A LITTLE POISON IN MY LIFE by ltm66165

VIEWS: 2 PAGES: 7

									                           A LITTLE POISON IN MY LIFE


       My medical specialty, forensic pathology, involved me with a wonderful and terrible

assortment of people, some of whom you might prefer to avoid. Forensic pathology, to

remind you a bit, is that area of medicine dealing with cause and explanation of injuries. It

deals with those twists of fate that bring about sudden, unattended death without obvious

cause, as well as violent; unnatural, and suspected suicidal, accidental and homicidal

deaths. The issues are public safety, public health, civil as well as criminal justice, and

public peace of mind. These constitute about a fifth of all deaths. The work experiences of

the various forensic pathologists are similar in the investigation of cases but are far from

duplicative. One extreme variation from the typical in my own career is the many

encounters with arsenic poisoning.

       Mystery fiction not withstanding, homicidal poisoning is rare. In the past half-

century a forensic pathologist would likely not encounter an arsenic homicide, suicide or

accident in an entire career. Arsenic has been more accessible to the public in the more

rural states but rare even there. Fate has dealt me about 50 cases, fatal or non-fatal,

homicide, suicide, accident and --- unknown.

       I have chosen three cases of attempted and of accomplished arsenic homicides to tell

you about. I make no apologies for what approaches humor amidst the sadness and

depravity of these all-too-true tales. My versions of my involvement in these episodes will

sound self-serving. So be it. The cases are described as I encountered them. I changed

personal names where I deemed it appropriate.



                              Number One: EXTERMINATOR

       My secretary rapped on my door and tilted her head in to ask, “Can you talk with

Mr. Abbott? He’s a medical student and wants to ask you about a case.” I wasn’t going to

finish the paper work in front of me that day anyway but I had to try. “I’m sorry, Myra, I
just can’t. You know I always want to talk with students but I have to finish this stuff.”

She offered, “I’ll tell him to call another day when things ease up. He wanted to ask you

about arsenic.” Arsenic! To me a dynamic word! “Well, ask him to come in but for just a

minute.”

       The medical student had been assigned a patient, a young man, who had been in the

hospital ten days with an undiagnosed illness. Blood chemistry disarray, high

concentrations of blood sugar and the development of tingling and weakness in the hands

and feet led to a tentative diagnosis of juvenile diabetes with complicating nerve damage.

But out of the blue had come results from an analysis request sent to a reference laboratory

elsewhere days before, a test for toxic metals. The results were normal for each metal

except for arsenic which was present in huge amounts. It fitted! This explained the signs

and symptoms as well as the abnormal lab values and the nerve problems. The student,

who was to make a presentation about arsenic to his fellow students and attending medical

staff, came to me to expand on what he might say about the poisonous metal that was not in

his texts. I remember our dialogue went something like this: PH: “I don’t suppose you

know if your patient is married?” A: “He is.” PH: “Would you know if his wife was ever

married before?” A: “She was.” PH: “Do you know if husband number one is alive?” A:

“I do, he isn’t.” PH: “You certainly would not know where he died.” A: “He died in the

local hospital here three or four years ago. His hospital autopsy report said some sort of

kidney infection.” PH: “You are amazing! Follow me!” I dropped my paper work and

bolted out of the office.

       Our office and lab space shared a building with the hospital’s pathology

department. One minute and three flights of stairs later, student in tow, I was opening the

files for the husband-number-one’s autopsy records. They revealed that nothing had been

found at that examination beyond trivial urinary tract problems. The patient’s illness

history was of repeated bouts of belly pain, nausea and vomiting, followed by tingling and

nerve damage in his hands and feet. Classic arsenic signs and symptoms indicating
                                             2
repeated episodes of poisoning! A quick look with a convenient microscope at the glass

slide of the autopsy’s liver sample revealed mitoses (a very rarely seen change in the nuclei

of the liver cells -- a change I was finding in most arsenic cases and no others).

