Red Flags Redux

Author’s note: The first iteration of this story was graciously selected by Chuck Palahniuk for his House Call series, #18. This go-around is the thoroughly considered culmination of chasing a thousand wild horses in hopes of saddling one raucous mount.

Andrew Shick leaned on the stainless-steel table looking down at the naked body. For the life of him, the usual excitement he felt in these initial moments, the almost giddy nervous buzz in his chest, had abandoned him completely. The human being lying in front of him was breathtaking, as they all were to him. His usually meticulous, thorough attention was only partially there.

Andrew could not get his last date, Jamie, the seemingly perfect woman whom he’d spent hours with, out of his head. The one woman who was genuinely interested in everything he had to say and sat close enough all night that some part of her body touched his and he could feel her warm breath when she laughed at his jokes.

Everything about her haunted him relentlessly. Jamie Dyer, he’d say to himself dozens of times a day. Standing at the microwave waiting for pizza rolls, piling dishes in the sink, trying to stuff one more empty cereal box in the full garbage. He could still smell her on the clothes he wore that night and hadn’t yet washed. Her face and mindblowing sexuality would come to him in the shower and he would get an immediate hard-on. It had been three weeks, and he hadn’t heard a word from her. It shouldn’t have been surprising, but this time was different. He knew it in his bones.

Historically, Andrew had an unreasonably hard time in the romance department. It wasn’t for a lack of securing first dates. He had formulated a rotation of various dating apps, of which there seemed to be a fortuitously growing roster, to keep the dating pool from getting stale, and between his better-than-average looks, self-effacing humor in his profile, and Pathologist listed as his occupation, matches came about as fast as first dates, and the occasional second, were exhausted.

A great deal of Andrew’s struggle arose from his affinity for talking about his work, whether asked by his female prospects or not, and his work, at least the parts he enjoyed most, was considered by the acceptable human standards as morbid at best, borderline sociopathic at worst. Once online matches made it out of the virtual and met up at a restaurant, bar, coffee shop, ice cream stand, public park, or, once, a zoo, Andrew was a walking red flag almost as soon as initial pleasantries were exchanged and his dates shifted topics, with gross miscalculation and misunderstanding of medical specialties, “Pathologist, huh? Must be so fulfilling to save lives.”

Andrew had worked in the same hospital in Buffalo since he left his job as a Verizon sales associate at the local mall just out of college. A family friend who worked in Orthopedics had told him that the Pathology department was looking for a diener and would train the right person. No medical degree needed.

“Diener?” Andrew said.

“Yeah, the guy who does autopsies in the morgue.”

“No kidding.”

“It’s a pretty cool opportunity, if you’re into it,” the family friend continued. “I know you’re a nut about that CSI show and studying dead bodies for clues and all that. If you want to get into the field, this is about as fast-tracked as you can get. And no med school required. It’s all OJT.”

Andrew gave the friend a questioning look.

“On-the-job training.”

“Ohhh. Gotcha.”

The friend was right, he was obsessed with the show and had dug into his fascination with anatomy and physiology, chemistry, and biology at a local college that unlocked a world of exhaustive professional research and practice-based possibilities.

“They call them posts, the autopsies. Short for postmortem,” the friend said. “They pay something like $100 per. I can get you the contact for the head of the Pathology lab, if you want. I’ll put in a good word for you.”

Andrew shook the molasses from his head, inhaled deeply through his nose, and let out a groaning exhale. Fucking Jamie Dyer. He pulled a disposable plastic apron over his head and tied it off around his waist, snapped a pair of black latex gloves onto his hands, and rolled a cart with his array of autopsy tools — #10 and #60 scalpels, pruning shears, forceps, and two stainless bowls — organized on an instrument mat closer to the table.

“Sorry, Francis,” Andrew said to the body and adjusted the overhead light. “A bit distracted today. Woman troubles. Go figure, right?”

He surveyed the spent, gray body. The atrophied limbs, dozens of scars, pot belly, tiny acorn penis and deflated testicles, gout-wrecked feet, and unclipped yellow toenails. Andrew leaned over the man and searched the wrinkled, sunken, and bristly face. A blank, inert palette, like hundreds of bodies before, full of answers to not yet asked questions. “Don’t worry, old man. I’ll pull it together.”

