy. In a case such as this, they would expect him to perform the autopsy tonight. Answering this call would be the beginning of a long, unpleasant evening.
‘Go ahead,’ Susan said with a smile as he glanced in her direction. ‘You’d better answer your cicada.’
Ben flipped the phone open, and took a few steps away from his wife and son. ‘Yes, hello,’ he said.
‘Dr S,’ the voice on the other end spoke excitedly. ‘It’s Nat.’
‘Hey. What’s up?’
‘You heard about that kid they found dead in the woods this afternoon, I guess. The one who was stabbed to death?’
‘Yeah. We heard.’
‘Well, the cops have finished with their crime scene investigation and they’re releasin’ the body to us. I’m about to head over there to pick him up right now.’
‘Okay. Just give me a call when you get back to the office and everything’s ready.’
‘Sure, Dr S. No problem. But, hey. There’s a lot of reporters settin’ up outside the CO with their camera crews ’n’ stuff, you know. Body’s not even here yet and they’re startin’ to gather round like they’re expecting an Elvis sighting or somethin’. I mean, this is a big case for us, don’t you think?’
‘Nat, listen to me.’ Ben kept his voice as calm and as clear as he could. He spoke slowly, hoping that by maintaining his own composure he could exert some positive influence on his overenthusiastic assistant. He doubted that it would do much good, but at least it was worth a try.
‘Yeah? What d’ya need me to do?’
Take two Valium and call me in the morning, Ben thought to himself. Instead, he said, ‘You’re right about this being an important case.’
‘Sure ’nough,’ Nat exclaimed. ‘Murder like this – in cold blood and all – ain’t somethin’ you see round here every day. That’s for sure.’
‘That’s right,’ Ben replied. ‘It’s not something we see around here every day. It’s big news in a small town, and those reporters are going to want some footage and a nice ten-second sound bite for the eight o’clock news.’
‘Ain’t that the truth. Things are about to get a lot more interesting round here. It’s gonna be a regular three-ring circus.’
‘You’re probably right,’ Ben agreed. ‘But right now we have a job to do. It’s an important job. A boy was murdered today. He’s lying on the ground surrounded by yellow police tape. And somewhere out there is a family whose son won’t be returning home tonight. Now, our job is to gather as much information as we can about how he died, and the evidence that we have is his body. If we do our job carefully and professionally, we might find something that will help the police track down his killer.’
‘That’sright,’ Nat agreed excitedly. ‘Wouldn’t that be somethin’? You think they’d want me to testify in court?’
‘Maybe. But I can tell you one thing for sure. If we let our emotions get the best of us – if we allow ourselves to be distracted and start thinking too much about the reporters and the police and the eight o’clock news – well, then we’ll screw it up. We’ll miss something, or allow a break in the chain of custody, or jump to some conclusion that we’ll regret later. But by then, it will be too late.’
‘Too damn late,’ Nat agreed seriously. His voice was quieter now, more subdued, and although Ben could still detect a hint of the earlier excitement just beneath the surface, the boy’s tone was held in check now by something of even greater significance: a sense of sobering responsibility. He could picture his young assistant standing in the lab’s small office with the phone held tightly in his right hand, the adrenaline-laced muscles of his body filled with purpose and ready to act. Nathan Banks was a good kid. At twenty-two, he was a bit young for the job of pathologist’s assistant. But Ben had known him for most of the boy’s life, and he was also friends with Nat’s father, who’d been flying for United Airlines for the past eighteen years and, as a commercial airline pilot, was away from home more often than not. Nat had taken an early fascination with the Coroner’s Office. He’d started volunteering there at the age of sixteen, helping Ben mostly by preparing and cleaning instruments, attending to certain janitorial duties and the like. But Nat also enjoyed watching and eventually assisting with the autopsies Ben performed. His mother, Karen, had given her hesitant permission, although she’d expressed some reservations to Ben about the interest her son had taken in the field. One afternoon she’d shown up at the office and had asked Ben with a worried look if he thought it was normal or healthy for a sixteen-year-old boy to want to spend his days working around dead people. Ben, who had entered medical school at the age of twenty-six, but who had volunteered both in his local hospital’s emergency department as well as at the Allegheny County Coroner’s Office since the age of eighteen, explained to Karen that her son’s interest in the work was probably nothing to worry about. It might even serve as a potential career someday, he’d suggested, and over the next two years Nat had slowly been allowed to assume a more hands-on role in the autopsies Ben performed. Eventually, he became skilled enough to be a real asset in the lab, and when Nat graduated from high school Ben had offered to turn his volunteer position into a paid one. Nat had enthusiastically accepted, and he had been working there ever since.
