Coroner Story: Road

She was found by the road. And so, I was called.

It can be foggy after a rain in the spring. The wheat loves the rain that rolls in from the ocean two hundred miles west. We get good rain here in June. Dry land wheat flourishes.

I got the call before lunch on a Saturday. I wasn’t covering the ER or working in our Saturday clinic. I thought I had it to myself. But I am the county coroner.

“Dr. Hawthorne, Idaho State Police request that you come to a scene.” The polite professional dispatch lady gave me directions. She was not a patient, though some of them were. It can make the professionalism a bit hard.

It was south of town, off the main highway.

I’d been to plenty of death scenes on that highway. Three people killed when a semi had braked on the downhill and its’ unloaded trailer had swung into the oncoming lane. Two young women dead, and one child in the back seat as the big semi-trailer wheel had rolled over their compact. An infant had survived.

I had known both the young moms from their ER visits. Sometimes crazed by drugs, other times desperate from emotions. Those can look the same. But they are dead now, a different, other time coroner call. It seems this county, my home is peopled with these memories, these events. My limited contact of an ER visit, an office visit, or a death scene investigation doesn’t really bring out the best. These interactions don’t all run together, except when they do.

As I see up ahead the grade where the two moms were killed, I remember another, further along, past the crest of this hill.

A head on, both drivers dead, one trying to pass. Both cars were in their lanes, but the southbound car was now facing north, and the northbound car now facing opposite, their mangled front bumpers about ten feet apart. When such energy is applied squarely, inversion can happen. Like making a ball stop on the pool table, the impact has to be square. Both died almost instantly.

Back a half mile, had been another scene. A mother who had gone off one of these dangerous curves in her minivan. All the kids survived.  She had not. This stretch of road has killed a lot of folks. And our state has still not fixed it.

But this call was off a slow side road.

The morning fog had burned off and it was a bright, early summer day. The fields were deep green with two-foot-tall winter wheat. They plant it in the fall, and it slowly grows, then erupts in the spring rains and warmth.

I rounded the treacherous curves and climbed the hill where the semi-trailer had taken out the young moms and one of their babes. On the other side I got down to the country road that headed due west, off the main two-lane fatal highway.

After a half mile, the ISP rigs were there. And I saw a tan blanket over something on the left, south shoulder.  I pulled over to the right in my little rusty Hilux..

As I got out, I just looked around. There was a tall field of winter wheat to the south. The ISP rigs bracketed the blanket covered victim. And the two ISP officers were striding down from the hill north of the quiet road.

I waited.

Introductions. I didn’t know them, and they didn’t know me. Now we did.

They told me the story as they had sorted it out, but suggested I come up the hill to see what they had seen. I appreciated they were open to my observations.

A local had been going to town early this morning. It was quite foggy, but he had seen the deceased right there by the side of the road and had called it in. The sheriff’s office had assumed from the description it was a highway fatality and had called the State Patrol, so that’s why they were here. Jurisdiction wasn’t something I studied. But I learned it mattered to many I dealt with.

They had investigated. The deceased was identified. The scene was confusing.

By now we have crested the little northern hill. I turn and look south as they are laying out their understanding.

Green fields tell the tale of recent intrusion. The signs are clear from here. There is a mashed up stand close to the road, then a two track through the field in a long loop ending at an older sedan stuck out in the soft, moist soil. The field where the car is stuck is below the road. It is softer, more fertile soil.

“So, it looks to me like she went off the road and landed in the field.” The ISP officer is painting the picture. “Then she tried to keep driving but got stuck.”

I can see what he’s saying.

“Have you looked at the vehicle?”

He laughs. “Yeah, it’s all beat to shit.”

I look for a while.

“Let me look at her.” We go back down the hill to the tan blanket.

She’s a young, vital woman. But dead. She lies face up, her head to the east. It’s as if is she is at peace next to the road. It’s like she just couldn’t keep going.

Her blouse is torn and there are linear bloody scratches on her upper chest.

I notice an asymmetry. Her left chest is much prouder than her right. I notice her trachea, her windpipe, is deviated to the right. These are signs we were taught to look for in accident victims when they came into the emergency room.

I press on her sternum. I feel a grating.

I place my hand on her curly brown hair and twist her head. There is no crepitus.

I have decided from this brief examination she had a significant chest trauma that probably gave her a tension pneumothorax. This is a serious condition that pushes air into one side of the chest and deflates the other side. There is a simple treatment. But untreated, the tension slows the blood flow through the heart, suspended there in our chest. And we die of acute heart failure. The air pressure blocks the blood flow to the heart, and we can’t get enough blood to pump to us. I had been schooled in how to treat this when such patients come into the ER. But she never made it that far.

“Let’s look at the car.”

We head out into the soggy wheat field. Winter wheat can be tall in these bottoms. It’s above waist height.

The old sedan had lost its windshield. The roof isn’t caved in, but the side windows are blown. I can’t get the driver side door to open.

“This car landed on its roof and rolled back onto its wheels.” I’m telling the ISP guys my impression. “She thought she was OK, so she kept driving. Then she got stuck in this wet ground.”

They are looking at the rear wheels sunken in the soft soil.

“She couldn’t open the door, it’s jammed.” I jerked on the handle. “So, she climbed out. See the blood on these shards?” I pointed to the jagged glass on the driver’s door window. “She must have been high as hell.”

“So, what killed her?”

“From my examination, she had a tension pneumothorax. One side of her chest got deflated and the other got too full. She must have pounded her chest against that steering wheel when her car flipped. It’s even possible she was partially ejected. When a car spins the force is powerful, and I doubt she was belted. She could had been half out the window as the car rolled on top of her. I’ve seen that before. It had to hurt like hell, but she was probably high and didn’t feel it. After a while, when she was walking along the road, she couldn’t breathe. Each breath fills one lung, and it pushes into the other collapsing one. It messes up the blood flow. She must have headed off walking back to the highway and just laid down and died when her oxygen ran short. Meth is powerful.”

Her tox screen came back with morphine and methamphetamine.

Cause of Death: Chest Trauma from Motor Vehicle Accident

Manner Of Death: Accidental

I didn’t usually take these calls as coroner. I was always afraid it was some voyeur, too interested in something that was none of their business. But coroner reports are public record, even if it’s none of their business. That was why I rarely completed a coroner’s report, just filled out the death certificate.

I try to make it about the paperwork, the investigation, keep things official. There’s always more to the story.

But I got told this woman wanted to talk to me about this roadside death. It was weeks after I had filed the death certificate.

I’m not sure why, but I called her back.

We swapped identities. She stated she was the sister of the deceased. I believed her.

“Sandra always struggled.” She offered. The toxicology findings are not on the death certificate.

“I’m sorry for your loss.” I paused.

I could hear her sorrow, her struggle for peace on the distant phone.

She asked: “Was there any other evidence about her death?”

I paused again, not knowing if such information would bring peace, or more misery. But through the long wires and distance I thought it might help her some to share.

So, I did. Kind of against my professional nature, but really, even the dead, and the survivors, need care. That’s what we should do. Care for each other. And telling a story can be caring.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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