Andrew’s fascination with and aptitude for autopsy procedure had made him a quick study. From initial Y incision and cracking open the chest cavity to flaying all twenty-five or so feet of intestines and locating and excising the adrenal glands to removing the heart, lungs, and esophagus en bloc for the Pathologist and discarding the viscera into a biohazard bag lining a bright red five-gallon pail to sewing the incision shut, cleaning up the body, and returning the empty vessel to the large walk-in cooler.

Andrew had found a rhythm to the work. Almost waltz-like as he moved from step to step around the stainless-steel table and its anatomical wonders. Every body was different in spite of every body having basically the same guts. His amazement never waned, even on days when he was back-to-back for twelve hours straight and had to eat his lunch on the fly at his desk in the morgue.

Within a month after his first post, he was performing procedures without the oversight of actual Pathologists who collected samples from the organs he removed. Andrew was efficient, precise, thorough, and oftentimes pre-empted doctors’ requests by identifying whatever bodily element needed scrutiny and taking samples himself, which the docs could simply collect and say thanks on their way out.

Within a year, he was covering shifts at the Medical Examiner’s Office, where he was actively part of law enforcement investigations into all suspicious or outright grisly deaths. Gunshots, stabbings, poisonings, ODs, hit-and-runs, asphyxiations, falls from great heights. Andrew’s powers of observation and insatiable curiosity made him a priceless asset. He didn’t miss a thing. Except for social graces.

Andrew once tried to illustrate the size and location of a tumor in a 54-year-old woman who occupied his table by making a fist and carefully pressing it snugly under the left breast of a stunning, and stunned, redhead while they waited for a table at a quiet little Italian restaurant, prompting her to announce she had forgotten to call her boss about a deadline, she’d only be a minute. She walked out. Andrew ate an amazing chicken parm alone.

“I’ve been so damn out of it, Francis. I’m not sleeping well. I’ve crashed over there lately.” Andrew rested his right hand on the table, holding a #10 scalpel, and nodded past the body toward a reclining hospital chair and blanket he snuck from the maternity ward. “I haven’t been to my place in days. The formalin in the air down here totally screws my sinuses, and Herman’s probably thirsty as fuck.”

Herman, a monstera, overstuffed a corner of his apartment near his turntable and vinyl collection. The tropical climber was a well-intentioned housewarming gift from the matronly head nurse in the Pathology lab, and roughly a quarter of its current size. “Every young man should have a plant to care for,” she winked. “It’s good for the soul. And the girls like them.”

She had no way of knowing Andrew’s awful luck finding his plants a female audience, or that he had inherited an affinity for plants, which hung in front of the window over his sink and lined the windowsills in the living room and bedroom, from his mother, who once confided they were a little burst of life she grew to spite a marriage that was dead.

Andrew sighed over the body. “Okay, this is gonna hurt you more than it’ll hurt me. Just kidding, Francis. You won’t feel a damn thing.” He rested the scalpel on the outside knot of the left collar bone. The skin was flaccid and paper-thin. Fluorescent lights hummed, and the condenser for the walk-in cooler droned softly and then stopped. “I’m the only one here feeling anything.”

As he started to apply pressure, Andrew stopped and lifted the blade. “Seriously. Why me? Why? After all the shit I’ve been through, why do I keep getting the short end of the stick? You know what I mean, Francis?” Andrew patted the man’s cheek patronizingly. “Of course you know.”

He returned the blade to its starting point, reapplied pressure, and the skin parted right down to the ribs in a perfect, blank line to the bottom of the sternum. Andrew repeated the stroke on the right side and then opened a third seam a little faster and more aggressively from the sternum to just above the sparse tuft of gray pubic hair. Andrew stood upright and stared into the distance.

“I mean, the date couldn’t have gone any more perfectly. Jesus,” he sighed. “I’ve replayed it a million times. Our chemistry was ridiculous. I just don’t get it.”

Andrew had been mostly seated on a wood-backed vinyl-cushioned stool with a draft beer in an unfamiliar bar, half turned between the bartender and the dimly lit area of tables and chairs occupied by a scattering of people and two pool tables in an adjacent room when Jamie Dyer walked in, making a slow, deliberate beeline toward him. He turned fully in her direction.

