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“It’s just like last summer,” murmured Marquette, still staring at the trees. “The Surgeon started killing around this time, too.”

“It’s the heat,” said Rizzoli as she reached for her cell phone. “It brings the monsters out.”

SIX

I hold freedom in the palm of my hand. It comes in the shape of a tiny white pentagon with MSD 97 stamped on one side. Decadron, four milligrams. Such a pretty shape for a pill, not just another boring disk or torpedo-shaped caplet like so many other medicines. This design took a leap of imagination, a spark of whimsy. I picture the marketing folks at Merck Pharmaceuticals, sitting around a conference table, asking each other: “How can we make this tablet instantly recognizable?” And the result is this five-sided pill, which rests like a tiny jewel in my hand. I have been saving it, hiding it away in a small tear in my mattress, waiting for just the right time to use its magic.

Waiting for a sign.

I sit curled up on the cot in my cell, a book propped up on my knees. The surveillance camera sees only a studious prisoner reading The Complete Works of William Shakespeare. It ca

Downstairs, in the well of the dayroom, a commercial blares on the TV and a Ping-Pong ball clacks back and forth on the table. Yet another exciting evening in Cell Block C. In an hour, the intercom will a

I curl forward, bending my head to the page, as though the print is too small. I stare with fierce concentration at “Twelfth Night, Act 3, Scene Three: A street. Antonio and Sebastian approach…”

Nothing to watch here, my friends. Just a man on his cot, reading. A man who suddenly coughs and reflexively puts his hand to his mouth. The camera is blind to the small tablet in my palm. It does not see the flick of my tongue, or the pill clinging to it like a bitter wafer as it’s drawn into my mouth. I swallow the tablet dry, needing no water. It is small enough to go down easily.

Even before it dissolves in my stomach, I imagine I can feel its power swirling through my bloodstream. Decadron is the brand name for dexamethasone, an adrenocortical steroid with profound effects on every organ in the human body. Glucocorticoids such as Decadron affect everything from blood sugar, to fluid retention, to DNA synthesis. Without them, the body collapses. They help us maintain our blood pressure and stave off the shock of injury and infection. They affect our bone growth and fertility, muscle development and immunity.

They alter the composition of our blood.

When at last the cage doors slide shut and the lights go out, I lie on my cot, feeling my blood pulse through me. Imagining the cells as they tumble through my veins and arteries.

I have seen blood cells numerous times through the microscope. I know the shape and function of each one, and with just a glance through the lens I can tell you if a blood smear is normal. I can scan a field and immediately estimate the percentages of different leukocytes- the white blood cells that defend us from infection. The test is called a white blood cell differential, and I have performed it countless times as a medical technician.

I think of my own leukocytes circulating in my veins. At this very moment, my differential white count is changing. The tablet of Decadron, which I swallowed two hours ago, has by now dissolved in my stomach and the hormone is swirling through my system, performing its magic. A blood sample, drawn from my vein, will reveal a startling abnormality: an overwhelming host of white blood cells with multilobed nuclei and granular stippling. These are neutrophils, which automatically swarm into action when faced with the threat of overwhelming infection.

When one hears hoofbeats, medical students are taught, one must think of horses, not zebras. But the doctor who sees my blood count will surely think of horses. He will arrive at a perfectly logical conclusion. It will not occur to him that, this time, it is truly a zebra galloping by.

Rizzoli suited up in the autopsy suite’s changing room, do



She took a deep breath, inhaling a last gulp of unfouled air, and pushed through the door into the next room.

She had expected to find Dr. Isles and Korsak waiting for her; what she had not expected was to find Gabriel Dean in the room as well. He stood across the table from her, a surgical gown covering his shirt and tie. While exhaustion showed plainly on Korsak’s face and in the weary slump of his shoulders, Agent Dean looked neither tired nor bowed by the day’s events. Only the five o’clock shadow darkening his jaw marred his crisp good looks. He regarded her with the unabashed gaze of one who knows he has every right to be there.

Under the bright exam lights, the body looked in far worse shape than when she had seen it, just hours ago. Purge fluid had continued to leak from the nose and mouth, trailing bloody streaks on the face. The abdomen was so bloated, it appeared to be in the advanced stages of pregnancy. Fluid-filled blisters ballooned beneath the skin, lifting it from the dermis in papery sheets. Skin was peeling away entirely from areas of the torso and had bunched like wrinkled parchment under the breasts.

Rizzoli noted that the fingerpads had been inked. “You’ve already taken prints.”

“Just before you got here,” said Dr. Isles, her attention focused on the tray of instruments that Yoshima had just wheeled to the table. The dead interested Isles more than the living did, and she was oblivious, as usual, to the emotional tensions vibrating in the room.

“What about the hands? Before you inked them?”

Agent Dean said, “We’ve completed the external exam. The skin’s been sticky-taped for fibers, and the nail clippings have been collected.”

“And when did you get here, Agent Dean?”

“He was here before me, too,” said Korsak. “I guess some of us rate higher on the food chain.”

If Korsak’s comment was meant to feed her irritation, it worked. A victim’s fingernails may harbor bits of skin clawed from the attacker. Hair or fibers may be clutched in a closed fist. The examination of the victim’s hands was a crucial step in the autopsy, and she had missed it.

But Dean had not.

“We already have a positive I.D.,” said Isles. “Gail Yeager’s dental X-rays are up on the light box.”

Rizzoli crossed to the light box and studied the series of small films clipped there. Teeth glowed like a row of ghostly headstones on the film’s black background.

“Mrs. Yeager’s dentist did some crown work on her last year. You can see it there. The gold crown is number twenty on the periapical series. Also, she had silver amalgam fillings in numbers three, fourteen, and twenty-nine.”