To calm himself, Jack turned to composing an e-mail asking the thirty-plus other New York City medical examiners if they’d had any cases of VAD, particularly chiropractor-induced VAD. He was about to send the message when he decided to expand the request to deaths involving all types of alternative medical therapy, including but not limited to homeopathy, acupuncture, and Chinese herbal medicine.

Jack then searched the Barnes & Noble website for alternative-medicine titles and was amazed at the number available. Reading through the descriptions, he noted that there seemed to be many more pro than con, despite what he felt was the shaky underpinning of the various therapies. This only added to his curiosity, especially in an era when conventional medicine was moving toward more evidence-based therapy.

One title struck him: Trick or Treatment. He called one of the Barnes & Nobles on the West Side and asked that a copy be put aside. He was motivated to rectify his shameful ignorance of the subject.

Feeling more like himself, Jack went back to telephoning Ronald Newhouse. Again, halfway through the dialing process, he stopped and hung up the phone. He suddenly decided a site visit was in order, even though he knew very well that the powers-that-be frowned on site visits by the MEs. The OCME protocol called for site visits to be made by the well-trained medicolegal team, not medical examiners, unless extraordinary circumstances demanded the presence of a trained forensic pathologist. Although Jack guessed that neither the deputy chief nor the chief would see the current situation as one of those “extraordinary circumstances,” he decided to do it anyway. He had an irresistible urge to look the chiropractor in the eyes while he explained how spinal manipulation could cure sinusitis. He also wanted to see his expression when he told the guy he’d killed Keara Abelard, treating her for a garden-variety tension headache.

It had been a while since he last made a site visit. Back when he was newly hired, especially when he was involved in a complicated infectious-disease case, he made a lot of them, and almost got himself fired several times. The chief, Dr. Harold Bingham, had come within inches of dismissing Jack for willful insubordination.

As he waited for the elevator, Jack realized that if Ronald Newhouse had treated Keara with the suspected cervical manipulation, Jack wasn’t required to put “therapeutic complication” as the manner of death on the death certificate, which would be what everyone from Bingham on down would expect. He didn’t even have to put “accidental,” which was the designation for such a case before “therapeutic complication” had been devised in the mid-nineties. Jack realized he could put “homicide” as the cause of death, then turn the case report over to the DA as was done in more typical cases of criminality. “What a stir that would cause,” Jack said to himself with a mischievous smile as he boarded the elevator. And thinking in that vein, he thought that perhaps such a “political bomb” was what was needed to draw attention to the dangers of cervical manipulation.