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Thread: Medical question

  1. #1
    standing on head, typing one-handed... muse's Avatar
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    Medical question

    My scenario: Character was semi-strangled before being pushed down a large flight of stairs, breaking their neck. Body is lifted straightaway – 10/20 mins - and put in cold storage – a large freezer room, used for food. The body isn’t examined until a few hours later.

    My questions are:
    1: How soon would bruises show up on the body?
    2: Would the bruising show a) that the character was partially strangled, and b) that they were pushed down the stairs?
    In case it's relevant the character is a model, ultra-thin, fine-boned… and I really need something to point towards suspicious death.
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  2. #2
    Feeling lucky, Query? jclarkdawe's Avatar
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    Breaking one's neck does not necessarily mean instant death. It depends on exactly where the neck breaks.

    Bruising is somewhat dependent upon the individual, with some individuals showing bruising quickly, while others take longer for it to develop. Bruising, as commonly used, is the visible to the eye discoloration of an area caused by the leaking of blood from the broken capillaries. However, with a microscope one can see the broken capillaries immediately, before the leakage become sufficient to be observed by the naked eye.

    A broken or bruised hyoid bone is a good indication of strangulation.

    Strangulation is likely to show up with a visual exam without instruments, even if death does not result. It can be possible to get thumb prints. Thumb marks are often left. Being pushed may or may not leave any signs, even with instruments. The broken neck will indicate differently then the strangulation and may be visible on a visual exam without instruments.

    Coronary death will cause the end of blood flow from coronary action. Blood flow will continue due to gravity, as the blood slowly seeks the lowest point of the body. Cold will slow the flow of blood, but not stop it.

    Bruising will continue in areas of the body that are lower then other areas. It will leak out of the capillaries. This will present somewhat differently then post-mortem lividity, where the blood remains within the capillaries but are at the lowest point of the body.

    Police would almost immediately identifiable as suspicious. Medical examiner at the scene would be even more suspicious. Autopsy would confirm the fact of an assault prior to death. Strangulation tends to be difficult to hide, as some level of force needs to be used to crush the wind pipe.

    Understand that there is a significant difference between strangulation and suffocation, both in cause and effect, and in how they present for an autopsy.

    Jim Clark-Dawe
    EQUINE LIABILITY: WHAT EVERY HORSEOWNER NEEDS TO KNOW Published 2002 sold through

    GEORGE'S STORY MORTON'S FORK Let's see how many agents I can catch with the query

    THE NEXT STEP ASHES TO ASHES INTO THE VALLEY (48,00079,000 words) Need to up my game.

    THE PICTURE Might be my next project.

  3. #3
    practical experience, FTW
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    To add to Jim's comprehensive comments, the fact that the body was moved is sufficient to immediately classify this as a suspicious death. The results of the autopsy will corroborate a finding of homicide.

  4. #4
    Feeling lucky, Query? jclarkdawe's Avatar
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    I should mention that I'm addressing manual strangulation from the front. Ligature strangulation produces very different signs and manual strangulation from behind (i.e., "choke holds") also produces different signs. However, from the description, manual strangulation from the front seems the most likely scenario.

    Ultra-thin people tend to bruise easier as they don't have as much padding over their skeleton. I'm not sure I've ever seen any references to "fine boned." Brittle bones tend to break easier, but seems unlikely with the character described.

    Jim Clark-Dawe
    EQUINE LIABILITY: WHAT EVERY HORSEOWNER NEEDS TO KNOW Published 2002 sold through

    GEORGE'S STORY MORTON'S FORK Let's see how many agents I can catch with the query

    THE NEXT STEP ASHES TO ASHES INTO THE VALLEY (48,00079,000 words) Need to up my game.

    THE PICTURE Might be my next project.

  5. #5
    standing on head, typing one-handed... muse's Avatar
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    Thanks ironmikezeo.

    And thank you so much for the extensive answer, Jim, much appreciated.

    If I'm reading you correctly, bruising could show on the neck, especially if she were prone to bruising easily? (And yes, it was a face-to-face attempted strangulation.)

    She is killed instantly by the fall down the stairs. There's no medical examiner at the scene, so no autopsy can be performed for a few days. The body is moved by other people in the house because it's lying in the middle of the foyer. So, as such, wouldn't raise any suspicion.

    I have 2 police officers arrive 2-3 hours later and want them to be suspicious. Hoping the marks on the throat would be enough. Originally, I thought maybe she would have bruises on her back from being pushed, but I'm guessing that may be asking too much?

    Again, thanks for the help.
    Last edited by muse; 11-13-2017 at 02:41 PM.
    PUBLISHED:
    Novel:
    Where There's Smoke. Links:

    Short Story: A Killer Week, available to read in the Anthology Crime AfterCrime

    CURRENT WORKS:

    The Hungry Ghost - Mystery/Suspense. Looking for beta readers. PM if interested.

