Spelunking Death: Between a Rock and a Hard Place

Spelunking, or caving, is a popular but dangerous sport. I’ve been in caves before and they’re fairly spooky places. As a kid I went on several trips where we were taken deep into one cave or another. Each was dark, cold, musty, and left you with a feeling that the real world was far away. I grew up in Huntsville Alabama, a city spread over hundreds of caves. In 1805 the city was founded by John Hunt after he camped near where water rose from one of these caves to create the Big Spring. Big Spring Park, where I played many Little League baseball games, remains a focal point in Huntsville.

North Alabama, with its ubiquitous limestone, is the ideal area for cave formation. As the water seeps into and eats away the limestone, caves of varied sizes and shapes are produced, including the famous Cathedral Caverns near Woodville. So caving is a popular sport in the area. So much so that there is a volunteer organization known as the Huntsville Cave Rescue Unit.

This week a tragic caving accident occurred near Salt Lake City Utah. Twenty-six year old John Jones, an experienced spelunker, became wedged head-down in a very tight space and could not be rescued. After 28 hours he died. Because of the danger and difficulty in recovering his body, efforts to remove it have been abandoned and the cave known as Nutty Putty will be closed so that John Jones’ final resting place cannot be disturbed.

How did this tragedy happen? What caused Mr. Jones’ death?

It seems that he, along with 11 friends, all experienced cavers, entered the cave last Tuesday. Jones, who is 6 feet tall and weighs 190 pounds, a medical student at the University of Virginia, a husband, and the father of an eight-month-old, was attempting to slip through an area known as Bob’s Push, a narrowing that measured only 18 inches wide and 10 inches high. He apparently became wedged in a head-down position and could not free himself.

As many as 50 rescue workers began their efforts to free him at approximately 9 p.m. and over the next 28 hours worked frantically. At one point they managed to pull him back some 12 feet, accomplishing this with the use of a pulley system that was anchored to the ceiling of the cave. They managed to get him some food and water but then the pulley system failed and he slid back into the crevice. apparently wedging him in even tighter than before. His condition rapidly deteriorated and he died after some 28 hours.

What actually caused the death of John Jones may never be known, but there are several possible mechanisms that could have come into play.

Hypothermia: This is a significant and dangerous drop in the core body temperature and is a well known cause of death in people with prolonged exposure to cold environments. Since this is November and the cave is located near Salt Lake City, the temperature and conditions inside the cave could easily have caused hypothermia in John Jones. He was apparently some 700 feet from the cave’s entrance and approximately 150 feet below ground at the time he became trapped. It is likely the cave was cold and damp so that as time went by his body lost heat. With no way to protect him from this environment he could easily have slipped into hypothermia and died from this alone.

Asphyxiation: Another possibility is that his death was due to asphyxia. The mechanism for this would be similar to how a boa constrictor works. When a boa wraps around its prey, it contracts its muscles and traps the prey in its coils. Each time the prey exhales and its chest becomes smaller, the boa clamps down a little tighter. Breath by breath it compresses the chest to the point that the prey can no longer inhale because it can no longer expand its chest. Death is then due to asphyxia.

This easily could’ve happened to the victim of this accident. Each time he exhaled, his chest becoming smaller, he might have slipped a little deeper into this trap. With each breath the space became more constricting until he could no longer expand his chest and asphyxia resulted.

Aspiration: It’s possible that aspiration of stomach contents could also have occurred. Since he was in a head down position anything that exited his stomach could easily be inhaled into his lungs and this could also lead to death from asphyxia. This might be particularly true since at one point during the rescue he was free enough to be given food and water. Then when he slipped back into the crevice, he could have vomited and aspirated his stomach contents.

Doesn’t it seem like the worst and most unexpected tragedies occur around holidays and this one is no different. It seems that John Jones not only left behind a wife, a young child, and a grieving family, but apparently also an unborn child. And all the day before Thanksgiving. Some things just don’t make sense.

