Blood and Money

by Thomas Thompson

  “If I didn’t marry her,” said John, “she threatened to call I. D. McMaster and say I killed Joan. And if I divorced her, she said she would commit suicide and leave a note saying I was responsible for her death.”

  Ernie Ernst believed that a murder case could not be built around Ann Kurth’s testimony alone. A good defense lawyer like Racehorse Haynes would bear down on the fact that she had testified at variance before two grand juries, that she was hostile toward her now ex-husband and still involved in a fight over property settlement and alimony. The Kurth testimony might be useful, but it could not stand unsubstantiated.

  “Where the hell is that Helpern autopsy report?” growled McMaster as April 1970 began. This was the grand jury’s last month.

  If this grand jury failed to indict, then the folder would probably close. There is a fine line between prosecution and persecution, and Ernie Ernst from time to time felt they were falling onto the wrong side of the fence. He telephoned Dr. Jachimczyk, the coroner, and asked him to check with Helpern in New York.

  Over long distance Milton Helpern, normally urbane, cool, seemed rather embarrassed. Yes, he was still writing the report. But no, it was not yet finished. Nor would it contain any revelation to hang John Hill. It would be, however, critical of the circumstances surrounding the woman’s death.

  Cecil Haden and Ash Robinson hatched another idea. With time running out on the grand jury’s term, why not import Milton Helpern and have him deliver the report in person? In his very own words? They presented the notion to McMaster, who said it sounded good but that the county lacked funds to pay air fare and expenses. But if somebody else paid the freight, then the grand jury would be happy to welcome the prize package.

  Ash Robinson happily wrote a check.

  Dr. Helpern was smuggled into town under the wraps of secrecy, installed in the Warwick Hotel in a suite under Cecil Haden’s name, and taken into the courthouse through a basement entrance to avoid reporters. With him he carried an 18½-page report on the exhumation autopsy, but it was incomplete, literally stopping in mid-sentence. The explanation was that the trip to Houston had come about so suddenly that his secretary had not finished transcribing his dictation. But never mind. He could deliver his findings to the grand jury verbally, from rough notes.

  “This death should have been reported to the medical examiner’s office for official investigation,” said Dr. Helpern in his preface, “and this point must be emphasized because the embalming of the body prior to autopsy did interfere with the extent of toxicological study and made entirely impossible microbiological examinations which were clearly indicated in this case on the basis of the entire symptomatology, including an abrupt onset of severe persistent diarrhea, nausea and vomiting, shock and impaired renal function and a rapidly fatal outcome after a short period of hospitalization.” Helpern’s report was an extraordinary document, containing very little scientific material damaging to the position of John Hill. In fact, Helpern actually cleared the surgeon of many of the rumors swirling about the city.

  Rumor: John Hill was up to something more than just searching for a missing ring when he opened his wife’s casket three days after burial.

  Helpern’s finding: “There was no indication that the body of the deceased had been disturbed.… When the garments were removed [in the exhumation autopsy], the sutured incisions of the first autopsy did not appear to have been disturbed after the body had been ‘laid out.’ In other words, there was no evidence that the body had been re-opened, or that any organs had been removed or replaced subsequent to the first interment.”

  Rumor: John Hill injected his wife with some elusive poison in an unusual part of her body—such as on the back of the hand between the knuckles. The maid, Effie Green, had stated—and Ash repeated it far and wide—that she saw John Hill rubbing the back of Joan’s hand.

  Helpern’s finding: “Careful scrutiny did not reveal any injection sites on the hands.”

  Rumor: John Hill stole his wife’s brain and substituted another one for the exhumation autopsy—a brain riddled with meningitis.

