The Assembler of Parts: A Novel (27 page)

The next morning, Friday, he phones Burke again. He is asked to leave another message. He tells the young-sounding receptionist, “It’s about our daughter’s autopsy report. I just wanted to know if it’s finished. If Dr. Burke has received the report. We are supposed to get a copy and then have like a final meeting.”

“I’ll let him know,” she says. “Thanks for calling!”

“Wait,” he interjects before she hangs up, “where is the report coming from? I mean, who issues it? Maybe they would be the best place to check on its status.”

“Well, that would be the medical examiner’s office. Would you like that number?”

Father dials the number robotically, convinced it will be another dead end. “Benton Ridgely,” the speaker says smartly into the phone. “Medical examiner.”

Father is doubly surprised it is the medical examiner himself who answers. He was prepared for another secretary, a wait on hold, more time to practice his words silently again before they died silently in his head. But there is no time to do that now. “Yes. Sir. This is Ford Jackson. Jessica Jackson’s father. The girl you did an autopsy on just before . . .” Father has to stop to compose himself. His voice is wavering, his silent practice undone by his ears. The words coming out of his mouth sound too distanced, too coldly clinical, for the emotional weight they carry, and they collapse in his chest. He takes a deep breath and is about to continue when the medical examiner speaks.

“Mr. Jackson. Let me express my deepest sympathies on your daughter’s death. How very sad. And how difficult it must have been for you and the family to witness her . . . passing. With her airway already partly compromised by that aberrant blood vessel, well, even a cold could have closed it over enough that she couldn’t breathe. I’m so, so sorry for your loss.”

Father is stunned. He tries to form a sentence in reply. “Well, ah, well, thank you for your kind words. But I . . . we didn’t know . . . hadn’t heard—”

“Mr. Jackson. It’s all right. Just take a second. I got all day.”

Father tries again. “I don’t really know what you’re telling me. A blood vessel and her airway? I was just calling to see when you would be finished with your investigation so your report would be issued. We’re supposed to meet with Dr. Burke to discuss it. And we hadn’t heard anything from him.”

“Well, I sent him . . . no, I faxed him the final report on Monday. I thought you had already seen it, and maybe were calling for me to clarify something. I’m sorry. I didn’t mean to overwhelm you with the findings like that, but I thought you already knew. I’m sorry.”

“No, it’s okay. But explain it to me again. Jessica had what?”

“She had . . . Everyone has two large arteries that branch off the top of the heart. They are called subclavian arteries. They are large and normally bring blood from the heart into the upper extremities. The arms. Well, in Jessica’s case one of them came off the top of the heart at the wrong spot. It then had to run all the way across the upper chest from the left side of the body to the right, so it could go into the right arm. It’s usually not a big deal unless it runs behind the trachea. Which it did. The trachea is . . . You know what the trachea is, Mr. Jackson?”

“I do. It’s the main windpipe into the lungs.”

“Right. So this large blood vessel ran behind the trachea and pressed in on it from the rear, making the diameter of the airway much, much smaller than it should have been. So the real problem happens when there is something that causes
additional
narrowing in the diameter of the trachea. Like what happens in croup. And any new narrowing produces marked and immediate increase in resistance to airflow. It’s a law of physics. You know, it’s not hard to breathe through a regular straw, but narrow that opening just by half and you can’t. Like trying to breathe through a cocktail straw. Impossible. That’s what happened to Jessica in her bedroom that night. Her airway narrowed quickly and unexpectedly to the point where she couldn’t move air. It was a totally unexpected problem. And totally undiagnosed until the autopsy. That’s what I told Burke. And Officer Mattingly.”

“Mattingly has the autopsy report, too?”

“Monday. I talked to both of them Monday.”

“And he—”

“He should be ending the investigation into Jessica’s death. Cause of death is natural. That’s what I wrote on the autopsy report and the death certificate I issued. Laryngo-tracheo-bronchitis (croup), mild. Airway obstruction secondary to aberrant right subclavian artery, severe. I have it all right here. You have a fax machine?”

“I do,” says Father. He becomes breathless and lightheaded as he recites the ten digits of the post office’s fax.

“But you have to review this with Dr. Burke. There’s a lot in here for a layperson to grapple with. You’ll see. Meet with Dr. Burke. He’ll take you through it.”

