West of the Rotunda

It’s not that I have anything against mobile homes. Folks gotta have a place to live. But I’ve had some bad experiences in mobile home parks as the county coroner. Is it the nearness to poverty? Is it the thin walls and lack of privacy? Is it the mud and detritus we pile up and our neighbors observe and resent? I can’t say I know. But I have seen some of it.

This call came to me on a rainy fall evening, after dinner, before the little girls were going to bed. The city dispatch lady told me I was needed south of town. It was in a mobile home park. She gave me a number.

My little rusty Hilux had new wiper blades, so I was doing great heading south. I had not asked any details, any name. Maybe that was because I was new to this and wanted to seem on solid ground. I knew my way in the rainy dark.

Or thought so. I turned into the entrance of the mobile home park and then started to wonder.

No numbers were visible, the cars half obstructed the graveled, muddy street between the single wides. Some had a light on, most just a slight glow from curtained windows. Some all dark here at 730 PM in the wet cool fall on the Palouse.

I kept going, expecting a city patrol car to be my clue. Down one line, around the dark turn at the bottom and back up another. Then the next loop. A lot of people lived here in this dense plot of sloping soil down by the creek. Over the coming years I would return here again. And again. I could tell all those stories now, but I need to find the scene.

On my third loop I saw the patrol car. The light shone from the newer single wide porch.

An officer stood there in the drizzle, probably wondering where the hell I was. Do all three loops to find the scene? Jezus.

I parked the Hilux behind a neighbor’s rig, since there really was no street parking. I shuffled to the slick steps and greeted the patrolman. “Detective Frye is inside.” He nodded to the door. I went through. The detective turned from some folks in the well-lit living room and ushered me back out into the drizzle.

Here, by the glaring 60-watt porch bulb he told me the story. We were on a slick 2×6 deck with a railing. This was a significant home improvement in this area.

“This is a bit long so you gotta stay with me on this.” He started.

The deceased is in the back bedroom, he went on. He gave me a name, and age, 26-year-old male. Maybe some trouble with drugs, no trafficking.  It seems there had been a confrontation this evening.

The deceased was recently married to a younger woman, maybe girl and they had just had their first child. This marriage had been forced by the father when the younger girl had become pregnant. It turns out our deceased’s wife was 17, probably 16 at the moment of conception. But she and the deceased seemed to be making a go of it.

I wondered if “the deceased” was going to be the litany of this story. But Detective Frye soon lapsed into calling him by his name. I appreciated he was trying to do the respectful thing.

But tonight, it seems another man had made a complaint to the father who had forced this marriage. It sounded like the dad was a real patriarch, though I never met him. Detective Frye told me I wouldn’t, since the old man was downtown at this moment giving his statement.

This evening the patriarch had received the complaint of another man, probably another patriarch, that his daughter, just 16 had been impregnated by “the deceased”. And there must be justice. The patriarch had agreed and had come to this single wide to confront his errant son to insist he make things right.

The young bride with the infant, and the patriarch’s wife, the mother of the deceased had witnessed the confrontation. The old man had insisted the son come with him to the police station to make a statement. Son had agreed, “I’ll do it Dad.” But he needed to go get his coat. He went into the back bedroom, and they all heard a shot. Dad checked, then called the cops. And so, we are here.

I’m getting drizzled on. Detective Frye has a hat. I ask, “So you think they are all telling the same story, old man and wife and mom?”

He nods.

“Let’s go look.”

I wipe my feet again on the welcome mat as the door is opened. I first go to the living room. An older woman is sitting by a young dark-haired woman with an infant in her arms. I introduce myself and tell them my purpose. The older woman looks at me with a glance of derision and the young woman doesn’t make eye contact. Coroners are rarely welcome.

We walk back down the narrow hall. The floor feels soft, like walking on a hay loft, or maybe a weak stage for some traveling troupe. It may hold up tons, but it gives with a good stomp.

The path to the bedroom goes past the bathroom. The door open and the light is on, white and clean. Detective Frye opens the bedroom door and moves to the side so I can go in.

