“We do have one drug that we are going to test for specifically,” Jack said to Neil, while he watched Laurie free up the heart. “Again, thanks to the resuscitation effort on the third case, where they encountered hyperpyrexia and surprisingly elevated potassium, we’re going to concentrate our efforts on succinylcholine, which is known to cause both on occasion. At this moment, unless we find something very unexpected, that is the most promising agent.”

“My gosh,” Arun said. “This is fascinating.”

“There’s no heart disease here at all,” Laurie remarked. She’d made a series of slices into the cardiac muscle and along the tracks of the major coronary vessels. “Specifically, there’s no obstructive disease.”

The other three looked over her shoulder. “There is a sprinkling of hemorrhages on the pericardium,” Jack said. “That’s not pathognomonic of succinylcholine poisoning, but it’s consistent.”

“There are some on the pleural surfaces of the lungs as well,” Laurie said.

“Arun, could you take some photos of this with Vijay’s camera?” Jack asked.

“I certainly can.”

After the photos were taken, Laurie prepared to take the samples for toxicology. Using separate syringes, she wanted urine, blood, bile, and cerebrospinal fluid.

“There are two other reasons we’re thinking succinylcholine,” Jack said. “Succinylcholine makes the most sense from a purely diabolical point of view. If the perpetrator is a doctor, as we suspect, he or she would want to use the agent least capable of being detected, and succinylcholine certainly fits the bill. First of all, succinylcholine was probably used during the patients’ anesthesia, so even if succinylcholine happened to be found by the likes of us, its presence could be explained. And second, the body deals with succinylcholine very rapidly, which is why in an overdose situation, all you have to do is breathe for the patient for a short time and there’s a happy ending.”

“But you are still going to run samples?” Arun commented, “even if the body metabolizes succinylcholine rapidly.”

“Absolutely,” Laurie said, filling a syringe with bile. “If someone uses succinylcholine for nefarious purposes, they invariably inject a major amount, worried they might not be injecting enough. With a large dose, the body’s ability to handle it can be overpowered, so not only do you find a host of succinylcholine metabolites in body fluids, you often can find some of the drug itself.”

“Succinylcholine has been used in a couple of high-profile forensic cases in the United States,” Jack said. “There was a nurse by the name of Higgs who killed his wife in Nevada, and an anesthesiologist by the name of Coppolino who killed his wife in Florida. In the Higgs case the drug was found in the wife’s urine, while with Coppolino it was isolated in muscle.”

“Well, it will be interesting to see what our toxicologists can do at the All India Institute of Health Sciences. Our head guy has an international reputation.”