Marie Joseph

The questions are many and the facts are few about the events surrounding the death of a 36-year-old woman in Fall River, Massachusetts, on Sunday. As you may have heard, the body of Marie Joseph (1st image, holding the daughter of a friend) was found in a public swimming pool 2 days after her apparent drowning. During that interval, the pool remained open and was inspected twice.

Here are the facts:
On Sunday, Marie went to Vietnam Veteran's Memorial Pool (3rd image, from above) in Lafayette Park with neighbors. She was last seen at 1pm, but friends assumed she had gone home and did not report her missing. A 9-year-old boy whom Marie had been watching told a lifeguard that she had not surfaced after accidentally sliding down the water slide (shown in 2nd image) with him, but the guard did nothing. According to a friend of Marie's, the boy attempted to rescue her himself when he was ignored. “The little boy was trying to pull her back up, but he couldn’t. She was too heavy, and she was too slippery from the water.’’ Marie's body was found at 10pm on Tuesday by teenagers who jumped the locked fence for an after-hours swim

Here is the fallout:
Pool staffers have been suspended and the 2 city inspectors have been placed on paid leave. Two dozen state-run pools were temporarily closed, but are expected to reopen this weekend. Fall River mayor William Flanagan ordered the immediate inspection of 21 public and semi-public pools in the city, including hotel pools. The mayor and Department of Conservation and Recreation (DCR) Commissioner Edward M. Lambert, Jr., held a press conference outside the pool yesterday. Governor Deval Patrick has ordered DCR to conduct an internal investigation into Marie’s death, but the state has agreed not to question the pool’s employees until the district attorney’s office does. Investigators are examining video footage from the pool while awaiting autopsy results, which could be released today.

Here are the questions:
Why would Marie have climbed the slide if she did not intend to slide down, and in fact could not swim? Why didn't the lifeguard respond to the boy's concern, and why didn't the boy bring the problem to the attention of any of the adults at the pool? How come none of the swimming patrons nor the 6 lifeguards on duty saw or came into contact with Marie's lifeless body? How was the body missed during the protocols for opening and closing the pool each day? How did inspectors, who closed the 12' deep end on Monday and Tuesday because the water was cloudy, fail to notice the submerged body? And why was the pool allowed to operate when the Health Department permit had expired 6 months earlier?

Marie is survived by her 5 children, her heartbroken partner of 8 years (on video here) who calls her death "a big shock," her father who called the circumstances "terrible...unbelievable," and her puzzled friends and neighbors who never knew her to frequent the pool. This is a mystery, a tragedy, a failure of the public trust, and certainly much more than a "teachable moment."

Autopsy specimen

There are 2 sides to this story, and a New York judge has just ruled that the dispute can be settled in court.

From the perspective of the New York City Medical Examiner's Office:
A 17-year-old African-American male living in Staten Island was killed by crushing injuries in an auto accident on 1 Jan 2005. Consent for an autopsy was obtained from the victim's father. The postmortem was performed and the remains were released to the funeral home the same day. The medical examiner's office is accused of failure to inform the Shipleys that they had removed and retained Jesse's brain, violating their right of sepulcher. The retention of the organ came to light during a visit to the morgue by the classmates of the decedent's sister. "In what can only be described as a surreal coincidence, the label on the jar indicated that the brain was that of Jesse Shipley, a circumstance which evoked strong emotional reactions from some of the students who were present." The office had retained the brain to perform further neuropathologic examination, which was scheduled shortly after the class field trip. Although this was 2 months after Jesse Shipley's death, the analysis was pending the accumulation of 6 brains to warrant the trip of an examiner from the Office of the Chief Medical Examiner to Staten Island.

From the perspective of the Shipley family:
Beloved son and brother Jesse, a Port Richmond High School student, lost his life in a car crash on January 9th, 2005. Jesse's father gave permission for an autopsy. Three days after his death, Jesse's funeral was held. When classmates of Jesse's sister Shannon - who had also been injured in the accident - went on a field trip to the Richmond County Mortuary 2 months later, they noticed a human brain suspended in formaldehyde. They were stunned and sickened to see that the label on the jar read "Jesse Shipley." News of the macabre discovery soon spread to Shannon Shipley, who told her parents. The Shipleys petitioned for the return of their son's brain, held a 2nd funeral, and sued the city and the M.E.'s office for not returning all of Jesse's remains.

While the M.E.'s office has the statutory authority to retain organs for further examination and testing, they are obligated to release them to the next of kin for burial once the legitimate purposes for retaining them have been fulfilled, concluded a judicial panel, allowing the lawsuit to go forward. In question is whether the defendants had properly advised the family when the body was released that one or more organs had been removed for further study. "This requirement, hardly onerous in nature, strikes an appropriate balance between the fulfillment of the legitimate scientific and investigative duties of the Medical Examiner's Office and the recognition of the long-established rights of next of kin to receive and provide final repose to the remains of their loved ones," said the judge in his ruling. But the family also wonders whether the brain had been lawfully retained for scientific purposes in light of the fact that the cause of death was known. The court denied the Shipleys' motion to sue for additional damages arising from what they alleged was the brain's public display. The specimen was in a cabinet with other organs and had not been mishandled.