  Helpern’s finding: “The pathologist [Dr. Morse] who performed the first autopsy delivered a mass of sectioned formalin-fixed brain, weighing a total of 1,020 grams, in a plastic bag. He identified it as being the brain of the deceased which he had removed at the time he performed the first autopsy.… The fixed brain did not show any visible evidence of meningitis on naked-eye examination, but later did on microscopic examination. The spinal canal was opened and the spinal cord removed.… The cord was fairly well preserved except for a reddish discoloration which had taken place in the white matter. In all of the sections, at first glance, the reddish color appeared dull suggesting the possibility of an inflammation of the pial layer. The entire cord was then removed with the meninges for study, and sections were prepared from the various levels from the cervical to below the lumbar segments. A smear was made from the inner surface of the arachnoid. When stained … only an occasional leukocyte was observed.… This section of the cord, when first examined microscopically, appeared to be normal, but on close scrutiny of the leptomeninges, an occasional scattered polymorphonuclear leukocyte and mononuclear leukocyte were found.… This evidence of inflammation in the spinal cord was very slight and in most places absent, entirely unlike the fairly conspicuous microscopic inflammatory cell infiltration in the pia-arachnoid of the brain.… The inflammatory findings in the brain and cord, although quite different in amount and intensity, could represent manifestations in different areas of the brain and spinal cord of the same individual.

  “It must be kept in mind that in acute meningitis the purulent condition of the spinal fluid for the most part is derived from acute inflammation in the meninges of the brain rather than in the cord. It is also a fact that in many autopsies … the spinal cord does not necessarily exhibit the same intensity of inflammation as does the brain.”

  He thus shot down, for all intents and purposes, the “switched brain” rumor.

  Nor did Helpern discover anything potentially criminal in the toxicological examinations of the bits and pieces of tissue he snipped from the body during the exhumation autopsy. “Portions of the esophagus, stomach, large bowel, kidney, liver, hair and fluid content in the small bowel … were examined extensively by X ray and emission spectroscopy. No heavy metals (arsenic, etc.) were found in these tissues. Further analysis for the presence of fluorides was also reported negative. Because of the embalming of the body, it was not feasible to carry out any further toxicological studies.

  “The chemical examination, as far as it could be carried out on the exhumed body tissues, was negative, consistent with the negative analysis carried out in the laboratory of the Medical Examiner’s Office in Houston on the embalmed tissues obtained from the pathologist who performed the first autopsy.…”

  For the first ten pages of his report, Dr. Helpern traveled on professional ground, discussing each organ of the body with authority and in meticulous detail. Then he did an extraordinary thing. In mid-report was suddenly inserted a scenario of how things happened, or how they might have happened, if one relied solely on the inflammatory statements offered to Ash Robinson by Effie Green, the maid, and by the two Dallas women, Diane Settegast and Eunice Woolen. None of these statements was sworn before a public authority under penalty of perjury, or even notarized. Nor did Helpern interrogate these women as to their veracity. Most damningly, the pathologist did not incorporate any of John Hill’s position into the report, nor did he interview him, or even request written answers to harmful questions raised by the maid and the house guests. Upon reading a copy of this report, Racehorse Haynes swore mightily. He was not only angry but disbelieving. “Helpern was employed to autopsy a body and nothing else,” snapped Racehorse. “His credentials as a Houston homicide cop are not widely recognized.”

  The balance of Helpern’s report read like the synopsis of a terribly complicated, badly written Victorian crime novel. Because he apparently fe
lt it more dignified—or professionally proper—to refer to Joan Robinson Hill throughout as “the deceased,” his sentences became not only confusing but unintentionally funny. Example: “The house guest and the deceased’s mother went out to purchase chicken for the deceased, the deceased husband, and the child. At that time the deceased was having a drink.… It was noted that between 7 and 11 P.M., the guests and the deceased each had about four drinks.”

  Black humor not withstanding, the report was damning to Dr. John Hill through innuendo. Helpern’s document contained phrases such as: “The husband then went upstairs for something and returned to administer a ‘shot’ to the deceased.” By putting his own quotation marks around the word “shot,” Helpern gave it ominous emphasis, as if to say, “It might have been a shot of medicine, then again it might have been a shot of something else.” Helpern then jumped in his writing to the next day of Joan’s life, Sunday, March 16, 1969, and summed it thusly:

  “On Sunday … the deceased was ill with persistent vomiting, diarrhea and chills, and, one presumed, accompanying fever, although there is no mention about her temperature.” Here Helpern engaged in speculation about the existence of fever.

