Read Online The Silent Sleep of the Dying (Eisenmenger-Flemming Forensic Mysteries) by Keith McCarthy - Free Book Online Page B
Authors: Keith McCarthy
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cancers are also primaries."
"Exactly. And then there's the spleen. I suppose it could be carcinoma from somewhere, but if I didn't know better, I'd say that has the classical look of lymphoma, wouldn't you?"
She was forced to admit that it did. "And there are about a dozen other findings that indicate multiple primaries," she added.
"Exactly."
"So … ?"
There, so quickly, was the rub.
It was really only to say something, anything, so that he wouldn't look stupid that he remarked, "This must be an inherited syndrome."
To his great relief, Belinda didn't dismiss this with a contemptuous snort, but actually took it seriously. "Of course!" Disillusionment set in immediately afterwards, for she then enquired, "But which one?"
Which one indeed. There were numerous inherited syndromes, usually caused by a single gene mutation, that resulted in families dying of cancers in their early years, often dying of a variety of cancers, but Hartmann could not think of one that resulted in fifteen or twenty tumours occurring simultaneously in a single individual.
"I don't know," he admitted.
"The odd thing is," Belinda was off again, musing into areas that were beyond Hartmann, "she's not known at the hospital. Surely if she had cancer — only one cancer, let alone so many — she would have found her way into the hospital system."
"Perhaps she didn't want to know."
Belinda clearly found this unlikely. The very old, afraid or just uncaring were the ones who kept their fungating tumours hidden under layers of clothing, not young people; certainly not young people working in the Medical School.
He knew that he wasn't going to get anywhere solving this without time, thought and a good few textbooks. It was already nearly eleven o'clock and he still had another autopsy to perform as well as some paperwork to clear up before he left for Glasgow. Deciding that he had made enough of a prat of himself, he said, "Whatever's going on, I think the thing to do is to take some samples for histology."
Which meant that he would have to give the Coroner's Office a presumed cause of death as opposed to a definite one (they hated that); the relatives would have to be informed of the samples he took for microscopy and much paperwork would have to be completed.
Denny came in. As it was nearly time for lunch, not even a Royal Command from Genghis Khan would have made him do any work in the dissection room in the afternoon. "Haven't you fuckin' finished with that one yet?"
Hartmann smiled at him.
"Nearly, Denny. Nearly."
"Well don't forget you've still got cocky to do," he pointed, gesturing at the unfortunate cyclist who was slowly desiccating behind them. "If I'm still clearing up in here this afternoon there'll be fuckin' hell to pay."
The implication was menacing and not lost on Hartmann. He said sweetly to his subordinate, "Don't worry, Denny. I'll be finished soon."
When Denny had again wandered away Hartmann began cutting a small piece of tissue from each organ. Each was about five millimetres thick and two by one centimetres in area. These he dropped, about twenty in all, into the pot of formalin.
Belinda asked, "What about freezing some tissue? It might be worth doing some genetics."
Again she had proved to be ahead of him. He nodded and she said at once, "I'll do that."
He was undecided between trying to appear in charge and trying to appear anal-retentive. He decided on the latter and asked, "Why?"
"You know I've been doing some research in Professor Bowman's laboratory? On the cell biology of adrenal tumours?"
One of Patricia's interests. Belinda had been enlisted, as all registrars were.
"I could probably do some of the analysis … " She paused, uncertain. "If that's all right … "
He said only, "Let's see what the microscopy shows first, shall we?"
This was clearly a rebuff. He caught her fleeting look of discomfort and said, "We ought to proceed in steps, don't you think? We'll take the samples but before we do any
"Exactly. And then there's the spleen. I suppose it could be carcinoma from somewhere, but if I didn't know better, I'd say that has the classical look of lymphoma, wouldn't you?"
She was forced to admit that it did. "And there are about a dozen other findings that indicate multiple primaries," she added.
"Exactly."
"So … ?"
There, so quickly, was the rub.
It was really only to say something, anything, so that he wouldn't look stupid that he remarked, "This must be an inherited syndrome."
To his great relief, Belinda didn't dismiss this with a contemptuous snort, but actually took it seriously. "Of course!" Disillusionment set in immediately afterwards, for she then enquired, "But which one?"
Which one indeed. There were numerous inherited syndromes, usually caused by a single gene mutation, that resulted in families dying of cancers in their early years, often dying of a variety of cancers, but Hartmann could not think of one that resulted in fifteen or twenty tumours occurring simultaneously in a single individual.
"I don't know," he admitted.
"The odd thing is," Belinda was off again, musing into areas that were beyond Hartmann, "she's not known at the hospital. Surely if she had cancer — only one cancer, let alone so many — she would have found her way into the hospital system."
"Perhaps she didn't want to know."
Belinda clearly found this unlikely. The very old, afraid or just uncaring were the ones who kept their fungating tumours hidden under layers of clothing, not young people; certainly not young people working in the Medical School.
He knew that he wasn't going to get anywhere solving this without time, thought and a good few textbooks. It was already nearly eleven o'clock and he still had another autopsy to perform as well as some paperwork to clear up before he left for Glasgow. Deciding that he had made enough of a prat of himself, he said, "Whatever's going on, I think the thing to do is to take some samples for histology."
Which meant that he would have to give the Coroner's Office a presumed cause of death as opposed to a definite one (they hated that); the relatives would have to be informed of the samples he took for microscopy and much paperwork would have to be completed.
Denny came in. As it was nearly time for lunch, not even a Royal Command from Genghis Khan would have made him do any work in the dissection room in the afternoon. "Haven't you fuckin' finished with that one yet?"
Hartmann smiled at him.
"Nearly, Denny. Nearly."
"Well don't forget you've still got cocky to do," he pointed, gesturing at the unfortunate cyclist who was slowly desiccating behind them. "If I'm still clearing up in here this afternoon there'll be fuckin' hell to pay."
The implication was menacing and not lost on Hartmann. He said sweetly to his subordinate, "Don't worry, Denny. I'll be finished soon."
When Denny had again wandered away Hartmann began cutting a small piece of tissue from each organ. Each was about five millimetres thick and two by one centimetres in area. These he dropped, about twenty in all, into the pot of formalin.
Belinda asked, "What about freezing some tissue? It might be worth doing some genetics."
Again she had proved to be ahead of him. He nodded and she said at once, "I'll do that."
He was undecided between trying to appear in charge and trying to appear anal-retentive. He decided on the latter and asked, "Why?"
"You know I've been doing some research in Professor Bowman's laboratory? On the cell biology of adrenal tumours?"
One of Patricia's interests. Belinda had been enlisted, as all registrars were.
"I could probably do some of the analysis … " She paused, uncertain. "If that's all right … "
He said only, "Let's see what the microscopy shows first, shall we?"
This was clearly a rebuff. He caught her fleeting look of discomfort and said, "We ought to proceed in steps, don't you think? We'll take the samples but before we do any
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