Friday, November 30, 2007

Coroner supports Santa's girth

Thank goodness the acting United States Surgeon General is there to tackle the important health issues of our time. Yes, obesity (in kids and adults) is a serious problem in our country and does contribute to disease and death. Yes, we are seeing more 300+ pound folks and they are dying at younger ages from heart disease than you would really expect. But to attack Santa as a bad example and in need of slimming seems a bit weird.
“It is really important that the people who kids look up to as role models are in good shape, eating well and getting exercise. It is absolutely critical,” acting U.S. Surgeon General Rear Adm. Steven K. Galson said in an interview after a presentation on obesity at the Boston Children’s Museum…
“Santa is no different.”

I participate in a number of initiatives to promote health and forestall death, but I will not support this “hit” on Santa. Growing up I don’t recall ever thinking that I wanted to grow up fat like Santa and I don’t recall ever hearing anyone say it.

Keep Santa fat, but promote health and fitness in other ways.

Mr. Surgeon General lets come out with some real stuff to promote health in the U.S.. Thank goodness that the Ghostbusters took care of the Stay Puft Marshmallow Man.

Thursday, November 29, 2007

Unnecessary ER deaths

Unnecessary ER and hospital deaths continue to occur. We ought to be confident in our health/life safety once we reach the hospital, but all too often that is a trust not well placed. Our system needs to be changed, there is a critical need for improvement, as I have previously mentioned here, here, and here (to tag only a few).

Another ER waiting room death hit the news.

Why are we still talking about stuff that we talked about years ago, stuff I worked on through my 20 years in the ER. People shouldn’t die a few feet from effective treatment because they don’t fit someone’s idea of who has heart attacks or whatever the medical problem might be. You know what they say about “assume”, it makes an "ass" out of “u” and "me", and it can lead to someone’s death.

Wednesday, November 28, 2007

Coroner's job is interesting

This job is always interesting.

The “pump” was primed/the tone was set this morning with an email at 7:50 am, got to love Blackberry capabilities, always connected. This led to a “running gun battle” of email and phone calls through the day to work toward resolution of an office issue.

Walking in from my parking place a 4X6 piece of insulation board blew off the roof (we are getting our leaky roof fixed, finally) and hit the ground about 5 feet in front of me. That was a surprise.

I went to the gym and found I only had a sleeveless t-shirt with me, which is OK but more summer wear than winter. Lucky for me, however, it was apparently sleeveless T day at the gym; all the other guys had them on too.

I had a very interesting conversation about homeless folks with a reporter. I have been involved in homelessness issues since about 1989, so do have some background for the discussion. They are real people, not nameless and faceless as they are often perceived. We discussed how there is a “community” that gathers at “soup kitchens”, service sites, and emergency shelters. They watch out for each other. They work odd jobs to make a little money. They shop, they live.

A sampling of interesting other stuff through the day: “Lending” autopsy specimens (i.e. histology slides and paraffin blocks, etc) to a law firm for their use in litigation; discussions on how to get a badly decomposed body (partially skeletonized) to the University of Texas and their CODIS-associated facility for DNA testing and examination; scheduling an autopsy for an individual found in Lake Michigan, likely who has been there for about a month (finally the family will be able to move ahead with their lives, which have been “on hold”). This is just a sampling, there were even a few things I can’t comment on here, always a reminder that there are no typical days in the Coroner’s Office.

Let’s see what the evening holds.

Tuesday, November 27, 2007

Kids shouldn’t die before their parents

I have heard a radio ad several times recently that really caught my attention.

It is simply a father calling and leaving messages for his daughter who was supposed to meet him for lunch. We aren’t told why she didn’t make the lunch date or why she isn’t answering her phone. This ad catches my attention like a beacon, like a clarion.

I have heard those types of messages on cell phones. I have heard the stories of fathers (and mothers) leaving such messages on the phones of their sons and daughters. There are many nights that I pray that I will never leave messages in such a situation.