       I notified the patient’s docs and telephoned the police chief and the District

Attorney where the patient and his wife lived. The DA knew the couple and had been the

scoutmaster who awarded an Eagle Scout banner to the deceased husband when he was a

lad some ten years before. The DA quickly drew up an exhumation order. Our subsequent

examination of the remains confirmed the diagnosis of arsenic poisoning. I remember yet

the telltale white stripes, so-called Mees lines, across the finger nails. That first victim’s

mother, we found, suspected arsenic herself and was going to contact me.

       The surviving husband responded well to treatment and to eating food not prepared

by his wife. The precaution was taken of banning all edibles except those prepared in the

hospital kitchen. He was informed of his condition. He opted to split from his wife. The

DA, better know in his county for his poetry than for prosecuting crime, led the attack on

finding the person who added arsenic to the diet of two men who had married the same

woman. Despite the efforts of the DA and law enforcement organizations no indictment

was ever made. Although the grass widow/nee widow was the chief suspect the DA

contended there was never sufficient evidence to try her in court. The mother of the first

victim kept a close eye for years on Ms. Almost-twice-a-widow, even after the later moved

out of state. The last I heard from the Mom was that the suspect wife had married still

again -- this time to an Orkin Man!



                           Number Two: THE DEATH PENALTY

       Dr. Bob, one of the fine hospital pathologists who volunteered to be a medical

examiner for his county as well as performing some of the forensic autopsies, telephoned

and set a tragically complex case in motion. He prefaced his remarks with, “What I want

to ask you about is not a medical examiner (forensic) case. I did a hospital autopsy and
                                             3
can’t find anything to explain the death. I thought maybe you could advise me how to

proceed.” When I asked him to tell me about the patient’s immediate history, he related

how the middle age man came to the hospital after days of increasing abdominal pain,

nausea and vomiting. His behavior became bizarre but mood-relieving drugs did little.

His blood chemistries showed many elevated values but nothing specific. After a day or

two of improvement on non-specific support therapy he was discharged home. There he

became manic and started vomiting again. He was returned to the hospital where there

was vigorous but unsuccessful effort to treat his falling blood pressure. The next-of-kin

granted permission for an autopsy. The pathologist relating this story said he found

nothing abnormal at autopsy including the microscopic tissue examination. About one-

quarter of the way into his tale, I blurted out, ’Who gave him the arsenic?’ There had been

a pause, then a muttered something about not knowing anything concerning any arsenic,

and then Dr. Bob continued his saga. He said he had put a set of the microscopic tissue

slides in the mail; I said I would look at them, think about the story and call him back. The

slides had already arrived so I quickly hauled them to my microscope. The only

abnormality of note was of nuclear changes in liver cells I had come to associate with

arsenic poisoning. My pathologist friend was surprised to hear from me so quickly and

promised to send me for chemical testing tissue fragments he had retained from the

autopsy.

       The Office of the Chief Medical Examiner’s excellent toxicology laboratory

demonstrated excessive concentrations of arsenic in the submitted tissue. I telephoned the

results quickly to my friend, Bob, who asked, “But what do I tell the family?” My response

was, “For now tell them nothing but get the word to the Sheriff’s Department and to the

DA as quickly as possible! I’ll be glad to speak with them as well.” My parting admonition

was, ‘Tell them to check on illnesses in the family similar to this victim’s, Oh, yes, and to

ask the wife where she bought the Singletary’s Pest Control.”

       “Whaaat?”
                                               4
       Singletary’s was a two per cent solution of arsenic salts hawked from Rocky Mount

NC as a solution to rat and other pest problems. An impressive number of Tar Heel

women had used it to remedy pesky or pesty problems with husbands and other male

family members. Even an occasional fellow had tried it on wife or girl friend. My smart-

alecky rat poison reference to Bob was in part to anticipate the inevitable questions about

the source of the arsenic.

