Fatal Impact (6 page)

8

A
s she left Hairtastic, Anya noticed a heightened police presence in the main street. Uniformed officers had begun door-knocking the shops with photos of Jenny and Mia. Anya headed back to Hobart for Emily’s post-mortem, hoping someone would know enough to help the investigation. On the way, she called Schiller and filled him in on what she had learnt.

Along the A6 past colourful orchards, she left the pristine Huon River behind. It always amazed her that she could be in planted orchards and a relatively short drive away lay the rugged World Heritage Southwest Forests. Tasmania was full of contrasts and contradictions, she remembered all too well.

After parking near the hospital and locating the morgue, she braced herself before entering through the plastic screen doors. Inside lay the small, pale body. Emily Quaid had acted beyond her years, translating the world for her mother.

Dr Clive Arneil and a technician were already inside the suite, along with Schiller. ‘Anya, it’s good to have you here. Last time we worked together, it must have been Bali, wasn’t it?’

‘After the hotel bombing.’

‘You two identified those bodies?’ Schiller seemed impressed.

Anya nodded. ‘We all do disaster work, there aren’t enough pathologists to go around so we all do what we can when there’s an emergency.’

Clive went back to the task. If the case of a child bothered him, he hid it well. He had once quietly admitted to her that he preferred dead people. He found them less complicated than live ones. He avoided conferences, and preferred to correspond with colleagues via letter or email, such was his shyness with strangers.

Schiller retreated closer to the doors. ‘Detective Bowden decided he was better off going over the Quaid house again for evidence.’

‘Anything so far?’ She averted her eyes from the table.

Clive had already opened the chest plate. ‘External examination is a female child, 134 centimetres, weight 22 kilograms.’

Anya knew that was small for a ten-year-old girl. Ben, now eight, was 130 centimetres and weighed more than that.

‘Skin turgor was increased, suggesting dehydration. Otherwise, unremarkable.’

‘A natural therapist had her on a diet of raw foods and “detox” recipes,’ Anya said. She also explained the procedure Dylan Heyes had performed through the nose and asked Clive to check for damage to the nasal cavity and sphenoid bone.

Clive didn’t look up. ‘That doesn’t explain a distended abdomen. There were no other distinctive markings, wounds or injuries. I noted blood and faecal matter around the anus.’

Anya stepped forward and had a look for herself. Emily’s skin was like alabaster. There were no visible contusions, bruises or dot-like haemorrhages. Nothing to suggest trauma, no ligature marks. ‘External genitalia?’ she asked.

‘Hymen was intact with no signs of perineal trauma. Nevertheless, I took swabs.’

That suggested Emily hadn’t had vaginal interference. But the blood around her rectum remained a concern.

Anya moved to the lit up viewing boxes. X-rays of the skull, limbs and chest failed to reveal any fractures, new or healed. There was no evidence of foreign bodies either. The chest appeared congested and loops of bowel were enlarged.

A rancid smell Anya recognised suddenly filled the room. Schiller covered his nose. Anya moved closer to the abdomen. In his gloved hands, Clive held a stretch of large, perforated intestine. ‘Appendix isn’t inflamed,’ he announced. Anya’s attention was drawn to the wall of the bowel. It was oedematous, swollen.

The pathologist dissected a section, opening it up, continuing to dictate into the hanging microphone above his head. ‘The wall is friable and tore on minimal disruption. There are longitudinal ulcers near the caecum.’ He extended the cut. ‘And in sections of the large bowel.’

Schiller reached over to see. ‘Could she have had Crohn’s?’ He added, ‘When we were fourteen, my twin brother got sick and lost all this weight. They diagnosed it on colonoscopy. He used to pass blood.’

‘Crohn’s is a possibility, but it’s too early to reach a conclusion.’

An inflammatory bowel disease might explain what they were seeing, but Anya was drawn to the appearance of the kidneys.

Clive pulled a stretch of bowel to the side and exposed them. Like the bowel, both were congested and inflamed. He asked for a needle and syringe, which the technician prepared. Inserting it into the tiny bladder, he pulled back on the plastic syringe. He repeated the process. The syringe remained empty. ‘Looks like she was anuric.’

‘Anuric?’ The detective took notes on a small pad.

‘She wasn’t producing any urine,’ Anya answered. ‘You’d expect the bladder to have something in it, even if she had recently voided.’

The phone in the centre rang. The technician answered and handed it to Anya.

‘Ken Kuah, Professor of Haematology. I’m told this is an urgent police investigation so I had a look at the blood films myself.’

Dr Arneil asked Anya to place the handset on speakerphone and open the email on the desk laptop. Anya clicked on the message sent by Kuah. Multiple images downloaded. Anya enlarged the first one. ‘We’re looking at the first slide now. Full blood count showed leucocytosis, white cell count was forty-one. Haemoglobin’s down but haematocrit’s up. There’s a marked thrombocytopenia. As you can see, there are significant numbers of schistocytes.’

‘What are they from?’ Schiller was understandably impatient to know what it all meant.

‘The Greeks, of course,’ Clive answered. ‘
Schistos
– divided, and
kytos
– cell.’

