Tuesday, March 21, 2006

3/20/06

9:11 p.m.
Right now LHM is looking over my shoulder as I write. Stop it! Go back to dreaming about past episodes of “Lost”. He keeps telling me that when we crash he wants me to call him John Locke. I don’t know what the hell he’s talking about but he keeps laughing to himself every time he says it. I’m going to have to watch that show sometime.

I’m in a plane over the Rocky Mountains right now. As we were taking off about an hour ago the flight attendants performed a field experiment. The hypothesis was that the bag of peanuts would sail down the aisle faster than the pretzels. Pretzels won. LHM owes me 10 bucks. I love Southwest.

All right, here’s my latest ME story. It’s Saturday morning. I am just returning from releasing a body to a funeral home when my pager goes off in my pocket….again. Perfect timing, guys. You couldn’t hit me ten minutes earlier while I was still at the morgue.

I call dispatch and am directed to respond to a residence out in the county. A young woman, about 15-years-old, was found dead by her mother this morning. Dispatch can’t give me any details, but I’m assuming that it’s a drug or alcohol OD since it was St. Patrick’s Day yesterday.

I pick up the van at the MEO and head out. There are miles and miles of farmland once you cross to the west side of I-94. Stubborn patches of snow lay in patches on the fallow fields and a thin fog hovers over the trees. It’s really a beautiful morning and my mind registers this, though I am not able to fully appreciate it. I’m too distracted going over what needs to be done when I arrive at the residence. I am tense because I know that this will be a difficult scene. The girl was so young and her death was unexpected. Her family will be shocked and highly emotional. I need to be prepared.

I arrive at the home 20 minutes later. There are several men out in the yard. I note the stark faces as I pull in and get out of the van. A man about 40-years-old walks over. I introduce myself and tell him I’m from the Medical Examiner’s office. I tell him I’m sorry.

“I need to talk to you about this,” he says with barely controlled anger. “My daughter will not be taken away in that truck. You need to tell them to bring an ambulance. I’ve done that once and I won’t do it again.”

I’m not sure what he’s talking about so I sidestep the issue by telling him that I will need to go inside to speak to the officer in charge.

I walk through the front door and the situation is no better. Women are gathered in the living room, sobbing and holding each other. I hate walking in on scenes like this. I feel very acutely that I am an intruder at a very personal, horrible time. I give another general introduction, explain to the people in the room who I represent and what I’ll be doing before moving quickly to the side of the waiting detective. Det. Brown and I exchange a few words in hushed tones before he takes me to a small bedroom off the kitchen.

“So, what’s the story?” I ask. “Dispatch didn’t tell me anything but that it was a 15-year-old girl.”

Det. Brown opens the door and steps in with me. The room is sweltering hot, at least 90 degrees, and there is a small television on in the corner. I scan the room as Brown speaks. A teenage romance novel on a nightstand. A formal gown in the closet. My heart aches for this girl who will never see her first prom.

“Seems that the girl suffers from migraine headaches. She’s had problems with it for a couple of years. Her mother took her to the ER on Wednesday night because the pain was so bad and she was throwing up. She was given a couple of prescriptions and sent home. Over the next two days she just kept throwing up. Couldn’t keep anything down. There’s a bag of vomit there on the floor next to the bed.”

I look into the corner at the bag. “I’m taking the puke and the prescriptions with me.” I say as I bend down and mark the bag with a date.

“They’re all yours,” Brown says. “There’s another bag of vomit from the day before outside by the front stoop.”

I’m not sure why these people would save barf, but I am grateful. It will be analyzed for any clues as to what happened to the girl.

“Did she drink alcohol, do drugs…anything like that?” I asked.

“She had a tox screen back last year and tested positive for barbs, opiates, all sorts of shit.”

My mind starts going over the possibilities. Maybe she got a bad batch of drugs.

“Did they run tox at the ER?”

“Yes. She was clean.”

Hmmm. Okay. So she wasn’t hyped up on goofballs…at least none that your average, everyday drug screen will test for. She wasn’t out partying over the past few days. She’s got a history of migraine headaches but has been otherwise healthy.

“What did she drink or eat over the past few days?”

“She had water and tea on Thursday, but didn’t keep it down. On Friday she had water, a spoonful of warm jello and a cracker.”

“How many times did she vomit?”

“On Thursday, about 10 times. On Friday, 8 times.”

Nothing the girl ate or drank over the past couple of days contained any electrolytes. Meanwhile, she was throwing up everything she consumed and becoming more and more dehydrated.

“Do you know what her labs were like at the ER? How were her electrolyte levels?”

Detective Brown looks at me and raises an eyebrow. “How the hell should I know? Do I look like a doctor?”

I sigh. No. You look like a horse’s ass.

I make a mental note to call the ER as soon as I get out of here. Right now I need to examine the body.

