Hush Little Girl

blue scrubs and skull cap. She waved them over. “I called Mett and Gretchen, both of whom are otherwise engaged. They both said one of you should be available to hear autopsy results.” She stared at them, a slow smile curving her lips. “Or did I interrupt something?”
Noah held out the wedding dress. “Josie had to get changed.”
Dr. Feist raised a brow. “Sure. Whatever. Come on. You can leave that in my office for safekeeping until you’re ready to take it home.”
They followed her down the hall and into the exam room. It was windowless, its walls pale gray cinderblock. In the center of the room were two stainless steel autopsy tables with light fixtures overhead. As always, the combination of chemicals and decomposition made for a stomach-turning odor. No matter how many times Josie smelled it, she never got used to it. Dr. Feist took the dress from Noah and disappeared into her office in the adjoining room. Before them, both examination tables were occupied. The bodies were covered with sheets, but Josie knew the larger one was Lorelei and the smaller one was Holly. Dr. Feist returned with a laptop and opened it up while standing at the stainless steel countertop that ran along the back wall of the room. She pulled up a set of x-rays and then turned back to Josie and Noah.
“Whose exam would you like to hear about first?”
Josie swallowed. “Lorelei’s.”
Dr. Feist gave a solemn nod. “I was able to confirm her identity using her driver’s license which the ERT took from her home. I found no evidence of sexual assault. Her cause of death was, as I predicted, exsanguination. She bled out from a gunshot wound to the chest. I extracted a number of shotgun pellets from her abdomen and chest cavity. There was massive internal damage, but I believe the worst of the damage came from one pellet that punched through her left lung, causing a sucking chest wound, and another pellet that went right through her heart. Basically, her left lung and heart were shredded. All the heavy scientific language will be in my final report. In addition to that, she had quite a nasty head injury. However, it appears to have happened probably within minutes of her death, as I would have expected to see swelling in the brain or a subdural hematoma, but that didn’t have time to materialize.”
“Time of death?” Josie asked.
“Given her body temperature and the temperature of the house, I’d say she died sometime between six a.m. and ten a.m. There was coffee and some oatmeal in her stomach, so it appears she’d just had breakfast. There are some incidental findings I think you should be aware of. They have nothing to do with her death, but may impact your case.”
She walked over to the table with the larger form on it and peeled back the sheet to just above Lorelei’s breasts. Brushing aside Lorelei’s curls, Dr. Feist indicated the skin along the side of her neck and down to her trapezius muscles. Josie leaned in and immediately saw at least a half-dozen silver-white lines, each one about an inch long. “Stab wounds,” she said.
“Yes,” said Dr. Feist. “Very old ones. These healed a very long time ago. Many more are on her upper back and neck. I counted thirty-four in all. Most were relatively superficial, meaning they didn’t penetrate beneath the fascia. Two of them, however, nicked the left collarbone and another penetrated the back of her neck deeply enough to nick the bone of her spinal column, taking a small chip out of it, but not damaging any of the nerves or vessels around it. She was extraordinarily lucky.”
Noah said, “You’re saying someone stabbed her thirty-four times in her upper back and neck?”
“Yes,” said Dr. Feist. “My guess is that she was attacked from behind. Probably a blitz attack—lightning fast and relentless.”
“My God,” said Josie. “Is there any way to tell how old they are?”
Dr. Feist shook her head. “I can’t say for certain. Several years is my guess.”
A moment of silence unfurled around them as they considered what Lorelei had survived at some point in her life. As if of their own will, Josie’s fingers brushed over the scar on her face. When she saw Dr. Feist watching her, she lowered her hand.
“What about Holly?” asked Noah.
Dr. Feist grimaced. “Her case is a little more complicated. Have you ever heard of ‘talk and die’ syndrome?”
Josie and Noah shook their heads in unison.
“That’s shorthand neurologists use when they’re talking about a closed head injury, usually an epidural hematoma, which is when blood accumulates between the dura—the covering of the brain—and the skull. With a ‘talk and die’ injury, the person usually sustains a head injury without a skull fracture. They usually appear just fine for minutes, even hours. They’re laughing, walking, talking—”
“Until they die,” Noah filled in.
“Right. The decline happens extremely rapidly. The accumulation of blood can cause pressure and swelling in your brain. It can even cause your brain to shift inside your skull. That’s what I saw on examination with Holly Mitchell. She had a very large epidural hematoma that put intense pressure on her brain and caused it to swell and shift. That is her cause of death.”
Josie said, “Is it possible to tell how long it was between the time she sustained the head injury and when she died?”
Dr. Feist frowned. “Unfortunately, no. As I said, with ‘talk and die’ syndrome, a person could seem fine for five minutes or for several hours before death. Given her body temperature as well as the outdoor temperatures, she probably died between eight a.m. and noon.”
Noah asked, “Is there any way to tell what injured her?”
Dr. Feist said, “I’m afraid not. The injury was over her left ear, behind the temple. Either someone struck her, or she sustained some sort of fall, although she would have had to land at exactly the right angle with exactly the right amount of force to sustain