Fox 13 Story

CS Monitor Story

KDKA Story

 

Cocaine and Pepper Spray: A Lethal Combination?

So you’re out for an evening of doing fuzzy rails with your buddies and on the way home you’re pulled over by the police because you’re having a little problem staying between the lines — pun intended. Of course the officer will ask for identification but your coked-up brain will misread this as a threat so you go off on the officer. A word of warning — this is never a good thing to do to someone who carries a gun, or in this case, pepper spray. So the cop, rather than shooting you, sprays you with pepper spray and you go down never to rise again. Then people stand around a hole in the ground and talk about what a good guy you were and what a jerk the cop was for killing you with pepper spray. Could happen.

Was it the combination of cocaine and pepper spray that did you in? Maybe, maybe not. Some new research suggests the answer is yes but, as usual, the devil is in the details.

In a recent issue of Forensic Toxicology, there is a report that suggests the mixture of cocaine and pepper spray could indeed be deadly. The study seems to revolve around two sets of data.

Mice were injected with cocaine and capsaicin, the chemical that gives peppers their kick. It’s also what makes pepper spray such an unpleasant chemical. They initially used a dose of cocaine that killed only a few of the mice and then found that when the same amount was injected along with capsaicin approximately 50% of the mice died. Then they injected the mice with an amount of cocaine that would kill approximately 50% of them. In medicine this dose is called the LD50 (Lethal Dose 50%) or the dose of any drug that would be expected to kill 50% of those who received it. When capsaicin was added to this amount the mortality rate approached 90%. From this one could construe that the combination of cocaine and pepper spray interact in some way and become a lethal combination and this could explain pepper spray deaths in humans.

Not so fast. The problem here is that these are mice and not humans. Though a great deal of medical research begins with mice it must eventually evolve into human trials before any real conclusions can be drawn. Studies done on mice are merely suggestions. Also these drugs were injected, which changes everything. Snorting cocaine is not the same as injecting it. Close but not quite. Pepper spray to the face may be a more local reaction and it may not be absorbed into the bloodstream at all. Injected capsaicin would indeed reach the bloodstream and just might be more toxic or might undergo some chemical alteration that is not present when it merely contacts the face and eyes. So this is the classic apples and oranges and little can be gleaned from this study that would help us determine if this combination is lethal to humans or not.

The investigators then looked at 26 autopsy reports between 1993 and 1995 on people who died shortly after receiving a spray of pepper. They found that 19 of them had evidence of some form of “psychostimulant,” and nine of these indeed did have cocaine in their system. This again would make someone consider that cocaine, or a similar chemical, within the victim interacted in some way with the capsaicin and this combination caused the deaths.

Again, not so fast. First of all, this is a very small study, involving only 26 people, and therefore any statistical analysis is fraught with inaccuracies. Sort of like winning 19 of your first 26 blackjack hands in Vegas and thinking this means you’ll win all night long. Never happens. Had this been a study of several hundred, or better several thousand, people then we might be able to draw some statistical conclusions.

The other part of the equation is why such a combination would prove lethal. What about cocaine and capsaicin make them a dangerous combo?

I doubt seriously that there is an actual chemical reaction between the two though this is possible. More likely, if there is an increased incidence of death with this combination, it is due to how each of these chemicals work independently. Cocaine is a stimulant. It stimulates the brain and the cardiovascular system. It causes euphoria, which is the desired effect, but can also cause confusion, disorientation, seizures, massive elevation of the blood pressure with a resulting stroke, and spasm of the coronary arteries which can lead to a heart attack (myocardial infarction) or a cardiac arrhythmia — a change in the cardiac rhythm which is potentially lethal.

