Training fellows often vie for the homicide cases at the New York City office, but I didn’t find most of them terribly intriguing. Piece of metal goes in, cuts something, guy dies, the end. I enjoy puzzling out cases that aren’t what they seem.
Mary Lynch was an elderly lady of considerable means with a history of drinking who, on a hot day in August 2001, was found by her husband at the bottom of the stairs inside their Upper East Side penthouse apartment. Hers seemed like it would be an unremarkable death investigation. New York is a city with a lot of stairways, senior citizens, and alcohol abuse.
It was a quick autopsy. On external examination I found no sign of disease or injury apart from a nasty contusion on the left side of the head. From one of her fingers I removed a ring of diamonds set around an emerald the size of a lima bean and sealed it in an evidence bag. It looked like it was worth more than I would ever earn in my career as a forensic pathologist. The paramedics had cut open her clothes, but the elegance of the outfit was still evident. Even her hairdo and manicure bespoke deep wealth.
When I opened up Mary Lynch’s torso, I found two rib fractures but no other trauma, and no scar tissue from old surgery that might have complicated my job. Apart from the moderately fatty liver typical of many drinkers, she looked like she’d not suffered much ill health in her seventy-eight years. I incised her scalp and peeled it back. Blood stained the muscle and fibrous tissue on the flip side of the contusion, and I found a long, straight crack in the bone beneath this injury. I noted, “Five-centimeter left frontoparietal linear skull fracture,” then fired up the bone saw to make a careful equatorial cut around the cranium and remove the top of the skull. The cause of death was right there on the surface of Mary’s left brain: a nasty slick of partially clotted black and red blood, a subdural hematoma, was pushing that delicate organ to the right. “Midline shift,” I wrote.
The cranium is a rigid dome and the brain is a jelly. In a subdural hematoma, a traumatic injury causes bleeding into the space between them. The blood can’t escape, and the skull can’t expand to accommodate it. The result, cerebral herniation, is awful. Parts of the brain get squashed under hydraulic pressure into parts of the skull. Your vital centers—the parts of the neurological system that tell your heart to beat and your lungs to breathe—shut down. Then you die.
In Mary’s case, this happened sometime between a few minutes and a couple of hours after the fatal blow. She was probably knocked unconscious and lay there at the foot of the stairs as a growing pool of blood mauled her brain. The linear fracture was the only defect on her skull, which suggested that a single impact to the head had killed her. After weighing the organ, I lowered it gingerly into a pail of formalin and wrote a request for a neuropathology consult; Dr. Armbrustmacher would be able to tell me about the specific injuries to the brain’s structures. The case appeared to be clear-cut. I signed the line on the death certificate giving Mary’s husband permission to cremate the body, and under manner of death I wrote, “Accident.”
I performed two other perfectly mundane autopsies that morning, a forty-eight-year-old AIDS patient found decomposing in his home, and a twentysomething drug overdose from a crack house. Three autopsies made for a busy day, but at least the paperwork was going to be easy. Or so it appeared until my phone rang.
Maureen claimed she had been Mary Lynch’s best friend for forty years. “I was at her wedding to Bill, God rest his soul. Now, that was a happy marriage. But after Bill’s passing, when she met this . . . this phony! Oh, the poor thing. The fights they had!”
Twenty years ago, Maureen related over the phone, her friend the rich widow had met smooth-talking Mr. Lynch—handsome, tall, a snappy dresser, and younger than she. Mary took him in, and soon there was a marriage proposal. Mary, however, was no fool. She got a prenuptial agreement and kept her fortune sequestered. Mr. Lynch was not happy with this arrangement and, according to Maureen, became abusive. They lived that way for years. He beat her; she drank.
“The pawnshop incident was the last straw,” Maureen told me with the blunt relish of a good gossip. Mary had gone on vacation in Europe without Mr. Lynch. While she was away, he tried to hock some of her silver at a fancy neighborhood pawnshop. “The pawnbroker is a friend of Mary’s from way back. He recognized that silver right away. They were family heirlooms! He called me, and I got in touch with Mary in Europe. After that . . .” She trailed off.
