dissection reveals no deep bruising or other injury.’ Waterhouse waved a hand over the flayed body. ‘Nor could I find any sign of the pinpoint haemorrhages in the conjunctivae or mucus membranes that would suggest asphyxiation.’
He beckoned her over to a deep stainless steel sink where he plunged a gloved hand into a pile of what looked like offal, spread out on a large plastic chopping board.
‘Here we are,’ he announced. ‘The hyoid bone – from the lady’s neck.’ He brandished a pair of tiny bony horns with bits of tissue still attached – which, to Kershaw, looked a lot like a truncated chicken wishbone. ‘When someone is strangled, more often than not, the hyoid gets broken. But this little fellow is intact.’ With the air of a conjuror, he pressed his thumbs into the centre of the horns until they snapped. ‘Voilà!’
Kershaw stifled a grimace. ‘So, in your view,’ she said, pencil hovering over her notebook. ‘She wasn’t beaten, stabbed, strangled or suffocated.’
‘Correct.’
‘How did she die then?’
‘Well, the chalky residue I found in the stomach does suggest she had ingested drugs a few hours before death,’ said Waterhouse.
‘Suicide?’ Kershaw didn’t try to disguise the disappointment in her voice.
‘I’m afraid I must leave intent to you, Detective,’ he said. He drummed gloved fingers on the board. ‘But if I were to stick my neck out, I’d say it wasn’t the common or garden bottle of paracetamol.’
Rummaging through the pile of entrails with the air of a man trying to find matching socks, he retrieved a glistening brown lobe the size of a fist and set it in front of her.
‘Kidney?’ she said. Disgusting stuff – wouldn’t eat it as a kid, or now, come to that.
‘Well done!’ said Waterhouse, smoothing the organ out on the board. ‘Have a little poke around, tell me what you see.’
She took the proffered scalpel and used it to open up a series of incisions in the tissue. What was she supposed to be looking for? Then, bending closer, she saw something – a scatter of bright magenta dots across the pinky-brown surface.
‘These spots,’ she asked. ‘Are they normal?’
‘No, Detective, they are not.’
Waterhouse picked up the kidney and turned it to and fro in the light. ‘These petechiae – haemorrhages – are suggestive of acute renal failure.’
Kershaw frowned at the constellation of dots. ‘What could have caused it?’ she asked.
‘Half a dozen things.’ He pursed his lips. ‘But off the record, I’d put my money on rhabdomyolysis.’ He smiled at the look on her face. ‘Damage to muscle fibres releases a protein called myoglobin into the bloodstream, which can ultimately cause the kidneys to fail.’
‘Muscle damage?’
‘Yes, rhabdomyolysis is often seen in serious crush injuries, for example.’ He paused, tilting his head. ‘But I think the likeliest cause in this case is chemical. Drug-induced hyperthermia could have raised her body temperature so high that it started literally to cook her tissues.’
Kershaw remembered a news article someone had posted on the noticeboard at uni, about a student who took too many tabs of Ecstasy and nearly died from overheating. The ‘alternative’ types, the ones with facefuls of metalwork, had been routinely off their tits on the stuff, and even some of her fellow criminology students had dabbled, but she’d never been tempted. A few drinks was one thing, but the idea of losing control over her brain chemistry totally freaked her out.
‘You think she OD-ed on Ecstasy?’ she asked.
‘I wouldn’t dream of pre-judging the toxicology report, of course,’ said Waterhouse. ‘But it’s possible that she died of renal failure brought about by an overdose of MDMA, yes.’
Kershaw tried to picture the scenario, how the girl might have ended up naked in the Thames. Maybe, after a night out clubbing with her boyfriend, they’d gone to bed, and he’d woken up next to a dead body. If he’d given her the drugs, or sold them to her, he could easily have panicked and dumped her in the river.
‘What’s she likely to have experienced, when she OD-ed?’ she asked.
‘A massive surge of serotonin in the brain would have caused a breakdown of the body’s temperature control mechanisms, like a fire raging out of control through a house.’ Waterhouse started scooping the girl’s organs from the chopping board into a blue plastic bag in the sink. ‘When her core temperature exceeded 39 degrees, there would be neuron damage; at 40 degrees, she was probably suffering seizures, followed by coma. When it reached 41, the organs would begin to shut down.’
He handed the bag to the Goth technician who took it without a word.
‘Nasty way to die,’ said Kershaw. ‘Presumably she wouldn’t be in a fit state to get down to the Thames and throw herself in?’
Waterhouse tipped his head. ‘That depends at what stage of the overdose she did so – if indeed that’s what happened.’
He started rinsing his hands under the tap. Over his shoulder, Kershaw could see the Goth girl inserting the bulging bag back into the dead girl’s body cavity, pushing it this way and that, like someone trying to squeeze a last-minute item into an overstuffed suitcase.
Waterhouse snapped off his gloves and checked his watch. ‘I’m afraid I must leave you, I have a court case at the Old Bailey.’
Kershaw said she’d walk with him to the tube. Five minutes later he emerged from the changing room, wearing a tweed jacket and carrying a briefcase.
He held the door open for her with a flourish. Out in the chilly air, she asked, ‘So you reckon this is just a case of one too many tabs of E, do you?’
‘Not necessarily,’ he said. ‘I attended a conference in Berlin last month where I met a very interesting toxicologist. He said they’re seeing a rash of these deaths across Europe at the moment.’
They were out on the pavement now. Seeing Kershaw struggling to keep up with his long stride, Waterhouse slowed his pace.
‘The toxicology shows the victims all ingested a counterfeit version of Ecstasy, called para-methoxyamphetamine.’ He shot her a mischievous look. ‘You’ll be pleased to hear it’s more commonly known as PMA.’
Kershaw wished she could take notes, she’d never remember all this. ‘Does it have the same effect as Ecstasy?’
‘It’s similar, but much more dangerous. This chap told me that recently, three young women died in a single night.’
Kershaw raised her eyebrows. If the girl turned out to be a victim of a dodgy drugs ring, it could still be a big case.
Waterhouse strode off the pavement and practically into the path of an oncoming truck – meeting the blare of the driver’s horn with an urbane wave. Kershaw scurried after him.
‘So why do people take this PMA, if it’s so risky?’ she asked.
‘They often don’t know that they are,’ said Waterhouse. ‘Apparently the dealers pass it off as Ecstasy. And although it’s much more toxic, its effects take considerably longer to manifest themselves.’ He shook his head. ‘Consequently, the hapless user often takes further pills, believing that they have bought a weaker product.’
She could see the tube entrance only metres away, and she still had so much to ask him.
‘But if these PMA deaths all happened in Europe,’ she said. ‘What’s it got to do with DB16?’
‘You said in your email that our lady might be Polish,’ said Waterhouse, as if that made everything crystal.
Kershaw