As Laurie rode down from the fifth floor to the basement morgue level, she thought of what she was going to find on Jeffries. According to the PA's report, the man had had all the symptoms of a toxic shock-like syndrome: high fever, an obvious wound infection at both incision sites, diarrhea with abdominal pain, vomiting, severe prostration, low blood pressure, unresponsive to medication, low urinary output, rapid heart rate, and respiratory distress with some blood-tinged mucus. Laurie shuddered at the thought of how quickly the man had succumbed and how virulent the bacteria had to be. She also couldn't keep herself from worrying about the case being a negative omen, involving, as it did, the exact same surgery Jack was facing, even the same knee. Jack had blithely dismissed the coincidence, but she couldn't. It made her more committed than ever to talk Jack into at least delaying his surgery. She even saw a bright side to David Jeffries's tragedy. Maybe if she found something different or unexpected at the post, it could help her change Jack's mind, which was why she had requested the case. Generally, she tried to avoid cases involving fatal infection. She'd never admitted it to anyone, but they made her uneasy. Yet as she approached the locker room, she acknowledged that she felt more eager and keyed up about doing the case than she had ever felt about doing another.

Laurie changed quickly, first into scrubs and then putting on her disposable protective gear. Although the newer gear was less burdensome and limiting than the old moon suits, she occasionally groused about the equipment like everyone else, but, on this occasion, dealing with a fatal infection, she was pleased to have it. She carefully cleaned off the plastic face mask – even slight smudges bothered her – and turned on the fan before pulling the contraption over her head. Then, prepared, she pushed into the pit.

Stopping just inside the door, she surveyed the scene. Four tables were in use. The nearest supported the corpse of an extremely pale Asian-American male. Three people were grouped around the head, the scalp of which had been reflected forward and the skullcap of which had been removed. The bloody brain glistened in the raw light. Although Laurie couldn't see any faces through the plastic face masks, she guessed it was Jack, Lou, and Vinnie, since they had started first.

The next table also had three people working, and as Laurie viewed them, her face flushed. She'd forgotten that the chief, Dr. Harold Bingham, was expected. He rarely came to the autopsy room, as most of his time was spent in administrative duties or testifying at high-profile trials. It was easy to pick him out, not only because of his almost square silhouette but because of his harsh baritone voice that suddenly reverberated throughout the tiled room. He was giving one of his impromptu lectures about how his current case reminded him of one of his innumerable previous cases. As he was carrying on, a slight figure standing on a stool opposite him, who Laurie surmised was her office mate, Riva, was actually doing the work. For her reward, Bingham intermittently interrupted his monologue to offer negative comments about her technique.

The next two tables had a pair of people working at each. Laurie had no idea who they were. The fifth table contained the corpse of an African-American male. Standing at the head of the table, a figure she assumed was Marvin waved toward her, and over the sound of Bingham's raucous voice, he called out, "We're set to go on table five, Dr. Montgomery!"

Bingham's head snapped around toward Laurie, making her wish she could disappear. The overhead light glinted off his plastic face screen, blocking a view of his face, so she could not anticipate his frame of mind. "Dr. Montgomery, you are a half-hour late!"

"I've been going over my cases for this morning, sir," Laurie said quickly, and as deferentially as possible. She could feel her heart rate bump up. Laurie had struggled with authority figures since childhood. "I also needed to speak with Cheryl Myers to get some missing data." Cheryl Myers was a PA whom Laurie had slipped into the investigator's office to see after leaving the ID room. Although Cheryl had written a generally good note for the construction death, Laurie's second case, Laurie had noticed that the distance from the building the corpse had ended up after the fatal ten-story fall was not included. As Laurie had assumed, Cheryl had obtained the figure but had mistakenly left it out of the report.

"All that is supposed to be done before seven-thirty," Bingham snapped.

"Yes, sir," Laurie said, not interested in arguing. Unlike Jack, Laurie generally followed rules reflexively. However, the one mandating that autopsies start at seven-thirty sharp she generally ignored, since it conflicted with her belief that it was more important to know the case prior to doing the post. In an attempt to preclude any more conversation with Bingham about the issue, Laurie stepped directly up to Jack's table and asked loudly how his case was going.

"Stellarly" Jack quipped, "except the inconvenient fact that the patient died. The only bad side is that it has been dragging on. We'd have made significantly more progress if there was any decent help around here."

"Screw you!" Vinnie said. "If you two old windbags hadn't carried on like you've been doing, we could be up having coffee by now."

"Gentlemen," Bingham's voice called out. "I'll have no disrespect, nor profanity, in the autopsy room."

Lest she incite any further comments from Jack and subsequent retorts from Bingham, Laurie quickly headed toward Marvin and her own case. As she passed Bingham's table, she cringed for fear of being called over, but luckily Bingham had been distracted by what he called a "catastrophic mistake" on Riva's part as she dissected the neck.

"Are you going to need anything special?" Marvin asked as Laurie came up abreast of the fifth table. As prepared as Laurie was, she generally knew in advance when special needs were required for a case.

"A good supply of culture tubes," Laurie said as she surveyed David Jeffries's corpse. For fifty-one years of age, the man appeared to have been in good physical condition. There was no excess fat. In fact, his muscles, particularly the pectorals and quadriceps, had the definition of a much younger man.

Laurie grimaced behind her plastic face screen. Besides the obvious infection at the surgical sites on either side of the right knee, there was a sprinkling of small pustules all over his body, which given the time would have turned into abscesses or boils. Even more striking were areas of desquamation, particularly on his pelvis, with the skin sloughing in relatively large sheets.

"Are you looking at his hands?" Marvin asked.

Laurie nodded.

"What caused his skin to peel off like that?"

"Staph makes a lot of toxins. One of them causes skin cells to separate from their neighbors."

"Ugh," Marvin said.

Laurie nodded again. She'd seen staph infection before, but this was the worst.

"Anyway, to answer your question about culture tubes," Marvin said, "I got plenty."

"Did you get a good supply of syringes as well?"

"Yup."

"All right, let's do it," Laurie said, as she pulled down the suspended microphone.

"Want to check out the X-ray? I put it up just in case."

Laurie stepped over to the view box and gazed at the film. Marvin followed and looked over her shoulder.

"Our X-rays are mainly for foreign bodies and fractures," Laurie said. "Even so, you can certainly appreciate the pneumonia and how diffuse it is. It looks like the lungs are filled with fluid."

"Hmmm," Marvin said. X-rays were a mystery to him. He couldn't understand how doctors could see what they did in the foggy image.

Laurie went back to the body and completed the external examination. After making sure the endotracheal tube was where it was supposed to be in the trachea, she pulled it out. It had been placed by the doctors to ventilate him when he had begun to have trouble breathing. She cultured the bloody mucus adhered to it. Turning to the multiple IV lines, she made sure they were also properly placed and, after doing so, pulled them out and cultured them as well. Medical examiners insisted such tubes be left in place to be sure that they played no role in the patient's death. She also cultured the pus issuing from the surgical site.