Flesh and Bone: A Body Farm Novel

my collection of still-evolving skeletons, I accused myself of going too far, speaking too harshly, because I’d gone into class already mad about the newspaper article. It was important for scientists to defend good science and expose pseudoscience. But it was also important to do it gently, at least when students were involved. “Damn, Bill,” I said to myself, and at myself. “Damn.”

CHAPTER 9

TESTIFYING AT A HEARING to revoke a physician’s medical license wasn’t exactly the same as testifying in court, but it was damn close. This hearing looked like a trial and it quacked like a trial, complete with lawyers and oaths to tell the truth.

The Tennessee Department of Health and Environment had a lawyer whose job was to ask me easy questions, and Dr. Garland Hamilton-the medical examiner whose license was on the chopping block, so to speak- had a lawyer whose job was to chip away at my answers.

The case that had prompted the state to try to revoke its own regional medical examiner’s license was a fascinating one. A man named Eddie Meacham called the 911 dispatcher in Knoxville one Saturday night to say that his friend had just collapsed. By the time the ambulance arrived, Billy Ray Ledbetter was dead, with a bloody wound in his lower back. Dr. Hamilton performed an autopsy, found copious amounts of blood in Ledbetter’s right lung, and pronounced the cause of death to be a stab wound in the lower back, with the blade penetrating the lower lobe of the right lung.

Trouble was, it turned out that the “stab wound” was inflicted by a big shard from a glass-topped coffee table, which Billy Ray had shattered when he collapsed onto it. I had the dubious plea sure of getting involved when I did an experiment at the Body Farm that showed it would have been impossible for a knife blade-even if there had been a knife wound, which there wasn’t-to puncture the back on the left side, cross the spine, and then veer ninety degrees into the right lung. The real cause of the lung hemorrhage, it turned out, was a bar fight a couple of weeks before Billy Ray’s death, when he got severely boot-stomped, breaking multiple ribs and puncturing the lung with a sharp piece of bone. My testimony had served the dual purpose of clearing Billy Ray’s friend of an unjustified murder charge-which pleased me-and of spotlighting Dr. Hamilton’s incompetence-which displeased me on two counts: first, that he was incompetent, and second, that I was now part of the effort to strip a longtime colleague of his license to practice medicine.

Hamilton had confronted me furiously after the trial, so I was prepared for the worst when I entered the hearing room. He stood up and stepped toward me; I braced for an assault, verbal or even physical. Instead, he stretched out his right hand. Startled, I took it and shook. “No hard feelings, Bill,” he said with a smile and a squeeze of my hand.

Surprised at his change of tone, all I could come up with was, “I hope not, Garland.”

Up at the front of the room, which was just a large conference room in one of the state office buildings in downtown Knoxville, a panel of three physicians-members of the Board of Medical Examiners-sat behind a long table. To one side, a stenographer perched at a much smaller table, her fingers poised over the odd little machine she used to transcribe words. I was fascinated by the technology. Her machine, a stenograph, looked more like an old-fashioned adding machine than a computer or typewriter; as she typed, though, she would often press two or three keys at once, like playing a chord on a piano. I had once asked a court reporter to explain and demonstrate the technique to me. “I’m transcribing sounds, not words,” she’d said, and she had me speak a few words at a time. She showed me what combinations of keys she used to transcribe the various sounds I had uttered- sometimes a “chord” represented a syllable; sometimes an entire word; in one case, even an entire phrase. It beat the hell out of anything I’d ever seen: as if she’d had to master a new language and a musical instrument all at the same time. Ever since, I’d had great admiration for court reporters’ abilities.

