"I thought you might want to see this," Change said. "It could change your schedule for tomorrow."
McCain mumbled, "Then show it to us tomorrow."
Dorothy nudged him in the ribs. "What is it, Doc?"
"Here we go." Change pulled a large X-ray out of an envelope and placed it on the backlit monitor.
"A chest X-ray," McCain said.
"Exactly."
"You found the aneurysm?" said Dorothy.
"No aneurysm. But now more than ever, I believe that Julius died of one." Change picked up a pointer. "It should have been right around here. See this area of gray, this arch? This is where the aorta splits into the subclavian and the carotid."
"I don"t see nothing except a bunch of ribs," McCain groused.
"We"ll get to that in a moment," Change said. "There"s nothing anatomically suspicious in this radiograph. Everything looks normal-No, let me modify that. Everything looks normal in the vascular department." He turned to McCain. "So since you"re focused on the ribs, let"s look at the ribs. Twelve ribs in all."
"Looks to me like a lot more than twelve," McCain said.
"That"s "cause you"re seeing a double image. Ten ribs are attached. They come from the spine, swing around, and attach to the sternum." He picked up a pointer and traced. "Because the image is two-dimensional, what we"re seeing is the same rib from both front and back projections."
"Got it," McCain said. "Go on."
"Here we have what we call the floating ribs-these projections on either side of the spine that appear to hang."
"And that"s not normal?" Dorothy asked.
"No, that"s very normal. Stay with me." Again, Change traced the ribs. "This twelfth rib is easy-nothing in its way. The eleventh rib in this X-ray is a little shorter than normal, meaning the tip is partially obscured by the rib cage, specifically by the tenth rib"s arch. But if you look really carefully at what I"m pointing to, tell me what you see."
The detectives stared at the X-ray. McCain said, "It"s like split."
"Yeah, yeah," Dorothy said. "I see it."
"It isn"t like like split," Change said. "It split," Change said. "It is is split. It"s called a supernumerary rib, in this case a bifid rib, and the condition is somewhat unusual but not really rare-one in twenty." split. It"s called a supernumerary rib, in this case a bifid rib, and the condition is somewhat unusual but not really rare-one in twenty."
He faced them. "I autopsied the boy. I studied him from the inside out. The extra rib has nothing to do with Julius"s death. But it also has nothing to do with Julius. This X-ray isn"t from the body that I autopsied. The body I autopsied did not-I repeat did not-have a supernumerary rib. I would have seen it clearly, and I would have noted it."
Change"s eyes heated. First time the detectives had seen that.
Dorothy said, "It"s not Julius"s X-ray."
Change said, "You"re the detectives. You might want to find out what"s going on."
Silence.
The ME tapped the X-ray with his pointer. "If I were you, I"d go back and look at all of Julius"s medical records, not just those from his most recent year. "The one that the school gave seemed fine at the time, but now we"ll want to see all of them. What was Julius, a senior?"
Dorothy nodded.
"So Boston Ferris Health Services should have other chest radiographs. Go back and see if you can find different X-rays-at least one that really belongs to Julius."
He removed the film and placed it back in the manila envelope. "I"ll keep this as part of my files."
"Oh my G.o.d, you know what this means, Dorothy?" McCain exclaimed. "It means we gotta go back to Boston Ferris and deal with Violet Smaltz."
Dorothy said, "This woman is impossible. She"s just going to stonewall us-not because I think she has something to hide, but she loves drowning people in paperwork."
"I know the type," Change said. "Tell you what. I"ll come with you. Maybe that"ll speed things up."
"It would also speed things up if we enlisted President McCallum again," Dorothy said.
"He better help us out," McCain said. "Something"s wrong at his d.a.m.n school."
15.
At eight in the morning, the campus was grayed by a heavy, moist sky. Somewhere behind the pewter mist the sun was trying to poke through, adding a little light but no warmth. The pathways that wound through the college were still slick with ice. McCain"s boots crunched. His nose was brittle from the cold. He and Dorothy and Change had to work to keep pace with President McCallum.
"I"m sure it"s an oversight." McCallum tightened his coat. "A simple mix-up." His voice lacked conviction. "It happens, you know. Mistakes in hospitals."
"This was a fatal mistake." McCain"s teeth were chattering. "No doctor in his right mind would have allowed Julius Van Beest to play with a major aneurysm."
McCallum frowned and flung open the double gla.s.s doors to the health center, allowing the three of them to step inside. The waiting room was already packed with red-nosed, wan students, coughing, sneezing, slumping, shivering. The nurses greeted McCallum with surprise and deference as he blew past them and marched into the records room, where Violet Smaltz was worshiping her paperwork.
She looked up from her desk, her eyes darting back and forth between her visitors" faces. Then she stood up and tried to suppress a sneer. "President McCallum."
"Get me all of Julius Van Beest"s medical records."
The woman went slack-jawed. "Sir, that"s not standard procedure. I need permission-"
"The boy is dead!" McCallum shouted. "Get me his records, and get them now now!"
Violet bit her lip. "It"ll take a few moments."
"Then don"t waste any more time!" McCallum bit his thumbnail. Inhaled, exhaled. Softened his tone: "It"s of extreme importance, Violet. The reputation of the college hinges on it."
Smaltz nodded solemnly and disappeared behind the stacks of medical folders.
McCallum rubbed his hands together. "And you"re positive, Dr. Change, that the X-ray that you saw couldn"t possibly be that of Julius Van Beest?"
"One hundred percent positive."
"Well, then, we"ll just wait and . . ." McCallum"s voice faded.
No one spoke until Violet came back with the files. "These are all of them." She handed them to McCallum, who pa.s.sed them to Change.
