Antique ivory-handled scalpel

The Antique ivory-handled scalpel is the weapon Rosario used to stab a clinic orderly, an assault that exposed a breach—or an unresolved possibility of a breach—in a maximum-security psychiatric facility. Its short, sharp blade and timeworn ivory handle make it conspicuously unlike the modern instruments kept under lock in the clinic. The object’s precise route to Rosario remains uncertain: it may have come from outside, or, as Inspector Ayegui suggests, it may already have been inside.

Identification and Physical Description

The weapon first appears as an unidentified sharp object that Rosario had hidden beneath her pillow. Inspector Ayegui describes it cautiously as a cutting awl, perhaps like an ice pick or burin, with a short, sharp blade. When a uniformed officer brings the evidence case, the object inside its bag looks at first glance like a small knife.

Amaia Salazar photographs it on her phone, but the flash reflects off the plastic and obscures the detail she needs. At her request, the officer removes it from the bag and holds it in a gloved hand. The handle is yellowed and cracked with age, features that distinguish it from an ordinary contemporary medical tool. Amaia sends the photograph to Doctor San Martín, who identifies the object as an antique scalpel, probably European and dating from the eighteenth century. He recognizes the ivory handle, a material later discarded in such instruments because of its porosity. Blood stains indicate that the scalpel has been used as a weapon; dirt on the metal prevents him from distinguishing it clearly.

The Stabbing and Its Immediate Consequences

According to the account Inspector Ayegui gives Amaia, the attack happened at about half past seven in the evening. Rosario had watched television and eaten dinner in her room. As an orderly helped her into bed, she pulled the concealed object from beneath her pillow and stabbed him in the lower abdomen. The wound caused heavy bleeding immediately.

The orderlies wore alert bracelets, similar to those used by victims of domestic violence to signal an attack. The wounded man pressed his button, and colleagues arrived within seconds. They gave him emergency treatment. His condition was serious, but Ayegui expected him to survive, noting that the staff had medical training. The description establishes both the abruptness of the violence and the practical chain of response: an object concealed at the bedside, an alarm, and rapid intervention.

Afterward, Rosario was restrained, sedated, and moved to a secure area. When Amaia and Ayegui reached the room, officers guarded its entrance and red-and-white tape barred access. The room was still being processed, so they could not enter. The scalpel was therefore presented to Amaia as evidence outside the scene, first sealed in a collection bag and then handled by a gloved officer for photography.

Security and the Unresolved Route

The scalpel’s age and appearance sharpen the central question of how it reached Rosario. Ayegui initially reasons that someone must have supplied the weapon from outside: giving an armed object to a dangerous psychiatric patient would imply intention. Yet once Doctor San Martín identifies it as a scalpel, Ayegui raises another possibility—that it might already have been in the clinic. The two explanations remain possibilities, not a settled account of its provenance.

The director rejects the suggestion that the scalpel belonged to the facility. He describes strict rules forbidding objects that could be used as weapons, including even pens in doctors’ coat pockets. Sharp or heavy items, shoes with laces, and belts are prohibited not only for patients but also for staff, doctors included. Medical instruments are available only in the infirmary, kept under guard in a security cabinet, and are modern equipment unlike the antique in Amaia’s photograph. In that account, the scalpel does not fit the clinic’s authorized stock.

The director also insists that visitors pass through a metal detector and leave their bags at the entrance. Patients in the blue area receive no visits; visits to other patients require authorization. For Rosario, he says, only her siblings are permitted. Visitors must disclose any item, food, or reading material before giving it to a patient, remain in the patient’s room, and have no contact with other patients. Most patients are isolated much of the time, and always during visits. Amaia corrects the director when he refers to Rosario’s visitors as brothers: they are sisters. The detailed restrictions make outside delivery difficult to explain, but do not, by themselves, establish how the weapon entered the room.

Evidentiary and Narrative Significance

The scalpel matters not just because it inflicted a grave wound, but because its material particularity resists an easy explanation. Its antique date, porous ivory handle, cracked yellow surface, blood, and obscured metal give investigators tangible details to examine, while leaving the key question—its path to Rosario—open. The object is simultaneously recognizable enough for Doctor San Martín to identify and dirty enough to conceal further information.

That tension drives the inquiry from the assault itself toward the clinic’s procedures, inventory, and visitors. The apparently secure setting, with carpeted corridors and suited doctors, is explicitly described by Ayegui as a maximum-security center; the antique weapon makes the contrast between orderly institutional appearance and vulnerability concrete. Nor does its age prove whether it was smuggled in or was already present. The scalpel’s significance lies in making access and intent unavoidable questions, without yet answering either one.