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?”


“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

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
This entry was posted in Uncategorized and tagged . Bookmark the permalink.