The patient set his pants on fire while in a bar. He sustained minor burns.
Me: [enters room]
Him: "Hey, clean my foot off, please, it's got soot on it."
Me: "Why did you set your pants on fire?"
Him: "I'm God, and they're trying to put out my fire! Clean my foot off, please."
Me: "Were you trying to kill yourself?"
Him: "No, I'm God!"
Me: "Have you ever tried to kill yourself before?"
Him: "Yeah, lots of times."
Me: "Do you know your psychiatric diagnosis?"
Me: "Have you been in a psychiatric hospital recently?"
Him: "Yeah, a few days ago."
Alcohol level: 158 mg/dl. (Legal driving level in PA is 100.) Patient also uses crack. It seems unlikely to me that God would have schizophrenia, smoke crack, get drunk in bars, or set His pants on fire. It would make me question my divinity, I think. But not this guy. That's schizophrenia for you.
The patient had a seizure at home, then became very still. Roommate called 911. Medics found patient in cardiac arrest. Resuscitation measures started, patient transported to the hospital. Remained dead. Pronounced.
"He has metal plates in his head," his son said. So, his seizures were probably due to brain injury. Common cause of seizures.
I called the Medical Examiner to report the death. "Anything suspicious about the death?" he asked. All the ME cares about is death by crime or accident. That's the purpose of the ME. Nothing especially suspicious, I told him. Guy with a seizure disorder had a seizure and died. Happens, rarely. Florence Griffith Joyner, for example.
"Any history on him?" he asked. I told him what his son said about the metal plates, that was all I knew. "How'd that happen?" the ME wanted to know. Huh? What did it matter? But the son was still in the ER, so I rounded him up. "Someone hit him on the head with a hammer," he said, "ten years ago."
"I'll take jurisdiction," the ME said. "I'll be by to pick him up."
Why? Because now it's murder. Hitting a guy on the head and causing injury is aggravated assault. But if he dies, it's murder. If it causes a seizure disorder and the guy dies of that, it's still murder, because it was all caused by the original hammer injury.
Even ten years later, it's murder.
From a pictograph of a horn. Henshall
suggests as a mnemonic: 'Angled horn.'