Morgue

by Dr. Vincent DiMaio

  But Linda was visibly uncomfortable with this morbid reward. As soon as Marina left the room, she inconspicuously slipped it into my hand. She didn’t want it.

  Neither did I. As well-meaning as her gesture might have been, it was a sordid souvenir of a grim task and an even grimmer history. I wished for it … for Oswald … for Kennedy … for the bad memory … for the whole wretched mess to just be buried once and for all.

  So just before they sealed Lee Harvey Oswald’s coffin for his next eternity, I dropped the ring into the box with him and then drove home to San Antonio in the dark.

  ‹ SIX ›

  Monsters Among Us

  People haven’t changed in five thousand years. They are still driven by money, sex, and power. Some are purely and inexplicably evil, some are purely and inexplicably good. The rest float along like leaves on the stream, bumping into good and evil all the way to the sea.

  I remain shocked by people who refuse to believe in monsters. Do they not realize there are people out there who would cut their throats just to see if the knife was sharp?

  KERRVILLE, TEXAS. TUESDAY, AUGUST 24, 1982.

  A lot of mothers in Kerrville were excited when the new pediatrics clinic opened on Water Street, just a block off Main Street, literally a stone’s throw from the Guadalupe River. And, even better, the new doctor was a woman, Dr. Kathy Holland. And her nurse, Genene Jones, was a star, recruited from a San Antonio hospital’s pediatric ICU. Until now, an appointment with Kerrville’s lone local pediatrician was hard to get, and children’s serious health scares required a one-hour trip to the big city.

  For sure, the new clinic was a godsend for Petti McClellan, a mother of three who lived with her husband and three kids in a mobile home on a rural patch west of town.

  Their youngest, fourteen-month-old Chelsea, had been born prematurely and immediately life-flighted from Kerrville to San Antonio, where she spent her first three weeks in the pediatric ICU with underdeveloped lungs. Months later, she was rushed to the San Antonio hospital again when she stopped breathing and turned blue. After five days of tests, no obvious breathing abnormalities were found and Chelsea was sent home, where she later experienced a few minor “spells” of erratic breathing and a toddler’s usual sniffles. Nothing that required hospitalization, but because of the frightening days after Chelsea’s birth, every uncertain breath, every hiccup, every silent night rattled Petti.

  Petti was a secretary and her husband was a lineman for the local electric co-op, so they couldn’t really afford the time off to visit doctors in San Antonio, much less the expense of even routine trips, which required most of a day. The new clinic was a blessing for them.

  Early on the morning of the clinic’s second day, Petti McClellan called to make an appointment for Chelsea, who had a cold. They arrived around one p.m. and Dr. Holland took them straight into her office to get Chelsea’s medical history.

  As they talked, blond, blue-eyed Chelsea wriggled on her mother’s lap and grabbed any loose thing on Dr. Holland’s desk. So Dr. Holland’s genial nurse, Genene, offered to take Chelsea to the treatment room to play with a ball. Genene scooped the child up and left.

  A few minutes later, Dr. Holland heard Genene’s voice down the hall: Don’t go to sleep, baby. Chelsea, wake up!

  Then a moment later, the nurse called down the hallway. “Dr. Holland, would you come here?”

  Chelsea lay flaccid on the examining table as Genene quickly snapped an oxygen mask on her little face. They’d been playing, the nurse said, when Chelsea just slumped over, unconscious. She wasn’t breathing. She was starting to turn blue around her lips. As Dr. Holland inserted an IV into the toddler’s scalp, her little body was suddenly racked with seizures. The doctor ordered an anticonvulsant drug, then ran to tell some carpenters in the building to call an ambulance.

  Back in the office, Dr. Holland told Petti that Chelsea had had a seizure, and she ran to see her baby splayed across the table, utterly still. The ambulance arrived and Genene rode with the child to the Kerrville hospital’s emergency room, two minutes away. By the time they arrived, Chelsea had begun breathing on her own again.

  After ten days of tests in ICU, doctors could find nothing to explain Chelsea’s breathing spell and seizures, but she quickly regained her spunk in the hospital. The grateful McClellans believed the new doctor and her nurse had saved their little girl’s life, and they told every parent they knew to take their kids to the new pediatrician in town.

