Coroner Story: A Gun

I was starting one of my usual working days, seeing patients as a family physician. 

I got a call from the sheriff’s office early in the morning.  I was interrupted from seeing a physical to come out and talk to a deputy on the phone.  He was at the scene of a suicide in the northern part of our county.  We discussed the case.  It was an elderly man who had shot himself in his yard.  He had left a note.  His wife had found him, shot in the neck and head with a shotgun.  The deputy described the scene and the circumstances to me.  The man was suffering from some condition with chronic pain. He had seen his physician in Spokane the day before.  He had been denied his usual pain medication for reasons that were unclear.  This was quite upsetting to the man, according to his wife, and he returned home despondent.  The next morning, he shot himself after leaving the note.  His death was pretty clearly a suicide and the sheriff’s deputies felt comfortable handling the investigation. They didn’t think I needed to come to the scene, and I was thankful.

I spent the rest of the day being a family physician.  Later that afternoon, in a clinic we have in a smaller, rural town, I visited with a young high school student. He described vague abdominal complaints to me.  While I was talking with him it seemed like there may be more to the story.

I found him likable, but he had deficits. He was on a regular seizure medication for epilepsy and his features were a bit dysmorphic. That means, “funny looking”.

I asked him if his parents were with him, and he allowed me to invite his mother into the room.  A prolonged discussion ensued. 

He was not doing well in school. 

He had medical problems, but they were stable.

I could see how he might be labeled by his fellow students as not bright.  He spoke slowly; his speech was sometimes slurred.  However, in my discussions with him he seemed to have insight and be cheerful. 

But he was not doing well in school. 

His mother said he didn’t study or apply himself.  When I asked the student what he would change about school if he could he said, “I wish they’d ask me to do more things.”

“What do you mean by that, more schoolwork, or more activities with your fellow students?”  I asked.

“Both,” he said. “They think I’m dumb but I’m not.”

I looked at his mother.  She looked at her son.  She asked, “What do you do when they ask you to do more?”

“I don’t do it,” he said looking at the floor. I could see this conversation had been done before.

“What does he like to do?”  I asked the mother.

She paused for a moment and the two discussed this. It sounded like he likes to play computer games, listen to music, and play sports.  He really does not like to read or do schoolwork.

The mother has tried to encourage responsible behavior by getting him a job mowing lawns.  But she described continually nagging him to get this done. He doesn’t do it on his own.  The two talked with each other in a warm and open fashion, but it was obvious there had been some conflict, maybe even a lot of conflicts.

I asked the mother if she had tried withdrawing privileges.  She said she had tried but it never really worked.  I asked her how hard she had tried.  She seemed puzzled.  “Have you taken all the things that he likes to do away from him?”

“Well, I’ve tried, but that doesn’t really work,” she replied.

“How long did you do it for?”

“Oh, a day or two, and it works a little bit, but then he slips back into not doing his homework.”

I looked at the mother, and then I looked at the boy.  “What we are talking about here is learning discipline. Do you know what discipline is?”

I looked at the young man. “Discipline isn’t spanking or punishment. It’s what we all need to learn to be happy in this life. It’s the duty we feel and the obligation we fulfill to do the tasks we need to do, when they should be done.”

I turned to the mom. “You’re going to have to do it for longer.  He’s going to have to understand that you mean it.”  As I looked at the boy, he looked at me and actually grinned.  I smiled too.  It seemed like he knew this was coming, and he was somewhat relieved by this discussion.

I outlined the plan to both of them. Everything except the bed, his clothes and a lamp were to be taken out of his room. No extra activities until his grades were at a certain level (C’s-B’s, whatever was an agreed, realistic goal). As he achieved these marks the privileges are reinstated. I warned this usually takes a couple weeks. It will not be without conflict or anger. The two seemed quite comfortable and warm with each other, even loving.

I wasn’t sure if the mother had the fortitude to pursue this.  I had never met this family before. This is what I call, as a physician, shooting from the hip.  You try to get a sense of the family and advise as appropriate.

I had a good sense about the meeting. Maybe even a little elation, like I might have actually helped somebody in the allotted fifteen-minute time slot. But then, who really knows. They go home and I see the next patient.

Later that night I got another call from sheriff’s dispatch. Another suicide. It seems they come in bunches.  This one was in the eastern part of our county; out past that rural clinic I had been in this afternoon. A 16-year-old boy had shot himself. 

Usually, I ask the dispatcher the name, so if I know the person I’m not surprised at the scene. A little preparation helps the mind be clear for observation.  I forgot to ask this time.  Then, as I was driving through the night to the small town, a worry came over me.  A deep sense of dread weighed down that this might be the kid I saw today.  I wondered if I had misread the family and things had gone very wrong.

I drove through the small town where the clinic was. The old brick high school on the hill looked down on me darkly. I didn’t get lost this time on the rural county roads and I approached the location where the dispatch had told me the suicide had occurred.  The deputies’ cars were parked off the rural lane and their lights were circling red and blue in the dark.  I approached Brandon, the deputy in charge of the scene and asked him first thing, “Do you have the name of this kid?”

He scowled and admitted he didn’t. He’d forgotten. He got on the radio to call dispatch to get the name. 

As we waited for the reply he launched in: “Let me tell you the story, Doc,” he said.

Then he turned and started to lead me back into the brush with his flashlight to look at the body.  He’s walking ahead with his flashlight, talking, leading. I follow. “It sounds like the parents weren’t happy with this kid’s school performance.  It sounds like they came down on him pretty hard tonight, and he got pretty upset. They were giving him grief, I guess around dinner, about schoolwork, and saying he couldn’t see his girlfriend anymore. He grabbed a gun and ran out of the house.”

I step over branches and brush, following downhill, listening.

“The way the parents talked he was a hot head and had stormed off like this before, so they didn’t run after him. When he didn’t come back for half an hour his little brother went looking for him.  He found him out here in the brush.  There’s a note by him, and there’s a gun. He’s just back here in the brush down off the bank.”

By now, I’m reeling.  I’m following a bobbing flashlight into the black and enclosing brush. As we step over twigs, and they snap and crunch I tell the deputy he has to stop.  I can’t look at this kid until I know his name. I bend over and put my hands on my knees to steady myself. I say out loud, to the ground and the dark warm air, “If this is the kid I saw this afternoon this family will never forgive me.”  And I wonder if I could either.

There are no blood or guts nor dismemberment, no bloated body to see on this dark brushy hillside, but it’s the closest I’d ever come to throwing up or passing out on a coroner call.

This one might not be all right.

I have come to find that most deaths are forgiven. Homicide, suicide, accident. In some way the sense of it fills in and I can come to peace.

The families do or they don’t, and it wears them down, but peace and forgiveness heal. Maybe not this one for me.

 It’s taking forever for dispatch to come up with the name. I stand up and wait for the name over the radio. Brandon is walking on in the dark, leading the way, unaware of my hesitation. He’s talking away into the radio.

I steady myself and follow.

Down the bank I can see the flashlight beam on the shoes. I’m dizzy and cannot brace myself, but I can see the shoes.

They are not the shoes I looked at on the kid in the office today. 

The name that finally comes through the radio is not the name I heard today. 

It’s not the same kid. So, my guilt is assuaged. And I can now recover the distance. The faint I feel fades.

I climb down the bank to look at the face. It is misshapen now with the top of the skull gone and the bones of the face left with little to hold them up.

