CSI: WhiteCoat
Posted by WhiteCoat on March 1, 2008
Haven’t been on clinical duties for a few days, but had a discussion about forensics with a friend and thought of an interesting case.
This picture was from way back when digital cameras first came out. I think it was taken with an old Casio QV10. While grainy, the picture is still chilling.
This patient was brought in by paramedics, with the left side of her face missing from a shotgun wound. From the location of the wound and the trajectory of the pellets, she had apparently put the gun under her chin and pulled the trigger. You can see the shotgun pellets on the inside of her skull and the multiple fracture lines from her skull being pushed upward from the force of the blast. She was DOA.
She had a small stature and was apparently arguing with her boyfriend before this incident occurred.
Her boyfriend stated that she became so upset after the argument that she went into the bedroom and began throwing things around. Then he heard the shotgun go off and found her laying on the bed when he went in to see what had happened.
The girl’s family stated that the boyfriend had a history of being violent with the patient and believes that he may have killed her.
She was found fully clothed laying on the bed with no other objects found near her body.
Was it suicide or was it murder?
I’ll put the answer in the comments section.
March 1, 2008 at 11:24 am
The investigators believed it was a murder.
The shotgun was long enough and the patient body frame was small enough that she wouldn’t have been able to reach the shotgun trigger with her hands if end of the shotgun was under her chin.
Someone thought that she could have used one of her toes, but she had her shoes on.
Someone else suggested that she could have used some other object to actuate the trigger, but nothing else was found near the body.
The boyfriend was charged with murder, but I changed hospitals after this happened, so I never found out whether he was actually convicted.
Be interesting to see everyone else’s verdict after reading this.
March 1, 2008 at 1:51 pm
That was my first thought when you said she was short stature, how would she pull the trigger?
March 1, 2008 at 3:00 pm
See, I would argue very firmly (all other evidence aside) for self-inflicted. The scatter pattern on the x-ray is consistent with a right-handed approach (I’m presuming she was) person putting the trigger under her chin with her the stock pointed to the right (in order to reach the trigger), while a right-handed person (I’m presuming the boyfriend was) when shooting someone else who’s facing dead-on (as he would have had to be, in order to get some form of approximation of the under-the-chin (that is to say, if he was going to kill her, and make it look self-inflicted, he would have put the shotgun under her chin right-handed, which, thanks to the reflective property, would have made the scatter pattern appear on the right side of the x-ray.
(Does that make any sense at all? I’ve been awake for a very long time. *laugh*)
I am not a forensic scientist (though my girlfriend is), nor a firearms expert, but I am a writer and we know a lot about how to kill people.
March 1, 2008 at 3:02 pm
…well, it might or might not have made sense, but I certainly had epic parentheses-balancing fail…
March 1, 2008 at 9:11 pm
Doesn’t seem like there is enough evidence in your post to make a judgment, but shouldn’t they have checked for fingerprints on the weapon? How about a lie detector test?
Also, he could have moved the objects from her body before the police arrived. Was the victim suicidal before?
One last thing, if she was sooo upset, wouldn’t it make sense that the victim shoot her boyfriend instead of herself?
Chilling story btw.
I don’t know about the investigation or any of the other evidence. All that I was privvy to was the discussions with the detectives in the ED. It does make sense to have fingerprints, although if it was the boyfriend’s gun, they would probably have been on the gun anyway. I don’t think lie detector tests are admissible as evidence.
March 1, 2008 at 10:59 pm
Sub-mental shotgun wounds are not unusual. You’d have to measure the arms to see if they’d reach the trigger. Some shotguns have very long barrels–28 or 30″. I’m surprised also that the head was in as good a shape as it was. in contact 12 or 10 gauge wounds, there is usually bursting of the head with avulsion of the brain at the brainstem. I’d guess that this was a 20 gauge or a .410 weapon–plenty of blast, plenty of pellets, but not so much powder as to cayse devatstating wounds.
