Suicide jumpers typically presented with internal organ bleeding. The impact of the fall, depending on the height of the jump, brought death in a number of ways. Oftentimes, a broken rib impaled a lung or pierced the heart, and exsanguination—bleeding to death—was the cause of death. The impact could dislodge the aorta from the heart, or shear another vital vessel to cause the bleeding. In these cases, Livia would open the abdominal cavity to find pooling blood trapped in one of the compartments surrounding whichever organ had suffered the damage. Other times, the body was in decent shape with the internal organs having been protected by the skeletal shell. When Livia saw this presentation, she knew to look at the skull and the brain, which would likely show fractures and subarachnoid bleeding.

As she looked at the body in front of her, which had been presented as a floater found drifting in Emerson Bay, Livia knew it wasn’t so. First, in order for this body to reach such a level of decomposition—there was barely a flap of skin present, and what was there was rancid and black—it had to have been in the water for months or longer. If that were the case, it would not have been floating, as Livia was certain this body had not been. The intestinal gases that float a body need to be contained in the abdominal cavity, and this body had no such cavity. All that was left of the gut was a wall of muscle and tendon that held the organs in place but certainly was not airtight to hold gases. Second, the broken leg the investigators had documented was not typical of a jumper who landed feetfirst. Those bodies showed impact injuries and upward compression of bones, sometimes with the tibia rising past the knee and into the thigh; and the femur displaced into the pelvis. The body in front of Livia held a horizontally fractured femur that suggested localized trauma, not full-impact trauma of a body landing sideways on water and definitely not a feetfirst landing.

Livia jotted notes on her clipboard and then started the internal exam, which showed a lack of any damage to the organs. The rib cage was in full working order. The heart was healthy, with the aorta and inferior vena cava well apposed. Liver, spleen and kidneys showed no damage. The lungs were empty of water. She was meticulous with her documentation and careful as she weighed each organ. An hour into the autopsy, perspiration covered her brow. She felt her scrubs sticking to her arms and back as she checked the wall clock—just past two p.m.

Moving to the head, she checked for facial fractures and inspected the mouth and teeth. If an ID were made on this body, it would come from dental-path since this John Doe possessed no skin for fingerprints. And with no dermis present, there were no distinguishing tattoos that might aid in the identification.

It was during the examination of the head that Livia noticed them, the circular holes poking through the left side of the skull. She counted twelve holes randomly seated through the bone, and she racked her mind for a potential etiology. No obvious answer came to mind, besides an atypical bacterial infection that had reached the bone. But surely, had this been the case, there would be peripheral damage to the surrounding skull and some mass loss or erosion. This skull looked perfectly healthy but for the holes, which Livia quickly determined could not be from bullets or shrapnel, but might be blamed on pellets from a shotgun.

She went back to her pad and made more notes. Then, with the aid of the bone saw, she performed the craniotomy and removed the top of the skull the same way she’d do to a pumpkin at Halloween. The brain was soft and syrupy and had not been vibrant for some time. Much of working on a decomp was more difficult than a tradition autopsy. Removing the brain was the exception. If still intact, it usually came out of the skull without much effort, the dural lining no longer enclosing it. After severing the spinal cord, Livia placed the brain onto a rolling metal cart next to the autopsy table. The brain, normally laced with an intricate network of blood vessels, was usually a red mess that pooled blood beneath it when placed on the scale. This one was different. The vessels that ran through it had long since bled dry, and now the tissue was sloppy only from the water in which it had been submerged.

Examining the brain closely in the area underneath the skull piercings, Livia located corresponding holes in the tissue. Rooting deeper into the left parietal lobe, Livia was convinced after ten minutes of exploration that no shotgun pellets were present. She wiped her brow with the back of her forearm and looked up at the clock. She was due in the cage in ten minutes and didn’t have a prayer of finishing the autopsy by then, let alone being prepared to stand against the assault of Dr. Colt and her supervisors.

In front of her was a body pulled from the bay that had no internal injuries besides a non-jumper’s femoral fracture and piercings through the skull. Despite the panic Livia felt, she had the urge to call Kent Chapple, the scene investigator, and tell him he had things wrong. Not just about the body—this clearly wasn’t a jumper. But also about Dr. Colt’s timing. He’d dumped a homicide in front of her and it was technically still summer.