The buzzing in my head recedes. I can look at the suicide note to his girlfriend and find myself smirking at the misspellings. Distance lets you smirk.

But it’s still a dead kid. Another dead kid.

I look up at the deputy. I can’t see his face since he holds the flashlight. “Kinda makes you not want to lay down the law on your kids, huh?” I say.

“You got that right Doc. I was riding my daughter about her homework tonight before I came on shift. And soon as I heard this one, I called her on the cell and said, ‘You know honey, it’s OK how you’re doing in school’.”

I thought about the kid this afternoon and his mom.

Was this the horror she thought she was avoiding?  Or did she know she could not forgive herself if this happened.

We cannot prevent the tantrum.

A gun makes a tantrum fatal. And our sense of self can be so confused that we feel responsible for the cause or the cure.

And then there’s the gun.

Cause of death: Rifle shot to the head.

Manner of death: Suicide

Posted in Uncategorized | Tagged | Comments Off on Coroner Story: A Gun

Coroner Poem#7

Apartments full of sleeping students

Draped with white sheets of snow

Over the old apple orchard knoll

Where he shot himself some years ago.

He sat on an old apple tree stump.

Facing south, there was no sun only cloud.

The revolver shiny a few feet from his hand

Now open to the gray overcast shroud.

The clouded-over eyes no longer looking,

Faced upward. The mouth open, teeth dull,

Blood puddled in brown clots on the mud,

Next to the hole on the right side of his skull.

Assume a student, his life unknown pain

Escaping, he thought, days and nights of misery.

With a brief pull of the easy shiny trigger

Died where we left not one apple tree.

Asphalted over his last bloody bed, the mud where he lay.

Awaits my quiet early tread on this sleepy snowy day.

Posted in Uncategorized | Tagged | Comments Off on Coroner Poem#7

Idiots

Are we, or are they? Maybe they just think we are.

Megan Blanksma is no idiot. But her posture of protecting us from government intrusion makes me think she might think us so. Shame on her.

She wants to change how immunizations are recorded here in Idaho to “protect privacy”. She should set her sights on Google or Amazon, not the Immunization Registry.

I wish Representative Blanksma could have been with me in the ER on the weekends in Grangeville. I can’t tell you how many times folks showed up with a scratch or a cut from the rusty nail wanting a tetanus shot.

“I don’t need no stitches, doc, just the tetanus.”

When was your last shot?

“Heck, I don’t know. It’s been years.”

We will look it up. The nurse starts logging in.

“That shot keeps it from getting infected, don’t it?”

Well, no. Tetanus is a rare complication from an anaerobic wound. Last year in this country about seven people died from tetanus. But wound infections are much more common, and the tetanus shot does not keep you from getting a wound infection.

The nurse finds that his last shot was three years ago, recorded in the state registry.

It looks like you don’t need a shot, you are well protected from tetanus. But make sure you wash that wound, soak it, let us know if it gets red or painful. You don’t need another tetanus shot for another seven years. Though there is some evidence you only need them every thirty years. You’ll be fine.

The current immunization registry guidelines are that people can “opt out” at their request. If they don’t opt out, their immunization data is recorded in a protected data base. Identified health care providers can access the information.

Do you think your shopping data is protected? Are you an idiot?

When you Google 18 cubic foot refrigerators then log in to Fox News and see ads for 18 CF refrigerators, do you think this is just a coincidence? Then you’re an idiot.

It’s all about information. For some reason, our state does not have the capability to find people we have improperly disenrolled from Medicaid. But our DMV knows if you have car insurance. Why doesn’t Representative Blanksma go after that data base?

I think it’s because she knows an avid base when she sees one. Antivaxxers are at the head of any Trump rally. So why not combine the universal desire for privacy with the antivaxxer sentiment? It’s a win-win. But that’s just because she thinks we are idiots.

I don’t believe we are.

Opt in and opt out is a crucial pivot point.

Most of us don’t think about our retirement.

Nor about keeping up to date on our immunizations.

Good evidence shows that employees enrolled (opted in) into a retirement plan, with no cost to themselves, have more savings in the long run. When the retirement benefit is structured so they must “opt in”, some choose not to. Maybe they are suspicious of their employers’ motives, who knows. But the opt in, opt out pivot point is powerful.

Please, look in your wallet. Do you have a smudged immunization card?

Maybe you think this service of keeping track of immunizations is best done by the private sector. Make sure you give them your credit card information and email address.

Yes, you are an idiot.

Representative Blanksma described being shocked when she found out that her children’s immunizations were recorded in the state registry when she had “opted out” from that process years back. I can appreciate that affront.

But dismantling a good system is an idiotic response.

Posted in Uncategorized | Tagged , | Comments Off on Idiots

Coroner Story: Hunting

It’s hard not to think of the families, you know.  There is a job to do, and you do your best.  Still, it can be heartbreaking.

It was a Saturday, fall, mid day.  I was on call as the doctor in town, seeing walk-in patients in our clinic when my nurse knocked on the door.  She looked sideways at the phone and said under her breath, “Sheriff’s office, line three” like she knew I would not be able to finish with the last six patients in the lobby.

            Dispatch told me of a gunshot death in the Eastern County.  It looks like a hunting accident.  There were two deputies on the scene.  She gave instructions twice as I wrote them down.  No address, just a road off a road off another winding road.

            It was a bit of a relief to get away from the rush of Saturday clinic. All those people searching for the instant cure to get better so they can go back to work or to school by Monday.  It had snowed a bit, but the sun was out now, and it was beautiful.  I thought about my own hunting recently.  I’ve gone off by myself on a weekend day, sneaking through the brush and timber, excited, alone, purposeful.  But I didn’t shoot anything — nor did I see anybody.  The peaceful solitude was enough of a distraction to keep me from asking what I was looking for in my busy days. For the very nature of hunting is not restful.

Seeking.

Wanting.

I could remember times I watched a distant hillside, and the strength of the desire was so great that I would see a deer in the patterns of the bunch grass or brush. Those times I rarely really saw something. The deer most often show up when you aren’t expecting, when you are peaceful. I was working on that being peaceful thing.

The solitude and peace I would get today would be in my little pickup on the back roads of the county, looking for a road off a road.  Almost every other year there was a hunting-related death in our county, either due to firearms or due to accident or sometimes a heart attack in the field.  It sounded like this was an accidental gunshot wound…  Still —

            I found the road off a road and one of the deputy’s cars was at the turn off.  A lane led uphill.  It was snow-covered and I didn’t have four-wheel-drive, so I parked and walked.  The sun was brilliant on the snow.  It was still freezing but a breeze knocked snow out of the branches, and it floated down to join the snow on the ground.  As I crested the hill, I saw the other deputy’s four-wheel-drive rig at the end of the lane.  There was thinned timber here between sections of field on both sides.  The timber was young trees, pretty far apart with little cover.  I saw the deputies 100 yards into the timber wearing safety orange vests.  As I approached, they stood and watched me.  I picked my way over logs, crunching the few inches of snow.  When I got to them, I saw the body slumped back against the log.  His face was ashen pale with a quizzical expression.  Dead.  He wore an insulated hat, a vest, Levi’s, and boots.  His rifle was in his hands across his chest.  I saw the blood-soaked vest as I caught my breath.

            “So, what’s the story?”  I asked the older deputy, Earl.

            “This is a bad one Doc.”