All the floors are carpeted. But the springiness isn’t just the shag. It just feels soft. The strong odor of blood hits me. Warm blood is unmistakable. I had learned it early on in the operating room, but before, as a child I had toured our towns slaughterhouse. Seeing the rubber booted Mexicans handling the hanging carcasses, the pools of blood they waded in, had given me a strong reaction. And this smell is deep in my memory.

The red, pink splattering over all the white of the walls, the ceiling, the bedspread, the dresser almost came off as a design touch. But it was not consistent with the motif.

I turned from the wide dark red pool on the shag toward the crumpled body beyond. I didn’t want to go there just yet. I looked at some pictures on a dresser just inside the door.

Somebody had paid a photographer to enshrine the images. The dark-haired bride smiled but the skinny groom looked stiff, wan, strung out. There was another portrait with her holding the baby. He looked even more drawn, more quartered, more desperate, though grinning. And there were red splatters that masked the smiling family portrait.

That was all I would know of his face. For it was not present on his body. Few appreciate what a deer rifle does at close range to the human head.

He wore polyester pants and jacket, like he might have just gotten off work. He was lying on his front, back up at the foot of the bed. The red pool soaked the carpet from under him to the middle of the dresser. There was no way I could not step in it. I could see the butt of the rifle off to his left, the rest under him. I looked at Detective Frye. He winced; maybe like I was. I got closer, stepping into the red goo. There was going to be little room to turn him over between the foot of the white now splotched-pink fluffy queen bed and the dresser.

I bent over him. There was just the back of his scalp left. Two long shreds of skin hung from the back of his neck. The white ceiling above was stippled with red to a pink. In the center of the splotch was a dark hole where the jacketed round had left the single wide, through the acoustic ceiling tiles, then through the metal roof out into the wet night above.

“If you lift him up, I’ll clear the gun.”

I bent and grabbed his polyester jacket on the left and raised him as best I could. For some reason, maybe the blood made the floor feel more solid here. I pulled. The shreds of the back of his head drooped, and the movement made a sucking sound as the pool of blood beneath let him up. The detective pulled the bolt action rifle back and out.

It was then I looked ahead to a crib next to the bed. The flesh, the floppy mask of the skinny, scared young mans face laid there, looking up at me.

Somehow, the ballistics and trajectory brought the shards of the explosion here, to the crib. This shred had none of the worry, none of the sorrow in the portraits. It was just a flaccid, mobile mask, like someone might pull on for a masquerade party, with nothing behind it, just ready to fit the wearers face. It lay still in the white, small crib next to the big empty bed.

I said goodbye to the two women in the living room. Another derisive glare and another averted glance, and I was out onto the wet porch.

“Do we need an autopsy?” The detective asked. They always want an autopsy.

“No” I said. “I can call this.”

Cause of Death: Gunshot wound to the head.

Manner of Death: Suicide

Earl is trying to talk me into seeing this as an accident. “See, he could have pulled the shotgun this way by the muzzle across the seat. With the truck canted over on the slope like that it would be about right to hit him in the temple.”

I use all my patience not to laugh. I like Earl. He’s a good detective. He’s been out here on this back road in the dark for hours, taking pictures, setting up lights. He wants this to be an accident. It just isn’t. I have got to tell him so, one way or another. Kindly.

The call had come around 2AM. Dead asleep, not on call for my group, no lady in labor, so I was sound, dead asleep. But I still keep the skill of waking briskly whenever needed. The nice dispatch lady asks me to go to a scene in the far north of the county. For once, I know the location as she describes it. I used to hunt up past there. “Plus” she says, “You’ll see all the lights.” What? “They got all the night lights set up to investigate the scene.”

Sure enough, when I got there about 45 minutes later, in the chill of a dark late winter night, the whole valley glowed from the generator driven work lights. Their hum, roar, mutter kept a constant crowd noise in this isolated spot.

As I pull up, between the Sherriff’s Department rigs, I see a dirty four-wheel drive truck kind of on its side, down below the road. The passenger side is up against a tree. It doesn’t look like a wreck or a rollover, just like the little truck is tired and leaning on its right two wheels to take a break.

