Dead Center

by Shiya Ribowsky

  Abolishing the use of that particularly offensive term did not mean that every homicide was treated the same. During the heyday of the crack epidemic, there were just too many homicides for the police to give them each a full court press. Friends of mine in the NYPD privately confirmed what I was seeing at death scenes—cases were unofficially triaged, and detective bosses decided which to investigate based on the case’s apparent solvability and on the identity of the victim. Simply put, the murder investigation of an Upper East Side investment banker would of course be the beneficiary of more resources and attention than the murder of a street hood with twelve prior narcotics arrests.

  The city denied then that any such triage existed and blustered on about how dedicated civil servants devoted equal attention to every crime, big or small, and every victim, rich or poor, minority or majority. Such protestations made for good sound bites but simply did not reflect reality. However, I must note that as the homicide rate in New York City dropped, through the remainder of the decade and on into the twenty-first century, to record lows, there was an increasingly more equitable distribution of attention to homicides.

  While the NYPD may have been able to unofficially shrug off any particular death, in the 1990s, OCME could not then, and cannot ever do so. Perhaps the difference is a function of our respective mandates. Remember, cops focus primarily on the perpetrator and on the questions: Who did it? and Why? We at OCME focus on the victim: Who is dead? and What happened? Each death therefore must be treated by us with the same care, attention to detail, and dignity as any other. This difference of focus is a further reiteration of the status of OCME as not being a part of law enforcement, though one of OCME’s functions is indeed to support the criminal justice system. Its other duties are to support the public health system and the civil legal structure—the latter, for instance, coming into play when an ME testifies in a civil case, or, more frequently, in the issuing of the death certificate that is necessary to the proper processing of the decedent’s estate.

  The “misdemeanor homicide” brouhaha also brings to mind that our designation of the manner of death as a homicide sometimes causes problems for the police. We must call any death purposefully brought about by the hands of another person a homicide, even if there is no attendant criminality. Sometimes this legal requirement drives cops crazy. Take, for an exaggerated example, an instance in which a bank robber shoots his way out of a bank, only to encounter outside a phalanx of police and circling media, all alerted by the bank’s silent alarm. Despite appropriate warnings given by the police to drop his weapon, the robber decides to try to shoot his way through the cordon and is met by a hail of police bullets that ends his life. All of the action is recorded by the impartial media, with the result that there was never a more open-and-shut case of a “justifiable shooting.” Even so, OCME must still label this death a homicide. And because we do, a grand jury will have to be empanelled to consider whether the homicide is, as the police will argue, a justifiable one. That it is justifiable will probably take the grand jury only a few moments to determine. But OCME has to call it a homicide and issue a death certificate that lists homicide as the manner of death. There is simply no other choice for us.

  Should New York State ever enforce its death penalty, and if the resulting execution takes place in New York City, OCME will issue the death certificate, and I guarantee that the manner of death will be listed as homicide. This is the major reason that I am firmly against the death penalty. Despite all of the deadly violence that I have witnessed or perhaps because of it, I am against murder of any kind. This is not to say that I’m soft on criminals; on the contrary, I am a firm believer in life without parole truly meaning life without parole. That is fitting retributive justice for committing the sorts of homicides I saw way too often in my years as a medicolegal investigator.

  In the early 1990s, the crack epidemic was its own death penalty for far too many victims, some of them much too young to have merited execution by the poison and the violence it spawned. In order to keep up with the death toll, I sometimes worked three shifts in a row, not because I wanted to but because every other MLI was also busy with the caseload. Now and then, on the midnight-to-eight shift, we could catnap until the phone rang. Still further on into the crack epidemic, the office decided that on our third shift in a row, if it was an overnight, a slow time for death reports, we could stay at home and only respond when calls came in. Later, that stay-at-home policy was disallowed by the city, in response to a perceived scandal in which some MLIs were shown to be taking home more money in a year because of overtime pay than the mayor and other top officials earned. The tabloids had a field day when my fellow MLI Joe Savino earned so much in overtime that he made more than the president of the United States. The New York Post published a list of the city’s top overtime earners, with Joey as number one. I was no slouch that year, coming in at number four or five, but I received little media attention—that was reserved for Joey. Much of the attention was negative. The city’s Department of Investigation began to look into the overtime “scandal.” They found no illegalities because there were none to find. Joey Savino put in so many hours talking to doctors about the deaths that occurred in their hospitals that in one Bronx hospital, when someone died in the ER, they would say that the patient had “done a Savino.”

  At that point, OCME was simply understaffed and overworked; there were twelve investigators doing the job that today is done by forty. And in those days, we MLIs handled more then four times the current annual load of murders. Sometimes, in the mid-1990s, it seemed to me that I was always working; and when I was tired, say toward the end of a double shift, I’d think to myself, “Well, at least my patients are already dead.” At such moments, out at a scene and knowing that my judgment was not at its best, I’d often just have the body brought into the OCME house, so we could look at it in the morning, when we were all fresh.

