Chapter 4
James spent the next several days thinking about Mary O’Brien as the house settled into a sort of hectic routine. Abbey home schooled Sara so she just included Elizabeth in the classes since she had not attended kindergarten yet. Martha took the bus to her school in town. Sam cleared up the funeral details and agreed with the Phelan’s to work off the $600 the simple funeral would cost. The farm provided ample opportunity to pay them back for loaning the funeral money to Sam. They buried Mary the following Monday after the autopsy. It was a cold, bright, blustery March day. Their hearts seemed as raw as the weather. Martha and Elizabeth both cried as though their little hearts would break. Sara stood sobbing and hugged Elizabeth tightly. The girls saw their mother for the last time on the Sunday evening prior to the funeral service at the visitation at the mortuary. It seemed to James that half the town turned out to honor Mary’s memory. He had no idea that Mary made such an impact in New Bedford.
It had been three weeks since Mary’s death and over two weeks since the autopsy. James became impatient for the results. James finished clinics early and decided to go talk with Dr Josiah Skinner, the county coroner. James knew Dr Skinner well and thought very highly of him. Dr Skinner trained over forty years ago when doctors took rotating internships and participated personally in autopsies of their patients. He had practiced general medicine for over 40 plus years in New Bedford and been county coroner for over 30 years. Dr Josiah Skinner may have been a small town doctor but he loved forensic medicine and did superb autopsies. James could never figure out how he had time to practice and do the coroner’s work too.
James jumped in “Barney” and headed over to Dr Skinner’s office. He parked out front and walked into the Spartan waiting room. Dr Skinner ran his practice out of an old fashioned, store front, cramped, street side building. He started in that same building some 40 years earlier and never saw a need to move. His father practiced out of the same building over 80 years earlier and Josiah followed in his footsteps by taking over the practice and office. The patients had to park curb side in the street but they never seemed to mind. The office always had that faint sort of odor of rubbing alcohol and disinfectant. James loved that smell as it reminded him of going to the doctor as a boy. Louise, Dr Skinner’s nurse/office manager greeted him.
“Hello, Dr Phelan. May I help you with something? Does Dr Skinner know you’re coming over?” she asked.
“No, I’m dropping by to bend his ear for a minute. Is he just about done with clinics? If not, I’ll just have a seat and wait here.”
“He’s just about done. I think he’s seeing Mrs. Bottni about her bunions and then has Mr. Johnson for his asthma and is done. Would like some tea or coffee?” Louise asked.
“I’d love a cup of decaf coffee if you’ll point me in the right direction,” said James.
“Now don’t you trouble yourself. I’ll have a fresh cup out in a jiffy. Why don’t you grab a magazine there. The doctor just received a new rose growing magazine you might be interested in reading,” returned Louise as she bustled off to get the coffee.
James found the magazine and settled in to read about black leaf spot and the systemic fungicide to treat it. James’ passion for roses seemed almost legendary in the town. He often won local prizes for his roses. He babied the bushes like his children. James tended yellow, bold reds, soft pinks, lovely blues, and pure whites. He loved his plants and absorbed everything he possibly could about rose care. With the harsh New England winters it often posed a challenge to just keep his bushes alive. He sat for about 20 minutes absorbed in the article. James felt a tap on his shoulder. He looked up, and there, stood Dr Josiah Skinner, MD.
Josiah Skinner came from that breed of old MD who truly believed he was called out to minister to people with his hands in medicine. His enthusiasm and love for his patients shown through everything he did. Many people in town owed their lives to him.
Dr Skinner stood ram-rod straight even at 69 years of age, with a snowy white mane of hair that resembled a lion’s mane on the top of his head (except it was white). His bright blue eyes often twinkled with infectious good humor and is whole person resonated good will and interest in you.
James stood up and shook hands with Josiah Skinner.
“What can I do for you today, James?” boomed out Dr Skinner. “I’ll bet it is about that autopsy on Mary O’Brien isn’t it? I just received the final slides yesterday and looked at them last night. They’re in the back. Would you like to look at them with me?” Skinner performed autopsies at St Francis Hospital instead of Hasting’s Mortuary now that there was a new, fully equipped morgue in the hospital. The slides he still read in the small laboratory area in his office because he loved his old Olympus microscope so much. Many places frowned on taking medical slides out of the hospital due to legal implications, but since there never had been a lost slide or a question of Skinner’s integrity, autopsy slides still went to his office.
“I’d love to see what you found,” responded James.
“Of course we have to wait for the official inquest to make the results public. Since you were one of her physicians, I feel it’s alright to let you see what we found,” began Skinner. “Sit down over there at the other head of the teaching microscope. I’ll just sort through these slides and we’ll go through the most interesting ones,” shared Dr Skinner.
Skinner shuffled through the glass pathology specimens and found the tray he was looking for under a report.
“Ahh, here they are. I am going to show you representative slides of Mary’s heart, stomach, mouth, nasal mucosa, liver, and esophagus. We’ll look first at the heart. The myocardium shows acute ischemic changes consistent with a myocardial infarction. There does not appear to be any enlargement of the ventricles or chronic changes. The heart, aorta, pulmonary arteries, and veins are all normal except for the acute hypoxic changes. I’d say our young lady died from an acute MI from cocaine use. The interesting question to answer is how she ingested the drug. Her stomach showed no traces of cocaine, nor did her nasal or oral mucosa. That leaves only intravenous administration. The intravenous lines showed cocaine residue as well as traces in the injection port so that is your point of entry,” said Dr Skinner pushing back from the microscope.
“But, when I talked with Dawn Johnson, her nurse, she said they didn’t find a syringe or a stash of drugs,” responded James thoughtfully.
“I didn’t say that Mary O’Brien injected the drugs herself. I just said that is where the drugs came from and how she probably died. There were no other marks on her body. Her body exhibited no bruising or abrasions. I suspect poor Mary never knew what happened and died in her sleep from the massive cocaine overdose. The powder by her bed definitely turned out to be cocaine. Pretty pure stuff too. Estimated street value would be a couple of hundred bucks,” said Dr Skinner.
“Mary and Sam didn’t have that kind of money to start with and Mary never was known to use drugs,” replied James confidently.
“Of course the State crime boys will want to confirm my autopsy but I doubt there is much question about the cause of death,” said Dr Skinner confidently.
“Have you told all this to Sheriff John Edwards? What does he think about the fact that we don’t have a syringe and yet all this pure cocaine in Mary’s veins?” asked James.
“That self-aggrandizing dolt?” snorted the old doctor. “He pays no attention to me even though I delivered him. He seems to think since I am semi-retired, and over 60 years old, that my brain doesn’t function anymore. If that is the case, why doesn’t he find another coroner? Probably because the county doesn’t pay anything for the job, that’s why. He can’t afford anyone else,” Dr Skinner answered scornfully.
“Even so, I am going to stop by the sheriff’s office and talk to him about the autopsy and what Dawn told me. Maybe he can help shed some light on Mary’s death. I’ll talk to you later Josiah. And thanks
for the information. I’ll keep you posted on anything I find out,” responded James.
“Just let me turn things off, grab my coat, lock up, and I’ll walk out with you,” said Dr Skinner.
Death By Intention Page 4