“Andrew?” she said from two steps away and closing.

“Yeah. Jamie?” He recognized the needlessness of asking her name, since she obviously had identified him as the man she was meeting. She stopped close enough in front of him that her hip brushed one of his knees. Andrew felt his face flush hotly. Jamie smiled.

“Never been to this place,” she said, looking around, her hip now pressed full against his knee. “I’ve heard about it. I mean, it’s townie, but I like it better than being tits-deep in a crowd of entitlement and small dicks in expensive clothes.”

Andrew was momentarily stunned by her frankness. He was also caught by the body that seemed to flow from her full hips and thin t-shirt that hinted at a peach bra to her gentle, long neck and carelessly pulled ponytail. Good. Lord.

Disappointment rushed him, and his shoulders dropped a little. This woman was so far out of his league, he doubted if they were in even the same universe. Dammit, he said to himself. I know exactly how this is going to go.

As if sensing the defeat starting to creep into him, Jamie turned and nudged his other knee with her other hip.

“You’re not entitled or have a small dick under those jeans, do you?” She lowered her chin an inch, smiled again, and met his surprised look with a wink. “I’m just kidding with you. Be right back. I have to pee.”

Andrew watched her saunter past the pool tables and turn a corner. He shook his head and looked at the bartender, who smiled and shrugged.

Jamie returned, slid onto the stool next to Andrew, and motioned to the bartender for the same beer as Andrew. She cut directly to the chase. “So, what exactly does a Pathologist do?”

Over time, Andrew had crafted a gentle delivery of what his occupation consisted of on a daily basis. Even though results never varied, and never willing to outright lie about his work, he at least felt as though he tried to soften the inevitable blow. After all, he wanted to meet someone who accepted him as is. Someone who embraced honesty, warts and all.

In a moment of nervous courage, he decided to shoot his shot and test just how bold Jamie was.

“Well, I deal with dead bodies every day.” Andrew spoke in a voice he hadn’t ever heard issue from his mouth. Slightly deeper, confident, almost no-bullshit in how soundly it resonated. “At the hospital morgue in the city and the Medical Examiner’s Office. Been at it for eight years.” He took a swig from the pint, keeping his eyes fixed on hers, expecting the inevitable look of disgust.

“No shit?! How cool is that!” Her face lit up with genuine surprise and enthusiasm. Andrew almost spit out his beer.

“Like, actual dead bodies? Naked, cold, lying on a table, dead bodies?” She leaned toward Andrew with a hand on each of his knees, smiling and excited.

“Uh, yeah.” Andrew suddenly found himself in almost paralyzingly unfamiliar territory.

“Okay, that’s wild. I’m seriously intrigued.” Jamie sat back, whistled, and reached for her beer. “What’s it like? I mean, you cut them open and, like, put your hands in their guts, yeah? Are they ever still warm?”

“Uh, well, I’d say ninety percent are cold. They died the night before. They’re almost all pulmonary embolisms or myocardial infarctions.” Andrew was back in comfortable conversational territory. “You know, throwing a clot after surgery. Once in a while, we have to take out a brain. Now that’s an intense experience. Pretty rare, though. I’ve done ten in eight years.” Andrew leaned an elbow on the bar. “Head, heart, or lungs. Those are the three ways everybody goes.”

Jamie considered his statement for a second, as if she was looking at the TV hanging across the room. “Head, heart, and lungs. Huh. You’re right, taking out any of those is ultimately what does it.”

“Warm bodies are rare, though,” Andrew circled back to her original question. “Unless they died that morning. But people mostly tend to die in the evening or in the middle of the night. Not exactly sure why. When it comes to stuff at the Medical Examiner’s, they’ve always been in the cooler a while before they reach the table.”

“So, what does it feel like? The scalpel into flesh, opening the ribcage, holding organs that were working perfectly well just hours before.” Jamie said. “Don’t you kind of feel like a god or some sort of powerful being?”

“I feel amazed, mostly,” Andrew shrugged. “It’s mindboggling to think that in the tangled chaos an open body looks like at first, there is a perfect, intricate system that, somehow, worked. It sustained life. And I’ve got the same perfect, intricate chaos inside me. So do you.”

“Perfect, intricate chaos,” Jamie repeated. “I love that.”

