Showing posts with label forensics. Show all posts
Showing posts with label forensics. Show all posts

21 June 2016

Sweet Dreams and Armpits


by Melissa Yi, M.D.

A is for…


I'll start off with the second part of the title first.
When I get a trauma case, my priorities are ABC, or C-ABC

C-spine (some experts put this first, so we don't forget to immobilize the cervical spine)

Airway: is the patient talking? Bleeding? Suffering from a burn that will close off the airway?

Breathing: now check the lungs and chest. Look at the respiratory rate and oxygenation.

Circulation: is s/he bleeding anywhere? How are the blood pressure and heart rate?

D is for disability, which means a neurological exam. Pupils, reflexes, and strength if the patient will cooperate.

Dr. Scott Weingart, an emergency physician intensivist based in New York, emphasizes E for Exposure in penetrating trauma. You need to find the entry and exit points so the patient doesn’t bleed out from a bullet wound in the back while you’re messing around with a chest tube in the front.

So even before establishing airway, if the patient is maintaining an airway and has no blunt injuries, Dr. Weingart inspects “every square centimetre” of the patient’s skin, including the axillae, the back, the gluteal folds and the perineum, including lifting up the scrotum in a male patient. A much catchier mnemonic, proposed by Dr. Robert Orman, an emergency physician in Portland, Oregon, is: “armpits, back, butt cheeks and sack.”

With thanks to Leigh Lundin for pointing out that I had forgotten to post, and to the Medical Post for originally printing this clinical pearl.

Sweet Dreams

And now for a happy dance: one of my writing dreams has come true. When I looked at Rob Lopresti's column, I recognized the Forensics book cover by Val McDermid.

Why? Because it was chosen as one of CBC's best crime books of the season--along with my own Stockholm Syndrome.

Kris Rusch has said that you should make sure you set writing goals, which are within your control, as well as dreams, which are pies in the sky.

Well, I've been wanting to get on CBC's The Next Chapter for years. So I updated my list of writing dreams and goals here.

Goal: unlocked!

Of course, I have approximately 2 million other unrealized goals, but it's a start. How about you? What are your writing goals and dreams?

Signing out so I can get some sleep before my ER shift tomorrow. I hope I won't need to use my C-ABCDE mnemonic, but you never know what'll happen.

Peace.

15 June 2016

The Scientist and the Man in Black


by Robert Lopresti

Call this the third in my extremely occasional series of reviews of non-fiction books.  As before I am including two at no extra cost.

Forensics by Val McDermid, is a terrific guide to the science of crime-solving.  McDermid was a reporter before she became a best-selling crime writer and it shows. She gives you just enough of the technology, while focusing on the people, and often on the history.

For example, the chapter on entomology begins with the earliest recorded case of insects being used in the investigation of a crime.  In China in 1247 a man was found murdered with, it was determined, a sickle.  The coroner ordered all 70 men in the area to stand together with their sickles.  Flies immediately detected what the eyes couldn't, identifying the guilty man by landing on his weapon to feast on traces of blood.

There are chapters on fire scene investigation, pathology, toxicology, digital forensics, and much more.  McDermid tells of heroic scientists, and others who botched their work, usually out of over-confidence.  Sometimes their mistakes ruin, or even end, the lives of suspects.

One horror story is that of Colin Stagg, an Englishman who seemed a perfect match for a forensic profiler's description of the man who killed a woman in a London park in 1992.  The cops tried hard to prove he was the man, even introducing him to a policewoman who claimed to be attracted to him and into rough sex.  Astonishingly, this guy who had apparently never had a successful relationship with a woman, offered to give her what she said she wanted.  Clearly proof of guilt!


The judge politely called the prosecution's theory of the case "highly disingenuous" and dismissed it.  The policewoman took early retirement for PTSD, and Stagg was awarded a ton of money because his name was so ruined he couldn't find work.  In 2008 another man was convicted of the murder, based on DNA evidence.

The last chapter is about giving courtroom evidence, which most of the scientists appear to hate.  I suppose if an attorney was going to try to make me seem incompetent and dishonest I wouldn't like it either.

