The Apprentice: A Rizzoli & Isles Novel

of curvature for a tibia.”
    “So why’re you getting all excited? Lotta folks have bow legs.”
    “It’s not just the bow legs,” said Isles. “It’s also the chest. Look at the angle the ribs make with the sternum. She has pectus excavatum, or funnel chest. Abnormal bone and cartilage formation caused the sternum—the breastbone—to be sunken in. If it’s severe, it can cause shortness of breath, cardiac problems. In this case, it was mild, and probably gave her no symptoms. The condition would have been primarily cosmetic.”
    “And this is due to abnormal bone formation?” said Rizzoli.
    “Yes. A defect in bone metabolism.”
    “What kind of illness are we talking about?”
    Isles hesitated and looked at Dr. Pepe. “Her stature
is
short.”
    “What’s the Trotter-Gleiser estimate?”
    Isles took out a measuring tape, whisked it over the femur and tibia. “I’d guess about sixty-one inches. Plus or minus three.”
    “So we’ve got pectus excavatum. Bilateral genu varus. Short stature.” He nodded. “It’s strongly suggestive.”
    Isles looked at Rizzoli. “She had rickets as a child.”
    It was almost a quaint word,
rickets.
For Rizzoli, it conjured up visions of barefoot children in tumbledown shacks, crying babies, and the grime of poverty. A different era, colored in sepia.
Rickets
was not a word that matched a woman with three gold crowns and orthodontically straightened teeth.
    Gabriel Dean had also taken note of this contradiction. “I thought rickets is caused by malnutrition,” he said.
    “Yes,” Isles answered. “A lack of vitamin D. Most children get an adequate supply of D from either milk or sunlight. But if the child is malnourished, and kept indoors, she’ll be deficient in the vitamin. And that affects calcium metabolism and bone development.” She paused. “I’ve actually never seen a case before.”
    “Come out on a dig with me someday,” said Dr. Pepe. “I’ll show you plenty of cases from the last century. Scandinavia, northern Russia—”
    “But today? In the U.S.?” asked Dean.
    Pepe shook his head. “Quite unusual. Judging by the bony deformities, as well as her small stature, I would guess this individual lived in impoverished circumstances. At least through her adolescence.”
    “That isn’t consistent with the dental work.”
    “No. That’s why Dr. Isles said we seem to be dealing with two different individuals here.”
    The child and the adult, thought Rizzoli. She remembered her own childhood in Revere, their family crammed into a hot little rental house, a place so small that for her to enjoy any privacy she had to crawl into her secret space beneath the front porch. She remembered the brief period after her father was laid off, the frightened whispers in her parents’ bedroom, the suppers of canned corn and Potato Buds. The bad times had not lasted; within a year, her father was back at work and meat was once again on the table. But a brush with poverty leaves its mark, on the mind if not the body, and the three Rizzoli siblings had all chosen careers with steady, if not spectacular, incomes—Jane in law enforcement, Frankie in the Marines, and Mikey in the U.S. Postal Service, all of them striving to escape the insecurity of childhood.
    She looked at the skeleton on the table and said, “Rags to riches. It does happen.”
    “Like something out of Dickens,” said Dean.
    “Oh yeah,” said Korsak. “That Tiny Tim kid.”
    Dr. Isles nodded. “Tiny Tim suffered from rickets.”
    “And then he lived happily ever after, ’cause old Scrooge probably left him a ton of money,” said Korsak.
    But you didn’t live happily ever after,
thought Rizzoli, gazing at the remains. No longer were these just a sad collection of bones, but a woman whose life was now beginning to take shape in Rizzoli’s mind. She saw a child with crooked legs and a hollow chest, growing stunted in the mean soil of poverty. Saw that child passing into adolescence, wearing blouses with mismatched buttons, the fabric worn to frayed transparency. Even then, was there something different, something special about this girl? A look of determination in her eyes, an upward tilt to the jaw that announced she was destined for a better life than the one into which she’d been born?
    Because the woman she grew into lived in a different world, where money bought straight teeth and gold crowns. Good luck or hard work or perhaps the attention of the right man had lifted her to