The Sinner: A Rizzoli & Isles Novel

World” was playing over the sound system.
    Even in the ICU, the holiday spirit twinkled in ironic good cheer. The nurses’ station was draped with fake pine garlands, and the ward clerk had tiny gold Christmas bulbs dangling from her ears.
    “I’m Dr. Isles, from the Medical Examiner’s office,” she said. “Is Dr. Yuen here?”
    “He just got called into emergency surgery. He asked Dr. Sutcliffe to come in and turn off the ventilator.”
    “Has the chart been photocopied for me?”
    “It’s all ready for you.” The ward clerk pointed to a thick envelope on the counter, with “Save for Medical Examiner” scrawled across it.
    “Thank you.”
    Maura opened the envelope and took out the photocopied chart. She read through the sad accumulation of evidence that Sister Ursula was beyond saving: two separate EEGs had shown no brain activity, and a handwritten note by the neurosurgeon Dr. Yuen admitted defeat:
    Patient remains unresponsive to deep pain, with no spontaneous respirations. Pupils remain mid-position and fixed. Repeat EEG shows no brain activity. Cardiac enzymes confirm myocardial infarction. Dr. Sutcliffe to inform family of status.
    Assessment: Irreversible coma secondary to prolonged cerebral anoxia after recent cardiac arrest.
    She turned, at last, to the pages of lab results. She saw neatly printed columns of cell counts and blood and urine chemistries. How ironic, she thought as she closed the chart, to die with most of your blood tests perfectly normal.
    Maura crossed to Cubicle #10, where the patient was getting her final sponge bath. Standing at the foot of the bed, Maura watched the nurse peel back the sheets and remove Ursula’s gown, revealing not the body of an ascetic, but of a woman who had heartily indulged in meals, generous breasts spilling sideways, pale thighs heavy and dimpled. In life, she would have appeared formidable, her stout figure made even more imposing by her voluminous nun’s robes. Now, stripped of those robes, she was like any other patient. Death does not discriminate; whether saints or sinners, in the end, all are equal.
    The nurse wrung out the washcloth and wiped down the torso, leaving the skin slick and shiny. Then she began to sponge the legs, bending the knees to clean beneath the calves. Old scars pocked the shins, the ugly aftermath of infected insect bites. Souvenirs of a life lived abroad. Finished with her task, the nurse picked up the washbasin and walked out of the cubicle, leaving Maura alone with the patient.
    What was it you knew, Ursula? What could you have told us?
    “Dr. Isles?”
    She turned to see Dr. Sutcliffe standing behind her. His gaze was far more wary than the first time they’d met. No longer the friendly hippie doctor with the ponytail.
    “I didn’t know you’d be coming in,” he said.
    “Dr. Yuen called me. Our office will assume custody of the body.”
    “Why? The cause of death is pretty obvious. You only have to look at her cardiogram.”
    “It’s just protocol. We routinely take custody whenever there’s a criminal assault involved.”
    “Well, I think it’s a waste of taxpayer money, in this case.”
    She ignored his comment and looked at Ursula. “I take it you’ve spoken to the family about withdrawing life support?”
    “The nephew agreed to it. We’re just waiting for the priest to get here. The sisters at the convent asked that Father Brophy be present.”
    She watched Ursula’s chest rise and fall with the cycling of the ventilator. The heart continued to beat, the organs to function. Draw a tube of blood from Ursula’s vein, send it down to the laboratory, and none of their tests, none of their sophisticated machines, would reveal that this woman’s soul had already fled her body.
    She said, “I’d appreciate it if you could forward the final death summaries to my office.”
    “Dr. Yuen will be dictating it. I’ll let him know.”
    “And any last lab reports that come in as well.”
    “They should all be in the chart by now.”
    “There was no tox screen report. The test was done, wasn’t it?”
    “It should have been. I’ll check with the lab and call you with the results.”
    “The lab needs to send the report directly to me. If it wasn’t done, we’ll do it at the morgue.”
    “You do tox screens on everyone?” He shook his head. “Sounds like another waste of taxpayer money.”
    “We only do them when indicated. I’m thinking about the urticaria I saw, the night she coded.