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by Murder

  Sarin, Soman, Tabun, and VX are powerful neurotoxins that act quickly and damage the neurologic system of those who are exposed. Since many of the symptoms of GWS are neurologic in nature, these chemicals could easily be involved. Mustard gas, thiodiglycol, cyanogen chloride, and Lewisite can damage the skin and lungs. The botulinus toxin and anthrax can cause severe neurologic defects. The vaccines mentioned above as well as pyridostigmine bromide have neurologic side effects.

  Unfortunately, a great deal of what is believed, suggested, or speculated to be the cause of GWS has little if any scientific support—not yet, anyway. Research in this area is ongoing. While we await a better understanding of this syndrome, no cure or effective treatment is available.

  THE EFFECTS OF GUNS, KNIVES, EXPLOSIVES, AND OTHER WEAPONS OF DEATH

  Can a Stun Gun Serve as a Murder Weapon?

  Q: I'm working on a story that requires one man to kill another while both are in a crowd of people. My thought is that the killer uses a stun gun. While these devices are not supposed to be fatal, is it possible that death could result from the application of a longer-than-usual dose of electricity if the victim has a heart condition or pacemaker?

  A: Interesting question.

  You are correct in your assumption that stun guns are nonlethal and would result in the death of a normal, healthy adult only in the rarest of cases.

  Stun guns and TAZERs deliver a high-voltage, low-amperage shock;—usually around 50,000 volts, but some deliver up to 300,000 volts. This causes violent contractions of the muscles and is very painful. Most people collapse to the ground and writhe in pain. Some people are tough and can yank out the TAZER electrodes or knock the handheld stun gun from the attacker's hand. Individuals who are larger, angrier, or on certain drugs such as PCP or methamphetamine would be more likely to overcome the effects of the electric current.

  A pacemaker consists of a pulse generator (the device itself) and leads (wires) that connect the pacer to the heart (Figure 11). Pacers are typically placed just beneath the clavicle (collarbone) and are visible as a watch-dial-sized lump on the chest wall. The pacing leads are passed through the subclavian vein, which lies just beneath the clavicle, and advanced through the superior vena cava into the right side of the heart, where they are wedged into the lower tip of the right ventricle. The leads are then attached to the pulse generator.

  The electrical current from a stun device would permanently damage the pacemaker only if it was applied directly over the pulse generator unit itself. This could fry its electronics. A stun gun would have to be held against the chest or the TAZER wires would have to penetrate the skin directly over the pacer for this to occur. If the charge was applied anywhere else on the body, it would be unlikely to harm the pacer itself.

  That said, the current could interfere with the sensing function of the pacer in such a way that the pacer would think the heart was beating when it wasn't. A pacer is a demand device, which means it reads the electrical current of the heart and fires only when the heart doesn't. If the heart beats normally, it simply sits and watches. An electrical current could be sensed by the pacer as cardiac activity, and thus the pacer would do nothing.

  However, most people with pacers are not what we call "pacer dependent." Pacer dependent means that the native heart rhythm is absent or very slow, and without the pacer, the person's heart rate drops to very low levels—thirty beats per minute or less—and death could ensue. Most people have pacers as a safety net for intermittent slowing of the heart rate. In this case, interfering with the pacer's sensing function would not be lethal since these patients have a sufficient native rhythm to survive.

  A stun device could kill someone with a pacer, but it's unlikely.

  As for someone with heart disease, if the person had coronary artery disease or some form of dangerous cardiac rhythm for which he was taking medication, the pain and shock of the attack could precipitate a heart attack or a fatal arrhythmia. Pain, shock, fear, and anger cause the release of adrenaline from the adrenal glands into the bloodstream. This causes an acute increase in heart rate and blood pressure, which could lead to a heart attack or could precipitate fatal changes in heart rhythm.