  So when Chelsea’s three-year-old brother Cameron got sick with the flu a few weeks later, Petti was delighted to take him to see the fabulous Dr. Holland, who urged her to bring Chelsea, too, for a routine checkup. She’d been chipper ever since her distressing episode the month before, but it wouldn’t hurt for the doctor to look her over, Petti thought.

  Petti and her two kids arrived for the first appointment on September 17, around ten thirty. While unwell Cameron sat quietly, the lively toddler Chelsea giggled and scurried up and down the hall, a happy little girl in her happy little gingham-and-lace dress. Dr. Holland gave her a quick once-over on the waiting-room floor, then suggested two routine inoculations, one for measles, mumps, and rubella, the other for diphtheria and tetanus—ordinary vaccinations for toddlers. The doctor suggested that Petti not watch, lest she get upset by the injection, but Petti had grown protective. She wanted to hold Chelsea, just to ward off some of the fear and pain.

  Back in the crash room, the smiling nurse Genene had already filled the syringes.

  As Petti held Chelsea on her lap, Genene pushed the first needle into Chelsea’s plump left thigh. In a few seconds, Chelsea’s breathing faltered. She tried to say something, but the words froze inside her.

  “Stop!” Petti hollered. “Do something! She’s having another seizure!”

  Genene comforted Petti. Chelsea was just reacting to the prick of the needle, she said. Petti calmed down as Chelsea relaxed.

  Genene injected the second needle in Chelsea’s right thigh. This time Chelsea stopped breathing completely, panicked for breath, then suddenly slumped over. It was happening again.

  An ambulance arrived quickly. Genene carried Chelsea in her arms, and before they arrived at the Kerrville hospital, she inserted a breathing tube in the baby’s throat. But Holland wanted to get Chelsea to a bigger hospital where they could do neurological tests, so Genene and Chelsea got back in the ambulance and rushed toward San Antonio, with Dr. Holland following in her car and the McClellans in theirs.

  Eight miles from Kerrville, Chelsea flat-lined. The ambulance jerked to the side of the freeway. Jones gave Chelsea several injections while Dr. Holland climbed inside and began cardiopulmonary resuscitation, trying valiantly to restart Chelsea’s little heart.

  But Chelsea never regained consciousness. By the time the ambulance driver pulled into a little clinic in the small town of Comfort, Chelsea McClellan was dead.

  Genene swaddled the baby’s body in a blanket and handed her to Petti, who had lapsed into a fog of denial. Chelsea was just sleeping, she said, and she’ll wake up soon. She’s been through this before.

  But Chelsea never awoke.

  They all returned to the Kerrville hospital, where Genene took the child’s body down to the basement morgue, then went back to work while Dr. Holland arranged for an autopsy.

  Chelsea was buried on a Monday afternoon, dressed in a pink dress and wearing a pink bow in her hair, with a blanket to keep her warm and her favorite doll to keep her company. She wore tiny star-shaped earrings in her ears and a heart pendant on a silver chain around her neck.

  Petti was a mess. She refused to believe Chelsea was dead. She wandered around in a mournful haze. When she first saw the miniature white fiberglass casket containing her daughter’s body, she shrieked, “You’re killing my baby!” as she collapsed in a heap.

  They buried Chelsea under a bronze marker—“Our Little Angel”—in the Babyland at the Kerrville cemetery. Weeks later, the autopsy would blame the death on SIDS
, a wastebasket term applied to the death of any young child when the real cause isn’t known. In short, the autopsist didn’t have any idea what killed her.

  The McClellans bought an ad in the Kerrville paper a couple of days after the funeral, thanking those who’d helped bury Chelsea, sent flowers, cards, or brought food. “Special thanks” were extended to Dr. Kathy Holland and Genene Jones—the only two people named in the entire ad—for keeping Chelsea alive as long as they did.

  A week after the funeral, a grieving Petti somehow got herself to the Garden of Memories Cemetery to lay flowers on Chelsea’s grave. To her surprise as she approached, she spied nurse Genene Jones kneeling on the fresh grave, rocking back and forth, weeping and repeating one name again and again: Chelsea. Chelsea. Chelsea.