But I do like Forensics, and highly recommend it.

Unlike all the other books I have reviewed in this series, As You Wish by Cary Elwes has nothing to do with crime.  But it certainly has something to do with writing, specifically one of the best-written movies of all time. If you aren't a fan of The Princess Bride you may stop reading right now (and never darken my towels again, as Groucho Marx said).

Cary Elwes, of course, played Westley in that movie and, to celebrate its 25th anniversary he has published his memoir of the filming of the show.  If you love this flick you will relish his stories.  For example:

*William Goldman, who wrote the novel and the script (which for many years was considered by Hollywood one of the best unfilmable scripts around) was terrified that director Rob Reiner would butcher his darling work.  On the first day of filming the sound man picked up a strange noise.  It was Goldman, at the other end of the set, praying.



*Remember the sword fight between Inigo Montoya and the Man in Black?  Except for the swing on the horizontal bar, there were no stunt doubles (well, I have my doubts about Patinkin's flying somersault).  You are seeing four months of daily training with Olympic fencers and a solid week of filming.

*Wallace Shawn, who  played Vizzini, was terrified that Reiner was going to replace him.  Making things worse, the vagaries of film scheduling meant that his first scene was his most complicated: the Battle of Wits.

* Remember the scene where the six-fingered man strikes Westley with the butt of his sword and he falls down unconscious?  That wasn't acting.  He woke up in the hospital.

*When Andre the Giant (who played Fezzik, of course) was a child in rural France he outgrew the school bus, so every day he was driven to school by the only man in town who owned a convertible: the playwright Samuel Beckett.

So, if you love this movie, read this book.  To do otherwise would be... (say it with me) inconceivable.

18 September 2012

Saucy Jack


By David Dean

It was inevitable, I guess, that after doing postings on Lizzie Borden, the princes in the tower, the Symbionese Liberation Army, the child murders in the Bahamas, and even Uncle Jimmy, that I must, at last, come to this--Saucy Jack...that Jack...the Jack.  I do so almost reluctantly because of the emotions  he stirs to this day, and the controversy that continues to swirl round his legend.

By today's standards, Jack the Ripper's body count wouldn't even get him into the top ten of modern serial killers.  He had only five, though some argue there are one, or more, additional murders that should be attributed to him.  Whatever the true count may be, his savagery places him right up there with the heavy hitters of any age.  Additionally, he has the distinction of being both an original and uncaught.  After five (or more) unsolved murders of prostitutes, he simply stopped--his mystery remains.

Just like Lizzie, but much, much more so, there have been millions of words written about Jack--so much, indeed, that you might think he was still among us and practicing his devilish trade in murder.  There have been dozens of suspects offered up by writers and scholars that were unknown to the police of that time, or never considered by them if they were.  In fact, there has probably been no case in the history of recorded crime in which the public has done more second-guessing of the police than this one.  It went on during Jack's heinous career, and has continued to this day.  I will not be doing that.  I can't come up with a single theory or suspect that hasn't already been put forth by someone...somewhere.  So I'm not even going to try.  Why this case continues to fascinate us so long after the brutal acts were committed--that, I might can answer.


A number of elements conspired to make Jack the Ripper a household bogeyman during his own time: The emergence of the modern tabloid newspaper, a Victorian-era fad of philanthropic concern for the destitute of London's slums, the thwarting of the seemingly implacable Scotland Yard, and interest in the case from Queen Victoria herself.  For later generations, I would add that the glamor of a seemingly genteel, mysterious, and by-gone era, cloaked in fog and black lace, provided an irresistible backdrop to Jack's horrors.  He was a real-life Mr. Hyde, and the mystery lay in trying to uncover his Dr. Jekyll alter ego.

Of suspects, there is one for every taste; they run the gamut from butcher to surgeon, royal heir to crazed foreigner.  But Jack was no gentleman, whatever his day job might have been.  Though his murder spree only extended over a few months (much longer according to some), each killing was more brutal than the last.  The victims, all the poorest of prostitutes, were savagely killed, their throats sliced, their abdomens mutilated, and in several instances, organs were removed.  All, but one of the murders were carried out on the streets, the bodies left for a terrified public to discover.  The last was accomplished indoors, in a small, bed-sitter, as the British dub them.  There he was able to work without fear of discovery or interruption, and he, quite literally, destroyed the poor woman.  Then, he seemingly vanished.

