Thursday, January 18, 2007

WARNING: DISTURBING

I look at my watch. It's time. Det. Porte catches my eye and we each make our way slowly into the room. Det. Porte speaks. "The medical examiner needs to examine the body now. Everybody please leave the room."

Six or seven people clear out and only the father and grandmother remain. The father looks up at me. His eyes are dull and and his face is expressionless. "Will I see her again after you do the examination?" He's holding the little body protectively as if he's ready to fight anybody that comes near.

"I will need to interview you after I do the examination." I say quietly. "You can come back in here with your mother at that time, but nobody else. After the interview, I need to take her with me back to the Medical Examiner's Office, do you understand?" I am sitting in a chair across the room. I don't want to get too close yet. I need him to trust me first. He nods his head and looks back down at his child. His chin is trembling as he brings a shaky hand up to stroke her cheek. I look down at a spot on the floor in front of me. Det. Porte is also averting his eyes. As always, I feel like a voyeur intruding on somebody's most private and vulnerable moments.

The grandmother goes to her son and nudges him up. "Put her down, son. Let the lady do her job. We'll be back soon." The white paper crinkles as he lays the child on the table. I hear a quiet sob from deep in his throat. The grandmother puts her arm around him. As they pass me I touch the father's arm and whisper to him. "I'll take care of her. I promise." He meets my eyes before allowing his mother to lead him out of the room.

The door shuts with a click. I sigh deeply and look over at Det. Porte. "This sucks," I say.

"Yeah. At this rate we're not going to get out of here for another hour, at least."

I turn to the tiny form on the table. I fold back the blanket. Her skin is as white as snow except for some flushing around the upper chest area. I look closely for crease marks from the couch cushions or blankets that might indicate how she was positioned at the time of death. There is nothing. I'm not surprised. She was found shortly after she died and then was moved. There was no time for impressions to settle.

She's wearing nothing but a diaper. I estimate her to be about 2'5" tall with plenty of baby fat. No bruises or traumas. My initial impression that she would be too big for a roll-over is strengthened. I check her eyes to be sure. I am looking for any sign of petechiae, small pin-pricks of hemmhoraging that are indicative of asphyxiation. Nothing. Her bright blue eyes are crystal clear. I open her mouth to look for bruising or damage to the frenulum. Again, nothing. "She appears well cared for. No indication of neglect or abuse. If she asphyxiated, it would have been at a very, very slow rate because there are no signs of petechiael hemmhorage in her eyes and no pressure marks on her body. The only scenario I can imagine is if dad was drugged to the point that he didn't feel her struggling or heard her making noise." Det. Porte takes out a pad of paper and starts writing.

I feel her torso and her extremities. I bend the joints in her feet, fingers, and knees looking for rigor. It's slight. Just beginning. "She's still very warm." I check my watch. "It's been four hours since she was found. Usually a baby will cool at a much faster rate than an adult. I would have expected her to be near room temperature and in full rigor right now, but she's been wrapped in a blanket and pressed against her father's body for hours."

I turn her on her side to check her back. The skin is flushed red from blood settling to the lowest point. I press a finger into the flesh and watch as it blanches white. "Lividity has not yet set." I take some photographs and then swaddle the little girl back up in the blankets. I glance at Porte as I work, remembering what the DA said about the child possibly ingesting her father's prescription psych meds. "There's nothing conclusive here. We'll have to wait for tox to come back before we know anything for sure."

"Maybe you'll have more luck getting the dad to talk. He doesn't like me for some reason." Porte smiles sheepishly.

"I can't imagine why not." I say sarcastically. "You're like a big teddy bear. All sensitive and in touch with your feminine side..."

Porte grunts. "Yeah. That's me. You want me to bring the dad back in? I'll just sit over there in the corner and hope he forgets I'm here."

Porte leaves the room and returns mementarily with the father and grandmother. I am sitting next to the baby on the edge of the examining table. I have my hand touching the blanket. I want dad to know that I am watching over his little girl.

He walks over and kisses her cheek, whispering something that I can't quite hear as he does so. I back away again, not wanting to make the father feel at all that I'm stealing his baby.

"Do you know what happened to her?" The father asks.

People ask me this a lot after I examine a body and only very rarely can I give them something solid in response. "No. I'm sorry. We won't know anything until after the autopsy and toxicology come back. That can take a while, so I need you to try and be patient. I know you're looking for answers and it's frustrating to wait, but it may be a couple of weeks or longer before we can give you any difinitive cause of death."

He nods his head and looks me straight in the eye. "I didn't hurt my baby. I was a good father."