Andrew’s face flushed hot. “I don’t buy into the whole life is short thing, but I do appreciate what it takes to be alive.” After a half-second, he blurted, “And I have lots of plants. I love plants.”

Oh my god. I love plants? You dumbass!

“Good to know,” Jamie giggled.

In that moment, Andrew vowed he would spend the rest of his life being alive with this woman.

Hours had passed with Jamie asking questions about things like the position of organs in a standing body versus sitting versus lying down, abnormal anatomy, and the various steps of the brain-removal procedure. Andrew happily answered her questions. It wasn’t last call, but the bar had emptied except for the two of them and the bartender.

“You didn’t go to med school, huh?” Jamie said. “I’d have thought that would be, like, required to do what you do.”

Andrew frowned slightly. “Was never in the cards. If I moved away, it would’ve killed my mom. My dad is a mean drunk who blamed everyone but himself, as he constantly reminded us, for a lifetime of shitty bosses, a terrible wife, and a useless son. He beat the hell out of both of us. Mom got it worse, though. That’s how I was conceived. He’s like ten years older than her. If I wasn’t there, she’d be dead.”

“That’s fucked up, Andrew.” She put a hand on his shoulder.

“He’d come home from work loaded and start in on us, and I’d “accidentally” drop dishes, spill shit, throw a ball through a window from the yard, leave doors open so the flies and mosquitos got in, block the driveway with the garbage cans, play music too loud. Anything to keep him focused on me and not my mom.”

Jamie gave the bartender the high sign. “Hey, you want to do a shot? Let’s do a shot.”

“You know that old piece of shit has a collection of drink chips? A huge glass jar with years of them. It’s his prized possession. Like some fucked up trophy of the only thing he’s good at. Mom’s still stuck there, but he’s getting old and his lungs are shot from smoking, so now all he does is yell at her. I still can’t bring myself to leave.”

Andrew paused. “Sorry, I don’t know why I’m spilling my guts about all this. Hell of a first impression I’m making.”

“Here.” Jamie slid a shot of tequila in front of him. No lime or salt. “Cheers to online dating.”

“Ha. Seriously.” Andrew downed his and inhaled sharply. “Thanks for that.”

They sat silent for a minute. Andrew slid his shot glass in circles in tequila that missed the mark when the bartender poured them.

“So, what’s the most interesting death you’ve dealt with or heard of?” Jamie said.

“I mean, they’re all interesting to me,” Andrew said. “Nothing stands out more than another. But I did talk to another Medical Examiner at a conference in New Mexico last month about a case he had that blew my mind.”

“Oh yeah? Was the case in New Mexico?”

“Yeah. Las Cruces. State Troopers found a body in a hotel room. Fully dressed. Laid out on the bed. Looked like it might’ve been an overdose. They found a couple empty bottles of tequila and some meth.”

“You mean fentanyl?”

“Huh?”

“Oh, sorry. I just thought an OD would go for a double downer. Go on. Dead cowboy in a hotel.”

“Right. The ME was in the process of a standard autopsy when he found a single puncture wound just below his left pectoral muscle. One inch wide. Initially, he thought it was a scar since there was no blood.”

Jamie crossed her legs tightly, slid to the front edge of the stool, and leaned an elbow on the bar. “Oooh. The plot thickens!”

“The wound track was eight inches deep. When he opened the chest cavity, he found the pulmonary arteries and the vena cava severed clean. Not a scratch on anything else. And there was no blood pooled in the chest cavity. Zero. A single incision in the diaphragm let the blood pool in his belly. I guess there have been five or six other men reported in multiple states with the same COD.”

“There are more than that.”

“What?”

“I mean, if it’s a serial killer, there has to be more than that, don’t you think?” She uncrossed her legs, opened her knees, and leaned closer to Andrew. Her breath was hot on his face.

“Yeah, I guess so. They have no other evidence to go on. The killer’s a ghost.”

“Hmm…a killer that literally breaks hearts and…ghosts.” Jamie laughed, sat up and arched her back, rocked her hips slowly on the stool, and ran her fingers through the hair at the nape of her neck. She looked beggingly at Andrew. “What else? Tell me more. Those cuts. I mean, they’d have to be from some sort of dagger, right?”

