Fatal Reaction

wouldn’t be having this conversation.
    “In reviewing the case I’ve come across some rather unusual findings.”
    “Unusual in what way?”
    “Well, for one thing, some curious abnormalities have showed up in the microscopic slides of organ tissues.”
    “What kind of abnormalities?”
    “There are pervasive thrombi in the glomeruli of the kidneys. In lay terms that means that there are lots and lots of blood clots in the filtering apparatus of the kidneys.”
    “Big clots?” I asked, without thinking. “I take that back. How big can they be if you have to use a microscope to see them?”
    “It’s not the size that’s the issue, but rather their pervasiveness that makes me suspicious.”
    “Suspicious of what?”
    “Well, for one thing, D.I.C.”
    “What’s D.I.C.?”
    “It’s short for disseminated intravascular coagulation. It’s a clotting syndrome that’s usually associated with things like massive thrombosis, pulmonary embolism, cardiogenic shock, liver failure due to cirrhosis, snake bite, anaphylaxis. You also see it in some end-stage cancers.”
    “Could Danny have had one of those things?”
    “Dr. Breuner found no evidence of them at autopsy and these are things that would be hard to miss. Dr. Breuner just assumed that D.I.C. had followed the erosion of a blood vessel by the gastric ulcer. Certainly that is possible, but it would have occurred over a much longer period of time than is consistent with the blood evidence at the scene. However, since Dr. Breuner was not the pathologist who examined the body in situ he had no way of knowing that.”
    “I don’t understand.”
    “Judging from the condition of the apartment, D.I.C. must have occurred very rapidly—too rapidly to have been the result of an ulcer.”
    “And AIDS couldn’t have caused it?” I asked.
    “I’ll grant you that AIDS poses some special issues for forensic pathologists. For example, lung cancer can kill in only so many different ways, all of which are recognizable. HIV, on the other hand, offers a seemingly endless range of scenarios depending on which organ system is set upon by the virus and which of a wide array of microbes breaches the immune system first. I think that’s why Dr. Breuner initially discounted the abnormal tissue findings. He sees many fewer cases of AIDS in his jurisdiction than we see here and I think he just assumed that the virus was in some way involved.”
    “So what does all this mean?”
    “Unfortunately, Ms. Millholland, there is no cookbook that tells us how to figure out how people die. Some things are clear-cut—gunshots, dismemberments, strangulation— but sometimes the footprints that death leaves behind can be very subtle. I don’t usually take my work home with me, but in this case I took the liberty of showing Mr. Wohl’s tissue slides to my husband, who as you probably know happens to be a hematologist.”
    “What did he say when he looked at the slides?” I asked.
    “He took them back to his lab, where they have a setup that allows them to photograph microscope slides. He took these and suggested that Dr. Azorini have a look at them.” She handed me a manila envelope.
    “Why Stephen?”
    “I understand that Azor Pharmaceuticals is currently trying to get a new artificial blood product approved by the FDA.”
    “So?”
    “So Hugh seems to think there’s a good chance that a substance being used at Azor in one of their labs might have been the cause of D.I.C. in Mr. Wohl.”
     

CHAPTER 18
     
    As soon as I arrived at Azor I went straight to Stephen’s office. I didn’t even bother to take off my coat. I wanted to show him the pictures that Julia Gordon’s husband had made of Danny’s tissue. I needed to know what explanation, if any, he could offer for its appearance.
    Blessedly he was in. I found him deep in conversation with Michelle Goodwin. Anxiously I hovered in the doorway, hoping for a good opportunity to interrupt. I didn’t understand a word of what they were saying. Whatever it was must have been important—to Michelle Goodwin, at least. Her entire body sang with intensity as she leaned forward to make a point with the keenness of a runner straining for the finish line. She had shed her customary shyness. Her manner was animated, her skin flushed with excitement. For a moment I thought I caught a glimpse of what the lecherous Nobel prizewinner had seen in her.
    I also couldn’t help wondering, once again, where the myth of the cool and