  “What are you doing here?” Petti asked softly, watching from a distance, but the nurse didn’t seem to notice her.

  Without answering, Jones rose from the grave and walked away in a kind of weird trance.

  After Genene had driven out of the cemetery, Petti saw that she’d had left a small spray of flowers on Chelsea’s marker, but she also noticed the bereaved nurse had taken something, a pretty little bow.

  How odd, Petti thought.

  * * *

  Only eighteen months before Chelsea McClellan died, I’d taken the job of Chief Medical Examiner of Bexar County, Texas. Our headquarters in San Antonio were about an hour’s drive from the small town of Kerrville, a couple of counties northwest of the city, although at the moment I knew nothing of Chelsea McClellan’s death.

  In the previous nine years, I’d risen to deputy chief medical examiner under the legendary Dr. Charles Petty in Dallas, but even when he hit retirement age, Petty couldn’t let go. It simply wasn’t in his nature to quit.

  I was still in my thirties but I’d learned forensic science from the best—Dr. Russell Fisher in Baltimore, Petty, and my own father. I was eager to run my own operation, but it wasn’t going to be in Dallas. In March 1981, I took over as chief in San Antonio, which had become Texas’s first medical examiner’s office twenty-five years before.

  Before 1950, while many big cities and other states were converting their old coroner systems to medical examiners, Texas dithered. It wasn’t until 1955 that the state legislature passed a law permitting any Texas county with more than 250,000 people to abandon its county coroner and open a countywide medical examiner’s office. The public’s reaction was an immediate … yawn. Nothing happened.

  But the winds shifted when tragedy struck.

  Late on an early December night in 1955, a motorist crashed his car just four blocks from the home of a Bexar County justice of the peace, one of several elected officials who performed the tasks of coroner in their precincts. Police rushed the man to the hospital, where he was pronounced dead on arrival.

  Cops called the justice of the peace where the crash happened, but he refused to hold an inquest because he believed police shouldn’t have removed the body from the scene. So cops then called the justice of the peace whose precinct covered the hospital; he refused because he hadn’t been called first. A third justice of the peace finally called an inquest, but by that time, the dead man had lain in the hospital an unseemly long time.

  The local newspapers covered the bickering among the egotistical justices of the peace, and citizens finally came awake. At its next meeting, the Bexar county commissioners established Texas’s first medical examiner’s office. For $14,000 a year, the commission hired Dr. Robert Hausman, a Dutch-born forensic pathologist who was then the lab director at an Atlanta hospital. Coincidentally, before he started the job, Hausman spent a month alongside my father, getting a quick forensic refresher under New York’s Chief Medical Examiner, Dr. Milton Helpern. I was only fourteen years old at the time and certainly couldn’t have imagined that someday I’d lead the office Hausman founded in San Antonio.

  Death didn’t dawdle. Two hours after Texas’s first ME was sworn in on July 2, 1956, his first case—a suicide—arrived. He had only one assistant and a secretary, but he inaugurated a new era in Texas forensics when he was called to a ninth-floor suite in a downtown San Antonio hotel where a forty-eight-year-old white male had shot himself through the heart with a Spanish-made, .32-caliber semiautomatic handgun.

  Case No. 1 (as it was officially labeled) was simple enough from a forensic perspective—the room had been locked from the inside and the single gunshot was heard as a bellboy knocked on the door at eleven a.m. But from a human perspective, it was much more complex: The dead man was Joseph Cromwell, the only son of a pioneering Oklahoma oil wildcatter and heir to his late father’s vast fortune. A ninth-generation descendant of English Lord Protector Oliver Cromwell, he lived on the sprawling family ranch in nearby San Marcos. As a young man, he had graduated from a prestigious military college and Hoover’s secretary of war, a family friend, had personally commissioned him as a second lieutenant. Parties at the family’s sprawling ranch were legendary, and the last ten years of Joe’s hedonistic life were boozy, gluttonous, and aimless. By the end, the money was almost all gone.

