by John Coston
“Is he dead?” they asked each other. Ellen had not said so.
While Ellen was out of the room, Stacy came over to Elaine. Hoping to keep the child entertained, Elaine suggested they wander out into the hall. By now, Ellen’s mother had arrived, and she started to talk to Ruth. Catherine’s monologue wandered, as if she were trying to understand how such a thing could happen. Her grandson Steven was such a good-natured and even-tempered boy, she told Ruth. He was his mother’s favorite. David had been impossible to control, and even Stacy was difficult compared to Steven. Ruth just sat and listened, wanting to be supportive and sympathetic. When Catherine began to relate her version of the events of the morning, though, Ruth’s ears pricked up. Catherine’s telling didn’t bear any resemblance to what Ellen had told Elaine on the phone, or what Ellen had, in fact, just told her.
“Ellen took him to the cemetery. He wanted to see his brother, David.”
Ruth Brock was dumbstruck. Had Ellen been to the cemetery this morning?
At this moment, Stacy and Elaine came back into the room, and soon Elaine joined them. After a pause, Stacy asked Elaine if she would come with her to see Steven. So Elaine took the eight-year-old by the hand, and joined by Ellen and Ruth, they all walked down the corridor to Steven’s room.
Stacy was a composed little girl. She had seen her brother in a hospital before. The shiny steel beds that have motors to raise and lower your head, the scary life-support tubes, all the white linen and all the clear plastic IVs were not completely unfamiliar to her. As they looked down at him, Steven was perfectly still. They were in Steven’s room only a few minutes before Stacy asked Elaine another question.
“Would you kiss him?”
“Uh-huh.” Whatever Elaine was feeling, she didn’t miss a beat. She leaned over and gave little Steven a kiss, and then they all left the room.
By the time Elaine and Ruth left, sometime after six o’clock, Steven had been officially dead for more than two hours. Though they arrived after four, anticipating the agony of a decision about sustaining life support, they didn’t know—because no one had told them—that the boy had already been declared dead at 3:45 in the emergency room.
That night, after Elaine and Ruth had gone, while Ellen was still in the parents’ waiting room, she bumped into someone else she knew. Susan Emily was accompanying her daughter, who had a feverish child.
“What are you doing here?” Susan asked when she spotted Ellen, expecting to hear about a broken arm or a bad cut.
Ellen didn’t hesitate. “The same thing that happened to David happened to Steven. I donated his eyes to science. He’s right in there,” she said, pointing, “if you want to go in and see him.” Susan was stopped short. Ellen’s words had come out in a continuous, matter-of-fact stream. She wasn’t showing any outward signs of grief or tragedy. Her blunt, unfeeling tone was almost unbelievable.
“He died about four hours ago.”
That’s all Ellen said. Susan had some experience with Ellen’s chilly approach to tragedy. She would never forget how Ellen had behaved after David died. Grief, she realized, can do funny things to people, but she had been shocked by a comment Ellen had made at the funeral. The two of them were leaving together, walking through the front parlor, when Ellen stopped her and pointed to a couple of men who stood in the hallway. Ellen said they worked at her office.
“I don’t know what to do. They both want to go out with me. But I have to choose one, then.”
Susan wasn’t listening anymore. All she could think was that it would be the last thing on her mind if she had just viewed her son in a casket. Months later, Ellen made another unusually cold comment following David’s death. She had been venting on the subject of Paul when she told Susan: “I guess that’s one less that he’s got to pay child support for.”
Susan had witnessed such disturbing, cold-hearted behavior years earlier when she offered her sympathies about John Booker’s death. “I’m sorry to hear about your father,” Susan had said to her.
Ellen responded by laughing out loud. “I’m not. I’m glad the bastard’s dead.”
Then, more recently, Ellen had shocked Susan with a similar comment about her mother. They had been talking about nothing in particular when the conversation drifted to her mother. Susan couldn’t believe the venomous thing Ellen said: “I’ll be glad when she’s dead.”