    Legacy - The Beginning - First Draft - 54,443words so far.

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  6. #6
    Benefactor Member WeaselFire's Avatar
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    Quote Originally Posted by muse View Post
    She is killed instantly by the fall down the stairs. There's no medical examiner at the scene, so no autopsy can be performed for a few days. The body is moved by other people in the house because it's lying in the middle of the foyer. So, as such, wouldn't raise any suspicion.
    Two problems. Bodies, in US jurisdictions, don't get moved except by medical examiners for any unattended death. Other people moving a body is a crime and they become automatic suspects. Police showing up hours later happens only if they aren't called and, at least in the current world, someone will call. Bodies get priority attention and EMS response, if it's an unattended death, since only the medical examiner or a medical doctor can pronounce them as dead.

    Jeff

  7. #7
    Feeling lucky, Query? jclarkdawe's Avatar
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    Quote Originally Posted by muse View Post
    Thanks ironmikezeo.

    And thank you so much for the extensive answer, Jim, much appreciated.

    If I'm reading you correctly, bruising could show on the neck, especially if she were prone to bruising easily? (And yes, it was a face-to-face attempted strangulation.) Bruising WOULD show up on the neck. This area has a fair amount of strength that requires some level of force to interfere with. There's going to be some discoloration of her neck. The only question is the time line from the strangulation to going down the stairs. There's a possibility, not a probability, that if this period is brief enough, and her skin is dark enough, the bruising might not be visible during that time period.

    However, there's going to be a few minutes between the strangulation and cardiac death. Blood would leak out of the broken capillaries even after cardiac death, unless the neck is the highest point in the body. With what I'm seeing of your time line, there would be a distinct discoloration on the neck by the time the police view the body. The only reason the police would not notice this is if the police are too stupid to live, or if she is wearing a scarf or something else around the neck.


    She is killed instantly by the fall down the stairs.

    Well, not exactly. People do not die like a light switch, but as part of a process. In the case of cardiac death, with the type of injury you want, regular heartbeats would cease within thirty seconds of the fall. However, there would be some level of cardiac function, producing marginal blood flow, for up to five to ten minutes after death. This is important to understand because bruising from blood flow will continue at some level for a while.

    In this case, you're talking about a fracture in the C1 to C3 range of the spine. You need a complete dislocation of the spine with lateral separation. In other words, the head will no longer be in line with the torso. This is the same type of fracture as a proper hanging will accomplish. At that level, the separation causes a complete termination of any signals from the brain to the heart. This means that the heart will almost immediately stop normal beats, but the heart will continue to function at some level for up to ten minutes. This is why the doctor at executions does not check the victim immediately. Although death can not be avoided at the time of the dislocation, death is not complete for quite a few minutes.

    There's no medical examiner at the scene, so no autopsy can be performed for a few days. With a moved body, there's no way this is not a suspicious death. There's no way a medical examiner will not go to the scene. The body doesn't care how long it waits, the cops are paid by the hour, no one is in a rush. Don't confuse a medical examiner going to the scene with an autopsy. The medical examiner is going to want to view the body in situ to determine how the post mortem lividity will operate. There's no way pictures will tell the medical examiner exactly what he or she needs to know. Further read Weasel's post.

    The body is moved by other people in the house because it's lying in the middle of the foyer. So, as such, wouldn't raise any suspicion. Balls. Cops would have to be too stupid to live to not be suspicious.

    I have 2 police officers arrive 2-3 hours later and want them to be suspicious. Hoping the marks on the throat would be enough. Originally, I thought maybe she would have bruises on her back from being pushed, but I'm guessing that may be asking too much? Best case I know of for a push showing up was the guy's hands had oil on them. Left great marks on the victim's shirt. For bruising to occur, capillaries have to be broken, which means there has to be resistance. Often in pushing there's no resistance so there's no bruising.

    Again, thanks for the help.
    Read Weasel's and Mike's responses. A moved body is suspicious. As an EMT I've had to move bodies for various reasons. Cops are never happy about the fact, even when the circumstances are indicating a natural death.
    Last edited by jclarkdawe; 11-13-2017 at 07:43 PM.
    EQUINE LIABILITY: WHAT EVERY HORSEOWNER NEEDS TO KNOW Published 2002 sold through

    GEORGE'S STORY MORTON'S FORK Let's see how many agents I can catch with the query

    THE NEXT STEP ASHES TO ASHES INTO THE VALLEY (48,00079,000 words) Need to up my game.

    THE PICTURE Might be my next project.