To save time, Anya pointed to the screen. ‘Can you see how these cells are irregular and look like broken pieces?’

‘Yeah, compared to the red, round ones.’ Schiller was concerned with their relevance to the investigation. ‘Do they happen with physical trauma? Maybe as a result of what that Heyes did to the nasal area?’

‘They are damaged, but at a microscopic level, when they pass thrombi, or clots,’ Dr Kuah commented. ‘We didn’t receive a clinical history, just a date of birth. Did the child have an artificial heart valve?’

‘No,’ Clive said. ‘I’m looking at a friable, ulcerated large intestine.’

‘Sorry,’ the detective interrupted, ‘you’re talking about clots? If the blood was full of clots, doesn’t that mean she won’t bleed much? I mean, someone’s blood was all over that bathroom floor and if it isn’t hers . . .’

Anya clarified, ‘Microscopic clots occur in vessels and organs, using up things called thrombocytes or platelets. They’re what stop you bleeding to death if you have a simple nose bleed or a cut.’

‘Okay,’ Schiller reasoned, ‘so once they are all used up .
. .’

‘Inflammation leads to leaking blood vessels. Without platelets, bleeding gets
out of control. It means,’ Anya deduced, ‘the blood on the floor in the bathroom could have come from Emily’s bowel.’

Schiller asked quietly, ‘Just so we’re all clear. Did outside interference, like a sexual assault, cause the bowel inside to bleed?’

‘Detective,’ Clive interrupted, ‘in this case the rectum was doing what it was designed for. It is an exit, not an entrance. There is nothing to suggest sexual assault in this instance.’

Anya felt relieved for Emily. She clicked the next image on the computer. ‘I’m looking at the electrolytes. Raised serum creatinine, lactic dehydrogenase, low sodium, elevated potassium. Kidney failure and severe dehydration, to the point that she could no longer produce urine.’

‘There’s blood in the lungs as well,’ Clive added.

‘Could those results be caused by something like leukaemia?’ Schiller asked. The question was reasonable.

Dr Kuah spoke again. ‘I believe we’re looking at a haemolytic anaemia. The faecal smear is overrun with gram-negative bacteria that also appear on portions of the blood film. The child had an overwhelming form of sepsis, or infection, if you like. I’ll organise serology for antibodies to E. coli strains.’

Schiller suddenly looked pale. ‘Infection? So Emily wasn’t murdered but she still ended up stuffed in a box?’

‘Stomach’s full of blood,’ Clive announced. ‘That would cause vomiting, another potential source of the bathroom blood stains.’

Anya thought about what Beatrice Quaid had said. She believed Jenny was guilty of negligent homicide by refusing to get Tom vaccinated. If Emily had developed a serious infection and hadn’t been taken for medical treatment, Jenny could be considered responsible as well.

She turned to Schiller. ‘We won’t know for sure until we have the blood cultures back, and they may not grow anything anyway. But it looks like Emily died from Haemolytic Uraemic Syndrome, or HUS for short. It’s caused by a bacteria that produces its own toxin, which is why it causes so much damage.’

‘Then why the hell put her body in a box?’ Schiller’s brow furrowed. ‘Unless you’re guilty, or trying to cover up something else.’

It was possible Jenny had panicked. With two children dead, she could have been frightened of losing Mia, her only surviving child.

Schiller said, ‘Any chance the brain-bone shifting nose treatment caused or introduced the infection? If it did, I’m going straight for that snake, Heyes.’

‘The bacteria is transferred via the faecal-oral route,’ Clive muttered.

‘The family friend I spoke to was adamant, Jenny was meticulous about kitchen hygiene and safe food storage,’ Anya said.

‘Then how did she get it?’ Schiller pulled out his phone. ‘Is it contagious?’

‘No,’ Dr Kuah said down the phone line, ‘but cases like this are rarely isolated. They usually occur as part of an outbreak. The sufferer ingests the bacterium in either uncooked, undercooked or contaminated foodstuffs.’

‘In lay terms,’ Clive said, ‘it’s a deadly form of food poisoning.’ He moved to examine the skull.

‘So if Jenny Quaid did all the cooking and even made their bread,’ Schiller reasoned, ‘chances are .
. .’

The answer hung in the air. Mia and her mother could be in desperate need of medical assistance. Not to mention that any number of other people might have come into contact with the source of the infection.

‘This is a notifiable infection. The public health unit has to be told,’ Clive said flatly. ‘This could be the first case of an epidemic.’

‘Or, it may have been confined to Jenny’s home.’ Schiller suggested. ‘Remember the rat on the garden bed?’

Irrespective, given the attention a child death and missing family garnered, Anya knew it would be made public before long. ‘If you and Bowden don’t mind, I’d like to let the grandmother know how Emily died. Once public health know, it will be open to the media. Mrs Quaid deserves to hear it from someone other than a reporter.’

Schiller checked his watch.

‘Uniforms brought her in to ID the body about an hour ago. She went home to wait by the phone for word.’

‘Good news,’ Clive interrupted. ‘About
that intranasal business. You’ll be pleased to know, the sphenoid
bone is intact.’

