Bare Bones

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Beside me, Larabee did the same.
“Could you see involvement when you examined the nasal bones?” the ME asked.
“One lesion.”
“Active?”
“Yes.”
I heard Larabee’s soles squeak on the tile, his palms rub up and down on his upper arms.
“Are you thinking leprosy?” he asked.
“Sure looks like it.”
“How the hel does someone get leprosy in North Carolina?”
The question hung in the air as I dug through layers at the back of my mind.
Graduate school. Systematics of bone pathology.
A: anatomical distribution.
...
I pointed the tip of my pen at the finger and toe bones.
“Other than the nasals, the process seems to be restricted to the bones of the hands and feet, especial y the proximal and middle phalanges.” Larabee agreed.
B: osseous modification. Abnormal size, shape, bone loss, bone formation.
“I see three types of change.”
I pointed to a punched-out-looking circle. “Some lesions look round and cystic, like the one on the nasal.” I indicated a honeycombed pattern in the index finger.


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