Coroner Story: Lessons

I don’t learn well about myself.  Do you?

Memorization.  Lists of things, formulas, I find I can commit lots of these things to memory if I can give them some meaning, some relationship to my life.  But my own mistakes and shortcomings, maybe they are forever hidden.  They just keep reemerging into my flawed consciousness like a hammer blow to a thumb.

 For instance, I write this story in the City Library at San Luis Obispo in California, far from my Idaho home and duties.  My daughter is in a soccer camp for four days.  I drove her down here the 1500 miles and now have these 4 days to kill while she sharpens her football skills. 

What to do?  No friends to stay with.  Do I rent a hotel room?  It’s expensive.  I have a sleeping bag…  Why not just sleep out on the ground tonight?  Save some money.  Besides it will be fun… 

Yeah.  Dirt, stiff joints…  Fun.  But I am by nature and by many years of upbringing a cheapskate. I don’t know if that will ever change.

We have our natures, our personal shortcomings. These shouldn’t afflict us in public service. But they can.

But this story should not be about me. 

It’s about a dead old man in his basement.  It was one of the early years I had doing this coroner job.  It was still very perplexing, and I felt very alone.  No one to call for advice.  Further, I was working with a sheriff that hated me and wanted me to look bad so he could get his friend elected coroner. This may all sound like excuses to you, but it helps me to make sense of my thinking at the time, since, looking back now, the decisions seem so wrong. And then, there was the dead guy.

The call came on a late fall evening at a reasonable hour, maybe seven o’clock.  The dispatcher told me of a dead body found in a home in Potlatch. The deputy was requesting me to come to the scene.  I called the deputy at the deceased’s home phone.  It’s always interesting how they will answer.  “Mr. so-and-so’s residence,” is often it since they don’t want to give away his death to a casual or mistaken caller.  They are standing there with a dead body in a delicate situation, etiquette– wise.  If they pick up a ringing phone and answer with their own name or rank, “Deputy Jack M. Hoff” the caller may wonder what the sheriff’s deputy is doing there.  No, they will wonder. They may just be polite enough not to ask. 

The deputy doesn’t want to go telling who ever might happen to call about the death, you know, all those messy questions.  Best to let that come out in an official manner. 

But they want me to call them at the residence over a land- line since the sheriff radios get picked up on scanners and they know people are listening in. The nice dispatch lady gave me the home landline number.

The deputy I’m calling answered this time, “Uh, hello” after the fourth ring.  He sounded a bit nervous.  I asked if this is the residence of Mr. Thompson.  I’m letting him know he could’ve answered the phone this way. But this question seems to puzzle him a bit, no answer right away. I figure he’s confused about the tense.  Is versus was.  I can hear his confusion. Kind of a stammer-pause, awkward sort of thing, like you hear in class when the kid doesn’t know how to get past the teacher.  So, I interrupt,” Is this deputy Smith?  This is the coroner.”

“Oh, Hi,” he says.  So, I’m getting the picture of a low-watt appliance here.  I ask the setting, where the body is, any sign of a struggle.  Can’t we just call it natural and save me the drive to the small town?  But he says, “Doc, I think you better come out here.”

“So, you think there might have been a crime?”

“Well, I don’t think so,” he offers.

I still don’t want to make the drive.  “So why don’t we say he died of a heart attack and have the funeral home pick him up?”

“I really think you ought to come out here.”

“Has the Sheriff assigned any detectives?”

“No.”

I give him a big sigh, “Oh, all right.  I’ll be 30 minutes or so to get there.  Give me the directions…”

No traffic, no snow, but I still drive by it two times before I find the house.  No real house

numbers or mailboxes in his little old mill town. 

The sheriff’s deputy car is down in the lower part of the driveway, and this is my clue on

the second pass. It wasn’t easy to see from the road and I missed it the first time around. 

I knock on the front door and a younger man opens it.  The deputy is standing in the living

room behind him. 

They want me to go right down to the basement and look at the body. 

I get them to slow down a bit and set the scene for me. 

The young man is the neighbor.  He checks on the elderly Mr. Thompson every day or so. 

The neighbor saw him Saturday but didn’t check on him Sunday.  Weekend and all and he

took his kids hunting, a family activity in this part of the state.

After work tonight he came over to check on him. Today’s paper was still on the front

porch from this morning but not the Sunday one.  The door was locked like usual, but he

had a key and let himself in as usual. 

It was common for the front door to be locked. 

The neighbor also picked up the mail and the paper and brought them in dropping them all

in an easy chair in the living room on the way into the kitchen. 