There’s another drug that lives in our body that will also do most of the same things. This chemical is epinephrine or adrenaline. It resides in our adrenal glands, which sit just on top of the kidneys on either side. This is the fight or flight chemical. When someone says boo or the bad guys are chasing you down a dark alley or a bear crashes into your living room, this is the drug that will save your life. It revs up the heart rate and blood pressure and the reflexes and the muscular strength and the speed of muscular contraction and allows you to fight or run more effectively. But when present in excess, epinephrine can also cause coronary spasm with a heart attack, elevated blood pressure with a stroke, and dangerous cardiac arrhythmias.

Pepper spray is a very painful product to have sprayed in your face. The reaction to this sudden pain and burning of the eyes and throat is a fight or flight response. Epinephrine is released by the adrenal glands in massive quantities and, in a situation where there is already cocaine in the system, it could easily cause dangerous arrhythmias, heart attacks, or strokes. The combination of cocaine and epinephrine is known to be potentially deadly.

I would suspect that if this combination does indeed prove to be lethal that this is the mechanism by which it occurs. The danger is not from the cocaine and the pepper spray, at least not directly, but rather from the combination of cocaine and the epinephrine that is released due to the pain of the capsaicin. The devil is in the details.

But from a practical point of view, dead is dead and the mechanism is more or less irrelevant. Very interesting and I hope there is further research in this arena.

 

Dirty DNA

There is no doubt that DNA profiling is a powerful tool in criminal investigation. Its ability to identify an individual or place someone at the scene of the crime or connect someone to a murder weapon is its primary usefulness.

DNA profiling depends upon good quality and uncontaminated DNA. To develop a DNA Fingerprint, the sequence of the bases that make up the DNA chain must be intact. That is, the chain can’t be broken into pieces. If the DNA has been damaged by heat, acids, decay, or other circumstances, the DNA strands tend to be fragmented and therefore the sequence cannot be accurately determined. This can make any DNA useless from a forensic point of view.

Contaminants can also interfere with DNA testing. How many times have you seen on TV or read in the paper about DNA being obtained from discarded cigarettes or soda cans? The small amounts of DNA that would be found on a cigarette butt or the lip of a can are typically subjected to Polymerase Chain Reaction (PCR) amplification. This is a technique where enzymes known as polymerase enzymes are added to the DNA sample. The enzymes cause a replication, or duplication, of the DNA strands by a process that is very similar to what the body does naturally when DNA is copied as part of the complex cell division sequence. Unfortunately, things like tobacco and aluminum can interfere with the function of these enzymes and therefore the DNA cannot be amplified. The result is that the inability to obtain enough DNA from a very small sample to use in the profiling process is hampered if not rendered impossible.

But apparently all is not lost. Johannes Hedman and his team at the Swedish National Laboratory of Forensic Science have come up with three other polymerase enzymes that circumvent this problem. These enzymes, which have not typically been used in the forensic arena, seem to be oblivious to contaminants such as tobacco and aluminum and therefore are useful for amplifying contaminated DNA samples. If this pans out, this will be a very useful new tool for the DNA analyst.

If you want to read an excellent article on exactly how DNA profiling is done then go HERE.

 

On This Day: The “In Cold Blood” Murders

Holcomb Kansas is one of those places you’d miss if you blinked. A small farming community in America’s heartland, it was not prepared for what happened 50 years ago on the night of November 15, 1959. It was a town where murder was an unknown word. A town where people got up and went to bed with the sun and never worried about locking their doors. A town where children could walk to school and nothing bad would come their way. A town where the Clutter family became part of American criminal history.

By all accounts Herb Clutter was a hard-working, decent man. He lived in a modest home on a working farm with his wife Bonnie and their two teenage children, 16-year-old Nancy and 15-year-old Kenyon. Mr. Clutter apparently hired transient workers from time to time to help out around the farm and this act of kindness led to his family being massacred on that dark night.

 

After the family had turned in for the night, Dick Hickock and Perry Smith entered their world. It seems that Hickok. a recent prison parolee, had heard a rumor from a fellow inmate that a man named Clutter had a safe stuffed with money. That wasn’t true, but Hickok believed it to be. He recruited Perry Smith into his murderous scheme in which he repeatedly said that they would leave no witnesses. They didn’t.

