LITMIR.BIZ

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lifted out of the abdominal cavity like a bad caesarean birth. De Koninck reopened the foul-smelling stomach and pointed with a latex-gloved finger to the clearly visible remnants of a small white tablet.

      ‘Arnold van Blanken. Ninety-five,’ she began. ‘Amsterdamer, born and bred, who was apparently visiting a friend in a different neighbourhood when he felt ill. I understand he registered at the surgery as a temporary emergency patient. When he came in here, as I told Paul last night, I took one look at him and presumed it was natural causes. A worn-out heart giving up.’

      ‘He just died in front of me,’ Van den Bergen said to nobody in particular, staring at the florid post-mortem colours in the old man’s face. ‘I had to get closure, I suppose. My doc wouldn’t tell me anything. That’s why I came. And I’m glad I did.’

      ‘Well, he looks ancient,’ George said. ‘Is that medication inside his stomach?’ She shrugged. ‘Surely there’s nothing weird about old guys taking tablets for this, that and the other.’

      De Koninck stood straight, towering above George, looking austere and unforgiving in her white coat beneath the bright mortuary lights. The prominent veins in her masculine hands gave her away as the athletic type. Her punishing regime of tennis or hockey or whatever the fuck she did outside work had stripped away any softness to the woman’s face. She was all long Patrician limbs and skinny, shapely legs beneath those scrubs and the lab coat, unlike George’s bone-crushing tree-trunks. The pathologist had no arse to her name, though. Those blonde, northern European types never had any booty to speak of.

      ‘It’s cisapride,’ De Koninck said, ‘twenty-milligram tablets, which is normally prescribed four times per day for those with gastro-oesophageal reflux disease. I sent it off to the toxicologist overnight to get it analysed. There were four tablets, half-digested just like this one. Too high a dose in one go.’ She rummaged inside the upper end of the stomach and showed George a scene of coagulated gore, muscle and connective tissue that made little visual sense. ‘Van Blanken had a hiatus hernia. See where the stomach is protruding into the gullet?’

      ‘Like me, George!’ Van den Bergen said, his voice a shade higher than his usual low rumble. ‘Listen to this!’

      Barely able to believe she was passing up a trip to Torremolinos to look at the dead body of a man who’d had more than his fair share of life, George folded her arms and put her weight on one foot. Tapping the tiled morgue floor with her steel-toe-capped Doc Martens. She rolled her eyes. ‘You’ve got staff for this, Paul. Put me on the payroll, or I’m off to catch a late flight to Malaga.’ She checked her watch. ‘My family needs me.’

      ‘Listen!’ Van den Bergen placed a hand on her shoulder.

      Marianne de Koninck raised an eyebrow and snapped off her gloves, throwing them into a biohazard bin. She sat down in front of her computer. ‘When I found the hiatus hernia, I wasn’t surprised that Mr Van Blanken should be taking cisapride, which is an antacid medication. But four twenty-milligram tablets at once? That’s dangerously high.’

      ‘Senility?’ George asked. ‘If you’re meant to take one four times per day, is it not feasible he got mixed up and took four instead? It’s easy to be forgetful, even at my age.’

      ‘No.’ De Koninck scrolled through a report. ‘I’ve had his medical records sent over, and it seems his GP, a Dr Saif Abadi, had prescribed abnormally high doses of the medication, which is weird. You could say it’s professionally negligent at the very least. The Americans have taken their version of cisapride – Propulsid – off the market entirely. One of the dodgy side effects is that it’s widely known to put patients at risk of something called Long QT Syndrome.’

      ‘What?’

      ‘It’s a rare condition where a delayed repolarisation of the heart, following a heartbeat, increases the risk of something called Torsades des Pointes.’ She shook her head disapprovingly at George’s blank expression.

      ‘Do you want to tell me all about the foibles of drug mules or poor mental health among the female prison population?’ Now it was George’s turn to shake her head. ‘No? So, why the hell should I understand about bloody Marquis de Sade or whatever it is you just mentioned?’

      ‘Georgina!’ Van den Bergen said.

      But George had had enough. ‘Look. Why am I here? What’s so fascinating about poor Arnold damned van Blanken and his dicky ticker?’

      De Koninck pursed her lips, the nostrils of her narrow Dutch nose flaring. ‘Torsades des Pointes is an irregular heartbeat originating from the ventricles. It can lead to fainting and sudden death due to ventricular fibrillation. It basically brings on heart failure.’

      ‘And his GP intentionally put him on an unnecessarily high dose,’ Van den Bergen said, reaching into his pocket and withdrawing a pack of tablets that said ‘Omeprazole’ on the side. ‘I was worried that my own doc had prescribed the same killer meds.’

      Well, thought George, that explains the previous night’s tossing and turning in bed.

      ‘Potentially killer,’ De Koninck said, smoothing her expensively streaked urchin cut behind her ears. ‘Normally, it’s a very safe drug.’

      ‘So, the old man was wantonly poisoned,’ George said.

      ‘And that’s the least of it,’ Van den Bergen said, approaching the corpse and pointing to his neck. He beckoned her over with a nod of his head. ‘See this tattoo?’

      Not wishing to get too close, George craned her neck to see a tiny inking of a lion that had faded presumably from black to navy blue over time. The lion wore a crown and carried a sword. ‘I wonder what the S and the 5 stand for?’ She sniffed and took a step back. ‘Looks like a prison tattoo. Ink and a needle. Something really old school.’

      Van den Bergen raised an eyebrow and treated her to a wry smile. Was he being patronising about her turn of phrase? Or was she overreacting because she was already so mad at him?

      ‘Well,’ he said, grabbing surreptitiously at his throat, ‘Marianne has had more than one old guy in here lately who’s died of a meds-induced heart attack and sported one of these tattoos.’

      Breathing in sharply, all the cynicism and defensive, studied boredom fell away from George like a layer of dead skin, revealing the questioning machine of her intellect and curiosity beneath. ‘Really?’ She unfolded her arms and looked again at the tattoo. ‘You got photos?’

      ‘What do you think?’ De Koninck said, taking a file from her desk and opening it to reveal post-mortem shots of another old man. ‘Brechtus Bruin. Another ninety-five-year-old. I did his autopsy a couple of weeks ago. He’d been taking Demerol and OxyContin as prescription painkillers. And guess what he died from?’

      ‘Heart attack,’ George said.

      De Koninck nodded, raising both finely plucked eyebrows with a wry smile. ‘You guessed it.’

      George studied the shots of Brechtus Bruin’s neck, feeling the hairs rise on the back of her own. ‘The same tattoo! Marie’s going to have a field day searching for the background to this on the internet.’ She was undeterred by the sight of the lifeless nonagenarian in the pictures. It was far easier than cosying up to the discoloured, slowly decomposing neck of the actual corpse before her.

      ‘Both Bruin and Van Blanken had the same superficial cause of death and the same tattoo,’ Van den Bergen said, peering over her shoulder at the regal lion. ‘There’s a definite link.’

      The pathologist switched tabs on her computer screen to another report. She scanned the notes, tapping the screen. ‘Though Brechtus Bruin took ill at home, so there were no witnesses. As I understand it from the ambulance team who brought him in to me, he’d been lying dead in his house, undiscovered, for several days before his neighbour realised he wasn’t picking up his grocery deliveries. But the painkillers he was taking are also notorious for causing heart attacks in the frail in high doses.’

      George

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