There’s a body back behind the truck, up on the road. I can’t really see it because they’ve thrown a red tarp over it. But there’s a blood trail in the gravel I can see leading from right outside the driver’s door to the tarp.

The road is gravel here. The pavement ran out a quarter mile back. The truck is off the outside of a turn. The drop off is steep, as is the uphill cut bank. If that little tree hadn’t held, she could have tumbled a few times before she landed in the river below. But instead, she’s on two wheels, the uphill ones up in the air. I can’t imagine rocking out of this stuck spot.

Earl tells me the story. “Well Doc, it looks like he got off the road here and couldn’t get back up on. See the spin marks under the tires? Hell, that little tree is starting to bend a bit since we got here. These uphill tires are six inches higher than they were. See, we think he reached across the seat to get his shotgun after he got stuck and it went off right in his hand.”

Rushing the story, a bit. I’m groggy. It’s cold. The lights make your breath a cloud at their angle. My nose is dripping. Back up a bit. Keep getting the story.

“Earl, who called it in?”

“Well, we got his name. Seems he came by and saw this guy dead on the road and the shotgun by him. He was worried someone shot him and might still be around, so he drove on. Called it in from Potlatch.”

“What time?”

“That was around ten.” And I’m here at 3AM. And these guys much longer. I appreciate that.

“Did he know him? Did the guy who called it in know the guy?” I gesture toward the tarp.

“No.”

“Anybody else see him today?”

“Well,” Earl shifts, “Somebody said they saw him with a passenger go through Potlatch this afternoon.”

“Jesus, Earl, you think somebody was with him when this happened?” I’m not being real kind here. I should have done better. But Earl plugs on.

“Not really, no sign of it. Course, the ground is frozen, and we wouldn’t see any tracks.”

“Who is this guy?”

He gives me the name, struggling with the pronunciation.

“You guys know him?”

“Well, yeah. He’s been taken in a time or two, mostly for drunkenness. Last time he was wacko, doc. He had to go to the State Mental Hospital for a time. Seems he’s got some mental problems, plus he drinks.”

“Where does he live?”

Earl smiles. “Up here somewhere. No one knows, really. When we took him in before he wouldn’t tell us where he was staying. Some of the guys are pretty sure it’s up one of these logging roads. I figure he’s built himself a hooch out here in the woods and just comes to town now and again. He’s a real looney, doc.”

Earl smiles at that, knowing I love medical terminology.

“But get this, doc. Look at all these papers we found on his front seat.” He goes over to the back of one of the rigs and pulls out a plastic Ziplock with the papers. “These describe his diagnosis, what the VA is treating him for and all his disability forms. Seems he was working with this lawyer in town to get the disability he wanted. And right here on top is the notice that he got it. Dated just last week. So, the guy should have been as happy as a pig in shit.”

I look down at the frozen gravel, almost white in the glare.

 I know this story.

The disability dance so many do for so long, and then what does it mean? I have watched patients fight, so sure they were right to get “their disability”, like it was a possession kept from them. Then, when granted, this long sought determination, it gives so little. But the fight, at least was over. And their touchdown dance was as pitiful as their chronic pain. This long-sought determination of permanent disability granted that they would receive a measly $759 a month was not a real victory. It was a sentence. But that’s maybe another story. Why is this guy dead?

I keep asking Earl questions. I’m putting off going straight to the body.  “Any family? Is he from here?”

“No, family back east somewhere. We don’t got no next of kin. But we’re going to call his lawyer in the morning, see if he knows anybody to contact.”

I’m feeling tired. And it’s cold. But I’m trying to respect the work my colleagues have done. They have put a lot of information together. “Can I look at those papers?” I take the Ziplock, but then ask, “Any booze in the truck, any medications?”

“Look for yourself, doc. Brandon, open up the door for him, would you?”

The deputy who has been standing by us goes to the driver’s door and opens it upwards.