I say nothing, only reach over and touch his arm. "I am going to need to ask you some questions to help us figure out what happened to your daughter. Some of them may seem insulting to you, but keep in mind that they are necessary questions that we ask every parent who suffers the loss of a baby, good parents and bad parents alike. Okay?"

He nods again. I start out asking him to give me the general story of what happened from the time he woke up in the morning. He explains that he and his little girl woke up late in the morning. He said he fed her a cereal bar and was just getting ready to take his meds when the phone rang. He left the bottle open on the counter. When he got back the little girl had pushed a stool up to the counter and was standing on top of it. He was afraid she'd eaten some of the pills and swept her mouth with a cloth. He found nothing and assumed everything was okay. "I should have taken her to the emergency room," he says. "I should have." Yes. You should have, I think to myself sadly.

"Can I hold her while you talk to me?" He asks.

"Yes. Go ahead." He picks the child up and sits back down in the rocking chair. He looks down at her and then up at me again. "Why is she so stiff?" He asks me. "She wasn't like this before."

Det. Porte speaks up from the corner of the room. "It's part of the process of decomposition. It's called rigor mortis." I glance over at Porte in irritation. I probably wouldn't have said it in quite that way.

"It's normal," I say. The father seems to accept this as he continues to rock in the chair.

I ask him about his daughter's prenatal care. Was she born full term? He tells me that the girl's mother was on heroine during the pregnancy and she was born a month premature and addicted to drugs. Did she have any resulting disabilities? No. Was she exposed to any illnesses recently? Who besides himself cared for her? How was his health? He tells me he's schizophrenic and suffers from severe depression and he has to be on powerful meds to keep it under control. I imagine how difficult it would be caring for a toddler while in a drug-enduced fog.

After I finish the interview I check my watch again and tell him that it's time for me to take her. He starts to sob and holds the baby close. His mother comes over and whispers in his ear and I move in front of him. I know from experience that unless I reach for the baby he won't let go. I bend down and place my arms under his. I whisper to him that I'm sorry. That I promise to take care of her. That it will be okay. He lets me lift the little girl out of his arms.

There will be no body bag or stretcher for this child. I turn her toward me and tuck her close with her head resting on my shoulder. I feel the familiar weight of her. It's so natural to hold a child like this. Like a mother with her own offspring. Det. Porte takes my bag and opens the door for me. I craddle the back of the little girl's head with my free arm and avoid making eye contact with anybody in the hall. I hear voices all around me rise up in anguished cries. Four police officers flank me on all sides as we move quickly away from the crowd of people and down the corridor.

When we get to the van, Det. Porte opens the back for me. "No. I'll take her up front."

"You sure?" he asks.

"I'm sure."

I step up into the driver's seat and lay the baby across my lap. I just can't bring myself to strap her to the cot or lie her on the floorboard of the van.

"I'll meet you guys back at the morgue," I say before slamming the door and driving away.

The doc is waiting for us. She's appropriately upset that we're an hour late getting back, but understands how it can get with families. Her physical exam is fairly consistent with my own and she echos my doubts about this case being a roll-over.

"Okay," she says. "Did the warrant go through okay?" she asks D.A. Tate.

"Yep. All set, ma'am. We were just waiting for you."

"Well, let's get going. Maybe we can wrap this up before midnight."

"Hey, doc?" I ask. "Do you want me to get a body bag for her?"

"Nah. She should be okay until tomorrow morning."

The doc and detectives leave the office. I am alone for just a moment with the little girl. I wrap the blanket around her tightly, making sure her toes are tucked in and her shoulders are covered. It will be cold in the cooler, I think irrationally.

I softly hum a lullaby as I push the tray into the cooler. I tuck her in between two other bodies, a tiny pink bundle. I am sad and I am drained, but I have hours of work ahead of me yet tonight and I need to go. I touch her forehead.

"Goodnight, little one," I say. I walk to the cooler door and shut it behind me. I pick up my bag and turn off the lights on my way out.

Saturday, January 13, 2007

1-13-07a WARNING: DISTURBING

I call the Doc and she says she'll be at the ME's office to examine the body in 45 minutes. I turn back toward the family and wait with the other four or five law enforcement officials. I want to give them time, but I also need to examine the body and get it back to the morgue as soon as possible.

The cluster of people in the room prevent me from seeing the father or the child. An older man walks out with red-rimmed eyes. He looks me up and down. "Are you the dead doc?" He blurts.

Wow. I'm not quite sure how to respond. "I guess so," I say, "though I've never been called that before."

"Well, he's dead. That's for sure." The man wipes his eyes and watches me, expectantly.

This time I don't say anything.

"You know, I always watch those weird dead people shows on TV. I get a kick out of that stuff."