  It was during these hectic years that the hours and demand of my job began to have consequences beyond the office. As I tried to stay grounded throughout the trials of my work, I found that my relationship with my wife, and my religion, were growing strained. My faith would ebb and flow in reaction to my shifting moods and constantly evolving beliefs about Orthodox Judaism. During that same period, partially due to my dissatisfaction with Orthodoxy, and partially due to the huge amounts of overtime that I was putting in, my first marriage crumbled and my wife and I divorced. She remained within the Orthodox community, while I continued the process of leaving it. The divorce and my diminishing adherence to Orthodox doctrine put a tremendous strain on my relationship with my birth family.

  I was learning painfully the extent to which my job would take its toll. Such was the nature of my life with other people’s deaths.

  SEVEN

  WORKING A TON of hours as an MLI and handling many cases, I got to know a lot of cops. I came to recognize most of the detectives working in Manhattan and a fair number of the uniformed officers too, but even more of them seemed to know who I was or at least where I worked. That was logical because during the homicide heyday of the early 1990s, we MLIs were working many hours and cases and there were fewer of us than there were police detectives. Everywhere I went, I’d bump into some police officer, either a uniform or a detective, who would say, “Hi, doc.”

  Once, on my way to visit a sick friend, I was walking along a street on Manhattan’s Upper West Side. I was out of my customary work uniform—a dark suit, braces, white shirt, tie, and polished black shoes. Like NYPD detectives, most MLIs dress in business attire when out in the field, but since I was not on the schedule that day, I was wearing my off-duty uniform: jeans, sweatshirt, and sneakers.

  As I walked along, I noticed out of the corner of my eye that an NYPD patrol car was pacing me. I walked a little faster, and it matched my speed. I slowed and so did the car. Getting a little paranoid, I crossed the street and started walking the opposite way. They flipped on their overhead lights and made an illegal turn a
cross a double yellow, caught up with me, turned off their lights and kept pacing me. Feeling a little like a wanted man, I turned toward the police car, ready to surrender, and got my first really good look inside of it: two of New York City’s Finest, laughing their heads off. As I drew nearer, I recognized the pair of jokers from dozens of death scenes that we had worked together.

  “Okay, you two, what gives?” I demanded.

  “Well, doc,” one of them said through his laughter, “we just wanted to see what an ME did on his day off, so we followed you—but it was a good six blocks before you noticed us!” I pretended that this was funny and joked with them for a few moments before going on my way.

  Sure, it was funny. But this was also a significant moment because it demonstrated to me that the cops had finally come to accept the MLIs—not necessarily as their own, but as people they could have fun with. For the first time I could see a level of acceptance that meant they’d made room for me on their side of the Thin Blue Line. The MLI corps had only been around for a few years and cops have always lived by tradition. While their initial skepticism about this new breed of ME investigator often led them to doubt our abilities, as time went on, they (and the DAs) became impressed with our technically expert performances at scenes. It was also our sharing of their social interactions—going to the same retirement parties and attending the same lectures and conventions—that eventually paved the way for us to become accepted partners in New York’s criminal justice community.

  The more comfortable the NYPD became with our crime scene roles, the more we were able to take on roles that were not ordinarily prescribed for MLIs. These special relationships that we seasoned MLIs developed with the members of the police force sometimes took us a bit far afield of our usual endeavors as death investigators. In just this way, I came to be asked to do something highly unusual for an MLI: go undercover. My friends on the force thought the particular situation called for someone with my…talents.

  The detective squad at the First Precinct had received word that a set of “babies in bottles,” preserved fetuses, were going to be auctioned off at a “nature” or “curio” store in Lower Manhattan. The detectives wanted me to get a look at the preserved remains and to determine if they were really human. If so, the next step would be to figure out whether this proposed auction was legal. To the cops, it seemed that selling the preserved bodies of human babies should be illegal; as one detective opined, “it just feels wrong.” I assured them that if the remains were human, it was very likely that selling them was illegal. But before we brought this to the DA’s office, we agreed that I should go in undercover, posing as a potential buyer to assess what was really in those bottles.

  The back story was this: For many years, an abortionist in Florida had collected fetuses as part of his work and had chosen to preserve some of them with formaldehyde, storing them in large glass jars. He had evidently intended to create a panoramic display that showed every stage of the development of a human being in utero, from microscopic to full term, and when completed, to donate the collection to a medical school. At the time of his death, he had accumulated a nearly complete set of sixty or so fetuses, stored in a number of large jars. However, someone executing the doctor’s estate had chosen not to donate the fetuses but to sell them—to a traveling freak show.

  Eventually, that traveling freak show came to Brooklyn’s Coney Island, and there alongside the bearded lady, the midget, and the inevitable fat man, the jarred fetuses were put on display. An offended patron (who obviously drew the line of good taste at preserved babies) phoned in a disgusted complaint to his local police precinct. The OCME was eventually called, but by the time my Brooklyn colleagues arrived at where the show was supposed to be located, it had packed up and moved on.

