Book Review: First Cut by Judy Melinek, M.D. and T.J. Mitchell

Dr. Jessie Teska is determined to start a fresh in San Francisco as the city’s newest medical examiner. Having come from sunnier Los Angeles, the inclement weather is a surprise, but the department where she works will prove even less pleasant in comparison with the modern, well-funded morgue she just left. The technology is out of date and the premises seriously understaffed—the whole place has only one morgue technician, the long-suffering Yarina Marchenko, when it should have three—but at least the routines for handling the corpses haven’t changed:

With my shiny pink scalpel I made an incision across the top of his head from ear to ear, and peeled the scalp off the skull. Yarina fired up a heavy bone saw with a worrying rattle—another piece of morgue equipment past its prime—and scored an equatorial line around the calvarium. When I pried the cap off [the victim]’s skull and peeled back the membranes covering the brain, I found a subarachnoid hemorrhage. I hooked my fingers under the brain behind the eyes and lifted it right out. The force of the exiting bullet had fractured the orbital plates and pulped a section of frontal lobe. A class one brain lesion, immediately fatal.

Taking on a big caseload in an undermanned department is the kind of challenge Jessie is ready to dive into, but when the autopsy of a seeming opioid overdose raises more questions for her than it answers, she finds herself facing more obstacles than expected. Rebecca Corchero was a nursing student, intelligent, athletic and driven. She seems the least likely candidate for dying of a drug overdose after shooting up in her own foyer, especially when her friends and family swear up and down that she would never do drugs. Jessie wants to rule the case a homicide and finds, to her surprise, that her superiors want her to close it as an accidental death, and fast.

Could their impatience have to do with the fact that Rebecca died of the same new street drug that features in another autopsy the morgue recently had to perform? And what relationship does Rebecca’s death have to do with the racketeering case Jessie’s boss, Deputy Chief Medical Examiner Michael Stone, is making a hash of testifying in for the prosecution? Could Rebecca’s dabbling in cryptocurrencies have anything to do with her demise, and could Jessie’s new love interest, a tech startup investor named Arnie Spitz, have any connection to the dead girl too?

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All these threads and more are deftly woven by the married writing team of Judy Melinek, M.D. and T. J. Mitchell in First Cut, their first novel together. Dr. Melinek brings a ton of experience to the table, having been an assistant medical examiner in San Francisco herself for nine years. The details are authentic and the presentation scalpel-sharp, with witty dialog and terrific thriller writing. Readers with a weak stomach should brace themselves, however, as the authors pull no punches when detailing the nitty-gritty of a medical examiner’s job.

It isn’t all blood and gore, though. The authors also highlight the emotional toll the job takes, having to be on scene and not always knowing the best thing to say to a victim’s loved ones:

I fought back tears for the boy’s mother. I had screwed up. I made it worse for her. What good came of telling that poor woman that her child’s corpse wasn’t fit to view? It was a clumsy response to a cold, shitty situation: Your son is dead, and you can’t be there for him, can’t hold him, can’t stroke his hair. All that’s left of your boy is evidence. His young body, not yet cold, is evidence in a crime. How do you tell a mother that? How do you show up outside her home and spirit her baby away?

This is only one example of the terrific way Dr. Melinek and Mr. Mitchell balance heart with thrills,  and fact with fiction. I was also really appreciative of the background choices they made for Jessie. I loved how fully fleshed out she felt, and especially loved everything about the depiction of her Polish roots as well as the tight bond she shares with her brother, Tommy.

First Cut isn’t a novel for the squeamish but is a compelling look into the life of a medical examiner who isn’t satisfied with merely rubber-stamping autopsy reports. I haven’t been this excited by a forensic thriller since the day I read Patricia Cornwell’s first Kay Scarpetta book, and truly cannot wait to read more.