Human Remains for Valentine’s Day: Chapter 2

I hardly celebrate Valentine’s Day. It’s not that I’m against romantic love; I figure one of the ace cards in my life is that I met Matt in high school and didn’t waste a few decades finding the right person. (This is us, struggling to say goodbye before he flew off to Greece on a school trip. Our friend Zygo took a picture of us through the bus window.)

So I’m not going to bludgeon you with flowers. Instead, I’m going to give you anatomical hearts and
circulation pictures and the second chapter of Human Remains, because nothin’ says romance like trying to resuscitate a dead body in the snow. This book is almost ready to rock and roll! Let me know if you want to be part of my “street team,” reviewing an advance copy.

And if you want to read Stockholm Syndrome first, they’re down to their last two copies at Librairie Paragraphe Books! Go grab it in the next 24 hours, support an indie bookstore, and rebel against the norm by reading about a hostage-taking while everyone else.

Human Remains

Chapter 2

The body wore a shiny, new, navy ski jacket. It lay crumpled on its left side, its black-jeaned legs slightly bent, and one arm rolled up underneath it, while the other arm hung forward, half-blocking the chest. Its skimpy black gloves and beat-up Converses didn’t look like much protection against the snow.

But of course, the most shocking thing was the black bag over its head.

Ryan stood frozen. His breath spun into the air, making white clouds in the night.

Roxy bent her head, tipping her floppy ears forward. Her nostrils flared and glistened under the dim light of the streetlamp.

“Let me check it while you call 911,” I said to Ryan. Even as I spoke, he pulled his phone out of his pocket. With the other hand, he reeled Roxy’s leash in tight to his body. He yanked off his left glove so he could work the buttons while watching the body.

If this was a crime scene, I shouldn’t touch anything, including the bag taped around its neck.

But I was a medical doctor.

Okay, a resident doctor. But still. My job was to make sure he was alive.

And if he wasn’t, my job was to bring him back.

There’s a saying in medicine, “They’re not dead until they’re warm and dead.”

Snow meant zero degrees Celsius or lower. This man was definitely not warm and dead.

I swallowed hard.

I had to do my job.

If only I could do my job with gloves and a face mask.

I crouched low. “Hello?” I raised my voice to be heard above the traffic, including the stuttering roar of a helicopter. Normally, I’d shake him, or do a sternal rub, but I didn’t want to touch the body.

More snowflakes landed on the jacket.

The bag didn’t flutter with the man’s breathing.

No airway. No breathing.

“Hope, he’s—” Ryan didn’t want to say it, but we both knew he was thinking the D word. Not Disability, but Death. “Don’t touch it, Hope.”

If only I had an ultrasound machine to do a sono pulse check, looking for a beating heart, instead of going skin to skin. “Just the radial artery,” I said. I reached for the closest arm, the right arm, sheathed in the painfully new ski jacket.

The wind carried Ryan’s words toward me as he spoke on the phone. “Ambulance. But maybe police. We found someone with a bag over his head. He’s not moving. He looks…gone.”

I touched the man’s sleeve first, through my mitten. His arm felt firm, even with that light touch, and it belatedly occurred to me that I didn’t have to check for a pulse if the man had rigor mortis.

The arm resisted me when I lifted it. It did move, but only a few centimetres before I’d have to apply greater pressure. The muscles had seized up. But it didn’t feel locked-in, like I imagined rigor mortis would.

On the other hand, it was literally freezing outside. Was I feeling rigor mortis, or one very cold person?

I didn’t trust my numb hands to undo the black tape around his neck, and surely there might be fingerprints or hair trapped in the tape that constituted police evidence, if this was a homicide.

I yanked off my mittens and used my nails to lift a bit of the right sleeve and expose the skin. In the dim light, I couldn’t detect bruising or obvious lacerations on his dark brown wrist.

Since I didn’t have any open cuts or sores either, it was probably safe to touch him bare-skinned.

Ryan was giving directions. “We’re near the corner of Lindsay and Bullock. Yes, just south of the hospital. My girlfriend is a resident doctor from Montreal. She’s checking for a pulse.”

I slid my hand just inside the radial styloid, pressing hard to compress the artery against the bone and maximize any pulse.

His skin felt slightly cooler than mine, but not icy. Faintly warm.

No pulse.

The radial pulse is the first to go. Unless you’ve got a blood pressure of at least 80 millimetres of mercury, the body shuts down circulation to the arms.

The blue lights of a police cruiser raced up Lindsay Lane toward us, its siren splitting the air.

