Darkness Rising (The East Salem Trilogy) (9 page)

The medical examiner was wearing blue jeans, cowboy boots, and a black turtleneck sweater. He apologized in advance for slurring his words, explaining that he’d just come from his dentist and the Novocain had yet to wear off.

She waited while he established a Wi-Fi link and then connected his laptop to the large monitor on the wall. Irene Scotto was still out of town, which left the DA’s office uncharacteristically serene. Stuart Metz was in court and the holding cells on the ground floor were empty. Dani briefly wondered if Baldev Banerjee was the one the angel had said would betray her, but dismissed the thought—what possible reason could he have?

“Here we are,” Banerjee said when the file he’d been searching for came up on the monitor. “Would you mind?”

Dani dimmed the lights and sat opposite the ME at the conference table.

“I apologize for making you come this far, but they won’t let me send my files to unsecured computers,” he said. “Have to keep it in the house.” He clicked on the file and opened it. “Given what we knew about Amos Kasden’s talent for pharmaceutical experimentation, my first thought was simply to get his serum toxicology to see if he was drinking the same punch he’d given his friends.”

Amos Kasden had drugged not only his victim but a half dozen other East Salem teenagers who’d attended what they’d believed would be a “passage party”—a chance to enter a controlled, drug-induced near-death state that would, they believed, afford them a glimpse of what was beyond death. It was one of those idiotic things teenagers believed in, but Amos had used this allure to get them to drink a cocktail that combined the date-rape drugs gamma-hydroxy-butyric acid (GHBA) and Rohypnol (“roofies”) with an amnesia-producing drug called Versad, used by children’s dentists to help kids forget traumatizing experiences in the chair. Kasden’s father
was a pediatric dentist and he’d stolen the drug from his father’s supplies. None of the teens Kasden had doped could remember what happened, but all of them thought they’d helped him kill Julie.

“I’m gonna go out on a limb and guess Amos Kasden was drug-free,” Dani said.

“He was. And as you know, he had rather long hair, so we were able to test hair samples going back at least a year, maybe a year and a half. No indication of marijuana use, no cocaine, no methamphetamines or hallucinogens. His liver was clear, so I don’t think he even drank alcohol.”

“A real all-American boy,” Dani said.

Amos had been adopted from a Russian orphanage that had failed to disclose why he’d been sent there—he’d killed his abusive, alcoholic father. With an ax. When he was five. His adoptive American parents had him in public schools until he was ten, but sent him to St. Adrian’s Academy at eleven when he’d begun to develop emotional problems. The school had a reputation for teaching “troubled” kids. As far as Dani could tell, it taught them how to be even more troubled.

“That was simple toxicology,” Banerjee said, clicking on a link to a large table of numerical values. “I asked the FBI lab for the works, partly to see what they could find. They did a complete proteome analysis, liquid chromatography, catecholamine assay, and shotgun mass spectroscopy. I was hoping to find protein biomarkers for schizophrenia, but no luck.”

“I wouldn’t have thought so,” Dani said.

“You knew the boy, did you not?”

“I spoke to him twice.” She still had a hard time talking about it.

“And your impression was?”

“I was leaning toward a dissociative identity disorder. DSM-IV code 300.14. Dead inside, emotionally.”

“These are his postmortem homeostatic levels,” Banerjee said. He gave her a moment to consider the chart. The numerical values represented the relative concentrations of hormones and neurotransmitters in Amos
Kasden’s cerebrospinal fluids. Studying it reminded Dani that it had been a long time since she had taken a class in neurochemistry. She’d done well in the subject but had decided to focus her studies on the behavioral side of cognitive disorders.

“Did you look for tumors on the adrenal medulla?” she said.

“Ah,” Banerjee said, glad to see that she’d zeroed in on the same anomaly he had spotted. “I did not, but I did run a cranial MRI. No catecholamine secreting tumors on the adrenal medulla to explain the discrepancies.”

Catecholamines were essential hormones synthesized by the nerve synapses in the brain and used to communicate between neural cells. They included dopamine, sometimes called the “pleasure molecule”; adrenaline; and noradrenaline. Amos’s dopamine levels were lower than anything Dani had ever seen. His adrenaline and noradrenaline levels, on the other hand, were extremely high.

“But look at this,” Banerjee said, clicking to a different table that gave values for a postmortem urine analysis. “Urine levels for vanillylmandelic acid are significantly disproportional to catecholamine plasma levels. Almost negligible.”

Dani recalled that after adrenaline and norepinephrine crossed the nerve synapses in the brain to transmit messages, they were not reabsorbed; instead they were metabolized. The metabolites should have been excreted as vanillylmandelic acid.

“How can there be high plasma levels but low urine levels?” she said. “It’s gotta go somewhere.”

“Something is blocking it?” Banerjee said. “In other words, I have no idea.”

He clicked back to the previous screen. “Note the serotonin levels as well. This is not my field, but as I understand it, after the synapses release serotonin, half of it is reabsorbed.”

“Ten percent is lost,” Dani said. “Ninety percent is reabsorbed.”

“Which is why serotonin reuptake inhibitors have proven effective as
antidepressants,” Banerjee said. “They prevent the transporters from reabsorbing serotonin, resulting in higher homeostatic levels. Flip that around and low levels—”

“Cause depression,” Dani finished.

“It appears that something in this poor boy was enhancing serotonin reuptake, rather than inhibiting it. You said in your report that he was being treated? At the school?”

“I don’t know what they were doing for him. Or to him. They claimed
in loco parentis
on top of doctor-patient and refused to release his medical records. But they confirmed that he was in treatment.”

