10 September 2017
Unlike all the other inmates of this asylum, Mary Fernando, MD, is not a professionally published mystery writer. She was, however, a 2017 finalist for the Arthur Ellis Award for Best Unpublished Crime Novel (Canada).
She is the first of what we hope will be a new class of SleuthSayer: the special consultant.
Mary will talk about medical mayhem. She will also field questions from readers and writers about medicine as it relates to crime. Please don't ask her about your rash.
We are still working at where her permanent slot in our monthly calendar will be, but this is a great chance for her to get started. Let's give her a big SleuthSayers welcome! - Robert Lopresti
by Mary Fernando
“Magnets are a simple way to kill someone,” he says, sipping his wine.
“How?” I ask, pen in hand, recording the conversation by scribbling illegibly in my notebook.
My Saturday night guest is a cardiologist. He opens up blocked heart vessels with stents, puts in new heart valves and uses defibrillators to bring people back from the brink of death. When my guest is not busy saving lives, he spends his time being a fabulous husband, a loving father to his children, a puppy-daddy extraordinaire and engaging in extreme sports. He is also a voracious reader of mystery novels, making him a wonderful combination of someone who saves lives and ponders how to kill people. Although I find this combination a delicious one, I am not sure everyone would share my opinion. So I am disguising my guest’s identity by a pseudonym, Mystery Cardiologist, or MC.
The illegible scribbles I use to record this conversation are the unfortunate side-effect of my own medical training.
Now, back to the magnets and murder.
MC understands that a writer wants to kill a character in a manner that doesn't draw attention to the fact that they are being murdered, and that the death should look, at first glance, like an accident or natural death. He also knows that it is always important to have a means of eventually discovering the murder.
“Using lifesaving devices like pacemakers to kill people is a great way to murder someone,” MC continues, nibbling on cheese. “Basically, these devices have failsafe mechanisms built into them and these can also be used to kill people.”
By the time he has finishes off his glass of wine, and eaten more cheese, he explains this in full.
A pacemaker is surgically inserted if the natural heart rhythm is not working. It keeps the heart going at the right pace, hence the name pacemaker. These electronic devices consist of a battery and computer circuitry inserted under the skin in the upper chest or shoulder with wires that extend into the heart. The pacemaker both detects the rhythm of the heart and, when the heart’s rhythm is wrong, it adjusts the heart rate by sending out signals to correct it. More that 3 million Americans have pacemakers. Generally they are inserted in older patients, over 65 years old. Less than 10% are inserted in those under 45. In older people, pacemakers are inserted when the heart rhythm is thrown off by aging or heart attacks. In young people, congenital heart disease or even unexplained slow heart rates are reasons for pacemaker insertion.
A means of turning off key functions of a pacemaker is needed, for example, in the event of surgery where electrosurgical cauterizing might confuse the pacemaker’s sensing system. So a magnet protects the pacemaker’s function when something could confuse its sensing system by going into a failsafe mode with often a very slow pacing heart rate.
So, back to killing with a magnet.
If a character needs to be killed and is dependent on a pacemaker, hold a magnet over their pacemaker, and when they are weakened by a slow heart beat, gently push them into an oncoming car or over a cliff. This creates an apparently accidental death. Sans screaming. This also has the added benefit of damaging the pacemaker, so the crime is covered because pacemaker function can be analyzed.
Now, when your detective comes in and starts questioning this death, they have a means of figuring it out. The pacemaker that the murderer thought would be damaged is, in fact, intact enough to be ‘interrogated’ - that means, the programming can be examined and it can be discovered that the heart rhythm was thrown off before the character’s death. Perhaps the magnet could be found in the murderer’s home.
MC explains there is another, more modern way to kill someone with a pacemaker that allows for murder from a long distance. A pacemaker needs to have a means of reprogramming it. This ability to reprogram a pacemaker makes it vulnerable to being hacked, that is, reprogrammed with a deadly rhythm. But if the pacemaker is hacked, you would want to remove the evidence of this hack, again by hacking the device while the victim is driving a car or climbing a mountain. The resulting accident would damage the evidence of the hack.
“Hospitals are a great place to kill people,” continues MC, popping a chocolate. “Sick people dying in hospitals are unlikely to be autopsied. Even if doctors ask for an autopsy, the family often says no.”
So, giving a character a pacemaker and using the failsafe mechanisms of the pacemaker to murder with magnets or hacking, provides an intriguing way to murder. The interrogation of the pacemaker provides the necessary means of discovering the crime.
This is just a snippet of my conversation with MC. He came up with other intriguing ways to murder people, many using failsafe mechanisms and, at times, using medical interventions to cover up a murder. I recorded it all in illegible scribbles, providing me with more info for my next blog.