As he tells this he’s a little agitated and wants me to go look at the body right away.  I need

to get him to concentrate so he tells me all the details in order, carefully. 

I ask about the old man’s habits. 

The neighbor, a short, lumberjack- dressed guy in a clean flannel shirt and clean work

pants and Romeo slippers obviously showered after work before coming over. He seems

bright and observant but sort of pressured. He obviously thinks the answer is in the

basement, what’s with all these questions?

However, he answers the best he could.

 “Oh, he was real regular, nothing special.”  It sounds like there’s no family nearby, he had a wife, but she died quite a while ago. 

Had he seemed despondent, sad?  Was he in poor health?  Any changes in his usual ways? 

Did he drink?

 The neighbor, frowning, shakes his head.  He’s paying good attention.  But he has no clues

for me.  And I can tell he’s feeling bad about not being able to help me.

So, I look at the little table in the kitchen.  The whole kitchen is just neat as a pin.  Coffee cup rinsed and tipped up in the strainer.  Oatmeal bowl rinsed and tipped next to cup and saucer.  Spoon standing up.  At his place was a lined stationery pad with four lines of pencil verse, oddly sad with the general melancholy of the Scots.

            A time to remember is now past

            my heart once younger now breaks

            the love of mine heart did not last

            my soul wanders wherever the Lord takes.

I offer a wry smile.  “Look at this”, I note to the neighbor.  “It looks almost like a suicide note.”  The neighbor stands over it.   He’s frowning at the verse.  I figure he finds it too dense, but he says, “Nah Doc, he was always writing stuff like that.  Look.” 

And he points to the wall above the little table. Sure enough, similar four-, six- or eight-line verses are torn from the same lined pad and scotch taped to the wall.  They all seem as melancholy and vague.  And the yellow of the tape lets you know some of them are not recent.  Some more are on the kitchen cabinets. Regular Robbie Burns fan, I guess.

Dead end, so to speak, the suicide note idea.

They want to rush me down the stairs, but I go to the old man’s bathroom first.  Regular stuff, some high blood pressure medications, no antidepressants. No pain medications.  Nothing exciting.  I did get the name of his doctor. I’ll give him a call in the morning and review the medical record.

Now it’s time to go down the stairs.

The basement is well lit and neat like the rest of the house.  Laundry in one section with a washer and dryer.  There was a load in the washer, clean but wet.  Nothing in the dryer.  There was a plastic clothes basket overturned at the bottom of the stairs and there were dry, clean clothes, some folded, strewn down the steps and onto the cement floor.  The deceased was lying on his side near the center of the room.  In the center of the basement was a small wood stove backed to a brick flue. It was cool.

The dead man was cool and stiff, probably dead now at least a day, maybe a day and a half.  The cement floor was cool.  He had fixed, full body rigor, but the fingers were loosening.  The lividity was fixed.  It showed no movement of the body since death. This put his death about Sunday morning, after breakfast but before afternoon. 

The clean, worn Levi’s he wore were unbuckled and unzipped and pulled down to mid-thigh.  He was lying on his left side with his left arm underneath him.  The right arm was out, extended.  His underwear were still up and urine-soaked.  But his forehead was injured.  There was a significant pre-morbid contusion, laceration with dried blood going down the nose and dried blood on the forehead.  Some was on his lips and on the teeth.  There were no injuries to his mouth.

Geez

I looked up at the neighbor.  He was pretty nervous.  “You got anything further here?”  I asked him.  He shakes his head and I look at the deputy.  I ask him if he needs anything from him.  Then I send him off home.  I turned to the deputy. 

“Has a detective been called?”

“Um, no sir.”

“Can you call one?”

He shook his head. “I suggested that earlier to dispatch and the sheriff said to call you.”

I looked down at the cement floor next to the dead body and shook my head. So, this is how it is going to play, no cooperation.

I try to work with what I’ve got. “What do you think happened?” I ask the deputy. I do this, trying to get folks to rise to the situation.

“I’m not sure.”

So, I go on. “If you look at these clothes all over the floor here it looks like he dragged himself around some.  These clothes kinda hooked on him and got pulled this direction.  You take any pictures of this?”  The deputy shakes his head.  “Nope Doc.  I’m no detective.”

Usually, the sheriff’s office does these investigations since their budget is a thousand times mine. Plus, they have all the camera equipment and record keeping.

But this guy and me aren’t getting along. I’m pondering what to do as I’m looking down at the smooth cement floor and I notice a blood spatter. 

