August 14th.

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A promising morning. Inspector Evans visited my surgery at ten o’clock, regarding what he promised was the strangest mystery he had ever encountered. He has a body in the morgue and wants my second opinion on it. I explained he would have to wait three hours until my surgery was over, since the patients – the living – must come first. Evans bade me call for a locum doctor, because of the urgency of the situation, and I complied.

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In the next ten minutes, he gave me an account which set my imagination afire. I’ll summarise it now to make a permanent record, while we travel by hansom cab to the morgue.

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Evans is a tall, lean man in his forties. His well-groomed hair and beard, intense dark eyes, and high forehead give him a natural authority. Moreover, his mind is razor-sharp. There is a Welsh lilt to his careful, measured speech.

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At eight o’clock he was summoned to a family mansion in Kensington. Apparently, something strange had been going on there for a few days. Neither the owner Lord Carmichael, or his wife, or any of their six servants, had been seen outside. The staff had not even visited local shops and markets to buy provisions. It was as if they had all vanished.

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This morning, at a quarter past seven, Lord Carmichael screamed and fell from a third-storey window of his mansion. Two neighbours saw the incident and rushed onto his property to see if they could help him. The fallen man was dead, but his appearance was bizarre.

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The neighbours rang the front doorbell of the mansion and received no answer. They had to leave the body and run to find a patrolling policeman for help.

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Soon, several officers were on the premises. The appearance of Lord Carmichael led them to call for a doctor, who saw the body and also feared some strange affliction had overcome the Lord. They all feared it could be contagious. At this point, Evans refused to describe the body – he wanted me to see it for myself, commenting that I probably wouldn’t believe him anyway.

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Two policemen volunteered to break a window and enter the house to search for Lady Carmichael and the servants. Neither man has been seen or heard from since, and the sergeant in charge chose not to risk any further officers.

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Lord Carmichael was rushed to the morgue, and an autopsy was performed. The police surgeon made discoveries far more baffling than the neighbours who first saw the corpse.

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No one has any explanation for what has happened. A Lord is dead. A Lady, six servants and two policemen are assumed dead also.

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Evans hopes I might be able to shed light on the matter.

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I wonder what on earth awaits me.

 

*     *     *

 

Given the circumstances, I intend to record everything which happens at the morgue. If Lord Carmichael is the first victim of a new kind of plague, I may succumb myself. This record could prove invaluable to someone else. Excuse the handwriting – since I must write while on the move.

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There are no grimmer places in London than the morgues. Dim-lit; reeking of blood and decomposition; exuding an aura of gloom and finality. We pass along a narrow corridor and reach a small room where Dr Howard performed his latest autopsy.

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Howard greets us at the entrance. He looks eager to leave the vicinity. The doctor has been performing autopsies here for over fifteen years, and normally I would assume he’s seen every kind of death possible. A small, rotund man of fifty-eight, bald and bespectacled, Howard tends to be dispassionate in his manner.

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“From the initial report,” he says, forfeiting any kind of greeting, “I expected a gas leak. It would explain the apparent deaths of everyone else in the house and of the two missing policemen. A simple look at the body told me otherwise, and when I opened-up the corpse...”

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I gaze at him, expecting more. Evans and I are by the doorway, and Howard is between us and the body on the table.

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“You found..?” I prompt.

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“You should see for yourself.”

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The inspector and I follow him, to find the corpse hidden by a sheet that was once grey and is now seeped in crimson.

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We are ushered to stand by the body’s left. Howard positions himself to the right.

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“The anatomy of a human torso is nothing new to you,” the doctor says to me. We are not close friends, but have worked together many times. “But I doubt you have seen anything like this.”

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He pulls at the sheet and exposes the torso. Evans swallows hard. The skin has been surgically drawn back from the abdomen, and the ribcage is wide open. At a glance, the chest resembles a horrible butterfly, with gory wings stretching out.

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It isn’t the open chest which stuns me, it’s the arrangement of organs.

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Inside the chest cavity, Howard has moved the lungs left and right to fully expose the heart between them. The average human heart is positioned roughly central, but the lowermost part projects over to the body’s left. This is a shape I have seen too many times to count. Lord Carmichaels’ heart does not conform. The lower half of his heart projects down and left, and down and right. The right side of the heart is a complete reflection of the left.

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Howard knows I am focussed on the heart. He points above the organ.

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“Look at the blood vessels.”

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Any anatomy student can name and describe the veins and arteries connecting the heart to the rest of the body. Aorta, superior vena cava, inferior vena cava, pulmonary arteries, pulmonary veins...

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Not in this case. Projecting from the top of the organ are what I could only describe as two aortas, one left and one right. My eyesight roams the heart, and I see every other vein and artery is reflected left-to-right.

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I turn to Howard: “How could a human heart function with so many more blood vessels attached to it?”

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“I’d say it was impossible. God knows what it’s like inside. And the heart isn’t all I found.”

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I peer down below the lungs. The main bulge of the stomach should be on the body’s left. There is also one on the right, and the two join at the centre. The large intestine should extend from part-way down the right side (from the end of the small intestine mass), up and across, then down the left side to finally reach the rectum. In Carmichael’s case, it looks as if there are two large intestines, running from opposite sides of the body, both merged together. Even the shape of the small intestine is impossible – the left and right sides are perfect reflections of each other.

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Reaching a hand down into the exposed digestive system, I make another discovery. Carmichael had two appendices, one on the left and one on the right.

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“Good God,” I utter. “The question isn’t how Lord Carmichael died, it’s how someone so internally deformed could have ever lived.”

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And I feel certain worse is to come.