1. PathCentre LESSONS FROM CELEBRITY DEATHS Dr Clive Cooke PathCentre

2. CELEBRITY LESSONS Is it necessary to do anything differently?

3. PathCentre CELEBRITY LESSONS l presume a hidden (concealed) homicide l scene l clothing l time of death l blood stains l conduct of the post mortem l toxicology, etc

4. PathCentre SCENE l scene often disturbed (cleaned) l encourage investigating authority (police) to have best scene investigators l evidence recording Video Photographs l evidence collection l statements (as if a homicide)

5. PathCentre BRIEFING MEETING l prior to the Post-mortem examination l Coroner l investigating officer (police) l pathologist (s) l mortuary manager

6. PathCentre Mortuary Facility l State Mortuary l not peripheral centre l Forensic pathologist l not lesser pathologist

7. PathCentre Mortuary l Security l locked, refrigerated area (no access, even to staff) l body continuity sheet (register of all body movements)

8. PathCentre Attendance at PM l Limited to essential, operations personnel l mortuary staff (selected) l forensic pathologist (and observers) l Coroner l operational investigators (police)

9. PathCentre Medical Observers l 2 forensic pathologists (including the most senior) l professor of pathology

10. PathCentre IDENTIFICATION l Avoid “Elvis lives” allegation - confirm identification objectively l dental chart (always) l fingerprints (always) l DNA identification paternity body part dispute

11. PathCentre Timing of the PM l normal working hours l PM can be planned l accusation of too hasty or too tardy l delay transcription of PM report

12. PathCentre Record of the PM l photographs +++ (official) l video (prints and negatives to be secured) l whole body Radiology

13. PathCentre The PM Report l closely controlled document l homicide level and style

14. PathCentre PM Evidence l toxicology and other samples l duplicates (at least) 1 set tested 1 set stored

15. PathCentre Toxicology l there is often allegation of poisoning (irrespective of the COD and MOD) l routine toxicology samples (duplicated) l extras (duplicated) hair nails kidney whole of intestine (segmentalised) solvent samples – fat, lung, brain swabs – nares; hands Joseph Stalin poisoned by KGB?

16. PathCentre Tested Samples l letter of referral to the lab l confidentiality reaffirmed l specific testing to be done l return of unused samples to the Mortuary (retained) l cc the Coroner

17. PathCentre Body Part Retention l neuropathology recommended (likelihood of allegations of aberrant behaviour) l ? other (Make sure the Coroner is aware)

18. PathCentre Release of Body l after debrief l identification certain l NOK has been identified (multiple partners, children) l NOK aware of body part retention l evidence collected – suitable and stored l formal authorisation of release

19. PathCentre Accusations l expect accusations of l bias l incompetence l cover - up l conspiracy l racism

20. PathCentre Outside Interests l attempted interference whilst the case is hot l media l authorities senior police ombudsman politicians l individuals l further inquiries (might last for decades) l commissions of inquiry l amnesty l books

21. PathCentre Avoiding Stress l stay above public hysteria (media; politicians; Coroner and mortuary staff; police; public – threatening calls and e mails; pathologists; doctors, etc) l don’t neglect (seek comfort in) normal business l be aware of high rate of problems for the investigators burn – out divorce suicide dismissal

22. PathCentre Other Suggestions l don’t include the case in public presentations (Nelson Rockefeller – Dr M Baden) l don’t falsify information (Tennessee Williams, 1983 – Dr E Gross sent toxicology samples under another name) l don’t give press statements (remember – it is because you are socially inept that you have become a forensic pathologist) l don’t be careless (even if you have battled bureaucracy for years, are under resourced, with little support – this is not the time to make a statement)

23. PathCentre MARILYN MONROE l body found face down on her bed in bedroom, room secure (by maid/nurse) l Dr Greenson attended (body stiff with rigor mortis – “5 minutes to straighten her out”) l police not called for 2 hours

24. PathCentre MARILYN MONROE l problems with the scene examination : l associated Press journalist impersonated Coroner’s officer and gained access l no drinking glass or water noted l police report said 15 medicine containers on bedside table – only 8 apparently sent to tox lab (bedroom cleaned the following day and containers destroyed) l delay in police call l interference with body

25. PathCentre MARILYN MONROE l problems with the mortuary : l 2 photographers gained access, with whisky, and photographed the body before post-mortem examination

26. PathCentre MARILYN MONROE l Deputy Medical Examiner (Dr Tom Noguchi) l no injection sites (surface of body examined with magnifying glass, including beneath the tongue and vagina) l no tablet residue in stomach, or staining l small bruise top of left buttock

27. PathCentre MARILYN MONROE l toxicology : l blood : Chloral hydrate = 8mg% l liver : Pentobarbital (Nembutal) = 13mg%

28. PathCentre MARILYN MONROE l DME advised Coroner on 10 August l COD = “Acute barbiturate poisoning due to ingestion of overdose” l MOD = suicide (“probable” handwritten addition) l Coroner issued finding 1 week later

29. PathCentre MARILYN MONROE l problems with Toxicology : l not all intestine contents submitted (other than stomach) l no analysis other than blood and liver l no confirmation of medication types (8/15 containers) l samples destroyed within a few weeks

30. PathCentre MARILYN MONROE l alternative theories : l accidental overingestion l homicide injection enema FBI - to protect Kennedy’s Mobsters – linked to Frank Sinatra (alleged lover)

31. PathCentre MARILYN MONROE - LESSONS l security - scene, mortuary and information l scene – everything documented and retained (treated as a “crime” scene) l post-mortem examination – retain too much l toxicology

32. PathCentre MARILYN MONROE Born : Norma Jeane Mortenson 1 June 1926 (baptised Norma Jean Baker) Died : Night of 4/5 August 1962 (age 36) Childhood : foster care and orphanage

33. PathCentre MARILYN MONROE l Married 3 times 1942-46 : Jim Dougherty (she had just turned 16) 1954-54 : Joe DiMaggio (baseball star – just retired)) 1956-61 : Arthur Miller (playwright) l 1944 : Army promotions photo shoot led to photo model career l 1946 : contract with 20 th Century Fox – “Marilyn” from fellow actress and “Monroe” from mother’s family name l 1950 : “The Asphalt Jungle” l 29 movies

34. PathCentre MARILYN MONROE l 1950’s : increasing alcohol and prescription drug dependence Demerol (Morphine) Barbiturates – Nembutal; Amytal; Sodium-Pentothal Chloral hydrate and occasional use of Mandrax and LSD l Required medical treatment for overdoses l 1961 : physical ailments included Cholecystitis (cholecystectomy) Menorrhagia ? Irritable bowel syndrome

35. PathCentre MARILYN MONROE l 1960 : Dr Greenson – psychiatrist to the stars l 1961 : ? Relationships with JFK and Bobby (President and Attorney-General) l Evening of 4 August 1962 – several phone calls to friends – seemed very depressed; worried because had received threatening calls saying to leave Bobby Kennedy alone