“We will,” Father says. He wonders why Mattingly hadn’t called to inform them of the investigation’s end, to remove that weight from their backs. Or Burke. Burke who knew about the parenting classes they were attending on threat of CPS action. Burke should have called, he thinks. He had all week. He had my messages. He should have called.

“And Mr. Jackson,” says the medical examiner.

“Yes, sir.”

“You should . . . There is . . .” He stops for a moment. “I’m real sorry for your loss and everything that happened. Just wanted you to know that.”

“I appreciate that. Your report at least will . . . will help us understand what happened.”

“Yeah, that it will.”

Father has the sense Benton Ridgely wants to say more but can’t.

*

The Assembler brings more tapes. “You are troubled by what you see, yes?” He asks.

“Aren’t You?” I snap the tapes from His hands. Oh, the advantage to having thumbs. I turn away, but He’s still there* in front of me.

“Honestly?” He asks.

“It’s a sin to tell a lie,” I respond.

“Lies can be their own truth, as a path is part of the destination. I am not troubled in the least by My creation.” He looks at me with those big “Thou” eyes of His. Today* they are blue.

Father calls Ned from work after he’s read the fax twice. He asks him to come to the 7-Eleven near home to talk at three. “Three?” Ned asks. “Yeah,” says Father, “I’m getting off a few hours early today.”

“What’s it about?”

“The laws of physics.” Benton Ridgely said it was the laws of physics behind what happened. And Father knows only one person who might understand them, if only a little.

“Physics,” Ned says flatly. “Sure. But why can’t we talk physics in the garage. That’s where I keep it.”

“You’ll understand,” Father says.

“It’ll cost you a Slurpee.”

“Deal.”

They buy two hot teas instead and stand talking near the racks of magazines that offer everything from
Automotive Digest
to
Zodiacal Review.
Father gives Ned a copy of the autopsy report and lets him read through it before they start. When he is done reading, Ned says, “Whew. Some complex stuff here. What do you suppose all that stuff about feeling her bones is about? Even her neck bones.”

Father looks at him with his face set and angry. He blows on his tea. A puff of steam rises up and dissipates in the air. “Same reason Mattingly and CPS were on us afterwards.”

“Oh. No.” Ned shakes his head in disbelief.

“Yeah. They took the tack that we might have abused Jess, beat her.” He pauses, then says it. “Killed her.”

Ned shakes his head again. He looks over the summary paragraph at the end of page three. “Says here the cause of death was natural means, secondary to airway obstruction from an aberrant right subclavian artery and superimposed mild croup. I take that to mean they no longer have their suspicions.”

“That’s what the medical examiner told me. Thing is, these guys—Burke and Mattingly and Beatrice Smith— they all knew about these findings Monday. Monday, Ned. And no one contacted us. Would have saved us a week of worry. Would have saved us two trips out to those shitful classes. But no one did. They just went on letting us feel guilty, lettin’ us pay the price for something we had no part in. And I’m wondering why they would do that.” He blows on the tea again, and takes a tiny sip.

Ned’s eyes narrow. “Ford, I know where this is going. Says here Jess had an anomaly that no one knew about. Not us, not Burke, not anyone. And that’s what closed off Jess’s airway when she got the flu. You’re thinking—”

Father interrupts. “I’m thinkin’ they missed it. They flat-out missed it. Either they didn’t do the right tests or they missed seeing it on all the goddamned tests they did do. All those expensive X-rays and echo studies and CAT scans, something this big just has to show up.”

“That’s the law of physics you want to talk to me about? The limits of resolution of sonar waves and X-rays? Ford, I don’t—”

Father holds up a hand. “No, Ned. Two other laws. One is why no one can breathe through a cocktail straw. That’s what the medical examiner said to me to explain what happened to Jess and her airway because of this thing in her chest.” He nods to the report in Ned’s hands. “Like breathing through a cocktail straw.”

Ned scratches his head. “Well, not so hard a concept. Resistance to flow in a tube goes up by the fourth power for every decrease in diameter. So, you decrease the diameter by half, resistance goes up sixteen times. It doesn’t go up twice, it goes up by a factor of sixteen. Even plumbers know about that one. I can look it up in my books when we get home, show you on paper, but that’s the essence of it.” He studies Father’s face. There is something in it he hasn’t ever seen before. It’s not smugness, or haughtiness, but it’s close. “You said there’s another law you want my help with.”

“Yeah. The law of gravity.”

