Forensic Friday: Nurses + Patient Care = Evidence Collection

forensic_factsLast week Sisters in Crime of Central Virginia visited St. Mary’s Hospital Forensic nursing unit.  This unit of specially trained nurses handles some of the most difficult cases including sexual assault, domestic, child and elder abuse, as well as human trafficking cases.


Forensic Facts St. Mary's hospitalVictims generally arrive at the hospital through the emergency room.  Sometimes they walk in. Others are brought in by police or transported by ambulance.


Once the patient’s immediate physical traumas have been evaluated the goal is to get them up to the forensic nursing unit as quickly as possible.


Privacy in St. Mary's forensic nursing unit

Privacy in St. Mary’s forensic nursing unit

The unit doesn’t look like a typical hospital setting and that’s for a reason.  On this locked down unit away from the constant noise of the ER, there is no signage and the waiting area looks like a living room.  Only one patient is admitted at a time.  The entire set up is designed to minimize the trauma the patient has suffered.  It is the busiest unit of its kind in Virginia.


Patients are examined and evidence is collected in special kits.  The examination Forensic Friday St Mary's 1can take between 3-4 hours.  If a victim does not wish to press charges, the nurses can still gather data and hold it for two years on the chance the victim has a change of heart.  Based on exam results, the forensic nurse can advise patients on treatment and support.  If a case goes to trial, the nurses will testify in court.


Continuity of care and follow up is important.  Patients always receive a follow up call after they’ve been discharged.   In the wake of trauma, a victim might have trouble recalling the details of the attack and it can take a couple of days before the brain settles and they are able to provide more detailed information to the investigators.


Nurses are on call 24 hours a day, 7 days a week and they serve the entire Richmond Metro area.








Forensic Friday: The First 48 Hours

forensicsThere’s an oft quoted statistic that says the odds of solving a  Missing Person case decrease by 50{2bc7e4e23428b05b0f692f1ddf5d723165e7c1faee94cc402238e96593bfbeaa} if a solid lead isn’t found within the first 48 hours after the person has gone missing.  Making the most of that time is crucial.  Family and friends need to know they can report a missing adult to the police immediately.


If an adult is suspected to be missing some of the suggested first steps are to check his/her neighborhood and other places the person might usually be, including family and friends’ houses and the area around the person’s home. It’s important to connect with neighbors, friends and relatives. Then get to the police.


Photo: jim.henderson

Photo: jim.henderson

Ways to help the police get started quickly include sharing any reasons and suspicions that may indicate the person has not willingly decided to leave. Be honest about any activities, legal and otherwise, in which he/she has been involved that might precipitate a disappearance.


Also, whoever is reporting the missing person should be as prepared as possible to give information such as what clothes the person is wearing, accessories, and a physical description that includes tattoos and scars. Provide photos.


Mary Burton THE SHARK cover image hi res 4-28-16Once reported, produce and distribute flyers with a picture and other pertinent information including where the person was last seen.


Is the person elderly? In need of medication or medical attention?  Mentally impaired? Has no history of disappearing for periods of time? All of these things ratchet up the urgency.


High risk missing persons include those known to be abducted or for whom abduction is suspected, and those missing under dangerous circumstances.


That’s what Virginia state trooper Riley Tatum and former FBI agent Clay Bowman are dealing with in this excerpt from The Shark, the first of my The Forgotten Files novels.


“I can help you, Sandy.”


“Don’t worry about me,” she said, sliding from the booth. “Just find Cassie. She has a chance to get out.”


Riley slid to the edge of the booth, pulled another business card from her back pocket, and pressed it into Sandy’s hand. “Just in case.”


“I have your number.”


“Then give it to another girl who needs help.”


“You lived on the streets, didn’t you?”


Riley dug a twenty out of her pocket, set it on the table, and placed her untouched coffee cup on top of it. “What makes you say that?”


“A vibe. Like you get what it’s like. No judgment in your eyes.”


“I been a cop for eight years. I’ve seen my share.”


“A lot of cops see.” She texted a message on her cell phone. “Few understand.”


