DISCLAIMER: Don't Own It, No Money Made... Just for fun & enjoyment.

RATING: M for Mature. For language and mature situations in later chapters.

A/N: Are you ready to kill me yet? I was fairly certain one of my betas was going to kill me after that last chapter. Well, let's see how many death threats I can get with this one.

REVIEWS: Thanks to all who have reviewed. I know as a reader I get frustrated with cliffhangers, but my one concession is that I have concluded to never leave people hanging waiting for the next chapter for more than a day. That's why I always make sure I have a good outline of the story and several chapters in the bank before I start posting. So, thanks for the comments, and know that I will not go away for several days or weeks without posting. :D


Chapter 12

Nick had convinced Sara to go down to autopsy ahead of him to help him out with the new medical examiner, but she was not happy about him passing off autopsy work on her. She had spent most of the week either in court, chasing dead leads on the smash and grab or working yet another burglary, so she had yet to meet the new doctor. Her shift had also started out bad (Beyond bad, she thought) before she had even clocked in and she did not think she would make the best impression after all of that. Plus, she hated being in autopsy ever since she had become a vegetarian, but for Nick, she guessed she would make the sacrifice and just hope for the best. She was happy to find out it was a woman though, because they were always outnumbered at CSI headquarters, so it was comforting to think the balance might have finally shifted.

She pushed through the doors and looked around the room for the doctor. When Sara did not find anyone in the immediate vicinity she figured that it might be good to announce her presence, so as not to spook anyone. Just as she was about to call out, David came through the double doors of the big cooler, "Oh hey, Sara. Did you need something?" it was obvious from his dress that he was on his way out the door for a pick up.

"Ah, yeah, David. Where's the new ME? I need a prelim on a DB that came in earlier." She looked around the room again casually.

"Oh, she stepped away for a minute, but she should be back any moment. You want me to stick around for the introductions?" David was peeking at his watch while he spoke with Sara, so she knew he was probably in a hurry to get to a scene.

After some thought, she decided not to take him up on his offer, "Nah, that's okay, David… I think I can handle it. You can go ahead."

He was visibly relieved, "Thanks… Catherine is very impatient and I'm not wanting to be on her bad side for next week, too." David was already scuttling out of the autopsy room when he spoke the last words, leaving her to face the woman alone.

She stood there with her hands in her back pockets, rocking back and forth on her heels for a moment when she heard a sound coming from the office. She craned her neck around to find the back of someone slipping on a fresh scrubs top, but when that person's deep red hair popped out through the collar of the shirt, her breath was caught tightly in her throat and she was instantly nauseous. It's HER!

Before she had even a split second to flee the room, the woman was suddenly out of the office and had called out to her, "Hey, if you're looking for David, you just missed him."

Sara had to think fast and she had to say something, instead of standing there like a deer caught in the headlights and her mouth hanging open like a beached trout. "Ah… Um.. No… Not looking for David."

"Oh, sorry… I guess I just figured you were his fiancé." She waited for Sara to speak again, and when the uncomfortable silence continued, she spoke, "So, is there something I can do for you?" She walked over to the silent woman who was staring at her like she had six heads, and zeroed in on her name badge as she got closer. "Sara Sidle… Oh, you're another CSI… Night Shift?"

That snapped Sara out of her catatonia, "Um, yeah, Night shift… I was looking for the um… The ah.. The prelim on the ummm.. The Francosi case, d- do you have it yet?" Right about now, Sara wished she had a good stiff drink. She was sure she had just made a complete ass out of herself.

The doctor put her hand up to her forehead and rubbed at it, as though she was trying to produce the information from it, "Um, Francosi, twenty five year old female, suspected OD, right?"

"Ah, yeah, that's the one. W-We needed to get the prelim so that w-we could get started on the case." Sara felt like a complete amateur at that moment: like she needed to tell a medical examiner why she needed the report.

"Sure," she turned around to the table behind her and fumbled with some folders. "A-Ha! Here it is." She turned back and handed Sara the folder.

Needing something to do, Sara opened the folder and tried to start looking through the notes, without really reading them, just needing to look away from the very tall and very beautiful, auburn headed woman in front of her.

Stephanie figured the woman was just going to flip through the report there in the autopsy room, in case she had any questions off the bat. So, to keep herself busy, and try to get ahead of the mess that had been building in the morgue all shift, she sat down at the table and worked on another report. She knew that Catherine would be looking for her preliminary report from her first case of the night when she returned to the lab with her last one, so she wanted to have it ready before she started on the next body. Stephanie still had three bodies waiting in queue from when she came in tonight. Apparently the swing shift coroner had called in sick and she was expected to deal with it on her own. The only good news was that David had spoke with Dr. Robbins and he had mentioned that he would be coming in early to help her catch up, so she only had another three hours to tough it out alone. If only she could keep the bodies from piling up. David was already on the road to pick up the newest one, and she was sure that she would come unglued if Dispatch called her one more time tonight.