Perry Smith (Top) and Dick Hickock

Once in the home, they cut the phone line and tied up the entire family, each in a separate room. They demanded that Herb Clutter open his safe. Mr. Clutter said that he had no safe and did not keep money in his house. They didn’t believe him but their search turned up nothing except for one of the children’s piggy bank.

Hickock then told Smith to kill the entire family. He first attempted to cut Herb Clutter’s throat but this didn’t go well. He shot Clutter with a shotgun and then moved from room to room killing the rest of the family. Smith and Hickock were ultimately captured and brought to trial with the major forensic evidence against them being a bloody boot print.

 

Truman Capote, fresh off his success with Breakfast at Tiffany’s, read about the case in the newspaper and decided he would write an article for New York magazine on how these brutal murders affected a small town America. He went there, along with his longtime, childhood friend in Monroeville, Alabama Harper Lee (To Kill A Mockingbird), to investigate the story.

 

Harper Lee receives Presidential Medal of Freedom

The murders not only turned the town of Holcomb upside down, they also affected Capote so much that the article became a novel and the novel transformed literature. It would be the last novel he ever completed.

Capote was an arrogant and self-absorbed jerk but he was a great writer. He boldly stated that his book based on this murder, which he titled In Cold Blood, would revolutionize the way novels were written. He was right. It created an entirely new genre. He called it faction. Today we would call it creative nonfiction.

 

The book created great controversy on several fronts. Many were dismayed that Capote used fictional elements in what was a true crime story. He was accused of manipulating the facts for his own purposes. Kenneth Tynan, in his review for The Observer, went further. He accused Capote of using Smith and Hickock for their information about the killings but then did not help them with their defense as much as he should have. He felt that Capote actually wanted the pair executed so he would have an ending to his story. This controversy remains unsettled.

In Cold Blood is without doubt one of the best crime novels ever written and at the same time one of the best true crime stories you’ll ever read. If you have not read it do yourself a favor. The story is compelling, the writing even more so.

 

 

Adios John Allen Muhammad

John Allen Muhammad died by lethal injection today.

John Muhammad and his teenage accomplice Lee Boyd Malvo were a deadly team. They became known as the Beltway Snipers. They are a little unusual in that they formed a murderous pair while most snipers tend to work alone. Sniping is one of the most difficult crimes to solve and indeed this case took many twists and turns and crossed many state lines before this pair was finally captured sleeping in a car at an interstate rest stop.

Most murders are committed by someone who knows the victim. There is usually a connection. There is usually a payoff. There is usually some interpersonal reason for the murder to have taken place. Not so with certain types of serial predators: snipers, serial bombers, and serial arsonists. Rather than having an issue with an individual, these criminals tend to hold grudges governments, organizations, or some defined group of individuals. I’m not sure that we know exactly why this pair went on a shooting spree but Though some have suggested that the entire ordeal was some elaborate plan for Muhammad to off his ex-wife, I would suspect that it was likely an issue with the government.

In 2002, when the leaves were just beginning to show their fall colors, this pair gunned down 10 people over a three-week span in Washington DC and the surrounding areas. It created much fear and confusion for those who had to travel the freeways, pump gas into their cars, collect their children from school, or go about daily life. The lightning bolt could strike anyone, anywhere, anytime. How do you defend against something like that?

These guys were clever. They used the trunk of a car as their sniper lair, the trunk muffling the sound and hiding the shooter from view. This likely helped prevent anyone from seeing the shootings take place or from reporting the sounds of gunfire.

It’s entirely possible that at least John Muhammad, with or without Lee Malvo, killed as many as 27 people throughout the Southeast. At least Lee Malvo has made statements to suggest that.

Now the state of Virginia has put John Muhammad to death. Not with a gunshot, not with the electric chair, not with the inhalation of cyanide gas, not swinging from the end of the rope, but rather by lethal injection.

