Murder and Mayhem (2 page)

How Is the Time of Death Determined?

Would Storing a Body in a Cold Room Hinder the Determination of Cause of Death?

Can the Coroner Distinguish Between Electrocution and a Heart Attack as the Cause of Death?

Can the M.E. Distinguish Between Blunt Trauma and Stab Wounds as the Cause of Death?

Can the Coroner Distinguish Between Drug Overdose and Gunshot as the Cause of Death?

Can the Coroner Determine the Cause of Death a Month Later?

Is It Possible to Detect Morphine in a Body Two Months After Death?

Can a Blood Alcohol Level Be Determined in a "Floater" After Two Weeks?

How Long Does the Foam Around a Drowning Victim's Mouth Persist?

From How Small a Sample Can DNA Be Obtained?

Does the M.E. Use Tattoos and Body Marks for Corpse Identification?

Can the Age of Surgical Scars Aid in Victim Identification?

Will Stomach Contents Reveal When and What the Victim Ingested?

Can the Type of Alcohol Found in Stomach Contents Be Determined?

Can an Autopsy Reveal a History of Pregnancy or Childbirth?

Can the Coroner Determine the Caliber of a Bullet by Simple Inspection?

In Slashing Wounds, Can the M.E. Determine What Weapon Was Used?

Can the Coroner Distinguish Between Freshwater and

Saltwater Drowning? Will an Autopsy Determine If Chlorine Is Present in the Lungs?

Do Skin and Nail Changes Occur with Some Poisons? Is There a Poison That Can't Be Detected or That Can Be

Masked By Venom? Do Postmortem Wounds Bleed? What Do "Mood" Cosmetics Look Like on a Corpse? How Was Death Determined in the Seventeenth Century?

Odds and Ends, Mostly Odds

Do the Pupils Enlarge or Shrink with Death?

Do Bodies Move During Cremation?

How Is Body Weight Determined in a Quad Amputee?

What Drug Is Used for Animal Euthansia?

Will Oleander Poison a Cat?

What "Hot" Substance Can Be Used to Sabotage Someone's

Diaphragm? Do Blind Persons Have "Visual" Dreams?

A Few Final Words

Figure 1a The Intracranial Spaces

Figure 1b The Three Basic Types of Intracranial Bleeds

Figure 1c Mechanism of Brain Stem Herniation

Figure 2 The Spleen

Figure 3 Tension Pneumothorax

Figure 4 The Dermatomes of the Body

Figure 5 A Sucking Chest Wound

Figure 6 Lichtenberg Figures

Figure 7 Pupillary Reactions to Drugs

Figure 8 Coronary Artery Disease and Its Complications

Figure 9 The Life Cycle of Schistosomiasis

Figure 10 Ectopic Pregnancy

Figure 11 Cardiac Pacemaker

Figure 12 The Cervical Spinal Cord

Figure 13 The Anatomy of Throat Slashing

Figure 14 The Circulation of the Blood

Figure 15 The Blood Supply to the Lungs

Figure 16 Anatomy of a Severed Trachea

Figure 17 Materials Expelled from a Gun Muzzle

Figure 18 The Anatomy of a Gunshot Wound

Figure 19 Osmosis and Drowning

INTRODUCTION

Regardless of genre, every story must possess character and plot. These are the sine qua non of storytelling. Without plot, nothing happens; without character, no one cares what happens. The other story elements—setting, theme, mood, voice, subplots—are solely to support this relationship between protagonist and plot. Thus, a good story is a believable character with which the reader empathizes caught in some life-altering situation.

To reveal character and progress plot, we often place our heroes in stressful situations. Why? Stress brings out the best and the worst in people and makes for interesting and exciting plot elements. There is no better way to stress your protagonist than to apply physical, emotional, and/or psychological pressure.

This is particularly true in the mystery and thriller genres where readers demand to be enthralled, dazzled, informed, and kept awake at night. For this reason mystery and thriller writers often use illness, injury, and psychological stresses such as fear, anxiety, panic, anger, envy, jealousy, remorse, and guilt to thrill and mystify the reader.

In some genres, such as fantasy, allegory, and comedy, the writer can create a world that has no basis in fact or reality. He must, of course, remain true to the rules he has established for that particular world. Short of that restriction, anything is possible.

