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Category Archives: Q&A

Q and A: Can a Crochet Hook Be Used For Murder?

Q: I’m wanting the victim in my next mystery novel to be murdered with a crochet hook. The attacker and victim would be facing each other. The hook would be grabbed off a table and could be either hook end out the thumb side of the hand or out the pinky side of the hand (depending on what you would determine to be the easiest for delivering a fatal blow). It is an impulsive act. The victim is a 5ft. 11in., 157lb. female. Murderer is a 6ft. 1in., 298lb. male. He is a chef.

What would be the most likely spots for inflicting a fatal wound? Would the hook need to be removed (the victim bleeds out)? Can the hook be left in and the wound still fatal?

The hook is a size F 3.75mm crochet hook made of Brazilian bloodwood by the Furls Fiberarts company. I know the different woods they use have different strengths as some do not come in the smaller diameter sizes. (For example: the olivewood hooks start at 4.00mm while the blackwood starts at 3.25mm.)

Pearl R. Meaker, Lincoln, IL.

Crochet Hooks

A: Since this style of hook is made of wood rather than metal, the attack would have to be to a relatively “soft” area. Not likely this could penetrate the chest and reach the heart or get thru the skull without breaking or shattering. But grabbing the thick end and using the pointed (hooked) end as the weapon could prove deadly.

Two areas could work:

The eye–the skull behind the eye is thin and fairly easily penetrated. So a stab to either eye could reach the brain cavity and cause bleeding into and around the brain that could prove deadly. Here there would be some external bleeding from the eye wound but most would be internal within the skull. Here it makes little difference whether the

device is removed or left in place after the attack.

The carotid arteries—there are 2 carotid arteries–one on each side of the neck in the soft area on either side of the trachea–windpipe. This device could easily penetrate one of them. These arteries supply 90% of the blood to the brain. If punctured, the blood would spurt out in great pulses. Here it would be best if the device were yanked back

out after the stab so the blood would have a clear path.

In either case, the victim could die in a couple of minutes or, in the eye stabbing scenario, it could take some time—even 30 to 90 minutes or longer. Anything is possible.

 

Q and A: What Happens When a Person Is Exposed to the Vacuum of Space?

Astronaut

Q: What sort of damage does the human body suffer in the vacuum of space?  How long can one survive and what will happen to the person who does survive?  My scenario involves an astronaut whose faceplate blows out, but not before he depressurizes his suit sufficiently to prevent immediate death.

A: First of all the victim would not explode as was the case in the movies such as Total Recall. But some very bad things do happen internally and they happen very quickly. Whether he depressurizes somewhat beforehand or not, his survival once he reached zero pressure (vacuum) would likely be measured in seconds.

Space decompression sickness is similar to that of a scuba diver that rises too rapidly after a prolonged exposure to the pressures of the deep. In this case the diver is going from excess pressure to normal pressure. In space the victim goes from normal pressure to zero pressure. Same thing physiologically.

In diving, the problem is that the excess pressure causes excess nitrogen (N) to dissolve in the blood. This N will come back out of the blood as the pressure is reduced. This should happen slowly to prevent decompression sickness or the bends. But, if the diver rises rapidly, the pressure drops rapidly, and the N comes out of the blood quickly, forming N bubbles in the blood stream. This is similar to popping the top on a soft drink. Here the release of the pressure allows the carbon dioxide (CO2), which was placed into the liquid under pressure, to come out of the liquid and form bubbles. We call this carbonization. A good thing for your soft drink, but not so good for your brain and heart and muscles.

In space decompression basically the same thing happens. Apparently the culprit is water and not N in this situation, however. With the sudden release of pressure, the water in the blood “boils,” becoming a gas, and bubbles form in the system. I should point out that in chemical and physical terms boiling simply means the changing of a liquid to a gas. This can be accomplished by adding heat (boiling water on a stove) or by lowering the ambient pressure (popping open a soft drink). In the case of space decompression it isn’t that the blood gets hot, but rather that the pressure that keeps the water in its liquid state is removed and the water changes to its gaseous state, or boils. Doesn’t sound very pleasant does it?