I nod my head and give him a weak smile. "They're pretty good." (It's about this point where I remind myself that people all handle grief in different ways.)

Det. Porte walks over and whispers in my ear asking if they should clear out the room, now. I look at my watch. The Doc will be at the office soon. "Go tell the father that in five minutes I will need the room cleared so I can examine the body. That way he can prepare himself and we can maybe avert a scene."

Det. Porte nods his head once and heads into the room. The people surrounding the father and his little girl part like a wave and I get a fleeting glimpse of a tall man with short dirty blond hair sitting in a wooden rocking chair. He's got a bundle of pink blanket in his arms and is rocking it gently. He is looking down at a shock of shiny blond curls peeking out from the top of the wrap. There are tiny alabaster toes visible at the other end.

Oh, you poor baby, I think. Pity and grief well up in me and I suddenly remember the feel of all the babies I've carried out of hospitals and homes over the years. I turn away from the door and walk a few paces toward the wall behind me. My heart is racing in my chest and I feel off-balance. I can feel the sharp sting of tears threatening behind my eyes and I concentrate on a sign posted on the laundry shoot in front of me. "CAUTION: DO NOT LEAVE DOOR OPEN" I read it over and over again. I am on a crumbling precipice and I need to do something quickly to keep myself from falling out of control. I study the red block letters that were spray-painted on the metal door with a stencil. I imagine myself in a gray jumpsuit. I am shaking a can of red spray paint, listening as the mixing beads knock around inside. I place a cut-out piece of cardboard stock carefully up on the metal door, tape it down with masking tape, and spray a coat over the top, making sure it's thick enough so the fat letters will be easy to read and thin enough so they won't run...

When I allow myself back to reality a minute or two later my breathing has evened out and my pulse has slowed. I raise an eyebrow as I turn back toward the room. Cool. I can't believe that worked. Visualization. I'll have to remember that.

More later...

1-13-07 WARNING: DISTURBING

It's 5:00pm on Tuesday night. I'm not on call until 6:00pm, but I've already strapped on the pager and charged up the cell phone. Tonight I plan on going out with some girlfriends that I have been neglecting for the past, oh, year or so. It's always a roll of the dice making plans on nights that I'm on call. I guess we'll see.

5:03pm
HELL! My pager just went off. It's Nancy, my boss from the ME's office. Nancy is a very busy woman, so I've offered, on occasion, to take call early if she should get stuck with anything an hour or so before she's off for the evening. Unfortunately, Nancy more than took me up on the offer so that at least half the time I can expect to get a call or page before my shift starts.

I ignore the page. My pager is not officially on yet, I tell myself. Then my phone rings. I ignore it, too, knowing that if I take an early call I will never make it back in time to go out with the girls. Pretty soon my cell phone starts beeping at me, letting me know I have a message. What if a plane crashed or a chemical plant blew up and all hands are needed? What if the call is for somebody that Nancy knows and she just can't handle it?

DAMN! I open the phone and dial in my code for messages. "Um...Polly? It's Nancy. Can you please call me when you get this message? Thanks." Click.

I look at the phone and scowl. "Coward." I mutter. I walk back up to the bedroom and put the phone back on the charger. LHM is snuggled up under a blanket taking a nap. He stirs and turns to face me as I swear softly under my breath. "Whaa? Everything okay?"

"No," I snap. "Nancy is trying to get me to take call early again but I'm not going to do it. I have plans tonight. If it's my scheduled shift and I get called out, okay. But this isn't mine."

"Hmmm," he mutters and turns back toward the wall.

My pager goes off three times and the phone two more times without Nancy bothering to leave a message. Finally, on her third call (at 5:30pm) she leaves another message. "Polly, I was hoping you could take a call for me. It's a 20-month-old baby that was brought into the ER pulseless and not breathing. I've been holding off the hospital and haven't gotten anymore information than that, but I know this is going to be a long one and I just can't take it."

A baby. I close the phone without bothering to erase the message. I immediately start asking myself questions I don't have answers to. How did a baby end up dead in the ER? Was it a boy or a girl? Was it abuse? Neglect? An accident? I can feel my anxiety level rising. As soon as I start asking the questions, I know this is my case. I am now vested and need to get the answers.

I dial Nancy back and she answers on the first ring. "Hey, Nanc. What's up?" She gives me the few details she already has. A roll-over death. Dad was taking a nap with the little girl and when he woke up she was behind him, face-down between the couch cushions.