“Ryan,” I hollered, above the din, “there’s no radial pulse.”

Roxy barked twice and jumped onto her back legs. I sucked my breath in. Nice dog, but she was still a Rottweiler who wanted to snack on a dead body, as far as I was concerned.

“No radial pulse. That’s right, no radial pulse,” Ryan yelled into his phone while winding Roxy back into place beside him.

“I’ll have to open that bag over his face!”

“What?” Ryan frowned at me, trying to triangulate between 911, Roxy’s antics, and my voice.

I enunciated short, hard sentences. “The bag over his head. He can’t breathe. Do they want me to rip it open?”

Ryan’s eyes were so wide, I could see the whites glowing under the street light. “What? No, Hope, he’s dead. I think they want you to leave it for the police!”

I was already reaching for the bag, bracing for myself for whatever sick smell that would balloon out at me as I tore it. “Just ask them. He’s still warm.”

“Uh…my girlfriend, the doctor…she’s worried about the bag over the head. Do you want her to take it off?” He shook his head. “Yeah, he looks dead, and he has no pulse, but he’s still warm…yes, I’ll hold.” He glared at me. “Hang on a second.”

I nodded. In the ER, the staff and I could make the decision, but in the field, at what could be a crime scene, with the police car screeching to a halt on the other side of the street.

I stood up, and my vision started to blacken at the edges. I hadn’t eaten much today. Too busy packing and driving from Montreal through the snow. I blinked, waiting for my vision to come back. I’d never fainted in my life. I had no intention of doing so over a corpse.

“Hope, they said not to touch the bag. Hope? Are you okay?”

“Fine,” I said, too loudly. My vision was starting to clear. “I’ll do CPR.”

I donned my mittens to nudge the body onto his back. He wanted to stay curled up. Ryan had to hold down the shoulder while I twisted the hips flat on the ground.

I dropped to my knees, interlaced my fingers, and extended my arms to begin CPR. The new Advanced Cardiac Life Support algorithm is all about CPR. Get that blood pumping. Even if he’s hypoxic with a bag over his head.

His ribs cracked under my first compression.

I’ve never broken anyone’s ribs during CPR. It’s one of the risks of CPR, but it’s never happened to me.

I could be puncturing his lungs with his own ribs, with each compression.

I swore.

“Over here!” Ryan’s cry pierced the night air. Roxy barked ferociously as a police officer bolted across the road toward us.

Another siren whooped.

The first police officer yelled on his radio while I continued compressions, gritting my teeth.

Roxy barked and leaped in response. Ryan had to beat a retreat, holding her back.

A second officer sprinted to my side and took over CPR while I checked for a pulse in the wrist. It was strong, thanks to his efforts.

“Good compressions. Can I take off the bag?” I pointed at the garbage bag.

Sweat trickled down the side of the CPR officer’s face as he pounded the man’s chest. He shook his head and glanced at the officer on his radio, possibly for a second opinion, before turning back to his compressions.

Two more officers crunched through the snow toward us, already calling on their radios for more back up, but I was most relieved when an ambulance jerked to a halt on Lindsay Lane.

Paramedics hustled to the scene with a stretcher, a kit, and a monitor. One of them sliced open the head bag with scissors, reminding me that it’s better to ask for forgiveness than permission.

The sour smell of vomit hit the air as chunks fell out of the bag hole. I held my breath while the other paramedic cut open the jacket to apply electrodes to the man’s chest. Yes, it did look like a man. No breasts.

The CPR officer was gasping, so I said, “Do you want to switch off?” He nodded, and I signalled another officer, who ran in, dropped to his knees, and started compressions so enthusiastic that the man’s slim, dark brown-skinned chest indented with each one.

We paused for a second to check the rhythm: an occasional narrow complex at 30 beats per minute. No pulse.

Hypothermia is one of the causes of pulseless electrical activity. So is hypoxia.

“Restart CPR! And I can get an airway in!” I called, moving to the head, but the airway guy was already on his stomach, shoving what I assumed was a laryngeal mask airway or a Combitube into the man’s mouth. It was hard to see what was going on, in the dark, with everyone shouting on their radios, and Roxy still barking up a frenzy.

“Got it!” called the airway guy.

“Great. Let’s get him warm and oxygenated. Can you get a sat?” I turned to stare at the yellow tracing on the monitor, which was just showing the jagged movement of compressions right now.

“It’s not picking up, but the CO2 detector is yellow.”