Though studies on the effects of exposure to a vacuum have been done on chimpanzees, there are no real data on what happens to humans exposed to zero pressure except for a couple of incidents where an astronaut or a pilot was accidentally exposed. Of course, rapid decompression has caused deaths in both high-altitude flights and in June, 1971 when the Russian spacecraft Soyuz 11 suddenly lost pressure, killing the 3 cosmonauts on board, but survivors are few and far between.

On August 16, 1960, parachutist Joe Kittinger ascended to an altitude of 102,800 feet (19.5 miles) in an open gondola in order to set a world record for high-altitude parachute jumping. He lost pressurization in his right glove but proceeded with his ascent and jump. He experienced pain and loss of function in his hand at high altitude but all returned to normal once he descended via chute to lower altitudes.

In 1965 at NASA’s Manned Spacecraft Center near Houston, TX, a trainee suffered a sudden leak in his spacesuit while in a vacuum chamber. He lost consciousness in 14 seconds, but revived after a few seconds as the chamber was immediately re-pressurized. He suffered no ill effects—due to his very brief exposure—but stated that he could feel water boiling on his tongue. This was actually the above mentioned boiling scenario in which water (in this case saliva) becomes a gas on exposure to zero pressure.

A case of partial, prolonged exposure occurred during an EVA (space walk) in April 1991 on the US space shuttle mission STS-37. One astronaut suffered a 1/8 inch puncture in one glove between the thumb and forefinger. He was unaware of it until later when he noticed a painful red mark on his skin in the exposed area. It appeared that the area bled some but that his blood had clotted and sealed the injury.

So, what happens to a human exposed to zero pressure? Since there is no oxygen in such an environment, loss of consciousness occurs in a matter of seconds. Also, if the victim held his breath (don’t do this during scuba diving when coming up from depths either), the air in his lungs would rapidly expand and his lungs could be damaged, bleed, or rupture. Better to open his mouth and exhale the rapidly expanding gas from his lungs.

Water in his blood stream would immediately begin to “boil,” filling the blood stream with water vapor (the gas form of water) and stopping his heart. Bubbles might appear in the blood stream and cause damage to the body’s organs, particularly the brain. As a result, the brain and nerves cease to function. As more and more gas formed within the body, the entire body would swell but it would not explode.

Exposure to heat or cold or radiation might also occur but it will do little harm since the victim would already be dead.

But what if the exposure were brief and the person rescued? Treatment would be to immediately return him to a pressurized environment and give him 100% oxygen. He may survive unharmed or may have brain and nerve damage which could be permanent.

For your scenario, whether he partially decompressed or not, he would be in trouble very quickly. When your victim’s faceplate ruptured he would hopefully begin to exhale air to prevent the expanding gases in his lungs from rupturing them. As air, and thus oxygen, flowed from his lungs and into space, the oxygen content of his blood would rapidly drop and he would lose consciousness in 10 to 20 seconds. He would then die in short order. If he were quickly rescued, he would be returned to the spacecraft, which would be pressurized, and would be given 100% oxygen via a face mask. He could survive intact or with brain damage. It’s your call. Either way works.

 

Q and A: Will Ingestion of Bee Venom Kill Someone Who Is Allergic to Bees?

Q: If a person is allergic to bee venom and the venom is ingested, would the person be likely to die? Would the venom show up on a tox screen at autopsy?

Bee-apis

A: Bee venom is a protein toxin and would be digested by the acids in the stomach if swallowed. And once digested it would not likely cause an allergic reaction. However, an allergic reaction would happen once the venom contacted the buccal mucosa—big word for the lining of the mouth. This could cause an anaphylactic reaction and kill the victim.

