Written in Bone

by Sue Black

  Some metal was detected. Each find was discussed with the relatives, their lawyer and their anthropologist, and each in turn discounted as pieces of funeral furniture or nails used in the construction of the coffin. Then one object gave off a metallic signature that was of interest, because it was associated with the bones themselves: specifically, with the pelvis. We would investigate this further at the mortuary the following morning. The body bag was then transferred to the security of the mortuary, accompanied by a police escort and family observers.

  As the police drove us to our hotel in one of their vehicles, I admit to a complete brain-fade moment. Feeling warm, I asked why the windows wouldn’t open. They looked at me as if I was joking. When they realized I wasn’t, they informed me patiently that you can’t have bulletproof windows that open. The two features do not mix. It was a sobering reminder of the instability of Northern Ireland’s recent history.

  The next morning was bitterly cold, which made the chilly mortuary conditions particularly inhospitable. No amount of layering of socks or tops could get us warm. The body bag was photographed and opened on a side table and then, fingers freezing, we set about the first job in any skeletal evaluation: laying out the remains on a second table to make an inventory of what is present and what is absent. As each bone is placed in the correct anatomical position, a skeleton slowly takes shape and, from a jumbled bag of bones, the person they represent begins to materialize in front of your eyes. It always amazes the police and the legal observers that order can emerge from such apparent chaos.

  As we reconstruct this human being, we are thinking about the features that indicate sex, age, height and ethnicity. We are looking for any anomaly, injury or evidence of disease in every single bone of the two hundred or so we will handle. All of these bones, and especially the innominates, confirmed this was the body of a young man who would have been in his late teens or very early twenties when he died. We identified unhealed fractures to the front of his ribs and sternum, which were in keeping with the hospital records stating that his chest had been opened and direct heart massage performed in an effort to keep him alive. There were also unhealed fractures to the bones of his right hand. The medical reports noted an entry wound in the region of the right groin, and accordingly the right innominate showed fracturing of both the superior and inferior parts of the ischio-pubic region—a double fracture that isolated the right pubic bone from the rest of the pelvis.

  The metallic object we had seen on the X-ray the previous day was embedded within the inner surface of the pubic bone of the left innominate. The pattern of fracturing suggested that the ballistic projectile passed first through the man’s right hand, breaking several bones there, then entered his right thigh and travelled upwards to fracture the right side of the pelvis before losing most of its momentum and finally lodging in the left pubic bone.

  It was not our job to remove or analyse the bullet, just to find it, and that was what we had done. It was taken out by the pathologist, using plastic tweezers, sent off for analysis and that was the last we saw of it. I have heard no more about how that case has progressed, if indeed it has. Our brief was first to identify the coffin and lift the remains and secondly, to record, retrieve and present the evidence insofar as it related to establishing the trajectory of the bullet and its final resting place. Our task was complete.

  The second case was very similar: a forty-one-year-old man, in the same part of the world, also shot in the right leg. He had been rushed to hospital but his leg could not be saved and had to be amputated. Two days later, he died of medical complications. Again, the medical records indicated that there was bullet entry but no evidence of exit, suggesting that a ballistic projectile might remain within the body.

  An exhumation had already taken place—I was not present this time—but there had been a little complication with this investigation, in that the victim had been buried twice. His family had wanted to relocate him from the cemetery in which he had originally been interred to one closer to where they lived. With the body already having been moved once, the police had not been hopeful that the bullet would now be found, but it was. It had been picked up by a metal detector in the jumble of human remains and coffin detritus and removed by the pathologist for analysis.

  My colleague Rene and I were summoned first to a lock-up in the Police Service of Northern Ireland headquarters, where the wood from the coffin and associated artefacts had been stored overnight, to look for any other evidence that might be of interest. The bones had been transferred to the mortuary, where we would examine them later in the day. On our knees on the concrete floor of the lock-up, we sifted through a small mountain of graveyard flotsam and jetsam, which included large planks of wood, religious iconography, metal nails, escutcheons, pieces of cord, scraps of cloth, dirt and stones.

  The only thing we discovered was a finger bone, a metacarpal, that had been missed. This was bagged and tagged for us to bring with us to the mortuary. The probability was that we would find this particular bone missing from the skeleton. If we didn’t, there were going to be some serious questions to be asked and answered.

  At the mortuary we were relieved to find that the metacarpal was indeed missing from the skeleton and that the one we’d found was the right size to belong to the victim. It was clear, too, that the right leg had been amputated below the hip joint, which corresponded with the information in the medical records. This reassured the family’s lawyer that we had the correct body.

  Both pubic bones had been fractured and separated from the rest of the innominate bone, most likely as a result of the impact of the ballistic projectile. The bullet itself had, of course, already been removed, but the right pubic bone showed a starburst fracture that was consistent with the projectile, by that stage travelling at a lower velocity, becoming lodged in the top of the bone. The fact that there was no healing of the fractures supported the likelihood that they had occurred around the time of death. Again, that was our job finished, and we delivered our report to the police.

