"Innocent" - читать интересную книгу автора (Turow Scott)

CHAPTER 12

Tommy, October 27, 2008

Pathologists, toxicologists, the whole bunch weren't really wired like everybody else. But what would you expect when it was the dead who rocked their world? Tommy always figured part of the thrill for these guys was realizing the stiff was gone and they were still here. It was an idea, anyway.

The toxicologist who had come in with Brand looked okay. Nenny Strack. She was a little brown-eyed redhead, mid-thirties, attractive enough to be wearing a short skirt. She was over at the U Med School and worked for the county on a contract basis. Brand had gone directly to the police pathologist to get the work done quickly, and he in turn had leaned on American Medical Service, the Ohio outfit that was the reference laboratory for half of U.S. law enforcement. Tommy had feared these maneuvers would send up flares when the blood draws from Barbara's autopsy came back out of the coroner's refrigerator, but nobody noticed.

"So?" Molto asked the two of them.

"Long story or short?" Brand asked.

"Short to start," said Tommy, and Brand opened his hand to Strack. She had a file folder in her lap.

"The sampling of cardiac blood shows a toxic level of an antidepressant compound called phenelzine," she said.

Brand was looking down at his lap, maybe to keep from smiling. It was nothing to smile about, really.

"She didn't die of natural causes?" Tommy asked. He heard the shrill note in his own voice.

"Not to be difficult," said Dr. Strack, "but it's not my job to render an opinion on the cause of death. I can tell you that the symptoms reported-death by arrhythmia, with a possible hypertensive reaction-are classically associated with an overdose of that drug."

Dr. Strack took a minute to describe phenelzine, which was used to treat atypical depression, often in conjunction with other compounds. It worked by inhibiting production of an enzyme called MAO that broke down various mood-altering neurotransmitters. The effect on the brain often improved emotional states, but limiting the enzyme could have fatal side effects in other parts of the body, especially when foods or drugs containing a substance called tyramine were ingested.

"There's a whole list of things you shouldn't eat when you're being treated with phenelzine," Strack said. "Red wines. Aged cheeses. Beer. Yogurt. Pickled meat or fish. Any kind of dry sausage. They all increase the drug's toxicity."

"Where would she have gotten this stuff?"

"It was in her medicine cabinet. If it wasn't, American Medical would never have identified it." Dr. Strack explained how the mass spectrograph on the blood sample worked. Initially, it produced a virtual forest of color bars. All the spectrographic patterns for the one hundred or so drugs surveyed as part of a routine tox screen were then eliminated, because they had already been covered. The small number of remaining colors could represent thousands of ions. So the lab referred to the inventory of Barbara's medicine cabinet, matching against those knowns. Phenelzine was identified almost at once.

"So this could have been an accidental overdose?" asked Molto.

"Well, if you just look at the blood levels, you'd have to say probably not. The concentration is about four times a normal dose. Assuming that's a true result, then you'd ask if she could have forgotten and taken a pill twice. I suppose. Four times? That would be unusual. Patients who take this stuff are usually warned up and down about how dangerous this drug can be."

"So it wasn't accidental?"

"I'd say no, offhand, but there's a phenomenon called 'postmortem redistribution' that causes certain antidepressants to migrate to the heart after death, giving you inflated concentrations in cardiac blood. That's particularly true of tricyclics. Whether MAO inhibitors act the same way hasn't been defined in the literature. I don't know if phenelzine migrates, and neither does anybody else, not for sure. If we'd realized what we were looking for at the time of the autopsy, we could have done a blood draw from the femoral artery, because there's no postmortem redistribution that far from the heart, but a femoral draw's not standard practice in this county, and obviously, we can't do that now. So no toxicologist will be able to say for sure that the high concentration of phenelzine in her blood means she actually ingested a lethal dose of the drug, as opposed to it being a redistributive effect after her death."

Brand would never say I told you so, but Tommy realized that if he had let Jim treat this as a murder investigation from the jump, they might have those answers. Lost in himself for a second, Molto felt a sigh escape. Sometimes when Tomaso roused them in the middle of the night and Tommy rocked his son back to sleep, he would try to figure out which of a day's decisions was going to come back to bite him. He always went back to bed thinking, You can only do your best. Making mistakes was part of being in charge. You could only hope they turned out to be small.

He looked back at Dr. Strack. "So this redistribution thing means maybe she didn't get an overdose? Maybe she just took a pill and cheated a little and had a pepperoni pizza?"