The tilted cab is strewn with empty beer cans, Copenhagen tins, pop cans, candy bar wrappers, booze bottles and old papers. And mud; mud on the floor, mud on the pedals. It was like he couldn’t help but track it in. He lived in it when it wasn’t frozen. Or dust.

“Jesus.” I say again.

“Hate to find his hooch.” Brandon grins.

“Hell, it’s probably booby trapped, as crazy as this guy is.”

I look at the papers. Lots of government forms from VA hospitals with lots of diagnoses: Post traumatic stress disorder, attention deficit disorder, alcoholism, depression, personality disorder, chronic low back pain. There were the lists of drugs prescribed, but it looked like more miss than hit. I doubted any drug was going to cure what this guy suffered with.

“Where’s the gun?” I ask Earl.

He goes and gets it from his rig. Evidence. Pump action 12 gauge.

“Loaded?”

“We cleared it.”

“How many shells?”

“Four left.”

“Prints?”

Earl winces. “No.”

None? I look up startled.

“No but he was wearing gloves, doc. You’ll see.”

There’s still blood on the barrel and the pump handle. I’m standing in the road facing the driver’s side of the truck as it tips upward. At my feet is a bit of the blood and the trail leading back toward the tarp. I look up. There is a canopy of fir and spruce and cedar above, glaringly illuminated by the yammering lights. The cedar boughs hold bits of fat and blood smears that shine different in the tangent light. I scan. Bits of skull are across the cab and hood, as well as blood.

Not much of his head left, I guess.

No.

“Why did you move the body?”

“Had to get the lights in here, doc. Plus, he was kinda blocking the road.”

“Show me where he was lying.”

Earl and Brandon shuffle about, showing me with gestures where the body lay, where the gun was, what they had found.

“Let’s see him.”

We go back to the tarp. The light isn’t too good here. It’s crossways. I try to imagine their description of how he laid, and the gun.

“We gotta get him back into the light. I need to see what’s left of his head.”

Earl and Brandon and I drag him back toward where he was on the gravel by his rig. I put the vinyl gloves on in the cold so I can mess with his shredded head. I turn the shoulders so I can see his right temple. The skin left there is torn and ragged.

“Now show me how you think this happened.” I say to Earl.

He gets a hold of his eagerness and backs the story up to the beginning as he sees it.

“Well, we think he was actually headed out to town, see. There’s tracks up there on the cut bank where we think he turned around.” We all walk up beyond the glare about 40 yards to where there are fresh tire tracks in the uphill dirt. “So, as he’s headed out to town about nine or ten or so, he decides he’s forgot something, maybe and he turns around.”

“Any money on him?” I ask.

“Nine dollars.” Earl pauses. No robbery.

He continues. “Well, he’s drunk and can’t make this turn and drives off the downhill side here. He tries to drive out, but she won’t grab. So, he gets out to go get help. He thinks to grab his shotgun out a the front seat and it goes off as he’s pulling it toward himself.”

“And hit’s him right in the temple?” I ask, skeptical.

“Well, yeah.”

I exhale and shake my head. “Sorry Earl, that is a contact wound on his temple. He, or somebody, was holding that gun against his head when it went off. No powder burns, no distance from the muzzle to the skin. So, Earl, if no one else was here, and you don’t think this is a homicide….do you think it is?”

“No.”

“Then I’ve got a hard time seeing this as an accident. If he’s pulling the loaded shotgun toward him the shot would have gotten his arm, neck, the whole side of his face, and he’d have powder marks. But the blast hit him square in the right temple. Contact wound, or very near. The muzzle was less than an inch from his skin, maybe even up against it. Plus, look at all that spray.” I gesture toward the cedar branches with blood and brains above.

“I think he pulled the gun out, racked a slug in the chamber, put the butt on the ground, bent his head over the muzzle and pressed the trigger with his right finger.”

Earl and Brandon were quiet. “But why would he do that? When he just got all that money from disability and all? And his truck ain’t totaled. We could pull it up outa there easy enough. What’s the reason for suicide?”