Ellen’s incongruous behavior on the day Steven died would strike Deanne as more than curious as well. That night Ellen called and told Deanne how it had happened. She told Deanne that Stevie wasn’t feeling well when he got up in the morning. Ellen explained that he had been to the doctor over the weekend and had been vomiting and had slept a lot on Sunday.
“He asked me to stay home with him,” Ellen said. “So I did.”
As Ellen told the rest of the story, Deanne listened, her mind picturing the easygoing child, the one who was Ellen’s favorite. Deanne remembered all the times when Ellen would say: “Why don’t you take the kids for me?”
Deanne would kind of laugh about it, and would answer: “I’ll take Stevie.” Ellen knew what Deanne was saying, because he wasn’t the handful that her other children were. Then, Ellen would say back: “No, no. You gotta take David and Stacy, too.”
As Ellen was telling Deanne that Steven had stopped breathing about 12:30 in the afternoon, Deanne stopped her.
“I thought he died in the middle of the night.”
“No, it was this afternoon. About 12:30.”
“I thought it was last night.”
“No, uh-uh,” Ellen put a period on it.
But the receptionist at Deanne’s office had said it was the middle of the night. All afternoon long, Deanne had been thinking about Steven dying in the middle of the night. Could she have somehow heard wrong? The next day, when Deanne confirmed what Ellen had told the receptionist, Deanne was unsettled. I realize you’re upset, Deanne thought. You’ve lost another child. But damn, you ought to know when he died. I certainly would remember whether it was the middle of the night or the middle of the day.
Deanne was in a state of shock about Steven’s death, and she didn’t really want to let her thoughts take her where they were headed. Still, she couldn’t help wondering, What are the chances of the same thing happening to both children?
She didn’t like where this train of thought led, because she couldn’t believe Ellen would do something so monstrous. Still, the thought nagged at her. Ellen did have that remote side to her. Deanne would never forget that time when the doctors asked whether to remove the life support for David and Ellen had turned to her to ask: “What would you do?”
The Autopsy
How could two children die within ten months of each other? At first Deanne didn’t suspect Ellen of having committed murder. What perplexed Deanne was the sheer improbability of it. She had nothing to go on, but it was gnawing at her insides.
When she went to work the next morning, she called a friend. The more they talked about the circumstances of Steven’s death, the more uncomfortable they became.
Neither of them could believe that Ellen had anything to do with it, but they also couldn’t justify what had happened. David’s supposed crib death at twenty-eight months still seemed wrong somehow. Then, they asked each other, how unlikely is it that Ellen just happened to be home from work when Steven died, and that Stacy and Steven happened to be asleep when David had died? Deanne still hadn’t forgotten how strange Ellen was about taking David off the life support: It was as if she couldn’t wait for his life to end. Deanne had let it go at the time as an odd reaction in a crisis, but now she saw Ellen’s coldness in a new light.
“You know, these stories don’t match,” Deanne said.
“I know.”
“Ellen told our receptionist Steven died in the middle of the night.”
“I know.”
“But it was in the middle of the day.”
The phone line was awfully silent for a moment or two before Deanne spoke again.
“I’ve got to talk to somebody about this.”
“I’ve been thinking the same thing.”
Neither of them wanted to accuse Ellen of murdering her own children, but too many facts pointed that way to be ignored. Both women had some friends who were policemen in the city, and Deanne’s friend knew one well enough to call and just ask about the likelihood of something like this happening. That’s all they wanted to know, and that’s how her friend put it when she made the call the next morning to Sergeant Daniel Duffy, a supervisor in the gambling section.
“I would really like to know how two children can die in the same family ten months apart, and there’s no investigation.”
Both of them believed that if the police were already looking into this, Ellen would have told Deanne about it.
“I just don’t understand it. What is the chance of that?”
“Is this hypothetical, or do you know something?” Sergeant Duffy wanted to know.