            “So, did someone shoot him?  It doesn’t look like he shot himself.”

            Both deputies looked at me, slow to start the story.  The Earl finally said, “Yeah, his son shot him Doc.”

            I looked at them both.  “Tell me the story.”

            “We got the call about nine.  The neighbor said a boy was there saying he’d been hunting, and someone was shot.  Ambulance was dispatched and so were we.  Alan got here first.” He nodded to the younger man. I drove up-and-down the road half a dozen times before I could find it.  Hell, the ambulance never did find it. We radioed they didn’t need to come when we saw he was dead.”

            I turned to the younger deputy.  “What did you see?”

            “Well first I went to the house where the call came from and picked up the kid who called it in.”  He checked a notepad and gave me the name.  “He showed me how to get here.  We drove up to the top as far as I could.  I had the four-wheel rig.  We come over to where they both were, the dad, he was like this, we haven’t moved him, and a boy was sitting on the log there crying.” He checked his notepad again and gave me the names of the deceased and his son and their ages.

            “Apparently the dad was going to take the son and his friend out hunting.  The boy hadn’t hunted before and so they picked this spot ’cause it’s open.  They know the owner.  They got here early and spread out three across and were gonna walk east this away when a buck jumped and ran between ’em.  The boy fired, missed the deer and hit his dad.”

            I searched the faces of the deputies — they were just looking back at me.  “Do you guys know this family?”

            “No.  They live in town.  Good citizen folks from what I here.”

            “Do you think the boy intended to shoot his father?”

            Both the deputies were quiet.  I looked at the younger.  Alan swallowed hard.  “No sir.”  I turned to Earl.  “Did you talk to him?”

            “Yes, I took him back to the house.  He was pretty shook up.  I don’t think this is anything but an accident.  I don’t know how he is going to live with this.”

                                    Cause of death: gunshot wound to the chest

                                    Manner of death: accident

Posted in Uncategorized | Comments Off on Coroner Story: Hunting

Coroner Story: Not made for TV

This is one that I’m sure would’ve had a different ending if it was on a TV show.  Not enough drama in the truth.  They gotta give you a wrapped up bad guy, led away with someone, some detective giving them the Miranda litany.  I’ll bet third graders in this country know, “you have the right to remain silent.  You have the right to an attorney…”  Probably up there with, “I pledge allegiance to the flag…”  And just like the pledge means our day of merciless boredom is about to begin, Miranda means another bad guy is being hauled off and a commercial is coming.  But the beauty of any story is that there can be more than one truth.  But stories like that make it hard to cut to commercial. In other words, this shit doesn’t sell.

So, without commercial breaks…

 I got this call early one weekday morning as I was doing hospital rounds.  It wasn’t even nine o’clock in the morning and my pager gave me the number for Paradise Police Department.  I called and they said I was needed for a death at Garfield and Kenwood.  Fifteen years in this little town and I still don’t know all the streets.  “Where is that?  Is that over by the Junior High or by Safeway?”

The dispatch lady answers a couple radio messages in her code “10 99…  10 36” then replies, “it’s by the fairgrounds.  You can’t miss it with all the fire trucks.”

“There was a fire?”  I remembered all the sirens just a half-hour ago as I walked into the hospital.

“Small one.”  She doesn’t want to tell me too much.  She’s busy.  “It’s out now and one deceased.”

“Do you have a name?”  She gives me a name I don’t recognize, but she’s in our two-year-old computer database. But no office visits, no medication refills so I don’t know anything other than a 74-year-old lady.

Sure enough, I didn’t miss it.  The streets around the fairgrounds were blocked with the massive red pumper trucks.  Our all-volunteer fire department is quite handy and enthusiastic.  They were out in force on this cool spring morning.  It had rained and the streets were wet, no ice, no snow.

I had to park a couple blocks away since everyone parked their second or third cars on the street in this residential neighborhood, and between every second car was a driveway cut.  I walked up in my jacket.

The officer keeping the street blocked recognized me and waved me through.  I rounded the corner and came to the nexus of official vehicles.  The firemen were pulling hose and shouting and bustling.  There were two or three detectives there. Almost like the scenes you see on TV.  Except this was a 1960s ranch home with an unkempt yard, no high-rise or brownstone.  But the resemblance to the drama of TV shows might have explained the pulsing testosterone I could sense from the firefighters.  One recognized me and brought me over to a part of the back lawn where cops were standing. 

A blue tarp had been strung across a line between the garage and a pumper truck.  This was an attempt at privacy for the body I was to view.  Heck even the Chief of Police was there, but he just nodded hello in a professional and sober manner.  He was letting his guys do their job, not needing to steal the show.  I recognized the captain of the city police detectives, and he filled me in as we walked around the hanging blue tarp.

Neighbors had called in the fire about 8 a.m.  The trucks had rolled up to see smoke rolling out of the eaves and the front picture window obscured and black.  They’d gone in through the front door to a living room dense with smoke and junk. 

At this point one of the firemen who had joined us behind the blue tarp started describing the masses of piled up junk. They became an obstacle course in the dense smoke and now shallow flame and heat.  They had knocked down some flame and the picture window had shattered.  He described how he beat down the flareup when the oxygen rushed in.

They felt their way around to find the couch, mostly burned and our body, barely recognizable as such in the smoke.  But once that was confirmed they did their best and brought her out, but she was partially cooked into the position I now was looking at behind the blue tarp.

I imagine she was a difficult carry, since, as she laid on her back on the damp lawn her position was still as if seated.  Her legs bent at the waist and her knees at 90°, cooked into a seated position.  Her clothes, if she’d had any, were now incinerated and her skin was quite a bit also.  There were dark black patches, red raw patches, hair gone, but some areas still fairly normal looking.  Maybe she was slow cooked.  Smoked, or baked, not done yet so the joints were still stiff.

The husband had come back while the crew was here. He was down at the station giving his statement.  But the gist was that he had gone out for his usual 7 a.m. breakfast when McDonald’s opened and had said goodbye to her as she sat on the couch for the first or second of her morning cigarettes.  Nothing unusual reported.  The cops weren’t suspicious.  But it seemed a bit funny, a lady sitting on the couch that caught fire and not getting up, so I agreed that an autopsy might be helpful.  There was no obvious injury on her skull, like he might have cracked her one and then set the fire before heading to McDonald’s for his alibi. But there were enough for questions about the scene that more information from an autopsy would seem prudent. I had become more prudent in these years of doing this. I hadn’t always been so.

So, we might want to break for commercial here for dramatic effect: no definite crime, no real question of right and wrong, everybody kind of just shrugging.  Like I said, I don’t think this would make good TV.

I called the lady’s doctor.  I wanted to see if she had any natural history of diseases that would explain why she’d let herself get burned up:  overdose, suicide, maybe a heart attack or stroke on her third cigarette.  I explained the scene to him over the phone and his first reaction was “Oh!”  like now he understood.

“So, Doc, you think of any reason why she’d die suddenly?”

“No. Not really.  I saw her just a week or two ago.  She had high blood pressure, but I can’t imagine she had a stroke or anything.  But she did drink.  And she took a lot of drugs.”

“Really, what kind?”

“Prescription drugs.  She was always calling for refills.  Let’s see.  She was on Xanax and hydrocodone.  From me at least.  She could’ve been getting more from someone else.”

“She’s not getting any from our office.”

