Last Dance, Last Chance

critical condition. Anthony had told her only that his wife was “not herself.” Samie said she had then suggested that an MRI (magnetic resonance imaging) test be done at once. Anthony had agreed to that willingly enough and the results were normal. Another MRI on Sunday showed nothing more than the residual effects of Debbie’s neck surgeries.
    Sedita asked if the MRI could have shown arsenic in her system, and Dr. Samie said it could not.
    Frank Sedita was getting total validation of the written medical records on Debbie Pignataro—directly now from the doctors involved. Dr. Samie explained that arsenic poisoning is often misdiagnosed initially as Guillain-Barré syndrome because the two conditions present very similar symptoms at the beginning.
    Dr. Samie recalled the time when Pignataro was told that Debbie was suffering from arsenic poisoning. His first reaction had been to say, “Somebody must be doing this to me —because of what I went through before.”
    He was alluding to the investigation into Sarah Smith’s death. And, as always, he saw events almost exclusively as how they affected him.
    A few days later, Anthony had said to Dr. Samie, “You know that she has done this—tried to kill herself—before.”
    None of the doctors believed that Debbie Pignataro had deliberately poisoned herself. Now, when Sedita asked Dr. Samie about the expected progression of arsenic poisoning, the doctor was not optimistic. She explained that first the gastrointestinal system is affected, and then arsenic affects the nerves, where it can cause terrible damage. In Dr. Samie’s opinion, Debbie’s prognosis remained poor because she had suffered such severe damage to her nerves. She felt either that Debbie would lose the use of her hands forever, or that she faced a very long period of recovery before she could hope to regain normal use of them.
    Dr. George Jackson, division head for the Criminalistics Department of National Medical Services, helped Sedita interpret the lab results from tests on Debbie’s hair. Dr. Jackson, who has a Ph.D. in toxicology, explained that the hair samples, clipped carefully by Chuck Craven and Pat Finnerty on August 26, had been divided into three segments. As hair grows, the markings left by heavy metal will stay, and if more poison is ingested, other marks will be left closer to the hair root.
    Segment 1 of the samplings was considered to be hair growing from the root between August 10 and August 26, measuring 0.4 centimeter. Segment 2 would have grown between June 30 and August 10: 0.4 centimeter to 2.3 centimeters, and Segment 3 was hair grown from May 31 to June 30. It was 2.3 centimeters to 6.4 centimeters long.
    The rule of thumb for normal hair growth is about 1 centimeter a month. Jackson pointed out that the most dramatic increase in the arsenic level in Debbie’s hair was in the segment that had grown between August 10 and August 26. This corresponded to the dramatic worsening of Debbie Pignataro’s symptoms and to the fact that her urine had tested positive for arsenic on August 11, showing the highest level ever recorded by the New York State Health Department.
    The date of Debbie’s most significant poisoning had been narrowed down to a two-week period—probably less than that. It had taken a while for the chelation therapy to “catch” the arsenic in her system and gradually remove it.
    Meanwhile, Debbie’s agony was terrible to watch. She was prescribed as much painkilling medication as possible, but it wasn’t enough. Even the sheets of her hospital bed hurt her feet. Her hands and feet got worse instead of better, and she began to accept the awful possibility that she might never walk again or be able to feed herself, hold a pencil, or comb her own hair. The nurses who cared for her felt helpless; there was so little they could do for her.
     
    Frank Sedita, Pat Finnerty, and Chuck Craven met to go over the progress of their case. It was building steadily. They had made headway in both circumstantial and physical evidence. They knew now that if human beings are given arsenic in boluses big enough to produce acute symptoms, their hair will develop a crude “calendar” that gives macabre information.
    After two series of tests on Debbie’s hair—both without marks and with hair that showed the presence of arsenic—the Medical Services lab had been able to measure the exact amount of arsenic there. Debbie’s hair before June 1999 showed that her baseline