9

A
fter the post-mortem, Bowden called Schiller back to the Quaid home to check the scene one more time and interview anyone who might know where Jenny and Mia may have gone. They hoped to find out how close the community members were and if any of them had been ill.

On the way to the car park, Anya dialled Beatrice Quaid’s number. It answered on the first ring.

‘We have nothing to say. Please respect that,’ a male voice pleaded.

‘My name is Dr Anya Crichton. I met with Mrs Quaid this morning. May I speak with her?’

There was a muffled conversation in the background. At least someone was screening the calls to the home. The media would be on Beatrice’s doorstep and were probably calling for comments.

‘Have they found Jenny and Mia yet?’ Beatrice sounded raspier than earlier.

Anya closed her eyes. The waiting had to be intolerable. ‘They’re still searching everywhere possible. I’m calling about Emily.’

Beatrice took an audible gasp.

‘It looks like she died from a severe gastrointestinal infection.’ She deliberately avoided using the term
food poisoning
over the phone, in case the grieving and worried grandmother misheard and believed Emily had been poisoned. ‘The source was most likely something Emily ate. It isn’t contagious and there’s no vaccine that could have prevented it.’

There was a prolonged silence on the line.

‘I don’t understand. The police said she was .
. .
they said foul play. It’s why they were so worried about Jenny and Mia.’

‘Initially, that’s what they thought. Blood tests confirm the presence of the bacteria, but they can take a couple of days.’

‘Then where are my daughter and grandchild?’ Beatrice’s voice was strained. ‘Did Jenny .
. .
did she just let Emily die?’ She swallowed. ‘Then shove the dead child in a box and run away, as if no one would ever know? Not even Jenny could be that cold.’

Anya didn’t have the definitive answer. ‘Maybe Jenny panicked.’ It was difficult to imagine how any mother could let a child suffer without getting help. Especially when Emily was so close to Jenny. She had previously lost her son to an infection, and could have feared Mia would be taken away from her. By her own mother.

Without a car, it would have been almost impossible to take a three-year-old far, and even harder if the child were sick as well. Unless she had hitchhiked or someone had offered her a ride. But the house looked as if she’d left in a rush. The phone was off the hook. Records would show who she’d last spoken to, if she had, in fact, called for help.

‘The police are chasing up medical centres and hospitals, in case Jenny presented at one of them.’

‘Do you think Mia could have the same infection as Emily?’

Anya couldn’t lie. As difficult as it was for the grandmother, she deserved to know the truth.

‘It’s possible, if they ate the same contaminated food. Jenny as well. Public health and food inspectors will swab the contents of the home fridge. If this bacteria is there, they’ll find it.’

‘Thank you, doctor, for keeping me informed. I’m sorry, I have to go now.’

Anya wondered about Jenny Quaid’s mind-set. The woman had shunned conventional medicine and lost her baby in a hospital. Dylan Heyes came across convincingly with his pseudoscience and medical jargon. To perform his intranasal therapy, he had to have had Jenny’s complete trust. Anya wondered if he had dissuaded her from seeking medical help in the past. Or if he had advised that diarrhoea and vomiting were a normal part of his detoxification program. Without answers, and nothing more to offer the investigation tonight, she drove back to the hotel, showered and washed the day out before changing for dinner.

The loose cotton dress she’d chosen billowed as she approached the harbour. The sea air, and all her memories of watching the ocean, were invigorating. She pulled out her ponytail and let the breeze dry her wavy mane.

Her phone rang and she answered as soon as she saw the number.

‘Hi, Mum,’ Ben enthused.

She almost missed being called Mummy, but those days were past.

‘Hey, gorgeous boy, I’ve been looking forward to hearing all about your day. How was it?’

‘Good. We went to this really great zoo. I patted wallabies. The emus tried to eat my lunch but Dad chased them away. They’re cranky and I didn’t really like them much. They really need to learn manners.’

Anya smiled. At times the eight-year-old sounded more like an old man. ‘Lots of animals get rude when food’s around. Some people, too. Did you see the giant crocodiles?’

‘They didn’t move. All you could see was their noses sticking out of the water. Are you with Poppy yet?’

‘No, but I’ll give him a big hug for you. We’re having dinner at Constitution Dock. It’s a big harbour and there are lots of fishing boats, yachts, cruisers.’

‘Can you take some pictures? We had schnitzel and chips tonight at a cafe.’

Anya could hear Martin in the background say, ‘Don’t tell Mum all our secrets. Sorry, mate, we gotta go. Tell Mum I’ll call her later, visiting hours finish soon. You can talk to her tomorrow.’

‘Did you hear Dad?’

‘Yes, it’s okay. You need to go.’

‘Mum,’ his voice lowered. ‘We’re going back to see Nita. She’s got “
ammonia
”,’ he emphasised the pronunciation, ‘and is sick in hospital.’

‘I know, sweetie. Pneumonia is pretty serious.’

‘I have to put my shoes on. Say hi to Poppy for me. I love you.’

‘Love you all the way to the sky and back again.’

‘Love you all the way to the sky and never back again.’ He went one better every time.