Andrew was overrun and completely befuddled by the undeniable sexual tension emanating from Jamie. He could see, plain as day, that she was turned on, which sent a flood of dopamine directly to his crotch.

“Um, yeah. Exactly. They said it would’ve had to be a razor-sharp, straight dagger. But the exactness of the internal cuts…they were flawless. Elegant,” Andrew gushed. “They guy had some pics on his phone. Pure artistic mastery. A once-in-a-lifetime thing to see in person. I was actually jealous of the guy.”

Jamie closed her eyes, bit her bottom lip, shuddered with a soft moan, and let her hand run from her neck, over her breasts, and fall into her lap. Andrew had broken into an uncomfortable sweat and leaned forward to hide some obvious excitement of his own.

The bartender appeared and placed two more beers with a big smile. “On the house. You’ll have to go outside if you wanna smoke, though.”

Jamie laughed, flipped her hair back, and sighed deeply. They both took several deep swigs from the beers.

Jamie burped unexpectedly and loudly. “Sheesh! Sorry about that. Came out a little hotter than expected.” She leaned on the bar. “Have you ever autopsied someone you knew?”

“Nope, I haven’t.”

“Would you, like, recuse yourself if you knew the person?

“I don’t know. I guess it would depend. I can dissociate really well, so I could probably do it.”

“Eeeenteresting.” Jamie winked and paused for a couple seconds. “I could do this all night, Mr. Shick.”

“Well, I don’t go in on Saturdays till ten o’clock.”

“And you have plants.” She nudged his foot with hers.

“Jesus. Yeah. Plants.”

“Unfortunately, I have an early call with my boss.”

Andrew flinched. “Right. Phone call. Got it.”

“No, seriously. I’m in medical device sales. I’m headed to Wichita Monday. My boss always schedules these stupid weekend check-ins.”

Andrew realized, in all their hours of talking, she had led the entire conversation. He had never had a chance to ask her about anything related to her. She was a total enigma.

Jamie slid closer to him, squeezing both of his knees between hers and placing her palms gently on either side of his face. “Meet me here tomorrow night?”

Before he could answer, she leaned in and kissed him on the mouth, then whispered, “See you tomorrow,” and walked out.

“She fucking walked out, Francis, and I haven’t heard from her since. You realize, Francis, that I blame you for all of this, don’t you?” Andrew leaned in, pressed his knuckles heavily on the table next to the body, a scalpel closed in one fist like a dagger, and placed his face an inch from the man’s liquor-pocked nose. His ears rang behind fast pulses of blood. “I ought to fucking take you apart. Reduce you to nothing like you did mom and me, Francis.”

Andrew stood up and raised the blade. “You got off so easy, you asshole. Choking on your own phlegm. Drowning in fucking snot.” He punched the blade through the ribs into a lung and left the scalpel where it was buried.

Then he noticed it. An almost imperceptible scar at the base of his withered pectoral muscle that had opened slightly after his fist compressed the chest. Like a tiny mouth exhaling.

“Holy fuck.”

Andrew’s limbs and head throbbed numbly for a few heartbeats before the pinpricks, and then euphoria, exploded. His entire catalog of professional fascination, curiosity, diligence, passion, and undivided attention crackled back to life. The room was suddenly roaring and bursting with white light.

“Holy fuck!”

With instant laser focus, he pulled the scalpel carefully from the chest. No blood. He didn’t need to peel the skin back from the torso, cut the ribcage free with the pruning shears, and look at the heart in its diseased nest to know the breathtaking artistry he would find. His once-in-a-lifetime had, somehow, reached his table. The fact that it was his father made the gravity of the situation almost intoxicatingly satisfying. Like several birds with one stone, the monster was gone, his mother was free, and he had the autopsy to end all autopsies in one fell swoop.

Having composed himself after several minutes of walking in fevered circles around the white-tiled room, crying tears of colossal relief and joy, Andrew stepped back to the table and started to examine the entry wound.

As he manipulated the skin around the cut, he felt something solid just under the skin. He adjusted his light, grabbed the forceps from the mat on the rolling cart, gently penetrated the wound, pinched, lifted, and then dropped the perfectly clean, green drink chip in one of the silver bowls.

One second was all it took before the smile swept across Andrew’s face. “I told you, Francis. Our chemistry was ridiculous.”