Working Stiff

by Judy Melinek, Md

  I went over to the reception desk, placed a call to the chief morgue technician, and asked him to try to put the remains out for viewing. When I explained why, he said, “I’ll ask Jackie.” Jackie, an unflappable young woman with an air of calm and sympathy, was one of my favorite technicians. She was fluent in Spanish too. If anybody could jury-rig a funeral viewing in the medical examiner’s morgue, Jackie could.

  She did a beautiful job. It was nearly the end of the day, so the more horrifying trappings of the autopsy suite had been cleared away by the time I escorted Jaime Rubio’s sobbing sisters to a small room in the back. Jackie had laid out the skeleton on a gurney, with a blue sheet folded like a pillow under the skull. She had arranged more blue sheets over the rest of the remains so that they were recognizably human in shape, but not visible. She even draped the gurney in such a way that it almost resembled a casket. Jaime’s remains looked suitably peaceful.

  His sisters stood there in the little room, sobbing and peering at his skull from all angles. “It looks like him,” said Rosa in Spanish. “That eye was always crooked.” She paused, then cried out in English to the moldering skull, “I love you, Brother! It’s not fair we never got to say goodbye!”

  Irma held her sweater to her nose the entire time, though the dry bones didn’t really smell at all. She turned to Jackie at one point and asked her in Spanish, “How can you do this work?”

  “You get used to it,” Jackie replied.

  We stood there a few more minutes. The sisters stopped crying. The skull kept staring back at them with its empty sockets, one a little crooked. Then I walked them back out to the lobby. When we got there, Irma finally lowered her sweater from her nose and asked me the same thing she had asked Jackie—how can I do a job like mine? “It’s not about the bones,” I told her in all honesty. “It’s about the living. You and me. I do it for you.” They both hugged me and thanked me, and left the office arm in arm.

  * * *

  Not all the unidentified remains that come our way fall under the medical examiner’s jurisdiction. Some aren’t even classifiable. One time somebody called the police after stumbling upon a human skull wrapped in feathers and a beaded necklace, smeared with what appeared to be blood, arranged atop a rock in Central Park. After Amy issued her report, the police concluded it was either a voodoo ritual or a prank. The skull was real enough, though the feathers were fake and the “blood” was paint.

  In early May 2002, a detective came into our office carrying a plastic bucket. It had appeared in the hallway of an apartment building, and someone called the police in alarm. “Patrol took one look at the thing and called me,” the detective said. “I took one look and nearly puked. Now I need to know if there is a dead fetus in there, because that’s sure what it looks like.”

  The mystery bucket became Dr. Hayes’s case. He dipped into its cloudy red contents and fished out something cold and hard. It was a porcelain figurine of kissing angels. That was weird enough, but next came a couple dozen maraschino cherries. Finally he extracted a pair of two-foot-long ropy gobs of organic matter. To him they looked like either skinned snakes or donkey penises—he wasn’t sure which. Dr. Hayes washed the objects off and carried them over to radiography. X-rays revealed they certainly weren’t fetuses: There were no bones. Probably penises, then. Just to make sure, Hayes cut the gobs in half. They had a spongiform cross section. Yes, they were penises, from a nonhuman animal.

  Hayes is a fabulously witty and irreverent man to begin with, so hearing him present the Mysterious Case of the Maraschino Donkey Dongs in his genteel English accent was the highlight of everyone’s week. Somebody pointed out that just because the penises were two feet long and the girth of a Coke bottle didn’t mean they weren’t human. Yes, they were far outside the known range of human penises, but what about his obligation to scientific rigor? Why hadn’t he taken samples for microscopic study, just to be sure? There could be a journal publication in the case.

  Hayes told us that in Florida, where he had trained, they saw this kind of stuff all the time. It was probably a Santeria love potion. Not that it mattered to the Office of Chief Medical Examiner what the hell the penises were used for, of course. As soon as Dr. Hayes had determined that those ropes of tissue were definitely not human remains, his job was done. He tossed them out—along with the cherries, the kissing angels, and the bucket. I was disappointed to learn this. He should have at least kept the kissing angels as a paperweight.