“Why didn’t Mary divorce Mr. Lynch?”
“She made other arrangements.” Maureen went on to explain that the couple had remained married in name only. “She told me last year she changed her will again. She wrote him out. Not a penny to him, all of it to her grown children—Bill’s kids.” I asked Maureen how Mr. Lynch had reacted to that news. “He never knew. But if he’d found out about the will, I wouldn’t put it past him to hurt her. Not at all, not after some of the fights I saw them get into.”
Maureen gave me the number of the pawnbroker, who corroborated her story. Mr. Lynch was a longtime customer. He’d come in with quite a lot of women’s jewelry over the years, “always selling, never buying. He once came in with a woman’s watch that was one of the most beautiful pieces I’ve ever seen. Jeweled, and with the best Swiss works. God, what a watch.”
“Did you ever ask him where he’d come across such things?” I asked.
“Doctor, my line of work, it’s the opposite of yours. I try not to ask too many questions. I had no reason to suspect it was stolen, and nobody ever came in and complained.” Then he answered my next question before I could pose it. “But Mary’s silver—that I knew right away.” He went on to corroborate Maureen’s story. “When Mary came in a couple of weeks later? I see a lot of angry people come through the shop, but that day I remember. She was furious. With her husband, you understand—not with me. I sold it all back to her at cost, of course. She asked me to bring it by the building and leave it with Billy the doorman. I was happy to oblige.”
I hoped the last doctor to treat Mary, in the emergency room, might be able to tell me more. He didn’t have much to add to the story, though—Mary died before he could help her. “She coded eight minutes after coming through the door. No time to stabilize her for a craniotomy. You found a hematoma, I suppose?”
“Hundred cc subdural, midline shift with subfalcine herniation.”
“Ugh. No wonder. Well, there are worse ways to die.”
“Yes, there are,” I agreed.
I still hadn’t answered the critical question: Was there really a history of violence between Mary and her husband? A Hirschism came to mind: “More cases are solved with the telephone than with the microscope.” I had numbers for Mary’s neighbor Lana, and for Billy, the doorman who had called 911. I tried Lana first.
“Mary said they were ‘accidents,’ and I didn’t have any reason not to believe it,” Lana asserted immediately, though without much conviction. “She ended up in the hospital one time, I think. She said she fell at home and sprained her wrist. Accidents like that happen when you drink, and Mary was a drinker. I don’t mean to speak ill—but you’re a doctor, so you should know this. She was a drinker, all right.”
“How was her relationship with her husband?” I asked, wondering if Lana had the same impression as Maureen did.
“Oh, he and she led separate lives, you see. They had separate apartments.”
That got my attention. “Separate apartments? How do you mean?”
“It’s a big place, that penthouse. I’m afraid they didn’t get along very well. She told me they hadn’t spoken in years. I don’t see why not—he’s such a pleasant man, and so charming.” She laughed morbidly. “His ‘quarters,’ she called it. Mary used to say she was letting him stay around as long as he left her alone—it was less trouble than trying to be rid of him. She hired a contractor a few years back to divide the place up. You can ask the doorman, Billy.”
Billy the doorman. Everybody seemed to know Billy the doorman. “Yes, ma’am, I was the one who let in the pa
ramedics,” he said when I got him on the phone. “Then I stayed out of the way.”
“Did you look in the apartment? Did you see anything?”
“Mrs. Lynch was lying on the floor, at the bottom of the penthouse stairs. That’s a big place they have, two stories inside. Biggest in the building.”
“But it’s two apartments, isn’t it? His and hers?”
“Yes, ma’am. Two doors. Separate keys.”
“Oh. I see.” I labored to keep my tone neutral. “And Mr. Lynch was the one who found Mary at the bottom of the stairs?”
I heard the ding of an elevator in the background, while Billy said nothing for a moment. “That bothered me too,” he answered finally. “I never saw them together for years now. Then yesterday I get a call from Mrs. Lynch’s intercom. I pick it up, say, ‘Yes, Mrs. Lynch, what can I do for you?’—and it’s Mr. Lynch, telling me she’s fallen down and I should call 911. I brought the paramedics up in the elevator as soon as they arrived, but I didn’t go in. I had the other residents to worry about, you know. They were all coming around, wanting to know what was happening. If I’m not at my post by the front door, everyone complains.”