I turn my attention to the small figure on the bed. She’s petite, maybe 105 lbs. Her hair is long and dark and tangled around her head. She’s got dark circles under her eyes. Her head is drawn back and her eyelids are partially open. She is wearing a tank top and pajama bottoms. There are three EKG leads on her chest and abdomen where Rescue checked her vitals.

“Did Rescue move her at all?” I need to know if this was the position she’d been found in.

“No. They were careful not to move her. They made no attempt at resuscitation.”

And I can see why. I pull on a pair of latex gloves and place my palm on her torso. Cool. I move my hand to her arm. Cooler. I try unsuccessfully to open one of her hands. They are closed tightly and won’t budge. I move to her elbow joint. Same thing. Her jaw is also tightly clenched. Rigor mortis is full. She’s been dead for at least 10 hours.

“When was she last seen alive?”

“Mom was staying up with her, rubbing her back and talking to her. She left the room at 0200 hours. She came in to check on her again at 0400 hours. And she found her in the same position at 0830 hours.”

Huh. It’s now 1030 hours. Even if she died at 0200 that’s only 8 hours…too soon for rigor to be full. I consider. The room is so hot, though. Heat accelerates the decomposition process and can cause rigor to present more quickly than normal.

I work my way down her body…documenting scars, tattoos, cuts, bruises. When I get to her feet I stop. Her toes are pointed straight out. I’ve never seen that before. I take photographs and bag up the meds and the puke. I pull out a syringe and pop the cap off the needle. I look back at Det. Brown. “How’s your stomach?” He turns away when he sees the needle puncture the left eyeball and draw out vitreous fluid. I deposit the milky thick fluid into a vial and label it. Vitreous is an excellent measure of electrolyte levels at the time of death but it must be drawn as soon as possible to give an accurate reading.

Before I leave the room I close the girls eyes and cover her with a blanket.

Det. Brown meets me outside the door and brings me to a separate room where he has the mother waiting to be interviewed. We’ve barely finished the first sentence when the girl’s father walked in. “Carl,” the woman says quietly in a warning voice. “Carl, just be calm. Please, Carl.” The man’s eyes are a little wild and I remember our conversation outside about the van.

“I want to see my daughter,” he says almost as a challenge. My heart sinks. I know that people need that closure, but it is so traumatic and I hate witnessing it.

I glance over to Det. Brown who is standing in the doorway and nod.

“That’s fine. Take all the time you need.”

I lead the man and his wife to the back bedroom. They walk past me and I close the door so they can have a private moment. A few seconds later I hear the man yell, “Angel! Oh, angel, no!” I hear the woman sobbing. I watch the faces of the other officers. I can see the same bleak countenance on all of them that I am sure is reflected in my own. It’s a feeling of complete impotence.

Several minutes later I am sitting with the mother again. She is alone this time and as she speaks to me I can’t help but admire her strength. I can see how shocked she is. She tells me her story. I listen carefully and take notes. After we have finished, I am about to get up to leave when she touches my sleeve.

“What do you think happened? Was it her heart?”

“Well, I don’t know for sure yet. We’re going to have to perform an autopsy and run some other tests before I can give you a definitive answer, but it seems that her chemistry might have been off because of her illness.”

“You mean that she was dehydrated? You mean that if I’d brought her back to the hospital she would have been okay?” The woman’s face has paled and her hands begin shaking.

I touch her arm and look her in the eye before saying, “No. You did everything right. You brought her to the ER the day before and they sent you home. You gave her the medicine prescribed and did your best to keep food and water inside of her. Don’t you worry about that.”

She visibly calms and I squeeze her arm as I stand up to leave.

I am lying, of course. It’s a lie I’ve had to tell several times over the years. And it’s one I’ll probably tell again.

9 comments:

Higgy said...

Such a sad story - although now I'm really curious - not only about the Dad/van thing, but also the COD.

PollyME said...

Well, I think the dad had somebody else who was transported in a van at some point. Bad association? Either that or he might not have felt that a black utility van was a very dignified mode of transportation.

As far as the cause of death...this is very interesting. Dr. Frank posted her yesterday and found that she had an enlarged heart and wet lungs.

I looked back over the bloodwork from the ER and...sure enough... it appears that her white blood cell count was elavated.

So it turns out that the girl had some sort of viral infection. We'll know more when tox comes back. This case is turning into quite a mystery, though...

Mad Scientist said...

excellent writing Polly and an interesting case.

Anonymous said...

Welcome back, PPI. Well written, as usual.

PollyME said...

Hey, Mad!

We should get together while I'm here in sunny Cali! Any particular time good for you?

Cap'n Bob said...

John Locke? A long-ago girlfriend called me John Thomas and I called her Lady Jane. A nice combination of the sweet and the erotic. I miss those days.

annie said...

really creepy..... especially for someone like me who has periodic migraines and periodic bouts of uncontrolled vomiting. sigh. glad you're back though!

and man, do i miss LOST - they're running the first season over here :-(

Mad Scientist said...

Polly- call me!

Anonymous said...

Tragic.