Anaphylaxis is a rapid allergic reaction to some antigen. These antigens are typically foods, drugs, or insect venoms. Common foods are peanuts and shellfish; common drugs are penicillin and iodine, which is found in many radiographic dyes; and common insects are bees as in your story. There a myriad other foods, drugs, and bugs that can cause anaphylaxis in the allergic person.

This rapid immune (or allergic) reaction involves antigens (the food, drug, the bee venom, etc.) and antibodies, which are manufactured by the body and react to the specific antigen that they are directed against. This reaction is a critical part of our defense against bacteria and viruses. The body recognizes the antigen (virus, let’s say) as foreign and builds antibodies that will recognize and attach to the virus. This reaction attracts white blood cells (WBCs), which release chemicals that kill or harm the virus, which is then consumed by the WBCs and destroyed.  This process is essential for each of us to survive in our bacteria and virus-filled world.

But, in allergic individuals, this reaction is rapid and massive and causes a release of large amounts of the chemicals from the WBCs and it is these chemicals that cause the problems. They cause dilatation (opening up) of the blood vessels, which leads to a drop in blood pressure (BP) and shock. They cause the bronchial tubes (airways) to constrict (narrow severely), which leads to shortness of breath, wheezing, and cough. This is basically a severe asthmatic attack and prevents adequate air intake and the oxygen level in the blood drops rapidly. The chemicals also cause what is known as capillary leak. This means that the tiny microscopic blood vessels in the tissues begin to leak fluids into the tissues. This leads to swelling and various skin lesions such as a red rash, hives (actually these are called bullae and are fluid-filled, blister-like areas), and what are called wheel-and-flare lesions (pale areas surrounded by a reddish ring). These are also called Target Lesions because they look like targets with a pale center and red ring.

In the lungs this capillary leaking causes swelling of the airways, which along with the constriction of the airways, prevents air intake. In the tissues it causes swelling of the hands, face, eyes, and lips. The net result of an anaphylactic reaction is a dramatic fall in BP, severe wheezing, swelling and hives, shock (basically respiratory and cardiac failure), and death.

Usually anaphylaxis onsets within minutes (10 to 20) after contact with the chemical, but sometimes, particularly with ingested foods, it may be delayed for hours—even up to 24 hours. With a bee sting it would begin in a matter of minutes. Bee venom in the mouth might take only a few minutes to instigate the reaction.

Your victim would suffer swelling of the tongue and face—particularly of the lips and around the eyes—as well as swelling of his hands. Hives and wheel-and-flare lesions would pop out over the skin. He would begin to gasp for breath and develop progressively louder wheezing. As the oxygen content of his blood began to drop he would appear bluish around his lips, ears, fingers, and toes. This would progress until his skin was dusky blue. He would sweat, weaken, and finally when his BP dropped far enough would lose consciousness, lapse into a coma and die. Unless treatment was swift and effect that is.

Untreated anaphylaxis leads to shock and death in anywhere from a very few minutes to an hour or more, depending upon the severity of the reaction and the overall health of the victim. Treatment consists of blood pressure (BP) and respiratory support, while giving drugs that counter the allergic reaction. BP support may come from intravenous (IV) drips of drugs called vasopressors. The most common would be Dopamine, Dobutamine, epinephrine, and neosynephrine. Respiratory support may require the placement of an endotracheal (ET) tube and artificial ventilation. The victim would then be given epinephrine IV or subcutaneously (SubQ) and IV Benadryl and steroids. Common steroids would be Medrol, Solumedrol, and Decadron. These drugs work at different areas of the overall allergic reaction and reverse many of its consequences. The victim could survive with these interventions. Or not. Your call.

