9

ANUM BINEY, CHIEF PHYSICIAN at the Volta River Authority Hospital, could perform any operation, from an appendectomy to a facial reconstruction. He had to. The hospital served the entire population within a hundred-mile radius. Dr. Biney had the help of residents from the medical schools in Accra and Kumasi, but in truth he was on call twenty-four hours a day, seven days a week, 365 days a year.

And over the years he had become known for his skill at autopsies, much of it self-taught. With only about twelve pathologists available for the entire country, most of them at Korle-Bu, it was only natural Dr. Biney had become a much-sought-after postmortem guru. That would explain why he had a constant backlog of autopsy cases. He had added on an extra Wednesday evening to try to catch up.

The single-story cream-and-mahogany buildings of the hospital were nestled among trees, green lawns, and clipped hedges. Its sections-the male and female surgical wards, the children’s ward, and so on-were connected by long open verandas. This was no scruffy place fallen on hard times. Taking good care of it was revenue from the Akosombo hydroelectric dam on the Volta River, just a few kilometers away.

Dr. Biney crossed the expanse of tended grass in front of the morgue, the only building at the hospital not connected to the rest. Perhaps logically so: the wards were for the living, the morgue for the dead. Biney was weary, having been up practically the whole night with various calls, including one for a victim of a vehicle crash. He wore exhaustion like his clothes-he was aware of it, but he didn’t focus on it.

The morning was working up to the sweltering day it would become, and already the air was close on the skin like a cloak. Dr. Biney walked past the standby generators that ensured there would never be a failure of refrigeration in the morgue should there be a power cut. True, the Akosombo Dam was near, but blackouts did occur.

He unlocked the rear door and entered the mercifully air-conditioned morgue, first through the anteroom, where the bodies were washed, and then to the autopsy room itself. There were two postmortem tables. On busy days, every day really, Biney would finish one case and go almost immediately to the second table for the next.

He looked around for a moment, thinking he really must get the missing tiles on the wall replaced and get rid of that old defunct table in the corner that they needed to cart away somewhere.

He went looking for Obodai, the attendant, and found him scrubbing down the stone floor in front of the gleaming bank of aluminum storage drawers. There were twenty of them in columns of four. They were at full capacity and unable to keep up with the number of bodies arriving weekly. It was time to add some more drawers.

“Morning, Obodai.”

Obodai stopped his work and practically stood at attention.

“Good morning, sir.” He gave an imperceptible bow, a gesture so slight one might fail to spot it, but it was there-a show of eternal deference to his boss. Obodai had been working at the morgue for ages. He was wizened and wiry, loyal and unflappable. Whether you needed his assistance at five in the morning or eleven at night, he would be there. He was always the first to arrive and the last to leave.

“We’ll be doing the case of the young woman from Volta Region,” Dr. Biney said. “First priority.”

“Very good, sir. When do you wish to start, sir?” “We’re waiting for a detective from Accra. He’ll be witnessing. Should be here soon.”

“Very good, sir. Everything will be ready.”

Approaching Akosombo, Dawson slowed down at the security gate, but the guards waved him on. They had an instinct about who was legitimate and who was not.

Just a little way past the gate was the Volta River Authority Hospital. Dawson parked and went in through an open-walled reception area. About fifteen patients, some with children, were waiting to be called in for treatment. As Dawson paused, wondering where Dr. Biney’s office was, a young woman with a brilliant smile and expensively braided hair approached him.

“Good morning, sir,” he said. “Are you Detective Inspector Dawson?”

“Good morning. Yes, that’s me.”

“Welcome to the VRA Hospital, sir.”

Dawson shook hands with her as she introduced herself as Victoria, Dr. Biney’s administrative assistant.

“He is expecting you,” she said warmly. “Please come this way. Did you have a safe trip up from Accra?”

He followed Victoria through a double door into the skylit, air-conditioned corridor within. Dr. Biney’s office was the third on the left, and his assistant showed Dawson in.

“Dr. Biney, Detective Inspector Dawson has arrived.”

As always in new surroundings, Dawson took a quick snapshot of the room. A full-scale model human skeleton in the far corner, bookshelf bursting with medical texts and journals, stethoscope and ophthalmoscope on the desk, piles of folders and papers everywhere, including on the floor. An outgrown office space of a busy man with too much to do and too little time in which to do it.

Biney rose from his desk. “D.I. Dawson, welcome!”

He was a hearty man with a voice to match, standing at least six two. He was taller than Dawson and heavier by far. He had a neatly cropped head of hair and an amazing salt-and-pepper mustache that sprouted straight out to the sides. When they shook hands, Biney’s palm dwarfed Dawson’s.

“Thank you for coming, Mr. Dawson. I trust the journey was fine?”

“Excellent, thank you, Doctor.”

“Can we get you anything? Some refreshment, maybe?”

“No, thank you. I’m okay for now.”

“Come along, then. Shall we proceed to the morgue?”

They suited up-gown, apron, gloves, face shield, and shoe covers-and moved on into the autopsy room. Dawson had somehow imagined a long row of tables, but there were only two, and upon one of them lay the body of a young woman. Must be Gladys Mensah.

Arranging a tray of instruments nearby was a man in a heavy-duty apron and thick, knee-high rubber boots.

Dr. Biney introduced him. “Obodai is my most trusted assistant, and without him, this place could not run.”

Obodai laughed bashfully and offered a feeble denial, but Dawson had no doubt that Dr. Biney’s declaration was true.

