Morgue (9 page)

Baltimore, my father said, was the best. Dr. Russell Fisher had recruited the nation's best team of medical examiners and was in the process of building the most cutting-edge forensic facility ever conceived.

With a little nudge from my father, Dr. Fisher hired me, and on July 1, 1969, at age twenty-eight, I started my fellowship at the Office of the Chief Medical Examiner of Maryland with high hopes.

But Dr. Fisher's ultramodern morgue wasn't quite ready when I arrived. Instead, I started on one of the hottest days of a sultry summer in the nineteenth-century building on Fleet Street, near the harbor, that had housed the ME's office since James Garfield was assassinated. In the old days, when ordinary people were more familiar with death, unidentified bodies would be propped up in the morgue's street-side window in hopes a passerby might recognize them.

The low-slung, old brick morgue was virtually attached to the city's sewage treatment plant, possibly by city fathers who wanted all of the municipality's malodorous mechanisms in one spot. Worse, it had no air conditioning, and the autopsy room grew unbearably hot in summer, so autopsists would open the old sash windows and hope the screens were intact so hungry corpse flies wouldn't stream in to feast on and lay their maggot eggs in our “guests.”

In Baltimore, I began to see how other people grew blasé about death.

The Baltimore morgue had only two main areas, the autopsy room and the administrative offices up front. Before dawn every morning, the dieners would array the day's corpses on the tables in the small, unventilated autopsy room, ready for the medical examiners to splay them out under unforgiving, hot lamps that left patches of dark in the corners. Before the rest of the city was eating breakfast, the place already looked like a well-organized abattoir.

By midmorning, the secretaries and clerks would arrive for work, and the easiest way to the public offices from the parking lot was directly through the dank, fetid autopsy room.

Most of these administrative workers were young girls right out of high school—maybe seventeen or eighteen. Dressed in their summer skirts and fancy blouses, they would thread their way among the body-filled autopsy tables, primly carrying their sack lunches, chatting and giggling as if the corpses were not there.

Even then, I accepted my own nonchalance around dead people as a professional quality, but it seemed odd to me when “normal” people were detached around corpses.

Baltimore was a violent city then, as much as it is now. The parade of corpses never stopped, even when we moved a couple of months later into Dr. Fisher's palatial new morgue on Penn Street, where the air was cooled and cleansed, our cutting was hidden away, the lights illuminated every detail, and the office girls no longer sashayed among the dead.

I'd been on the job less than three months and was still just twenty-eight years old when one of the most fascinating and most important cases of my life landed on my table in the frail form of a dead baby.

 

‹ THREE ›

An Empty Nursery

A baby dies without dreams or memories.

That's why the death of a child is so tragic. We wish for them to know what we know about life, about us. They haven't yet wondered why there are stars, sung a song, or truly laughed. We yearn for them to have a chance to be happier than we ever were. We invest these new, tiny lives with hope.

Then that baby—that hope—dies, and we lose a little hope.

I'm often asked if it is harder to examine a dead child, but to be honest, it would be harder to look away.

BALTIMORE, MARYLAND. SUNDAY, SEPTEMBER 21, 1969.

Toward the end of a crisp fall weekend, the phone in our little suburban Baltimore apartment rang. On the other end was Walter Hofman, who was also a fellow at the Office of the Chief Medical Examiner of Maryland.

“Vince, I need a favor,” he said. “Yom Kippur starts tonight and I'm taking off tomorrow. Would you cover my cases? There's not much. The only one I know for sure is a baby boy coming in from Hopkins.”

Hofman didn't know much more about the case, except the child had multiple admissions but nobody really knew what killed him. I'd just have to look at the hospital's paperwork.

“Sure,” I said. “Shouldn't be any problem at all.”

*   *   *

The child was born February 9, 1969, to an unwed thirteen-year-old Maryland girl. Her pregnancy had been uneventful, but her child was born breech, meaning he'd come out feet or buttocks first, posing some risks as his head and umbilical cord squeezed through the birth canal together. Luckily, the birth was otherwise routine, and a healthy baby boy, six pounds and nine ounces, took his first breath on a Sunday in the midst of a killer nor'easter.