Unspoken in all of this is that sometimes kids die before their parents (kids shouldn’t die before their parents). Kids die through no fault of their own. Kids die because they take chances. Kids die because they make bad choices. May this never happen to your kids (or mine).

Tuesday, November 20, 2007

Rhoni Reuter and Skylar Reuter-Gayle Double Homicide

During Case Conferences today (which now serve the function of inquests), the manners of death for Rhoni Reuter and Skylar Reuter-Gayle were declared to be Homicides by the Lake County Coroner’s Office.

Rhoni Reuter and Skylar Reuter-Gayle died as a result of multiple gunshot wounds that Ms Reuter received October 4, 2007. Ms Reuter was 6-7 months pregnant, with Skylar, when she died. Skylar could have been viable if delivered at that length of gestation, and therefore is considered a second individual death and homicide. Skylar’s death was attributed to the blood loss her mother suffered as a result of her gunshot wounds.

The precise number of gunshot wounds and their distribution are a part of the ongoing investigation by the Lake County Major Crimes Task Force, so are that information cannot be disclosed at this time.

“This is certainly a heinous crime and we hope someone is brought to justice soon. I am confident that the ongoing investigation will accomplish just that”, said Richard Keller, MD, summing up the feeling of all those involved in this case from its tragic beginning.

Monday, November 19, 2007

National Survivors of Suicide Day 2007

We, i.e. the Lake County Coroner’s Office (my executive secretary) and the Lake County Suicide Prevention Task Force, set up a local site for a group viewing of the American Foundation for Suicide Prevention (AFSP) National Survivors of Suicide Day program webcast last Saturday. One of over 130 sites that offered that service.

The bulk of the webcast consisted of a panel of individuals who were survivors of suicide (i.e. they had lost a loved one to suicide). These individual’s talked of their experiences, how they coped, and how their lives had changed. They brought various perspectives and were at “different places” with regards to working with their grief and life changes. It was a profoundly affecting experience. There was not a dry eye among the viewers at our site.

The webcast will be available for viewing on the AFSP website for the next year. I highly recommend it. I think its greatest messages were how many lives are touched by suicide (20% of families and 60% of individuals know someone who has died by suicide) and along with that, the message that you are not alone in your life experience of death by suicide and that you, like the others, can survive. One other point that comes to mind as I type this is that everyone deals with the grieving in their individual way (not in stages, but in “floods”) and that that grieving does not go away, but you cope and you survive.

Friday, November 16, 2007

Make good choices

This will be a bit different.

I ran across story a couple of days ago that I had saved after running across it a few years ago (although I do not have a citation of its origin) I thought I’d share it, not because it has much to do with the coroner biz, but because it “speaks to me” and I felt compelled to share it.

There is a story about a kind, quiet man who went each morning to the river to refresh his spirit. One day while there, he saw a poisonous spider struggling in the water and he picked it up in his cupped hands a moved it to shore. As he placed it on the ground it stung him. Thankfully, the poison did not affect him lethally as it might have.

The next day the same thing happened. On the third day, the kind man was knee deep in the river and, sure enough, there was the spider, legs frantic in the water. As the man went to lift the spider yet again, the spider said, “Why do you keep lifting me? Can’t you see that I will sting you every time, because that is what I do?” And the kind man cupped his hands around the spider lifting it back to safety, replying, “Because that is what I do.”

Let it be said that what we do is to be kind and what is “right”. Make good choices.