There are as many theories about his disappearance as there are about his identity: he killed himself, he was imprisoned on unrelated charges, he was committed to an insane asylum, or he fled to another country; perhaps America.  These are just a few of the ideas put forth.  Of course, it is unlikely we will ever know who he was or what became of him, but his stealing away into the fog has impressed an indelible image into our collective minds; adding to his myth.

Jack was also his own publicist, which was a new wrinkle that contributed greatly to his legendary status.  He wrote several letters "From Hell," expressing his glee and enjoyment with mutilation and murder.  He signed himself, "Jack the Ripper" and also coined the coy moniker of "Saucy Jack."  The details leaked out to the public--the denizens of London may have been terrified of Jack, but they were also insatiably curious about him.  Jack was proud of his horrific deeds and didn't mind saying so; writing in  red ink, and once sending a piece of human kidney along with his message to the world.  He was truly a vile creature.

Much has been made of these letters, and like everything else about Jack, they have inspired debate and controversy.  The police and the professional ripperologists disagree over the authenticity of every letter attributed to the murderer.  Scotland Yard settled on two as being from the real Jack, the others they laid to "copycats."  None featured a return address, which  might have been useful.

Another factor that fueled the growth of Jack's hellish reputation was the slum of Whitechapel that he prowled.  This teeming, filthy neighborhood was no stranger to murder before, or after, Jack.  And the prostitutes that plied their trade there were often the victims of it, even as they are today.  But after the advent of the Ripper murders, every unsolved murder of a female in Whitechapel was laid at his door.  According to some his spree continued until February 1891; the police of that time lay only the five murders to Jack, the last being in November 1888.  In fact, the Metropolitan Police of London divide the murders into two categories: the Ripper murders and the Whitechapel murders.  They do so with good reason.  The details of many of the murders that took place in Whitechapel during the period of August '88 to February '91 show them to be clearly unrelated; the modus operandi, beyond the fact that the killing was of a prostitute, bore little resemblance to Jack's handiwork.  Ironically, some of these "Whitechapel Murders" may also have been the work of the same killer, an unknown person no less brutal than Jack who successfully operated in his shadow.  This, I caution, remains a possibility, not a proven fact.

In most minds, the shadowy, knife-wielding Jack remains the epitome, the touchstone of our acquaintance and fascination with serial murderers.  In spite of that, he was not the first.  Jack was predated by such bloodthirsty villains as Gilles de Rais, who may have murdered hundreds of children before being executed.  Sadly, there were others, as well...many, many others throughout history, and quite probably even before recorded history.  There's no particular reason not to think so.  But Jack remains the penultimate to much of the world because of a perfect storm of factors, not least of which was his penchant for self-aggrandizement and a voracious press.  Add to that mix a mysterious, fog-clad setting offering occasional and salacious glimpses of the seamier side of Victorian London and you have the makings of a dark legend.

On a personal note, I would add that Jack, just like those that come before and after him, was not, in any sense, a romantic creature.  He was a vicious, merciless killer of defenseless women--a monster, really.  You have only to look at the crime scene and autopsy photos to see that.  The last murder, that of Mary Kelly, is not for the faint of heart, or weak of stomach.  Jack may have written his gloating letters "From Hell," but if there's anything certain in this case, it's that he's certainly there now.

24 July 2012

Forty Whacks


by David Dean

Lizzie Borden took an axe
And gave her mother forty whacks.
When she saw what she had done,
She gave her father forty-one.
Just about everyone is familiar with that iconic verse, even if they are not familiar with the infamous case from which it springs.  The average person is usually surprised to learn that the axe-wielding Lizzie was found not guilty of the murders of her father and step-mother.  Why then, those same people might ask, does that danged poem hang on so?  Good question, which unlike the case itself, has a fairly easy and clear answer--everybody thought she was guilty.  Well, maybe not everybody, but just about.  She did have her defenders during her trial, and she has a vast horde of them today.  There are many websites and books dedicated to clearing her name, just as the jury cleared her of any wrong-doing.