The ME pulled out the chest X-rays. "Do you have a light box?"
"Of course," said Violet. "We"re not working out of tents, you know." She led them to an empty examination room and turned on the light box switch. Change mounted the X-rays to the clips and stared at the images.
It was McCain who spoke first. "The rib is still split."
"Indeed," Change said. "None of these images are of Julius."
"How can you be so sure?" McCallum challenged. "Isn"t it possible he had surgery to remove the extra rib?"
Change considered the question. "When"s he due to be buried?"
"He was buried yesterday," Dorothy said.
"I"ll write out an exhumation order."
"Doc," said Dorothy, "maybe before we start unearthing the dead, we should think this out. First step: You"re sure he died of an aneurysm."
"I would stake my reputation that this boy had some kind of preexisting vessel abnormality. And I see no reason for him to ever undergo surgery to remove a supernumerary rib. In fact, I"m certain he didn"t-there were no old scars indicating such. These X-rays are not of Julius Van Beest."
Violet said, "I don"t know if they"re Julius"s X-rays or not. But I"ll tell you one thing. None of them were taken on school premises."
Four sets of eyes locked into hers. She pointed to markings at the bottom of the films. "Says here Professional Urban Imaging. I never even heard of this lab. Probably some fly-by-night operation, if you ask me."
McCain turned to the president. "Do most of the athletes have their chest X-rays done on school premises?"
"Why are you asking him him!" Violet grumped. "I know the answer to that."
McCain waited.
"The answer is yes. Usually, the physicals are done two weeks before school starts. I come in here to personally supervise the record keeping. I once left it to some subordinate, and boy was it a mess."
"I"m sure it took you hours to clean up," McCain quipped.
Violet gave him the force of her angry eyes, but she held her tongue. "Not only was this X-ray taken off campus but it was done late. Look at the date-a month after the semester started. That is not not procedure." procedure."
Dorothy turned to Change. "You"re saying no doctor in his right mind would permit Julius to play with an aneurysm."
"Correct."
"What if the team doctor hid it from Julius?"
"He"d have to be a psychopath," Change said.
"That"s absurd!" McCallum protested. "Our staff is first-rate, and I will not tolerate such accusa-"
"Accusations or not," said Dorothy, "we"d be derelict if we didn"t talk to the team doctor."
"I"m sure," said McCain, "that he"d be as concerned about this as we are. Seeing as he"s first-rate and all."
McCallum grimaced. Stared at the ceiling. Threw up his hands. "I don"t know if he"s even on the premises."
"The coach is in," Dorothy said. "The team had an eight o"clock meeting today to talk about Julius. No exceptions. I"m betting that includes the team"s doctor."
"So what are we waiting for?" Violet said.
"What are we we waiting for?" McCain asked. waiting for?" McCain asked.
"The boy got his X-rays done off campus and as a result probably died from it. He shouldn"t have been allowed to do that. This whole thing has impugned my my record keeping and record keeping and my my system. That will not be tolerated!" Violet grabbed her coat from the rack. "Come on, people. Let"s get the lead out." system. That will not be tolerated!" Violet grabbed her coat from the rack. "Come on, people. Let"s get the lead out."
The boys were working through some nominal drills, probably to keep up the appearance of normality. But Dorothy could tell by her son"s drooped posture that he wasn"t focused, and the others probably weren"t, either. They were taking their cue from Coach Albert Ryan, a former Celtics journeyman and a twenty-year veteran of college coaching. Ryan, six-five and pole-thin and bald, normally a taciturn man, appeared paralyzed by the tragedy. His expression was captain-going-down-with-the-ship. When the group confronted him, he shook his head and pointed to a tall, paunchy man in his late fifties, wearing a blue blazer, gray slacks, and blue polo shirt, standing on the sidelines.
Martin Green was an orthopedic surgeon specializing in sports medicine. Besides running a full-time private practice, he"d been a.s.sociated with Boston Ferris for fifteen years. He spoke with authority, but Dorothy could barely hear over echoing footsteps and ball bounces.
"Guys, maybe we can talk where it"s a little quieter?"
McCallum said, "Coach, let"s call it a day."
Ryan nodded and blew the whistle, told the boys to pack it in. Slowly, they filed out of the gym. Marcus acknowledged Dorothy with the faintest of nods but stuck with his teammates.
McCallum tapped his foot. Empty, the room reverberated like a cathedral.
Dr. Green said, "Julius insisted on getting his X-ray off campus. He was terrified of the procedure and wanted his own physician to do it."
"Afraid of X-rays?" said McCain.
"Apparently, his grandfather died of cancer due to excess radiation exposure. He didn"t trust the school"s machinery. Too much leakage or some such nonsense."
"Total nonsense!" Violet agreed.
"What kind of radiation exposure did this grandfather experience?" McCallum asked.
"Apparently, he worked as an a.s.sistant in a university lab." Green shrugged. "I never got the full story, and the little Julius did tell me seemed strange. But the upshot was Julius was anxious, and he"d already made plans to have his own lab take the X-rays. I saw no reason to argue with him."
"That"s not procedure!" Violet chimed in.
"No, it is not," Green said. "But I didn"t see the harm in it. He"d been doing it this way since high school. I actually called up the coach there, and at least that part of the story was true. Like most superathletes, Julius was superparticular. He had his superst.i.tions, his rituals and routines, and I figured this was just another on a long list. Besides, as long as his chest X-ray was clean, what did it matter where it was taken?"
Change said, "So you examined the film."
"Of course. He handed it to me personally and we went over it together." Green"s eyes darkened. "Why? What"s going on?"
"Do you know how Julius died?" Change asked.
"He was shot."