Friday, August 24, 2012


The September 2012 issue of Forensic Science, Medicine, and Pathology contains an interesting article by Hejna, et al., analyzing a case of complex suicide. The article defines complex suicide as one "in which more than one suicide method is applied either simultaneously or successively (one after the other)" and distinguishes complex suicides by two variations: planned, where two or more methods of suicide are combined simultaneously; and unplanned, where a second method of suicide is attempted to compensate for some unsatisfactory aspect of the first, i.e. unbearable pain, or inadequate severity.

This particular case was an instance of planned complex suicide, with the 39 year-old victim employing both a firearm and hanging. While this combination tends to be the most common in planned complex suicides, what makes this case salient is the use of a black-powder derringer. In what was likely an attempt to improve lethality, the gun was loaded with a powder charge far exceeding manufacturer specifications. This resulted in instantaneous death and atypical markings circumscribing the ballistic entrance wound. The effectiveness of the shooting rendered the secondary method of suicide ineffectual, as evidenced by the lack of indicators which are normally present in hanging deaths (such as bleeding into the intevertebral discs).

Hejna, et al. conclude with five key points for forensic investigators to take away from this case:

"1. The combination of hanging and gunshot injury is the most common arrangement involved in primary complex suicides. 
2. Injuries and fatalities resulting from the use of black powder handguns are relatively rare compared to other firearms. 
3. Black powder weapons produce entrance wounds with extensive sooting and powder tattooing (in close range and intermediate range shooting). 
4. The wounds from black powder firearms may have a characteristic sulfurous odor and the soot deposits may have a yellowish color. 
5. The atypical morphology of the entrance wound with extensive back spatter in this presented case was conditioned by the excessively short barrel of the derringer, a higher amount of black powder charge and by artificial incision of the projectile ogive."

 View of the victim as found, with prominent atypical entrance wound. [Hejna, Fig. 2]

"The handgun used– black powder muzzle loading doublebarreled derringer." [Hejna, Fig. 6]

Hejna, Petr; Šafr, Miroslav; Zátopková, Lenka; Straka, Luboš. Complex suicide with black powder muzzle loading derringer. Forensic Science, Medicine, and Pathology (2012) 8: 296-300. 

Sunday, August 19, 2012


I'm through about 25% of Deborah Hayden's book, POX: Genius, Madness, and the Mysteries of Syphilis. Thus far, the work is riveting. Competing theories on the biological evolution and epidemiology of syphilis are weaved throughout a cogent narrative, flavored with notable excerpts from historical records. Apart from the Great Mortality, I can't think of another disease which was so widely personified by poetic mythos and dark imagination as was syphilis. Consider this lurid description by 19th Century French poet Théophile Gautier:

"There is a splendid American pox here, as pure as at the time of Francis I. The entire French army has been laid up with it; boils are exploding in groins like shells, and purulent jets of clap vie with the fountains in the Piazza Navona . . . tibias are exfoliating in extoses like ancient columns of greenery in a Roman ruin . . . lieutenants walking in the streets look like leopards, they are so dotted and speckled with roseola, freckles, coffee-colored marks, warty excrescences, horny and cryptogamic verruccae and other secondary and tertiary manifestations which appear here after a fortnight." [1]

1. Hayden, Deborah. Pox: Genius, Madness, and the Mysteries of Syphilis. Basic Books, New York: 2003. Quoting Claude Quétel: History of Syphilis (1990).

Monday, August 13, 2012


Today a coworker told me of a story that has recently featured in the news, wherein a Chinese woman checked into Changsha Central Hospital after days of intense irritation and itching in her ear. Further investigation with a video scope revealed that a small jumping spider had taken up residence in the woman's external auditory canal, yielding some pretty neat pictures and endless nightmares for arachnophobes the world over:

This account sparked some mental catalysis, and I began to chatter internally. This is just the proverbial tip of the iceberg; surely Deh interwebs must play host to a plethora of nauseating ear-canal discoveries! And boy do they ever. 

I quickly stumbled upon the ENT USA site, which is both informative and chock-full of revolting photos depicting objects in the ear canal -- objects that, by all rights, should not be there. I've inserted a few, um... favorites (?!) below. 

You've heard of the infamous deer tick, now witness the glory of the EAR tick!
It might not infect you with lyme disease, but it is extremely lethal to your sex life. 

I'm voting to replace the old adage "packed like a can of sardines" with the endearing quip, 
"all tucked-in like a warm bundle of ear maggots." Who's with me?

"This ear ache is killing me! What to do, what to do?... I know!--I'll grab one of my ciprofloxacin tablets, grind it up, and toss the powder in there. That outta make me right as rain!"

That's just a small sample of the fun in the ENT gallery, which includes among many other entries, photos of mastoid fistula, adenocystic carcinoma, and fungal infections of the ear. It's enough to make the most stoic Ferengi go wobbly in the knees with abject horror and despair. Enjoy now, thank me later. 

Friday, August 10, 2012


Who hasn't wondered what it would be like to work as a plague doctor -- that secretive scientist who tampers with the biological dark arts, manipulating viral agents to discover new ways of improving delivery, rendering a strain impervious to traditional responses, or selectively tweaking a bug's lethality? It wouldn't be a job for the faint of heart, and I can imagine the paranoia and guilt which accompanied nuclear scientists in the Forties and Fifties might pale in comparison. 
I'm not sure if there will ever be a point where human curiosity is trumped by legitimate danger--a threshold that, being too dangerous to cross, incurs a general consensus response of "screw that!" If such an occassion ever does arise, I suspect it will be rooted in the microscopic. The most dangerous things are invariably very small: a split atom, a bundle of seven structural proteins, a stubbornly self-replicating nanobot with a penchant for ecophagy.     
Certainly, the plague doctors toe this precipice daily, and for them it's business as usual. I'm not sure I'd have the balls to engage in such work, even if I were to pretend I possessed any inclination for it.

"One scientist from Sandakchiev's Vector Laboratories, Deputy Director Sergei Netesov, appeared one day in 1987 at Obolensk with a new idea for plague: he proposed taking the entire viral genome of Venezuelan equine encephalomyelitis (VEE), perforating the plague cell membrane, and planting the virus inside plague cells like another plasmid. At Vector, Netesov had made a career of proposing such devices. Popov, quoting Alibek, identifies Netesov as the originator of the whole concept of chimeras: genetically engineered viruses made of two component parts---smallpox and VEE, smallpox and ebola. Apparently on the strength of these novelties, Netesov had been promoted to deputy director of Vector at Novosibirsk. The name of the program he directed was Okhotnik---Hunter. His proposed plague-VEE chimera, fiendishly simple in design, but ferocious in concept, is probably the first time anyone had proposed putting together a bacterium and a virus. A victim of this chimera would be treated for plague with the appropriate antibiotics, which would kill the plague bacteria. But shattering the bacterial cell walls would release VEE into the lymph or the bloodstream; the invading virus would have already bypassed much of the immune system, and it would make straight for the brain. Within a week or ten days, the victim would be dead of encephalitis." [1]

 1. Orent, Wendy. Plague: the Mysterious Past and Terrifying Future of the World's Most Dangerous Disease. Free Press, New York: 2004.