  7

  Death at the Hand of Another

  On August 6, 2001, Domingo Suelo’s body came to the morgue, and Dr. Flomenbaum decided I was ready for my first homicide investigation. He hadn’t wanted to hand the fellows any multiple gunshot wound cases or messy stabbings until we had a couple of easier homicides under our belts. “I’d rather autopsy seven guys shot once than one guy shot seven times,” as the Hirschism goes. Flome took a look at the investigator’s report that morning and assigned the Suelo case to me. “Looks like a softball—two, maybe three stab wounds.”

  Domingo Suelo was cheating on his wife. His wife’s brother found out. Domingo got stabbed. He was twenty-six, short and slender, not notably handsome. None of his handful of tattoos signaled gang affiliation or prison time. The hardest thing about the autopsy was documenting all the minor wounds. His body told a story of a struggle, maybe in self-defense, and I spent a long time writing detailed descriptions of each scraped knuckle, bruise, and scratch, no matter how small.

  Suelo had gone to the ER and then straight to surgery, so distinguishing the medical punctures from the knife wounds proved more complicated than I had expected. The autopsy showed that Suelo lost a lot of blood from a cut subclavian artery after a deep stab to the right side of the chest. The hospital team had placed a surgical drain inside this fatal knife wound. At first I couldn’t fathom why they would do so. It was already a contaminated site, but dangling a hose out of the wound would turn it into a sepsis superhighway. Plus, when I tried to explore the bloody track left by the weapon, I found that the piece of plastic they had crammed in there made it damned hard for me to determine the length of the blade that had caused the trauma. So I was doubly annoyed by this blatant breach of surgical sterile technique—it exposed the patient to a high risk of infection, and confused the forensic pathologist.

  Suelo hadn’t died of an infection, though. He bled out. I knew from my own time as a surgeon that the trauma team was likely in damage control mode from the moment this patient arrived in their operating room, and putting a drain in the stab wound was the fastest approach. The surgeons closed the artery and stopped the bleeding, but it was too late. His vital organs looked pale, more like offal meats than fresh tissue. In a typical autopsy, the organs are brightly colored and glistening, and blood oozes out and collects on my table when I cut into them. Suelo’s were dry on the inside.

  The scene photos showed where he had spilled all that blood. The fight began on the roof of his apartment building, which was littered with discarded beer and liquor bottles. From there Domingo and his brother-in-law apparently brawled their way down into Domingo’s apartment, where the stabbing occurred. Suelo collapsed in the building’s lobby, leaving a pool of blood. When I met with the assistant district attorney assigned to this homicide, she told me that the brother-in-law was going to try to make the case that Suelo had pulled the knife himself and “fell” on it by accident. The ADA was planning to ask me on the stand whether the traumatic injuries I found on autopsy pointed to a prolonged struggle. She was confident my documentation of multiple stabs and defense wounds would foil any argument that it was an accident. The prosecutor never called me back with a trial subpoena, though, so I didn’t end up testifying.

  “Well?” T.J. demanded in frustration, when I ended the story of my first homicide case right there. “What happened to the brother-in-law?”

  “Beats me. Probably took a deal. He had refused at first, which the ADA thought was pretty stupid. I’ll bet he took the plea in the end.”<
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  “I can’t believe you aren’t even curious enough to find out!”

  “I’m busy,” I pointed out. “And so are the ADAs. All of us have plenty of open cases to worry about without gossiping over the closed ones.”

  Murders are the cases everybody wants to hear about. They comprise only 10 percent of my workload but eat up a disproportionate amount of time. A lot of detailed work goes into the postmortem investigation of a killing, so if I’m going to check “homicide” in the manner of death box, I had better be damned sure it really is one.

  My profession has been a hot subject for television drama for more than a decade. I get a kick out of these fictionalized accounts of what I do for a living. The female ME with bedroom eyes, stiletto heels, and a lot of cleavage shows up at a gory, atmospherically ill-lit murder scene. Her diagnoses are instant and ironclad, the banter with her colleagues witty—and smoldering with sexual tension. I laugh myself silly when that stuff is on. In real life, I visited murder scenes in New York for one week, during my training month, while riding along with the detectives of the police department’s Crime Scene Unit. I wore sensible shoes and a medical examiner windbreaker.

