“Or a poisoning,” Jack said. “It’s not going to be a right-to-left shunt: not with three patients. One, maybe. But not three. I think we’re looking at a toxicology problem here.”

“I agree,” Laurie said. “And I thought I was coming merely to be supportive.”

“You are being supportive,” Jennifer added.

Jack looked at Laurie. “You know what this means, don’t you?”

“Of course,” Laurie responded. “It means there definitely needs to be an autopsy.”

“They are not going to do one,” Jennifer interjected. “I’m telling you. And let me tell you something else, which is what I was talking to Mrs. Benfatti about. This afternoon I got a call from my favorite case manager, Kashmira Varini, and she had a new offer that she and the hospital administration thought would entice me to give cremation a green light. She said that the hospital CEO pulled some strings and had gotten permission for Granny, along with Benfatti and Lucas, to be taken to Varanasi to be cremated and her ashes placed in the Ganges.”

“Why Varanasi?” Jack asked.

“I looked it up in my guidebook,” Jennifer said. “It is interesting. It’s the holiest Hindu city; it’s also the oldest. It’s been occupied for over three thousand years. If you are cremated there, you get extra karma for your next life. When I didn’t jump up and down and agree instantly to the Varanasi offer, she then threatened me just like she threatened Mrs. Benfatti. She said the hospital intends to seek a magistrate’s writ to deal with Granny’s body as they see fit and have the writ in hand by noon tomorrow.”

“That means somehow we have to manage to do an autopsy in the morning,” Laurie said. She looked at Jack.

“I agree,” Jack said. “Looks as if tomorrow might be a full day.”

“I’m telling you they won’t authorize one,” Jennifer insisted. “I told this to Laurie on the phone. The Indian autopsy situation is horrid. It’s a kind of bad legacy system with no independence for the forensic pathologists. The police and the magistrates are in control of deciding if and when an autopsy is to be done, not the doctors.”

“It’s an extension of the British inquest system,” Laurie said. “It’s very much behind the times. It’s hard for medical examiners to provide the necessary oversight they are supposed to provide without freedom from law enforcement and the judiciary, especially if the police and the magistrates are in cahoots.”

“We’ll have to do the best we can,” Jack said. “You mentioned a death certificate. Is there a signed death certificate for your grandmother?”

“Yes, there is,” Jennifer said. “The surgeon was apparently only too happy to sign it out as a heart attack.”

“It probably was, ultimately,” Jack said. “What about the other two cases?”