“Gravity?”

“What goes up must come down.”

Ned looks from the report to Father’s face and back to the report again.

“Meaning?”

“Meaning, I’m getting even with those bastards for what they did. Their mistake is what took Jess from us. Then, as if that weren’t bad enough, they put it all on us. I’m going after them, Ned, and I asked you here to get your support. Kate’s going to be reluctant to do it. But I want to take those guys down for what they did. Will you help me?”

Ned thinks for a minute. “And how will it help if you do succeed in this? How will it help you grieve Jess’s death? It certainly won’t bring her back. And the money, if it’s money from a suit you’re talking about, the money would be tainted. Every nickel of it stamped with her loss. You’d get no joy out of any of that. I’m just saying, Ford, this paper exonerates you all. Let it all go. Just go on. Make a fresh start with BJ and the new one, keep Jess’s memory in our hearts. And just go on.”

“It’s justice I’m looking for, Ned. Justice and fairness. What they did was wrong. All of it, wrong. I mean to make it right.” He looks away to the racks of magazines. “They broke your daughter’s heart, Ned. And mine and yours and Mae’s. There’s a price to be paid for that. Are you with me?”

“I’ll start with you, Ford. I may not end with you, but I’ll start with you. We’re all subject to the law of gravity. We need to keep that in mind.”

Father sips his tea. It’s cool enough now to gulp.

It is a strange tape I now* watch. It shows Dr. Burke reading Father’s phone message late Thursday morning. I can see the note. “Father of d’csd pt wants info on autopsy/ death meeting. F. Jackson,” followed by Father’s home and work numbers.

The secretary has pulled my old chart and paper-clipped the message to its cover. Burke opens the folder and turns to the autopsy report. It has already been filed in my chart and initialed by Burke. The header shows the date and time the fax was received: January 7, 2005, 10:31 a.m. He wishes now he had called Father when the report had first arrived on his desk. And, what upsets him is that he’s not sure, really, why he didn’t call. He’s tempted to lay it at the feet of sadness. He’s sad about my death. Sad it happened, sad my life is over. But sad, too, the autopsy showed a serious deficiency in his team’s workup of my anomalies. Sad—and this truly saddens him, and troubles him that it does—it really
wasn’t
my parents’ fault, my death.

Sad and troubled about the unpleasantness to come when he would finally sit with my parents and discuss the findings.

Sad it would be with Eileen Marshall that he would share this experience. Sad he holds such a smart colleague in such low regard for her aloofness from patients, her calculating coldness, her shallow manipulation of parental feelings. He hears her say to Mother at the wake, in a voice choked with tears, “And we never got the chance to fix her heart,” when she
knew what was behind the girl’s death.

He thinks: But you did have the chance to study her heart, find out what was wrong a dozen times. And you missed it. The one cardiac finding that really mattered, you missed, Eileen Marshall. If we had known about that blood vessel, the family would have been instructed to get to the ER at the first hint of something going on in the airway, a cough, stridor, increased work of breathing. Had the family taken her in, the ER would have intubated her, bypassed the obstruction. She’d be alive today, at home on Christmas break, playing with toys, lost in the wonder of the time of year. She’d be normal, he thinks. “Normal,” he mouths. “Jessica Mary Jackson, normal,” he says aloud to the chart. And he smiles a brief smile out of the slew of sadness he has assembled in his mind.

I am shocked when he slips the autopsy report out of my chart and carries it to the reception desk. “Cindy,” he says to the young girl filing charts. “Would you please start a separate temporary file for all of the materials that come in about this girl’s autopsy report?” He hands her the fax. “I’d like to keep them all in one place so I don’t have to thumb through the entire chart when I need to reference those materials. You can start with that,” he adds, nodding to the pages he has handed her.

“Certainly, Dr. Burke,” she says.

As he walks away, he initials the phone message and jots: “no rpt in chart yet. 1/10/05.”

It is beneath him. Beneath the good Dr. Burke.

Ned and Father drive from the 7-Eleven to Burke’s office. It is almost four thirty on January eleventh. The return of the sun since the winter solstice has added a few minutes of light to the end of the day. The sun sits bright just above the milky blue horizon in the west. Father feels better inside than any day since my death. He is doing unto others what they have done unto him. These were the very words of the Assembler when he handed me the Friday tapes. I didn’t know what He meant then, but now I do.