  When the cab deposited me at the CSU headquarters in a Queens industrial park, I went inside and found detectives Wythe and Eagan sitting at a steel desk, sipping coffee out of Greek-themed paper cups. Charlie Eagan was in his late forties, a slender, serious black man with a Trinidadian accent. Paul Wythe was a handsome blond flirt in a sharply pressed suit and polished shoes, with a brilliantly white, confident smile. I had arrived just in time for their dinner break. I’d already eaten, so I picked at a couple of onion rings just to be polite and grilled Charlie on the finer points of covering a death scene. He knew his job well and was happy to talk about it—but before he got very far, the phone rang. A male teenager had been shot in the head on Flatlands Avenue in Brooklyn, near the Bildersee Playground.

  The street was swarming with police—blue lights flashing, yellow tape holding back a crowd, a puddle of fresh blood on the sidewalk—but no corpse. The boy had died in the ambulance, not on the street. The scene of his shooting was littered with .40-caliber shell casings; we would eventually retrieve eight in all. The precinct cops had placed Dixie cups over the casings on the sidewalk and street, but others had rolled under cars and behind the dumpster. A diamond earring set in silver lay beside a Yankees cap in the blood puddle. We recovered only one bullet slug.

  Paul, lead investigator for this case, started by mapping the area. He traced the sidewalk, the bagel shop, and an adjacent laundry, drew a box for the dumpster with a draftsman’s swift, meticulous hand, and labeled everything in square block letters. He then plotted on his map the precise location of each item of evidence, designated D1 through D12, measuring distances with a surveyor’s wheel and triangulating from the walls and curbs. He documented the license plate number and VIN of every car on the street, cursing under his breath at the complexity of this shooting’s aftermath.

  The detective pulled out his camera and photographed the scene after he had finished drafting it. He took establishing shots of the sidewalk, up and down both streets, and the bleak walls flecked with blood. We needed to photograph each piece of evidence from different angles to establish context. I offered to help, so Paul instructed me to number each shell casing with a sticker and stay there to make sure it didn’t blow away. After he finished photographing a casing I would pick it up (with a gloved hand) and place it in a labeled ziplock baggie. Somebody had to retrieve the shell casings that had rolled underneath parked cars. This too became my job, and the male detectives, both CSU and Homicide, gathered to ogle. “You guys ought to bring her along more often,” I heard one remark while I wiggled under a low-slung Honda.

  Once we had collected the evidence, Charlie and I sat in the cramped van with Paul, waiting for him to finish labeling and logging every last thing. “When I was new to this job, I used to bring it all back to the office and document it there,” Paul explained to me. “But every time, I’d walk in the door, spread the evidence out on my desk, uncap my pen—and the phone would ring. I never finished one case before I had a new one. Now I label everything on-site. They can’t send me on another run while I’m still working this one.” He tapped his temple with a pen. “Smart.”

  Charlie rolled his eyes. “It’s late,” he said. “Write faster.”

  We got back to the office well past midnight. Charlie was yawning. Paul’s suit was rumpled, his tie askew. The other CSU cops proceeded to tease him without mercy.

  “Tuck in that shirt, Detective!”

  “I’ve never seen him so wrinkled.”

  “He’s got to be flustered, having the lady around to impress.”

  Paul ignored them, and offered to drive me home to the Bronx in the CSU van so I wouldn’t have to call a livery cab.

  We were cruising on the Major Deegan Expressway, and I was nodding off—when the van lurched to a sudden stop. Two guys in a souped-up Mustang had spun out and crashed into an overpass wall. They looked unscathed but sufficiently sheepish when Paul turned on the van’s blue flashers and spotlight. “We stay put,” he instructed me, all the levity vanished from his demeanor. “Best way to get killed on this job is to step outside your vehicle on a highway.” He yanked the microphone off the dashboard and flipped a switch. “Stay by your car. A tow truck is on the way,” his voice boomed from a loudspeaker. The two men winced, and one of them gave a little wave of thanks. “Want to say anything?” Paul asked me, handing over the microphone.