Lethal injection is performed by giving three drugs in sequence. The first is a sedative such as sodium thiopental, a fast acting barbiturate that puts the person into a deep coma in less than a minute. The second is a muscular paralytic drug such as pancuronium. This is also extremely fast acting and paralyzes all muscles in the body, including those needed for respiration. The final drug is potassium chloride, a normal constituent of the blood and every cell in the body, which if given in large doses stops the heart immediately.

These first two drugs are used on thousands and thousands of people every day. They are common preoperative medications. When you go to the hospital and they start the IV and give you a medicine while asking you to count backwards from 100, this is usually some form of sedative such as sodium thiopental. Most people get to about 98. Then a muscular paralytic agent is given to relax the entire body and to facilitate the passage of the endotracheal tube, a tube passed through the mouth and into the trachea to ventilate the patient throughout the surgical procedure. The only medicine that is avoided in this circumstance is the potassium chloride. So lethal injection, at least from the recipient’s point of view, is not much different than getting a colonoscopy — except you don’t have to go through that aggravating prep.

I was recently asked by a writer whether someone who was given a lethal injection could then be saved. The answer is yes. It simply takes CPR. Since the drugs given are designed to stop breathing and then stop the heart, CPR with its ventilation support and external cardiac massage to provide circulation of the blood will prevent death. In order to reverse the potassium chloride that stopped of a heart in the first place intravenous glucose and insulin are given, and perhaps some intravenous calcium. These immediately reverse the effects of the potassium on the cardiac conduction system and the cardiac rhythm is quickly restored. Then it is simply a matter of breathing for the person until the other drugs wear off. If this intervention is done quickly, the victim will awaken and survive the ordeal with no ill effects. If the intervention is delayed then of course brain damage could follow, and if it is delayed further still, death would occur and none of these interventions would help. So it is possible to save someone after a lethal injection if actions are taken quickly.

The only downside that I can see to the death of John Muhammad is that there may be many unsolved murders, performed by his hand, that we may never know about. But he wasn’t talking anyway so even if he lived we still might never know.

All in all, John Muhammad got off pretty easy. Adios.

 

 

On This Day: King Tut Found

On this date in 1922, Howard Carter discovered the entrance to the tomb of the boy king Tutanhhamun, an historical figure that has been the subject of many investigations, several movies, many works of both fiction and nonfiction, and a parody by comedian Steve Martin. His place in world history is well-established.

 

He was born around 1341 BC and ascended to the position of Egyptian pharaoh of the 18th dynasty in about 1333 BC at the ripe old age of nine. He held that position until his death a decade later. One of the mysteries surrounding King Tut is his parentage. His father might have been Amenhotep III or maybe Akhenaten or maybe someone else.  His mother is equally controversial with some believing that she was Queen Tiye and others that she was Queen Kiya. This controversy continues and we may never know the truth.

There is also a great deal of speculation about what caused his death at such an early age. Everything from accidents, to medical problems, to murder have been postulated. In the search for these answers his body has been x-rayed several times and a CT scan has been performed at least once.

 

One of the x-rays showed a dense calcification at the posterior base of the skull and many postulated that this could be from a traumatic hematoma. The problem is that calcification (the addition of calcium to a scar, more or less turning it to bone) takes many months if not years. This would mean that he would have had to survive quite some time after the injury if indeed a blow to the back of the head caused this calcified area. In view of that, it is unlikely that a blow to the head in this region is what caused his death. Yes, some subdural hematomas that follow blunt trauma to the head can initially be small and nonlethal for many months and then can expand and cause death. But this would require the presence of a very large hematoma or a large amount of bleeding into or around the brain and apparently none of this was found in any of the examinations of the young man’s body. I think a blow to the head is very unlikely to have caused his death.

When discovered, his left femur (thigh bone) was fractured. Though this is a serious injury and can indeed lead to death from bleeding or from later infection or even from blood clots that form in the leg, break loose, and travel to the lungs as pulmonary emboli, many believe that the fracture of the femur occurred during the embalming process and was not a pre-mortem event. Again, it is unlikely that this was the cause of his death.

