“So, what are you looking for?” Vinnie asked, as Jack went through his exhaustive external examination. He ranged over the whole body but devoted particular attention to the head.

“Signs of trauma, for one thing,” Jack said. “That would be my number-one guess at this point. Of course, it could have been an aneurysm as well. She apparently became quickly disoriented and spastic, which led to coma and death.” Jack glanced into both external ear canals. He then used an ophthalmoscope to look at eye grounds. “Reputedly, she’d been out having cocktails with friends—nonalcoholic, according to history, and no drugs.”

“Could she have been poisoned?”

Jack straightened up and looked across the body at Vinnie. “That’s a strange suggestion at this point. What made you think of that?”

“There was a poisoning on a TV show last night.”

Jack laughed behind his mask. “That’s an interesting source for differential diagnosis. I’m guessing that’s not too likely, but we’ll still need to do a toxicology screen. We’ll also make sure she’s not pregnant.”

“Good point about the pregnancy idea. That was what happened in the show last night. The boyfriend wanted to get rid of the baby and the mom at the same time.” Jack didn’t respond. Instead, he began carrying out a painstaking examination of Keara’s scalp. Her thick, shoulder-length hair made progress slow.

“There’s no way this case could be infectious, could it?” Vinnie asked. He had never liked germs. In fact, he hated them. Whether involving bacteria, viruses, or “anything in between,” as he called some of the other infectious agents, he’d typically avoided contact as best he could, at least until Jack arrived. Since then, because of the number of infectious cases Jack had done, he’d become inured to his phobia. That morning he and Jack were wearing only Tyvek suits, regular medical masks, surgeon’s caps, and curved plastic face guards over their clothes. For a few years the front office had dictated full barrier protection on all cases with what were called “moon suits,” but that was no longer the situation, and now each medical examiner could wear whatever he or she wanted provided it was appropriate. Same held for the mortuary techs.

“There’s even less chance of it being infectious than it being poisoning,” Jack said.

Finishing with the head, Jack carefully examined the neck. When that was completed, he was reasonably certain there was no sign of trauma, as the external exam had been entirely normal. Jack had no more idea of what killed the young woman than he had when they’d started, and feeling less patient than usual, he was briefly and irrationally irritated at the patient for withholding her secrets.

After taking ocular fluid, urine, and blood for toxicology and checking out the X-rays on the chance they might provide a clue about the cause of death, Jack started the internal part of the autopsy. He used the typical Y-shaped incision from the points of the shoulders down to the pubis, then, with Vinnie’s help, removed the organs and examined each in turn.