  If your killer knew that your victim had a cardiac history or a "bad heart"—maybe he has daily angina attacks or uses nitroglycerin frequently during physical or emotionally stressful situations—

  he could reasonably expect that a TAZER or similar attack might cause the death of the victim. If you set up this background, your method of murder is completely plausible.

  What Happens to the Victim of a Stun Gun Attack?

  Q: In my current book a character gets hit by a stun gun. What will happen? Will she be unconscious? When will she be able to get up? Will she remember being hurt?

  A: Stun guns are handheld contact devices that require the user to place the business end against the attacker's or victim's skin, while TAZERs are handheld projectile devices that fire a pair of darts attached to the hand device by wires. The darts penetrate the skin, even through some clothing. The length of the wire in most commercially available devices is about fifteen feet.

  Either will deliver a high-voltage, low-amperage charge that paralyzes the victim by contracting all his muscles. The voltage varies from type to type over the range of 50,000 to 300,000 volts. In some TAZER devices the initial charge will last five to ten seconds and be followed by a series of shorter charges up to about thirty seconds in total duration. This varies by device and manufacturer.

  The victim isn't permanently harmed but may require several minutes to recover from the jolt.

  The victim will typically drop to the ground, and as the muscles contract, her back will arch and her limbs will convulse as in a seizure. We call these tonic-clonic motions. She may cry out or moan but will not likely be able to make any purposeful movements such as standing, running, or crawling. After several minutes she would be normal once again—perhaps a little more wary but able to perform all physical movements and activities. There should be no residual impairment.

  The victim is not unconscious and would probably remember everything, perhaps in great and painful detail.

  Will a Stun Gun Shock Others Who Are in Contact with the Victim?

  Q: have a scene where a character who feels no pain is down on the ground being beaten by guards who have nightsticks and stun guns. During the fray one of the guards hits him with his stun gun. If the guard using the stun gun is touching the man, would he be shocked by the electrical charge as well? And would the other guards who are also touching him be shocked, too?

  A: The answer is yes to both.

  Anyone in contact with the person who is receiving the current will also get the shock. That is why during cardiopulmonary resuscitation (CPR) we yell "clear" before we push the button that releases the current. You have seen this on ER, I'm sure. Otherwise, the person doing the chest compressions, taking a blood pressure, or touching the patient for any reason would also be shocked by the defibrillator current.

  Today, many patients have implantable defibrillators (basically a paramedic in a box): this is a device placed beneath the skin of the chest and attached to the heart by electrode wires. These devices monitor the patient's heart rhythm, and when a potentially lethal abnormal rhythm occurs, they deliver a shock to the heart internally, which hopefully restores the rhythm to normal. People touching the patient at the time of discharge will feel a mild shock—nothing harmful or painful but noticeable.

  What Would a "Bang Stick" Wound Look Like?

  Q: If someone used a "bang stick," like those used against sharks, as a murder weapon, what would the wound look like? Where is the most lethal place to aim it?

  A: A bang stick is basically a stick with an explosive charge at its end. The charge is typically a shotgun shell. These devices are used as a defense against sharks and for alligator hunting. The business end is pressed against the target and fired. In some, the shot (lead pellets) are left in the shell so that it acts like a sh
otgun, while in others the shot is removed and the killing force is the concussive force of the exploding gunpowder.

  The wound would be of the contact variety (see the later question, What Does the Wound from a Close-Range Gunshot Look Like? in "The Police and the Crime Scene" section). If the pellets are present, the wound would be as if a shotgun was placed in contact with the skin and fired. The wound would be a combination of the expanding gases, which would rip the skin in a stellate (starlike) pattern, and the shot, which would penetrate into the tissues and cause widespread destruction.

  If no pellets are present, the wound would be from the expanding gases alone. The resulting configuration would depend on where the contact was made. If it was over a bone, such as the skull, the explosive gases would expand laterally and rip the tissues into the classic stellate wound. If it was over softer tissues, such as the abdomen, the wound might still appear stellate but would tend to be deeper and less widespread.