“Well, that’s good. She was beginning to show signs of dementia.  I suspected this from the years of alcohol.  But her husband had commented on how forgetful she seemed. And I suspected that she might be forgetting and taking her medications inappropriately.  And she had started coming into the office in her housecoat, looking pretty ragged.  I just thought she might be drinking more.”

“Did the husband seem odd to you?”

“No, why?”

“Oh, just asking.”

So, I relayed this medical history to the pathologist.  Of course, the toxicology levels took weeks to come back but they were inconclusive.  None were in the toxic or lethal range like she’d overdosed, and her alcohol level was not zero but near that.  Her cause of death that he came up with, since this guy never wanted to be too committal, was “conflagration.”

Maybe he was an English Major.

The way he explained that to me was that there was evidence for smoke inhalation, but also severe burns.  And if you give the smoke inhalation as the cause, then the burns were postmortem, but some microscopic evidence suggested some of the burned injury was premortem or near, so you don’t want to commit to smoke inhalation as the cause…  So much hand waving really just meant he didn’t want to get off the fence and call it one way or the other. Here I had an unhelpful pathologist acting like a radiologist. That’s an inside medical joke that would not bring any TV laughs. And why would a dead body be a reasonable joke?

So, I was left imagining it.  Again, this imagining thing doesn’t do too good for TV.  Fade into fuzzy pictures, maybe black-and-white…  You know.  Anyway, the lady has her third cigarette, forgetful, maybe went back and took another Xanax, forgetting she’d taken the first after she’d peed.  Then she returns to the couch for her fourth or fifth cigarette.  It drops onto the carpet; she falls asleep sitting up.  The smoldering carpet fumes giving off carbon monoxide to further sedate her. They all slowly accumulate, drugs, smoke, CO, and she’s so far gone when the heat finally arrives to her legs, ankles, arms and as her nylon housecoat explodes, she doesn’t move. Maybe this is a merciful ending.

Wah-lah. Is this the answer?

So, I called it an accident. That’s my job, I gotta call it.

I did check with the police, and they were comfortable with that.  I had called the husband on the phone the day after the fire to tell him we were doing an autopsy and he could claim the body at the funeral home the next day.  I had asked him if he’d noticed anything unusual.  When he spoke, I recognized his voice.  I had heard him in the halls of our office when he had come to visit one of my partners.  He had a loud, abrasive voice like you imagine a man telling you to get off his lawn as you are chasing your Frisbee.  “Naw, Doc.  She was her usual self that morning.  I said goodbye like always.  She was there on the couch.”

“So, she wasn’t slurring her words, or she didn’t walk differently like she’d had a stroke or something?  She didn’t complain of a headache?”

“Naw, nothing like that.”

“She hadn’t seemed sick or anything?”

“Naw.”

“OK.  Well, I’ll let you know when we get the results of the autopsy.  It usually takes a good three weeks.  If you haven’t heard from me in a month, give me a call.”

“Sure thing.” His rough voice made me think of a chain saw. Not the big ones loggers use, but one of those small ones your neighbor uses to cut up limbs.

He didn’t seem too distraught, real matter of fact.  So, when I heard his voice in the hall about three weeks later my mind was brought back to this man and his burned-up wife.  I thought of his loss, his wife of 50 years, the drinker, smoking away her hours amid a cluttered living room and he off to get his breakfast with his buddies at McDonald’s.  I wondered about how he felt, his awareness of her growing infirmity, losing her mind, her function.  The coming conflicts of care, home, nursing home, feeding, dressing. Had there been arguments?  Was there conflict?  The receptionist said he was asking for me. 

I came around to greet him and invite him into a room for a private talk.  “Ah naw, Doc.  Don’t want to take up your time.  Sorry to bother you.  I just wondered what you found out and all.”

He wore blue jeans with red suspenders straddling the sides of a big beer belly over a cotton plaid shirt.  His baseball cap had the phrase, “You Want Trouble?”  on the crown.  His face was creased, and he walked with the arthritic roll of an old logger, now relegated to Social Security and tales of the woods, where men were men and the government wasn’t keeping anybody from their work of cutting down trees, building roads.  His eyes were hard and dull, like he wouldn’t mind knocking in the skull of a hippie or an Injun if they came into his bar on a Friday night.

“Did you want to step back here?”  I wanted to talk some more with him, see if there might be more. 

Here the TV show would’ve had the bereaved redneck husband come into an exam room and after a few heartfelt, kind questions from the sympathetic coroner he’d have opened up to how hard it was getting for him taking care of the old lady.  How she just sat and smoked all day and never picked nothing up.  How she wouldn’t even have sex no more Doc.  Hell, he’d look into my eyes, anger, and tears, and he’d demur, it wouldn’t be long before she’d be pissing herself. The conflict of true emotion and an unavoidable honesty resolved with my skillful open-hearted questions. And I’d have the forensic evidence from a state-of-the-art lab that showed he’d slipped her two or three extra Xanax’s, then held the pillow over her face, sat her on the couch and left the fire smoldering as he went out to the morning McDonald’s as his alibi.  But this isn’t TV.  This is life; uncertain, confusing, boring life.

“Naw Doc.  You’re busy.  I guess you didn’t find nothing.”  He turned and walked out.  It could’ve been the only way he could show his grief.  It could’ve been a wily cover. And I was just a county coroner.

            Cause of Death: injuries from a fire

            Manner of Death: accident

Posted in Uncategorized | Tagged | Comments Off on Coroner Story: Not made for TV

Seasons

The Idaho legislature has its seasons. Old hands know this, and young bucks and does have figured it out too. You, the interested public should also know it.

I don’t communicate this like I’m a wise old sage. Many are far wiser and have seen more seasons than me. But we should get this out there so we can all have a sense of what’s going on.

When I went hunting with my daughter this fall, she commented on how she’d heard rifle shots in her drainage. She was worried the elk had been spooked. “They don’t pay much attention to shots. They move when an animal falls.”

Here in the early season of the Idaho legislature we are hearing the shots.

The “antiwoke” bill proposed to change all the words in Idaho code that said “fetus” would be changed to “preborn child” got introduced for us all to be shocked and appalled. Then, the sponsor said it would go no further. It will be held in committee at her request.

Maybe the sponsor was shooting at something. Maybe she was just letting her fellow hunters know where she was. She didn’t harvest. Harvesting comes later in the season. These early weeks of the legislature are for location shots, not harvesting.

Similarly, we have the long, complicated bill from Representative Redman that would essentially repeal Medicaid Expansion. It has so many clauses, it makes my head spin. Don’t try to read it. It’s not worth your time. It proposes so many restrictions that it would accomplish repeal of the Medicaid Expansion that 63% of Idahoans favored in an initiative vote. Why is he so out of tune? These early season shots are important to let the rest of us know just who we are hunting with.

You see, our elected representatives are not our hunting camp buddies.

It was always fun to come back to camp and hear what the others had seen, build up the fire, eat the food.

You have to understand that our elected representatives aren’t sitting around the fire with you. They are in their own camp.

In my fifth year of Idaho State Senate service, I went to a presentation from the local Soil Conservation Districts. Their goal was to inform state legislators about the work they did. A colleague from north of me commented to the presenters about how, when he discussed this with constituents, he didn’t think this was a reasonable use of tax dollars. I asked him over lunch just which constituents expressed these ideas. “I just meet with my Republican Central Committee.”

These early shots reflect what they are talking about around their campfires, not ours.