You can test her and him for gunshot residue– an iffy test. Fingerprints? 1. Guns are oily and tend not to take good prints. 2. if it’s his gun, there will be his prints on it, and hers, if it was in the house.
Bottom line, there’s not enough information here. If the arm measurements rule out the mechanical actuation of the trigger-he done it.
March 1, 2008 at 11:39 pm
I would imagine if she was able to kill herself in this supposed manner her chin would have suffered more damage.
March 2, 2008 at 1:47 am
Meh, I’m a short-person (5′4″
and have put a shotgun under my chin. Looks about right to me. You have to cock the gun upwards and to the right slightly to get your toe in. If you’re right handed, anyway.
March 2, 2008 at 3:48 am
I don’t know. I am still all skittish about gun talk ever since that person I knew was killed by her husband point blank in the head (brains on the wall) almost a couple of weeks ago now. The police haven’t come out and said it but I know details (inside sources -so much for HIPPA) and I know about his temper although…i thought they got along well. Goes to show you you really don’t know what goes on behind closed doors. I feel sick about it every time i imagine her last moments. Our older son hung out with their 2 boys briefly before they parted ways. When my older son was 6, he came running home crying because the man came outside and shot the family dog in front of the kids. My son wasn’t over there but was playing with kids in a yard adjacent to theirs. i could go on but I’ll stop. The man had a temper. Still…never saw it directed at his wife. What a lovely woman. You see this stuff on the news. you never think it is going to happen to someone you know. you just don’t. And it rocks your world. And it doesn’t feel as safe or happy now. I’m sorry. delete if you wish.
Also, the husband tried to kill himself with the hand gun but wasn’t successful. something about a flap and i don’t know what else. I heard he was critical now moved up to serious. When the person told me he improved…I hesitated and then with a question in my voice said “Oh that’s good…he’s a human being.” I feel guilty for not knowing what to say or feel about him. he had no mercy for his wife. Yet this was someone I crossed paths with. I feel for the kids. He is their father who killed their mother.
He was a hunter. Had a lot of experience with guns. Obviously had no problem executing his wife. Interesting that he must’ve flinched when he tried to do it to himself.
We had a young girl brought to the ER who tried to kill herself with a shotgun. she rigged it with a string but ended up shooting her shoulder. So then she drank Draino. Guess she wasn’t crying wolf. I remember when she was in the OR that the ER staff was saying that the damage from the draino was worse than the shotgun blast to her shoulder.
If only desperate, hopeless, angry people could stop, take a breath and step back from what they are doing. These people can not be in their right mind when they do these things…can they?
March 2, 2008 at 5:22 am
I’ve heard women do not aim for their head when trying to kill themselves. I voted for the hubby, they always seem to be the guilty party.
March 2, 2008 at 1:53 pm
I think this was a homicide.
March 3, 2008 at 2:25 am
Back behind the cobwebs in my brain, I remember seeing an episode of Unsolved Mysteries, likely in excess of 15-20 years ago. The investigation and story matched this one to the point where I question if it was the same case. Dr. W.C., when did digital cameras come out, and is this in any relation to the episode that aired many years ago, or a coincidence?
I guesstimate that this occurred back in 1995-97. I’m not aware that it was the basis for a story on unsolved mysteries. If it was, no one said anything to me about it. That could have been my second claim to fame after the Discovery Channel cameo.
March 3, 2008 at 11:30 am
If only desperate, hopeless, angry people could stop, take a breath and step back from what they are doing. These people can not be in their right mind when they do these things…can they?
The “funny” thing is, it can seem like a perfectly rational course of action, given your perception of the world at the time.
I decided against it when it dawned on me that I am, by definition, a novice at suicide. Moreover, since I’ve managed to screw up everything else in life, there’s a good chance I would screw that up, too. Why take the risk? Cancer, heart disease, or an idiot driver will do me in eventually, anyway. All I have to do is wait.