“There was nobody else in there but Mr. and Mrs. Lynch?”
“Not that I could see.”
“Did it look like there’d been a fight? Did anything look out of place, broken?”
“Like I said, I was out in the hall. I can tell you this: I haven’t heard any complaints from the neighbors about the Lynches.” Billy paused. “I was sorry to see Mary that way,” he said softly. “It’s not the first death I’ve had to deal with. A long time I’ve been working in this building, and things happen. But I was sorry to see Mary that way.”
I hung up and immediately went downstairs to Zenette in the Identification office. I asked Zee to put a hold on Mary Lynch’s body and to generate a new death certificate, with the lines for both cause of death and manner of death “pending,” and to leave the “permit cremation” line blank. Then I returned to my office—and dialed the NYPD Homicide Division.
Two detectives, Quinn and Tyler, arrived at my office that afternoon. Neither of them appeared to be thrilled about this new assignment.
“What was her blood alcohol?” Detective Quinn asked.
“I won’t know for weeks, till tox comes back.”
“She smell like a brewery?”
“No,” I told him, “and, yes, everyone agreed she was an alcoholic. But I can’t sign this out as an accident without knowing what the husband was doing in her apartment.”
“What do you mean?”
I told them the story, but the detectives remained skeptical. They were up to their ears in bona fide thug shootings and park stabbings and drug dealer tit for tat, and did not seem inclined to go sniffing around a doorman building on the Upper East Side without a very good reason.
“I need to know if any neighbors heard a commotion,” I said.
Quinn closed his notebook. “Doc, when you have some physical evidence that this was anything other than a simple fall, you’ll let us know, right?” If there was no evidence that Mr. Lynch had ever put his hands on her, why should they be ringing doorbells and asking questions?
Without a police investigation, the case was headed nowhere. I went to Susan Ely’s office looking for advice. She rolled her eyes when I told her about the detectives. “They’ll bend over backwards to make this an accident if they can. There was no other trauma?”
“Not a mark.”
“Let’s look at her together, tomorrow morning. Sometimes injuries show up the next day.”
That was news to me. “What do you mean, they show up the next day? Where’d they go?”
Susan then explained how lividity can hide injury. When you die, your blood stops circulating and does what any fluid will: It follows the pull of gravity to the lowest plane available, where it pools. Mary Lynch died in the hospital in a supine position, so her back had patches of purple-red skin when I first cut into her. After the blood has drained from the body at the end of the autopsy, however, lividity fades. “In some cases, after twenty-four hours you can find injuries that were there the day before but were camouflaged.”
I remained pessimistic. “Even if we see something on her, how do we know the husband did it?”
“Well, short of finding his handprints on her back, you’d be hard-pressed to say he pushed her down the stairs. Let’s look tomorrow.”
Susan and I met the next morning in the women’s locker room and gowned up together. The body was waiting for us, lying on its back on an autopsy table. With Susan’s help I turned Mary Lynch over—and gasped. There were ten bruises on the back of her shoulders that hadn’t been there the day before, textbook-clear impressions of four fingers and a thumb on her left, and four fingers and a thumb on her right. “Susan, you’re a psychic!” I exclaimed.
Flome was in the Pit too, so I called him over. He smiled. “Yup, those are grab marks. That’s why we don’t rush bodies out of here. Make sure you get microscopic sections. If you see only blood cells, this was a fresh injury at the time of death, but if there’s inflammation, it may have been hours old. This is certainly a vital reaction we’re looking at, though. There’s no way it was postmortem.”
The photographer documented our new finding, then I cut into the area of redness on each shoulder with a scalpel to remove samples of tissue for the histology lab. Somebody had left handprints on Mary Lynch, all right. Somebody had grabbed her—and hard.
I called the Homicide Division as soon as I got out of the morgue. “I’ve got your physical evidence, Detective,” I told Tyler. He was not as impressed as my colleagues had been.
