Showing posts with label doctor. Show all posts
Showing posts with label doctor. Show all posts

11 February 2018

A Voice for the Dead

by Mary Fernando

“I don't believe it, and none of us believe it.”[1]

That was the response to the police assessment of murder-suicide from one friend of billionaires Honey and Barry Sherman. This was followed by a chorus of agreement from many prominent Canadians, and subsequently by an expensive independent investigation which resulted in a revised new assessment of double murder.

Leigh Lundin asked me to look at this now high-profile Canadian crime being played out, blow by blow, in the news. So here I am looking at it. But with Canadian eyes.

Honey and Barry Sherman
Honey and Barry Sherman
My question isn't about what happened in this particular crime. I feel confident that it will play out in the investigation, and that the truth will emerge. My question is this: What would happen if a family disagreed, but did not have powerful friends or the money to conduct their own investigation? What if the family were poor, but still vehemently in disagreement? What if a murderer was on the cusp of getting away with it? Who would stop them? 


I brought this up with Dr. Coroner – not his real name but it would be a good one, because he is indeed a coroner. He is called in if a death occurs outside a hospital, and occasionally in it. His job is essentially to assess the manner and cause of death. Is this death natural, an accident, a suicide or a homicide?

The body can be photographed but cannot be touched until he is finished his assessment and releases the body. He looks at the story, told by the body, of the manner and timing of death. There is also the story told by the place of death, and the question for him is whether it is consistent with the story the body tells.

My question: If the family disagreed with a murder-suicide verdict, but were neither educated or moneyed – what would he do? What if the family was unable to articulate a story as well as the friends and family of the Shermans? What if they were angry and threatening, or in general made themselves unsympathetic?

He said often his job is to help reconcile the disbelief with the reality. Some counselling is often part of what he does with families.

Also, he argues that marriage – by the nature of the long term relationship – can lead people to kill each other, even if they look to others like they are happy. Marriage itself can be the reason for murder.

Those caveats aside, Dr. C. said there was enough from the story of the “murder-suicide” of the Shermans to make him suspicious, largely because the story is wrong. Domestic murder is often more violent, angry. Hanging is not what he would expect as a means of murder or suicide in this case. Hanging is more often seen in cases of mental illness or extreme distress. Further, why would a man who has copious drugs available to him choose this manner of death for himself and his wife?

If the stories of the body, manner of death and family assessment make Dr. C. suspicious in any way, he has many options to augment the evidence he gathers.
  • The authority of the coroner overrides privacy of information, so he can seize records from sources such as the family doctor, psychiatrists, and psychologists. This could provide a more fulsome picture.
  • He can seize all radiological and dental records, to see if there is evidence of previous abuse.
  • He can order a post mortem, or a forensic autopsy and refuse to complete the death certificate or even provide the funeral home with a warrant to bury, until he is fully satisfied.
Ultimately, the story must hang together. Regardless of the ability of the family to articulate their concerns, or their resources to investigate on their own, Dr. C. relies on having a coherent story told by the manner of death, the body, the family and the records seized. If there are inconsistencies – then a further investigation is warranted.

If a family were unable to mount the same vigorous objection and investigation as the Shermans have, it could be the coroner who stands between the constructed truth of the murderer and the actual truth of the victim.

Ultimately, all crime writing is social justice writing. And the poor have a voice – the coroner. The story of the body, uncovering the life lived, the manner of death, might be the key to catching a murderer. The background knowledge and tenacity of the coroner is what most of us rely on when our bank accounts are meagre.

Dr. C. said that the job of the coroner is to provide a voice for the dead, to listen carefully to the story they tell. This is the first step towards social justice for those without money and connections. They do this by asking the simple question:
Does the story of this death make sense?

19 April 2016

Back Pain Attacks Writers and Readers


Do you love books? Reading them, writing them, anything to do with them?
And have you ever had back pain?

Chances are high that you said yes to both books and back pain. This is a site for mystery lovers, after all, and approximately 84 percent of adults get low back pain at some time in their lives.⁠1 ⁠2 So you and I are not alone.

(Wouldn’t that make a great birthday card? Happy 18th birthday! Party hard, because now you have an 8 out of 10 chance of hurting your back!)

So listen. I’m an emergency doctor who loves books. I decided to tackle this sucker by writing THE EMERGENCY DOCTOR’S GUIDE TO A PAIN-FREE BACK, which releases Thursday, April 21st.

Obligatory disclaimer: I am a doctor, but I’m not your doctor, so you have to go see your own health care  practitioner. All I can do is give you helpful advice on treatment and prevention.

I pored over research articles. I read other books and considered both traditional and integrative approaches, including acupuncture, yoga, and diet. What struck me is that some people want to give advice without anchoring it on research, so I’m proud to say that I included studies written right up until January 2016.

The other thing that struck me was that a lot of fact-based books were super dull, so mine is short, funny, and full of cartoons and pictures because hey, life is short.

Here are three tips for readers and writers:

1. You don’t have to be a book lover to get back pain. Even sitting all the time doesn’t automatically cause back pain⁠ 3, although it does predispose you to other problems (coronary artery disease, diabetes, breast and colon cancer ⁠4…I know! I’m full of good news today!). So try to get up and move throughout your day.

2. After you go see your doctor, you may well get diagnosed with non-specific low back pain. More than 85 percent of the time, we don’t find a particular cause.5 I consider that good news, because you don’t want the herniated disc, fracture, infection, or cancer. You want to get better. Fast. And to do that…

Kathleen can do it. So can you!
3. “Don’t tell me I have to exercise,” groaned more than one writer-friend on Facebook.
Yes, I’ve got triple good news for you. You do have to exercise once you get over your initial agony, or to prevent it in the first place. Exercise and education reduce your risk of a back pain episode by 25 to 40 percent, as shown in a 2016 meta-analysis by Dr. Daniel Steffens and colleagues at the University of Sydney. They considered 21 randomized control trials of 30,850 people.6

There’s no hard evidence on which type or amount of exercise is best. “It seems to matter less exactly what type of exercise you do than that you do it in a regular way,” said Dr. Timothy S. Carey, a physician at the University of North Carolina at Chapel Hill, who co-authored a commentary on the mega-study by Steffens.

So choose exercise that you like, and do it. Cardio, core, strength training, flexibility, and working your upper and lower limbs were all included in that mega-study.

Since we’re all busy, I developed a three-pronged exercise program where you can even work on your strength and flexibility in bed, at work, and while watching TV. My program is meant to be accessible to everyone. Look at my friend Kathleen. She’s a senior citizen, and she’s hitting it hard. With my book!

Click cover to preorder e-book now for a special price of $5.99 (regular price $9.99).
Direct Amazon.com link here.
Bottom line: most of us will get back pain sooner or later. As someone who loves words, you’re already at at advantage to prevent it through education. Keep reading and start moving, and you'll save your energy for more fun stuff like cat detectives and hard-bitten thrillers.


1 Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987; 12:264.
2 Cassidy JD, Carroll LJ, Côté P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine. 1998; 23:1860.
3 Chen SM, Liu MF, Cook J et al. Sedentary lifestyle as a risk factor for low back pain: a systematic review. International Archives of Occupational and Environmental Health. 2009 Jul, 82(7): 797-806
4 Lee I, Shiroma EJ, Lobelo F et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet. 380(9838): 219-229
5 Deyo RA, Weinstein JN. Low back pain. N Engl J Med 2001;344: 363-70
6 Steffens D, Maher CG, Pereira LS, et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016 Jan 11:1-10. doi: 10.1001/jamainternmed.2015.7431.