“Lucky, I guess.”


“See you around, Lucky.”


Riley watched the girl push through the front door and cross the lot outside. She moved toward a dark truck, spoke to the driver, and climbed inside the cab.


Never in Riley’s career had she wanted to see two people behind bars or dead more than she did Darla and Jax. Jo-Jo might not ever testify against Jax, but he’d broken enough laws, including evading the police and possession of drugs in his car, to get him some time in prison. A prison sentence would give her the time to build a human trafficking case against him.


Outside, she walked toward the parking lot, watching as Bowman stepped away from his vehicle. He wore a dark sports coat over his white shirt and dark pants, but when a flap of wind caught the edges of the jacket she glimpsed the weapon at his side.


“What did she say?” he asked.


“There’s a motel about twenty miles east of here.”


“You want to check it out?”


“I do. If we don’t find Cassie, I’ll call Sharp.”


“Let’s go.”


The first forty-eight hours in a missing persons case were the most critical. Didn’t seem like a case could go cold so fast, but the best leads vanished with the ticking clock. She didn’t want to rely on Bowman, but she wanted to stack the odds in her favor. She didn’t want to lose this hand. “Okay.”


“I’ll be right behind you. If we get separated, wait for me.”




Forensic Friday: Killers with Calling Cards


Through the centuries, criminals have left “calling cards” as a way to tag a crime as their own or to send a message, usually to authorities.  Actual calling cards harken back to the days when a visitor would leave behind a card with their name on it if the person they came to see wasn’t at home.


TheSharkIn The Shark my killer has a very distinctive and consistent calling card, literally leaving behind cards, in this case playing cards. And the cards Riley Tatum and Clay Bowman find on bodies are all marked with the same word–LOSER.


In general, it is unusual for a criminal to leave a calling card, but it happens.


Back in the day when calling cards were still in use, Jack the Ripper left two the night he killed Elizabeth Stride and Catherine Eddowes.


Police sketch of the man suspected of being the "Zodiak Killer," 1969.

Police sketch of the man suspected of being the “Zodiak Killer,” 1969.

San Francisco’s Zodiac Killer sent crytograms made up of zodiac signs and letters to the San Francisco Chronicle.


The Unabomber

The Unabomber

The Unabomber sent letters to the FBI.


The D.C. Beltway Sniper left tarot cards for police.



A couple of notable one-time calling card messages were those sent by the Son of Sam and Chicago’s Lipstick Killer. “Sam” left a note at the site of a killing saying “I am a monster. I am the Son of Sam.”  The Lipstick Killer inscribed “For heaven’s sake, catch me before I kill more. I cannot control myself” on a victim’s wall.


Here we see Virginia State Trooper Riley Tatum facing a bit of insomnia and using the time to research killings that may have similarities to victims in her area.


She checked the time. Several more hours to go before the alarm went off at seven and she would have to drag Hanna out of bed for her track practice. Wide awake and with no hope of getting back to sleep, she rose, shrugged off her nightgown, and tugged on her gym clothes. Cooper glanced up from his crate, but when she signaled they didn’t have to work, he curled back up to sleep. She carried her running shoes and laptop into the kitchen and fired up the coffeemaker.


While toasting a frozen bagel, Riley thought about last night’s meal she’d shared with Bowman. She hated leaving good food on the table. No matter how many years had passed, she never forgot the raw gnawing of hunger dished out to her by the streets. Since those days, she never wasted food. God, the steak on her plate had been so tender she could have cut it with a blunt knife. And she’d left most of it. Damn.


Finishing the last of the bagel, she moved to her computer. She typed: serial killer, New Orleans, and strangled girls. Everything and nothing popped up, so she added the date from twelve years ago. A few references hit that briefly mentioned four girls, all minors, found dead. Strangled. Because the girls were underage their names were never released. The bodies were all displayed in places where they could be easily found. There were no follow-up stories.


All the victims matched a similar description. Dark hair, dark eyes, between sixteen and seventeen, and all runaways. Just like her.