March 3, 2008 at 12:24 pm
Murder, if she’s fully clothed and didn’t hit the trigger with her toes. And she was little, so she couldn’t reach it with her hands.
But, I’d bag her hands, and do a gsr on both of them.
And from the angle, he came in, stuck it under her chin, she started to flinch away, which is why it blew out the left side of her face, he was holding the gun in his right hand, the angles are right.
Seen this before, with a guy who did do it to himself, only his reach was short too, so his head tipped back as he stretched to pull the trigger, the barrel was under his chin, and he blew his face off, we hauled him to the hosp, fully awake, where he got all kinds of reconstruction, and was ok, but not pretty. You could see right into his sinus cavities, it was kinda cool. Didn’t lose his vision either.
He was illegal from el salvador, and had gotten word that his entire family had been killed in some kind of uprising bullshit there.
March 4, 2008 at 1:43 pm
Anyone who would shoot the family dog in front of his kids (1) doesn’t deserve to have kids and (2) doesn’t deserve to live. I would have responded, to news that his condition was improving, with a “Damn! That’s too f-ckin’ bad…” IMHO, the world is a little lighter without violent psychopaths, particularly if they execute themselves and save taxpayers the expense of a trial, incarceration, etc. The kids are better off with relatives, hell, even foster care than if their twisted father gets them. Too bad he didn’t shoot himself first.
The shotgun blast? Murder. Most (not all) women would probably sooner shoot the boyfriend than themselves, and most female suicides are with pills &/or alcohol. Leastwise, that’s what I remember from my Psych and Behavioral Science classes.
March 4, 2008 at 3:05 pm
Reader 37- I am sorry you have had to deal with those kind of feelings. To say it is awful to feel such despair and believe there is no hope is an understatement.
I am thinking of 3 separate times in my adult life where because of specific events…I felt so depressed that breathing was an effort and I would’ve been perfectly happy to lie in the fetal position under my mattress until the problems went away.
But…actually…I had to be the strong one in the second incident and so fortunately snapped out of that plus had to go on the offensive which once in that mode actually brings energy with it. And my faith carried me through and the kindness of others.
The other 2 things were also a result of personal events out of my control but hurt me greatly. However, I can say…I never felt that I wanted to end my life. And fortunately didn’t last very long. I am someone who has a lot of faith and therefore ALWAYS believe there is hope. And it is true…as long as there is breath…there is always hope of something new and better around the corner. Life is amazing that way.
We all make mistakes and screw things up. But it is important when we recognize that and it is the first step to healing and recovery from a problem. Successful people fail a lot. No one is perfect. Once we purpose to work toward a solution, change a behavior or even roll with the difficult hand life deals us…we can take steps forward…even if they’re baby steps in the right direction to effect positive changes and results in our lives.
Also, I think when we go through the tough times…we learn from them and gain insight and sometimes that better equips us to help others going through a similar problem. And you know what? Just doing that reinforces within ourselves what we have learned and gives us more credibility when helping others because we have already walked in their shoes. Sometimes I think we are allowed to go through certain things so that we can be the rock and light in another’s life that might not have made it through to the other side.
Sometimes just talking with a wise and trusted friend, counselor, doctor, teacher, clergy, etc., helps. The things we internalize can magnify but when we release them they don’t hold us captive and maybe aren’t so bad after all.
And medication…a doctor or counselor might think you would benefit from that for a while.
I apologize for going on about that but feel passionately about never giving up on life…not on yours or anyone else’s.
I know of 3 people in my personal life who were suicidal. I am happy to say that they were all glad they were not successful.
one of them, was/is a dear friend who tried to kill herself several times in the years she was in 2 bad marriages. She was educated and worked in professions where she helped many people. As a friend, she helped me many times too. She was wonderful at helping others but couldn’t see the forest for the trees in her personal life. She had a traumatic childhood and so is probably in that mix too.