Others have suggested that he was poisoned, drowned, strangled, or that some other method of murder was used. There is no evidence to support any of these theories but they are interesting.

As far as a natural event causing his death, this is entirely possible but again there is no way of knowing. He was a very unusual looking young man. He had very large front teeth with a massive overbite and an elongated head, both of which were characteristics of his ancestors. He also apparently had a cleft palette and some degree of scoliosis. All of these findings could point to some musculoskeletal or connective tissue disorder such as Marfan’s syndrome. Marfan’s is a connective tissue problem where there is weakness of certain tissues. The joints tend to be loose, the palette tends to be high and arched, the lenses of the eyes can be displaced leading to visual difficulty, and the aorta can be weak and expand into an aneurysm that can rupture and prove deadly. Could this have happened to the young King Tut? Since the CT scan showed no evidence of an aortic aneurysm this is very unlikely if not impossible.

And so the mystery remains.

The Death of King Tut

Tutankhamun-Cause of Death

Mummification is one of the three main ways a body will change after death. The most common is decay, or putrefaction. This is a process mediated by bacteria and these bacteria prefer warm and moist environments. Most of the bacteria that cause decay of a corpse come from within the body, specifically the G.I. tract.

Under certain circumstances a body may undergo adipocere formation. Here the body takes on a waxy and mannequin like appearance. This is caused by certain acids and alkalis in the environment reacting with the body fats in a process similar to soap making. Once this process is complete, the body will appear like a pale white or grayish waxy doll.

For a body to undergo mummification, moisture must leave the body fairly quickly and leave behind an environment that is not friendly to bacteria. This can happen with a body dumped in a hot dry desert or one that is left on the hillside at a very high elevation where the air tends to be more moisture-free are even in bodies that are dumped into cool dry basements or closed up in the building crawl spaces. The bottom line is that a dry environment is essential for mummification.

The Egyptians were masters of the mummification process and Egypt’s hot and dry climate made their job much easier. Mummification follows from their basic religious beliefs in an afterlife where the person would need his body on the other side. By mummifying the body, it is protected, hopefully for all time. Since we have found mummies that are thousands of years old and are still incredibly well preserved, they seem to have accomplished their goal. But how did they go about doing it?

The process really addressed three goals: removal of the internal organs, dehydration of the body, and preservation of the tissues. The removal of the internal organs was essential to prevent decay since corpse decay begins inside the body. The ancient Egyptians did not have the knowledge of exactly what the decay process was or that it was mediated by bacteria or that these bacteria needed warmth and water, but rather they made the empiric observation that the internal organs decayed readily and their removal would slow or halt this process. They tended to remove all of the intra-abdominal organs, and were quite elegant at removing the brain through the nose or through small holes drilled of the skull, but they almost invariably left the heart behind. The lungs would be taken, but not the heart, indicating that it held great importance to them. The removed organs would be preserved by wrapping them in oil or resin soaked lenin and placed in ornamental jars around the tomb. I imagine this was done so that when the individual awakened on the other side he could simply reinsert his organs and carry on.

The next issue was to dry out the body. This removal of moisture from the tissues prevented bacterial growth and decay. They used various salts and oils and other solutions to accomplish this. Things such as myrrh, salt, natron (a combination of various sodium-containing compounds), mineral spirits such as turpentine, and other dehydrating herbs were used. Linens, soaked in resins, cedar and other oils, and other chemicals, were stuffed into the body cavities. These helped dehydrate the body and likely had some antibacterial effects.

The bodies were typically wrapped in linen soaked with oils and resins and sometimes beeswax or plaster was placed over the outside to serve as a final protective coating.

I imagine each mummy maker at his favorite technique and chemicals.

Making an Ancient Egyptian Mummy

Mummification in Egypt: An Overview