None of the articles mentioned playing cards discovered at any of the crime scenes. That made sense. Always a smart idea for cops to keep a few facts undisclosed that only the killer knew.

Absently, her fingertips now went to her neck. There’d been no sign of bruising on her neck. The needle marks had healed on her arm. Now, she almost doubted it had happened. But the playing cards didn’t lie. They were the evidence that she’d been taken.



Absently, her fingertips now went to her neck. There’d been no sign of bruising on her neck. The needle marks had healed on her arm. Now, she almost doubted it had happened. But the playing cards didn’t lie. They were the evidence that she’d been taken.



Forensic Friday: Blood Will Tell

forensicsI’m sometimes surprised at the information I end up digging into as part of my stories.  In The Shark, the first of my The Forgotten Files novels, my protagonist, Virginia state trooper Riley Tatum, is an experienced tracker of humans, mostly missing people.  If those people have been injured their condition can add TheSharkto the clues about the shape they’re in, where they’ve been, and when. I foune this really interesting, especially the part about blood trails, and thought you might, too.


First though, I want to note that, even though I researched several sources for background for The Shark, credit—and thanks—for the information presented below belongs to David Diaz, who shares it in his book  Tracking Humans: A Fundamental Approach to Finding Missing Persons, Insurgents, Guerrillas, and Fugitives from the Law, written with V.L. McCann. Here goes . . .


Blood Color:

Dark Red indicates a lack of oxygen and suggests a cut vein or puncture rather than an artery. Blood would keep flowing unless the wound is treated and would leave smears or drops of blood in heavy vegetation.  Minus lots of ground cover, bushes and other plants, a tracker would see more drops and fewer smears.


Forensic Friday Tracking HumansRed would point to the injury involving an artery and “blood would flow in a regular, pulsating fashion” along with the person’s heartbeat and “heavy vegetation would contain a combination of smears, drops and patterns at regular but separated interval patterns.”


Light red blood or blood that appears to include other liquids could mean an abdominal wound.  It might be mixed with gastric, bile, urine or other matter. Patterns would be inconsistent with this sort of wound.


Pinkish blood results from a mixture of air, oxygenated blood and lung fluid and point to a punctured lung. It’s usually foamy.



In this excerpt from The Shark, Riley and canine tracker, Cooper, take the lead in the search for a suspect thought to be connected to the killing of a young woman.


A half hour later, she spotted the outlines of fresh boot prints. The trajectory of the impressions confirmed a westward bearing. The right foot impression was deep but the left shallow, a sign Carter was favoring the leg. His stride appeared shorter, suggesting his pace was slower.




As Riley’s gaze now swept over the lush green foliage, she spotted red droplets of blood clinging to leaves ahead. Like all the markers on the trail, the color and patterns of blood told a story. Dark-red blood implied a punctured vein. Light red meant blood diluted with gastric fluids from an abdominal wound. Pink and foamy signaled a possible chest wound.


This blood was dark red. Unoxygenated. No doubt from the stab wound, which had sliced a vein. Ahead, the path forked and traces of red dotted leaves on both sides.


Close to Cooper’s ear she whispered in Czech, the language he’d been trained to follow while working. “Aport.” Fetch.


Cooper sniffed the ground around the first blood droplets and then around the second set. At the second location, his sniffing increased and his tail wagged. “Good boy,” she whispered.


As they continued, crimson splashes were smeared on more green leaves. The distance between drops shortened to less than four feet. The track was now in its sixth hour and had begun to open his wound. He was suffering, likely angry, and primed to make a mistake if pressed.


Even better.


She lifted a leaf and touched the blood. Still viscous. Fresh. She raised her boot to step when she heard the snap of a twig. She drew her weapon. Cooper’s head rose and he glared toward the right. The dog watched the woods, but his body language didn’t alert her that Carter was close.


Slowly she crouched, gently pulling the tense dog to her. Her heart revved from steady to overdrive, forcing her to slow her breath and listen to the wind whispering in the trees. Tense seconds passed. But there was no more movement. Only silence.


She could fall back, but that was a gamble. Carter’s odds of escape greatly increased if he found his way out of the woods and got hold of a car. Cooper could track people, not vehicles.