  The Helpern report further contained unsworn information about the French pastries that John Hill served his wife and guests, the fact that the Hills were in the throes of a deteriorating marriage, and a summation of Effie Green’s distasteful account of feces in the bed.

  Helpern’s document quoted Effie as scolding John Hill for lying about his whereabouts. “A nurse called from the hospital for the husband (Hill) to come because the deceased had ‘taken a change.’ When the husband came back to the house a few minutes after the call came, she asked him if he had come from the hospital. He said, ‘Yes, I have just left.” The maid said, ‘No, you wasn’t there. Your wife done made a change and they say come to the hospital right away.’”

  Having thus established John Hill as a cruel, uncaring husband who gave his wife a mysterious shot and left her to lie in her own feces, the report moved along to adultery. “The maid indicated that the deceased had told her that her husband had been having an affair with another woman for several months.… The maid felt that ‘Mrs. Hill ain’t just died from being sick.’ … The maid stated that she never saw the husband inject anything into the deceased, but that she saw a needle prick on the deceased’s hand. She got this impression because the husband was rubbing the deceased’s hand.”

  The melodramatic portion of Helpern’s autopsy report ended with a heart-tugging quotation from Effie: “‘I don’t hate Dr. Hill. The onliest thing is, he just, he didn’t do right. He just don’t—he just—well, when a husband don’t do right and treat his wife right, and wants to treat her like a dog, and when she’s humble and nice and sweet and kind to him, it’s no love there. Just—oh, God!—he just don’t—like God ain’t satisfied with that.’”

  Abruptly, Helpern then moved back into areas of legitimate concern for a pathologist. Under a subheading, “Opinion as to the cause of death,” he wrote:

  “The deceased, a previously healthy, athletic and physically active thirty-eight-year-old married woman and mother of a nine-year-old son, died after an acute illness in which nausea, vomiting and profuse uncontrolled diarrhea with progressive weakness, restlessness, confusion, hypotension, and collapse were the predominant clinical manifestations. Her illness began at home on March 15, 1969, and became progressively worse until March 18 with the aforementioned symptoms. The only medical attention she received was from her physician husband, who specialized in plastic surgery. Despite the severity of her illness at home, she was confined entirely to her room during the latter part of Sunday, March 16, and on Monday, the 17th, and on the morning of Tuesday, the 18th, when she was taken from her home to the Sharpstown Hospital by her husband in his automobile without benefit of stretcher or ambulance. She was admitted to the hospital in a wheel chair on March 18 at 11:45 A.M. and placed in a private room under the care of Dr. Bertinot who saw her for the first time after she was admitted to the hospital. After a vigorous course of treatment during which she did not improve but became steadily worse, she died 16 hours after admission. The admission diagnosis was recorded on the chart as diarrhea. According to Dr. Bertinot’s admitting note, the deceased had manifested nausea, vomiting and diarrhea for four days following the ingestion of shell fish. He also stated …”

  And here Dr. Helpern’s report terminated, in mid-sentence.

  To the grand jurors, spellbound by the report, Dr. Helpern now apologized. The press of work in violent New York City had robbed him of the needed time to complete the document. He would deliver the remaining few pages as soon as he returned to New York. But for the nonce, realizing the pressure that the grand jury faced as its term neared an end, he could summarize his findings. But first, he warned the jurors, his opinion was limited by the fact that the body had been embalmed prior to the first autopsy. “This is a procedure which made it impossible to carry out any bacteriological studies and may also have interfered with complete toxicological studies,” he cautioned.