Thursday, November 15, 2007

Coroner says NO to "flask on the fly"

Isn’t America and modern technology wonderful? Apparently because it isn’t easy enough to get enough alcohol to drink, especially alcohol in easy to carry bags, these folks have come out with “Pocket Shots”. I learned about these things at our Lake County Underage Drinking Prevention Task Force meeting this morning.
Pocket Shot is a brand new way to enjoy your favorite hard liquor. No longer will you need to carry full size bottles. Gone are the breakable glass mini bottles. Now you can have it one shot at a time, any place, anywhere.
Each Pocket Shot is sealed in a near unbreakable, flexible, squishable, pocket stuffable pouch making them perfect for active activities, outdoor adventures, and glass restricting venues

For crying out loud folks, this is a product that we really don’t need and again one that can easily contribute to underage drinking, despite their comment in the middle of their web page (although their photos show who they are targeting):
Pocket Shot condemns underage drinking and the irresponsible consumption of alcohol. Please drink responsibly. To find out more about responsible consumption, visit The Century Council.

You can voice your concern to distributors and sellers of alcohol in your area (these are available in Colorado, California, Arizona, New Mexico, and Wisconsin now). Tell them they don’t need to sell these in your area. It is plenty easy to get alcohol in bottles and we don’t need alcohol in a bag in our pocket. We aren’t that much in need of a quick shot. In Lake County the mayors are most often the liquor commissioner as well, let them know, too.

Take a stand.

Wednesday, November 14, 2007

Suicide among veterans

Shocking is an understatement in my opinion:

Some of America's 25 million veterans face their biggest fight when they return home from the battlefield -- when they take on mental illness.

A recent Veteran Affairs Department estimate says some 5,000 ex-servicemen and women will commit suicide this year…

The five-month CBS News probe, based upon a detailed analysis of data obtained from death records from 2004 and 2005, found that veterans were more than twice as likely to commit suicide in 2005 as non-vets.

Suicide is pervasive and preventative measures need to be very broad based. De-stigmatize, make help available, and support. A long-term, multifaceted project.

Sunday, November 11, 2007

Coroner’s Daughter Takes Notes

I gave a talk the other evening, not all that unusual I do give a lot of them. I have always wondered if the stuff I say gets across to listeners, just like everyone who gives a talk, but after this talk I got some feedback. My 9-year-old daughter was along and took some notes to pass her time. I thought I’d use her notes as the basis of a post (I corrected her spelling):

“more suicide dies than homicide” I start these talks with some local information about death, this information (although I use proper syntax) often seems to catch everyone’s attention.

“my dad does tours in his office old and young” We do a number of outreach activities to help demystify the office and as a nod to the huge public interest in forensics; e.g. tours for students and adults, talks at schools and to groups, and career day activities.

“kids aren’t allowed to die before grown-ups” My statement is actually: Kids shouldn’t die before their parents. I use this to drive home death prevention information for kids and teens that boils down to getting them to think, not take chances, and make good choices.

“kids, grown-ups and teens kill depending on their personality” I’m not sure where this came from, but I did talk about violence prevention as a part of premature death prevention.

“there are people drinking and driving then they die” I think this one speaks for itself.

“my dad made a blog, he’s called the blogging coroner, its like a public diary like and he is the first coroner to blog” Again, it is what it is.

(after taking a phone call) “its tough being on call 24-7” I had to pause the talk to speak with one of my deputies who was responding to a car crash with a fatality and dispatching a second deputy to a simultaneous death call at a local hospital. I am always on-call and take calls.

“Tips: don’t drink and drive; don’t do anything that can hurt you or others!” I closed with several tips, my Coroner’s Health Tips, on how to forestall death. I work just as hard to keep folks out of my office (i.e. alive), as I do taking care of medicolegal death investigations.

Thursday, November 08, 2007

Removal of a Dead Body

There is always stuff going on demanding and using my time, so it gets tough getting blogging done (it isn’t an integral part of my work). Ongoing union negotiations to get it ‘right”, 2 presentations last week on the updated county Questionable Death Protocol, instituting and reinstituting policies so memos have to be composed and sent, in addition to the “real” work of the office doing death investigations, are all part of the job.

