Working Stiff

by Judy Melinek, Md

  “I would say you’d be making the right decision here,” Dr. Hirsch said. His approval didn’t assuage my frustration over signing out Mary Lynch’s manner of death as undetermined. The cops had decided the lady had fallen, and that was that—the whole case came to a dead end. It might have been an accident, it might have been a homicide. No one will ever know.

  * * *

  The door to the apartment in Queens was ajar, the jamb torn off, pieces of splintered wood with protruding nails scattered across the threshold. Andres Garcia had been decomposing in there for days, maybe a week, before the stench drove the slum’s other tenants to call the cops. The MLI’s written report told me Garcia’s body was found on the floor of an interior hallway, in a semi-prone position. An electrical cord was wrapped tightly around his neck and tied at the other end to an exposed ceiling pipe. A second electrical cord bound his ankles; his hands and arms, however, were free. There were conspicuously visible cuts on his wrists and forearms, on the inside only, all the way up to the elbow. The report noted that plastic food wrap was wound tightly over his nose and eyes. Black fluid—maybe blood, maybe the products of decomposition—had puddled under the corpse.

  The television in the living room was on. A wallet on the bedside table held Bolivian currency. A single knife, apparently clean, sat on the kitchen counter. By the sink someone had smeared a word in blood—either “Pato” or “Bato,” the investigator wrote. Something also appeared to be scrawled in blood on the bathroom door, but it was illegible. A pair of latex surgical gloves floated in the toilet. Though paramedics had visited the scene in order to pronounce Garcia officially and extremely dead, they swore up and down that they hadn’t entered the bathroom, and certainly hadn’t dumped any gloves in the john. The adjective the MLI had used in his written report to describe the apartment’s overall condition was “ransacked.”

  “I wouldn’t say that,” Detective Fournier told me in the Queens morgue, while I was unwrapping the corpse from its body bag. “Some people live that way.”

  I asked him what the word scrawled in blood meant. “It depends. ‘Bato’ means ‘homeboy,’ but ‘Pato’ is ‘faggot.’ We can’t tell which one it is.” Beyond this, Fournier didn’t have much to say. The MLI’s report didn’t contain any photographs, so I couldn’t judge the state of the scene for myself. I had to rely on the body—and the body was in a state of stinking, sloughing decomposition.

  When Andres Garcia came out of the body bag and onto my autopsy table, the plastic food wrap wasn’t binding his eyes and nose anymore; it had fallen around his neck like a scarf, taking much of the skin with it. What remained of his face hung off in greenish-gray rags. The corpse was covered in a shiny slime and mottled in patches of brown, green, white, and yellow. The outer layer of epidermis slid off in my hand like the rind of a rotten fruit. His entire torso, including the genitals, was bloated, his belly stretched to bursting. When I cut into it to make the Y-incision, the bacterial gas escaped with a whoosh and reeked up my corner of the morgue. Detective Fournier retreated to the far end of the room.

  The electrical cord had dug a deep ligature furrow in the cadaver’s neck. I used my heavy shears to cut it off, then reapproximated the loop to measure its diameter. The cord around his ankles had also been tied tightly enough to leave deep furrows, even drawing some blood. The cuts on Garcia’s right forearm and his wrists were parallel incised wounds. They could have been the ‘hesitation marks’ of an attempted suicide—or evidence of torture. None had sliced deep enough to draw much blood, and his tendons were intact. He would have had sufficient dexterity to tie or untie the cords around his ankles and neck, even after sustaining the injuries to his arms.

  I was puzzled by the pattern of injury on the back of Andres Garcia’s neck. The furrow there passed between the fourth and fifth cervical vertebrae, level with the Adam’s apple. The ligature marks from suicidal hangings typically run diagonally behind the angle of the jaw, upward toward the nape of the neck, or even behind the ears. Garcia’s pattern of injury looked like a horizontal ligature strangulation, the force applied from directly behind him if he was horizontal and face-downward.