  Joe Cromwell checked into the hotel a week before with only a couple of changes of clothes and no valuables. Police found him lying on his bed in his undershirt, boxers, and blue-gray socks, his face unshaven for a few days. He’d left detailed instructions for the hotel manager, police, and his son in a series of suicide notes on the nightstand.

  Was it merely a coincidence that the first casualty on Hausman’s first day wasn’t an ordinary death? Well, no death is ordinary if you’re the one who’s dying. And I’ve found that most “ordinary” people have a few extraordinary stories somewhere in the book of their lives.

  A medical examiner’s job is to determine cause and manner of death (in this case a single bullet through the heart in a suicide), but a sentient human wants to know what is sometimes unknowable, the deeper why. The real reason Joseph Cromwell took his own life was never discussed by his family and is now forgotten, if it was ever known at all, but I know Dr. Hausman kept the suicide notes on his desk for a couple of days. Nevertheless, with an endless parade of suspicious or unattended deaths starting on that historic first day, he had to let the husk of Joe Cromwell go.

  We all do.

  When I first came to San Antonio, nobody from the ME’s office went to death scenes. I changed all that when I started sending my own investigators—who had taken all their reports by phone—to the actual places where people died. I worried at first that the cops might chafe, feeling as if I didn’t trust them to do their jobs. That wasn’t the case; forensic investigators are simply looking for different clues than policemen. Luckily, most of my investigators had police backgrounds and my chief investigator was a retired San Antonio detective known to reporters as Mr. Homicide. As I write this, his nephew, also a former homicide detective, is the Bexar County ME’s chief investigator, too.

  Being at the scene was important. The more information we can gather in the earliest moments after an unexplained death, the better chance we have to explain it. I wanted my investigators and forensic pathologists to examine as many deaths as possible, even when the cause seemed apparent. Why? Because what is apparent isn’t always true.

  In those days, as now, local police routinely reported suspicious deaths, but hospitals weren’t always quick or eager to call the medical examiner. The law didn’t require hospitals to report the deaths of patients directly under a doctor’s care if the doctor could certify without doubt why his patient died, but a wide spectrum of questionable deaths fell in the law’s gray area. Hospitals naturally want to avoid bad reputations, lawsuits, and even uncomfortable questions, so they too often pretend that any death in their hospital beds was completely natural. Attending doctors, not wanting any second-guessers, often sign death certificates without the certainty the law requires.

  And that’s not how we should treat death.

  In my first year as the chief in San Antonio, my frustration grew with stubborn hospitals t
hat refused to report all questionable deaths—especially at the Bexar County Hospital, a county facility used as a teaching center for the University of Texas Health Science Center at San Antonio. By the fall of 1982, I was not so quietly stewing. I knew some unexplainable deaths were not being reported to the ME, so I rattled as many cages as I could to force hospitals to be more responsible. I even resigned from the faculty at the Health Science Center in protest, but nobody listened. I totally alienated the University of Texas bosses, who did nothing. It was a fool’s errand to bang on the gates of a fortified culture that was arrogant, greedy, and opaque.

  And whether by providence or accident, that’s when the tragic case of little Chelsea McClellan materialized for me, literally on a whisper.

  In January 1983, after a speech to San Antonio pathologists, my assistant medical examiner Corrie May struck up a conversation with an old friend from the local medical school. The doctor, a neuropathologist, mentioned that the Kerrville DA was looking into the unexplained death of a little girl. The DA, she confided, suspected a doctor and a nurse who had both recently worked at the Bexar County Hospital.

  And, she whispered, there had been some suspicious baby deaths at the medical center, too. The hospital had been quietly investigating on its own for a few years, she said.

  When Corrie May told me, I was shocked and angry. I had been beating the drums about unreported deaths at the hospital for months, and now here was evidence that my suspicions were valid. But I had no idea the reality might be even worse than I imagined.

  The next morning I walked into the DA’s office to deliver the frightful rumor: Somebody might be killing babies at the county hospital.

  * * *

  Indeed, the Bexar County Hospital was worried. At least one nurse had come forward earlier with suspicions. At least one doctor expressed qualms about a baby death he couldn’t explain. The death rate in the pediatric ICU was higher than it should be. And whether this was anomalous or deliberate, it would all be an enormous embarrassment if it got out.