“No, I don’t know anything. And, you know, I don’t want to accuse a mother of doing something to those children. But it just doesn’t feel right.”
Sergeant Duffy got the name and address, and the information about the two boys’ deaths, as Ellen had explained it, and then he was told about a third child, a girl.
“Okay,” Sergeant Duffy said. “I’ll call you back as soon as I know anything.” After he hung up, he pulled his notes together, then rang Homicide. The caller, he said, wanted to remain anonymous, but the information, he would discover, was red-hot. The medical examiner had already started the autopsy on Steven Michael Boehm, and he wasn’t making much progress understanding what had killed the boy.
Dr. Michael Graham was a boyish-looking man whose clinical style didn’t overwhelm a friendly smile. He had been notified by the emergency room staff at Cardinal Glennon that the child had been home watching television on Monday morning when his mother found him unresponsive. Now it was Tuesday morning. The time was eight o’clock, and the dead boy had been brought to Dr. Graham’s pathology room for an autopsy. He was disturbed to receive the body of a boy who had suddenly died without explanation, but he had handled such cases before.
In fact, Dr. Graham had performed an autopsy on David Boehm less than a year earlier. In that case, he recalled, the mother had given a story that corresponded with the sudden death of a child. There was a viral illness of some kind, and Dr. Graham had seen sudden deaths associated with that kind of preexisting condition.
In David’s case there had been no injuries, and nothing really suspicious about the death, except that there was no medical explanation for it. As he looked down at Steven’s body, he remembered signing the record for David: sudden death of undetermined etiology following apparent viral syndrome. In other words, it was a natural death.
With Steven, the story was essentially the same. There were no injuries to the body. Just as he had in David’s case, Dr. Graham would take numerous samples of Steven’s tissues, blood, bile, and urine for lab analysis. He would have to await those results. At this point he was not comfortable saying that this too was a natural death, even though there was no evidence to suggest that anything was done intentionally to harm this boy.
This was the second, nearly identical death of a young male child in the same household within a year’s period, and Dr. Graham’s level of suspicion was raised severalfold.
When Steven had arrived at Cardinal Glennon, he had been in full cardiopulmonary arrest, but was still alive. This meant that he had had the typical, extensive blood sampling that is done. What was discouraging was that the analysis of those samples only excluded possibilities. Dr. Graham had found no clues as to why Steven had died.
With metabolic screening, he would be able to rule out any errors in metabolism that might be congenital. With other tests he would eliminate poisoning. He could exclude illness and rule out accidental death. The likelihood of two such accidents occurring in the same way, with the same exact result, argued against that conclusion, which led him to the supposition: How can you kill children without leaving any evidence?
It was possible with drugs, but all of the toxicology tests Dr. Graham conducted were negative for drugs. He even included therapeutic drugs, because Ellen was on some mild medication. Another way was electrocution, but there were no real indications of such a cause of death. Children could also be drowned. But this was an unlikely scenario, because to attempt to conceal an intentional drowning, the parent would have had to have dried the child’s hair and redressed them in fresh clothes. It didn’t seem to be the case here.
Death by asphyxia was high on Dr. Graham’s list of possibilities. It was difficult to strangle a child without leaving a mark about the neck area, but if someone either lay on top of a child or put something over the face, called mechanical asphyxia, there might not be telltale marks.
His findings left him with one course of action. The cause of death would be withheld pending the receipt of more laboratory tests. At least for now, he would have to say that the cause of death was undetermined, based on the completed autopsy and on microscopic and toxicological examinations.
In his ten years as a medical examiner, this was an extraordinary case: multiple deaths in the same family at the hands of a mother without leaving a mark on her sons’ bodies. Based on what he could surmise, he favored the mechanical asphyxia theory. Given the circumstances, it would be a double homicide, he knew. He also realized, though, especially considering the total absence of any physical evidence, that this was not the kind of accusation lightly made against a mother.
