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some peace. Sitting cross-legged on her lounge with a large red pillow supporting her back, she opened the first of the reports Morgan Tully had asked her to review.
    This case from 1998 involved the death of a three-month-old girl who was taken to an emergency department after being difficult to rouse in the morning. The mother had been out drinking with girlfriends the night before and left her twenty-four-year-old boyfriend babysitting. The next morning she had noticed vomit stains on the little girl’s pillow and tried to wake her. Instead of calling an ambulance, she put the child in the car and drove to the nearest hospital.
    The emergency doctor’s statement said that he suspected child abuse as soon as he saw bruising on the child’s upper arms and back. The child was already in a coma and didn’t respond to painful stimuli. She had suffered significant brain damage. A cerebral CT scan confirmed the large intracranial bleed. According to the notes, the child was placed on a ventilator but died before anything could be done to relieve the pressure on her tiny brain.
    So far the story sounded like a dozen other cases Anya could remember. Each one indelibly etched on her memory. The boyfriend said that the infant had gone to sleep at her usual time and slept through the night. He hadn’t heard any vomiting and had no reason to suspect anything was wrong.
    Anya sighed. She’d heard that so many times. Amazing how a carer could have no idea what went on in a house when most parents reacted to the slightest noise where their children were concerned. She turned to the post-mortem report.
    Alf Carney had described the gross findings. Multiple bruises ranged from 0.5 cm in width to 3.5 cm. On a tiny body, those bruises were anything but normal. The photographs showed round black bruises on both upper arms, consistent with fingermarks. The largest were at the front of the arms, where thumbs would have dug in if the child were held in an upright position. There was also bruising over the right collarbone and ribs.
    On the back were red circular lesions that, although enhanced after death, looked exactly like cigarette-burns. The PM X-ray report showed multiple fractures—clavicle and posterior ribs, and a partially collapsed right lung. Anya closed her eyes and imagined the horror this tiny child had been forced to endure in such a short life. She thought of her own son Benjamin at the same age. He would giggle, babble and smile at everything he saw. And she clearly remembered how much affection he had been given, even from two parents who were emotionally detached from each other.
    Anya took a sip of the wine and searched for the mother’s statement as to how she explained the wounds and injuries. Apparently, she believed that the lesions on her child’s back were eczema, and thought bruising was normal in children.
    Unable to conceive how a mother could be in that much denial, the more disturbing thought occurred. The mother may have been a willing partner in torturing her baby, or even the sole abuser.
    The post-mortem appeared straightforward, and Carney had documented retinal hemorrhages, small dot-like bleeds at the back of the eye, usually found in shaken-baby syndrome. Microscopic findings were barely commented on, and those in the report were consistent with the effects of severe physical abuse. Notably absent were histology reports on the lung and blood slides, or blood cultures. Apart from that, everything seemed routine and Anya suspected she’d been sent the wrong case to review, until she read Alf Carney’s final comments.
    A swab of the right lung had grown a small amount of E. coli, a common finding at autopsy, thanks to contact with the bench surface; but the pathologist deemed that sepsis and overwhelming infection was present at the time of death.
     
    Cause of death: Intracranial hemorrhage with cerebral edema, resulting in severe brain-tissue damage. The precipitating factors are:
     
    1. E. coli