Final Words: Reflections of a Forensic Pathologist


Prologue: Handprints

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Bright yellow, red, and blue artwork hung on my office wall. The handprints held my attention transforming from primary colors to dripping blood red. I stared at the finger-painted images, a framed Mother’s Day gift from my three sons. Their hands progressed in size, just like my boys progressed in age. I shut and reopened my eyes.

The snow fell thickly, a white blur against the black outside. At 4:30 p.m. it was already dark in Syracuse. A few reports lay open on my desk next to a cup of coffee, refreshment I needed in the afternoon.


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Description automatically generated with low confidence

Description automatically generated with low confidence

Earlier I had stood in my blue uniform jumpsuit before a small two-bedroom ranch, cream shingles with brown trim. Yellow tape that read “Crime Scene, Do Not Enter” lined the walkway. Police turned and nodded at me as I passed. The setting was muted although ten people were about. No one spoke. Tragedy permeated the air. I showed my badge, Medical Examiner, to the officer at the front door. 

Entering the house, I walked up the few stairs to a child’s bedroom, the only sound the swooshing of the plastic booties on my feet. 

“Morning, ma’am,” a detective said. He pushed open the bedroom door. I followed him into the room. 

Tiny, bloody handprints formed a crooked line from the floor to the wall to the door ––some right-sided, some left, many distinct enough to make a fingerprint identification. A few of the twenty or so marks were less defined and smeared, the individual imprints unevenly spaced as they determinedly made a path towards the hallway.

The detective closed the door to let me see the other side. There was staining on the lower half. The brass knob was crimson from slippery attempts by the child to turn it.

My throat caught. I blew deeply out of my nose in a forceful exhale. 

“Need anything, Doctor?” the detective said.

“Has this room been processed yet?” I said. Though I was responsible for the bodies, law enforcement was in charge of the scene.

In the middle of the wooden floor, between the twin bed and the door, lay a small blond child. At three years old, with a thin build, and a Dutch-boy haircut, he was a doppelgänger of my middle son, David, at that age. The little boy was on his stomach, arms outstretched, as if he had gotten tired while playing. Action figures, wood puzzles, and foam building blocks scattered around him. Except for the blood pooling around his head, the toddler could have been napping. His skin paled white but his palms and Superman pajamas were soaked red.

My gloved hands carefully turned his body over to examine the source of the bleeding, large wounds on his neck. Holding his head with my left hand, I noted that a serrated knife had been drawn against his neck with such tension it created little hatch marks from its edge along the adjacent skin. Four long incisions started near the ear and continued to the front at the Adam’s apple. One had gone deep and sliced into the jugular vein.

Noting the size and shape of injuries, I explained to the detective the kind of weapon the assailant used, showing him the unique pattern. He excused himself to inform the Crime Scene Investigators (CSI) about this new information.

Inspecting the child’s fingers revealed a small slice at the tip of the right index where he had tried to stop the blade. I imagined the last moments of his life––confused about the sudden pain, touching his neck with his hands.

Brushing the hair away from the little boy’s forehead, a cerise swelling bloomed, from a direct hit to his face or a fall at the time of fatal collapse. Lifting the pajama shirt to get a closer look at his chest and arms revealed bruises on the tops of the shoulders and biceps where someone had forcibly held him down. The circular contusions were made by large adult-sized digits. 

I envisioned the boy’s terror as he bled from the nick in his vessel. His airway uninjured, he might have screamed. The abstract sound hovered at the edge of my mind. Probing gingerly, I observed the carotid artery had been spared. If this large vessel in the neck had been pierced, the resulting blood loss would have caused unconsciousness in seconds. Instead, the injured vein led to a slower exsanguination making the ink for the trail of handprints. 

If the child had intended to escape the attack to find his mom, it was useless. She lay dead in the adjoining hallway, her head crushed by an ornamental rock wielded as a weapon by the same murderer. The mother was splayed on the floor, face down with arms extended toward her son’s bedroom. 

Blood soaked her long, brown hair and covered the wounds in the skull. Large clots formed a halo around her head. She had been dead longer than her son. I mentally arranged the timeline. The boy likely heard the fighting between his mom and the killer. How many blows did it take to silence the mom? Did the man gag her? Did she claw at him? These questions would wait until the bodies could be transported to the morgue where I would scrutinize them using surgical lights and dissecting tools.

Parent and child had been separated physically by the bedroom door but were still connected by their frantic attempt to reach one another. 

The search for the killer had begun before the murders when neighbors heard a loud argument and fighting at the house. Police arrived to find the two dead victims. The lady next door had seen the estranged husband entering the home before the fight. 

A dragnet ensued for the man using a picture on file from an order of protection issued earlier in the month. Officers reviewed closed circuit cameras at all gas stations and convenience stores within a five-mile radius. 

Inside the small bedroom, the detective’s pager buzzed. He checked the screen.

“Looks like they caught him,” he said. “He bought a pack of smokes less than a mile from here.”


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Description automatically generated with low confidence

Description automatically generated with low confidence

A knock on my office door interrupted this reflection. I hadn’t moved from my chair, the reports unfinished on my desk, my coffee long cold. 

My secretary said, “Dr. J, we’re leaving now. Don’t forget to lock up.”

The handprints had become artwork again. The blood was gone.

“Wait up,” I said. “I’ll walk out with you.”

I drove home sipping cold coffee.

As I opened the back door, feet thundered toward me. “Mommy’s home!” Arms found purchase around my knees, waist, and neck, as my three young sons welcomed me back to my world. My tears flowed freely, unrestrained by the confines of professionalism. They spilled onto my boys’ hair and faces, embraces returned. I held their bodies tightly.

The panic and sadness of the slain mother and child faded into the background, but the bloody handprints, a shadow behind my boys’ playfulness, remain fresh.

It is my job to bear witness and to remember. I speak for the dead.

Originally published by Tortoise and Finch 2017

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