Carved in Bone

Health and get that ulna set.”
    “Okay. No, wait. First I want to show you something on these ribs.” I helped her up from the steps, picked up her things, and held the door for her, seeing as she was wounded and all. Back in the lab, she made a beeline for the tray of bones and picked up a rib with her left hand. “Look at this,” she said, pointing with her right index finger. “Yow!” She laid the curved, ivory-colored bone down on the counter and pointed with her left hand. It was easy to see what she was excited about.
    The bone—rib seven or eight, I guessed from the size—was a comma-shaped arc roughly ten inches long. Its curve was asymmetrical, though that wasn’t the odd part: ribs arc sharply near the spine, but the curve flattens out near the sternum. There’s a slight sideways warp to the curve, too, which keeps the bones from lying flat on a desk or examination table. With all those compound curves, students sometimes have trouble telling which way is up on an individual rib, until they learn to look at its cross-section. In cross-section, the rib is shaped like an upside-down teardrop; in other words, the rounded part is the top surface. The lower, more pointed edge is a bit lopsided—it’s actually slightly concave on its inner surface, to make room for the artery, vein, and nerve that nestle beneath each rib. The architecture and engineering of the human body never cease to amaze me.
    What had gotten Miranda excited enough to ignore her throbbing arm was a region about midway along the shaft of the rib. A ring of thicker material, maybe half an inch wide and an eighth-inch thick at its midline, encircled the rib. Several other ribs in the tray had similar features. “Recently broken,” she said proudly. “But already healing. Definitely not perimortem.”
    She was right; it couldn’t have been broken at the time of death. “Got a guess on how long before death?”
    She swung the lamp with the built-in magnifier down over the bone and switched on the doughnut-shaped light. “Well, the hematoma at the break would have turned into this healing callus within a week to ten days, so I’d say the fracture occurred at least a couple of weeks prior to death. But the callus is still more cartilaginous than bony, so it’s got a ways to go yet. Just a guess—I’d need to search the literature to pin it down—but I’d say this break was two or three weeks antemortem.”
    “Would you say it’s consistent with injuries sustained in a barroom brawl eighteen days before death?”
    She swiveled her head to look at me. “Well, yeah . Would you say our friend participated in a barroom brawl eighteen days before he died?”
    “Got the shit kicked out of him, according to the defendant, who also came out a little the worse for wear. Happened in one of those windowless cinder-block beer joints in Morgan County that practically shout, ‘Enter and die!’ Couple other locals corroborate the story. Apparently Mr. Ledbetter here got stomped by some bad hombres wearing combat boots.”
    She laid down the first rib and picked up another. “Here’s the really interesting one. See the callus? Not a nice, neat ring around the bone. I’ve never seen one shaped like this.” Neither had I. The patch of new bone was long and irregular; instead of encircling a cross-section of rib, it extended for several inches in a lumpy, wavy path. “Weird, huh?” I nodded. “Must be a comminuted fracture, with multiple fragments,” she went on. “But that’s not all. Look at the distal end of the break. Something’s missing.”
    I leaned closer to the lens. Sure enough, extending beyond one end of the healing callus was a gouged-out groove in the underlying bone. “I’ll be damned,” I said. “Looks like a piece splintered off.”
    Miranda nodded excitedly. “So where’s the missing piece?”
    “Maybe somewhere in the right lung,” I said.
    “Exactly what I was thinking,” she grinned. “Let’s go see.”
    “No. I’ll go see,” I said. “ You’ll go get your arm fixed.”
    She made a face, then brightened. “This is a great case!”
    “Yeah. I’m mighty glad to have your help. Good work, Miranda. Thanks.” I caught and held her eyes. They glistened and filled—damn, was she going to cry again?—and then she smiled and nodded briskly. Thank you, God, I thought, and nodded back.
    I let her out at the service entrance to the health service. We were regulars there, what with our frequent