If you decide that your victim will die, then at autopsy, the findings are non-specific. That is, they are not absolutely diagnostic that an anaphylactic reaction occurred. The ME would expect to find swelling of the throat and airways and perhaps fluid in the lungs (pulmonary edema) and maybe some bleeding in the lungs. He may also find some congestion of the internal organs such as the liver. He must however couple these findings with a history of the individual having eaten a certain food, having ingested or being given a certain drug, or having receives an insect bite or sting and then developing symptoms and signs consistent with anaphylaxis. And in the case of insects, such as the bee you are using, he may be able to find antibodies to the insect’s venom in the victim’s blood. Maybe not. So you can have it either way—yes he finds the antibodies or no he doesn’t.

Originally published in the October, 2014 issue of Suspense Magazine

 
6 Comments

Posted by on December 14, 2014 in Medical Issues, Poisons & Drugs, Q&A

 

Q and A: Could Death From Bleeding Be Delayed For Several Days After a Frontier Wagon Wheel Accident?

Q: My story takes place in a wagon train in the late 1800’s. My character is dragged by a horse while crossing a river. He hits rocks and is bounced off the back wheel of a wagon. Of course the horse’s hooves do damage as well. Three days later he dies from massive bleeding from his internal injuries. This three day delay followed by the sudden loss of blood is important to the story’s timing, but is it realistic?

wagon_train-2

A: The answer to your question is yes.

This type of accident could, as you can imagine, result in all types of injuries. Broken bones, skull fractures, neck fractures, cracked ribs, punctured lungs, and intra-abdominal injuries (injuries inside the abdominal cavity). This last type of injury might serve you well.

A ruptured spleen or lacerated liver or fractured kidney would bleed into the abdominal cavity. Death could be quick or take days if the bleed was slow. There would be great pain, especially with movement or breathing, and the abdomen would swell. Also a bluish, bruise like discoloration could appear around the umbilicus (belly button) and along the flanks. This usually takes 24 to 48 hours or more to appear. This occurs as the blood seeps between the “fascial planes.” The fascia are the tough white tissues that separate muscles from one another. The blood seeps along these divisions and reaches the deeper layers of the skin causing the discoloration. But, these injuries wouldn’t lead to external bleeding since the blood has no exit from the abdominal cavity.

However, if the injury was to the bowel, then external bleeding could occur. For blood to pass from the bowel, the bleeding would have to be within the bowel itself and not just in the abdomen somewhere. If the bowel were ruptured or torn so that bleeding occurred within the bowel, the blood would flow out rectally. But, blood in the bowel acts like a laxative so the bleeding would likely occur almost immediately and continue off and on until death, which in this situation would be minutes to hours to a day, two at the most. It would be less realistic for the bleeding to wait three days before appearing in this case. With one exception.

The bowel could bruised and not ruptured or torn, and a hematoma (blood mass or clot) could form in the bowel wall. As the hematoma expanded it could compromise the blood supply to that section of the bowel. Over a day or two the bowel segment might die. We call this an “ischemic bowel.” Ischemia is a term that means interruption of blood flow to an organ. If the bowel segment dies, bleeding would follow. This could allow a 3 day delay in the appearance of blood.

In your scenario, the injuries would likely be multiple and so abdominal swelling, the discolorations I described, great pain, fevers, chills, even delirium toward the end, and finally bleeding could all occur. Not a pleasant way to die, but I would imagine this happened not infrequently in frontier days.

The victim would be placed in the bed of one of the wagons and comforted as best they could. He might be sponged with water to ease his fevers, offered water or soup, which he would likely vomit, and prayers would be said. They could have tincture of opium (a liquid) available and give him some. This would lessen the pain since it is a narcotic and would also slow the motility (movement) of the bowel and thus lessen the pain and maybe the bleeding.

Of course, during the time period of your story, your characters wouldn’t know any of the internal workings of the injury as I have described. They would only know that he was severely injured and in danger of dying. Some members of the wagon train may have seen similar injuries in the past and may know just how serious the victim’s condition is, but they wouldn’t understand the physiology behind it. They might even believe that after he survived the first two days that he was going live and then be very shocked when he eventually bleed to death. Or they might understand that the bouncing of the wagon over the rough terrain was not only painful but also dangerous for someone in his condition. They train may be halted for the three days he lived or several wagons might stay behind to tend to him while the rest of the column moved on.