Facts had to be gathered. Detectives had to enter the case. And, Dr. Graham decided, this was one for Joe.
An Extraordinary Case
It was like any other day for Joe Burgoon. He sat at his steel desk in the spartan and slightly cramped offices of the Homicide Section. When he wasn’t found here, he was in his black Plymouth, going to a crime scene, or out on an interview, driving the familiar streets of St. Louis, listening to the crackle of the police radio as the details of a case looped around in his mind. It might be someone whose face was blown away by the blast of a sawed-off shotgun, or someone shot through, leaving no evidentiary slug. It might be less obvious, such as the discovery of a young woman’s remains stuffed in a wooden box down a grassy bank of I-70. Whatever the circumstances, this Irish-American cop had probably seen something like it before. He could correlate one or another of the particulars to a prior experience. Until the Ellen Boehm case.
The Wednesday morning when he saw Sergeant Duffy’s report, it was less than an hour old. Sergeant Duffy had confirmed that the medical examiner had the body, and that an autopsy had been conducted the day before. Joe Burgoon looked over all the facts, and of course they didn’t add up.
When the phone rang, Joe’s eyes didn’t move from the report on his desk.
“I got one here, Joe,” Dr. Graham said.
“Whaddya got?”
As Dr. Graham spelled it out—two young boys in the same family, found dead by their mother, no marks on the bodies—Joe was moving from his desk to the coatrack behind him, his neck pinched to keep the phone at his ear. He slipped into a tweed jacket and told Dr. Graham he would be right over. As the M.E. had already concluded, multiple deaths in the same family without any telltale marks on the bodies was extraordinary. What Joe made of this lineup of facts was one simple observation: Something was amiss here. That was all he needed.
The M.E.’s office was next door. It was a warm, late September morning, and Joe walked through the gate and up the steps to Dr. Graham’s office. As soon as the M.E. saw him coming, he got up from his desk and they both headed to the lab.
“We got a call,” Joe said.
“Yeah, I know,” Graham said back.
Right now Joe didn’t want to talk. He wanted to see the body. He shrugged as he looked down at the boy. The little hands. The whiteness of the eyelids. The straight light brown hair. Whatever could have been for this child would nev
er be.
Dr. Graham explained that this death had been sudden, that it had been unexpected. Dr. Graham excluded illness and accidental death.
“How can you kill a child without leaving a mark?” he asked out loud. “One way is electrocution, but I don’t see any real indication.”
“Uh-huh,” Joe was listening.
“I wouldn’t absolutely exclude it.”
“Uh-huh.”
“Drowning. That’s unlikely. Asphyxia. It would be unusual to strangle a child without leaving a mark. You’d have to lie on top of the child, or put something over the face.”
“Mechanical?” Joe queried.
“All the toxicology was negative, including therapeutic drugs. The mother is on some medication. That tested out. We’re going to run some tests. Maybe there’s something with the heart, a congenital anomaly.”
“Okay,” Joe muttered, shaking his head.
“Prolonged QT Syndrome,” Dr. Graham continued, “has to do with the interval between the Q-wave and the T-wave. The Q-T interval. When the time is longer than normal, you can get sudden death like this.”
Joe wasn’t necessarily taking all this in. In fact, he had already gestured that he was leaving, and as he headed for the door, Dr. Graham understood.
“Yeah,” the doctor said, nodding. “I’m concerned about the little girl.”
“Uh-huh. Bye, Doc,” Joe said as he slipped out the door.
Depending on the level of suspicion on Dr. Graham’s part, he typically had two recommendations to make to detectives. If nothing showed up on the initial examination and he was waiting for lab results, he might advise them to start looking into it. Once his suspicions were confirmed by medical evidence, or, if something was obvious from the autopsy, he would recommend that they push hard right away. In this case, without saying it, both men knew that this unsolved death was not going to be routine, but Dr. Graham did not see any reason to recommend an all-out, immediate push. They had their hands full as it was.