  “Be thankful I’m looking at you two morons out here and not on my autopsy table,” I said in a loud monotone, speaking into the microphone without pressing the switch. It gave Paul a good laugh. He called the dispatcher to report the accident. We continued to sit there with the blue lights on for half an hour, maybe more, until a local cruiser and tow truck arrived. I was home ten minutes later, happy to have arrived safe and sound.

  My week with the Crime Scene Unit reinforced Hirsch’s lesson that I was part of a far-flung team, of disparate fields and with different skills. That was my signature on the death certificate, yes—but the investigation was never mine alone. In the memorable Birthday Suit case, for instance, I collaborated with both the police and the district attorney, and contributed a critical piece of wound interpretation evidence that helped send a killer to prison.

  Patty Brown and her boyfriend were alone in her apartment at one o’clock in the morning, arguing loudly about infidelity, when he opened a standard-issue Swiss Army knife and stabbed her three times, hitting her left jugular vein. Patty ran out into the hallway, half naked, blood pouring from her neck. Her boyfriend, buck naked, followed.

  A neighbor cracked open his door. He saw the bleeding woman crumpled on the floor, a naked man covered in blood standing over her. The neighbor slammed the door shut and called 911. The naked man started banging. Apparently Patty’s apartment door had locked when it closed behind him, and he was hollering for someone to bring him some clothes. Patty was still bleeding to death. The boyfriend pounded on some more doors, but nobody offered to clothe him, so he ran downstairs and out the front entry. And there, across the street, parked in front of a doughnut shop, sat a New York City police cruiser.

  Birthday Suit, as someone at the DA’s office would later christen him, told the cops, “I stabbed her.” One of the officers detained Birthday Suit while the other sprinted into the building. He found the victim slumped in a pool of her own blood. Patty Brown managed to say her boyfriend’s name to the cop. Those were her last words. She lost consciousness, then died in the ER.

  Patty Brown’s autopsy took me a long time. The neck dissection was extremely difficult, but it ultimately yielded a clear view of the three wound tracks, all the way to the fatal incision of Brown’s jugular vein. The morgue photographer came over and took perfect pictures of it in situ. I also had to perform my first New York State Sexual Offense Evidence Collection Kit, commonly (and inaccurately) called
the rape kit, which ended up taking me half an hour—twice as long as Dr. Flomenbaum when he trained me in its protocol. If the circumstances of the death involved sex, if there was indication of domestic violence, or if the decedent was found naked or partially clothed, the medical examiner might be prompted to do a rape kit. This doesn’t necessarily mean a rape occurred. The rape kit is a set of tools for collecting trace evidence, DNA, and evidence of sexual activity, whether consensual or not. Combined with a physical exam finding of bruising or laceration, the presence of sexual evidence might indicate the sex was not consensual—but my job was only to gather this evidence, and the police or DA would decide whether they needed it to press a charge.

  The rape kit consisted of a plastic bag with four cotton swabs and a bunch of small prelabeled envelopes, which fit inside one large envelope. The first swab was labeled to sample the vaginal vault, the second the anal area, and the third the oral cavity. The fourth swab was for “secretions.” I didn’t know what to do with it. Susan Ely was working on a suicide at the next table in the Pit, so I asked for her help. “Oh, that’s for any suspicious gunk you find anywhere else on the body,” she said. There was a fingernail clipper in the kit, and separate envelopes for the left and right fingernails—an assailant’s DNA can be retrieved from under the victim’s nails. After I had completed and sealed the rape kit with red evidence tape, I finished the autopsy and presented the Brown case at our three o’clock conference. I was feeling good about my work afterward. This postmortem homicide investigation, only my third, was going without a hitch.

  The next day Dr. Stephany Fiore caught up with me after morning meeting. She had a predatory look in her eye that made me nervous. “You do realize that yesterday at Hirsch rounds you called the cause of death on your homicide ‘incised wounds of the neck,’ right? They’re ‘stab wounds.’” I told her flat-out she was wrong, but Stephany insisted. “You said ‘incised wounds.’”