I looked down at the frozen gravel. I thought of all the stories, the reasons, all the patients I have worked with as they struggled with their disabilities and whether they could get “Their Disability”. I had some idea, but I really didn’t know just how the brain, now gone from this dead man might have worked. And I kick frozen gravel.

“Earl, I’m not sure I know. I’ll talk to his lawyer in the morning. I know him. Maybe he’ll have an idea. But the scene says this was a suicide.”

I turn and walk back toward the Hilux, then turn back to them in the glaring, raging lights. “I’m gonna go. I’ll ask the funeral home to run his blood. I’ll talk to you guys in the morning.”

His lawyer was little help. “No way he’d kill himself now. We worked on this for two years getting him his disability. He should have been as happy as a pig in shit.”

“When did you last see him?”

“Thursday, four days ago. I gave him the final determination papers.”

“He seem okay then to you?”

“Yeah, he was fine. He was happy the judge had decided for him, and he would be getting regular money.”

“Thanks.”

Blood alcohol 280

Cause of Death: Shotgun Wound to the Head.

Manner of Death: Suicide

This call came right after dinner. Martha would wrangle the little girls to bed, I could go do the coroner business and keep being a doctor in the morning. I was chipper.

I didn’t have to go far. It was dark, still late winter but not snowy or icy. We were in a thaw that teases the trees and bushes about spring.

This is a small town, and this scene was just about two miles from my house. The roads were wet but no ice. It was just off the two-lane highway heading to the eastern county and four blocks or so off the north south highway. These are two lane roads, no interstates in this country. But they were highways, nonetheless.

Martha and I used to live over here when I was trying to get into medical school. This is some thirty years back. I didn’t know much about this house where I was going, though. We had known some neighbors, but not here.

This area was called “Swede Town” by the old timers. Frame houses 80 years old, some without foundations. Great for renting to students, back when such housing was affordable.

I wasn’t looking for the shiny thing when I decided I wanted to be a doctor. I truthfully, had no idea of the incredible income of physicians. A high school girl friend had a doctor as a dad, and they were sure better off than we were, but not lavish. Then I learned more in medical school, and still. Maybe shiny things draw us. Even when we don’t look to the shine.

I must have looked away from it. I chose the lowest paid specialty in the medical field, though I had all the credentials, scores, recommendations for the top paid ones. Sometimes that shiny thing repulses us. Sometimes it draws us to it.

Our old Swede Town house had wool carpets that got moths in them, and in the winter the walls dripped condensation behind the posters we put up. When it got real cold the electric wall heaters ran nonstop. We loved that place. Our first little baby was born into that hovel.

We liked the little home, and the rent was what we could afford. It was a happy time in our young married life.

This house looked like a rental too as I parked. I found a spot in the alley behind a patrol car. There were two, both city cops here in town. A patrolman was by the door. The house had a board porch, soft and rotting I could feel, and the paint was peeling. But with some work it could have been nice. It seemed to have a foundation.

“Detective Frye is inside.” I went in past the uniform at the door.

All the lights were on, and the unkempt home gritted under foot. The linoleum crackled, though the floor didn’t seem springy. I saw two uniforms in the main room and Detective Frye talking with them. He turned as I came in.

“Sorry to get you out this evening.” He smiled. He and I went way back.

“I wasn’t doing anything. What have we got?” We become four men, listening to one tell the tale.

“The deceased is in the basement.” He gives me the name and age. “Seventeen-year-old male.” I don’t know him, at least by his name. But neither could I remember the names of most the patients I had seen today in the clinic.

I think I decided to forget names early in this small-town practice so that uncontrollable reaction of recognition wouldn’t betray me in idle or stupid conversation. Maybe that’s just my excuse for bad memory.

My medical school board scores refute that. I can remember long lists of nerves, muscles, bones and body parts and I can tell you just how they are connected. But I can’t, or don’t remember the names of the patients I see. I need analysis.

“It seems there was some partying here tonight. There were four, maybe five people here. They have all corroborated the story. We’ve gotten their statements.”

“Four or five?”

“Yeah, it seems one person left before this went down. We have her name. We’re tracking her down.”

