Morgue

by Dr. Vincent DiMaio

  They found no smoking gun, either literally or figuratively. But this hypothesis made more sense to Naifeh and Smith than the accepted, overly romantic suicide theory. It answered so many previously unanswered questions: Why hadn’t the gun ever been found? Why would Vincent choose to shoot himself in such a peculiar way? Why would he have lugged a large new canvas and all his painting gear a mile if he only intended to kill himself? Why were his deathbed “confessions” so tentative and hedged?

  Some in the art world added one more question: “You’re joking, right?”

  Naifeh and Smith had blasphemed. They might as well have nailed a thesis about the impossibility of resurrection to the Vatican door.

  Many van Gogh scholars have been quietly uncomfortable with the suicide story, but Naifeh and Smith’s homicide theory didn’t just feel like shameless book promotion; it threatened the romantic symbolism of an artist’s struggle against an indifferent world.

  “There’s plenty of reason to look at the unclear circumstances again,” said curator Leo Jansen of the Van Gogh Museum in Amsterdam. “We cannot yet agree with their conclusions because we do not think there is enough evidence yet. There’s no proof.”

  Jansen admitted that Vincent’s suicide confession couldn’t be proven either. It’s just what Vincent said, and he had no reason to lie about it.

  While some art writers and Internet trolls were more caustic in their response to Naifeh and Smith, others argued that even a clumsy suicide was a far more logical conclusion, a last irrational act by a disturbed man who’d acted irrationally before. What’s so incredible about a lunatic who had mutilated his own ear shooting himself in a highly unusual way?

  And finally, there were the guardians of the sacred myth.

  “If Vincent van Gogh would have died of old age at 80 in 1933, basking in glory and in possession of his two ears, he would never have become the myth he is today,” the Dutch daily De Volkskrant editorialized after Naifeh and Smith’s theory went public. “Van Gogh’s psychoses, his depressions, his mistakes and their manifestations—an ear cut off, a suicide—are more pertinent to the painter narrative, mystique and inscrutability than his cypresses and corn fields.”

  In 2013, scholars Louis van Tilborgh and Teio Meedendorp of the Van Gogh Museum mounted a vigorous frontal assault on the homicide theory. Their far-reaching article in a prestigious British art magazine argued point by point that the only genuine inference was suicide.

  As evidence, they prominently submitted the wound described by Dr. Gachet—a hole rimmed with brown and encircled by a purplish halo. The purple ring, they said, was a bruise caused by the bullet’s impact and the brown edge was powder-burned skin, proving that Vincent held the gun against his side, possibly even under his shirt.

  Van Tilborgh and Meedendorp argued that Vincent was highly agitated by turmoil in Theo’s life and a little off-balance in Auvers. In Vincent’s last paintings, Naifeh and Smith had seen brighter, more hopeful strokes, but the scholars saw ominous, darker emotions.

  The scholars also disputed any interpretation of the Secrétan interview as a “confession” and dismissed the old, secondhand rumors about gunplay by teenagers.

  “Truly nothing substantiates their argument for the train of events they construe,” Tilborgh and Meedendorp summarized, “apart from a twentieth-century rumour arising from an authentic story of a trigger-happy brat in 1890, who merely claimed that van Gogh probably stole the gun from him. And we do not doubt that for a moment.”

  The Burlington Magazine article by two van Gogh experts offered more questions than answers, but they had unambiguously challenged the new theory

  With their largely circumstantial argument under counter-attack, Naifeh and Smith needed solid scientific evidence. They needed an expert on gunshot wounds to examine all the evidence and reach a scientifically unassailable conclusion.

  So one summer day, my phone rang.

  * * *

  It was easy to see what didn’t happen. In all medical probability, Vincent van Gogh didn’t shoot himself.

  How did I know? I cannot know beyond a shadow of doubt, just as I cannot know what was in the mad genius’s disturbed mind and heart on the day he was shot. Although it might have been dark and disordered, nothing suggests he was in a psychotic state.