‘What you and I have to decide,’ Ben now said into the phone, ‘is whether we want to be part of the three-ring circus, or whether we want to act like professionals and focus on the job in front of us. You can do either one, Nat, but you can’t do both. What I need to know from you now is how you want to handle it.’
‘Well, let’s do our J-O-B,’ his assistant replied. ‘Don’t sweat it, Dr S – I’ve got your back.’
‘That’s what I needed to hear.’ Ben glanced back at Susan and Joel, who were standing on the sidewalk in the gathering darkness. ‘Listen, I’ve got something I need to do before heading over there. You think you can go pick up the body and give me a call on my cell once you get back to the CO?’
‘No problem.’
‘And if the reporters want a few words from you for the evening news, what are you going to tell them?’
‘I’ll tell them, “No muthafuckin’ comment!” Excuse my French. We’ve got a job to do.’
‘That’s right.’ Ben smiled, feeling a modicum of levity for the first time since arriving home that afternoon. ‘I’ll see you in a little while.’
‘Over and out,’ Nat saluted, and terminated the connection.
‘Over and out,’ Ben sighed to himself as he returned the phone to his pocket and turned back to his wife and son. A moment later, he heard the sound of an approaching diesel engine, and as it rounded the corner they were silhouetted in the headlight beams of the approaching bus.
Chapter 4 (#ulink_cf656cbd-4c1d-511b-a4c9-6090abecc214)
Fifty minutes later, Ben found himself sitting in the darkened interior of the Honda as he headed east toward the Coroner’s Office. A tentative drizzle had begun to fall from the sky as his family had walked home together from the bus stop, and by now it had progressed to a steady drumming that pattered the car’s rooftop insistently with its heavy, hollow fingers. A light fog clung to the ground, and Ben was forced to negotiate the dark, rain-slickened streets slowly and with exceptional caution. He’d habitually turned on the radio as he started the car, but most of the local stations were running news of the murder, and the more distant ones that he could sometimes pick up on clear days were reduced to static in the mounting storm. He flipped the knob to the off position and decided to simply concentrate on driving.
Thomas had stepped off the bus that evening to the warm embrace of his relieved and grateful parents, and to the boundless questions of his spellbound younger brother. As it turned out, Thomas didn’t have much more information on the identity of the victim or the details of the crime than his parents had already received from Phil Stanner. This stood to reason, since the police were remaining tight-lipped until after they’d had a chance to notify the victim’s family.
What was clear from the moment Thomas stepped off the bus to join them was that he regarded the day’s events with a certain quiet thoughtfulness that Ben had not anticipated. He spoke very little during the walk home, and let his family’s questions wash over him without much comment. Ben wondered whether his son might be in a mild state of shock, or simply trying to wrap his mind around the idea of a violent attack so close to home and school. Ben felt that children of Joel’s age tended to regard death as an obscure and distant entity, far removed from their own daily lives and therefore relatively inconsequential. This view seemed to change as children entered their teenage years and began to explore and sometimes even to court this previously intangible eventuality. Popular movies often romanticized the notion with blazing shoot-outs among beautiful people against an urban backdrop at sunset, or titanic ships that slowly sank in the freezing Atlantic while lovers shared their final fleeting moments together aboard a makeshift life raft only buoyant enough for one. This was not the type of death that Ben encountered as a physician. He supposed it could be described as many things, but mostly his experience with death was that it was impersonal, and seldom graceful.