Again, the grainy black-and-white surveillance footage of Carter’s fist pounding the skinny girl jabbed her gut. If Carter escaped, he would double back and drop that girl into a hole so deep no one would ever find her.


Standing, she looked up the trail into the dense brush. At five foot nine, she was tall for a woman, and though she was in peak shape, wrangling an injured, possibly armed suspect off the mountain in the fading light would be reckless. She’d stay close but would not engage, knowing at worst an overnight without food and water would drain Carter’s energy reserves, making him a softer target when backup arrived at first light.


Again, Cooper’s gaze cut right. This time she caught a faint flicker of movement. Someone else was there. Freezing, she searched the dense thicket. Had additional police arrived, or worse, one of Carter’s kin?


Her right hand tightened slightly around the gun’s grip as she waited. Watched. There was stillness. Silence. As hard as she searched, she saw no threat. Finally, Cooper looked away. Mouth closed, he sniffed faster as his tail wagged.


Up the trail, the snap of twigs was followed by a painful grunt. Carter. He was up ahead. Close. Grabbing her cell, she texted an update to the base station and seconds later a reply fired back.


Two deputies are one hour out.


Cooper remained alert and silent, a sign her hours of continuous training had paid off.


She typed, Roger.


Wanting a visual on Carter, she tucked her phone back in her pocket before she and Cooper inched forward through the branches. Monitoring her foot placement and her breathing, she made almost no sound. When she crested the next rise, she spotted Carter staggering toward a tree, one hand on a gun and the other on his bleeding thigh. He pressed his back to the thin trunk, slowly lowered to the ground, and pulled a water bottle from his pocket. He drained the container, then tipped his head back and closed his eyes. He thought he was alone. Safe.


Now it was a waiting game.


Forensic Friday: Sleep of the Dead


Propofol took center stage in the news several years ago when Michael Jackson died following an injection of it from physician Conrad Murray. Murray was later convicted of involuntary manslaughter. Nonetheless, propofol is rarely an instrument of death, let alone murder, though several cases have been brought to trial.


Anesthesia Medications Propofol is at top.

Anesthesia Medications Propofol is at top.

While abuse of the drug is spreading, propofol itself is not easily accessible to the general public as its primary use is with anesthesia. A respiratory depressant, it can affect both respiration and the heart. Since an overdose can cause death, it is also a weapon.


Used without intent to kill, effects last only a short time and the last evidence of it leaves deep tissue in about six days.  It’s not illegal.  It’s felt by users in just seconds and is somewhat easily obtainable by many in the medical community.


TheSharkHere’s a scene from THE SHARK  in which Dr. Kincaid, the Medical Examiner, Joshua Shield, head of Shield Security, former FBI agent Clay Bowman and Virginia state trooper Riley Tatum  look for leads in a murder—and suspect propofol as the means.


He released the button and the elevator descended, the doors opening to the cool antiseptic air of the medical examiner’s offices and Joshua Shield.


Shield was dressed in his trademark dark suit with his shock of white hair combed off his angled face. He strode straight to them, his attention riveted on Riley. Dark eyes collected and inventoried details quickly. “Trooper Tatum. I’m Joshua Shield.”


“I recognize you from your press pictures.”


Bowman noticed that most people were intimidated by Shield. They dropped gazes, shuffled feet, or fidgeted in some way. Not Riley. She glared at him as if he were a rookie intern late for his first briefing.


Shield extended his hand to her. “Nice to finally meet you,” he said. “Mr. Bowman speaks well of you.”


Clasping hard, she held his gaze.


“Solving this case is a team effort,” Shield said.


Smiling, she shook her head. “We’ll see.”


Bowman gave her props for not pulling punches.


“Consider the advantages of my expertise,” Shield said. “My company resources helped you in the past.”


“You were an uninvited guest that I could have managed without.”


He grinned as if enjoying the sparring.


Before he could respond, Dr. Kincaid appeared. She wore a lab coat and glasses that covered slightly bloodshot eyes.