CHAPTER 3

It was close to four p.m. when Livia completed the autopsy. Rounds in the cage had been running for an hour. Currently, she was both tardy and ill prepared, and Livia had seen the consequences of wearing these qualities into the cage. An unexcused absence bore less wrath than a poor performance, so in lieu of rounds Livia dropped off her specimens for further analysis by the dental-and derm-path labs, then picked up the X-rays she had ordered and headed upstairs. She skated past the cage, where the lights were dimmed and Jen Tilly was presenting. Dr. Colt and the other attendings had their backs to the entrance and their attention trained on the screen, making possible Livia’s stealth escape behind them. She took the stairs to the second floor, where the neuropathology lab was located, and found Maggie Larson behind her desk and busy with paperwork.

Dr. Larson ran all things in the Office of the Chief Medical Examiner that dealt with brains. She had a single neuropath fellow assigned to her for the year, who was likely down in the cage listening to Jen Tilly.

“Dr. Larson?” Livia said from the doorway.

“Livia,” Dr. Larson said, eyes squinted. “No rounds this afternoon?”

“They’re going on right now but I was assigned an afternoon case and I need some help before I get murdered down there.”

Dr. Larson lifted her chin, noticing the transport container Livia carried by her side like a pail of water.

“What’ve you got?”

The woman had a sixth sense for brain tissue, and Livia and the other fellows knew a conversation could not be had with Dr. Larson if an unanalyzed brain was nearby. It was like trying to talk to a dog while holding a bone-shaped biscuit.

“I’m confused by something I found on exam and was hoping to get your opinion.”

Dr. Larson stood from her desk and pointed to the examining table. A short woman whose hair had long ago sprouted gray roots and was now marble-streaked with the few dark strands that refused to give way, Margaret Larson held a PhD as well as a medical degree, which told Livia she’d spent years in paperwork and research labs. Livia placed the container down as Dr. Larson clicked on the overhead lamp.

“What do we have?”

They snapped on latex gloves as they gathered around the table, Dr. Larson stepping onto a stool to gain height over the specimen.

“The investigators brought in a supposed floater found by fishermen this morning. From external exam, I know the body wasn’t floating.” Livia took the brain out of the container and placed it on the table, dripping the pungent formalin solution along with it.

“While examining the skull, I found this.” Livia handed Dr. Larson the autopsy photos of the skull piercings.

With no hesitation, Dr. Larson juxtaposed the photo next to the brain. She stuck her gloved pinkie finger into one of the holes in the brain tissue.

“I was thinking maybe pellet wounds from a shotgun blast, but could find no foreign bodies.”

Without talking, Dr. Larson grabbed her slicing knife—which looked much like a long, serrated bread knife—and began cutting the brain into one-inch sagittal sections. She made it through, end to end, like a seasoned chef on a reality cooking show. Livia watched the slices fall to the side, soupy and wet and old.

Dr. Larson inspected each of the sections.

“No pellets. And the pattern isn’t quite right for a shotgun blast. You’d see more randomness, and the angle of the pellets could come from only one direction.” She pointed back to the autopsy photo. “See here? This set of holes is temporally located over the ear; this other set is located more posteriorly. Pellets from a shotgun can only go straight, they can’t curve.”

Dr. Larson looked at Livia to make sure she understood. Livia nodded.

“X-ray?” Dr. Larson asked.

Livia pulled black-and-white scans from a manila envelope, which Dr. Larson held up to the light. “No foreign bodies in the brain, so let’s move on from the shotgun theory. What else?”

“Infection was my other guess,” Livia said, knowing it was incorrect but wanting confirmation from Dr. Larson, as she was sure Dr. Colt would request.

“No peripheral or collateral melting or bone loss,” Dr. Larson said, looking back at the X-rays and the autopsy photos of the skull. “What else?”

Livia shook her head. “Congenital?”

Dr. Larson shook her head. “Doesn’t explain the concurrent piercings into the brain.”

“I’m out of theories.”

“That’s not enough ammunition for the cage.”