Ice Cold: A Rizzoli & Isles Novel

about a hundred pounds overweight. I’m betting he had an MI.”
    “He wet himself,” said Maura.
    Again, her voice went ignored. She was like a ghost hovering at the periphery, unheard and unheeded. She pressed a hand to her head, which was pounding even worse, and struggled to think, to focus. Somehow she managed to push her way into the throng ofpersonnel and kneel down near Gruber’s head. Lifting one of his eyelids, she stared at the pupil.
    It was barely a pinprick of black against the pale blue iris.
    The stench of urine wafted up from his body, and she looked at his soaked scrub pants. Suddenly aware of the sound of retching, she glanced across the room and saw the morgue assistant was vomiting into a sink.
    “Atropine,” she said.
    “I got the IV in!” a nurse called out.
    “I’m still not getting a blood pressure.”
    “You want a dopamine drip?”
    “He needs atropine,” said Maura, louder.
    For the first time, the doctor seemed to notice her. “Why? His heart rate’s not that slow.”
    “He has pinpoint pupils. He’s soaked with urine.”
    “He also had a seizure.”
    “We all got sick in that room.” She pointed to the morgue assistant, who was still leaning over the sink. “Give him the atropine now, or you’re going to lose him.”
    The doctor lifted Gruber’s eyelid and stared at the constricted pupil. “Okay. Atropine, two milligrams,” he ordered.
    “And you need to seal that lab,” said Maura. “We should all move into the hallway now, as far from that room as possible. They need to call in a hazmat team.”
    “What the hell is going on?” said Jane.
    Maura turned to her, and just that sudden movement made the room seem to whirl. “They’ve got a chemical hazard in there.”
    “But the GasBadge readings were negative.”
    “Negative for what it was monitoring. But that’s not what poisoned him.”
    “Then you know what it is? You know what killed all those people?”
    Maura nodded. “I know exactly why they died.”

O RGANOPHOSPHATE COMPOUNDS ARE AMONG THE MOST TOXIC OF pesticides used in the agricultural industry,” said Maura. “They can be absorbed by almost all routes, including through the skin and by inhalation. That’s how Dr. Gruber probably got exposed in the autopsy room. When he removed his respirator and breathed in the fumes. Fortunately, he received the appropriate treatment in time, and he’s going to recover.” She looked around the table at the medical and law enforcement personnel who had gathered in the hospital conference room. She did not need to add the fact that she was the one who’d made the diagnosis and saved Gruber’s life. They already knew it, and although she was an outsider, she heard a tone of respect when they addressed her.
    “That alone can kill you?” said Detective Pasternak. “Just doing an autopsy on a poisoned corpse?”
    “Potentially it can, if you’re exposed to a lethal dose. Organophosphates work by inhibiting the enzyme that breaks downa neurotransmitter called acetylcholine. The result is that acetylcholine accumulates to dangerous levels. That causes nerve impulses to fire off like crazy throughout the parasympathetic nervous system. It’s a synaptic storm. The patient sweats and salivates. He loses control of his bladder and bowels. His pupils constrict to pinpoints, and his lungs fill with fluid. Eventually, he’ll start convulsing and lose consciousness.”
    “I don’t understand something,” said Sheriff Fahey. “Dr. Gruber got sick within half an hour of starting that autopsy. But the coroner’s recovery team dug up forty-one of those corpses, put them in body bags, and moved them into an airport hangar. None of those workers ended up in the hospital.”
    Dr. Draper, the county coroner, spoke up. “I have a confession to make. It’s a detail that was reported to me yesterday, but I didn’t realize it was significant until now. Four members of our recovery team came down with the stomach flu. Or that’s what they thought it was.”
    “But no one keeled over and died,” said Fahey.
    “Probably because they were working with frozen bodies. And they were wearing protective garb, plus heavy winter clothes. The body in the autopsy room was the first one to be thawed.”
    “Would that make a difference?” asked Pasternak. “Frozen versus a thawed corpse?”
    Everyone looked at Maura, and she nodded. “At higher temperatures, toxic compounds are more likely to aerosolize. As that body