Spider Bones(30)

Tap. Tap. Tap.
"You know what?" Pointing the pen at me. "I'm going to do it anyway."
"Do what?"
"A DNA comparison."
"Where will you get a family sample for comparison?"
"I'll think of something." One finger tapped a temple, just as it had outside the Lanikai house upon our arrival. "I've got an arrival ceremony this afternoon, but right after that, I'm on it like fat on bacon."
Sunday, Monday, happy days!
I checked my BlackBerry.
Hadley Perry.
Not wanting to dampen Danny's good mood, I opted to take the ME's call in the lobby.
While worming through stacks of books and papers, I noticed a shadow cross the tile beyond the open office door.
In the corridor, I looked left and right. Empty.
Had someone been eavesdropping? Dimitriadus? If not, who? Why?
Perry's news blew the issue right out of my head.
     
 

      "LÔ JUST CALLED. HE FOUND A FIFTEEN-YEAR-OLD MALE WHO broke his left tibia and fibula back in two thousand three. Francis Kealoha. The kid spent time as an in-patient at The Queen's Medical Center."
"In traction?"
"Yes, ma'am. The pins were removed the following year."
"The guy's quick."
"The Queen's is Hawaii's only designated trauma center, so Lô started there, put the screws to some chick to do a database search using our suggested parameters. Kealoha's record popped right out."
"Did Lô contact the family?"
"The mother died in oh-seven, father's been out of the picture for years. But he managed to track down a sister. Gloria. A real piece of work. Gloria said the last time she talked to or saw her brother was three years back. She thinks."
"Did Lô learn of any associates, anyone who might have noticed that Kealoha had disappeared?"
"Gloria swears she knows none of her brother's friends, has no idea where he's been living for the past few years. Or what he's been doing. Lô's working on it. I'm heading to The Queen's now, thought you might want to meet me."
"Why can't Lô pick up the medical file and drop it by your office?"
"The treating doc's being a prick. Says he can't release anything without permission from a parent or guardian. Or proof of death."
"That's ass backward."
"Yes."
"How old is Gloria?"
"Thirty-two."
"So what's the problem? Lô can get a release from her."
"Gloria's a prossie with no love of cops. Lô's call must have spooked her, because she's stopped answering the phone. He went by, got no response, heard no sounds of activity."
"Is Hung having any luck with the tattoo parlors?"
"Apparently that shark motif is fairly common. The only unusual elements were those little loopy things along the top border. One tattoo artist thought they were probably added later. The tat angle may turn out to be a bust."
"Who's Kealoha's doctor?"
"Sydney Utagawa, an orthopedic surgeon."
"Where are you meeting him?"
"In his office at The Queen's. We can examine the file, but he keeps possession."
"Give me directions."
She did.
"I'll be there in twenty."
When Captain James Cook stumbled onto the Hawaiian Islands in 1778, the population numbered roughly 350,000. By 1854, when Alexander Liholiho ascended the throne as King Kamehameha IV, that number had dropped to approximately 70,000. Such was the impact of Western microbes.
From the moment of his inauguration, King K and his queen, Emma Naea Rooke, fought for the establishment of health care for native Polynesians. In 1859 the royal couple's dream was realized in the form of a tiny, eighteen-bed, temporary dispensary. The following year, a permanent facility, The Queen's Hospital, was built on a parcel of land called Manamana, at the foot of the Punchbowl.
Over the years, buildings spread outward from the original rock coral and redwood structure championed by his and her highness. Renamed The Queen's Medical Center, the hospital is now a megacomplex of high-rise towers, multilevel parking decks, specialty research and treatment centers, physicians' office buildings, medical libraries, and conference centers.
I got lost leaving Hickam, but eventually blundered onto Vineyard Boulevard. Following Perry's directions, I turned onto Lusitana Street and found the parking area for Physicians Office Building 1. Seems the docs are no more creative than the troops in naming their habitat.
Or maybe someone was making a statement. Physicians Office Building 1 was a nondescript stone block devoid of redeeming architectural detail. Nice tree to one side, though. Baobab? Nawa? An arborist I'm not.
As I walked toward the entrance, I noted the main hospital tower looming beyond, chalk white, its backdrop the glass and steel of downtown skyscrapers.
