West of the Rotunda

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

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.

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.

Sometimes how you get the call is an important part of the story. Sometimes, it’s who calls you, sometimes it why they thought you needed to be called, sometimes it why you weren’t called. All these little nuances to being a small town, rural county coroner fascinate me. So, when I picked up my phone on a warm fall afternoon and I got gruff old Ivan’s voice yelling into my ear, “Doc!?”, I didn’t expect this to be a coroner call.

“Yeah Ivan, what can I do for you?” He’s 85 years old, a crusty skin and bones old rancher in the east county. I see him maybe once a year as his doctor, less if he had his way. But the time I stuck him in the hospital with congestive failure and told him he wouldn’t make his 82^nd birthday inspired him to come in annually after that, mainly to rub my nose in my errant prognosis.

I saw him more when his wife was dying. They cared for her at home right up to the end. She got demented and went fast, thank God. I’d met her three or four years earlier and while I was asking her about her family history, she looked me in the eye and told me a fractured but intelligible story of her brother, five years older, who’d gotten demented and died within a year.

“That old Alzheimer’s can really take you down,” she’d tsk’ed and shook her head. I nodded but silently disagreed. Alzheimer’s usually takes some one five years or more after the initial diagnosis. My mom had taken more than ten years. Usually, it’s plenty of time for families to flounder with personality changes, bed sores, diaper changes, nursing home costs and guilt. But Ivan’s Irene had just gotten pleasantly forgetful and died a year later. Her pattern, and her brothers made me fear I’d missed a diagnosis. None of this was on Ivan’s still sharp mind this fall Saturday afternoon.

“You still the coroner?” he yelled. His deafness made him yell. He was the deaf one, but he yelled to others out of politeness, I guess. “I know I voted for you once but maybe I missed something.”

“Yeah Ivan, I’m still the coroner. You fixing to die or something?”

“What?”

“How can I help you? Yes, I’m still the coroner.” That last part as loud as I could yell into the phone.

“Oh no, I’m not dead. At least I don’t think so.” He laughs. “Say, I got a dead guy for you.”

“Really?”

“Yup. Out on American Ridge. I was out looking to bring in some cows and found him.”

“You call the sheriff?”

“No. Should I? I don’t think he needs arresting, he’s dead.”

“Where are you now?”

“I’m back at the house. But he’s up on the ridge like I said.”

“OK Ivan. I’m going to call the sheriff’s office then we’ll come out to your house, and you can show us this guy.”

“When’ll it be?”

“Maybe an hour. Why?”

“I was gonna get something to eat.”

“You go right ahead. See you soon.”

I hadn’t wanted to suss out details, yelling into the phone and his hard of hearing. I knew Ivan was a solid guy and wouldn’t be calling me about some pile of deer bones or an old flannel jacket on a log. So, I called the sheriff’s office. I think this was the first and only time I ever called them about a dead body. They usually called me. But it can go all sorts of ways. One time the funeral home called the local police about a coroner case. An old guy had driven his ’63 Chevy truck into the funeral home parking lot, taped a note to the driver side window and shot himself behind the wheel. He was trying to save us all the hassle. But we all got rousted out anyway and then had to call to get his bloody truck towed away.

I got to Ivan’s house after the deputy. They have radios. The deputy and Ivan were up on the front porch. Though sunny, there was a fall chill and a westerly breeze that suggested rain. Hunting season was full bore, so my hunch was this body was a lost hunter. But usually Search and Rescue hears about such a thing before the guy’s feet get cold. He doesn’t come back to camp and the word goes out. Still, some guys go out by themselves, break a leg, who knows.

I climb the porch steps. “Hello Ivan. Hello Brandon.”

Ivan smiles. Brandon grins. “Did you take a wrong turn doc?” He knows I’m famous for getting lost on the county roads.

“No, I just had to put the tools away. I’m mudding some sheet rock.”

“Oh yeah. Don’t want that shit to dry on the tools.” He’s being familiar but I doubt he’s ever remodeled or fixed up even his single wide.

“So, what have we got?”

“Ivan here says it’s a plane wreck.”

“Really?” I’m surprised. I felt bad for not asking more over the phone. But in person is best with this old guy. I made him come in once a year at least for his medicine refills, though he only took one or two pills, way below average. He took great glee showing me he had beat my prognosis. I had to go over him pretty good, since he minimized everything. The 2-centimeter skin cancer on his right shoulder I’d found under the Carhart jacket, wool shirt and long underwear.

“Oh, that.” He’d said when I asked him about it. Plane wreck? Small potatoes, I guess.

Ivan was retelling Brandon about how he’d noticed all the broken trees across the canyon. I could figure this was a retelling since Brandon rolled his eyes at me. Somebody had to cut him off; we’re losing daylight.