1st image) A set from the "Preserved Specimens and Specimen Jars" collection that can be rented from B.J. Winslow Prop Rentals and Fabrication in Los Angeles, 2nd image) Mr. and Mrs. Andre Shipley, 3rd image) Jesse Shipley.

Embalming Elvis

You may have heard the news this week - as reported by the Chicago Sun-Times, Reuters, BBC, Time, and many other media outlets - that the tools used to autopsy Elvis Presley (1935-1977) are being auctioned off. Quigley here to clarify the terminology for her readers: these are not autopsy tools, but embalming tools - as the Associated Press and the Chicago Tribune correctly trumpet in their headlines. The lots to be offered by Chicago's Leslie Hindman Auctioneers (2nd image) include a needle injector, an arterial tube, and aneurysm hooks that would have been used to carry out the arterial embalming of the body at the Memphis Funeral Home before Elvis was casketed (1st image) for a private and public viewing. The items include a toe tag, but not the scalpel, scissors, and saw that would have been necessary to open the body for examination at the autopsy, which was conducted at his father's insistence at the hospital before Elvis' remains were released to the funeral home. The items, retained after their use in 1977 by the senior embalmer at the funeral home, consist of the embalming instruments and a collection of postmortem articles, and are expected to fetch a combined total of $10,000 to $14,000.

Jimmy Garlick

In the tower of this English church, which may date back to Saxon times, lies a mummy - but more about that in a minute. First, I find that St. James Garlickhythe has been rebuilt numerous times: in the 14th c., when it was established as a religious guild; in the 17th c., after the Great Fire of London; in the mid-20th c., after it was damaged in World War II; and in the late 20th c., when it was struck by a construction crane. The name "Garlickhythe" refers to an important landing-place on the River Thames nearby where garlic was delivered to market. The mummy in question was dubbed "Jimmy Garlick," and I can't find a single picture of him. The embalmed body was discovered in the vaults in 1855 and - after examination by the British Museum - believed to be that of an adolescent child from the turn of the 18th c. For years (some say centuries), Jimmy was on display in a cupboard in the vestibule. In 2004, the Discovery Channel focused on the "Mummy from the Tower" during an episode of the series Mummy Autopsy. The investigation indicated that Jimmy was not a teenager after all, but an older man with signs of balding, tooth decay, and osteo-arthritis. Carbon dating placed his death between 1641 and 1801. Jimmy Garlick remains a lasting presence, not only physically (he now rests in a new casket in the privacy of the tower) but spiritually: strange noises and transported objects are blamed on his ghost.

Stryker saw

I still find it counterintuitive* that there is a power saw that will not cut human skin. The Stryker saw is used to cut the cast off a broken limbs and to remove the cranium during an autopsy. Rather than circulating, the toothed blade oscillates, so it just wiggles a surface that is not rigid. And the idea is not new - it was patented by American doctor and inventor Homer Stryker (1894-1980) in 1947. Dr. Stryker writes in the patent:

"My improved implement is highly efficient in the cutting of casts and other hard surfaces but yielding surfaces or materials are not cut or injured thereby in the event the cutter should accidentally contact the skin of a person and it does not cut fabrics or other objects unless they are supported by a fairly rigid backing."

When sawing off a cast, the site www.fixbones.com recommends that the orthopedist demonstrate - especially to children - the operation of the cast cutter on his or her hand to show the patient that it will not harm soft tissue. Earplugs or headphones can also be employed to reduce the noise of the saw and attached dust vacuum, which may otherwise provoke anxiety.

What is a new invention is the SawStop table saw (be sure to watch the "hot dog demo" video). First offered in 2005, this circular saw works in a different way. The blade carries a small electrical signal. Since the human body conducts electricity, the signal changes if it contacts skin and activates the safety system within 5 milliseconds. A brake is applied to the blade, which is lowered beneath the table, and the power to the motor is cut off. Inventor Steve Gass, interviewed on NPR, is lobbying the Consumer Product Safety Commission to pressure the power tool industry to adopt this kind of safety device. Table saws alone cause more than 60,000 accidents each year, 3,000 of which involve amputation (caution).

*One of my favorite words.

Forensic pathologists

Thanks to the 1976-1983 television drama "Quincy M.E." and because of his many high-profile cases, Dr. Thomas Noguchi (pictured, top) became the country's most well-known forensic pathologist. Dr. Noguchi, now retired, became coroner-chief medical examiner of the County of Los Angeles in the 1960s. As "coroner to the stars," he has autopsied a number of celebrities: John Belushi (1949-1982), William Holden (1918-1981), Janis Joplin (1943-1970), Robert F. Kennedy (1925-1968), Marilyn Monroe,(1926-1962), Sharon Tate (1943-1969), and Natalie Wood (1938-1981). When asked in a 1986 interview how forensic scientists differ from other scientists, Dr. Noguchi answered, "The public expects unusual personalities, but we are temperamentally similar to lab researchers. Yet medical detectives are congenial and able to work closely with police, juries, and lawyers. Also forensic leaders never give up -- we work at a case even though many years may go by. Gallows humor, or better, morgue humor, is a safety valve for us. Because of the pressure of being surrounded by dead bodies and death scenes, we tend to see matters in a different vein."

