If These Bodies Could Talk. True Tales of a Medical Examiner

If These Bodies Could Talk
True Tales of a Medical Examiner



Alexey Reshetun




Alpina

Alpina 4th Magistralnaya 5, bld. 1 Office 159-169
123007, Moscow, Russia International@alpina.ru

Copyright © 2021 by Alexey Reshetun

Managing Editor: Marina Krasavina Project Editor: Natalia Pepelina Translator: Sonja Swenson-Khalchenia Copyeditor: Kevin Bridge Proofreaders: Karen O’Donnell, Beth Dymond Cover design: Yuri Buga



All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review.



Printed in Russian Federation



                                   ISBN 978-5-9614-7201-1

To my colleagues — the forensic medical examiners at the Moscow Forensic- Medical Bureau.

                Contents







Foreword to the New Edition.................................. 9
Introduction ............................................... 11

PART ONE
Laying the Groundwork .......................................15
    1. What Exactly Is Forensic Medicine?................... 17
    2. Just Who Is a Medical Examiner?...................... 22
    3. Pathologist or Medical Examiner? What Is Similar, What Is Not. 28
    4. To Cut or Not to Cut? That Is the Question .......... 32

PART TWO
The Professional ........................................... 39
    1. Our Tools ............................................41
    2. Put On Your Lab Coat ................................ 49
    3. When the Cure Is Worse Than the Disease...............60
    4. Land of the Living .................................. 67
    5. Student Life ........................................ 76

PART THREE
Working With the Dead                 .......................85
    1. Phenomena of Phenomena .............................. 87
    2. Examining a Body: Expectations and Realities......... 94
    3. Exhumation ......................................... 107

PART FOUR
Trauma ........................................................121
    1. A Bat, a Hammer, a Stick, and Other Ways to Die: Blunt Hard Objects........................................ 123
    2. Forks Over Knives: One Hole versus Five—Sharp Instruments and the Wounds They Leave Behind ......................... 129
    3. Buckle Up for Safety, Buckle Up!....................... 136
    4. Gunshots and Explosions in Times of Peace ............. 145
    5. Mass Casualty Incidents ............................... 152
    6. Off with Her Head! .................................... 159

PART FI   VE
Asphyxiation ................................................. 165
    1. Hanging: Fact and Fiction.............................. 167
    2. Strangulation: “Eventually, It All Comes to Light” .... 173
    3. Death in the Water: Sometimes It Is Drowning, Sometimes It Is Not....................................... 177
    4. There’s No Life without Air............................ 184
    5. Warning! Choking Hazard ............................... 187

PART SI   X
Heat and Electricity ......................................... 193
    1. Fair Heat Breaks No Bones.............................. 195
    2. The Cold Never Bothered Me, Anyway..................... 201
    3. I Am in Shock ......................................... 205

PART SE    VEN
Drugs and Alcohol ............................................ 209
    1. Drink Like a Fish........................................211
    2. Say No to Drugs!....................................... 216

PART EI   GHT
Children ..................................................... 221
    1. Cannibal Parents........................................223
    2. You Are Going to Poke an Eye Out! ......................226
    3. Parental Neglect .......................................229

PART NI    NE
Disease ...................................................... 239
    1.  Sudden Death: Cardiovascular Diseases ................ 241
    2.  Cancers................................................245
    3.  Tuberculosis and HIV.................................. 249

PART TEN
Myths ........................................................ 253
    1.  Old Wives’ Tales ......................................255
    2.  Worms and Fecal Stones................................ 258
    3.  Smells................................................ 261

PART ELE    VEN
MISCELLANEOUS ................................................ 265
    1.  Morgue-turned-abortion Clinic..........................267
    2.  A Bad Neighborhood ....................................270
    3.  Transgender and Intersex Cases........................ 272
    4.  Train and Quarry...................................... 274
    5.  A Funny Story ........................................ 277
    6.  Spirituality ..........................................279

Conclusion ................................................... 283
Notes......................................................... 285
Bibliography ................................................. 287

                Foreword to the New Edition







It has been over a year since the first edition of my book was published. During that time, I have given many talks in several cities, given media interviews, and even been recognized in the street a few times (I am famous!). I have received over one hundred letters, both emails and handwritten, two of which invited me to join an organization to save the universe, the others simply expressing gratitude. I answered all of them, other than the two from another realm. It is nice when all kinds of people you do not even know like your work. That was a new feeling for me, something I was not used to. Before the first edition came out, I had no idea what kinds of things readers would share with me. I learned that many of them were really interested in finding out more about my specialty, that they were able to look beyond old prejudices, and some were even able to re-evaluate their lives. It would seem that my work was done. After all, the book came out, and people liked it. But, my dear readers, you have rightly pointed out to me that some things were missing from the book. I have tried to include them all here.
    In this new edition, I will talk about the many types of tools we use at work. Each of them has a specific purpose. I will also talk about what we do in the lab, about exhumations, motorcycle injuries, dismemberment, and iatrogenesis, and, finally, about some of my favorite students.