  Shortly thereafter, the police learned that the preserved fetuses had turned up again and now were in Manhattan and were about to be auctioned off by the curio shop on Spring Street. This was when my police friends persuaded me to go into the shop, undercover, as a potential buyer of the fetuses.

  I had actually been to the store before. It was a legitimate place of business, chock-full of preserved insects, animal-hide rugs, fossils, meteorite fragments, bones, and other assorted knickknacks. It was one of the few places in the city where you could purchase a full-size replica of a human skull or even a fully articulated human skeleton. It billed itself as an “oasis for children,” and, indeed, kids loved to browse around the aisles and cluster around the shark teeth and preserved alligator heads.

  As undercover debuts go, this one was—for me, at least—disappointingly tame. I did not wear a wire (hidden recording device), and no backup waited in unmarked cars outside in case the operation went bad. I entered the store, found the owner, and inquired if it was true that he had some babies in jars for sale. He did not attempt to conceal this, nor did he ask me any questions that might have betrayed some nervousness at selling the jars and their contents. He took me downstairs to the storage area, where he showed me a few jars holding the well-preserved remains of what were clearly human fetuses, some of whom were obviously full-term babies. Hiding my shock, I talked to the owner for a few moments and gained the impression that he felt that there was nothing wrong in selling these human remains. He indicated to me that he considered the babies to be anatomical specimens, much like the preserved baby sharks that were for sale upstairs. I declined to buy a baby-in-a-jar that day, and to allay suspicion, I browsed aimlessly around the store for a few more moments before leaving.

  Using my report, the cops raided the place, confiscated the specimens and brought them to the ME’s office where Mark Flomenbaum, the first deputy Chief Medical Examiner, looked them over. Mark agreed with my field assessment that at least five of the fetuses were near- or full-term babies. The shop owner was eventually arrested and charged with a series of crimes ranging from mishandling hazardous materials (the formalin) to illegal possession of and attempted sale of human remains.

  I don’t know the outcome of the case against the owner, but I do know that the preserved babies were eventually donated to a medical school. I was happy to have played a small but critical part in this crime-busting endeavor.

  By this time, I had been working at the ME’s office for a number of years, and since much of the crushing workload of the early years had subsided, I started to have some time to myself after my usual workweek came to a close. I had grown concerned that my clinical skills were deteriorating to the point that I would never be able to return to clinical practice, so I began looking for a part-time clinical position where I could work a few shifts a month and hone my clinical abilities. Glancing through the newspaper, I came across an advertisement for a job that seemed perfect. An inner-city clinic, located in the Bronx and quite similar to the one where I began my career, was seeking PAs for shift work. I called up the clinic, faxed in my credentials, and was asked to come to meet the owner, a man I’ll call Michael Smith.

  From our first meeting, he was incredibly forthcoming about what he was doing. He had hooked up with a retired psychiatrist in the Bronx and was planning to use that psychiatrist’s license number to write prescriptions and to submit the bills to Medicaid and Medicare. Smith, whom I came to realize had no medical degree and no experience in clinical medicine, even though he walked around in a long white coat that read “Michael Smith, MD, Trauma Surgeon,” told me that together we could make enormous amounts of money, seeing patients at the clinic on Webster Avenue and maybe even opening additional clinics. After the interview, he took me to City Island and onto his yacht, a fifty-footer, the largest boat, other than a cruise ship, on which I had ever set foot. He wined and dined me and treated me as though I was the answer to his prayers.

  I went home and turned the events over in my mind, eventually deciding to call a friend who was an assistant DA. He put me in touch with the Medicaid/Medicare fraud unit at the New York State Attorney General’s office, and I arranged a meeting there, walked in, and started telling m
y story. As soon as I mentioned the name Michael Smith, I could see they were interested and that they already knew this guy.

  At the suggestion of the AG’s investigators, I returned to the clinic and “worked” a couple of shifts that were agony for me. Many of the patients I saw were quite ill, and as word got out that someone in the clinic was actually listening to patients and, presumably, treating them (actually I was deliberately not treating them to prevent any potentially illegal action on my part), the waiting room became crowded, and lines started to form outside the clinic. These patients broke my heart. They were the poorest of the poor. They would plaintively ask, with hope in their voices, “Are you going to be my doctor now?” Many were quite ill, needing medications. One told me he hadn’t been able to afford blood pressure medication for two years, so he hadn’t taken any in that time and his pressure was through the roof. Smith stalked around the place in his white coat, stethoscope, and phony ID badge that announced he was a “trauma surgeon,” but saw no patients himself. He confided once again, during that day, his plan to open other clinics all over the Bronx and his offer that if I stuck with him, we were going to be rich.

  My job, for the AG’s office, was to get Smith to act as though he was a physician supervising my work. Since I absolutely could not treat patients or write prescriptions for them, all I did was talk with them and take their histories. I did not even give them advice. I couldn’t, or else I’d be part of the scheme, too. My frustration was palpable, and being unable to help people suffering from such treatable illnesses was utter torture.