  8. #8
    down the rabbit hole of research... CWatts's Avatar
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    Quote Originally Posted by WeaselFire View Post
    Two problems. Bodies, in US jurisdictions, don't get moved except by medical examiners for any unattended death. Other people moving a body is a crime and they become automatic suspects. Police showing up hours later happens only if they aren't called and, at least in the current world, someone will call. Bodies get priority attention and EMS response, if it's an unattended death, since only the medical examiner or a medical doctor can pronounce them as dead.

    Jeff
    Quote Originally Posted by jclarkdawe View Post
    Read Weasel's and Mike's responses. A moved body is suspicious. As an EMT I've had to move bodies for various reasons. Cops are never happy about the fact, even when the circumstances are indicating a natural death.
    Agreed. I don't have any special expertise to add, just that, as a reader I'm hoping these accessories to her murder are your antagonists. People who would casually move a dead woman around like a piece of furniture are...not people I care to read about.

  9. #9
    Rewriting My Destiny Cyia's Avatar
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    Quote Originally Posted by muse View Post
    I really need something to point towards suspicious death.
    I think you covered that with "freezer."

  10. #10
    standing on head, typing one-handed... muse's Avatar
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    Quote Originally Posted by WeaselFire View Post
    Two problems. Bodies, in US jurisdictions, don't get moved except by medical examiners for any unattended death. Other people moving a body is a crime and they become automatic suspects. Police showing up hours later happens only if they aren't called and, at least in the current world, someone will call. Bodies get priority attention and EMS response, if it's an unattended death, since only the medical examiner or a medical doctor can pronounce them as dead.

    Jeff
    The book is set in the UK, where it's probably the same, Jeff.

    In this instance, though, the group are on an island, cut off from the mainland. No one will be able to get to them for a couple of days.

    The two police officers arrive unexpectedly on a different matter and are cut off, too.

    Quote Originally Posted by jclarkdawe View Post
    ruising WOULD show up on the neck. This area has a fair amount of strength that requires some level of force to interfere with. There's going to be some discoloration of her neck. The only question is the time line from the strangulation to going down the stairs. There's a possibility, not a probability, that if this period is brief enough, and her skin is dark enough, the bruising might not be visible during that time period.

    However, there's going to be a few minutes between the strangulation and cardiac death. Blood would leak out of the broken capillaries even after cardiac death, unless the neck is the highest point in the body. With what I'm seeing of your time line, there would be a distinct discoloration on the neck by the time the police view the body. The only reason the police would not notice this is if the police are too stupid to live, or if she is wearing a scarf or something else around the neck.
    The victim is fair-skinned, so the bruises will show up on her skin. Thanks for the extra info.

    Quote Originally Posted by jclarkdawe View Post
    In this case, you're talking about a fracture in the C1 to C3 range of the spine. You need a complete dislocation of the spine with lateral separation. In other words, the head will no longer be in line with the torso. This is the same type of fracture as a proper hanging will accomplish. At that level, the separation causes a complete termination of any signals from the brain to the heart. This means that the heart will almost immediately stop normal beats, but the heart will continue to function at some level for up to ten minutes. This is why the doctor at executions does not check the victim immediately. Although death can not be avoided at the time of the dislocation, death is not complete for quite a few minutes.
    I didn't know that. Useful info, thanks.
    Quote Originally Posted by jclarkdawe View Post
    Best case I know of for a push showing up was the guy's hands had oil on them. Left great marks on the victim's shirt. For bruising to occur, capillaries have to be broken, which means there has to be resistance. Often in pushing there's no resistance so there's no bruising.
    That's actually given me an idea, Thanks, Jim.

    Quote Originally Posted by CWatts View Post
    Agreed. I don't have any special expertise to add, just that, as a reader I'm hoping these accessories to her murder are your antagonists. People who would casually move a dead woman around like a piece of furniture are...not people I care to read about.
    Never considered that the reader would think their behaviour cavalier. Good point.
    PUBLISHED:
    Novel:
    Where There's Smoke. Links:

    Short Story: A Killer Week, available to read in the Anthology Crime AfterCrime

    CURRENT WORKS:

    The Hungry Ghost - Mystery/Suspense. Looking for beta readers. PM if interested.

    Legacy - The Beginning - First Draft - 54,443words so far.

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  11. #11
    standing on head, typing one-handed... muse's Avatar
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    Quote Originally Posted by Cyia View Post
    I think you covered that with "freezer."
    PUBLISHED:
    Novel:
    Where There's Smoke. Links:

    Short Story: A Killer Week, available to read in the Anthology Crime AfterCrime

    CURRENT WORKS:

    The Hungry Ghost - Mystery/Suspense. Looking for beta readers. PM if interested.

    Legacy - The Beginning - First Draft - 54,443words so far.