There are regular spatters, about 3 inches in diameter in the line I think he drug himself around.  The blood marks are like he’s hitting his forehead against the floor as he tries to drag himself forward.  There are splatters outward from the circular smear, like he hit his head downward with pretty good force.  Hard enough to split the skin and splatter droplets of blood a foot or two outwards. 

He’s kinda made a circle in the floor starting near the base of the stairs and coming clockwise around the central wood stove.  He’s now lying facing the washer and dryer across from the foot of the steps.  He’s perpendicular to the steps, a bit to the right of them and a little behind where they came into the room. 

At the landing on the stairs a 2×4 railing had pulled loose. We’d missed this on the first trip down the stairs.  Then the clothes are scattered down the steps from the landing to the floor.  There is no blood at the bottom of the stairs. It’s just in the last three to 4 ft. of what I presume was his path dragging himself across the floor.

Foul play?  Did somebody shove him down the stairs in a struggle, then pound his head on the floor?  Why the pants down?  No evidence of sexual assault.

I stood looking at this for a long time with the deputy watching me.  I wasn’t sure whether to ask him for help or tell him to go away.  Finally, the way I put it together was that the old man had a stroke, or broken hip, or some sudden injury on the landing.  He’d stumbled and fell to the basement floor, letting the clean folded clothes in the basket go flying.  As he falls to the basement floor, he can’t get himself up.  He can’t arise because of either the hip fracture or paralyzing stroke, which I am favoring because of the difficulty pulling down the pants.  As the bleeding in his brain worsens and he realizes he will not be getting up the stairs to call for help he tries to end himself, do himself in with the only tool at hand, a hard concrete floor.  He also realizes he needs to urinate but cannot do this with one hand.  He cannot fully get his pants down.  Imagine the shame and indignity for this neat, tidy, poetic man.

 Or at least so I put it together.  I ran the scenario by the deputy.  He nodded about wasn’t enthusiastic.

“You going to get an autopsy?”  He asks.  They always want an autopsy.

“I’ll tell you what….”  I’m now arguing with my cheapskate self and the Sheriff who is not in the room. 

The deputy just wants an answer to a very interesting question.  Kind of like the folks who say, “What does this pain in my stomach mean, Doc?”  A pain they know well but haven’t the context in which to place it. No meaning to a memorized fact. I struggle with the range of diagnostic tests available.  The tests have a quite fallible ability to answer the question of the pain. Expensive, uncomfortable, imperfect tests.  And I also ponder the likelihood of this pain making any difference in the long run to this poor suffering student’s mortality or morbidity.  In other words, I think of it in terms of how to best spend their resources to answer this question.  I usually frame my answer in these cases based on my impression of whether this pain is minor, self-limiting, like most pains we suffer are, or if it is related to a bigger more problematic situation needing intervention.  This is also how I am thinking about the expensive autopsy test we are considering, me and Mr. Deputy on the cement floor next to Mr. Thompson now a day and a half dead.

Plus, I consider I am over budget for autopsies this year.

I decide I would try to take a shortcut and do an x-ray of the hip in the morning. Maybe I could save the taxpayers a couple thousand dollars.  If the x-ray is positive, then a broken hip led to his death.  I’m trying to pinch the taxpayers’ pennies.  Nothing is missing from the house, no money, no goods, and there was no forced entry.  It does not look like there was a struggle, at least I don’t think so.  So, the manner of death is most likely “natural” or at the worst accidental.  Why all the expense?

But the x-ray was negative: no broken hip.

His doc had nothing to help me. Just a little high blood pressure in a guy in his late seventies who hated doctors. My kind of patient.

By morning, even with the negative x-ray I managed to convince myself I could call it a stroke. I signed off the manner of death as natural, cause of death stroke.

Then, a year later, in the same little community, an elderly woman disappears.  There is a new sheriff now.  The careful detective’s investigation finds blood on the walls of her bedroom (only traces) and her skull is found two years later.  Her cause of death was a homicide. No forced entry. Nothing missing from her home except her body. And this has not been solved to this day. So now, at this advanced stage of my career, after years of pondering and reflection, I order more autopsies. I have learned a little bit about my skin flint self, and I have made some adjustments.

But writing this story has taken a long time, and I need to get going.  I’ve decided to get a campground spot.  I’ll sleep in the chill and the fog on the hard ground in my inadequate sleeping bag.  Stiff bones in the morning.

Cause of death: Stroke

Manner of death: Natural

About ddxdx

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