The only bright spot in her day was her drive in with Gil. She felt safe with him, and as soon as she took one look into his deep blue eyes her entire resolve had melted away, just like it would when she was a little girl. Uncle Gil had always been her 'saviour,' and today had not been any different. Perfect timing, as always. She realized just how much she missed him (and her father) that night he had taken her to the airport on her first trip to Las Vegas. And with the wedding plans getting into full swing, she knew just what she was going to have to do, and now she just had to figure out how. As she was pondering everything that had happened, she reached over the table for the rest of her notes and became completely lost in her work, totally forgetting about the woman standing in the room with her.

Sara finally made herself focus on the report in her hands, and started scanning it for the cause of death. When she found it, she was dumbfounded. "Natural causes," she whispered under her breath. "Hey, what's with this COD?"

The young doctor did not even blink when Sara asked her question, and that got under her skin. Was it not enough that this woman was taking Grissom away from her, but she was going to ignore her, too? Well, that was just something that Sara would not take lying down, "HEY!"

Stephanie was suddenly reminded there was someone else in the room and her head popped up to find the source of the sound, "Oh, sorry… Got caught up in it again, I guess… Did you have a question?"

"Yeah, what's with the COD?" Sara was holding the report in one hand and had her other planted firmly on her cocked hip.

"Nothing… There just wasn't any foul play. Unless you count bad genes." Stephanie returned her attention to the report in front of her.

Sara was quickly becoming indignant, and started looking through the report for the toxicology results, "Where's the tox report?"

"Huh?" Stephanie looked up again, "Oh, it ah... It hasn't come back yet, but it won't change the cause of death. She didn't OD." Stephanie was starting to feel like her skills were being called into question, and her bile was starting to rise.

"Doc Robbins does not give any reports without tox results… Just how new are you?" Sara sent a direct stab in the doctor's direction.

"Excuse me?" Stephanie was doing her level best to maintain her composure, but this woman was coming perilously close to getting a what for from her. With her patience being on the jagged edge already, the last thing she needed was some investigator questioning her ability to perform her job.

"How on earth can you sit there and tell me that the COD is not an overdose if you haven't even seen the damn toxicology report?" Every word that came out of Sara's mouth dripped with her disdain of the woman before her, and she was in no mood to hide it.

Standing up from her chair, Stephanie had finally had enough of the woman's inflammatory questions, "I'll tell you what, when I see an 'MD' following that name on your badge, maybe then I'll take the time to explain to you what I learned after four years of intense training in medical school, two years of demanding clinical research as a resident, and a year spent in the L.A. County Coroner's Office posting eight to ten bodies a night… But until then, maybe you should just read the damn report and trust that an expert in her field knows more about cause of death than a frigging investigator!"

The look on Sara's face was all that Stephanie needed to see to know that she had just crossed the line. And when Sara turned to walk out, Stephanie reached out and put a hand on her shoulder to make her stop. "Wait." She let out a deep breath that she had apparently been holding, "Look, I'm sorry for blowing up like that… I'm having a day from hell, and I'm still adjusting to everything here and at home, so I probably should've stepped out before I went off like that." Sara turned around, fully prepared to lay into the younger woman with both barrels, "And I'm really sorry for jumping down your throat like that… I'm sure Gil has taught you guys to question everything." Hearing her use his first name like that made her heart contract, "If you could just give me a minute to pull myself back together, then I'll be happy to-." Before she was able to finish her last phrase, the phone was ringing on the wall, "Answer the phone, since it's probably a ten car pile up on the freeway and-." She slumped down and she turned towards the phone, "I'm never gonna get out of here today… Excuse me."

She walked over to the phone and lifted the receiver to her ear, leaving Sara to hide the pain in her eyes and give her a chance to recover. "Autopsy… Oh, thank the lord! I thought for sure you were Dispatch telling me I had twenty bodies on the way… Just another day in hell down here… No, I didn't miss the irony in that statement…" A smile spread across her face, "Yeah?... Well, I remembered how much you liked those sandwiches… And you drank the O.J. too?... Good, because I know you haven't been eating right…" She giggled at whatever the caller was saying, "Yeah… Hey, I really wanted to thank you for last night… That was exactly what I needed…" She laughed outright, "Hey, you know what they say? It's a stress reliever…" She was twirling the cord around her fingers absently as she talked, "Oh don't worry about it… Well, if you're still here when I get done… Yeah, and I'll even let you make me breakfast this time…" That was all Sara could handle.