I call the ER and get further details from the nurse. She doesn't know much, either. She tells me that there are cops swarming the place and that the father is in the room holding the baby. "He's been holding her since the doctor pronounced. We can't get him to let go." I swollow a lump in my throat imagining this man rocking his dead baby. When you get right down to it, a body is a piece of evidence. We (and hospital staff, for that matter) are strictly instructed to prevent anybody from handling it after death. On the other hand, this father's baby just died. I reason that the damage is already done. "Just make sure that only the parents handle the body and that they know not to remove any tubes or alter anything. "They know. I already told them." The nurse assures me.

I head to the ME's office right away. I pick up an infant death questionnaire and a special doll that we use for reinactments. This is an invaluable tool when trying to determine what position a baby was in at the time of death because when a baby is found unconscious adults invariably move them.

Twenty months, I think as I drive to the hospital. That's really old for a roll-over. She wasn't a helpless infant anymore. You would think she would have struggled or screamed loud enough to wake dad.

I arrive at the back entrance and am greeted by two security guards in scarlet blazers. We chat as we take the elevator up to the first floor. They tell me there are at least twenty family members gathered in the ER and that they are very emotional. I walk down the long hallway that leads to the "family room", a place designated for those who just lost a loved one or who are waiting out an emergency situation. A crowd of people are loitering in the hall outside of Room 1. Room 1 is where ER staff always put bodies before transferring them to the morgue. It's right across from the family room and is out of the way of the rest of the ER. As I approach, Det. Port sees me and begins walking my way. We whisper greetings and he tells me what he knows..which isn't much.

"This guy is a piece of work. He won't tell us jack about what happened. We've got cops outside his home but he won't allow us entry. The DA is getting a search warrant as we speak."

"Whoa, whoa, whoa. A search warrant? I thought this was a roll-over."

"Yeah. Well, things aren't adding up. Seems he fell asleep on the couch with the kid on his chest. Less than an hour later, his girlfriend showed up at the house and woke him up. No kid. He pulled back the blanket and she was lying there by his feet with her face in the cushions. They thought she was sleeping so they covered her with the blanket and went into the kitchen to make dinner. About an hour later, they went back into the living room to wake her and dad noticed that it smelled like vomit. He picked her up and saw she was blue in the face. They called 911 and did chest compressions and breathing as instructed by the dispatcher until rescue arrived."

I note that CPR was performed. This is very important because many times adults who are trying to save a child do chest compressions and inadvertently break ribs or cause bruising...injuries that look very much like child abuse if not documented.

A short, squat man with a gravely voice approaches us. He's wearing a ratty sweatshirt, jeans, and is carrying a gym bag. I figure he's a family member, but then he reaches out his hand to shake mine. "I'm Assistant DA Tate." Oh. Well. That'll teach me to judge a book by its cover. I grip his hand and introduce myself. He tells me that he wants the doc out here, stat. He wants her to examine the body and then come to the residence after the warrant is issued.

"Well, Dr. Frank is aware of the case as we understood it. A roll-over. She generally relies on my incident reports in these cases and, though I already invited her to accompany me to the home scene, refused the offer. So, before I really piss her off by calling her out in the middle of the night, can you enlighten me as to why this is potential criminal investigation material?"

"Sure." He says. "The father was on anti-psych meds. Really strong ones. To the point where he couldn't function on a job or drive a vehicle. Family said his speech was slurred and he got so off-balance that one time he fell down the stairs into the basement and broke his collarbone."

"Where's the mother?" I ask. "Is there anybody who was helping him care for the baby?"

"Not really. The girlfriend worked during the day, so he was the primary caregiver. The mother is currently in jail on drug charges."

"So, what are you thinking? Neglect?" I ask.

"Well, he mentioned to one of the nurses that he left his little girl and an open bottle of meds on the kitchen counter when the phone rang."

"Possible accidental overdose."

"Yeah."

"Damn."

"Yeah."


More later...

Tuesday, January 09, 2007

This is Cali.


Cali is a rescue dog from the local Humane Society that I adopted this afternoon. She's part Border Collie part Golden Retriever (and a few other varieties thrown in there, too, if you ask me). She was a stray that was found near a local grocery store. She was skinny and shy and skittish when I met her the day after the Humane Society got her. I would have taken her home that day, but they have a week waiting period in case her owners (if she had any) came looking for her. Her back paw was hurt and she had a big gash on the back of her head. We think she was rolled by a car.

Anyway, she's really smart and funny. She already knows her name and follows the comands "get your toy", "sit", "stay", "down" and "lay in your bed". Not only that, but she already goes to the bathroom in one precise corner of the yard (after my showing her only twice). Somebody must have loved her very much and spent a lot of time training her. Either that or she's the smartest dog ever.

I am seriously thinking of training her to be a cadaver dog. We'll see how she reacts to me coming home some night with dead guy smell all over me...

My new puppy!!