Nameless and unwanted, the small but healthy newborn fell directly from the delivery table into the cold hands of the government. A temporary foster family saw him through his first five months, during which he had no illnesses of any kind. His foster mother reported him to be a happy baby who was seldom irritable. In less than five months, his weight doubled, and he showed no signs of any defect whatsoever.

That spring, a perfect family appeared. Army sergeant Harry Woods, his wife Martha, and their two-year-old adopted daughter Judy had recently been transferred to Maryland's Aberdeen Proving Ground, where the US military tested chemical weapons and other equipment.

Harry was a mess-hall cook and Martha a stay-at-home mom. They'd each grown up in big families in Columbus, Ohio's blue-collar Bottoms neighborhood, where they met in 1958 after both had failed first marriages. They married in 1962 just before Harry shipped out to Korea while Martha stayed behind. Over the next few years, Harry went to Vietnam and Germany while Martha moved in and out of homes in Columbus, Ohio; Fort Gordon, Georgia; and Fort Carson, Colorado—where they adopted the infant they named Judy Lynn in 1967—before being transferred to the Army's Aberdeen Proving Ground.

Martha, now forty, had lost three natural-born children and suffered almost a dozen miscarriages. She desperately wanted another child, preferably a boy she could name after her youngest brother, Paul, who'd lost an infant child of his own eleven years before. The child could be physically or mentally disabled, she told the lady from the adoption office, but given her past heartbreaks, she'd rather not have a child who was physically unhealthy. She needed a new chance to prove what a good mother she was.

No red flags. A typical itinerant military family. An eager mother. A steadily employed father. A healthy older sibling. Harry and Martha were approved.

So in early July, a county adoption officer unexpectedly phoned. She told the Woodses a little boy was available. They could see him and, if they wanted, take him home. Ecstatic, they hurriedly shoved a crib into Judy's room in their Army-issue two-bedroom bungalow, bought some baby clothes, and welcomed their new son—Paul David Woods—on July 3.

Martha had what she wanted: a new chance.

A month later, on August 4, a paramedic carried Paul into the emergency room at Kirk Army Hospital, a worried Martha close behind.

Martha told the ER doctor that a little after lunchtime, Paul had been playing with Judy on a blanket spread across the living room floor when his head arched backward unnaturally and he keeled over. He stopped breathing and turned blue around his mouth, nose, and eyes. Martha scooped him up and began mouth-to-mouth resuscitation as she frantically dialed for an ambulance.

By the time the ambulance reached the base hospital, just a mile away, little Paul had recovered. The doctor described him as alert, active, and not in distress. The doctor ordered an X-ray to be sure the baby hadn't aspirated a toy, but his airways were clear. Maybe the child had suffered some kind of mild seizure, or maybe the mother had overreacted, but nothing appeared wrong. Twenty minutes after they'd arrived, the doctor sent them home.

A few hours later, Paul was rushed back to the Kirk emergency room, conscious but pale, limp, and cyanotic—the medical term for the bluish skin discoloration caused by a lack of oxygen in the blood. Martha told a new doctor that she'd returned from the hospital and laid Paul in his crib for a nap. After a while, she heard gasping, choking noises and found the baby had stopped breathing again.

This time Paul was admitted. The doctors still had no idea what might have caused his spells. For three days, they ran tests—chest and skull X-rays, an electrocardiogram, complete blood work, urinalysis, even a spinal tap—but all showed the baby to be completely normal. And during those three days, he showed no signs of breathing trouble. Perhaps more to soothe an anxious mother's nerves, the doctor blamed it all on an upper respiratory infection, although he saw no real signs of it. So the hospital released Paul a little before noon on August 7.

He wasn't away long.

The next afternoon, August 8, Martha told doctors Paul was playing in a bouncy chair while she talked to a neighbor through an open window when Paul suddenly gagged and went stiff. Again he stopped breathing, and again he turned blue. Again Martha called the ambulance. And again Paul was alert and active when he got to the hospital.

Puzzled doctors admitted Paul for a new round of tests—all of which showed nothing wrong, and Paul had no further breathing spells in the hospital. The attending physician attributed the episode to “breath-holding.” Paul left the hospital four days later, August 12, happy and hearty.

