Patricia Cornwell - Portrait Of A Killer - Jack The Ripper - Case Closed

Dr. Llewellyn misinterpreted just about every detail in Mary Ann Nichols's murder. But he probably did the best he could with his limited training and what was available at the time. It might be interesting to imagine how the murder of Mary Ann Nichols would be investigated today. I'll place the scene in Virginia - not because it is where I once worked and have continued to be mentored, but because it has one of the best statewide medical examiner systems in America.

In Virginia, each of the four district offices has forensic pathologists who are medical doctors trained in pathology and the subspecialty of forensic pathology, training that involves ten years of postgraduate education, not counting three additional years if the forensic pathologist also wants a law degree. Forensic pathologists perform the autopsies, but it is the medical examiner - a physician of any specialty working part-time to assist the pathologist and the police - who is called to the scene of a sudden, unexpected, or violent death.

If Dr. Rees Ralph Llewellyn were employed in Virginia, he would have a private practice and serve part-time as a medical examiner for one of the four districts, depending on where he lived. If Mary Ann Nichols were murdered at the time of this writing, the local police would call Dr. Llewellyn to the scene, which would be cordoned off and protected from the public and bad weather. A tent would be set up, if need be, and there would be a perimeter of strong lights and spitting flares. Officers would be on the street to keep away the curious and divert traffic.

Dr. Llewellyn would use a clean chemical thermometer and insert it into the rectum - providing there was no injury to it - and take the temperature of the body; then he would take the temperature of the air. A quick calculation could give him a very rough idea of when Mary Ann was killed because a body under relatively normal circumstances, assuming an ambient temperature of about seventy-two degrees, would cool one and a half degrees Fahrenheit per hour for the first twelve hours. Dr. Llewellyn would check the stages of livor mortis and rigor mortis and carefully perform an external examination of the body and what is around and under it. He would take photographs, and collect any obvious evidence on the body that might be dislodged or contaminated during transportation. He would ask the police many questions and make notes. He would then send the body to his district medical examiner's office or morgue, where a forensic pathologist would perform the autopsy. All other scene evidence collected and photography would be handled by police detectives or a police forensic squad.

Fundamentally, this is not so different from the way a homicide is handled in England today, except that a coroner's court would hold an inquest at the conclusion of the scene investigation and examination of the body. Information and witnesses would be marshalled before the coroner and a jury, and a decision would be rendered by verdict as to whether the death was natural, an accident, a suicide, or a homicide. In Virginia, the manner of death would be the sole decision of the forensic pathologist who performed the autopsy. In England, the decision would rely on jurors, which can be unfortunate if a majority of them don't comprehend the medico-legal facts of the case, especially if those facts are weak.

However, jurors can go a step further than the forensic pathologist and commit an "undetermined" case to trial. I think of the case of a "drowned" woman whose husband has just taken out a large life insurance policy on her. The medical expert's job is not to make deductions, no matter what he or she privately believes. But jurors can. Jurors could convene in their private room and suspect the woman was murdered by her greedy husband and send the case to court.

The American way of investigating death was imported from England. But over the decades, individual U.S. states, counties, and cities have slowly been withdrawing from the notion of the "coroner," who is usually a nonmedical person elected and invested with the power to decide how someone died and whether a crime was committed. When I first began working at the Office of the Chief Medical Examiner in Richmond, I assumed that other jurisdictions had the same medical examiner system that Virginia did. I was dismayed to learn this wasn't true. Many elected coroners in other states were funeral home directors, which at best is a conflict of interest. At worst, it is an occasion for medico-legal incompetence and the financial abuse of people who are grieving.

The U.S. has never had a national standard of death investigation, and we are far from it now. Some cities or states continue to have elected coroners who go to the scenes but do not perform the autopsies because they are not forensic pathologists or even physicians. There are offices - such as the one in Los Angeles - in which the chief medical examiner is called a coroner, even though he isn't elected and is a forensic pathologist.

Then there are states that have medical examiners in some cities and coroners in others. Some locales have neither, and local government be-grudgingly pays a small fee for what I call a "circuit forensic pathologist" to ride in and handle a medico-legal case, usually in an inadequate - if not appalling - location such as a funeral home. The worst facility I remember was one in Pennsylvania. The autopsy was performed in a hospital "morgue" used as a temporary storage room for stillborn infants and amputated body parts.

The English system of investigating death can be traced back some eight hundred years to the reign of Richard I, when it was decreed that in every county of His Majesty's realm, officers would insure the "pleas of the crown." These men were called "crowners," a name that eventually evolved into "coroner."

Coroners were elected by the freeholders of the county and were required to be a knight, assuring they were financially secure, of good standing, and, of course, objective and honest in their collection of revenues due to the crown. A sudden death was a potential source of income for the king if there was a finding of wrongdoing in murders and suicides, or even if there was an inappropriate response by the one who discovered the dead body - such as not responding at all and looking the other way.

It is human nature to make a hue and cry when one stumbles upon a dead body, but during the medieval era, not to do so was to risk punishment and financial penalty. When a person died suddenly, the coroner was to be notified immediately. He would respond as quickly as he could and assemble a jury for what would later be called an inquest. It is frightening to consider how many deaths were labeled evil deeds when the truth may have been that the poor soul simply choked on his mutton, had a stroke, or dropped dead at a young age from a congenitally bad heart or an aneurysm. Suicides and homicides were sins against God and the King. If a person took his or her own life or someone else did, the coroner and jury determined wrongdoing by the deceased or perpetrator, and the offender's entire estate could end up in the crown's coffers. This placed the coroner in a tempting position to perhaps bargain a bit and show a little compassion before riding off with coins jingling in his pockets.

Eventually, the coroner's power placed him in a seat of judgment and he became an enforcer of the law. Suspects seeking refuge in the church would soon enough find themselves face-to-face with the coroner, who would demand a confession and arrange the seizure of the man's assets in the name of the crown. Coroners were involved in the gruesome practice of trial by ordeal, requiring a person to prove innocence by showing no pain or injury after holding a hand in the fire or enduring other dreadful tortures while the coroner sat nearby and somberly watched. Before the days of medico-legal autopsies and professional police investigation, a wife's tumble down the castle steps might be murder if her husband could not endure terrible tortures and escape unscathed.