  Is it a coincidence that these two cases from around the same time were alike in so many respects? Both victims were men, shot just once, both in the right leg, both had bullets embedded in their pelvic bones. Both died from their injuries and neither was given a postmortem examination, even though entry wounds, but no exit wounds, had been reported. Whether any or all of this was coincidental or evidence of a pattern of behaviour was for others to ask and answer.

  All manner of items may be found in the pelvic region, so it is an important area of the body to examine carefully. And not only the remains but deposition sites, too, should be carefully searched with metal detectors. Genital piercings are commonplace, and a huge range of metal bits and pieces can be used to pierce or modify the genitalia of both males and females. Probably the most unusual I’ve come across was a scrotal ladder, which involved eight rings inserted into a row of piercings along the midline of the scrotum, with something resembling a very big safety pin running through them, all connected to another ring at the tip of the penis. I can only imagine the pain, but from a forensic anthropologist’s point of view, it was certainly helpfully distinctive.

  Other foreign bodies that regularly turn up include bladder stones, an assortment of intrauterine contraceptive devices and suspect packages associated with illegal activities such as drug trafficking. In one case we even retrieved a toothbrush from the anal canal. No matter how many questions we asked ourselves, we never came up with a plausible explanation for that one.

  8

  The Long Bones

  “It is therefore indisputable that the limbs of architecture are derived from the limbs of man”

  Michelangelo

  Artist, 1475–1564

  The long bones of the human upper limb and those of the lower limb are directly comparable, in other words, they are homologues. This is not surprising given that we were originally a quadrupedal animal. But millions of years ago, many species of tetrapods found they could forgo
equivalence of power in all four limbs as long as they retained it in their hind limbs. This freed the forelimbs to do other things. Think of a squirrel grasping a nut or climbing a tree. In general, when there is modification of the forelimb in terrestrial animals, it tends to be shorter than the hind limb. Which is why you can’t wear a cardigan on your nether regions without looking like a rapper with a hanging gusset. Every child has tried it.

  It has recently been suggested, on the basis of something called a “constraint hypothesis,” that kangaroos have small forelimbs because they are born at such an early stage of fetal development that the forelimbs need to be well developed to successfully make the perilous climb to their mother’s pouch. This is critical to survival and the forelimb is therefore “constrained” by the early maturity needed to ensure that it meets its primary function. The hind limbs remain unconstrained and so can continue to grow.

  This hypothesis has also been used to explain why there are no marine or airborne marsupials. A hotbed of scientific debate has long surrounded the reasons behind the “vestigial” upper limbs of the therapod Tyrannosaurus Rex. Maybe these were a grappling hook for mating or pinning down prey, or perhaps they were used as a lever to help it get up from a prone position. We may never know.

  When describing our limbs after the point, about 4 million years ago, when our species decided to stand up and walk on two legs, we refer to them as upper and lower limbs rather than fore and hind limbs. Our upper limbs connect our body to our hands so that we can perform complex tasks and interact with the world, while our lower limbs connect our body to our feet so that we can move.

  Anatomists are very specific about naming the parts of the body to ensure there is no ambiguity about which bit they are talking about. The part of the upper limb closest to the trunk is the arm and its equivalent in the lower limb is the thigh. Each contains a single long bone: the humerus and the femur respectively. The section of the limb furthest away from the trunk is the forearm in the upper limb and the leg in the lower limb. There are two bones in each of these segments. In the forearm these are the radius (on the thumb side) and ulna (on the little finger side), and in the leg they are the tibia (big toe side) and the fibula (little toe side). The radius in the forearm corresponds to the tibia in the leg and the ulna to the fibula. These six bones on each side—humerus, radius, ulna, femur, tibia and fibula—are known collectively as the long bones.

  In our early years, our long bones grow at a fairly predictable rate and we can therefore say with reasonable accuracy what height we expect a child will be at two or ten years old. After that we start to lose our confidence. There will be a largely unpredictable growth spurt during puberty, an unpredictable event in itself in terms of when it will start and when it will stop. Once our long bones have finished growing (usually by around the age of fifteen or sixteen in girls and eighteen or nineteen in boys), we will have reached the maximum height we are ever going to be.

  Our upper and lower limb bones increase in length pretty much in harmony with each other and on both sides, so that we don’t end up with a really long right limb and a short left one, or with long arms and short legs or vice versa. Provided, that is, everything develops normally.

  Those of us of a certain age will remember the effects of thalidomide, a drug manufactured in the late 1950s and early 1960s, initially by a German pharmaceutical company. It was designed to relieve anxiety, insomnia and morning sickness in pregnant mothers. The tests performed on animal models could not have predicted the devastating effects the drug would have on human fetal development. Mothers were therefore not discouraged from taking the drug during their first trimester until it emerged that there was a direct correlation between the drug and certain birth defects.