“So, Ivan, can you get us to this wreck? I wore my boots. How far is it?”

He puckered to an expression of thought. “Well, what rig we gonna take?”

“Which one did you take?” I yell at Ivan.

Brandon interrupted. “You get the twenty doc. I’m gonna tell dispatch about the plane wreck thing.” He went to his rig and the radio.

Ivan’s grinning at me about his answer. “Well, doc, I was on Sadie.” He looked at me intently and waited.

“Who’s Sadie?” You gotta let them tell the joke.

“She’s my old mare!” He slaps his thigh.

Old brittle 85-year-old on horseback with congestive failure rubbing my doctor nose in it.

“So how can I get there?”

“You driving that thing?” He nods at my rusty old Toyota two-wheel drive pickup.

“I drove it here. We need four-wheel?”

“It’s a bit muddy past the gate.”

“We’ll take the deputy’s rig. It’s got four-wheel.”

Brandon said no one knew of any plane wrecks but dispatch was going to check with the FAA. We all got into the deputy’s Ford Explorer. I got to sit in the back where the doors don’t open from the inside, so Ivan managed the gates. They were his anyway.

It was about three in the afternoon now and it would be getting dark by 5:30 or 6. At least it wasn’t raining yet or snowing. We passed three wire gates then we get into broken timber. Ivan was telling Brandon how he’d come at it a different way on horseback so he’s not sure we can see it here from the dirt track. “Hell, Sadie saw it first!” he yells. “I’m looking for cows and she keeps staring off at the far ridge, so’s I think she’s seeing some there, but that’s when I saw the broken trees and the plane.”

“Did you go up to it?” Brandon asks.

“Naw, but I could see something in the pilot’s seat with the glasses. He’s dead.”

After twenty minutes and maybe five miles Ivan suggests we stop. By the rig he offers, “Just climb up this ridge and head south a bit.” He’s gesturing with gnarled hands and stiff shoulders. “We was up on this ridge I think when we seen it.” He twists back. “I could show you but I’m not too good in this downfall.” Another gimped up gesture and I’m looking for a path.

“If you’re staying here, I’ll leave the keys with you if you need to warm up.” Brandon handed the old man the keys.

We clambered over logs and through brush. I didn’t sense any ridge nor even magnetic direction. After thirty minutes we agreed to go back and get Ivan. “I seen you were dropping down too soon” he grinned.

There were the usual jokes about if anybody got hurt at least we had a doctor. And if it really went to shit, we had the coroner. I’ve heard them too many times. Ivan was remarkably agile, though slow and I’m thinking of daylight. He followed game trails and stayed with the grade until we came to a clearing.

“You might be able to see some broken trees from here off that a way.” He gestured again. Both Brandon and I looked off. It was a quarter mile or so below us still. The thing that got my attention was the fine white dusting across a couple hundred yards before the broken trees and white fuselage shined at us.

“Think it was a crop duster?” Brandon asks.

“Nope,” I say. “They don’t spray white powder.”

“OK Ivan, we can see it. Do you think you can get back up to the rig?”

“I think I better stay with you guys. You got pretty fouled up last time I sent you off. It ain’t far.”

We dipped back down into the timber following the old man. There was a temptation, like when you shoot a deer, to head off full bore to where you think it’s down. But long ago I learned that temptation is to be avoided. Slow and steady got Ivan to 85. By the looks of it he’ll make 90 at this rate.

The white powder I saw contrasting the dark needles wasn’t visible on the ground, but I warned Brandon. “Don’t touch the ground and put your fingers in your mouth. You won’t be passing any drug screens the sheriff puts you through.”

“Is it OK to breathe?” He chuckles.

“Only through your nose.”

The wreckage was mostly intact though both wings had sheared, and the fuselage buckled. We could see it was a twin-engine prop, no numbers on it. Ivan had stopped and was looking back. “I think I spotted her from up over there.” He gestures back toward a clearing across the canyon a couple hundred yards up and over; always orienting. “I could see the guy in the pilot’s seat. He’s dead. That’s why I called you.” He reminds us.

Brandon was ahead of us downhill looking into the tilted cabin, past the bent and split open fuselage. There were lots of wrapped bricks and white powder back here. He hustled up the slope a little breathless. “I gotta call this in. They’re gonna want to know about this. I’ll head back to my radio in the rig. Hope I can raise them here. If I can’t I’ll drive out a ways. You guys gonna be OK? I’ll be right back.” He was panting.

“Sure.”

“Take your time.” Ivan advised. “We’ll be fine.”

Brandon scoots up the sidehill back toward the Explorer. I walk down toward the cockpit. Ivan follows. It’s pretty quiet here in this canyon, no wind, but I can see it’s getting gray. We have another couple hours of light I figure.