“Good job! Give him an amp of Epi!” I said. We had airway and we were providing primitive breathing and circulation. Epi is controversial in hypothermia, but you can give one dose.

“Let’s load him up and protect his C-spine,” said the second paramedic. I helped lift the legs on to the stretcher while they managed to get a cervical spine collar on him and some pads on either side of his head. A third officer took over CPR.

“I can take over compressions,” I told the CPR police officer, even though I’ve never done them while jogging along beside a stretcher, but he shook his head.

The patient’s belly looked distended. I opened my mouth to mention a nasogastric tube, when they had the chance, but a female police officer took my arm and said, “We have some questions for you. Could you come to the station with us?”

#

While you’re waiting for more Human Remains (deeeeelicious, I tell you), check out two mega-giveaways: science fiction and fantasy (I’m giving away Fairy Tales Are for White People!) and mystery/thriller (I’m giving away Code Blues, the first Hope Sze novel, in hopes that sane people will leave a good review).

Just to show you that I’m not a complete V-Day Grinch, I’ll end with another story. Remember Zygo, who took the picture of me and Matt in high school? When Anastasia was a baby, we attended Zygo’s own wedding with his lovely wife Jenny and a Tardis wedding cake. (Gosh, I miss that sweet little baby. However, I have to admit that Matt carried her around the entire time.)

Ah, love. I heard it makes the world go ’round. Of course, I’ve also heard that the earth’s spin is due to “gravitational collapse of accreting material,” but details, details.

Stockholm Syndrome debuts in Montreal! (CBC’s Homerun & Paragraphe Books)!

Yo yo yo!

The first four Hope Sze books take place in this creative, crazy, multicultural bouillabaisse known as Montreal. I’d really love to get the word out in Hope’s hometown. But how does one accomplish this? 

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It’s surprisingly difficult to take a cool selfie with Stockholm Syndrome and Paragraph Books. I had to take a dozen to be sure.

<cue the fanfare of trumpets> Richard King of CBC Radio’s Homerun will review Stockholm Syndrome tomorrow, October 19th!

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In honour of this monumental occasion, Librairie Paragraphe Books is now carrying Stockholm Syndrome for the next three months. Please run over and snag a copy!

In honour of this, I’ll be celebrating Montreal throughout the next quarter. Stay tuned for inside tips where to eat, hang out, and do yoga in la belle province!


While I was at Librairie Paragraphe Books, I bought a copy of Jessica Hagy’s book, How to Be Interesting (preview here).

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Even if you don’t read, you need Empower-mints or Manly Mints, right?

It feels fantastic to support an indie bookstore in the heart of Montreal. They’ve got kid books, travel books, gift books, literature, Louise Penny’s latest novel, pre-orders for other people that you’ll want to touch but have to be instructed to leave alone (oh, maybe that’s just me)…

I could’ve stayed there all day, except my parking meter was about to expire. Support your bookstores!

Just don’t buy the Jessica Hagy book for Alexandra Beauregard–it’s my gift to her. 😉

When you come, here are some Montreal travel tips.

Construction is terrible. Use your phone or GPS. Get a parking space and walk if you have decent legs. As I strolled down Sherbrooke, I spotted not one, not two, but four police cars crowding down the single remaining lane of traffic. You can update your parking slip through an app, and be vigilant: they love to give parking tickets.

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Finally, I checked his screen. It says “Steve Jobs is dead.” Sobering reminder.

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I met a fellow writer, even if he was a statue.

So why show up, aside from hitting up the bookstores? Well, I love the incidental art.

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Everyone wanted a picture with this guy.

 

 

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Restaurant Park’s bar

 

 

 

 

 

 

 

FOOD:

Restaurant Park (in Westmount). Just look at those orchids. I chose the bento surprise lunch to go. I was pleasantly surprised to enjoy tempura vegetables, including a piece of squash that showed they were using seasonal vegetables; maki sushi; a refreshing beet salad; and tofu with ground pork, all fresh and delicious, for about $20. Wow!

The chef, Antonio Park, has a Korean background, but grew up in Argentina, Paraguay, Brazil, and Montreal before he trained formally in Japan.

I look forward to going back. Honestly, I felt like the beet salad spoke to me. It was so simple and so good. I tried to get my kids to eat it, but they’re scared of anything unusual. I was selfishly glad to polish off every bite. I’m not generally a tempura fan (is the frying worth the calories?), but this tempura was light and intelligent, if that makes sense.2016-10-05-14-22-07

2016-10-05-14-00-54 Momesso (NDG area): I used to bring my parents here. We’d descend into the basement, stuff ourselves with 14 inch subs, and feel good about the world afterwards. Check out the decor: old-style NHL hockey pucks. That’s what I’m talking ’bout.