Little will be harvested. But it’s something to brag about back in camp. But maybe someday they will harvest.

The middle season of the Idaho legislature is when the menial work is done. Simple budgets get passed; repair bills fix up the sloppy bills from years before. There are always the lingering hot button bills that are held late to consume some drama. Abortion, libraries, pornography, some other issue might fill this middle season when we should have harvested much earlier.

But the harvest is always late since Speaker Moyle has risen to power.

These early bills might garner support back in the Central Committee meetings, whether they pass or fail. But the real juice comes at the end.

And then, at the end of the long hunt, there’s little time to direct the shot.

These last two sessions have seen tax bills proposed in the last week, rammed through committee, transferred long past the deadline for such, and approved. The hero took the final shot and dropped the harvest.

Are we so eager for meat? We should want more.

Posted in Uncategorized | Tagged | Comments Off on Seasons

Again

I had this conversation with my wife yesterday about Idaho’s abortion laws. I have told this before, but she said I needed to say it again. She didn’t remember. Maybe you don’t either.

The Idaho antiabortion statutes are so confusing, even Boise State couldn’t get it right. Up here in Moscow, we are not surprised. “Who do we hate, Boise State” has not been a chant heard here for a long time, but it echoes still between the grain elevators.

In their recent poll of Idaho residents, BSU prefaced a question with the statement “Currently in Idaho, abortion is banned after six weeks of pregnancy…”. That prefacing has no basis in statute. All abortions are banned, unless the doctor can positively attest the life of the mother is in jeopardy. There is also the exception for rape, if a police report has been filed, but my State Senator is trying to remove that. The BSU professors gulped when a reporter pointed this out to them.

In my previous column, I pointed out how these laws, no longer subject to Supreme Court protection, would make me a criminal. I guess I might be spending the last of my days in Idaho Correctional facilities. I ask the local prosecutor to come knock on my door.

I’ve told this story before.

A young woman didn’t want to be pregnant. But she was pretty far along when she came to me. It turned out her baby had a deformation not compatible with life outside her womb. It was anencephalic. The baby’s brain had not developed. She also had excessive amniotic fluid. Her cervix was ripe, meaning, I thought she could soon go into labor. I explained the situation to her, that her baby would not live, but in my opinion, she should deliver. She agreed.

The next day, I ruptured the membranes that surrounded her fetus, excuse me, “preborn child”. If the Idaho Legislature has it’s “Anti-woke” way, those are the words we now should all be using.

So now I want you to read the text of Idaho statute defining an abortion:

the use of any means to intentionally terminate the clinically diagnosable pregnancy of a woman with knowledge that the termination by those means will, with reasonable likelihood, cause the death of the unborn child…I.C. § 18-604(1)

I ruptured the membranes… “any means”.

The child will die outside of the womb… “cause the death”.

I could not attest that the condition of excessive amniotic fluid would cause the death of the mother, though it does carry a risk. I am guilty.

So, all women in Idaho carrying an anencephalic “Preborn Child” will need to leave the state, unless they are comfortable having their baby without medical intervention. For that doctor could go to prison.

Maybe the frequency of this condition is so rare we should just ignore it to protect all the other “Preborn” that could be murdered. There were probably only 5-10 anencephalies in Idaho last year. But there were a few Potters Syndromes, some other chromosomal aberrancies. It’s not up to the mother, the family. The legislature knows best, don’t they?

That is where our legislature, the people we have elected, have put us. I pity the women. I feel for the families. This is a tragedy. But our representatives do not have the compassion to consider their condition. Maybe they just can’t be compassionate.

But maybe we Idahoans can. The responses to that poorly prefaced BSU poll showed that 58% of Idahoans favored offering exceptions to the misrepresented restrictions. Remember, Boise State said you could get an abortion in Idaho before six weeks of pregnancy. Legally, you cannot. Ever.

It doesn’t really matter to our elected officials just what we think. I can’t tell who the heck they are listening to.

Posted in Uncategorized | Tagged , | Comments Off on Again

Coroner Story: Alone

I often seek solitude, but it’s always temporary. I lived very isolated for a couple years and I got a clear sense what it was doing to my psyche. So, I jumped back into the world. But I still tend to isolate.

This lady was not like me. Or maybe she was in her way. But I appreciated her fortitude. Some call that stubbornness.

I got the call on a cool fall weekend when I thought I could get something done. Maybe I was painting or finishing sheet rock or tearing out walls. I don’t really remember those details. But it was a sheriff’s dispatch call into the county so I paid as good attention as I could to the directions. I made notes. They were long.

I told Martha I was heading out and went to the old Hilux. The differential had been howling recently, but it would make the twenty miles, I hoped. I got gas as I headed out of town.

It seemed more quiet than usual. Maybe there hadn’t been a football game here this weekend, I didn’t know. The sun was heading southwest, and the golden harvested fields glowed. We’d had frost this morning. Might get cold again tonight.

I hadn’t been out these roads. I knew the main roads, but there’s little sense going out all these little back roads unless you live here, or you get a call.

After the second turn I started to worry I was on the wrong road, but the third turn came as the nice dispatch lady had described and now it was gravel. So, I kept going.

That is my nature, to keep going. That is why, when I felt that danger of solitude and I dove off back into people, it was a significant move. I can keep going, even when I think it’s wrong. Unless, for some reason, I don’t. Driving unknown roads makes we wonder these things.

The road narrowed and climbed. There were occasional driveways off into the trees, but mainly just gravel and cutbanks. I knew this direction was toward the mountain that dominated our prairie.

On the turns one rear tire would slip and spit gravel. Everybody else has four-wheel drive. I just wished Toyota gave me a limited slip differential. I downshifted and kept on, now very unsure. I was entering a bit of a canyon. Not like the red rock of the southwest, but what we have out here on the edges of the Palouse. Steep hillside with timber, absent from the windblown rolling hills. These canyons usually have a stream, while the undulating prairie just has mud.

I pledged to do another two or three twists before I headed back.

But there he was, Detective Earl, my hero. I felt relief to see him here. I don’t always get along with all the sheriff’s staff.

I parked behind his rig as far off the road as I dared, given the drop off.

“So, Earl, what have we got?” I walked up toward his Ford Explorer. The rear hatch was up, and he had his camera gear all exposed.

“I’m not sure Doc. That’s why I wanted you to come all the way out here.”

We stood shoulder to shoulder with our backs to the Explorer, facing the uphill cutbank.

“Do you have a name?”

He exhaled and shook his head. “Yeah, but I’m not sure that’s going to help you much.”

He told me what he knew. She was a 63-year-old lady who seemed to live out here on her own. The neighbor would see her walking into town once a week, then walking back. She seemed to always do this on Wednesday. She’d come back with bags in her hands. They didn’t seem to know where she lived, just that she walked up and down this road on a weekly basis. They didn’t know her name, nothing about her.

But a guy had gone down to the creek down below in the draw this week looking for his dog and come upon her. She’s dead. So, we called you.

And that is the definition of the coroner job. Dead, call the coroner.

“So, Earl, how do you know she’s 63? You got ID?”

“Yes, we looked through her stuff and found her ID.”

“Foul play?”

“I don’t think so.”

“Let’s go look.”