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IF THESE BODIES COULD TALK

                Some chapters include case studies and quotes from real criminal cases.
                I am always open to hearing from you. And I would be grateful if, after reading my book, you send me a few lines letting me know what you think. Email mossudmed@gmail.com or Instagram @mossudmed.

                Introduction







Once upon a time, when I was a boy, I saw the three-volume Atlas of Human Anatomy ¹ by Raphael Sinelnikov at my parents’ friends’ house. I got carried away by the book and its realistic drawings and Latin inscriptions. I could not understand a thing, but the words sounded so mysterious and fascinating. I was too young to be thinking about a career in medicine, but I knew that I was deeply interested in the human body, and the way that every single detail has been designed so carefully.
     Then I enrolled at the Omsk Medical Institute, which was renamed Omsk State Medical Academy just two years later (today, it is known as Omsk State Medical University). In Omsk (thanks, in part, to the excellent professors of the general anatomy department), I decided to specialize in this particular field of medicine. Even now, at Omsk State Medical University, there is an anatomical preparation* of upper extremity blood vessels and nerves in a formalin bath, prepared by me under the watchful eye of the admirable Professor Vladimir Rublev. After Omsk, fate took me to the challenging city of Chelyabinsk, where I completed my studies over the next four years, and where I delved into the most interesting topics, such as topographic anatomy and pathological anatomy. I also began specializing in forensic medicine there. In 1997, the Department of Forensic Medicine was a sad

    * Anatomical preparations—natural or artificially prepared parts of the human or animal body.

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IF THESE BODIES COULD TALK

sight, with boring classes and absolutely no scientific community. But we learned Vitaly Kryukov’s textbook by heart, and by my fifth year, I knew what I wanted to do. I met Professor Pyotr Novikov, who only strengthened that decision. Then, I could not have imagined that I would one day be lucky enough to work in the same department as Professor Kryukov and so many other wonderful professionals whose books I read in medical school and as an intern. If someone had told me that one day I would rub shoulders with Evgeny Kildy-ushov, Evgeny Tuchik, Ivan Buromsky, Natalia Kachina, Yuri Solokhin, Natalia Selyutina, and Oleg Kriger, I would have never believed them.
                 But, as they say, man proposes, but God disposes. In 2006, I landed in Moscow, and I hope that is where I will stay. I work in the best forensic medical bureau in Russia—the Moscow Medical-Forensic Bureau. This bureau is Russia’s most advanced forensic institution, with enormous labs, departments, and top professionals.
                 Over the last decade, so much has happened in my personal and professional life, but the one constant is that I have always studied. I have studied with people, some of whom are no longer with us, and I have studied books. I have a personal library of over one hundred forensic medical books, some of them dating back to the 1800s, and others are recent editions. Some of them have ink or pencil notes in the margins, left by their previous, nameless owners, and others have been restored. I have helped write a couple of them. To me, a book is always so much more than sheets of paper bound together.
                 And I had never thought that, one day, I would be asked to write a book of my own.

              WHO IS THIS BOOK FOR?

              It all began in 2011, when I discovered LiveJournal and created my own page, mossudmed.livejournal.com. At the time, I had been working as a medical examiner for about eleven years, and I had formed a set of views on human life, health, bad habits, and human vices.
                 I had decided that I would share my professional observations on LiveJournal, with occasional illustrations to help explain things. I did

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INTRODUCTION

               not do anything to promote my blog, but over five years, its readership grew, and it is now consistently among the top ten blogs in the Moscow region, and the top twenty blogs in Russia.
    The blog’s popularity grew to the point that Alpina Publishing House’s Deputy Editor-In-Chief, Irina Gusinskaya, approached me with an offer to write a book. Thanks to her incredible enthusiasm and support, my book became a reality.
    Medical examiners work between the earthly realm and that which has yet to be. We have a front-row seat to the way people sometimes forget to value their present life or think about the future. Medical examiners get up close and personal with the destruction wrought by nicotine, drugs, and alcohol. Most people have no idea of what those poisons are capable of doing, and as a society, we often turn a blind eye to certain bad habits.
    I would like that, after reading my book, people are able to take a step back and see themselves from the outside, and take care to avoid having a hand in reducing the time they have with us in this world. I hope that the information in this book will help my readers preserve their health, and the health of their loved ones.
    Though forensic medicine is not secretive, it remains a mystery for most laypeople, rife with all kinds of legends, preconceptions, delusions, and myths. As you read this book, you will understand what it really means to be a forensic examiner, and what our job entails. You will learn how forensic medicine differs from pathology, when and why an autopsy is necessary, what kinds of injuries can kill someone and what they look like, as well as many other aspects of my specialty.
    It is not a scientific textbook, and it is intended primarily for people who have little to no background in medicine or, more specifically, forensic medicine. For that reason, I avoid any specialized jargon and dry facts and figures, and have attempted to describe pathological processes as simply as possible.
    There is nothing fictional in this book. All of the stories described are actual cases from my own practice or were relayed to me by trusted colleagues.