This time, I was working a bunch of shifts, so I bought three subs. The best was the steak and sausage ($15.25 for a 14 inch sub before tax or tip).

Cash only & closed on Sundays.

Shopping

I didn’t buy any clothes that day, but Paragraph Books is the Golden Square Mile, so enjoy:

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2016-10-05-13-26-13 This one is from Westmount, but I was like, who decides which Canadian art is important?

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Before I bid you adieu, remember that your Thanksgiving/Christmas shopping can include Stockholm Syndrome at Paragraphe Books! In case you’re wondering, this is a slightly different picture that I like better (looks like a sky-scraper in the background, slightly reddish hair my hair in the face). I fit right in on the Golden Square Mile.

And tune in tomorrow to CBC Radio One’s 88.5 for Homerun with Richard King‘s review of Stockholm Syndrome. I’m working, so please let me know if you hear it!  Thank ye kindly.

Top 5 Moments at Writers Police Academy 2016

What’s the Writers Police Academy? A hands-on conference teaching you about law enforcement, forensics, and emergency medical services.

I’m a doctor, which means I expect conferences to teach me something (it took me a long time to realize that other people go to “network” and “hang out with friends”). I can’t waste a lot of time on useless retreats. So was WPA worth flying to Wisconsin in the middle of August? You can judge for yourself, based on my top 5 teachable moments.

Trigger warning: #3 has a staged but disturbing photo.

5. Talking about Killers

Most of us know that psychopaths lack empathy and remorse. I also knew that they’re easily bored and seem to need more stimulation. But I never fully understood the difference between sociopaths and psychopaths until this lecture by Katherine Ramsland.

Both types can kill. But here’s a thumbnail version of the difference:

From the notebook of author JC Andrijeski http://www.jcandrijeski.com/

Lecture notes from the notebook of author JC Andrijeski. ASPD is antisocial personality disorder.

SOCIOPATH: I may be absolutely ruthless with outsiders, yet care about people within my group. I’m like the mafia. I can have a brotherhood or sisterhood.

The key is the word “social” in sociopath.

PSYCHOPATH: it’s all about me. No one else matters. I might pretend to care, if there’s a benefit to me. But otherwise, back to me.

The great thing about Katherine Ramsland is that she based her talk on evidence. For example, not all serial killers are psychopaths. Not all psychopaths are serial killers. Although people like to believe it’s a direct relationship because it’s simpler, you should go with science. And always keep an open mind. If you jump to conclusions too soon, it will often be the wrong one.

4. Native Gangs

This vehicle was seized from a drug dealer. Photo courtesy of author Terry Odell.

This vehicle was seized from a drug dealer. Photo courtesy of author Terry Odell.

It’s always inspiring to meet real-life heroes. Arguably, I work with them every shift in the emergency room. But it’s a different type of heroism for someone like Officer Matt, who might have to break down the door of someone from his own tribe, looking for drugs, while the kids in that house sit blank-faced, staring at the armoured police, because it’s just one more thing they have to endure. But Officer Matt comes back later to bring them a Dr. Suess book so that they remember him for that and not just the violence. He also participates in the group blanket-making every Christmas

A per capita payment is the money that each tribal member receives from casino income. It can be minimal, like for the Oneida tribe, where they pool their money for health care, education, and other services, or it can be $10,000 a month. It sounds wonderful, especially for babies who are born into the system and have the money held in trust for them until they’re 18—except that gangs have sprung up to prey on underage kids who’ll turn over their “eighteen money,” without question.

3. Blood Spatter

2016-08-12-10-12-10We spent the first part of the class talking over real-life cases. The first took place in a remote cabin. Two children, 6 and 8 years old, went down to the beach without their mother for just 15 minutes and came back crying. The cabin owner called for help, but he was hysterical and couldn’t explain what was wrong except “She needs help, she needs help.” The police officer came in with his gun out, and his job was to clear the cabin. Even if he saw someone who needed help, he had to say only, “Stay there” and keep moving from room to room, making sure that the perpetrator wasn’t lying in wait.

Once done, he could circle back to the master bedroom, where the mother had been attacked, and determine if she had a pulse.

We spent the next part of the talk reviewing the fictional staged death scene in the next room (above), trying to piece together clues.