For mystery and thriller writers the world of their stories is typically "the real world," and therefore "real world" rules must apply.

This places a heavy burden on the writer to get it right. Meticulous research, attention to the smallest detail, and avoidance of a "fast and loose" approach to the facts are essential to building a believable story. Inconsistent motives, convenient resolutions, and errors of fact can undermine even the most likable characters and clever plots.

A major obstacle for many writers is obtaining the specialized knowledge needed to bring their story to life. This is especially true when scientific or medical issues arise. Whether these are the procedures or inner workings of hospitals, emergency departments, or operating rooms; the functioning of doctors, nurses, paramedics, and other paramedical personnel; the mental and physical repercussions of acute or chronic illnesses or injuries such as auto accidents, gunshot wounds, or lightning strikes; the effects of both prescribed and illicit drugs; the impact of acute and chronic psychiatric disorders on victims and their loved ones; or issues in determining the cause and time of death or other forensic procedures, a valid understanding of the complex issues adds depth and drama to any manuscript and lends it the ring of truth.

Where do writers obtain this information? Too often from rehashing the stories of others or echoing what they see on television. Even the promise of the Internet as a source of unlimited information has proven to be false. One can find an overwhelming amount of data on almost every imaginable subject but be ill equipped to separate the truth from the flotsam and jetsam of cyberspace. The old medical adage that "bad data is worse than no data" holds for mystery writing as well.

What This Book Is

This book is intended to inform and entertain not only writers of mysteries and thrillers but also writers in all genres. In addition, lovers of books and movies and anyone with an inquisitive mind will find items of interest within these pages.

This project began at the suggestion of Jan Burke, past president of the Southern California chapter of Mystery Writers of America. She asked if I would write a medical Q and A column for the Southern California chapter's newsletter,
The March of Crime.
My column, "The Doctor Is In," now appears in that publication every month as well as in the newsletter of the Southwestern chapter,
The Sleuth Sayer.

Since this project began, I have received and attempted to answer hundreds of questions from writers of all genres, including many well-known novelists and screenwriters. Some of the best, most interesting, and most informative are included in this book.

My thanks to each and every writer who submitted a question, for your curiosity, your amazing imagination, and your dedication to "getting it right." I have learned as much from researching and answering your questions as I hope you have from the answers given.

My hope is that all the readers of these pages will find that this material answers some of their questions, raises their level of understanding of medical and forensics issues, causes new questions to germinate, and, most of all, stirs their creative literary juices.

This book is a compilation of some of the medical and forensic questions I have received from writers over the past several years. In the answers I have striven to give writers enough medical and scientific background to provide depth and breadth to their understanding as well as address the nuances of their particular scenario. The goal is to allow writers to use this newly gained understanding to craft more believable scenes or stories. I have attempted to make each question and answer stand alone while minimizing unnecessary repetition of information contained in other questions.

What This Book Is Not

In no way should the material contained in this publication be used for diagnosis or treatment of any medical disorder. Even the simplest question and answer would require decades of education and experience before it could be applied in a real-life situation.

Medicine is an exacting discipline; it is both a science and an art whose mysteries are revealed only after years of practice.

Although I have endeavored to make the information accurate and scientifically correct, many subjects are too complex to explain in detail while addressing the nuances and controversies of modern medical knowledge. Such is the art of medicine. The answers are provided for use in the context of fiction writing and storytelling, and should be used only for such purposes.

TRAUMATIC INJURIES AND THEIR TREATMENT

How Would Death Occur from Blunt Head Trauma?

Q: At the climax of my book there will be a death scene, and I want to make sure I portray it accurately. Essentially, my heroine's love interest sits on a motorcycle that is parked near a curb. The kickstand gives way, and he falls to the side while sitting on the bike. His head hits the curb, the impact killing him. What happens when a person dies from such a head injury? Does blood come out of the ears or nose, or is there no sign of outer trauma? Does the body shake in any way, or will he be found still? At first my heroine doesn't realize that he's hurt. From her view, she can't see the curb. How would he look to her only seconds after he falls? How will he look by the time the paramedics arrive a half hour later?