 

Q and A: What Would My Victim of Scaphism Look Like After Two Weeks in a Pond?

Q: My question is what would a corpse be like, a victim of scaphism and encased in leather with only the head, hands and feet protruding, discovered after about two weeks in a stagnant pond in summer in England.

Alicat

 

Scaphism

 

A: This is a very complex situation which means that almost anything can happen. Particularly in face of your killer employing scaphism in your poor victim’s ordeal. There are many forces in this circumstance conspiring to destroy the body. After two weeks the decay process would be well along and the body should be swollen and discolored and there might already be some sloughing of tissues, particularly in the hands and the feet so that the fingernails and toenails might have slipped away. The leather binding might lessen the degree of abdominal swelling but maybe not.

Or the decay might be a little less and the body might appear only slightly swollen and discolored. Either is possible. When you add the insects and marine predators such as fish to the picture, tissue destruction could be significant—-or again very mild. Once the body floated or if it were placed on a wooden float of some sort, the insects would easily reach the corpse. These insects prefer warmer and moister areas so they tend to accumulate around the eyes, nose, mouth, groin, and any wounds such as an open abdomen or a stab wound.

Their activity could be significant or minimal, often depending on the weather. If it has rained a lot or if it is windy or if there has been a great deal of fog, insect activity would be diminished as insects do not like these conditions. But, i the weather was warm and sunny, they would be more active. Often when the medical examiner is determining the time of death in bodies that are several weeks old, he will consult a forensic climatologist to assess the weather effects in play and from this make his best guess as to insect activity and this in turn will tell him how long it took for the insects to reach the level of infestation seen. Again is always only his best estimate. And then you throw in predators, both marine and otherwise, and his problems multiply.

At the end of the day, your body would likely have a great deal of decay as described above as well as insect activity. The latter could be everywhere but would be particularly pronounced in the exposed areas where the tissues were easier for the insects to get to. Still they find their way beneath leather bindings and clothing and coverings in order to get to their next meal.

You have a great deal to work with here in that the body can either be slightly or severely decayed and the insect activity can be great or small and anywhere in between. The old adage is that whatever happens, happens. This actually gives you great leeway in how you construct your plot.

 

Q and A: How Could My Character Keep Blood In a Liquid State For Later Consumption?

Q: I have a killer who drinks the blood of his victims. If he wants to bleed out a victim and wind up with blood in his freezer that he can reheat in a Mr. Coffee, I assume he’ll need some sort of anticoagulant. Is that right? Would he have to use it immediately at the murder scene? What would the average person have access to that could serve this purpose, especially if he didn’t preplan his first kill. Better still, is there some way to reconstitute the blood after it coagulates?

Craig Faustus Buck, Sherman Oaks CA

 

LEFT: Clotted and Separated Blood RIGHT: Unclotted Blood

LEFT: Clotted and Separated Blood
RIGHT: Unclotted Blood

 

A: Actually there are several ways to accomplish this. If your killer has access to the victim for several days or weeks prior to the event, he could slip some Coumadin into his food daily for two or three weeks prior to the killing. Coumadin, or warfarin, is an oral anticoagulant that works mostly in the liver to prevent blood clotting. It takes a week or so to build up to levels that would keep the blood liquid.

That might be cumbersome for your story, so there is another choice. Heparin. Heparin should be given intravenously but it works immediately as an anticoagulant. Your killer could inject a large dose of heparin right before the killing. This would of course require that he have full control of the victim or at least convince the victim that the injection was harmless. Either way, if he gave 100,000 to 200,000 units of heparin intravenously the victim’s blood would be anti-coagulated within seconds and he could then bleed him and store the blood as a liquid for an extended period of time.