  I shouted across the noise of the morgue to get an answer. “Detective! How was this guy positioned?”

  “He was leaning forward, on his knees, facedown,” Fournier replied, taking a couple of steps closer but still keeping his distance.

  “Was he hanging?”

  “Yeah.”

  “How’s he hanging if he’s facedown?” I asked. “This ligature looks like it’s horizontal.”

  Fournier came near enough to the autopsy table to take a look, then shrugged. “The other end of the cord was attached to an overhead pipe, and this end was around his neck. It’s in the scene photos.”

  “There are scene photos?” The MLI hadn’t provided any with his written report. “Why don’t I have them?”

  “They’re with Crime Scene.”

  “I’m gonna need to see them,” I said, and continued eviscerating the decomposed body. When I looked up a few minutes later, Fournier was gone.

  I called the detective two days later. The crime scene photos weren’t available yet, he told me. Crime Scene was also going to try to lift fingerprints off the latex gloves from the toilet. He would let me know if they got anything—but in the meantime there had been a new development. The investigation had uncovered some papers belonging to Andres Garcia, and among them was a document that allowed him to bypass airport security and police checkpoints in Bolivia. “He might have been part of a police or drug enforcement agency.”

  “Whoa!” I said. “So this could be a drug hit? Wait—an international drug hit?”

  “We can’t assume that. It still looks self-inflicted to me.”

  “What about his apartment being ransacked? There were words written in blood in the man’s home!”

  “People do weird things when they’re suicidal, you know that.”

  “The body shows evidence of torture!”

  “Looks self-inflicted,” he repeated.

  He and I went back and forth like this for a while. The detective refused to acknowledge the possibility that the man could have been strangled by an assailant. I refused to sign the case out as a suicide without more investigation. We were both pretty irate by the time we hung up.

  While Stuart and I were out at lunch one day later that week, I told him about the Garcia case. “Did you check his rectum?” he asked, to the visible surprise of our waitress.

  I waited till she was gone to reply. “Why his rectum?”

  “Sometimes they torture people in the drug trade by impaling them in the rectum. We used to see it all the time in Miami.”

  I couldn’t remember whether I had examined Andres Garcia’s rectum. I agonized about it all evening at home, thoroughly ruining my husband’s dinner. The next day I pulled the corpse out of the morgue cooler and took a second look at the rectum and sigmoid colon. No trauma.

  I requested a rush on the toxicology report, and it came back in about a week, negative except for alcohol. When I called the detective to tell him about this result, he still hadn’t obtained the crime scene photos. I was getting annoyed. He pressed me again to call it a suicide and make it go away, but there was no way I was going to agree to do that until I had looked at the scene.

  Nearly a month later the thick sheaf of eight-by-ten photographs finally arrived. I was floored.

  The crime scene photos showed Andres Garcia slung with his chest on the seat of a kitchen chair, bowing forward, legs bound behind him. The electrical cord on the pipe was holding his neck up, keeping his head from slumping—and his head was completely encased in plastic cling wrap. It must have fallen off his face and ended up around his neck when the MLIs moved him into the body bag, but in the pictures of the undisturbed death scene it was wrapped tightly around his eyes, his nose, and most of his mouth. I flipped through the pictures of the unexplained gloves in the toilet and came to the kitchen scene. That word
on the counter was “Pato”—“faggot”—plain as day. In the bedroom every single dresser drawer was pulled out, the mattress off the bed, clothes strewn everywhere.

  The scene photos had arrived on my desk just five minutes before afternoon rounds, and I was still flipping through them in shock when I arrived at the conference room. I handed the pictures around to my colleagues. When I related Detective Fournier’s assertion that it could be a suicide, and that we couldn’t say the apartment had been ransacked because “some people live that way,” several of them scoffed audibly. What was Fournier thinking, trying to sell me this case as a suicide? I wondered out loud. “Maybe he figured that if he kept delaying the pictures you would just sign it off as a suicide and forget about the whole thing,” someone suggested. After all, it wasn’t completely impossible this was a suicide, was it? I could file this as another undetermined, right?