She knew exactly who was on the other end of that phone call and she just could not deal with listening to the woman's mewling any longer. She had to get out of there. She just dropped the report and bolted for the door while Stephanie had her back to her.

She was moving so fast, she did not even see Nick exiting the stairwell when she ran headlong into him, "Hey there! Slow down, Sara… Where's the fire?" She threw up her hands and could not say a word, so she just shook her head and continued carrying out her escape.

Nick looked after her until she disappeared with an utterly confused look on his face, which he continued to have as he ambled into the autopsy room. When he heard a woman's voice talking, he looked around to find Dr. MacInnerney talking on the telephone to someone. At least she seemed to be okay, from what Nick could discern from her tone and body language. He decided that maybe Sara had just come across something that turned her stomach in the room. She did have some issues with stomach contents since she had become a vegetarian. And he had to admit to himself that he was never much for the stuff either, so he could not blame her for wanting to get out quickly.

The doctor hung up the receiver and turned around talking, "Okay, attitude has been sufficiently adjust-." She looked perplexed when she found Nick standing there, but he just smiled, "Either I was worse off than I thought, or someone is missing?"

Nick laughed, "Ah… Yeah, I saw Sara boltin' outta here when I showed up: probably just got somethin' foul in her nostrils." Nick obviously did not know what was going on and Stephanie knew that she was going to have to fix the situation before it got out of hand.

"Well, I guess we'll just add that to the laundry list of other crap that's gone wrong this week." She blew out a breath and headed off to the body sitting on the exam table, "Sorry, if I don't stop, but I have three bodies in queue and David is picking up a fourth right now. So, what can I help you with?" She reached the body and removed the drape to begin her examination.

"Oh yeah, no sweat… I was lookin' for the prelim on the Francosi case?" He stepped in her direction, but was stopped by her arm gesturing at the table behind him.

"Over there, um, ah, that last person was asking about it… What was her name?" She squinted her eyes and put her forearm to her brow in her attempt to bring the name out, "Damn… I can't very well apologize to someone if I can't remember her blasted name!"

Nick looked from her to the report and back again, "Oh, you mean Sara?"

"SARA! That's right…" She slapped her forehead, "Why are first names such a pain to remember?" She started putting her gloves on as she continued, "Yeah, Sara was in here asking about that case. All of my notes are in the prelim, as is the COD, the only thing missing is the tox report."

Nick started flipping through it, "So, what's the tox say?"

She shrugged off the question, "I have no idea; it hasn't come back yet."

Nick looked up from the report, because he could not believe what he had just heard, "Wait… How do you know cause of death without the tox?"

She let out an exasperated sigh, "One more time with feeling, Steph… Physiology is NOT just found in a tox screen… She presented with enough anatomical symptoms to confirm a definitive diagnosis."

The doctor was obviously frustrated with his questions, but he got the distinct impression that it had nothing to do with him, specifically. However, her statement was not making sense to Nick, and so he scanned the report for the cause of death, but when he found it, he just had to ask another question and he struggled with the pronunciation, "What the heck is 'hereditary hay-mo-chroma-tosis?'"

"Hee-mo." She corrected the pronunciation, "Sorry, but I always use the proper spelling instead of the Americanized one. Hereditary Haemochromatosis is where iron is not properly metabolized in the body and contributes to an early and painful death when untreated." She rattled off the disease name and layman's description to Nick, while she began the internal exam of the body on the table in front of her.

"Hereditary? That would mean this girl was born with this thing… How could she go untreated like that?" Nick was scratching his head.

"Well, actually, it's rarely diagnosed before the age of thirty, and for women, typically only when they become post-menopausal. Iron's not shed from the body the way most minerals are. It's used for blood cell production, so, unless you bleed, you don't lose any iron. People with iron deficiencies are often suffering from other issues which contribute to the depletion of iron from the blood stream; most commonly cancer, since it feeds on the iron in the blood." She made her "Y" incision as she explained the disease's pathology.

"Okay, I get that, but how do you make that call without a tox report?" Nick saw her face contort with her frustration again, and figured that she had probably already gotten into it with Sara, and that was what the problem had been, so he headed it off at the pass, "Sorry for all the questions, I've just never come across this one and we were totally sure it was an OD or poisoning. If I can understand your diagnosis, then I can be ready if I ever see it again." He walked a little closer to her while he explained himself, in order to save her from having to holler across the room. "It's kind of a thing around here… Learnin' from your mistakes and all." When she looked up from the body and saw his face, he was flashing a crooked smile.

"I get it… And I'm sorry if I'm being a little short right now… It's just been a tough week all the way around." She nodded her head and smiled back.