The windows are all broken out and I can step into the tilted plane pretty easily with the left side torn open. Ivan was right, the pilot was very dead, not days, just pale and stiff. But it’s been cool, and this is a north slope, so maybe a couple days. No animals had gotten to him. There’s blood out both ears and the head is tilted at a funny angle.

I spook when “What do you think killed him doc?” is yelled in my ear. Ivan is all serious and frowning.

“Jesus, Ivan.” I want to tell him to soften his voice here in the presence of the dead, but I know it’s no use. “I think he died in a plane wreck.”

Ivan’s laughter is loud, and he laughs too long; my skin crawls a bit, I don’t know why. He gets serious and asks me intently, wanting to know. “No, I mean doc, did he bleed to death? I see some blood but not that much.”

“Oh, Ivan, it’s hard to tell. Here let me check.” I reach in and twist his head a bit and feel some grating bones. “Yeah, I think his neck is broken.” The yelling I have to do makes this almost obscene.

“But is that what killed him? People survive…” he trailed off as I turned my back to him. I wanted to get some identification. There were satchels that looked like luggage on the cabin floor and more stacked up where the copilot’s seat would have been. I zipped open a small one behind the pilot’s seat. There on top of rumpled clothes were three passports, one Columbian, one Mexican, one Peruvian. Miguel Sandoval was on the Mexican, Manuel Salinas was on the Peruvian and Miguel Santoro was on the Columbian. There were three other satchels jumbled next to him. I unzipped one. Bundles of US currency were neatly stacked and wrapped, some fifties, some twenties, some hundreds.

I jumped again when Ivan said, quieter this time, “Don’t know as I’d called you guys if I’d a known all that was there.”

Brandon got back in about a half hour. He looked troubled. “We’ll stay put ‘til they get here. Won’t be long.” For some reason I didn’t ask who. “Why don’t you take Ivan back up to the rig so he don’t have to scramble around if it gets dark.”

Ivan and I made the slow walk back to the Explorer, then I headed back down and across the slope, a little faster on my own.

When the big black helicopter came over just before dark and all the paramilitary dark suited guys came down the slope, I knew it wasn’t our sheriff’s department. A short man approached us with his combat weapon by his side as the others fanned out and disappeared in the gloom. He had night vision goggles up on his helmet, black clothes, black gloves and a smile. He didn’t offer his hand. He spoke to Brandon. “OK, we got it. You can take off.”

Brandon nodded and softly gestured to me as he turned up the slope. “Hey,” was my simple objection and the short man turned toward me.

“Who are you?” he shot at me.

“I’m the county coroner.”

His smirk didn’t feel so good. “You can go, sir. We got it.”

“And just who are you?”

Brandon was three or four steps up the slope. He stuck out a beckoning hand. “C’mon doc.” Like I’m a balky puppy. The short guy was getting ready to turn away again and I asserted all the authority a county coroner has. “What happens to the body?”

This time he wasn’t deferential. He snapped back toward me and up in the trees I could see a dark shape, maybe two, step into view. The short man looked me directly in the eyes. “You can go. We got this.”

Brandon was now stepping down the slope, impatient with me. “Come on doc. We’re going. These guys are taking over. They’ll take care of it. We gotta get back.” He put his hand on my shoulder, softly, not like he would have grabbed a puppy’s scruff, but like we were having beers. “C’mon.”

The trail back up was dark.  I only slipped a couple times.

“You guys see that big black heelocopter?” Ivan asked. Brandon wouldn’t tell us nothing. Maybe he didn’t know.

It was about three weeks later I got a call from the medical examiner’s office in Spokane. “Dr. Hawthorne?”

“Yes, how can I help you?” I hadn’t requested their services for years.

“We have a body here and we need your permission to release it to the family.”

I’m clueless. “Who is it?”

“Manuel Sandoval”

“Why are you calling me? I don’t know this guy. It’s not my case.”

“Our paperwork says you are the coroner on this case, and we just need your permission to release the body.”

“So, are you sending me a death certificate; an autopsy report?”

“Uh, no. Those were sent to Washington. We just need your authorization to release the body.”

“Call Washington. I don’t know anything about this.”

“Uh, we did. They said to call you.”

Deep sigh. I thought of Ivan’s smile and his slow steady gait. How he looked the graceful scarecrow under the dark pine canopy weaving through the brush and sticks. I thought how he would laugh at this silly joke. I wanted to be sitting on his porch in the afternoon sun, telling him this story, yelling him this story, repeating myself when he said “eh?” and finally getting tired of the whole tale, realizing it’s not a short joke but a long one with nothing really to laugh at. But then we’d just sit there and look at the sun on the hills from his old farmhouse.

“You have my permission to release the body.”

No death certificate filed.