Rizzoli & Isles 8-Book Set

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 defrosted, it started to release gases. Dr. Gruber probably sped up the process when he sliced it open, exposing body fluids and internal organs. He wouldn’t be the first doctor to fall ill from exposure to toxins in a patient.”
    “Wait. This is starting to sound familiar,” said Jane. “Wasn’t there a case like this out in California?”
    “I think you’re referring to the Gloria Ramirez case, in the mid-1990s,” said Maura. “That was discussed quite a bit at forensic pathology conferences.”
    “What happened in that case?” asked Pasternak.
    “Gloria Ramirez was a cancer patient who came into the emergency room complaining of stomach pains. She suffered a cardiac arrest. As the medical team worked on her, they began to feel ill, and several of them collapsed.”
    “Was it due to this same pesticide?”
    “That was the theory at the time,” said Maura. “When they performed the autopsy, the pathologists donned full protective gear. They never did identify the toxin. But here’s the interesting detail: The medical personnel who collapsed while treating her were successfully resuscitated with intravenous atropine.”
    “The same drug used to save Gruber.”
    “That’s right.”
    Pasternak said, “How sure are you that this organophosphate stuff is what we’re dealing with?”
    “It will need to be confirmed by the tox report. But the clinical picture is classic. Gruber responded to atropine. And a STAT blood test showed a significant drop in cholinesterase activity. Again, that’s something you’d find with organophosphate poisoning.”
    “Is that enough to say it’s a slam dunk?”
    “It’s pretty damn close to one.” Maura looked at the faces around the table and wondered how many of these people, aside from Jane, were ready to trust her. Only days ago, she had been