During his intern year as a medical resident, Ben had been working his third shift in the emergency department when paramedics brought in a fifty-eight-year-old man with crushing substernal chest pain radiating to his left arm and neck. Ben had examined the patient quickly in the limited time available, and after reviewing the EKG he’d decided that the man was having a heart attack. Emergency treatment for heart attack patients with certain specific EKG changes called for the administration of thrombolytic agents, powerful clot-busting drugs designed to open up the clogged blood vessel and restore adequate blood flow to the heart. The supervising physician was not immediately available and the patient’s clinical condition seemed tenuous, so Ben had given the order for the nursing staff to administer the thrombolytic drug to his patient. The results had been almost immediate. Within five minutes, the patient was complaining of worsening pain, which was now also radiating to his back. Eight minutes later the patient’s blood pressure plummeted, his heart rate increased to 130 beats per minute and he vomited all over himself and the freshly pressed sleeve of Ben’s previously impeccably clean white coat. Several moments later the patient lost consciousness, and Ben could no longer palpate a pulse. He attempted to place a breathing tube into the patient’s trachea but couldn’t see past a mouthful of emesis. Instead, the tube slipped into the patient’s esophagus, and each squeeze of the resuscitation bag aerated the patient’s stomach instead of his lungs. Ben began CPR, and the first several compressions were accompanied by the sickening feel of cracking ribs beneath his interlaced hands. ‘Call Dr Gardner!’ he shouted to the charge nurse standing in the doorway, and he soon heard the overhead paging system bellowing: ‘Dr Gardner to the ER, stat! Dr Gardner to the ER, stat!’
For eight minutes Ben pumped up and down on his patient’s chest, attempting to circulate enough blood to generate some sort of blood pressure. Every so often, he paused long enough to look up at the patient’s heart rhythm on the monitor. ‘Shock him, two hundred joules!’ he ordered the nurse, who would charge the paddles, place them on the patient’s chest, yell ‘CLEAR!’ and press the two buttons that sent a surge of electricity slamming through the patient’s body like an electric sledgehammer. ‘No response, Doctor,’ the nurse reported each time, and Ben would order another round of electricity to be delivered like a mule kick into the patient’s chest before resuming chest compressions over splintering ribs. Somewhere during the nightmare of that resuscitation – Ben’s first resuscitation as a physician – the patient’s bladder sphincter relaxed and about a liter of urine came rushing out of the man’s body and onto the bedsheets. A small rivulet of urine began trickling steadily onto the floor. Ben continued his compressions on the patient’s mottled chest, which was now tattooed with burn marks from the defibrillator paddles, as the nurse had failed to place enough conductive gel on the paddles before delivering each shock. The room stank of burnt flesh and a repugnant potpourri of human sweat, urine and the vomited remains of a tuna fish sandwich that the patient had apparently eaten shortly prior to his arrival. The endotracheal tube, temporarily forgotten, slipped out of the patient’s esophagus and fell onto the floor with a resounding splat.
‘What in the hell is going on here, Dr Stevenson?!’ Dr Jason Gardner, Ben’s supervising physician, stood in the doorway, gaping in disbelief at the scene. He appeared to be moderately out of breath from having run across the hospital from the cafeteria on the other side of the building. Ben noticed a small bit of pasta clinging like a frightened animal to his yellow necktie.
‘Heart attack.’ Ben’s voice was hollow and uncertain, small and desperately apologetic, and his words fell from his mouth in a rush as he tried to explain. ‘He came in with chest pain radiating to his arm, neck, and back. Only history was hypertension. He had EKG changes – an ST-elevation MI, I thought. I gave him thrombolytics. I was going to call you, but I didn’t think there was enough time. He coded shortly after I gave the ’lytics. I tried CPR and defibrillation, but I couldn’t get him back. I don’t understand it. I had the nurse call for you as soon as he lost his pulses, but—’
‘What did his chest X-ray look like?’
‘His chest X-ray?’ Ben thought for a moment. Had he ordered one? ‘I … I don’t know. I think they got one when he first came in, but I didn’t get a chance to look at it.’