"Yeah, and having that sexist jackass start off your week with that scene probably didn't help, huh?" That time she laughed.

"They've been riding you pretty hard on that one, huh?" She said with her head tilted down.

"Nah… No more than I deserved."

She stopped what she was doing with the body before her and motioned for Nick to follow her over to the drawers. "Okay, Hereditary Haemochromatosis (or HH) is something that builds up over years and years and is most prevalent in men over the age of thirty and post-menopausal women of Northern European descent. And it's actually pretty common; one and a half to three people in every thousand persons (I looked it up). It's figured that ten percent of the American population contains the genetic mutation that causes it. Now, if you notice in the report, the liver and the spleen were both greatly enlarged, with the spleen sitting at nearly two kilograms (with a normal spleen coming in at around a hundred and fifty grams for someone of her build): very common in HH patients, since the excess iron is deposited in those tissues." Nick nodded his head as she retrieved the body from the drawer and pulled the sheet back. "Now, if you'll notice the areas of the face and the flexural folds; there is an almost metallic gray coloration in some places and her face is appearing almost like it was bronzed."

"Yeah, we noticed the face, but Sara thought it might have been some of that fake bake." Nick was really getting in to the information now.

"That would be a negative. Regardless of what they tell you, it does leave a residue and the swab came back negative for any foreign substances outside of Vaseline Intensive Care Therapy Lotion, or a generic thereof…" When his face told her he did not understand how she knew that detail, she explained, "Sorry, it is THE most common lotion used by bodies coming through autopsy, so I have the formula memorized." They both chuckled a little, "Anyway, the bronzing or the gray pallor are signs of the liver being effected by the protein deposits. Okay, next, you'll notice the cutaneous atrophy on her lower legs. That happens in more than a third of HH patients. Also, check out her fingernails." She held up the young woman's hand to give Nick a better view from beside her.

Nick shook his head and pointed down at the white lines in the fingernails, "Yeah, see those lines are what made us think maybe it was an unusual OD, or something that acted similar to arsenic."

"Well, you were sort of right, it was just an OD of naturally occurring iron in the bloodstream… But, if you'll notice, the nails of the thumb, index and middle fingers are concave, and almost spoon shaped, right?" She brought the hand even closer for him to examine it.

"Yeah, but she worked for a sheet metal company, so we didn't even look at that."

"Well, this is a classic symptom of HH, and a fourth of the patients have very prominent 'spoon nails.' Its technical term is a pain to pronounce even for me, so when you see that 'K' word in the final report, just remember 'spoon nails.'"

"Got it." He looked at her arms and pointed at the scaly build up of skin there, "So, I take it that's not some kind of reactionary problem with her work?"

"Good call. Ichthyosiform alterations occur in nearly half of all HH patients. It's where there are these thickening patches of skin that get really scaly, like a fish (which is where the term comes from). It's also accompanied with hair loss in more than half of the patients; most common in the pubic region (as we see with her) and in some cases, total body hair loss."

Nick was still in awe at the diagnosis, but he was beginning to understand why the doctor was so sure of her conclusions. This woman appeared to have all the classic symptoms, except that her age made her very atypical, based on what the doctor had told him, "Okay, all that makes sense, but there's no way this twenty five year old girl is post-menopausal, Doc."

"Nice catch… When David was prepping the body, he noticed a scar in along the pubic cavity. Your vic had a complete hysterectomy; probably within the last year." She pulled back the sheet some more to show him the very thin scar. "And whoever did it was good. I mean, without her hyperpigmentation, it would have been hard to see that scar."

Nick was confused now, "Okay, but why does that make the difference?"

"Cessation of menstruation."

That did not clear up his confusion, "And?"

She laughed that time, "Silly boy… The only way to purge the body of the excess iron is to BLEED. The most common treatment for HH is phlebotomy, which is why it typically isn't diagnosed in women until they are finished menstruating."

It was Nick's turn to slap his forehead that time, "Got it!" He flipped through the report a little more before he thought of something else that the doctor had said, "Hey wait a sec… You said it was most common in Northern Europeans, right?"

"Sure did."

"Her name is Francosi and she's got black hair… That would normally scream Italian to me." He was just playing with her, but it was something that did not fit the classic symptoms.

"Yup, and when you see the wedding ring on her finger in the photos of the body, and notice the freckles on her body, you'll be leaving a bigger red mark on your forehead." She had a sly grin on her face, so Nick dug further into the report.

That was when he found it; "Parents: Margaret & Jonathan O'Brien, Residence: Belfast, Ireland."

He looked up from the report sheepishly and just said, "Oh… Never mind."