  He commented briefly on the three causes of death discovered by previous doctors. The first was pancreatitis, announced by the Sharpstown Hospital pathologist, Dr. Morse. “There was no clinical or pathological evidence of pancreatitis,” he said bluntly. “This was an erroneous impression of the first pathologist.” The second, viral hepatitis, originally announced by Harris County medical examiner Dr. Jachimczyk, was also wrong, but not as wrong as pancreatitis. There was extensive liver damage wrought by hepatitis, but Helpern felt the source was not from a virus but only part of a widespread inflammation that ravaged the woman’s entire body, particularly her throat, esophagus, and meninges. The acute meningitis announced by the Hill autopsy team was “a terminal complication and not the primary event,” said Dr. Helpern. The pathologist also addressed himself to the kidney failure which the Sharpstown doctors tried to treat in the dying patient a few hours after she was admitted to the hospital.

  “The acute nephrotic changes observed microscopically in the kidney are best related to the shock and hypotension induced by the vomiting and diarrhea of the original illness and aggravated by over-treatment with intravenous fluids and a variety of medications which were given to combat shock and hypotension, but which unfortunately disturbed the electrolyte balance and caused an irreversible retention of fluid, metabolites and terminal kidney and circulatory failure.”

  Then what caused the death of Joan Robinson Hill?

  “An acute inflammation of some sort,” he said, “the origin of which I cannot determine.” Most likely, he said, the “portal of entry was by way of the alimentary tract.”

  One of the grand jurors asked, if it could have been something she ate.

  Helpern’s answer was non-committal. Possibly. Or possibly not.

  Another juror asked if Helpern felt any crime had been committed in this event. “If any death should have been reported in time for an official investigation,” he said, “this one obviously should have been.”

  The jurors had further questions. Was Joan Hill’s treatment at home by her husband satisfactory? Was she taken to the hospital too late?

  Helpern incorporated the answer to these in his final written report, which he mailed down a few days later. More than anything else, it sealed the case against John Hill. “Failure to provide medical attention at home, and resultant delay in hospitalization for diagnosis and effective therapy aggravated a situation which proved fatal.” Now the climate on the grand jury was unmistakable. The cries of the wolf pack rose and the scent of blood was over the courthouse.

  NINETEEN

  The Helpern autopsy report split the medical community of Houston like a sharpened cleaver. Those faithful to Ash Robinson predictably hailed the document and lent their support to its findings. Of the four doctors whom he had requested to stand over his daughter’s corpse while it was autopsied, three fell quickly into line. “I agree with these findings and c
onclusions,” wrote Grady Hallman, the heart surgeon. “I am in complete accord,” wrote Ed Gouldin, the internist on whose home Ash had once held the mortgage.

  But, more pointedly, the only trained pathologist Ash hired to represent him, a physician named Paul Radelat, wrote an eloquent and thundering letter of opposition to the report. Not only did he blister Helpern for including the “internal curiosities” of unsubstantiated testimony from the maid and the house guests, he wondered why in the name of fairness a statement from John Hill himself was not included.

  “One would assume,” wrote Radelat with pen of heavy sarcasm, “that he is at least as familiar with the events of those days as were the female house guests, and a report from him would have given an opportunity to explain his own reactions and observations during those ill-fated days.”

  His own microscopic studies showed, declared pathologist Radelat, that Joan died “a natural, albeit tragic and premature death.… In my opinion, based on the anatomic evidence … Joan R. Hill expired in a state of shock secondary to gram negative sepsis. In my opinion, what may well have begun as a relatively mild gastroenteritis deteriorated rapidly and unexpectedly into a severe esophagitis.… Gram negative organisms or their toxic metabolites gained access to the general circulation through this site producing sepsis and inflammation most notably in the leptomeninges, central nervous system, and liver.”

  In other words, a stomach flu that turned into fatal blood poisoning.

  “Examination of the remains of Joan Robinson Hill turned up absolutely no evidence of any poison, drugs, or other injurious agents administered to her either by self or another person.…

  “John Hill, as everyone knows, is a physician, and physicians are notorious for ignoring the aches and pains of their families, and for practicing less than ideal medicine with their wives and children. Fortunately for us, the end result of this hit or miss attitude is usually not as tragic as what occurred in this case. Everyone has perfect judgment in hindsight, and perhaps had Joan Hill been brought to a hospital sooner, her death might have been averted. But septic shock is a fulminating condition which is frequently fatal even when occurring in the midst of the best medical attention available.