Lastly, as he drained the blood he could put it into a container that contained EDTA. This is what is used in the blood vials when blood is drawn that needs to be anti-coagulated for certain tests. It’s a white powder that is available from pharmaceutical supply houses. Mixing some of this with the blood would prevent it from coagulating so it could be stored as a liquid.

As far a reconstituting it, once blood clots it immediately begins to separate into the reddish clot and the yellowish serum. Vigorous shaking or running it through a blender could remix the blood, resulting in a red liquid that he could then consume.

 
5 Comments

Posted by on July 18, 2014 in Blood Analysis, Medical Issues, Q&A

 

Q and A: How Would the Time of Death Be Determined in a Corpse Found in Snow?

Q: In my story, the body of a young woman is found by cross-country skiers in high-mountain country. (Average temps in December: 20 degrees/low to 40 degrees/high;  elevation about 9000 ft.) If the person had been dressed in heavy clothes, and the body had been there about 24 hours, would it be completely frozen? Partially? Would there be any way to determine when death had occurred?

MT, Albuquerque, NM

Jack-Frozen

A: The corpse would be at least partially and could be completely frozen–perhaps with some of the deeper internal organs only partially frozen. It depends on the clothing, exposure, moisture, wind, etc. Also the old rule that whatever happens, happens comes into play here. So the freezing could be either complete or partial.

Under these conditions, rigor and lividity would be delayed to an unpredictable degree so these would be very crude indicators and not very useful in determining the time of death (TOD). Body temperature might be more useful—emphasis on might—but this would not be very accurate either. If the core body temp had reached the ambient temperature, this determination is of no use, since once the corpse reaches the ambient temperature it will remain stable at that temperature, making body temperature useless. For example, if the corpse reached the ambient temp after 18 hours then 24 hours would look like 36 or 48 as far as body temp is concerned.

But if the corpse hasn’t reached ambient temperature, core body temp can be used to estimate the TOD. Not very accurately but at least in the ballpark. Under “normal” circumstances, a body loses heat at about 1.5 degrees per hour, but this depends on many variables. Your scenario is definitely not “normal,” so temp would be lost more rapidly. Could be 2 or 3 or 4 degrees per hour if there is wind or cold rain for example. Let’s say the ME found the core temp was 40 with an ambient temp of 30. This means the body is still cooling since it has not yet reached ambient temperature. Let’s also say that in his experience he believes (educated guess at best) the body would lose about 3 degrees per hour under the circumstances he sees at the scene. If so, subtracting the measured corpse temperature (40 degrees) from the normal body temperature (98) and dividing by the rate of loss (3 degrees/hour) would yield the estimated TOD.

The math: 98-40 = 58; 58/3 = 19 hours.

Based on these calculations, your ME might conclude that the death occurred approximately 19 hours earlier, give or take a couple of hours.

Of course the major flaw here is that the actual rate of temperature loss might vary from his estimate so, despite the math, his assessment remains a best guess. He would likely suggest a broad range—maybe saying the TOD was between 16 and 24 hours earlier. That’s really the best he could do.

So your corpse could be partially or completely frozen and the time of death could be difficult to determine. Except for one more trick: stomach contents.

Let’s say the corpse is frozen so that temp, rigor, and lividity are of no help yet it was known that the victim had eaten a certain food at a certain time prior to his disappearance. It takes the stomach 2-3 or so hours to empty after a meal so if the ME found the undigested meal in the victim’s stomach and knew the time of this final meal from witnesses, he could then more accurately place the time of death as within 2-3 hours after that meal. Let’s say he had lunch around noon, went skiing, and was then found dead 24 hours later. If the ME found that last meal still in his stomach he might suggest that the TOD was between 1 and 4 p.m. the day before. This might be your best bet for narrowing down the TOD.

 
 
 
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