Deadly Decisions (13 page)

“I found the shunt in a normal-looking skull. Doesn’t hydrocephalus result in increased head size?”

“Only in infants, and only if left untreated. As you know, with older children and adults the bones of the skull are already formed.”

“What causes it?”

“There are lots of reasons for inadequate CSF drainage. Prematurity puts an infant at high risk. And most babies with spina bifida have hydrocephalus.”

“Spina bifida involves a neural tube defect?”

“Yes. The problem occurs during the first four weeks of gestation, often before the mother knows she’s pregnant. The embryo’s neural tube, which develops into the brain, spinal cord, and vertebral column, fails to form properly, leading to varying degrees of permanent damage.”

“How common is it?”

“Entirely too common. It’s estimated that spina bifida affects one in every thousand babies born in the United States, and about one in seven hundred and fifty born in Canada.”

“I recovered no vertebrae, so I have no way to know if my young lady had spina bifida.”

Russell nodded in agreement, then continued her explanation.

“There are many other causes of hydrocephalus besides spina
bifida.” She ticked them off on her fingers. “It can result from brain hemorrhage. The inflammation and debris resulting from brain infections, such as meningitis, can block drainage pathways. Tumors can cause compression and swelling of brain tissues and result in poor drainage. So can certain types of cysts. And hydrocephalus can be familial.”

“It can be inherited?”

“Yes. Though that’s rare.”

“So where does the shunt come in?”

“There is no way to cure or prevent hydrocephalus. For the past forty years the most effective treatment has been the surgical insertion of a shunt. The one you’ve brought is a bit outdated, but it’s really pretty typical.

“Most shunts are just flexible tubes placed into the ventricles to divert the flow of CSF. They consist of a system of tubes with a valve to control the rate of drainage and to prevent back flow. The early ones diverted the accumulated CSF into a vein in the neck, then into the right atrium of the heart. Those are called ventriculo-atrial, or VA shunts. Some VA shunts are still used, but there are problems associated with them, including infection, and, though rare, heart failure due to blockage of blood vessels within the lungs by particles of blood clot flaking off the shunt’s catheter tip. Most shunts now drain into the peritoneal cavity. They’re called VP shunts.”

She indicated the device I’d pulled from the skull.

“This is a VP shunt. In the living patient you would have been able to feel the bottom tube running under the skin that overlies the ribs. That part of the device is missing.”

I waited for her to go on.

“The peritoneal cavity is large and can usually handle any amount of fluid delivered by the shunt. Another advantage of draining into the abdomen is that the rhythmic contractions of the intestinal organs move the tip of the catheter around. That motion prevents its becoming blocked or sequestered in scar tissue.”

“When do these things go in?”

“As soon as hydrocephalus is diagnosed. As much as thirty-six inches of tubing can be placed in the abdomen of a neonate. As the child grows, the tubing unwinds to accommodate the increased length of the torso.”

“I found a small hole in the skull, near the parieto-temporal junction.”

“That’s a burr hole. It’s drilled during surgery to insert the upper end of the shunt into the brain. They’re usually made behind the hairline, either at the top of the head, behind the ear, or in the back.”

Russell’s eyes flicked to a round metal clock on her desk, then back to mine. I was anxious to learn what difficulties might be caused by hydrocephaly, but knew the woman’s time was limited. That research would be up to me.

I gathered my jacket and she returned the shunt to its jar, curling the paper and allowing the device to slide gently into place. We rose simultaneously and I thanked her for her help.

“Do you have any idea who your young lady is?” she asked.

“Not yet.”

“Would you like me to send you some reading material on hydrocephalus? There are problems associated with the condition that you might find helpful.”

“Yes, very much. Thank you.”

I
LEFT THE
N
EURO AND WENT DIRECTLY TO
C
ARCAJOU HEAD
-quarters for the second of Roy’s review sessions. The meeting was already in progress, so I slipped into a back seat, my brain still processing what I’d learned from Carolyn Russell. Our conversation had raised as many questions as it had answered.

How had the hydrocephaly affected my unknown girl? Had she been sickly? Disabled? Retarded? How did a teenager with that condition end up buried near a biker headquarters? Was she a willing participant, or another innocent, like Emily Anne Toussaint?

This time Roy was using transparencies, and a bulleted list filled the screen. I forced myself to focus.

“Outlaw motorcycle clubs are characterized by a number of common elements. Most OMCs are organized according to the Hells Angels model. We’ll come back and look at that structure in some detail.”

He indicated the second item.

“All clubs have membership which is very selective, and ‘prospects’ or ‘strikers’ are required to prove themselves to earn their colors.”

He moved down the list.

“The colors, or club patch, are the member’s most valued possession. Not everyone wears colors, however. Individuals who are useful to the gang are allowed to interact as associates without actually joining.

“The primary focus of an OMC is criminal activity. Each club has rules that condone violence to further the interests of the club and its members. Intelligence gathering is intensive, including the monitoring of other gangs and of law enforcement personnel.”

Roy pointed his pen at the last item on the list.

“The clubhouse, which is often strongly fortified and elaborately outfitted, is the meeting place for club activities.”

I thought of the Vipers’ house in St-Basile, and wondered what activities could have included a sixteen-year-old girl with hydrocephaly.

Roy removed the transparency and replaced it with another, this one a tree titled “Political Structure of an OMC: National.”

Roy explained the hierarchy, starting at the bottom.

“The basic element of the OMC structure is the chapter. An independent outlaw motorcycle club becomes part of a larger organization, such as the Hells Angels, only after a charter has been approved by vote of the national membership. This involves a long process that we can discuss later if we have time.