Hint #1: always think of blood spatter in three dimensions. Don’t forget to look at the ceiling and the walls as well as the floor.

2. Shoot/Don’t Shoot

Stand up. Pick up your modified gun, which uses a CO2 cartridge to fire a laser at the screen projecting the scenario. You are now an officer on duty.

You’ve been called to a domestic disturbance. An officer meets you in front of the house and says, “We heard a woman screaming. I’m going to take the back door. You take the front.”

Walk up the front door steps. You can hear your own breathing and hear your own footsteps.

What’s that in the front window?

You see a man standing and the woman on the couch. The man turns around, and what’s that he has in his hands—?

Shoot or don’t shoot.

Now, officer!

1. K-9

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Officer and K-9 Pal, as captured by author Terry Odell, who also wrote about WPA here.

I love dogs. I love their commitment to putting their pack above themselves. I love their shagginess and their sloppiness and their big, big hearts. I will always pick werewolves over vampires.

So no wonder I enjoyed reading Robert Crais’s Suspect and the sequel, The Promise. And no wonder I jumped on the K-9’s.

Meet Pal. Purebred German Shepherd direct from Germany. Four and a half years old, 92 pounds. His officer spent six weeks in Albequerque training with him, but now every day is training. Pal can sniff out drugs, but he most loves to track people. When he gets the command to bite, he will latch on to any available body surface area, and he will not let go until you choke him off.

He lives in a $2000 kennel that Dernbach built him out of his own money. The kennel is so large that he has his own couch, which he tears up. When the couch is completely shredded, Dernbach puts it out on the curb and picks up the next curbside couch for Pal.

He is not a pet. Do not pet him. He will, in fact, attack the officer’s other, personal dogs. He stays with his officer/trainer on duty and goes home with him as well. When he’s outlived his ability to serve, there are two options: euthanasia, or the officer/trainer takes him home. Fortunately, they never choose euthanasia.

Pal is a tool. And yet, he’s still a dog. He wags his tail. He loves the chew toy, and when Dernbach gets distracted by questioning, Pal chews the strap off the chew toy. He sneaks toward Dernbach when possible. He’s independent, not cuddly. “When other guys in the station would be lying on their dogs, Pal stayed five feet away from me. But it’s good that he’s bull-headed. Other dogs will start searching and then come back and keep checking with Daddy. Pal will keep going.”

Bonus: another dog! I also loved, loved, loved Ted, the PTSD dog. If Paul, the retired cop with PTSD who became a police counsellor himself, takes off Ted’s vest, Ted knows he’s off duty. He just wanted to explore the room, taste my friend Eleanor’s coffee, and trot up and down the aisles. At one point, when students surrounded Paul with questions, Ted came up to Paul, reared up on his rear legs, placed his paws on Paul’s shoulders, and looked him in the eyes, grounding him.

We were surrounded by bullets and bombs, both literally and figuratively at this conference, and more and more in real life. That just makes me love dogs even more.

The bottom line: was Writers Police Academy worth it?

Me and Tami Hoag. Would you like to know what I learned from her? Blog here.

Me and NYT bestseller Tami Hoag. Would you like to know what I learned from her? Sleuthsayers blog here.

I go to conferences for three reasons: so I can learn, so that I can meet people, and so I can write more and better stories. I learned a lot at WPA, and it was super easy to make friends. In fact, I hung out with the guests of honour an almost indecent amount as well as making new Facebook pals and deeper friendships. I even sort of crashed a birthday party on the last night.

Want to take $100 off your $395 tuition? If you join Sisters in Crime for the first time ($50 fee) and immediately sign up for WPA for the first time, WPA will take $150 off your tuition, a net benefit of $100. Sold.

Any cautions? Obviously, this conference is oriented towards law enforcement, and most people were also vocal gun advocates. Your political views may not overlap, but in general, most people are hard-working and good-hearted.

But in the meantime, WPA is an awful lot of fun.

My little white dress

My little white dress

Click to buy.

Now available at Montreal’s Paragraphe Books!

P.S. Stockholm Syndrome–CBC’s pick for one of the best crime books of the season–is now on sale in Montreal at Librairie Paragraphe Books, thanks to the magic of CBC Radio Homerun’s Richard King! More ecstatic raving to come.

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The Emergency Doctor’s Guide to a Pain-Free Back e-book is ON SALE, 50+ percent off! $3.99 U.S./$4.99 Canadian, until October 10th. Happy Canadian Thanksgiving!