“Dr. Kincaid,” Bowman said. “We appreciate you meeting us. Sorry to get you out of bed so early on a Saturday morning.”


“Mr. Bowman, Mr. Shield, you gentlemen have friends in powerful places.” Calm and unruffled, she extended her hand to both.


Shield shook her hand. “We help each other out when we can.”


Dr. Kincaid glanced at Riley. “I’m assuming Agent Sharp called you.”


“No, it was Mr. Bowman. But I contacted Agent Sharp.”


“Good,” Dr. Kincaid said. “Follow me.” She led them down the long hallway and pushed through a set of double doors. “I understand you also want to see Vicky Gilbert’s body.”


“Correct,” Shield said.


“Your timing is fortuitous. The funeral home is picking up her remains in a couple of hours. Her mother opted for cremation.”


“And you’ve done a complete exam?” Shield asked.


“I have. I’ve collected enough samples so that we can run any kind of test conceivable in the future if necessary. The Gilbert family is anxious to have a memorial service.”


“Their daughter ran away from home over a month ago and they didn’t call the police or try to find her,” Riley said. “What’s the big rush now?”


A slight shift in Riley’s tone could have made her sound bitter. But she kept her voice monotone, effectively hiding any potential anger or resentment.


Bowman reached in his breast pocket and removed a slip of paper. “Dr. Kincaid, I’d like you to test for this sedative.”


“Propofol? That’s a very powerful narcotic and I don’t see it often.”


“If we’re dealing with the man we suspect is the killer, this is likely the drug he used on his first four victims. This killer is a creature of habit. The sedative is one of his signatures.”



Forensic Friday—Set the Stage: Wednesday I Went to Jail

forensic_factsForensic science and details of how law enforcement operates play key roles in my police procedurals, and I’ve always believed that actually experiencing much of it, as I have at Writers Police Academy and elsewhere, has enhanced my writing.


I find the same to be true of setting.   It helps me tremendously to have walked around a city or to have visited the types of locales I’m planning to include in a story, even when I’m going to be making them up.  Getting the setting right is very important.  Whether I’m describing the inside of a  courthouse, a squad car or a jail, I try to be as accurate as possible.


Jail-MB in Jail with Sinc 4-20-16 ThreeWhich is why I went to jail the other day. The visit was courtesy of the Richmond City Justice Center, which gave Sisters in Crime Central Virginia the opportunity to tour and learn more about the facility and its people, including  a rundown of the procedures prisoners go through when they first arrive.


The gang from SINC Central Virginia happy to know we can leave at any time.

The gang from SINC Central Virginia happy to know we can leave at any time.


Worth pointing out is that some of us confuse the terms jail and prison.  Jail is a short-term incarceration—less than three years.  Inmates stay in jail while awaiting their trial and sentencing and then after that, they are transferred to a prison for the term of their incarceration.


The Richmond facility is new and houses up to 1000 male and female inmates, called “residents” by the staff. These individuals have been arrested in Richmond by law enforcement authorities including the Richmond City Police, FBI, Virginia Commonwealth University Police and J. Sergeant Community College Police.


Residents at a prayer meeting. (Image taken from the Richmond City's Sheriff Office Facebook page.)

Residents at a prayer meeting. (Image taken from the Richmond City’s Sheriff Office Facebook page.)

When prisoners arrive, they’re searched, given a Breathalyzer, their money is loaded into an account and a nurse medically assesses them.  If the magistrate does not set bond or if it isn’t paid, an individual’s threat level is then determined and he/she is assigned a uniform based on that threat level.  They are then assigned a spot among the thirty-two housing units, a.k.a. pods, which hold from twelve to seventy-two people.


While there, we also learned about the Center’s program, REAL (Recovering from Everyday Addictive Lifestyles), created by Director of Internal Programs Sarah Scarborough. Residents admitted to the 40-hour a week program complete classes such as remedial math, anger management and creative writing, taught by volunteers and staff.


Thanks to all at the City of Richmond Justice Center, in particular, Sarah  who showed us around and shared background and insights along with facts and figures.