“Are we ready to go?” Biney said.

“We are ready, sir,” Obodai said.

Dr. Biney turned to the body, standing to its right side as a doctor always does. Obodai stood at the head, near the sink, and Dawson took his position on the left. He looked down at the body. A courier had delivered the police file last night, complete with photographs of the body at the crime scene, but the Gladys Mensah now in front of him looked waxy and strangely unreal. He could tell she had been lovely alive, and he was trying to imagine her speaking, moving, animated.

Dawson lightly touched Gladys’s arm. “So cold,” he murmured. “Once she was warm and breathing.”

It was what he could never quite get his mind around-not just how complex life was, but why it was so easy for life to leave a person once so complex.

“Only twenty-two years old,” Biney said gently “It seems a shame, doesn’t it, Detective Inspector Dawson?”

“It does.”

Biney took a deep breath and let out a sigh as if to say, Be that as it may, we have work to do. He first brought his face closer to Gladys and examined her slowly from head to toe. He did not touch her yet.

“In medical school we were always taught to listen, look, and then feel a patient,” he said. “It’s no different dealing with a dead person.”

Dawson watched him, trying at the same time to spot anything on Gladys’s body that might be significant. She was lean, with perfectly smooth skin that had likely been the color of milk chocolate before death had darkened her.

“Anything catch your eye, Mr. Dawson?”

“Not yet.”

“Measurements, Obodai?” Biney said.

“She weighs fifty-two kilos, and measures one hundred and seventy-three centimeters long, sir.”

“Mm-hm. Thank you. No stab or puncture wounds that I can see so far. Nor contusions, or ecchymoses. No evidence for fractures of the skull or long bones…” He checked her fingers. “She kept her nails short-they look clean, but get clippings later, Obodai, would you?”

“Very good, sir.”

“Roll her up?”

Obodai smoothly and expertly turned Gladys’s body on its side so Biney could look at her back.

“Ah, Inspector Dawson, take a look. Here we see blanching at the shoulders and buttocks, indicating that she was lying on her back for some time postmortem. The weight of her body compresses the blood vessels in the areas in contact with the ground, preventing accumulation of blood there. I still see no wounds of any kind. The posterior scalp’s clear of contusions or hematomas. Interesting.”

“Let her back down, Doctor?” Obodai said.

“Yes, please. And we’ll put her on the head block now and open the skull.”

Obodai lifted the body at the shoulders and slid the wooden block underneath it. As he did that and Gladys’s neck became slightly more exposed, Biney seemed to notice something. He went closer and peered at her chin.

Dawson followed his lead. “What do you see, Dr. Biney?”

“It looks like an abrasion,” he said, with a tinge of excitement in his voice. “I’ve seen it before, in another case. The victim is being strangled, she lowers her chin to protect her neck and gets a bruise from the assailant’s hands. Strangling someone is not as easy as people think.”

“Strangling,” Dawson echoed.

“Indeed. Change of plan, Obodai.”

“Dissect the neck, sir?”

“Yes, let’s postpone the skull for the moment.”

“Very good. Your scalpel, sir.”

Dr. Biney began at Gladys’s chin and made a long, clean incision straight down the middle to the sternal notch. There was very little subcutaneous fat, and the muscle layer popped into view after minimal dissection.

“Do I see subtle hemorrhages in the soft tissues around the right sternomastoid,” Biney said, “or do my eyes deceive? I don’t want to be premature, but I think we may have something here.”

He continued carefully with short, precise incisions with the scalpel, peeling away the layers covering the larynx.

“Ah.”

“What is it, Dr. Biney?”

“Fractured thyroid cartilage. Gracious. Do you see it, Inspector Dawson? Let me show you. This is the thyroid cartilage. It looks like a roof we’re viewing from above. This is one side of the roof sloping up, this is the other, and where they meet is the prominence everyone knows as the Adam’s apple. We can’t see them, but the vocal cords are behind the cartilage-underneath the roof, so to speak. Got it?”

“Got it.”

“Look at the left side of the cartilage here. It looks smooth. When I poke it, it moves in one piece. Now look at the right. I depress it firmly, and what happens?”

“It bends in the middle.”

“Yes. Why?”

“Because it’s cracked.”

“Ten points. There you have it. Fracture of the thyroid cartilage.”

“Besides strangulation, is there any other possible cause of a thyroid cartilage fracture?”

“There are-such as falling against something and striking the front of the neck,” Biney said. “The armrest of a chair, for instance. Another would be a karate chop to the neck. But fractures of the larynx in circumstances like this mostly result from strangulation, and my finding of perilaryngeal focal hemorrhage-in other words, bruising-is consistent with this. I wonder if the hyoid bone was damaged as well.”

He returned to Gladys’s neck and moved upward from the thyroid cartilage to the apex of the throat.

“Dissecting around the hyoid bone now,” he said. “It’s a much harder structure to fracture because it’s protected behind the lower jaw.”

A few minutes later, Dr. Biney said, “It’s intact. No fracture. But, there’s swelling and hemorrhage around it. Again, consistent with considerable force applied to the neck over some sustained period.”

Dawson gazed at Dr. Biney, and their eyes met. It was, quite frankly, breathtaking.

“What you’re saying is-”

“That’s exactly what I’m saying, Mr. Dawson. In the case of Gladys Mensah, the cause of death is asphyxiation by strangulation. Manner of death is homicide.”