He turned and I followed. He hit a trail off the downhill slope that should have been obvious to anyone walking, looking. But left-hand drive vehicles kept the driver away from this perspective going up, and most folks going up this road would be alone in their rigs, no passenger. Going down, you wouldn’t catch it, watching the curves and road. Within twenty yards of where we dropped off, we were near the creek and coming to an overhang.

She had a decent spot. There was the creek down below, running even now in late fall. And the outcrop of granite sheltered her home. I could see her back there in hollow, curled up under a couple blankets. The charcoal fire pit before her was modest. She kept a neat camp.

“We haven’t moved her. I got all the pictures I need.”

I stood on the rocks and looked at the creek, the slope opposite. There was no elk stag looking back, no cougar poised, no drama. Just the dark hillside under trees.  I panned down and up, taking in her panorama. It was quite beautiful if you are OK with closed in places. I prefer a view of the distance. I walked around some before going to her. I found her latrine, quite neat. She had buried her cans and garbage in a couple spots downstream.

I walked back toward Earl. “So, why’d she die?” I ask the detective. 

He smiles his soft smile. “That’s why I called for you, Doc.”

I hesitated to look at her. I kind of knew what I would find. And just how little that would tell me. I stood by Earl and scanned her abode. Small axe and saw, a shovel leaned against the rock wall. There were a couple long gnarled sticks leaned up there too. Walking sticks, maybe, but too short for that. And I saw a pile of rocks build up to cover over stuff on the upstream side. She was keeping varmints out of her vittles.

“She’s got the tools she needs.” I nod toward the implements. “Those are too short for walking sticks.”

Earl smiled. “My wife uses those to dig camas.”

I nod.

I finally go up to her bedroom, under the overhang. As I do I feel the chill of the downslope breeze curling down mountain. It is still light above, but soon will be dark. How many of these sun downs has she seen?

She is close to desiccating. Her eyes have melted, and flies have laid eggs. But they are all gone now. I pull back the dirty blankets. She lies on her side with hands tucked under her cheek. Her knees are flexed, like the Buddha’s in his death pose. Or like you might for comfort as the cold comes toward you. No signs of struggle, no trauma. Earl takes pictures.

“She just died.” I say.

“Hypothermia, you think?” Earl asks as he snaps shots.

“Can’t call it that. The state codes hypothermia as an accident. I think her death was pretty natural.”

“Can’t get much more natural than this.”

“I’ll ask around. Maybe somebody knows her in the medical community.”

“Autopsy?” They always want an autopsy.

“No. I can call it.”

I found her in the hospital records. She wasn’t in our clinic files. She’d been admitted about a year ago, maybe earlier. The hospital records were very uninformative. Suspicion of pneumonia. She’d collapsed in the rural town and been brought in by ambulance. Recovered in a day. The attending physician had ordered a bath. She had left the next day before he could see her. I gave him a call.

“Oh yes, she was very interesting.” This doc was very thoughtful. I liked the way he would consider things.

“Can you tell me anything about her?”

“Well, she told me she had worked as a technician at the vet school over in Pullman for a while. But she had quit that.”

“Did she tell you where she was living?”

He paused. “You know, she was actually pretty evasive about that. She said she lived by herself out near Troy.”

“Did she mention family?”

“Yeah, she did when I asked.” He kind of chuckled. “She said her family didn’t approve of her. She didn’t talk with them anymore.”

I wished I had gotten to talk with her.

“Did she seem paranoid? Delusional?”

He hesitated. “Not really. I just got the sense she liked to be alone.”

I paused, “Thanks.”

At this point, after all these years calling deaths that I knew would not fit the boxes of the Department of Vital Statistics, I knew I needed to make something up. I wanted to submit the cause of her death as solitude, but I knew that wouldn’t fly. And solitude can restore. But most of us take it in shallow draughts, not swim in it.

I’m getting too metaphysical here, I know. Just do your job. Check the boxes, fill out the forms.

No expensive autopsy would add any insight. Nor any dignity to her life or death. So, I faked it. All alone, all by myself.

Cause of Death: Pneumonia

Manner of Death: Natural

Posted in Uncategorized | Tagged | Comments Off on Coroner Story: Alone

Shoot the Messenger

Last year I spoke too soon.

 I applauded Representative Blanksma for making some recommendations to her body. This year I’m offering raspberries.

She recommended expanded coverage for kids in the CHIP program, as well as a recommendation to expand Medicaid coverage to women to 12 months after they deliver their baby. These were recommendations that came from the Maternal Mortality Review Committee. This Board had been counting more and more Idaho moms die before or after they delivered their babies. Idaho now has a higher maternal death rate than Nicaragua. And Cuba, and practically every developed country in the world.

Except, the dismal standard, the great USA. This richest country in the world has a maternal mortality rate three times that of France, and twice South Korea’s. So maybe we should be proud Idaho’s maternal death rate is below our national average. It’s all relative, right. We are sure to protect the “preborn child”, but moms can die, I guess.

So, while Idaho has been making itself the banner state for abortion restrictions, we have been watching more infants, more moms die around childbirth. This doesn’t make me proud. Maybe it does you.

The MMRC was established in 2019. But the establishing legislation included a sunset in 2023. And the sun set without the legislature renewing it. The MMRC had as members an OB/Gyn, a Family doc, a midwife, a coroner, and a social worker. This sort of diversity makes good sense.

Idaho is the only state in the union that does not review maternal deaths. But that’s another word for “freedom”, maybe.

I would be considering myself too important to think my applause of Blanksma’s actions last year doomed them. I sure hope not. But that was always the risk for an Idaho Democrat. Sometimes it’s not the good sense the speaker offers, but the label attached. When I was in the legislature, I paid close attention to this. I should be now, too, but I’m getting too old for nonsense.

In fact, the guy who wanted Idaho to establish a Maternal Mortality Review Committee contacted me when I was a State Senator, back in 2016. I was busy then not getting Medicaid Expansion done. I listened to him, I agreed with his idea, then I asked him what he knew of Idaho politics.

He admitted very little. I gave him the names of some Republican legislators, now long gone, who might be able to advance such an idea.

I would hope my criticism this year of Representative Blanksma’s “compromise” doesn’t spur their adoption. But she has proposed a solution this is horribly unwise. If I was Trumpian, I would use different words.

Since I am retired, I guess I am free now to piss off the Idaho Board of Medicine. That is not my goal, but it may be the outcome of this rant.

Blanksma may see the value in having maternal mortality review. But her suggestion this year is that maternal mortality review be a function of the Idaho Board of Medicine.

The Idaho Board of Medicine has had the responsibility of licensing and disciplining its members. I have commented previously on how I thought they were doing.

I have known some of the Board members over the years, and I respect them. Doctors don’t always want to confront their colleagues. Will this review lead to discipline? Is that how it will be seen by the medical community? If so, frank considerations of actions and outcomes will be fraught. This is the wrong place to put this.

The previous MMRC was housed in the Idaho Department of Health and Welfare, a bugaboo for Republican legislators. Maybe that’s why Blanksma picked the Board of Medicine. Bad choice.

Posted in Uncategorized | Tagged , | Comments Off on Shoot the Messenger

Coroner Story: Never End

The Never-ending Story

See if you can tell where this begins.  Or if it ends.  I’m finally telling it because a young man asked me for a good story at the dinner table the other night.  To end a wonderful meal, he wanted a good story.  I got him to define “good story”.  He said, “You know, one that has an ending.  It doesn’t trail off into nothing…”

“OK,” I said.  “I’ll start this one.  You tell me if it’s a good story.  Stop me if it’s bad.  And we’ll all listen for an ending. Maybe it won’t trail off.”