There are parallel cases even today: The O.J. Simpson and Casey Anthony murder cases spring to mind.  Not guilty?  Most folks don't think so and never will.  People in Lizzie's time felt the same about her.  When you know the facts of her case it is difficult to rule her out...but not impossible, hence the verdict.  Here are the facts in brief: On August 4, 1892, Andrew Borden of Fall River, Massachusetts, father of Lizzie, 32, and Emma, 41, (spinsters according to the times) arrived home from his business rounds sometime close to 10:45am to take a rest.  The weather was brutally hot and it would appear that he lay down on a settee in the living room to nap.  He would not be getting up.  The maid (Irish, of course), Bridget Sullivan, was also lying down in her room upstairs when she heard Lizzie calling her to say that her father had been killed.  She stated that this was around 11:00am. 

Andrew Borden's Death Scene
 It is worth noting, that the entire household had been down with food poisoning the previous day, which may explain the need for rest in the Borden home.  Strangely, the fear of being poisoned had arisen in the days before the murders and created such paranoia that the Bordens had had some of their food tested.  The results were negative.  Other than the fact that Andrew was not the most popular figure in town, it is not clear why or how the Borden clan arrived at their suspicions.

In any event, Andrew was indeed murdered.  The number of whacks he had received fell well short of the infamous forty-one, but were more than sufficient at ten, or eleven, having been applied to the head.  The wounds appeared to have been made with an axe.  The police were summoned.  After their arrival, darlin' Bridget went in search of her mistress, Abby Borden, whom no one else seems to have missed up to this point...and found her in the upstairs guest room.  She was in a kneeling position between the bed and the wall, her face to the floor, her skull caved in.  It was estimated that she had received nineteen blows to the back of her head by an instrument similar to, or identical with, the one used on her husband.  A search ensued for evidence.

Abby Borden's Death Scene

All that was found of consequence was a hatchet with a broken handle.  This was in the basement.  There would later be conflicting testimony on whether the remainder of the handle was, or was not, discovered.  There were no blood stains evident on it.  Strangely, the police made a conscious decision not to dust the hatchet for fingerprints.  Forensics were just beginning to be used by police in the 1890's and trust in these new methods was not necessarily widespread.  Unfortunately in this case, this potentially valuable piece of evidence was left unprocessed.

On the day of the double murders, the only persons at home in the Borden household were the victims, Lizzie, and Bridget.  Emma was off visiting some friends in the country.  Lizzie would later testify that she had been out in the barn just prior to coming in and discovering her father's much-abused corpse.  According to her, there were some lead fishing sinkers stored in the loft that she wished to locate--this is Lizzie's testimony.  Bridget was supposed to be cleaning windows on that hot day, but had lain down to rest as previously mentioned.  There were no blood stains on the clothing of either woman.  Coincidentally, a few days later, Lizzie would be seen burning a relatively new blue dress in the kitchen stove.  She testified that the dress had got paint on it from some newly-painted baseboards and was ruined.  This was not the dress she had been wearing upon the arrival of the police.

That is the bare-bones of the crime scene. I'm not going to dwell on all the potentially relevant details as most are a matter of interpretation and debate, and there are a number of well-researched books on the subject available.  Instead, I will turn to a brief description of the dynamics underpinning the Borden household in the days prior to the murders: In a nutshell, no one was happy.  Abby, who was Lizzie and Emma's stepmother, was not popular with the girls, especially Lizzie.  In fact, about six years prior to the fateful day, Lizzie had quit calling her mother (she had been the mother figure in her life since the age of three) and began to refer to her as Mrs. Borden.  It is not recorded why.  Their father, Andrew, was a notorious skinflint who spent as little as possible on the home they all lived in.  In spite of the fact that they were quite well off, they had no electricity or indoor plumbing, having to dump their 'night soil' in the back yard each day.  A running dispute had arisen in recent times over the distribution of property and monies, both sisters demanding what they felt was their due.  Also, an illegitimate son of Andrew's had attempted a shake-down of the old man just days out from the tragedy.  He was not successful.  Did I mention that no one was happy?  On top of all this was the family's shared concern over poisoning.  Could it get any worse?  Yes.  According to Liz, her father beheaded all her pet pigeons that she kept in the barn.  He was concerned, it seems, that they were attracting curious neighborhood children who might cause damage or be hurt in the disused building.  Right...Murder, anyone?