  Of course, I only knew what books and movies had said about van Gogh, his instability, his self-mutilation, his genius in art, his suicide. Like most people, I wasn’t aware there had been any dispute about any of it.

  Nevertheless, the new facts that lay before me 123 years later—and everything I know about gunshot wounds—spoke loud and clear: Vincent’s mortal wound was almost certainly not self-inflicted.

  There were several reasons for my opinion.

  The first was the general location of his wound, although it was never recorded precisely. Drs. Mazery and Gachet described the wound’s location differently. A 1928 book by Victor Doiteau and Edgar Leroy said it was “along the side of the left ribs, a little before the axillary line,” an imaginary vertical demarcation from the armpit to the waist. In other words, the bullet entered Vincent’s side about where his elbow would touch his chest if he stood with his arms at his sides.

  But did it go through his rib cage or the soft tissue below the ribs?

  If you accept Dr. Mazery’s original observation, the wound was in Vincent’s left abdomen, just under his ribs.

  How odd would that location be for a suicide shot? When my colleague Dr. Kimberly Molina and I reviewed 747 suicides for a study of handgun wound locations, ranges, and manner of death, we found only 1.3 percent of self-inflicted gunshots were in the abdomen.

  If you accept the 1928 account that the bullet pierced Vincent’s left-side rib cage, we found that only 12.7 percent of suicides shot themselves in the chest. And overwhelmingly most of those were direct shots over the heart, not obliquely fired into the side.

  Simply put, very few suicides, no matter how frightened or deluded, choose to shoot themselves in their sides.

  But if Vincent did, that raises a whole different question.

  Let’s assume Vincent was the exception. Let’s assume he consciously chose to shoot himself in his left side with a handgun. How would he do it?

  It is widely accepted that Vincent was right-handed, so even if he’d decided to shoot himself in his side, why pick the side that would require the most awkward shot?

  The easiest way for Vincent to have made this shot would have been to wrap his left hand’s fingers around the back of the grip and pull the trigger with his thumb. He might even have steadied the pistol with his right hand, but he would have suffered powder burns on his right palm where he grasped the body of the gun, caused by flames, gas, and powder blowing out of the cylinder gap.

  Using his right hand would have been even more absurd. He would have had to cross his right arm over his chest, wrap his fingers around the gun’s grip and pull the trigger with his thumb. And again, if he’d used his left hand to steady the weapon, it would have suffered powder burns.

  No such powder burns were reported by Theo, the two doctors, the two gendarmes, or any of the people who saw Vincent alive or dead after the shooting.

  Even if you can accept the contortions it would have required in either case, the gun’s muzzle would have been against Vincent’s skin or, at most, a couple of inches away.

  And that’s the most important reason I believe his wound was not self-inflicted.

  Vincent’s wound was described by the attending doctors as pea-sized, with a reddish brown margin, and ringed by a purplish blue halo. The skin is otherwise clear and there’s no sign of powder burns.

  Some proponents of the suicide theory argue the purplish halo was a bruise caused by the bullet’s impact. Not so. It is, in fact, internal bleeding from vessels severed by the bullet, and I’ve seen it many times in people who live a while after they’ve been shot. Its presence (or absence) means nothing significant.

  The reddish brown rim a
round the entrance wound itself is not powder-burned skin, but an abrasion ring seen around virtually all entrance wounds. Again, not significant except that it signifies an entrance wound.

  But the most important element of this entrance wound is what isn’t there.

  Handgun cartridges of the 1890s were loaded with black powder, which burns very dirty. Smokeless powder had been invented in 1884, but at the time of Vincent’s shooting, it was only used in cartridges for a few military rifles.

  Close-range wounds by bullets from black-powder cartridges are messy. When black powder ignites, some 56 percent of its mass is solid residue, which bursts forth in a scorching spray of carbon particles.

