Thursday, August 18, 2005

8/18/05a WARNING: GRAPHIC/DISTURBING

8:24 a.m. I walk into the office Monday afternoon and am greeted by utter chaos. Or maybe this is how it always is and I've just been spoiled having just returned from a two week vacation.

There were eight cases yesterday and four of them went to autopsy. I pick up the files and sit down in my favorite chair to read. Two of these cases are death certificate inquiries because the doctor entered an erroneous manner or cause of death. This happens a lot. I look over the first file. Manner of death (MOD) is listed as "natural". The doc reasoned that the decedent had been bed-ridden and died of pneumonia...a natural consequence of being bed-ridden for an extended period of time, since fluid will collect in the lungs when you are horizontal too long. However, the dead guy had been in a car accident three years earlier which left him a quadrapolegic...which led to his being bed-ridden...which led to the pneumonia. So, the drunk driver that hit him that night three years earlier, in a sense, killed him yesterday. It was ruled vehicular homicide. I called the MD and explained the situation to him. He agreed to change the DC to reflect a homicide. After that I called Homicide so they could open a new investigation and determine whether additional charges were to be filed against the drunk driver.

The second DC issue was a doctor that entered "cardiac arrest" as the cause of death (COD). The Chief ME gets really pissed off about this one. Soon after I'd started working here I made the mistake of asking her what was wrong with cardiac arrest. "Cardiac arrest means that your heart stops!" she says with irritation, "Everybody's heart stops when they die! We want to know what led to the heart stopping...whether it was a heart condition or a Mack truck." Fair enough.

I moved on to two other files which turned out to be inspections. Inspections are cases where the manner and cause of death are fairly sure and the ME feels there is no need to perform an autopsy. The first was a 98-year-old woman who passed away in her sleep. She hadn't been to a doctor for years, but there was no need to believe that she had died of anything other than natural causes. The second was a 55-year-old, 400 lbs man who had been diagnosed with congestive heart failure 10 years earlier. The doctor that diagnosed him refused to sign the death certificate because he hadn't seen the decedent in so long. The man's ankles were swollen and red, a result of poor circulation. That and his gross obesity are classic symptom of CHF. The circumstances surrounding his death were not unusual or suspicious. He got up in the middle of the night to go to the bathroom and collapsed in the hallway. No need for an autopsy in this case, either.

I was just starting to look over the four autopsies that had taken place this morning when a call came in from Homicide. A hanging suicide. 35-year-old female.

I get directions and grab my jacket, happy to leave the office for a while.

This case is not far from the MEO. And it is in a very nice neighborhood. I was there a few weeks ago when a housewife whose lawyer husband was cheating on her left her multi-million dollar mansion after sending the kids off to school, walked to the park across the street, sat on a bench and shot herself through the head with a handgun. It took evidence technicians two hours and three metal detectors to find the shell casing in the debris at the base of a live oak tree several feet away.

More later....

12 comments:

Marvin | Paranoid Android said...

"...additional charges were to be filed against the drunk driver."

I can't imagine being that drunk driver, 3 years later, after all the court battles are done but still probably helping with medical expenses, finding out that the guy died and it was indirectly my fault and now I'm up for homicide. Stupid consequences.

Higgy said...

Marvin - yeah, that would suck. I mean, where does the statute of limitations run out on that? Seems odd that 3 years later you can be done on charges.

Anyway - my comment on the woman who shot herself - just goes to show that money can't buy you happiness. Sure, you can rent it for a while....

FCDA said...

There is NO Statue of Limitations on homicide.

Sling Words said...

I attended a lecture by a couple of forensics experts who focused on suicides. I came away with the opinion that most people who commit suicide have got to be the most selfish people in the world. Most seem to do it where a loved one finds the body. Based on the lecture and photographs, that's a scene that would haunt someone forever. What a picture to have burned into your brain of a parent, a child, a spouse, or a sibling.

insomniac said...

i remember on law&order when the red-headed m.e. explained all the various kinds of causes of death, it all sounded very philosophical (God=First Cause, and all that)

how much does your office suck when you are glad to get out of it to go look at a suicide?

Austin said...

I was thinking the same thing insomniac.

Anon said...

sling - I guess empathy isn't one of your strengths.

Medical Investigator said...

As I noted on my site suicide maybe painless to those who choose it (I guess we really will never know if that is true) but it leaves behing terrible feelings for those that care (And maybe that is the sick point of it) Anyway the phrase in my office is suicide is often a final solution to a temporary problem.

B-Dubbs said...

Sling- Have you had anyone close to you commit suicide? Based on your post, I'm guessing you're lucky enough to have not. If you had you would understand that there are often many more reasons that we can't understand behind suicide. Please spare us your judgement.

Polly P.I. said...

I have to say that I agree with Sling Words in that people who commit suicide ARE indeed the most selfish people around.

And I don't mean that to be judgemental. Just as I don't think Sling did. I mean, babies are pretty damn selfish and we don't fault them for it.

I think that something major has gone haywire in the suicidal person's head (most of the time) and they are incapable of seeing beyond themselves and their pain.

I think that if they were in their right minds, they wouldn't purposefully do something they knew would emotionally cripple their loved ones.

Then again, I had a case where a man video taped his suicide note telling his ex girlfriend how it was her fault he was doing this and he hoped she suffered forever knowing she "made him" kill himself.

Often times there is an element of revenge in it. I can't deny that.

And then sometimes none of those elements are involved. Euthenasia, for example. There were several cases that I had involving older people who were terminal with some disease and chose to take their lives rather than go through the dying process.

B-Dubbs said...

"Selfish" to me indicates a conscious thought on the person's part. I do agree that something goes haywire in the brain...but I also feel that it isn't always "selfish." A dear friend of mine committed suicide in 1994. I was very young then and didn't completely understand. He was sick.. not sick with a cold or the flu but sick with depression. It did crazy things to him and made him believe he was better off dead. I would never, ever, ever say that it was a selfish act. He was sick...and his loved ones he left behind know that.

Polly P.I. said...

B-dubbs

((HUG))

I'm so sorry about your friend.