Terri looked up at McCabe. ‘Are you alright?’ she asked. ‘You don’t look so good.’
‘Yeah, I’m okay.’ He didn’t elaborate.
Terri nodded and then went back to her work. She examined the incision that had been made in Katie’s abdomen. She carefully removed the small ornament that decorated Katie’s navel. Using a scalpel, Terri then cut diagonally from each of Katie’s shoulders down toward the opening that already existed in her chest and abdomen. She continued the cut down beyond the navel to the pubis. She reopened the already sawn sternum and began removing, examining, and weighing each of the girl’s organs, excepting, of course, her missing heart. With the body opened, the stench of decomposing flesh filled McCabe’s nostrils, and he felt a rising nausea. This was the moment in each autopsy where, for McCabe, the corpse lost its connection with the living, its human identity becoming once and for all time a memory. McCabe’s mind let go of Katie and now shifted to planning the next steps in the Dubois investigation. At the same time, he found himself wondering if Lucinda Cassidy might still be alive and, if she was, how on earth he’d ever find her before she, too, ended up on a table like this.
An hour later the autopsy was over. Terri, removing her gloves, walked McCabe and Maggie to the door. She looked at McCabe. ‘Like I said last night, someone surgically removed this girl’s heart. Underline surgically. Removing a heart is not a difficult procedure, especially if you don’t care if the patient – victim – dies, or if you actually want the patient to die.’
‘How could you remove someone’s heart and not have the person die?’ asked Maggie.
‘It’s done all the time,’ said Terri.
‘What do you mean?’ Maggie was genuinely confused.
‘It’s called a transplant. A sick heart is removed from a person and a healthy heart put in. In most cases, the patient who receives the heart goes on to live a perfectly normal life. At least for some period of time.’
A transplant was something McCabe hadn’t considered. He found the notion intriguing. He looked at Terri. ‘Do you think that’s even remotely possible?’ he asked. ‘That Katie’s heart was removed as part of a transplant procedure?’
‘I suppose it’s possible, but damned unlikely. There’s certainly a shortage of hearts available for transplant. Someone might even kill for one. Many have died for want of one. The thing is, a successful transplant can’t be done outside a modern OR, and I can’t imagine any American transplant center accepting a donor heart without knowing exactly whose it was or where it came from. It just wouldn’t happen.
‘Even so,’ Terri continued, ‘this extraction was done skillfully. The incision was clean, most likely made with a scalpel. I’d guess the sternum was cut with a Stryker surgical saw. Like the one I use for autopsies. Hard to find outside a hospital. Or someplace like this. Anyway, I’d say you might – underline might – be looking for a murderer who trained as a doctor. Probably, but not necessarily, a surgeon. Possibly, but not necessarily, a cardiac surgeon. Again possibly, a pathologist. That’s the best lead I can give you. Katie Dubois was alive, her heart was beating, when the surgery – and I’m going to call it that – began. The removal of her heart was the immediate cause of death. What I’m really curious about is whether or not she was either anesthetized or brain dead at the time the heart was removed.’
‘If not?’
‘If not, she would have suffered horribly.’
Maybe our boy got off on that, thought McCabe. ‘Your blood tox results will tell you that?’ he asked.
‘Yes. I’ll let you know as soon as I do. It’ll be a while, but I’ll try to hurry the lab along as much as I can.’
9
Saturday. 6:00 P.M.
McCabe’s cell phone rang on the return trip from Augusta. ‘This is McCabe.’
‘Sergeant McCabe? This is Dr. Spencer. Phil Spencer. My wife said you called?’
‘Yes, Dr. Spencer, I was hoping you could spare me half an hour.’
‘Hattie said you wanted to talk to me about the Dubois girl,’ said Spencer. Without waiting for a response, he continued. ‘I’m not sure how I can help, but I’ll be happy to talk with you. I keep an office in the hospital, in the Levenson Heart Center. It’s one of the luxuries the hospital affords me. If you can come up in an hour or so, say seven o’clock, I can spare you some time. I should warn you, though, I may have to run out midconversation. I’m waiting on a harvest.’
‘A harvest?’
‘Yes. We’re harvesting a heart. For a transplant. Or, more accurately, a surgeon in New Hampshire is harvesting a heart.’
‘You call removing a heart “harvesting”?’ McCabe found the term a little creepy.