  If Vincent shot himself, he would have held the gun point-blank against his skin, or maybe just a couple of inches away (because in 98.5 percent of all suicides the shot is fired against or close to the skin). So the skin around his wound would have been blistered by searing gases and spattered by hot soot and burning flecks of powder. The burns would have been serious and hundreds of flecks of burnt and partially burnt powder would still be embedded in his skin.

  What if he shot himself through his clothing? If Vincent had pressed the gun’s muzzle against his blouse, the edges of his wound would have been seared and blackened. There might or might not have been a wider area of tattooing, but his clothing would have been covered with soot.

  None of this was described by the doctors or anyone else who looked at the wound or had contact with Vincent after the shooting.

  Thus, the muzzle of the gun could not have been held against Vincent’s side. The lack of powder tattooing or burns of any kind suggest the gun was at least twenty inches away when fired.

  So Vincent van Gogh was mortally wounded in an atypical place for a suicide, by a gun that he couldn’t possibly have held so far from his body.

  We’ll likely never know beyond any reasonable doubt what happened on that Sunday afternoon in France. Even if civil authorities could be convinced to exhume Vincent, there’s very little to be learned about his death. Today he is probably just bones. A well-embalmed corpse in a lead coffin might have lasted more than one hundred years, but Vincent wasn’t embalmed—typical in nineteenth-century Europe—and he was buried in a simple handmade wooden casket.

  A forensic expert would likely find the small-caliber bullet that killed him, but without Ravoux’s old revolver for comparison, even modern-day high-tech ballistics couldn’t establish confidently that it fired the bullet. It might have come from any small pistol. And if all the soft tissues had decomposed, we couldn’t determine the bullet’s path or damage. We might end up with more questions than answers.

  We all invest in things we believe to be true, often without any real evidence. Myth can be more magical than truth. Do you believe somebody other than Oswald killed Kennedy?

  By and large, some in the art world resist the notion of a homicide, whether accidental or premeditated, because it’s neither dramatic nor poetic enough. After all, painters, poets, and lonely lovers die so much more romantically if they drink from their own little poison vials, or cut their veins beneath a pale blue moon, or swim far out into the sea with no intention of swimming back.

  Yes, the shooting—bathed in wishful conclusions, never fully investigated, and confused by conflicting accounts—is a puzzle. Nobody who was there is still alive, and we must glean forensic details from scant observations at the time. But these details don’t support the mythology.

  Nevertheless, the manner of Vincent’s death has become part of his greater legend, and the mystery might endure forever. As with many of my cases, what you believe might depend more on what you want to believe than the forensic facts. It might be more about Vincent’s tragic life than his actual dying.

  Whether he embraced death is for poets and academics to argue, but the forensic facts point to a shooter who escaped our questions.

  My personal verdict: Vincent van Gogh didn’t shoot himself. I don’t know who did or why. I don’t know if Vincent wanted to die. I don’t know if he feared the end or embraced it. It all comes down to something no medical examiner can determine with his scalpel, a computer, or sophisticated tests. Maybe he simply came to terms with his accidental dying. Even logic sometimes fails to provide answers.

  I can’t know what’s in a human heart.

  ‹ EPILOGUE ›

  At the End of Things

  Somebody once said that if you carry your childhood with you, you’ll never grow old. Nice sentiment, but not really true.

  I have been a forensic pathologist for more than forty-five years. All the lions I looked up to when I was young—Helpern, Fisher, Rose, among many others—are all gone. My father retired as Chief Medical Examiner of New York City at sixty-five and finally retired at about eighty-five. Even my contemporaries are mostly retired or “gone.”

  I’ve carried my childhood the whole time, and yet here I am, getting old. Go figure.

  Then there’s this: Some researcher recently concluded that an animal’s perception of time is inversely correlated with the rate of its heartbeat. The slower the heart, the faster time seems to pass. At least for this researcher, that explained why, as we get older and our hearts slow down, it seems like the days aren’t so long anymore. I don’t know how that works or if the theory even has legs, but a lot of old folks certainly would agree.