  The gravity and nature of these defects varied according to how many days into the pregnancy the mother was when she started the medication. Begun on day 20, for example, thalidomide was producing central brain damage in the baby. In the case of the long bones, it disrupted the growth of upper limbs when taken around day 24, and the lower limbs up to day 28.

  Deformities included phocomelia, which manifests as significantly foreshortened arms, forearms, thighs and legs, but with the development of the hands and feet often being less severely affected. In the UK, the drug was withdrawn in 1961, the year of my birth, by which time it is thought that at least two thousand babies had been born with defects of one kind or another associated with the drug, around half of whom lived for only a few months. Those with survivable deformities adapted. I remember being in awe of the dexterity of one girl in my class in school who could write with her feet. She helped me to learn at an early age that with adversity often comes ingenuity and determination. These children also needed great resilience, as people can be very cruel to those who look different.

  Given the rate of growth in the long bones throughout childhood, and the close correlation between height and age in children, it is no surprise that we can use the length of long bones to determine the age of a child. In an adult, we can use the same measurements to calculate height but not to estimate age. This is exemplified by the fact that we can buy a pair of trousers for a child based on their age but for an adult we will need their inside leg measurement as well as their waist size.

  The long bones keep growing in length and width until we hit the end of puberty but if something happens that slows development, this interruption can often be seen in their internal structure. We add bone longitudinally. Growing bones have little caps on their ends and when the caps seal, growth stops. Any event that hampers that process means that bone doesn’t get laid down normally.

  Instead it is added in lines or bands of increased density parallel to the growth cap. This “stutter,” which is visible on an X-ray, tells us that something has temporarily affected the growth of the long bones, although it doesn’t tell us what it was. It may be something as simple as a childhood infection like chickenpox or measles or even a period of malnutrition. These marks, known as Harris lines, can be seen most easily on the distal radius or distal tibia, but they may be found on many other bones within the skeleton where there is a high volume of cancellous bone. Once the incident is over, normal growth resumes and over time the body will reabsorb these white parallel lines as if they never existed.

  I was in a mortuary one day, looking at a mix of bones that had been brought in for investigation. It was fairly obvious that they were all animal and, having confirmed that, I prepared to make a swift exit from the room, where another postmortem was underway.

  The body being examined was that of a young boy of no more than ten or eleven years old, who, the pathologist confided, had almost certainly hanged himself. Suicide in children as young as this is, fortunately, extremely rare and his family and friends were apparently finding it incredibly difficult to come to terms with this explanation as there had been no sign of any illness or anxieties that might have been troubling him. He seemed normal, he seemed happy and he’d had his whole life in front of him. The police said he was from a “good” family and that there was no evidence of any form of abuse, psychological, physical or sexual.

  The pathologist popped an X-ray of the boy’s upper limb bones up on the screen and then an image of his lower limbs. He was looking for fractures, current or healed, to see whether there might be any history of physical abuse. I remember saying, uninvited, “That’s interesting,” as I noticed three or four very clear Harris lines at the lower ends of both the radius and the tibia. The spaces between these lines, which showed that normal growth had resumed for a while before being interrupted again, suggested that some kind of disturbance may have been repeated at intervals.

  The pathologist asked what I thought these might mean. I could not help, except to say that perhaps something like recurring illness might be a possible answer. I never imagined for a moment how the case would unfold, and indeed I would never have known, had it not been for the pathologist recounting the story to me afterwards in a bar at a conference
.

  The police talked to the family and their GP and established that the child had suffered from no obvious or recorded repeated episodes of ill health or anxiety. He had taken his own life just before his mum and dad were due to go on holiday and questions were asked about whether this might be relevant. His parents explained that, because they ran a seaside hotel, they were often not able to get a break during the school holidays so, every year for the past five years, they’d got away for a few days on their own in term time while Grandad, Dad’s father, came to stay to look after their son. That was when the child’s father broke down and revealed that his own father had abused him as a child. He had believed all this was in the past, but he now feared that history had repeated itself and that perhaps Grandad had been abusing his grandson. The grandfather was interviewed by the police and, after indecent images of child sexual abuse were found at his home, he eventually admitted that this was indeed what had occurred.

  The lines we could see on the X-rays may have been the boy’s body responding every year to the fear and the stress of anticipating his grandfather’s visit and what he would have to endure in his parents’ absence. On the last occasion, perhaps he had been so distraught that he had taken his own life at the end of a piece of rope rather than face the trauma again or share his dark secret with anyone.

  The little boy’s dreadful story was discovered too late to help him and only unravelled at all thanks to the testimony of some little white lines on the X-rays of some long bones. If I had been involved in the case, could I have said in evidence that the stress of abuse had caused the Harris lines? No, I could not. But their presence had been enough to lead the police down a particular route of inquiry that had resulted in an explanation, a confession, a conviction and the destruction of a family. At times the truth is very painful and its impact devastatingly wide.