  The best location to assure the death of the intended victim would likely be against his temple or his neck, where his carotid artery or jugular vein could be injured.

  Is a Blow to the Head More Deadly in a Heart Patient?

  Q: In my story an elderly man gets hit over the head with a cane. He falls and dies, either from the blow to the head or from his bad heart. Is it feasible that one good blow would kill a man with a bad heart? Would there be a lot of blood around? I'm hoping not, since I would prefer a fairly neat scene.

  A: It is indeed possible to die from a single blow to the head with a cane or any other object, especially if the victim is elderly. Older people are especially prone to skull fractures from falls or blows to the head since their bones are more brittle. But even without a fracture, an intracranial bleed (bleeding in or around the brain) can cause death.

  Death from an intracranial bleed could occur almost immediately or at a slower rate, depending on the force of the blow, the area of the brain injured, and the swiftness and volume of the bleed. You could almost guarantee death if the victim was not found for several hours and the intracranial bleed was extensive.

  An assault of any kind on a person with significant heart disease could precipitate a heart attack or sudden death from a cardiac arrhythmia, which would be caused by the outpouring of adrenaline from the fear and pain that would accompany such an attack. You don't really need that here since the blow alone could do the victim in.

  Blows to the head often lacerate (cut or tear) the scalp, which typically bleeds profusely. However, many result in only a bruise or abrasion of the scalp with little if any external bleeding. Either way, an extensive intracranial bleed can occur and lead to death, so it is reasonable for you to have a "fairly neat scene."

  Will Ground Glass in Food Kill a Person?

  Q: I'm writing a story about an abused wife who decides to kill her husband by feeding him ground glass from a saltshaker. How much would it take to do that? Would it have to go on over time? What would his symptoms be? Would it speed things up if the husband had an ulcer?

  A: First the bad news. This is unlikely to work.

  The glass would have to be very finely ground, or the victim would notice it as he ate. As we chew, we sense even tiny pieces of gravel, sand, glass, gristle, and so forth. Salt dissolves but glass doesn't, so the food would seem gritty unless the glass was ground into a powder. But very fine glass is unlikely to cause any lethal damage to the GI tract. It would be more of an irritation, with minor bleeding if any at all. If you could get the victim to eat coarser glass, such as crushed instead of ground, the glass shards would damage the stomach and intestine and could cause bleeding.

  This works with dogs because they don't really chew their food, and they are accustomed to biting through bones and gristle, and they wouldn't know what the glass was anyway. They simply swallow the larger pieces of glass that do the damage, then go off somewhere and slowly bleed to death. A person would know something was wrong with the food, and if not, he would go to a doctor about the bleeding.

  Even with coarser glass, the bleeding would probably not be massive or life-threatening but slow and lead to anemia and fatigue. The stools would become black from the blood, and the victim would see a doctor. Yes, an ulcer would make this worse since he would have two points for potential bleeding, but only the ulcer

  would have the potential to cause severe life-threatening bleeding. I doubt the ground glass would damage the underlying ulcer enough to cause a severe bleed.

  Now, the good news.

  If your victim had a serious heart condition such as coronary artery disease (CAD) and had had several heart attacks (myocardial infarctions, or MIs) in the past and now has ongoing angina (chest pain from the heart due to poor blood supply, usually felt as a tightness or squeezing sensation), then the anemia from the slow bleed might lead to a heart attack that could kill him.

  In CAD the arteries that supply blood to the heart are narrowed from atherosclerosis. This means that the blood that reaches the heart muscle is reduced by these blockages. Anemia is a condition characterized by reduced red blood cells (RBCs) in the blood. It is the RBCs that carry oxygen, and so in anemia the blood carries less oxygen.

  If these two entities occur together, not only does the heart muscle have less blood flowing to it from the obstructed arteries but also the blood it does get has less oxygen—a dangerous combination. We see this a lot. A patient with CAD and mild angina may become very unstable and even suffer a heart attack or die if he develops anemia from a bleeding ulcer or from some other cause.