  We do stuff like that. We make up little homilies, post cheerful Facebook memes, or contrive bits of pop science to make us feel better about dying. Too many of us end up believing it will be poetic.

  In this book, I’ve told a few stories about endings, even as I was telling the story of my own beginning. I haven’t really pondered my own ending. Maybe because in my world endings happen only to other people. So far, anyway.

  Still, I don’t romanticize death. I’ve seen too much of it to expect a dreamy Hollywood ending.

  Since the 1600s, when cheaply printed pamphlets circulated graphic descriptions of local murder, humans have been fascinated by crime stories. Shakespeare’s plays were full of homicide. Nothing sold better than intrigue … and the ultimate victory of morality and reasoning over disorder and depravity. And nothing was more mysterious than death.

  We haven’t changed much. Modern pop-culture depictions of forensic science, in all their glorious, computer-generated glory, tend to overglamorize the forensic pathologist and credit hypercool high tech with solving every crime and conquering evil. But as with all things Hollywood, it just ain’t so. It’s not about the gee-whiz technology.

  Let me repeat: A good forensic pathologist’s best tools are his hands and brain. With a day’s training on new sciences like DNA, a smart medical examiner from the 1940s could be operating in a modern morgue quite capably. Why? Because reasoning is still our most powerful forensic tool.

  I’m often asked, “How can you work in such a depressing field?” I would like to give a glib answer, but I cannot. If you get depressed in my work, then you do not belong. I will just say that it is interesting and challenging. I could never work with children dying of cancer, but I have had no difficulty handling disfigured corpses or explaining honestly (and gently) to their grieving families how they died. There is a value in that.

  Yet, my profession is at a crossroads. As I write this, fewer than 500 board-certified forensic pathologists are at work in America. At full tilt, each one can do only about 250 autopsies a year. We need twice that number.

  Sometimes I don’t know if I chose medicine or it was just born inside me, a seed waiting to blossom. But I know I became a doctor because I wanted to help people.

  Computers and various forensic sciences are booming, with more exciting developments to come, but the human factor is woefully lagging.

  Future forensic pathologists must finish four years of undergraduate college, four years of medical school, three to four years of training in pathology, and a one-year fellowship at one of thirty-six approved medical examiners’ offices, and pass an American Board of Patholog
y certification examination. Doing that, they accumulate a median debt of $170,000.

  There’s money in medicine—except for forensic pathology. Almost every other medical discipline earns far more. The average salary of a medical examiner is just under $185,000 a year; a deputy chief or chief ME are much better off at $190,000 and $220,000 a year. Their salaries are all much lower than those of their hospital-based pathology peers, who commonly earn an average $335,000 a year.

  And then there are the irregular hours, weird smells, emotional traumas, unhelpful patients, images that will never be erased from their brains, exposure to disease, lawyers, cops, trial testimony, bureaucrats, and budgets drearier than a morgue cooler. Sure, it looks fascinating on TV and the prospect of solving a real-life mystery is captivating, but who really wants to wade through corpses every day for less money than most of their medical school classmates?

  As a result, we train an average of twenty-seven board-certified forensic pathologists every year, but only twenty-one actually go to work as medical examiners.

  We need more forensic pathologists. As our population grows and ages, as we trust technology more and more (and humans less and less), and as the number of new pathologists declines, forensic pathology will hit a disastrous wall. Fewer autopsists mean fewer autopsies. Investigations suffer, evidence is lost or overlooked, crimes are unsolved.

  If that happens, we don’t just lose money or time … we lose justice. My patients no longer are suffering, but I know many of them would want justice. I can’t give them their lives back, or even a few more minutes to say good-bye, but I can give them justice.

  Acknowledgments

  We are profoundly grateful to our many friends whose contributions, large and small, made this book possible. Some of them became more than mere sources during the two years that we worked on this book, and some were friends long before.