    Website

    Twitter
    /Pinterest /Facebook/Goodreads/ Instagram






  12. #12
    Feeling lucky, Query? jclarkdawe's Avatar
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    Quote Originally Posted by muse View Post
    In this instance, though, the group are on an island, cut off from the mainland. No one will be able to get to them for a couple of days.
    Is this set modern day? Because there's a procedure in that situation that the medical examiner will have the police follow.

    Basically the medical examiner will have the police officers strip the victim, lying the victim on a solid surface such as a table. The officers will then take close up pictures of the body from head to toe. Hands will be placed in paper bags to protect any defensive injuries and possible DNA. Swabs will be taken of the palms and private areas of the victim. Rectal temperature should be taken if a thermometer is available. Scrapings of any blood will be gathered. I believe the victim is wrapped in cloth such as a sheet and placed in cold storage when this is finished. Each joint will be moved to test if there are any breaks, assuming rigor mortis has not set in. Basically any unskilled exam that can be performed will be performed. Video is nice and available through a smart phone.

    Murders are best solved as quickly as possible, and determining whether she is a murder victim is vital to that. You can tell people what to look for and much can be done without any instruments.

    Jim Clark-Dawe
    EQUINE LIABILITY: WHAT EVERY HORSEOWNER NEEDS TO KNOW Published 2002 sold through

    GEORGE'S STORY MORTON'S FORK Let's see how many agents I can catch with the query

    THE NEXT STEP ASHES TO ASHES INTO THE VALLEY (48,00079,000 words) Need to up my game.

    THE PICTURE Might be my next project.

  13. #13
    standing on head, typing one-handed... muse's Avatar
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    Quote Originally Posted by jclarkdawe View Post
    Is this set modern day? Because there's a procedure in that situation that the medical examiner will have the police follow.

    Basically the medical examiner will have the police officers strip the victim, lying the victim on a solid surface such as a table. The officers will then take close up pictures of the body from head to toe. Hands will be placed in paper bags to protect any defensive injuries and possible DNA. Swabs will be taken of the palms and private areas of the victim. Rectal temperature should be taken if a thermometer is available. Scrapings of any blood will be gathered. I believe the victim is wrapped in cloth such as a sheet and placed in cold storage when this is finished. Each joint will be moved to test if there are any breaks, assuming rigor mortis has not set in. Basically any unskilled exam that can be performed will be performed. Video is nice and available through a smart phone.

    Murders are best solved as quickly as possible, and determining whether she is a murder victim is vital to that. You can tell people what to look for and much can be done without any instruments.

    Jim Clark-Dawe
    I'm guessing this procedure would be basically the same in the UK?

    This is great info that I can add to the story for a little colour. Thanks a million, Jim.
    PUBLISHED:
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    Where There's Smoke. Links:

    Short Story: A Killer Week, available to read in the Anthology Crime AfterCrime

    CURRENT WORKS:

    The Hungry Ghost - Mystery/Suspense. Looking for beta readers. PM if interested.

    Legacy - The Beginning - First Draft - 54,443words so far.

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  14. #14
    Feeling lucky, Query? jclarkdawe's Avatar
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    Forensic medicine is basically the same throughout the world. There are things you can discover from dead bodies and those are only limited to the technology available to a person. Even before modern forensic science, we've known that examining bodies can tell us how someone died. So I would assume that any medical examiner would employ the same methods to examine a body that he or she can not get to physically.

    Stuck on an island today is so much different from what it was even twenty years ago and using modern communications to bring things up to date seemed like an idea you'd like.

    Jim Clark-Dawe
    EQUINE LIABILITY: WHAT EVERY HORSEOWNER NEEDS TO KNOW Published 2002 sold through

    GEORGE'S STORY MORTON'S FORK Let's see how many agents I can catch with the query

    THE NEXT STEP ASHES TO ASHES INTO THE VALLEY (48,00079,000 words) Need to up my game.

    THE PICTURE Might be my next project.

  15. #15
    standing on head, typing one-handed... muse's Avatar
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    Quote Originally Posted by jclarkdawe View Post
    Stuck on an island today is so much different from what it was even twenty years ago and using modern communications to bring things up to date seemed like an idea you'd like.

    Jim Clark-Dawe
    Oooh, I do. .
    PUBLISHED:
    Novel:
    Where There's Smoke. Links:

    Short Story: A Killer Week, available to read in the Anthology Crime AfterCrime

    CURRENT WORKS:

    The Hungry Ghost - Mystery/Suspense. Looking for beta readers. PM if interested.

    Legacy - The Beginning - First Draft - 54,443words so far.

    Website

    Twitter
    /Pinterest /Facebook/Goodreads/ Instagram






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