“Each chapter operates in a specific local area and maintains a certain degree of autonomy, but must live by the rules set out by the organization. These rules, either in the form of bylaws or a constitution, define the rights and obligations of the members and the gang.”

Roy slid a new transparency onto the projector. This chart was labeled “Political Structure of an OMC: Chapter.”

“Each chapter has its own controlling body, or executive, elected by the members. Typically there’s a president, vice president, secretary-treasurer, and sergeant at arms. These are the guys responsible for maintaining order within and peace outside the group.”

“Guess none of our local morons will make the Nobel short list this year.” Kuricek was up to form.

Roy waved down the laughter.

“There’s also an elected road captain who takes charge of the runs. Then there are the rank-and-file members—”

“And he does mean rank.” Kuricek held his nose.

“—who have a say in matters affecting the group, but the president makes the final decisions. Some of the larger clubs also have a
security officer whose duty it is to keep up-to-date information on rival gangs, reporters, lawyers, judges, public officials, witnesses, and, of course, on yours truly.”

Roy swept his arm across the room.

“What kind of information?”

“Personal, financial, family members, girlfriends, boyfriends, phone numbers, birth dates, addresses, vehicle descriptions, license plates, places of employment, daily habits, you name it, these guys get it. Their photo collections make the National Portrait Gallery look sparse. If there’s an intended victim, his dossier may include tips on the best places to kill him.”

“Merde!”

“Esti!”

Roy worked his pen from left to right across three boxes on the next to lowest line of the diagram.

“At the bottom of the chapter hierarchy are the prospects, the hang-arounds, and the women.”

Roy pointed to the box marked “Probationary Member.”

“The ‘prospect’ or ‘striker’ must be nominated by a full patch member. He does all the shitwork around the clubhouse and during runs. Prospects can’t vote and they can’t attend church.”

“Church?” Today the ponytailed investigator wore a silver skull in his ear.

“The mandatory weekly chapter meeting.”

“How long does it take to get in?”

“The prospect period averages six months to one year. You can spot these guys because they wear only the bottom rocker of the patch.”

“Which gives the chapter location.” Ponytail.

“C’est ça.
There are several pages showing club colors in the manuals I gave you. Some of them are true artistic marvels.”

Roy’s pen moved sideways to the box marked “Associates.”

“A hang-around must also be sponsored by a full patch member. Some go on to prospect, others never do. Hang-arounds do all kinds of menial jobs, and act as a support structure for the club in the community. They are excluded from all club business.”

Two boxes hung from the one at the far right marked “Female Associates.”

“Women are at the lowest level of the hierarchy and fall into one of two categories. The ole ladies are wives, either common-law or legal, and are off-limits to other gang members, except by invitation. The club ‘mamas’ or ‘sheep’ are a different story. How shall I put it?” He raised eyebrows and shoulders. “They mingle freely.”

“Warm-hearted ladies, all.” Kuricek.

“Very. Mamas are fair game to any color-wearing member. While the ole ladies enjoy a certain degree of protection, have no doubt about it, outlaw motorcycle gangs are male-dominated and highly chauvinistic. Women are bought, sold, and swapped like hardware.”

“The biker’s idea of women’s lib is to take the cuffs off after he’s through. Maybe.” Kuricek.

“That’s pretty close. Women are definitely used and abused.” Roy.

“Used how?” I asked.

“Aside from sex, there’s what we might call wage sharing. They get the women into exotic dancing, drink hustling, street-level drug trafficking, prostitution, then rake back the earnings. One hooker from Halifax claimed she had to turn over forty percent of her take to the Hells Angel who pimped for her.”

“How do they find these women?” I felt a knot forming in my stomach.

“The usual. They pick them up in bars, hitchhiking, runaways.”

“Wanna ride my Harley, sweet thing?” Kuricek.

I pictured the skull and shunt.

“Amazingly, there’s never a shortage,” Roy continued. “But don’t get me wrong. While many are victimized, some held against their wills, a good number of these ladies embrace the lifestyle with gusto. Macho men, drugs, alcohol, guns, round-the-mountain sex. It’s a wild ride and they go along gladly.

“The women also make themselves useful in ways not strictly sexual or economic. Often it’s the ladies who carry concealed drugs or weapons, and they’re very good at ditching when a bust comes down. Some make very effective spies. They hire on with government agencies, the phone company, records offices, any place they might have access to useful information. Some ole ladies have guns or property registered in their names, either because hubby is prohibited, or to protect his assets from seizure by the government.”

Roy glanced at his watch.

“On that note, I think we’ll call it a day. Some folks have just joined us from the CUM, so I may hold one more of these sessions.”

CUM. Communauté Urbaine de Montréal Police. I wondered why Claudel had not been present at today’s meeting.

“If so, I’ll post the date.”

•    •    •

As I drove to the lab my thoughts went back to the teenager from St-Basile, and to Russell’s explanation. Could the girl have been a victim of this biker insanity? Something about her resonated in me, and I tried again to piece together what I knew about her.

She died in her teens, no longer a child but not yet a woman. Her bones revealed nothing about how she had died, but they did disclose something of how she had lived. The hydrocephalus might help identify her.

The well-healed burr hole suggested that the shunt had been there awhile. Did she hate the shunt? Did she lie in her bed at night and palpate the tube running under her skin? Was she plagued by other physical problems? Did her peers torment her? Was she an honor student? A dropout? Would we find medical records associated with a missing girl that would help identify this skull?

Unlike many of my nameless dead, I had no sense of who she was. The Girl. That’s how I’d come to think of her. The Girl in the Viper pit.