Twenty minutes later, Vinnie leaned down to view Jack’s handiwork. “It’s looking good to me,” he said.

Jack straightened up, pleased. The field looked like an anatomy textbook illustration of the course of the vertebral arteries, particularly at the base of the skull. “Can you see the bluish discoloration and swelling around the S-curves on both sides?” Jack asked. “Come around to get a better look.”

Vinnie traded places with Jack. From that vantage point he could see what Jack was referring to. Each vertebral artery had a two- to three-inch section with a swollen bluish cast, the right slightly more pronounced than the left. “What do you think it is?” Vinnie said.

Jack shrugged. “Looks to me like an injury of some kind, but since there was zero bruising on her neck, it’s a bit strange. In fact, she had no signs of trauma of any form. And it’s peculiar how symmetrical it is.”

“Could it be a whiplash injury, something like that?”

“I suppose it could, but there’d be the history of the automobile accident. When I glanced through the medicolegal investigation report, there’d been no mention of any auto accident. I think I might be in for a bit of investigative work myself. There has to be an explanation.”

“What now?”

“More photos,” Jack said, reaching for the digital camera. “Then we’re going to remove both arteries and check the interiors.”

Ten minutes later Jack had the vessels on the cutting board with the brain. They looked like two small headless red snakes who’d swallowed something blue. The discoloration was more apparent than when the arteries had been in situ.

“Here goes nothing,” Jack said. Steadying each blood vessel between the thumb and forefinger of his left hand, he used his right to make a careful incision through one side of each artery’s wall. He then opened both of them lengthwise, spreading them out on the cutting board inside out.

“Would you look at that?” he said, still holding the scalpel.

“What am I looking at?” Vinnie questioned.

“It is called a dissection,” Jack said. “A bilateral dissection of the vertebral arteries. I’ve actually never seen it.”

Using the handle of the scalpel, Jack pointed to a spot just before the arteries’ S-curve where they looped up and over the first cervical vertebra. “Can you see this tear in the intima, or the inside lining of the blood vessel? In both arteries there is a tear at the point between the atlas, or first vertebra, and the axis, or second cervical vertebra. In such a situation, what happens is that arterial pressure forces blood into the tear and balloons the lining of the arteries away from the vessel’s fibrous wall, eventually blocking the vessel’s lumen. The brain is then deprived of a major portion of its blood supply and bingo, lights out.”

“Meaning curtains for the victim.”

“I’m afraid so,” Jack agreed.

With the pathology determined, the rest of the autopsy continued apace. Twenty minutes later, Jack exited the autopsy room to learn that Dr. Besserman had assigned him a second autopsy, the private-school meningitis case. While he waited for Vinnie to set it up, Jack ditched his soiled Tyvek suit and took Keara Abelard’s chart into the locker room.