       Bob called back in a few days and opened with, “The Sheriff says Mr. XX was not

married.” He let that sink in a moment before continuing facetiously with, “But he had a

house keeper who was either the worst cook in the county or was an unmitigated jinx. She

has lost several relatives, friends and employers in recent years, people who had illness

similar to Mr. XX’s. And she was cooking for them! And the search of her trash revealed

an empty container -- not of Singletary’s -- but of Terro.” One of the Terro products was an

arsenic-containing rat poison and that was the bottle the Sheriff’s Department found. The

suspect, Velma B., was interrogated and finally admitted poisoning Mr. XX. She was

indicted for one murder, tried and found guilty and sentenced to death. She eventually

owned up to fatally poisoning several people including her mother. Her first husband had

died in a house fire one day while she was grocery shopping. Exhumation and autopsy

revealed no arsenic but he had indeed been alive in the fire. She eventually admitted

setting the fire while her drunken, abusive husband slept. She gave arsenic to her daughter

and son-in-law but they survived. High poison levels were demonstrated in the several

bodies after exhumation and autopsy. Two of her victims previously had unrevealing

hospital autopsies because the deaths had not been suspicious and thus had not been

reported to a Medical Examiner. Mrs. Barfield was executed by lethal injection. This was

an especially sad case but also a remarkable repetition of what has been seen in court and

in texts reporting arsenic poisoning for several hundred years.



               Number Three: LOOK BOTH WAYS BEFORE CROSSING!
                                      5
       Arsenic cases were rare enough even at the large general hospital in our city that

each one was the first of its kind to most of the medical staff. So when another patient who

had been a patient there for a week or two with an unknown ailment was almost

accidentally found to have arsenic poisoning, I was asked to see him and confer with his

treating physicians. This man in his 30s was rapidly improving but still had some nerve

damage. We got along well enough but he wasn’t one to volunteer much information. I

determined that he had been zapped at least twice which rather took the case out of the

accidental category and also made suicide attempt unlikely. As was typical then, the

medical staff found communicating with law enforcement almost unimaginable. So I was

soon on the telephone with the police chief of the small Harnett County town that was the

home of the arsenic-stricken patient. I had to be in the Chief’s neighborhood in a few days

for court anyway so we met in his office for a chat about poisoning and about arsenic in

particular. He was keen and interested but admitted to being at a loss on how to start the

investigation. After first apologizing in advance for seeming presumptuous, I told him of

several instances where a very direct approach had been successful. An example would be

informing the suspect wife that the husband’s death (or illness as the case might be) was

due to arsenic poisoning and then asking where she got the arsenic. Crude but effective in

several cases! I contend that a sense of unbearable guilt lies close to the surface

psychologically for many of the poisoners as it does with a large proportion of those who

have committed other criminal acts. It often takes little to precipitate a confession. When,

my notion goes, they are surprised with the truth they are likely to own up to their acts. In

this instance the Chief was obviously dubious but said he would work out something.

About two weeks later I had to be in Harnett again and went by to see the Chief. He was

obviously very pleased with himself. He had backed into ‘success’ with something like the

approach I had suggested. The conversation after he told the man’s wife that her husband

had been hit at least twice with rat poison evidently went something like the following. He:

“I don’t suppose you know how he got the poison.” She: “Yeah, I put it in the bastard’s
                                           6
food.” He: “You did?!” She: “Yeah.” He: “Several times?” She: “Yeah.” He: “I don’t

suppose you have it here.” She: “It’s right here.” He: Will you give it to me?” She:

“Yeah, sure.”

         “Chief, that’s wonderful. Congratulations! I’m glad that worked for you. Do you

have it here at your office?” He did. From a desk drawer he pulled a cereal-size box and

handed it to me, evidence tags and all. My expression and color must have changed so

drastically at that point that he thought I was becoming ill. The box was of D-Con, a rat

poison indeed but one using warfarin -- an anticoagulant that causes the rats to

hemorrhage -- not arsenic. After I told him there was no arsenic in D-Con we sat in silence

a few minutes and then hypothesized murkily about some unlikely alternate scenarios. He

said he’d pursue it further and I left.

         The Chief telephoned a week or so later. It seemed that in addition to having a wife

who was feeding him D-Con, the fellow had a girl friend zapping him with arsenic

(Singletary’s!). The Chief and the DA had determined that this was one of the meanest,

nastiest abusers of women they had ever heard of and that if any one ever needed

poisoning, it was he. And if any one was going to poison him, these two women were the

ones to do it!

         That was twenty five years or so ago and I’ve tried to avoided Harnett County ever

since.




                                               7

								
To top