“Couldn’t those prints be from the paramedics?”
“What do you mean?”
“You know, from them lifting her. During resuscitation.”
I thought about it. He had a point. It was an unlikely place to be putting your hands during a resuscitation effort, though. “There’s no therapeutic procedure I know of that would require you to grab someone up there, much less grab her hard enough to leave those bruises.”
“But you can’t rule it out?”
“Rule it out? No. She wasn’t dead yet when the medics got there, so she could have had enough blood flow for a vital reaction. But you’ve got to remember, paramedics are careful with their patients, especially with little old ladies.”
“But it’s possible those marks came from the medics.”
“Possible but highly unlikely.”
“Okay. What about the husband trying to revive her after she tripped down the stairs? He could have grabbed her right there and shaken her, trying to wake her up. That doesn’t mean he pushed her.”
I told Detective Tyler that this too was not impossible. I couldn’t really opine about when precisely those handprints had ended up on Mary Lynch’s living shoulders, nor could I divine the exact circumstance. I could only tell him what I saw for myself: that the marks looked like they had been left by someone’s hands, that they had to have been applied with a good deal of force, and that the force was not applied after Mary Lynch was dead. The rest was up to him to figure out.
“Are you going to call this a homicide?” he wanted to know.
“I don’t have enough information to tell if it’s a homicide or an accident. I’m going to have to wait for the results of your investigation.”
That was late August. In September I received a neuropathology report from Dr. A, which confirmed the subdural hematoma as cause of death. A couple of months later toxicology came back. Mary was drunk, all right. High ethanol reading. All the people I’d interviewed agreed she had been a heavy drinker for many years, so it was impossible for me to say whether or not she was tripping-down-the-stairs drunk when she died. Finally, in early May, the histology slides came back. Under the microscope there was nothing but blood cells; no inflammation, no signs of healing. Those finger-shaped bruises were fresh.
I sat down to finalize the Mary Lynch c
ase on a paperwork day in mid-May. I had the cause of death, “blunt impact of head with skull fracture and head injury,” but the death certificate was still pending. I could not determine the manner—accident or homicide—until I had read the investigating detective’s report. This was nine months after the event, and I had still not received one. I called Detective Tyler again.
“Do you have anything more on Mary Lynch?” I asked him.
“What’s more to get?”
I was taken aback. “Well, the last time we spoke, I told you I was concerned the husband might have assaulted her. This case needs to be investigated as a homicide.”
“Are you going to manner it a homicide?”
“I don’t know—it depends on your investigation!”
“We interviewed the husband. He’s had a stroke. We can’t understand what he says.”
Now I was really floored. That’s it? That’s all it takes to get away with murder, have a stroke and develop aphasia? “Did you do a canvass, or talk to anyone else?” I asked.
“No.”
“The doorman?”
“Yeah, we talked to him. He didn’t see anything.”
“What about the neighbors?”
“We’re not going to canvass in that building if there’s nothing to investigate. And unless this is a homicide, there is nothing to investigate.” That was it, then. I couldn’t go knocking on people’s doors, and the police wouldn’t do it.
I took the case to three o’clock rounds that same day. “I can’t tell from the body alone whether he pushed her or she fell. The circumstances are suspicious, but that’s not enough to call it a homicide. I don’t feel comfortable calling it an accident either, though. Tox shows she may have been drunk enough to fall down the stairs, but what was the estranged husband doing in her house? Those are clearly grab marks on her back upper arms, but are they evidence he assaulted her, or a sign he ran down the stairs after she fell, and tried to shake her awake? I don’t know!”
Hirsch had taught me I was only one part of an investigative team. Detectives Quinn and Tyler were teaching me the limitations of that role. “If you can’t tell the difference based on the body between a homicide and an accident, that’s what ‘undetermined’ is for,” Dr. Flomenbaum said. I must have looked crestfallen. He smiled gently and continued. “An undetermined manner of death does not mean ‘I didn’t try to figure it out.’ It means ‘We don’t have enough information to make an accurate classification.’ That’s all.”
Working Stiff Page 12