  All eyes turned to Dr. Hirsch. “This is clearly a homicide,” he stated, and handed the photos back.

  I felt like Detective Fournier had played me for a fool, and resolved never to let it happen again. We medical examiners rely on the police to tell us what the body can’t. That didn’t mean I should naïvely believe that they were always working toward the same goal as I was. Somebody had tortured Andres Garcia and garroted him to death with sadistic brutality, and had done so with volition. The manner of death was not suicide and not undetermined. I signed the case out the next day—as a homicide.

  Juxtaposing the savagery of Garcia’s killer with the detective’s apathy left me jaded. When a violent crime occurs, there’s a rent in the social fabric. We in the forensic sciences are bound to help mend it. The task requires professional judgment and acuity of observation, and over time I cultivated an emotional distance from my patients. It didn’t hold up in every case, though. My practiced reserve was not enough to shield me when I came to investigate the killing of a child.

  I performed eighteen pediatric autopsies in New York. Many of the accidental deaths had terrible stories behind them—though, overall, the pediatric cases I investigated while a young mother eased my worries about my own rambunctious toddler. In two years I did not perform a single postmortem investigation on a child between the ages of four and fourteen. The children I autopsied, with a handful of exceptions, had come to the end of a life measured in weeks or months, not years. A tiny seven-week-old baby in a homeless shelter suffocated after his teenaged mother placed him facedown in a crib with dangerously abundant bedding. A six-month-old rolled off her mother’s bed and died of positional asphyxia, wedged against a metal rail near the floor. The most heartbreaking was a two-month-old smothered by an “infant positioner,” a foam wedge his nanny had placed in the crib to keep him from rolling—and which, instead, caused his death. Most of the rest were natural deaths, caused by bad genes or bad luck. Lakaisha was the only child whose death I certified as a homicide.

  I performed her autopsy a week before my Daniel’s third birthday. Lakaisha was a year older but a petite girl, about his same size. Her mother claimed to the police the girl had slipped in the tub, but she was lying. I knew she was lying, because the body on my autopsy table showed a clear pattern of immersion burn. Her face, wrists, and hands were totally unscathed, but the burned skin on her arms looked like a sleeve. Other parts of her body had been relatively protected by folds of skin or by the porcelain surface of the tub, which told me Lakaisha had not been struggling to climb out of the scalding water. She had curled into a ball, trying to protect herself from the source of pain. Someone had gripped that little girl by the wrists and ankles and forced her down, into the hot water—and held her there.

  Stuart was working the table next to mine in the autopsy suite. He took one look at Lakaisha’s body and said, “If that’s not an immersion burn, the textbooks aren’t worth anything.” Doctors Smiddy and Flomenbaum agreed. I called the detectives as soon as I finished the autopsy. When I presented the case to Dr. Hirsch, he said, quietly and without hesitation, “This is a homicide.”

  Lakaisha had siblings. Her eight-year-old brother told the police a harrowing story of lifelong abuse, which he said they weren’t supposed to talk about, “because ACS will take us away and put us in foster care.” The mom had burns on her hands, which she claimed were from cooking. While Lakaisha was in the hospital with the injuries that would, after a month of suffering, kill her, she told a nurse changing her diaper, “Yesterday I got in trouble. My mommy put me in the bathtub.”

  I went to that hospital and spoke to a pediatrician who had treated her. He had written in her chart the day after she was admitted that the burn pattern was consistent with an accident. This doctor twisted himself into knots to defend his note, saying it was possible her hands had been unscathed because Lakaisha might have slipped while getting in the tub and reached up to her mother. He admitted, though, that he hadn’t evaluated the state of her whole body the day he examined her—she had been swathed in bandages from head to foot.