Someone brought to our attention that we weren’t in compliance with statute in continuing a “common practice” (i.e. no written policy) that had been instituted and continued under previous coroners here in Lake County. There is a statute that says, in short (and in weird legalese), that a licensed funeral director must be present when they remove a decedent from our office to their facility.
“The removal of a deceased human body from its place of death, institution or other location. A licensed funeral director and embalmer trainee may remove a deceased human body from its place of death, institution, or other location without another licensee being present. The licensed funeral director and embalmer may engage others who are not licensed funeral directors and embalmers or funeral director and embalmer trainees to assist in the removal if the funeral director and embalmer directs and instructs them in handling and precautionary procedures and accompanies them on all calls.” (225 ILCS41/1-20(c))

Transport personnel, trained or not, can not do the transfer without a licensed funeral director actually present.

I found this out because the word was that that someone was going to make an issue of the practice, not that any problem had occurred from the practice, but just because they could make an issue of it. So the policy is changed and will become a written policy. I am sure that the prior practice was a help to some of the smaller funeral homes, but the law is the law and now that I know that the prior office practice violated the law we will change the practice.

Tuesday, November 06, 2007

National Survivors of Suicide Day

National Survivors of Suicide Day is November 17.

A survivor of suicide in this context is the family and/or friends of someone who died by suicide. I continue to be amazed at just how many of those folks there are, ranging from myself to folks in every walk of life.

National Survivors of Suicide Day is an annual event sponsored by the American Foundation for Suicide Prevention (AFSP). The event consists of a network of sites throughout the country where groups of survivors come together to watch a broadcast of speakers dealing with emotional support, available resources, and the like. It also communicates to the participants that they are not alone.

For the first time we in Lake County are setting up a site. It is a collaborative effort of my office (primarily my Executive Assistant), our Lake County Suicide Prevention Task Force and the City of Mundelein (which has helped with the actual location). We will hold ours at the Mundelein Fire Station (1000 Midlothian) on Saturday, November 17 [call Kathy, 847 377 2200, if you would like to attend; other information is available from the American Foundation for Suicide Prevention]. The other option is to watch the webcast that will be up for the ensuing year.

The AFSP promotes this event as a “healing conference” and I am sure that it is. Just knowing that you are not alone in your experience of losing someone to suicide has a great salutatory effect. Also knowing where you can get more information and support can be critical, because your feelings, grief, and questions will not go away quickly. There are those that can help and support for the long haul.

Friday, November 02, 2007

Drug-induced or Natural Death

Not everyone who partakes of a “lethal dose” of a drug dies.

The obverse of this would be: can someone die of a sub-lethal amount of a drug and still be considered to have died of the drug? I think (and others agree) that the answer is yes.

Consider this hypothetical. An individual partakes of an adrenergic-like drug that acts toxically on the vasculature. That drug causes vasospasm and/or vasoconstriction of cardiac blood vessels starving the cardiac tissue (muscle and electrical) of oxygen and “energy/food”. This in turn causes electrical instability and irritability, as well as poorly functioning musculature.

Next “stress” this individual with a fear of loss of integrity/life through fear of injury or capture. I don’t know; maybe have him chased by a wolf. This stress causes the body to churn out adrenaline as a natural reaction. In this hypothetical that adrenaline would compound the effect of the recently consumed drug on the heart. In addition to the fear stressor, add that the man runs say 100-200 yards. This compounds his heart’s problem by increasing demands for oxygen and energy supplies to the heart tissue. And on top of this he develops lung perfusion/ventilation mismatch in his lungs because he isn’t anywhere near fit and maybe gets a little bronchospasm in the mix because his lungs aren’t in great shape either.

He stops (wolf gone?) and tries to recover, but the insult to his system, his heart, is too great. A dysrhythmia develops, syncope and death result.

Did the drug kill him? It certainly set the stage. Was it a natural death? It was a dysrhythmia not necessarily directly related to the drug ingestion that actually took his life. Thank goodness we can ponder these things as hypothetical.