I rode the elevator with two men and a woman, all in lab coats with stethoscopes looped in their pockets. The woman flipped through a chart. The men watched the floor buttons blink in succession as we ascended. Discreetly, I scanned name tags.
Nussbaum. Wong. Bjornsen.
Cultural diversity. Honolulu rocks.
Utagawa's office was on the third floor. Perry was already there, positioned with her back to the door. The hair spikes were currently a tasteful magenta.
Behind the desk sat a man with wire-rimmed glasses and a hairline holding, for the moment, at midcrown. I assumed this was the intractable Dr. Utagawa.
Utagawa's face was blotchy, suggesting agitation. Or rosacea. Knowing Perry, I guessed the former.
Utagawa rose when I entered. Too quickly, as though glad of rescue. His left hand lingered on a file, palm arched, manicured fingertips spread like spider legs. Other than the folder, the desktop was empty.
We shook hands, exchanged names. Utagawa gestured to a chair beside the ME. I sat. He sat.
Utagawa aligned the file with the edge of the desk. Laced his fingers on it.
"I have been explaining to Dr. Perry, as I did to the detective with whom I first spoke, this case involves a minor. Until I have permission from a parent or guardian, or a court order, I can discuss this file only to the extent that ethics allow."
Utagawa squared his shoulders, prepared for battle.
"It's been years since you treated this kid-"
"Of course." I cut Perry off. "We understand completely, and wouldn't want you to do anything to violate doctor-patient privilege."
Utagawa's frown eased ever so slightly. He nodded, more with his eyelids than with his head.
"Please"-I smiled my most beguiling smile-"tell us what you can."
Utagawa's gaze flicked to Perry, back to me, dropped. Opening the file, he began extracting conscience-friendly facts.
"On August thirteenth, two thousand three, fifteen-year-old Francis Kealoha arrived by ambulance at the emergency department of The Queen's Medical Center. Kealoha had injured his left leg while surfboarding." Utagawa adjusted his glasses. Skimmed. "The ER attending took X-rays, concluded that an orthopedic consult was indicated. I was the surgeon on call."
Lots of page flipping.
"Following examination, I admitted the patient for reconstructive surgery." Utagawa's lips compressed. He was finished.
"Kealoha had suffered a distal metaphyseal fracture of the tibia?" I prompted.
"Among other injuries."
"The tibial shaft was unstable, so you managed the fracture with calcaneal pin traction, is that correct?"
"And subsequent plaster of Paris casting. There were no pin track problems, and the break progressed to complete union   ."
"How long did you treat Mr. Kealoha following his discharge?"
"Until removal of the cast. Though advised to continue therapy, the patient kept no appointment after that. During his final visit, he complained of slight residual subtalar joint stiffness."
"Do you have Mr. Kealoha's X-rays?"
Tight nod.
"May we compare Mr. Kealoha's left lower leg films to those taken from our unknown?"
Utagawa rose and strode to a wall-mounted light box. Perry and I followed. A large black square had already been clamped into place.
As Utagawa flipped the switch to illuminate the fluorescents, Perry withdrew her X-ray and popped it beside that which Utagawa had ordered in 2003. Utagawa straightened both.
We all looked from antemortem to postmortem and back, and back again, comparing details of bony architecture and microstructure.
Everything matched. The shape and robusticity of the malleolus. The diameter and contour of the medullary cavity. The density and orientation of the trabeculae. The number and positioning of the foramina.
The size, depth, location, and angulation of the traction pinhole.
"Oh, my." Utagawa spoke for all of us.
Minutes later, Perry and I were wending through the parking deck. She now carried two large brown envelopes.
"Lô and Hung plan to canvass Gloria Kealoha's neighbors?" I asked. "See if Francis was known in the neighborhood?"
"They're on it as we speak. If someone recalls Kealoha dropping from the radar, maybe they'll remember a pal vanishing at the same time. A twofer would make my job a hell of a lot easier. And God knows I could use a break. My ass is in a sling over the Halona Cove closing."
"Who's unhappy?"
"Everyone."
Wishing Perry luck, I headed to my car.
There seemed little point in returning to the CIL. Ryan and Lily were in Turtle Bay.
I dialed my daughter's cell.
Katy was pumped. Her new blog post had stimulated a lot of response. She wanted to stay with it for a couple more hours, then she'd be up for some beach time.