  That doctor’s statement to the police that it could have been an accident bothered me all the way home on the bus. To me it seemed instinctual that Lakaisha’s hands would shoot behind or beneath her if she had fallen into the tub accidentally. When I opened the door and found Danny still awake, I decided to test my theory. I brought the pajama-clad boy into the bedroom, held him a couple of feet over the bed, and dropped him. Sure enough, his hands shot out to his sides and toward his back. He, being Danny, loved it. “Mo,” he said, laughing. “Mo, mo!”

  I dropped him again. This time he was expecting it and did the same thing. “Mo, mo!” Each time, Danny’s hands went out the same way. Had he been dropped into hot water, his hands would have been scalded. The pediatrician was dead wrong.

  I gave Danny a big hug and thanked him for being my research subject, but he didn’t want to stop. T.J. was making dinner in the kitchen, so Danny and I played the dropping game over the bed for a while more. That night, I let him sleep in the bed with us, and I didn’t let him go.

  I faced Lakaisha’s mother in Brooklyn Family Court in mid-January 2003, while I was six months pregnant with Leah. The hearing before a family court judge was meant to decide the disposition of Lakaisha’s three siblings; the city’s Administration for Children’s Services wanted to take them away from the mom. For three days I took the stand as an expert witness and told the court the story of the dead girl’s body, the story she would never be able to tell.

  The courtroom was small. Two rows of chairs faced the bench, and a low wall paneled in ugly tan wood like a 1970s schoolroom separated the attorneys from the gallery. Terrell Evans, the lawyer for the ACS, got off to a slow start on my direct examination, but eventually the important things came out. The cause of death was “complications of second- and third-degree scald burns of approximately eighty percent of body surface area, including head, torso, and extremities.” Under the line asking “How injury occurred,” I had written on the death certificate, “Immersed in hot water.” I had certified the manner of death as homicide because of the pattern and extent of injury.

  Lakaisha’s mother had a full, pouty face and a perpetually irked expression. She was in street clothes, seated with her lawyer at the defense table, directly opposite the witness stand. She never once looked up at me. Her own mother, dressed impeccably in a colorful shawl with a matronly silver brooch, sat right behind her in one of the gallery chairs and nailed me with her brilliant green eyes during every moment I was on the stand.

  The lawyer representing Lakaisha’s mother started his cross-examination. He was a short man in a cheap suit and polyester tie, and dressed-up black sneakers. He started by asking that Lakaisha’s entire medical chart be admitted into evidence, which surprised me. There was no objection, though, so the young attorney, whom the judge referred to as Mr. Ellis, commenced interrogating me about the chart. He spent a long time getting me to read from the ambulance report, ER sheet, and hospital notes, each one estimating the different degrees and percentages of body surface
areas burned. I dutifully read each sheet and explained the difference between first-, second-, and third-degree burns, and also why and how scald burns evolve over time, and why the estimations by different doctors would be different. Eventually we got to what had actually transpired in that bathroom, and Mr. Ellis asked me an open-ended question about the story I had heard prior to making my determination. “I can’t answer that because I don’t know which version of the story you refer to. There were many,” I answered. The judge stepped in.

  “Dr. Melinek, why don’t you tell the court all the different versions you received.” I started by saying what was in the ambulance call report: that the mom told the paramedics Lakaisha was in the bathroom alone and had turned on the water by herself. Next was the version she gave to the hospital pediatrician, which was essentially the same, though the idea of the shower being on was also introduced. After that I got to Lakaisha’s own words to the nurses at the hospital, which I read directly from the nursing notes in the medical record.

  “‘Yesterday I got in trouble. My mommy put me in the bathtub.’”

  “Objection!” hollered Mr. Ellis, nearly jumping out of his sneakers.

  “Mr. Ellis, that statement is part of the medical chart you put into evidence,” the judge pointed out. “Dr. Melinek, please continue.” I did so, mentioning the DD5s (updated police reports) I had received during the NYPD investigation, and the detectives’ subsequent interviews with Lakaisha’s mom and her siblings. When I had finished, it looked to me like the judge had a clear picture of how varied and inconsistent the stories were.