With the popularity of TV crime shows, there are now 2 series based on forensic pathologists - both of them women. Kathy Reichs works for the Office of the Chief Medical Examiner of North Carolina and wrote the books that inspired the drama "Bones." Jan Garavaglia is the Chief Medical Examiner for Orange County, Florida, and stars in the documentary "Dr. G: Medical Examiner."

Several other forensic pathologists may not have name recognition, but are frequently interviewed on TV. Michael Baden, once the Chief Medical Examiner of the City of New York, has consulted on many high-profile cases, including John F. Kennedy (1917-1963) and Sid Vicious (1957-1979), and the murder trials of O.J. Simpson, Phil Spector, and Claus von Bulow. Cyril Wecht, an expert in forensic medicine who has conducted more than 14,000 autopsies, was consulted or interviewed regarding the deaths of Vincent Foster (1945-1993), John and Robert Kennedy, Mary Jo Kopechne (1940-1969), David Koresh (1959-1993), Elvis Presley (1935-1977), and JonBenet Ramsey (1990-1996). Henry Lee (pictured, bottom) is Chief Emeritus for Scientific Services for the State of Connecticut and has assisted in the investigation of more than 6,000 cases. Of his profession, Dr. Lee writes, 'The forensic field is not lucrative. You cannot become wealthy. If you want to be challenged, it’s the right field. But you have to have a good science background. You also have to learn to use deductive and inductive logic. You need to have curiosity. You can’t have an 8-to-4 attitude. I never have a day where I go home at 4:00. You have to have that persistence. Then you need an attitude, that you do your best. Win, lose, draw, you don’t care. Don’t let public opinion pressure you. Don’t let the police pressure you. Don’t let anything pressure you to do something unethical. Then you can survive and become one of the best forensic scientists.”

Morgue news

Morgues and mortuaries have been much in the news lately. Some are suffering from the economy, one is too lax with removals, and another has geared up for my favorite holiday at the end of the month...
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Detroit, Michigan The Wayne Co. Morgue in midtown is piling up with bodies that have remained unclaimed by family members who can't afford to bury or cremate them and unburied by the county since their $21,000 budget ran out in June. The freezer's occupancy (67) has tripled since 2000. "We see people here [who] society was not taking care of before they died - and society is having difficulty taking care of them after they are dead," says the chief medical examiner.
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Sydney, Australia Authorities have been forced to reopen the Westmead Hospital morgue because - as was predicted - the Glebe Dept. of Forensic Medicine does not have the capacity to store the current number of bodies awaiting identification, notification of next of kin, and autopsy. "This is further evidence the Rees Labor Government got it wrong when it closed the Westmead Morgue last year despite staff warning Glebe morgue could not cope." In another recent news report out of Sydney, funeral directors are faulting the Royal North Shore Hospital for its cavalier attitude toward security at its morgue. After a recent removal from the unlocked and unattended morgue, an unnamed mortician stated, "I was aghast...at the ease with which we were able to do this. There are not locked doors, no checks, no security cameras. It is my opinion that a body could easily be stolen and I'm surprised that it hasn't happened already."
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New Orleans, Louisiana A haunted house on Canal Street called "The Mortuary" opened for the season on Sept. 11th. It is housed in an 1887 mansion that was the home of McMahon & Sons Funeral Home from 1920 to the late 1990s, and is surrounded by the above-ground cemeteries that New Orleans is known for. "You couldn't ask for a better view," said owner Jeff Borne, as he gazed out the window at the vast expanse of tombs.
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Pasadena, California The Eden Bar & Grill (formerly the Holly Street Bar & Grill) occupies what used to be the Turner & Stevens Mortuary. "Pasadenans like to startle their friends by revealing that the building was once a mortuary. If it's any comfort, the dining room was the garage." I have not eaten at a mortuary restaurant, but I did once attend a party at a former funeral home - the beer was kept on ice in the casket that still remained in the living room!
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If interested, check out the series "Post Mortem" by German photographer Patrick Budenz.

Public dissection

Dissection was an event open to the public in the 19th century and the corpse came from the gallows, the criminal having been sentenced to be “hanged and publicly dissected.” It was punishment and it was entertainment. It has been part of the education of doctors, who got front row seats at the anatomy theatre back then. Today's dissections have only a medical (or medico-legal) audience, but anatomist Gunther von Hagens has challenged the notion of whether doctors should have a privileged view. During my graduate studies, I focused on the [dead] body, specifically its preservation by plastination and its comparison to a book, which is to be opened and read. I plan to use this background to research and write a book that lays out the history and sorts out our ambivalent feelings about viewing dissection. I found out today that my publisher, McFarland & Co., is willing to publish such a book! And, as you see, it has such illustrative potential...