The Doctor of Mercy County

My name is Simon Ashby, and for nine years I have practised medicine in San Francisco, the last six of them at a walk-in clinic on Geary Street that serves anyone who comes through the door with a problem and eleven dollars. Before that I was a battalion medic, which taught me two things: that a body keeps its own ledger of what has been done to it, and that most people would rather be told a comfortable lie than an accurate description of their own condition. I have never been able to supply the lie. It has cost me patients, and it has kept my practice small.

The twenty-fifth of October was a Friday of the kind this city produces in autumn, when the fog comes in off the ocean at four in the afternoon and sits over the avenues like a wet blanket until the following noon, and every second patient sits down and apologises for the weather before describing the thing that is actually wrong with them. By seven I had seen twenty-six people, signed four disability forms, set one broken wrist, and sent a boy of nineteen to the county hospital with a fever his mother had been treating with prayers and aspirin for a week. I was standing in the small back room we call the office, eating a sandwich over a stack of lab results, when I heard the front door open again and the sound of a woman's shoes crossing the waiting room with purpose.

"You're still here," she said, in the doorway. "Good."

She was somewhere in her sixties, built low and square, in a canvas coat that had seen weather and a knitted scarf that somebody who loved her had clearly made for her. She had a doctor's bag of the old leather kind that is now sold as a decoration and occasionally used as the real thing, and a tablet computer tucked under her arm as though it were a newspaper.

"Dr. Cray," I said. "Willa Cray. From up north."

"You have heard of me."

"I read your letter in the Journal of Forensic Medicine in the spring. The one about hypothermia in the elderly and the way the county coroner's offices misclassify it. I have quoted it twice this month."

"Then you'll do." She set the tablet on my desk and sat down without being asked. "I need your friend."

I put the sandwich down. "I have several friends. Which one?"

"Ronan Varley."

I should explain, since the reader will not have met him and there is no useful description of Ronan Varley that does not sound like an advertisement for a service that does not exist. He was fifty-two that autumn. He had been, by his own cheerful admission, a hospital orderly, a newspaper stringer, and for three years a civilian analyst contracted to a state bureau of investigation, from which he had resigned in circumstances he described only as mutually agreed. He now made his living as what he called a consultant, which in his case meant that people who could not go to the police, or had gone to the police and got nothing, came to him instead. He worked out of a two-room office above a print shop on Balboa, and he charged by the case, and sometimes not at all. I had met him four years earlier when a patient of mine died of an overdose that I was certain had been administered by somebody else, and the police were equally certain that it had not; Varley had proved me right in nine days and had never once mentioned it afterward.

"I can give you his number," I said.

"I don't want his number. I want him to come north." Dr. Cray folded her hands. "And I want you to come with him. You're a doctor. You'll see what I saw. He'll believe you."

"Believe you about what?"

She turned the tablet around and pushed it across the desk toward me. On the screen was a photograph, taken with a phone, of a man lying on his back on a gravel path in what appeared to be a garden. He was fully dressed, in a good coat and a scarf, and one of his shoes had come off. His arms were at his sides. His face was turned three-quarters toward the camera, and the expression on it was not the slackness I have seen on a few hundred dead faces. It was terror, entire and unmodified: the mouth pulled open, the eyes wide and the brows raised, every muscle in the upper face contracted as though he had gone into that state at full attention and stayed there. The skin had the grey waxiness that comes with death and the cold.

"Ambrose Vandermeer," she said. "Seventy-four. Founder, in a sense, of everything this county has. Found at nine-forty on the evening of the twentieth by his housekeeper, on the lower gravel walk at Harrow Reach, forty yards from his own back door. I was called at ten-twenty because the paramedics could not get a rhythm and the deputy on duty knew he had a dead man and wanted a physician to say so out loud on the record."

"You signed the certificate."

"I signed the certificate." She said it flatly, as a statement of fact that was also an accusation. "And then I went home and did not sleep."

"Cause?"

"Cardiac arrest. Which is another way of saying his heart stopped, which is another way of saying nothing at all." She reached across and moved the photograph with two fingers, dismissing it, and brought up the next. "This is why I did not sleep."

The second photograph had been taken in daylight, presumably the following morning, and showed the same path from a low angle, with a measuring card laid on the gravel for scale. In the card's field of view, pressed into the soft ground at the edge of the path where a border of low shrubs had been cut back, were two prints.

They were the prints of a dog. There was no question of it: four pads and the blunt double lobe of a heel, the nails showing at the front. But the scale was wrong. The measuring card beside them was printed in ten-centimetre blocks, and the prints sprawled across more than two of them, lengthwise, from the front nail to the back of the heel.

"The pads alone are a hundred and eighty millimetres front to back," I said. "That is three-quarters of the length of my own hand, and the whole print, with the claws, is two hundred and ninety. Nothing that walks on four legs in this state makes a mark like that."

"Twenty-nine centimetres front to back, including the claws," said Dr. Cray. "I measured them myself with a tape and photographed every one. There are five of them, and they are all the same, and they are all going in one direction, which is away from the body."

"Away from the body." I looked at her. "Something was standing over him and walked off."

"Something walked off, yes. And here is the part that kept me awake." She tapped the screen. "The gravel walk is raked. It is raked every morning by the groundskeeper as though it were a tennis court. So the prints are not old. They were made after the last raking and before the dew set — which puts them within an hour, either side, of the moment the man died. There is no collar, no tag, no chain, no leash, no handler's prints anywhere in the garden. There is no dog of that size registered anywhere in Mercy County. I have checked every kennel licence, every vet practice, every animal control record for forty miles. Dr. Ashby." She let her hands fall into her lap. "There is no such dog."

I sat back and looked at the photograph of the dead man again, at the ruined face.

"You are about to tell me," I said, "that the last of the Vandermeers was frightened to death by an animal that does not exist."

"No," said Willa Cray, with a certain dry satisfaction. "I am about to tell you that the last of the Vandermeers was frightened to death by an animal that does exist, and that everybody in Mercy County knows exactly which one it is, and that my professional colleagues have been writing 'cardiac' on certificates in that family for a hundred and forty years."

"Meaning what?"

"Meaning that when I went back up the hill the next morning I did not go alone. I took my neighbour with me, because I wanted a witness who would not be embarrassed to say what he thinks. His name is Mr. Penhale, he is eighty-one years old, and he has fished and cut turf on that coast his whole life, and he looked at those prints for a long while, and then he straightened up and he took off his hat, and he said to me: 'Well, doctor. It's come for another one.'"