the masseteric fascia.’ He lifted the boy’s chin slightly with one gloved finger, using a thin metal instrument to probe a penetrating wound noted there. ‘Inspection of the submental region demonstrates a puncture wound measuring 0.75 by 0.9 centimeters, which extends through the mylohyoid and hyoglossus muscles, continuing superiorly and dorsally through the body of the tongue, soft palate and nasopharynx. There are seven – correction, eight – similar puncture wounds to the cranium that extend through the scalp, underlying musculature and galea aponeurotica. Two of the eight wounds penetrate the skull and enter the cranial vault. A second avulsion injury is noted at the right inferolateral aspect of the neck 5.3 centimeters medial to the acromioclavicular junction and involving the inferior platysma, lateral trapezius and sternocleidomastoid muscles, as well as the right external jugular vein.’
This part of the examination – the initial inspection and description of the body – was the portion of the necropsy Ben always found most interesting. Every corpse, he found, had a tale to tell, and the details of one’s life were often prominently revealed by the compilation of physical marks collected along the way, like scrapes and gouges on the underside of a boat. Prior scars (both surgical and traumatic), tattoos, track marks from a lifetime of IV drug abuse, burns, calluses, fat and muscle mass distribution, exaggerated spinal curvature from decades of stooped physical labor, tan lines, nicotine-stained fingertips, chewed fingernails and even the state of a person’s teeth often spoke volumes about the course of their life. In Ben’s opinion, these were not only the most interesting details of the examination, but also the most aesthetically beautiful – strange words to describe the physical blemishes of a corpse, perhaps, but he was a pathologist, after all. These marks and imperfections represented more than simple anatomy. They had been born from action, behavior and life experiences, and were therefore the most human, the most in touch with the life they had left behind.
In the case of traumatic deaths, however, it was different. One’s eye is inexorably drawn to the fatal injury – that which has extinguished the flame of life so abruptly. Especially in the case of young people, the autopsy ceases to be about discovering the marks left behind from a life richly experienced, and rather is about bearing witness to the end of a life barely begun. Such was the case here, as Ben moved from one disfiguring injury to the other, each one denoting a blatant disrespect for the life of this young man, and for human life in general. It was a tragedy to behold. He wanted simply to stop, to cover the form in front of him with cloth, to save it from this last final disgrace. Instead, he continued, using practiced and precise descriptive terminology like a shield to defend himself from what was real.
‘Inspection of the thorax demonstrates puncture wounds to the right fourth and sixth intercostal spaces anteriorly, and to the right fifth, seventh and eighth intercostal spaces along the midaxillary line. There is a 4.1-by-3.8-centimeter serrated avulsion of the left areola and underlying pectoralis muscle, similar in appearance to those of the face and neck, described above. There is a displaced fracture of the xiphoid process. Inspection of the abdomen demonstrates a 0.8-by-0.9-centimeter puncture wound to the right upper quadrant, and two similar puncture wounds to the right flank. There is a 35-centimeter diagonal incision extending from the right upper quadrant of the abdomen to the suprapubic region, penetrating the rectus abdominus and peritoneal fascia. There is evisceration of the small bowel. The genitalia are … missing.’
He paused for a moment, looking up at Nat, who was positioned across the table on the other side of the body. Most of the color had run out of his round, boyish face as he stood bolt upright and unmoving, eyes transfixed upon the body. Ben was suddenly embarrassed. He should’ve had enough sense to send Nat home as soon as he’d unzipped the bag. This was not something a twenty-two-year-old needed to watch, regardless of his chosen occupation. When Karen Banks had agreed to allow Nat to volunteer at the CO, she had done so with an implicit understanding that Ben would watch out for her son’s physical and psychological welfare, and he regarded the trust and deference Nat’s parents had extended to him seriously. During his time at the CO, Nat had taken part in scores of autopsies, in cases ranging from the ravages of metastatic cancer, to self-inflicted gunshot wounds, to the death of young adults involved in motor vehicle accidents. He had even assisted during pediatric autopsies – cases of SIDS and child abuse. The boy was no novice at witnessing some of the trauma and unpleasantness that could descend upon the human body. But this … well, this was a different matter altogether.
‘Listen, Nat. Why don’t you let me finish up here,’ he said. ‘It’s late, and I’m going to need you in the office early tomorrow to help Tanya man the phones. From the look of Brady Circle out there, I don’t think the press is going to give up that easily, and I imagine that Sam Garston from the Sheriff’s Department will be stopping by bright and early looking for the coroner’s report. The rest of this stuff I can just take care of by—’
‘Umm … Dr S?’
‘What is it, Nat?’
‘This case here is the most interesting, most important thing we’ve had come through these doors over the six years I’ve been workin’ here.’
‘I know. It’s pretty—’
‘And if you think … if you think I’m goin’ home in the middle of the autopsy just because some nutjob lopped off the guy’s wiener and chucked it into the woods, well … you can forget it.’
‘I wasn’t trying to—’
‘You wanna weigh all them organs by yourself, type the report and spend another forty minutes cleanin’ up afterward?’
‘I think I can handle—’
‘How many hours you wanna be here tonight anyway, Dr S?’
‘It’s not about—’
‘No way. Discussion over. I’m stayin’. Or … or you can find yourself another assistant.’
Nat stood across the table, arms crossed, glaring defiantly back at Ben. The two considered each other in silence, neither flinching, for perhaps twenty seconds. Apparently, Ben realized, his assistant was quite serious. He considered his short list of options: send Nat home and risk losing him as an assistant, or allow him to stay, thereby rendering himself at least partially responsible for the possible long-term effects the experience could have on the boy’s psychological well-being.
‘How do you know?’ Ben asked. He was buying time while he tried to make up his mind.
‘How do I know what?’
‘How do you know the assailant chucked his wiener, as you like to put it, into the woods?’
‘Oh. Cops found it at the scene. Fifty yards away from the body. Police canine actually tracked it down. It’s in a Ziploc bag taped to his right ankle.’
‘I … see,’ Ben said.
The two men stood there for a while longer, neither speaking, as they surveyed the mutilated body.
‘Well, what’s it gonna be?’ Nat challenged, impatient for a decision.
‘I don’t know,’ Ben sighed, tapping his fingers on the table. ‘I’m trying to decide whether I want to be responsible for further corrupting your already quite tenuous psychological stability.’
‘Too late, Dr S! I hang out in a Coroner’s Office. My psychological stability is already all blown to hell. Now gimme that scalpel. I’m gonna slice-an’-dice this turkey like a Thanksgiving dinner.’
Ben looked at him incredulously, shaking his head. ‘That’s so inappropriate I don’t even know where to begin.’
‘How ‘bout you begin by pluggin’ in that Stryker saw for me, will ya?’
‘Riiigghht.’
‘Okay. I’ll do it myself.’ Nat bent over and plugged the instrument’s umbilical cord into the outlet on the floor. ‘You want the chest opened, right? The usual?’
Ben said nothing.
‘Great.’ Nat nodded, as if he’d