“Dr. Brockton, are you ready?” The state’s lawyer brought my mind back to the business at hand. He had already briefed me on the charge against Hamilton: “significant professional incompetence, with actual or risk of immediate harm,” the most serious charge possible. In this case, the harm was not to the patient, since Billy Ray was long since dead by the time Hamilton got to him; the harm was to the friend who faced life in prison for an unjust charge of murder. Pretty harmful, all right. If the examiners upheld the complaint, Hamilton’s license could just be suspended temporarily, but it was more likely to be revoked for good. And it would be good, judging by some other shoddy autopsy reports I’d seen.

I’d brought diagrams of the spine, rib cage, and lungs, showing the impossible “wound path” Hamilton had described the knife taking; I had also requested that a teaching skeleton be on hand so I could further illustrate the impossibility in three dimensions. The state’s lawyer led me swiftly through a recap of the experiment I’d done, in which I had been unable even to approximate the path Hamilton had described. He ended by having me describe finding the shard of bone, from Billy Ray’s own splintered ribs, that had pierced the right lung. The examiners on the panel asked a few questions: Might a thinner blade have been able to make the requisite turns? Was there any sign of a knife mark on the detached bone shard? Was there any possibility the shard had punctured the lung during postmortem handling of the body? — but they seemed satisfied with my answers.

Then Hamilton’s lawyer got his turn. I had been cross-examined by the Knox County district attorney about this same case, so I felt reasonably confident, well prepared, but his first question threw me off-balance. “Dr. Brockton, did you examine the decedent, Mr. Ledbetter, for evidence of scoliosis? Curvature of the spine?”

“Well, no,” I said, “but I think I would have noticed-”

“I’m not asking what you think you would have noticed, Doctor; I’m asking whether you took measurements or X-rays or conducted any other sort of investigation that would have yielded an objective indication of scoliosis?”

“Then I’d have to say no,” I said.

“And did you examine your research subject, the one you stabbed in the back, for evidence of scoliosis?”

I felt my cheeks flush. “No,” I said. “He appeared to be a normal individual. He was a marathon runner. I don’t imagine someone with scoliosis would have an easy time running marathons.”

“You ever see photos or news stories about amputees, wearing artificial limbs, running marathons?”

“Yes,” I said.

“Do you imagine they have an easy time doing it?”

“No, I don’t. I’m not sure I understand what you’re getting at, though.”

“What I’m getting at, Dr. Brockton, is this: You don’t actually know for a fact that Billy Ray Ledbetter’s spine was normal, and you don’t know for a fact that your research subject’s spine was identical in shape to Mr. Ledbetter’s. What I’m getting at is the fact that a knife could have followed a different path in Mr. Ledbetter’s body than in the body of your experimental cadaver if their spines were curved differently. Couldn’t it, Dr. Brockton?”

I was not willing to back down completely. “Slightly,” I said. “If one of them had severe curvature and the other did not. But neither of them had severe curvature.”

“You’ve just said you didn’t measure or X-ray either spine for scoliosis,” he shot back.

“I haven’t measured or X-rayed your spine, either,” I said, “but that doesn’t keep me from noticing that you probably have some anterior deterioration and compression in your cervical disks. That’s why your head juts slightly forward of your shoulders. Do you have neck pain? You might be a good candidate for cervical fusion.”

“We are not here to talk about my spine, sir,” he all but shouted at me.

“No, sir, we’re not,” I said levelly. “What we’re here to talk about is truth and competence, and what I’m getting at is that after studying thousands of skeletons, I don’t have to take X-rays and measure angles to notice a deformed spine. Neither of these two individuals had a deformed spine.”

He sputtered a bit, and tried to regain his advantage, but he had clearly played his one trump card, and it wasn’t quite the ace he’d hoped it would be. After a little more sparring, the physician who was leading the hearing called a halt, thanked me, and pronounced me free to go.

As I left the hearing room, I noticed Hamilton’s attorney rubbing his neck; the sight made me smile. Then I caught the stenographer looking from me to the attorney and back again. She gave me a wink and a smile; she crossed her legs at the same time. I wasn’t sure if that was just a happy coincidence, or if it was some sort of