“I wonder if Amos was on some kind of medication that could explain these results. Hard to imagine we’d get a proteomic profile like this on someone who was getting professional care.”

“It would be nice if we had a baseline,” Dani said.

“We need to get a good neurochemist to look at this,” Banerjee said. “It’s beyond my ken. Do you know anyone?”

“Yes,” Dani said.

Banerjee noticed the dubious look on her face. “There’s a problem?”

“The one I know,” she said, “used to be my fiancé. Sort of. We were never in the same place at the same time long enough to talk about it. We were both working in Africa for Doctors Without Borders. He’s quite brilliant. In a flaky sort of way.”

“Who broke off the engagement?”

“Nobody. We weren’t even sure it was an engagement. Then my parents died and I came home. I doubt he’s even in the country.”

“But you think he could help?”

“Definitely.”

Banerjee saved the Amos Kasden file to the district attorney’s secured hard drive, told Dani she was free to use it in the office, and departed. After wandering the halls for a few minutes, she found an open terminal in Stuart Metz’s office and entered the name
Quinn McKellen
in
the Google search box. Links to articles on neurochemistry McKellen had published in scholarly journals appeared first. Then she spotted a link telling her Quinn was speaking tomorrow night at a conference at Columbia, delivering a paper entitled “An Immunoradiometric Study of Hyperandrogeny and Autism.” Linz Pharmazeutika was listed as one of the sponsors.

When she clicked on the link to Linz, it took her to a page advertising a new drug called Provivilan, promoted as the first effective prophylactic vaccine against depression. She knew how to read between the lines of pharmaceutical ad copy, written to give care providers the information they needed while seducing the general population— always overpromising and underdelivering. Dani had heard numerous stories from colleagues about patients telling their doctors what antidepressants they wanted to try based on TV ads showing happy people picking f lowers and tousling the hair of small children. “Make me like the people in the ad,” they demanded.

Provivilan had been originally developed to treat autism in children, she read—that was the connection to the conference—by inhibiting serotonin reuptake in a specific set of receptors affected by growth hormones. Collateral studies suggested Provivilan was also effective against depression when taken by adults. It was also, according to the ad copy, safe to take during pregnancy, and significantly improved cognitive function and school performance in children who took it on a low daily maintenance dosage.
We’re changing the world, one child at a time
, the slogan in a larger font at the bottom of the page promised.

The Food and Drug Administration regulated what drug ads could and couldn’t say, and required them to list any potentially harmful side effects. Provivilan had remarkably few of those. Saying your product was going to “change the world one child at a time” was too general a statement to measure by any FDA standard for truthfulness, but it was exactly the kind of assertion that would make any concerned parent eager to try it.

She needed help. In this case, help was just around the corner, in a hotel room in Manhattan, where Quinn McKellen was preparing his speech.

Or was he the one who was going to betray her?

He’d done it once before.

8.

Tommy asked Carl to meet him at the East Salem library. He’d called Dani too but got her voice mail. He’d also called ahead to make sure the library’s media room wasn’t in use. His Aunt Ruth told him it was available, and added that since he’d donated the money to buy all the equipment in it, including a dozen new computers, an HD projector, and a Smart Board, he was welcome to use the room anytime.

The library, one of the oldest buildings in town, sat on the square and shared a parking lot with the Grange Hall, where the town meetings took place. The building was Greek revival, with white pillars out front and white siding, and it had served as a kind of daycare center for Tommy when his mother would drop him off to spend afternoons loosely supervised by his aunt. Tommy had read all the books he could find on sports first, and made many great discoveries, including the disappointment in sixth grade that a
National Geographic
story about the Bikini Islands was not actually about a place where ladies wore revealing two-piece bathing suits.

Aunt Ruth smiled and came out from behind the reference desk when she saw him push open the back door. She was wearing one of the cableknit sweaters she made herself. Tommy could remember many nights when she’d babysat him, and how the sound of her knitting needles clicking together had comforted him when he was young and afraid of the dark.
“Is that your friend I hear?” she said, referring to the sound of a loud motorcycle pulling up outside.

“I still think you should bake him a pie or something,” Tommy said. “He’s too shy to ask you out and you’re too stubborn to make it easy for him. Somebody’s gotta break the logjam.”

“I’m not baking a man a pie just to get him to ask me out.”

“Then bake
me
one and I’ll see that he gets it,” Tommy said as Carl strode through the library’s automatic front doors. He took his helmet off and tucked it under his arm as he removed his gloves.

“Carl,” Ruth said in a measured tone.

“Ruth,” Carl said. “How are you?”

She said, “Very well, thank you,” and returned to the reference desk.

“Why does she hate me?” Carl said to Tommy.

“She doesn’t hate you. That’s Scandinavian reserve. Saying, ‘Very well, thank you,’ is the Norwegian way of flirting. It’s actually almost lewd. Do you like strawberry-rhubarb pie?”

“It’s my favorite. Why?”

“Not important,” Tommy said, gesturing toward the media room. “We can talk in there.”

When they got inside, Carl took off his leather jacket and the down vest he wore beneath it and set them both over the back of a chair, then placed his helmet carefully on the seat. Tommy closed the door, turned on one of the computers, plugged an SD card into it, then turned on the projector and used the Smart Board as a video screen. Ruth had used the room for everything from toddler Music Together classes to senior citizen
Thin Man
movie marathons, though for the senior citizens a marathon meant four p.m. to nine p.m. Tommy had decided that his next donation would be a grand piano for the music series.