So, it starts, I think, just a week ago.  There’s a one car rollover in the Eastern County early in the AM.  Single occupant driver, dead at the scene.  25-year-old male.  Jeff Thompson. I get the call at the start of my day in the office, so I talk to the officers on the scene, get some information and instead of going to the scene of the accident I say I’ll look at the body in the funeral home once it’s brought in to determine the injuries that caused death. It would take an hour and a half to get out there and they take pictures and document everything anyway. They were agreeable. And probably glad they wouldn’t have to hold everything up for the coroner to get there. 

Usually, you can find a broken neck, caved-in skull or chest injuries that will help you fill out the death certificate.  I go about my morning with patients.  Maybe my loyalty to the schedule influenced my decision not to go to the scene. But I wear both hats, don’t I?

I get a call at noon from the funeral home.  When am I going to come look at the body?  I’m not sure.  Maybe this evening after office hours.  Can they see any obvious cause?  Not really, they say.  Did you get blood?  Yes, they sent blood off with the investigating State patrol officer.  He’ll send it to the state lab to check for drugs and alcohol.  Since they are calling and can’t see something obvious, I figure I better go out there on my noon hour and take a quick look.  Before I go, I look through his medical record.  It turns out this kid had a long history.  Just four years ago he was in the hospital for a month after accidentally shooting himself in the neck with a handgun.  He had been high on methamphetamine and drunk at the time.  He had a revolver in his belt when he got out of a car. The gun had fallen out onto the ground. It discharged, shooting him in the neck.  The bullet had entered in his lower neck right above the sternum, traveling up to the right exiting below the right ear.  He required lots of surgeries, transfusions, and he couldn’t swallow for months.  He was on tube feeding for a while.  Then he’d been depressed and on pain meds and antidepressants. Oh yeah, drugs in his system when first admitted.

Quick run to the funeral home to look at Mr. Thompson.  None of the staff were there.  They had a funeral to run out in Palouse that afternoon, so I came in the always unlocked back door.  The kid was laid out under a plastic sheet.  The scars from his gunshot wound and surgeries were there.  Small puncture wound over the heart where they had drawn blood.  Faint abrasion over the right forehead and temple and some minor abrasions on the left elbow.  No skull fractures.  No broken neck.  You check for that by twisting the head and listening for or just feeling for crunching.  No rib or sternal fractures with the same crunching test. No long bone fractures.  I thought that maybe his right collarbone was broken, it crunched a bit when I pushed on it, but that never killed anybody.  The pelvis didn’t crunch. 

But there was a significant finding.  The whole head, face neck and upper chest in a shawl distribution had petechiae.  These are the pinpoint purple marks on the skin when small blood vessels break.  They’re usually the sign of obstruction to venous return or a significant abnormality to blood flow.  That is, the heart is pumping but blood can’t get out of the area being perfused. They signify a blood pumping obstruction.

If you swing your arm in a circle real fast for a minute or two, you’ll get petechiae in your hand and forearm. The centrifugal force of your arm going around pushes the blood out the tiny delicate blood vessels from where it has been pooled in the veins. If you puke enough, your face will get petechia. Ladies get it across   their face after pushing babies out. It’s a common occurrence in my field.

You will also see this in people who have something obstructing veins. A lady came into our Saturday clinic for “a rash”. The nurse practitioner called me out of a room to look at it. She described a pink, punctate rash, in a shawl distribution, from her face down across her shoulders.

From her description, I didn’t need to see the patient, but I did. Then I told the nurse practitioner to order a chest x-ray. Because this patient had something obstructing her blood flow back to her heart. Indeed, she had a mass in her chest, a lymphoma.

 So, this was a sign for positional asphyxia or a crush to the neck or chest. I has seen this  before in a man who was working underneath a car. It dropped off the jacks and came down on him.  The weight of the car crushed him, but his heart kept pumping, building up the pressure on the small blood vessels.  The pressure on his chest kept the blood from returning to the heart.  That dead man had petechia from his nipples to the top of his head. The weight of the car restricted the flow of blood, though his heart was doing its best to push the life blood out there. The weight of the car was keeping it from coming back. Capillary don’t stand up to back pressure. They pop and you get petechia.

So, I was guessing this kid had gotten crushed somehow in the car wreck.  But I hadn’t gone to the scene, so I didn’t know for sure how he’d been found.  I will have to call the State patrol officer.

I thought maybe we ought to get an autopsy to make sure.  I left a note for the funeral home that I was going to try to arrange for an autopsy that evening or afternoon.  I asked them to try to get urine and a blood specimen for me since I never get a result from the state lab and I’d like to know in less than six months, which is what it usually takes for the state lab to run the tests.

Are you bored yet?  Stop me if you want me to quit…

OK.  The local pathologist guy who only charges about $900 for an autopsy wouldn’t do it.  He was worried about it going to court.  I call the forensic pathologist in Lewiston, and he said he’d do it tomorrow.  But I start thinking.  His starting fee is around $1500.  Once you add in all the x-rays, toxicology etc. this is going to cost the county about $3000 and that’s just what this guy cost us after he died.  Can’t imagine what his hospital bill from his gunshot wound cost.  I’m sure the county paid for that since he was an unemployed drug addict.  But I’ve got a job to do here, investigate deaths.  Oh hell; I try to call the State patrol officer but he’s not in and doesn’t return my page.  So, it’s kinda arranged that we’ll get an autopsy the next day.  The funeral home agrees to take him down to Lewiston the next morning. This took up my lunch hour.

So, I could trail off here on the story, with how I’m agonizing over spending another dime on this kid who probably never paid a dollar in taxes and how I’ve got to do my duty. Kind of sum it up with a sense of doing the right thing in the face of all the screw ups in the world.

Is that a good ending?  Are you bored yet?  No?  Good, because the story doesn’t really end here.

About three or four o’clock I get two rapid overhead pages in the clinic, ” Dr. Hawthorne, line 2″, then “Dr. Hawthorne, Line 5”.  First is from the sheriff’s office.  They want me to know they got a call from a Mr. Roberts, claims to be the father of the deceased and he’s mad as hell, doesn’t want anybody doing no autopsy on “his boy”. They were just giving me a heads up.  I say thank you.

The next call is from the funeral home saying the same thing, that this guy, a “Mr. Roberts” is really mad.  Would you please talk to him?  They ask me.  They want me to deal with this.  I think in their line of work they are always trying to make people feel OK about things, death and all.  They don’t really want to give them bad news if they can help it.  So, I say I’ll call this guy.  In between the last two patients I do a little research and look up the name.  It seems a little odd, the dad having a different last name.  Plus, the last name is a little familiar.

So which part do you want to hear first, the phone conversation or the history thing?  Or I can stop right here.  The phone conversation’s pretty short.  We’ll do that, then you can go to the bathroom and let me know about going on.

So, I call the guy and he’s pretty drunk by four in the afternoon.  He’s telling me he knows his boy was out partying last night, probably got high on meth and drunk and fell asleep on the road coming home. “Now what good is cutting him up going to do?”, he slurs to me over the wires.  “I ain’t going to let no one cut my boy.  He’s suffered enough in his life.  Hell, he shot hisself once.  And he’s been on drugs for years now.  Let us all have some peace.”