"That could have happened."

"And what about suicide? Is this one of those drugs that has a tendency to make depressives even more suicidal?"

"That's what the literature says."

"No note," said Brand, trying to discount the possibility Barbara killed herself. "Cops didn't find a note."

Tommy raised a hand. He didn't want a debate right now.

"So maybe it's suicide. Maybe it's murder. Maybe it's an accident. That's all you can say?" Molto asked her.

"Assuming phenelzine caused the death. You'll need the pathologist to say that definitively."

This Dr. Strack looked okay, but by now Tommy had a feel for her. She'd gotten bumped around on cross-examination often enough that she'd rather not go to court at all. He thought science was about investigating the unknown, but experts like Strack seemed to prefer that the unknown remain that way. He really didn't get it.

In the wooden-armed chair next to Strack, Brand was easy to read. His chin was lowered and he was making a face like he was biting back on heartburn. Tommy could see that Dr. Strack had spun Jim, gone soft when she sat down to talk to the PA himself.

Jim wouldn't have trotted her in here unless she'd been a lot more positive with him in his office. In the unlikely event this case went to trial, they'd have to insert a steel bar in her spine or find another expert.

"What about time?" Brand asked. "If you let a day pass after the death, what impact would that have on identifying the phenelzine overdose in the autopsy?"

Dr. Strack touched her face while she considered her words. She was wearing a wedding ring with a diamond chip the size of a bread crumb, the kind of ring that said 'I married my high school sweetheart when we had next to nothing but big love.' It made Tommy feel a little better about her.

"Probably quite a bit," she said. "The quicker the autopsy was done, the easier it would be to rule out postmortem redistribution. And of course, analysis of the stomach contents gets more difficult, because the gastric juices continue to erode what's there. It'd be harder to find a pill, or to identify the phenelzine or even what she ate, including products that contain tyramine. But again, a pathologist could give you a better answer."

Brand cut in. "Okay, but if somebody fed her a lot of cheese and then gave her a couple of pills, and then let the body cool for a day-that would make the phenelzine poisoning harder to establish reliably."

"Theoretically," said Dr. Strack, in character.

Tommy ran the whole thing back in his mind. "And we missed this initially because-?"

"Because MAO inhibitors aren't covered on a routine tox screen."

"And which of the pills in her medicine cabinet, at least the ones with a known toxicity-which of them aren't covered on a routine tox screen?" Brand asked.

Dr. Strack checked her file. "This is the only one. The sedatives, the antianxiety drugs, the antidepressants. They're all regularly screened. With her medical history, the phenelzine wouldn't stand out. If you didn't have toxic levels of anything else, you wouldn't expect it with that, either."

Molto asked some more questions, but the little doctor was gone in a minute.

"Fuckin little squirrel," Brand said as soon as he had closed the door behind her.

"Better to know now," Molto told him. "Did you check the transcript in Harnason?"

Brand nodded. Tooley had talked about phenelzine, among dozens of compounds, when he'd crossed Dr. Strack at trial. Mel had been attempting to show that not even an experienced toxicologist knew which drugs were included on the regular screening, let alone poor Harnason. Tooley's cross-examination, including his mention of phenelzine, had been summarized in the Statement of Facts in Harnason's brief to the court of appeals. So Rusty knew. They'd have no trouble proving that.

Tommy had felt his adrenaline rising throughout the conversation, and now he sat back in the PA's big chair with the aim of calming himself and thinking more carefully.

"This is great stuff, Jimmy," he finally said, "but no matter who our toxicologist is, we'll never prove the cause of death."

Brand argued the case. A girlfriend. Visiting Prima Dana. Asking Harnason what it felt like to poison somebody. Letting the body cool a day so the phenelzine and everything else would rot in her gut.

"You can't make him for murder, Jim, without proving beyond a reasonable doubt that she was killed intentionally." This was the problem he'd predicted to Brand from the outset. If you assume somebody as smart and experienced as Rusty Sabich did a thing like this, then you had to realize he'd make himself bulletproof. The reality that Sabich might have killed Barbara and would beat it anyway took Tommy down like a stone.

Brand wasn't ready to quit.

"I want to put a subpoena and a ninety-day letter on the pharmacy. See if Rusty connects to the phenelzine at all."

Tommy waved a hand, giving Jimmy carte blanche.

"We're this close." Brand's thumb and index finger were nearly touching.

The acting PA just shook his head and smiled at him sadly.