So what's the upshot of all this?  Not guilty.  Lizzie was acquitted less than a year later, June 20, 1893 to be exact, after only one and half hours of deliberation.  In modern terms it's not too hard to understand why--there was virtually no physical evidence.  Circumstantial evidence is another thing altogether.  There was some of that, but the jury chose to give it scant weight.  I think she would have been given the same result if it were tried today.  Recent verdicts would seem to indicate that juries don't want the moral burden inherent in circumstantial cases.  It was also difficult for the all-male jurors of the Victorian era to envision young ladies of the proper class committing heinous crimes.  It just wasn't done.  Unthinkable.

I'm thinking it's thinkable.  How about you?  With a verdict of not guilty, the slayings remain officially unsolved, as are the Simpson and Casey murders.  That does not mean that we don't form our own opinions, whether rightly or wrongly we may never know.  It's an interesting, if ultimately futile, exercise to think of what modern investigative techniques might have been able to do with the Borden crime scene.  There has been much speculation over the years as to what really did happen August 4th, 1892, including the tantalizing theory that Lizzie committed the murders in the buff.  The picture my mind conjures of the rather formidable Lizzie (see photo) creepy-crawling through that dark, narrow-roomed, stuffy Victorian home in her birthday suit is mind-jarringly terrifying.  Can you imagine the horror of the last thing you see in this world being your naked, adult child swinging a hatchet down onto your head?

The debate over the Borden case goes on, and probably will for some time to come.  It is possible that it may yet be solved.  Patricia Cornwell, famous writer of mystery novels, as well as a forensic pathologist, claims to have solved the Ripper murders of London.  She makes this claim in her book, "Portrait Of A Killer--Jack The Ripper Case Closed," setting forth a very intelligent investigation into the available evidence and arriving at a very convincing conclusion with the use of DNA.  Certainly a surprising one for me.  Though the case she puts forth can only be tested so far, it is the most compelling one I've read.  It's well worth a look if you're interested.  Perhaps she'll move on to the Borden case.  Maybe Lizzie really is innocent, or at least, not guilty.  Who knows?  Stranger things have happened--the actress, Elizabeth Montgomery (Bewitched), who played Lizzie in a made-for-TV-film, turned out to be actually related to her.  She did not know this at the time of the filming, and it was only discovered after her death by someone doing genetic research on Lizzie.  The doctor who did the autopsies on Andrew and Abby had to be sued to return their heads.  This was only accomplished after their funerals; the heads being buried atop the caskets in separate boxes later.  I did say stranger, didn't I?

Well, what say you?  Lizzie, or nay?  It could have been the illegitimate son, though he was never considered a serious suspect at the time.  He certainly had both a beef (his unacknowledged status) and a motive (money). What about dear Bridget?  She was supposed to be washing windows, not laying about in her room.  She wasn't too happy about that assignment.  Maybe she was very unhappy about it.  The Bordens couldn't have been easy to work for, I'm thinking.  Who's to say Emma couldn't have ridden in from her friend's home and committed the murders and returned the way she came.  Especially if she was in cahoots with Lizzie, the look-out, in the barn. Was the only thing that saved Bridget the fact that she didn't rise to investigate any strange sounds in the house?  Was she asleep?  She doesn't say so.  Was she an accomplice?  It would have been instructive, perhaps, for someone to have looked into her finances after the murders.

It was a long time ago...but it could have been yesterday--we see similar crimes far too often.  What do you think?  Did Lizzie give those infamous whacks?