  As the anemia progresses, his angina would get worse, and since he's an abusive jerk, he might not go to his doctor. He would develop progressive and frequent angina attacks, any one of which could blossom into a full MI and kill him.

  His M.D. might sign the death certificate since the wife would say her husband had had worsening of his angina, wouldn't go to the doctor, and finally clutched his chest and fell over dead. This way no autopsy would be done, his anemia and his irritated glass-filled GI tract would never be seen by the M.E., and her life would go on.

  So the ground glass could work in your story, just not directly.

  How Long Does It Take to Smother Someone with a Pillow?

  Q: My victim is killed by suffocation—a pillow over the face. How long would this take? She is an elderly woman and not especially strong. She is in a nursing home because of two broken legs suffered in a car accident. I've written this with the assumption that it would be a quick means of killing her. Then I saw somewhere that it can take as long as ten minutes to kill someone this way. So what's the story? Do I have to start over?

  A: No, you don't have to start over. An elderly lady would die in two to five minutes and probably toward the lower end of this range. A younger, stronger victim might be able to put up a good fight so that the suffocation would be intermittent; that is, he or she might knock or push the pillow away several times and be able to grab a gulp of air. He would be able to continue this until the oxygen level in his blood dropped sufficiently and he became weak, lost consciousness, and died. Your elderly lady would struggle but probably wouldn't be strong enough to dislodge the pillow, even for a gasp of air. This is particularly true since she has two broken legs and thus would not be able to get much leverage.

  Her struggles, as well as the fact that she would be extremely frightened, would lead to rapid consumption of the oxygen in her bloodstream so that death would occur more quickly. Also, an elderly victim such as yours would likely have at least some degree of heart and lung disease, and these would make her tolerance for lack of oxygen even less. Two to three minutes would probably be it.

  She would die from cardiopulmonary arrest (the heart stops). If she showed no signs of external injury, her death could be judged to have been natural by her family M.D., since elderly persons frequently die in their sleep—especially in nursing homes after auto

  accidents. Her private M.D. might assume she had a fatal heart attack or a pulmonary embolism
(PE). A PE is a blood clot that travels from the legs or pelvis to the lungs. This is a common cause of death in bedridden patients and in those who have suffered injuries to their lower extremities. Your elderly lady would have both of these risk factors for PE. Her M.D. might sign the death certificate, and that would be the end of it.

  But if the M.E. performed an autopsy, he would likely see the characteristic petechial hemorrhages (red dots and small splotches from broken microscopic capillary vessels) in the conjunctivae of the eyes (the pink part). These are found in smotherings and in both manual and ligature strangulations. If he did, a homicide would be suspected.

  How Does an Ice Pick to the Back of the Neck Kill?

  Q: In my story, a killer shoves an ice pick into the back of a guy's neck, right under the skull, and kills him instantly. Does this work? How?

  A: Since life depends on an intact communication between the brain and the body, any injury to the spinal cord in the cervical area is potentially lethal. If an ice pick or knife blade is forced between two of the neck bones (cervical vertebrae) and slices or macerates (chews up) the spinal cord, death is fairly well assured. The cervical portion of the spinal cord is divided into eight levels, which correspond to the eight cervical vertebrae. They are designated C1 through C8.

  Though damage to any level of the cervical cord could do the trick, the higher the better. Why? The levels between C3 and C5 control respiration, so any injury at or above this level would shut down breathing and lead to death.

  Your killer could best accomplish his deed by insinuating his

  weapon between the second and third cervical vertebrae (Figure 12). The entry point would correspond with the small hollow depression in the back of the neck that is just below where the skull joins the neck. A cut here would anatomically and functionally separate the brain from the spinal cord and, thus, the body. Think of it as a localized guillotine, a cutting of the spinal cord without completely removing the head. The effect is the same.