But in less than twenty-four hours, he was back. This time, Martha reported he'd stiffened in a kind of seizure, convulsed, then stopped breathing completely while she held him in her arms. Harry had been just a few feet away when Paul started turning blue. At the hospital, doctors injected him with an anticonvulsive drug called paraldehyde, and within a few hours, Paul was again alert and active. A neurological examination and another spinal showed no problems whatsoever.

His doctors at the little post hospital were flummoxed, so the next day, they transferred Paul to Walter Reed Medical Center, the US Army's flagship hospital in Washington, DC, where they'd have more resources to solve this mystery.

But after five days of brain scans, electroencephalograms, more skull and chest X-rays, and a battery of other sophisticated tests, Walter Reed's doctors were stumped, too. They decided Paul suffered from “a convulsive disorder of undetermined etiology” and sent him home on August 19 with a prescription for phenobarbital.

Paul Woods had spent most of his sixth months on earth in hospitals that couldn't understand why he was there.

And he wasn't done.

The next afternoon, August 20, Paul was rushed to Kirk Army Hospital. He was in cardiac and pulmonary arrest—his breathing and heart had stopped. Working furiously, ER doctors injected adrenaline directly into his lifeless heart, shoved a tube down his little throat, and restored his breathing, but he was comatose and didn't respond to any painful stimuli. He was quickly transferred to Baltimore's Johns Hopkins Hospital, one of the world's best hospitals. His chart bore a simple narrative: “Worthy of interest is the fact that the baby never presented any difficulty while in the hospital, but always at home and less than twenty-four hours after discharge.”

Martha told the Johns Hopkins doctors that she had laid Paul in his crib after lunch. As she got Judy ready for her nap, she noticed Paul wasn't breathing. His lips and face were blue. She blew little breaths into his mouth, but he was unresponsive. She ran outside and screamed for somebody to help. A neighbor rushed them to the hospital.

Doctors closely questioned Harry and Martha, who swore Paul had suffered no physical trauma, nor had he ingested any poison. But the parents raised a different possibility, almost as an afterthought and certainly never mentioned before: something toxic in the air. “Nerve gases” were being tested at the proving ground, they said, and the bay beside their home had been closed because “all the fish were dying from some chemicals that were spilled.”

Suddenly doctors had a lead. They sent samples of Paul's urine and blood to a lab that identified “something abnormal,” a foreign substance the lab said might (or might not) be an organophosphate known as diazinon—an insecticide. While they treated Paul for possible diazinon poisoning, they also learned the Army routinely sprayed two other insecticides on the post, although the dates didn't correspond to any of Paul's breathing spells, and subsequent tests of Paul's blood were inconclusive.

Then a shock. On September 9, twenty days after Paul fell into a coma, his adoptive sister Judy was admitted to Johns Hopkins. Dr. Douglas Kerr, a pediatric resident and a new father himself, worked the ER that afternoon and found Judy to be a lively child. No outward sign of any difficulty.

But Martha told Kerr that two-and-a-half-year-old Judy had collapsed, stopped breathing, and turned blue for a couple of minutes. After she started breathing again, she remained limp and sleepy, so Martha brought her in to be checked.

Martha struck Kerr as intelligent, caring, and knowledgeable, even as Harry appeared submissive and slightly dim-witted. She did most of the talking but was cooperative and courteous as he asked about Judy's surprisingly extensive medical history, which included at least five similar breathing episodes where she was rushed to the hospital after turning blue since she came to the Woodses as a five-day-old infant.

But Kerr sensed a reluctance in Martha on the subject of her own medical history—three natural-born children who died as infants of various defects, a stillborn baby, ten miscarriages, and sundry other ailments. He felt the middle-aged Martha might just be uncomfortable talking about such personal things.

Kerr was startled to learn that Judy's little brother lay comatose in Johns Hopkins's ICU, a few floors below. When he heard of the insecticide theory, he grew even more curious. Judy and Paul slept in the same room. If their air had been poisoned, wasn't it reasonable to think they'd both suffer the same symptoms?