Day 12

February 11th, 2010

Case 1
Black M, approx 55 YO
Homicide GSW
Deceased was shoveling sidewalk in front of house when he collapsed. EMTs thought at first that it was a cardiac event, found wound over L nipple.
ED doctor diagnosed as “puncture wound”, opined that it was not very deep.
Morgue staff immediately recognized as GSW upon receipt of body.
Organ donor; eyes, skin, long bones, and short bones taken.
Multiple lacerations of organs, lg amt blood in R and L chest.
Bullet recovered.
COD homicide GSW to the chest

Case 2
Caucasian M, approx 18 YO
Homicide GSW to the head
Deceased suspected to be a “drug mule”, had just returned from a trip “down south”, per mother.
Man attempted to enter house through back door, shot decedent in head, may have been shot by decedent.
Deceased spent 3 days in hospital.
Organ donor
Projectile recovered from skull
COD massive avulsed injuries to brain, skull.

Case 3
Caucasian F, approx 80 YO
Suicide
Deceased found in bathtub, believed to have cancer.
Cut on L wrist, two GSWs to head, poss. OD
COD multiple (suicide)

Case 4
Caucasian M, approx 10 YO
Suspicious fire
Deceased recently informed an adult friend that father was physically abusing him.
Father was witnessed leaving the house 10-15 min before fire
When mother woke up to smoke, she attempted to wake the decedent, but could not. There was no fire in the room at that time.
Body was recovered by firefighters some time later.
Massive fire damage to body.
Soot found in airways.
COD smoke inhalation, burns

When Greg flipped open the body bag (black, unfamiliar—this was an out-of-county case), little black flakes and chunks of something, clothes, skin, flesh, hair, unrecognizable, gently pattered onto the wet floor. This was both my first child case and my first fire victim, and I had somehow expected to be more horrified. I had seen photos of fire vics before, I knew pretty much what to expect, and it was bad. It was bad, but I was, again, as in every other time I had been worried, I found myself impassive. We joked with the Fire Marshall who had come to view the autopsy, laughed and sang as we waited for Dr. O., gloved and gowned and masked over the little, skinny body.

There were fragments of carbon, unidentifiable, blackened debris, a wet sludge of ash surrounding the body in the bag, and Greg lifted the whole body one armed as Matt dragged the dirty bag from underneath it and folded it to contain the sludge and ashes, lifted it one-armed, and he could because it was a skinny little boy, because burn victims bake into one very set position and don’t flop about like traumas or naturals. The Marshall held open a Mylar bag for the remains of the clothes, and they had to be peeled from the body, sometimes indistinguishable from the black and flaking skin. All that was left was the collar and a little bit of shoulder from a T-shirt of unidentifiable color, black and soggy, and a little of the back and waistband, adhered to the body, of a pair of SpongeBob Squarepants pajama pants.

The skin was partially spared on areas that had at some time been covered by clothing, brown and spotted with flaky, burnt flecks of flesh instead of black and crunchy and charred. Where the body was not black or brown, it had split from the heat, the skin bursting open to reveal yellow, cooked seams of fat. Lifted, it was light and stiff, cooked into pugilistic position. The tongue was pressed against the teeth, protruding slightly, and where it did, it was yellowed and blistered and speckled with charcoal. The teeth themselves were similar, burned unevenly, yellowly spotted and whitely mottled, the lips pulled tightly back around their margins. There was no hair left, the head and face had been subjected to too fierce a fire for anything but black, crusty, thin skin to be left, but the face and ears, though the same color and texture as the scalp, was surprisingly intact, though the eyes had sunken when their boiling vitreous steamed away. They were tightly closed, and I had to use tweezers to move the cooked-hard lids so that Greg could try to get some vitreous. The eyes were still round, but there was no way to discern their color. The pupils were opaque white, the iris nearly the same shade, and the surface of the eyeball thinned and stiffened. The white eyes in that black-burned face were shocking and hideous, ugly because they were unexpected, flecked with charred flesh that fell from the lids and tweezers.

The child’s arms were almost devoid of skin, bumpy, burned, yellowish fat and stringy, dried, red muscle taking its place. The flesh of the hands, particularly the fingers, which were clenched before the sternum, almost touching, had apparently melted away, hanging from the undersides of the stiff fingers in hard, black curves. The bones of the fingers were black, the nails sloughing with the degloved skin at the finger’s tips. When cut, the skin was hard and leathery, stiff, hard to keep back from the incision. The muscle beneath looked like nothing so much as rare-cooked meat. The organs were mainly unharmed, but awfully small. The tongue and trachea were badly burned, covered in soot. At least the child had not been murdered before the fire started. He had probably died of smoke inhalation, would have had no idea that his body was burning. There was no trauma to be found at all. There was also no smell when the body was opened—it was overpowered by the scent of the burned body itself, and, god help us, it smelled, just as burn victims always do, exactly like hot dogs.