“You know these folks?”

His thin-lipped smile again. “Yeah.” And nods.

“So, this is a party house.”

He shifts. “Kinda. We haven’t gotten anybody out of here for selling, but we know these folks use. And we know the deceased from prior interactions.”

“What are they using?”

The smile again. “Lots, doc. Mainly meth, but marijuana and some heroin. Pills. You name it.”

My old neighborhood.

“What happened?”

He pauses. I appreciate when someone is trying to develop a narrative. It can’t always be done.

“Well, they were partying here. There were the three folks who live here, maybe about 6 o’clock. The deceased came in and they all described him as kind of jittery, anxious, high strung. They smoked some dope to try to mellow him out and he seemed to relax they said. Then the girl came in.” He gave me her name, but I didn’t know it, or remeber it either.

 “They were all talking and being friendly, but the kid started bugging the girl and she ran out.”

“Was she his girlfriend?”

“Not according to the three guys. We haven’t talked to her yet.”

The weak couch is behind us, dirty and saggy. The corner has a lamp and there is a low cheap coffee table strewn with life and death and garbage. There’s a dirty soft chair in the corner, and another chair, not very comfortable against a wall. I can kind of see the scene.

“So, what happened?”

Detective Frye winces. Like his narrative might be weakening. We all wait. “The guys say he seemed to snap. He grabs the gun…”

“What gun?”

“Oh yeah, I forgot to say. They all described that they, one of the guys, had a gun he kept on the coffee table there.” He gestures toward the strewn low table.

“So, he grabs the gun?”
“Yeah, he grabs the gun and runs down the hall.” He gestures again, to our right. “They all thought he was pulling his usual drama and kind of laughed about it. Then they heard the shot in the basement. And called us.”

“They didn’t go down there?”

Detective Frye nods, acknowledging he has pushed the narrative. “Yeah, one guy went down and looked at him and that’s when we got the call.”

“Let’s go look.”

He leads me down the hall and down the stairs. Few houses in Swede Town have basements. This one was small and dank, as might be expected. It’s wet outside, and the ground is not fully frozen. But there was no water to walk in down here, no pools, just the damp smell of wet concrete below grade.

There was a bathroom down here. The original builder must have seen some value in excavating so far down. For the deceased young man was sitting on a toilet seat, lid down, in a dank well-lit bathroom, now splattered with his brains and blood.

A large caliber shiny revolver laid on the concrete floor.

He was reclining back toward the toilet tank, his arms relaxed by his sides, like he might be at peace, except the top of his head was gone.

I looked closely at what was left. It looked like he might have had curly blond hair, since the front of his scalp remained. The eyes might have been blue, though the lids were half down. Around his mouth there were short, linear lacerations radiating outward.

I turned to Detective Frye. “How do you read this?”

He shrugs. “He came down here and shot himself.”

“Can you see that he put the gun in his mouth?”

He leans in and looks closely. “Yeah, I can see it. There’s that hole back there in the back.”

“Can you see the stippling around the entrance wound? That’s from the powder from a near contact wound.”

He looks at me and looks onto the open mouth again.

“See the splits on his lips? That means he closed his mouth around the barrel and when it fired, they were blown outwards.”

He looks again and nods.

Might as well share what I have learned. It’s not shiny or bright, this business of investigating death. The revolver sure was, there on the cement.

“You can clear that.”

The detective has his vinyl gloves but looks up. “I’ll have to go get an evidence bag.”

I shrug.

A patrol officer had followed us down. He moves behind and points to a defect in the lousy tile above the toilet. “I think I can get the slug out of here. See, I think it’s imbedded.”

Detective Frye tells him to do his best, then heads up to do his business. I stand upright.

“I’m not sure what that slug will tell you. I can call it. We’ll get blood for tox, but I don’t see the need for an autopsy. I’m going to go now.”

The shiny revolver lays on the damp floor, splattered with just a bit of blood.

“Yeah, doc, you can go.”

Cause of Death: Gunshot wound to the head.

Manner of Death: Suicide

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

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.