I don’t know or remember how she tried to kill herself before I knew her but the last event stands out. She decided to stand in a big hefty garbage bag sealed up so she couldn’t breathe, while standing in the closet. (Could one really do that or would instinct take over?) She said when she was getting light headed the door bell kept ringing. She finally got so annoyed that she got out of the bag and out of the closet to answer the door. It was a pizza delivery for the wrong house! That was enough to deter her and to my knowledge…she never did that again. That was 20 years ago and she is still around today.
I am sorry to go on so long but I feel passionately about this and feel badly when I perceive someone resigning themselves to such a negative fate. I know life can just SUCK sometimes…but the good will come along.
March 4, 2008 at 3:18 pm
Anonymous Surgeon -OK…then maybe I am not so bad for hesitating on saying something positive on his improved condition. The kids are all young adult in their twenties now.
The thing that is so perplexing, even though he had a temper is that he always seemed to be respectful of his wife and they were your typical family attending all the kids events, the kids were well behaved and are nice adults and it just is a shock…to all of us who knew them. I feel for the kids having this in their memories.
One night in response to a suicidal female ER patient, an ER nurse said to me, “You shouldn’t kill yourself over a guy…you stick around to make THEIR lives miserable!”
March 5, 2008 at 5:02 pm
[...] a potluck of non-neuroscientific news to keep you well-rounded : WhiteCoat Rants had an amazing forensics post and another on antidepressants and cold meds, Bayblab continues to explain How Quackery [...]
March 5, 2008 at 8:56 pm
SeaSpray:
That ER nurse’s comments are a variation on a theme I played in my head in my darker, younger years before I had 2 rugrats and a wonderful woman to give me concrete reasons to “hang on” through the rough parts.
I would never contemplate suicide (except for unrelenting physical pain with no hope of relief), simply because I would ‘never give the b*st*rds the satisfaction’. If, someday, I should lose the ability to help someone get better, perhaps I can still at least cause enough trouble to those that have
troubled me.
Revenge can be a great motivator for self-preservation in the short term
.
Also, very nice words in your comment to #37 — though not unexpected, considering your blog often makes me smile.
March 6, 2008 at 8:28 pm
Haha…Rugrats! (I loved that cartoon) They do make a difference as do the supportive people in our lives.
When I was a teenager and living with my aunt and uncle, my aunt said, “Patricia…if you’re ever depressed…go help someone else because you’ll be so busy helping them that you won’t think about yourself.” Looking back…I wonder if she was depressed… because she threw herself into everything, was an achiever and seem to help so many people, including giving me a good home to live in. I think it’s true that when we help others it elevates them and ourselves. Perhaps why it has been said it is more blessed to give than to receive.
This world can be a cold,lonely place and to someone suffering with depression or some other disorder it must be so overwhelming at times. Shoot…it can be that way for people that seem to have it all.
I have been blessed with special people throughout my life that I shall ALWAYS remember because of their faith in me when I didn’t believe in myself and because of their many kindnesses toward me. I hope I am that person to some people. But I digress.
That all being said…I’ll admit to a couple of amusing revenge thoughts, but I forgive pretty easily. You can’t forget but you can will to forgive and then move on. Forgiveness is healing both physically and emotionally and we are set free when we decide to forgive. Besides…if we don’t then we are allowing that offending person to still have power over us while they go on their merry way. Haha! So…I guess I am saying forgive so we don’t give them the satisfaction of thinking we are miserable! OK…maybe it’s not really supposed to be that way but it could work.
Anonymous surgeon…thank you for your kind words about here and in my blog. You are making this girl smile.
May 6, 2008 at 10:07 am
“IMHO, the world is a little lighter without violent psychopaths, particularly if they execute themselves and save taxpayers the expense of a trial, incarceration, etc.”
Psychopaths do not kill themselves. They love themselves too much. They kill people who get in their way (or annoy them).