“Mr. Roberts, when did you last see Larry?”, I try the just doing business approach.

“Just last night.”

“What time?”

“About nine.  He said he was going out with some friends.”

“Had he been depressed?”

“Not recently. He used to be. He’d go up and down you know.”

“Listen Mr. Roberts.  I appreciate how you feel here but you need to understand it’s my job to investigate deaths and I’m not sure how your son died.  It is my decision if an autopsy will need to be done or not and I’ll make that decision based on my investigation.”

“Well just what good will an autopsy do?  He rolled his car over an he’s dead.  What more do you need to know?”

“You said he was using drugs.  Maybe he took an overdose and rolled the car.”

“What?  So, he was driving a car while he was overdosed? And just happened to roll it over?  He couldn’t have done that.  He warn’t that smart.”

“Well, look Mr. Roberts, I’m still investigating this, and I’ll be making a decision by tomorrow morning about the autopsy.  I’ll let you know.”

You go ahead and go to the bathroom now.  Then you can decide about the rest of the story.  Should we have some coffee now?

Still interested? I’m warning you; it could trail off here pretty soon.

So, by the next morning I got ahold of the investigating State patrol officer.  He described it as a fairly slow speed accident.  Straight stretch of road and didn’t look like he’d swerved to try to correct or anything.  So, it seemed like he could have just fallen asleep at the wheel like his “dad” had suggested.  It was a small car with a sunroof.  He got ejected and the car was actually lying on top of him when he was found so the positional compression asphyxia was a very reasonable cause of death.

I wondered whether he was awake as he was being crushed.  These sorts of morbid thoughts are common for me.  However, you never really know these things.  So, I called the funeral home and pathologist and cancelled the autopsy.  Save the county 3000 bucks.  I also called and left a message with the family at 9AM that we weren’t going to do an autopsy.  I’d make the old man’s day. I was relieved that a younger kid took the message.

So, is this the end? 

Cause of death, crush, positional asphyxia. 

Manner of death: accident. 

Oh yes, his drug screen was positive for methamphetamine and marijuana.  I guess we could end here.  Good story?  Endings are nice. 

Oh yes, the history part.  Well, I guess it was the name Roberts that triggered it.  I got his mom’s name, and it reminded me of another death.  A 10-year-old boy, eight years ago.  Would’ve been a little half-brother to this Jeff Thompson. 

David Thompson.  I guess this is the start of another story.  It might be related, you let me know.  Or we could stop here. God, I wish it would stop somewhere. It seems like it just keeps going on.

So, this was eight years ago in the fall.  I’m seeing patients in the office toward the end of my morning, and I get a knock on the door that the sheriff’s dispatch is on line three.  I pick up and the dispatch lady is hysterical.  “Oh Doctor, there’s been a horrible accident.  It’s an emergency.  They need you to go to Deary right away.  Oh, it’s just a horrible thing.  They need you their right away.  It’s an emergency.”

I’m waiting for her to calm down.  Finally, I interrupt her.  “Ma’am.  You are calling me as the coroner, right?  OK, well then ma’am, is this person dead?  OK, ma’am.  If they are dead, it’s not an emergency.  It’s a tragedy, but not an emergency.  I will finish up with my last patient before noon then I’ll go out there.”

“They need you right away doctor.  It truly is an emergency.  A young boy has been shot.  Can I tell them you’re on your way?”

“No, I’ll be leaving at noon.  It’ll take me half an hour to get there.  I’ll probably be there by 12:30. Goodbye.”

Five minutes later I get a call from the sheriff.  “So, Doc,” he asks, “are you going to this scene or not?”

“I’ll be going at noon.  I’ll be there around 12:30.”

“So, you are going?”

“Yes, I am going.”  I imagined that the dispatch lady shared her disappointment with the sheriff.

“OK.  See you there.”  The sheriff was a pretty reasonable guy.

It was a beautiful fall day.  I had to ask directions at the little store in town.  The shopkeeper seemed to know where I needed to be.  There were three sheriff’s department cars parked around the single-wide trailer up the hill.  It was a couple maybe three streets off the highway next to a bunch of other trailers.

I spoke with the sheriff and the investigating detective who were waiting for me outside the singlewide.  They outlined the scene for me. 

It had been a teacher training day for the school district, so the kids weren’t in school.  There were three boys playing in the trailer.  No parents were home.

The detective prepares me.  “When you go in, you’ll see evidence of them horsing around.  They must have gotten into their fathers hunting stuff because there are arrows stuck in the wall and the ceiling.” 

He outlined the events to me from interviewing the two surviving boys.  The deceased was a fifth-grader, David Roberts.  The other two boys, Jared Thomas and Billy Curtis were fourth graders, but were playing with him because they were buddies.  At one point David took the other kids into the parent’s bedroom to show them his dads hunting rifle.  Then he went into the bathroom and was sitting on the toilet.  The Curtis kid went back into the bedroom and got the deer rifle and took it into the bathroom to tease the Roberts boy.  The Thomas kid was trying to get them to stop he said. 

I can just imagine the Roberts kid on the toilet taunts. “You don’t even know how to shoot that!”

“I do too, see!”   The Curtis kid said he remembered racking the bolt once and chambering a round.

He held the gun up and pointed it at the kid on the toilet, the Roberts boy, and shot him.

I looked at the sheriff and at the detective.  “You guys are calling this an accident?”  Both looked at me and nodded. 

“You talked to the prosecutor about this?”  The sheriff nodded to me.  I’m aware that there is an election in three weeks and the prosecutor doesn’t want to look like he’s hard on 10-year-olds.

I shake my head and go in.  He got shot right between the eyes at close range.  He had had his pants down and was sitting on the toilet.  But the force of the shot had thrown his body over into the corner of the small bathroom, head down in the tub next to the toilet. His bare butt up was in the air with the pants down around his ankles.  Like the kids might have been playing at sodomy if there hadn’t been a fine spray of blood and brain parts all over the walls, ceiling, window, sink, and bathtub.  The floor was littered with small parts of skull.  When I first stepped into the bathroom, I thought I was stepping on spilled Cat Chow.  But no, the skull can be shattered into nice small little pieces.  The boy had left a long, large, slightly curled turd in the toilet.

Cause of Death: gunshot

Manner of death: accident

So, is the story over now?  That’s a pretty dramatic ending. Or should I tell you about the older brother of the Thomas boy?  He got shot at a drug party in the southern part of the county.  But he didn’t die.  He lived despite a short-range handgun shot to his right chest.  He never would tell the cops who pulled the trigger. 

That’s not really the part of how the story goes on, but it’s somehow related, I think. 

It really goes back a year or so before that poor kid got shot in the trailer. 

I met the Thomas boy’s mom in the clinic.  He was the one trying to talk down the other kid with the rifle. At least that’s the best I can do to sort all this out.

She came to see me because she was finally trying to deal with getting off booze and drugs.  She was also pretty depressed and finally, actually talking about and angry about the years of sexual abuse she had while growing up.  Her husband was supporting her efforts.

Apparently, she’d had to deal with a couple of uncles having sex with her from the age of 12 on.  She got married at 16 just to get out of the mess. 

Maybe you can tell here now that I’m starting to trail off…  Maybe this really isn’t a very good story.  I’m not sure how it’s going to end. I’m not sure I can stick an ending on it for you. Maybe we should end it here.

Posted in Uncategorized | Tagged | Comments Off on Coroner Story: Never End