“She needs to see the areas on his shoulder and leg,” Trent told the nurse in a low voice.

She got two packet of gloves, one for her and one forme, and we put them on. The boy was naked beneath the sheet, his skin grimy in creases and fingernails dirty. Patients who are unstable cannot be thoroughly bathed.

Trent tensed as the nurse removed the wet-to- dry dressings from the wounds. “Christ,” he said under his breath. “It looks even worse than it did last night. Jesus.”

He shook his head and backed up a step.

If someone had told me that the boy had been attacked by a shark, I might have gone along with it were it not for the neat edges of the wounds, which clearly had been inflicted by a sharp, linear instrument, such as a knife or razor. Sections of flesh the size of elbow patches had been excised from his right shoulder and right inner thigh. Opening my medical bag, I got out a ruler and measured the wounds without touching them, then took photographs.

“See the cuts and scratches at the edges?”

Trent pointed. “That’s what I was telling you about. It’s like he cut some sort of pattern on the skin and then removed the whole thing.”

“Did you find any anal tearing?” I asked the nurse.

“When I did a rectal temperature I didn’t notice any tears, and no one noticed anything unusual about his mouth or throat when he was intubated. I also checked for old fractures and bruises.”

“What about tattoos?”

“Tattoos?” she asked as if she’d never seen a tattoo.

“Tattoos, birthmarks, scars. Anything that someone may have removed for some reason,” I said.

“I have no idea,” the nurse said dubiously.

“I’ll go ask his parents.”

Trent wiped sweat from his forehead.

“They may have gone to the cafeteria.”

“I’ll find them,” he said as he passed through the doorway.

“What are his doctors saying?” I asked the nurse.

“He’s very critical and unresponsive.”

She stated the obvious without emotion.

“May I see where the bullet went in?” I asked.

She loosened the edges of the bandage around his head and pushed the gauze up until I could see the tiny black hole, charred around the edges. The wound was through his right temple and slightly forward.

“Through the frontal lobe?”

I asked.

“Yes.”

“They’ve done an angio?”

“There’s no circulation to the brain, due to the swelling. There’s no electroencephalic activity, and when we put cold water in his ears there was no caloric activity. It evoked no brain potentials.”

She stood on the other side of the bed, gloved hands by her sides and expression dispassionate as she continued to relate the various tests conducted and maneuvers instigated to decrease intracranial pressure. I had paid my dues in ERs and ICUs and knew very well that it is easier to be clinical with a patient who has never been awake. And Eddie Heath would never be awake. His cortex was gone. That which made him human, made him think and feel, was gone and was never coming back. He had been left with vital functions, left with a brain stem. He was a breathing body with a beating heart maintained at the moment by machines.