Monday, March 21, 2011

Medical Mondays: Constructing a Murder Scene


This week's question is from Erin Cole, who writes mystery and horror and recently debuted her novel, Grave Echoes. Hooray for Erin!

Her question:
"Unfortunately, my character must die a gruesome death, but by natural causes. Frankly, it needs to be bloody, so that it looks like a murder. I thought that maybe she could die of electrocution in the bathtub, and then because she was taking large doses of probiotics, her body (excuse the gore here) rather explodes (due to the yeast in the probiotics and the heat of the bath). Is this medically possible?"

Great question Erin.

What might cause a grisly death scene that looked like foul play was at hand, but really wasn't?

A few things immediately stuck out as possibilities.

1) Hematemesis (Fancy word for vomiting blood). You could die from a bleeding, broken blood vessel high up in the gut (stomach, esophagus). The blood fills the stomach and it causes vomiting, which as you can imagine, would create a horrific scene. Sadly, I've seen this myself, and yes, it can appear like a massacre took place. The number one cause has often been cirrhosis of the liver (liver failure from diseases, such as long standing alcohol abuse or viral hepatitis, which eventually causes certain blood vessels in the body to expand and bleed. The also have accompanying problems with their innate ability to stop bleeding, which makes the problem worse). A stomach ulcer that eroded through a blood vessel could also cause hematemesis, but less likely death.

So for Erin's character, a past history of alcoholism and markers of cirrhosis (little pink blood vessels over the skin [called spider hemangiomas], flushed palms, distended abdomen, jaundice) might be evident and yet still easy to conceal.

2) Boerhaave Syndrome. This is perforation, or ripping of the esophagus (the tube that connects your throat to your stomach). It occurs with severe retching and vomiting. It can be a cause of death in someone with bulemia, for instance. The death rate of this, untreated, is very high. To make the scene kind of gross for Erin's case, there might be vomitus mixed with blood at the scene of death. Or if the person does not die immediately, they would soon succumb to breathing problems, shock and then death. It's not nearly as messy as being caused by #1, and thus a less ideal choice for the character.

3) But what about exploding guts? If you remember my forensics post, a dead body at some point will bloat from the gases formed by bacterial decomposition. Many of these bacteria are naturally occurring, but eating lots of probiotics probably won't make you more aggressively decompose.

Furthermore, the body has many layers of fascia, muscle, and skin that keeps the abdomen a neat and tidy compartment. Even with severe bloating in decomposition, the belly probably won't explode, especially in a fresh post-mortem scene.

Erin would have to concoct a way for the person's belly to be partially penetrated/torn/stabbed during or just after death
, and the body would have to be discovered days later. Perhaps sooner, if a warm environment sped up decomposition. This way, the abdominal contents would have time to decompose to the point of expanding and popping outside of the abdominal compartment through the wound.

I've heard of exploding guts causing death, but it's only happened
when the layers of abdomen were compromised, such as at the onset of surgery. I once heard of a case where a patient who had such severe constipation (yes, really, really, really bad constipation can indeed kill--sorry for all the hypochondriacs out there) but this is extremely rare.

Thanks Erin for the great question, and sorry to all of you who just read this over breakfast (a frequent apology here at Medical Mondays, unfortunately!)


Please keep in mind this post is for writing purposes only and is not to be construed as medical advice.

If you've got a fictional medical question, let me know! Post below or email me at
All I ask is that you become a follower and post a link on your blog when I post your answer.

65 comments:

Laura Pauling said...

For some reason, I love these gory questions about murder and dead bodies, even with my morning coffee.

Magan said...

You just made every pregnant woman with constipation squirm a bit, lol.

Connie said...

Guts on the ceiling! Euw!!! But I love reading about the weird diseases and strange deaths. Keep up the good work. :)

Sarah said...

Oh my lord, Lydia, you've outdone yourself here. I bow to you.

welcome to my world of poetry said...

I should know by now not to read your post just before or after my lunch. You certainly went into detail and I hope it answered your reafer's question.

Yvonne.

Alex J. Cavanaugh said...

Well, that was gross but informative!

salarsenッ said...

Way to delve into a character's past. Congrats, Erin. Great question.

walk2write said...

My first time visiting on Monday. Fascinating even if it's a little icky!

Matthew MacNish said...

My god. Equal parts gross and fascinating, which of course means this is a winner, as far as blog posts go.

Carol Kilgore said...

Hence the saying 'when the s**t hits the fan'.

mist of the blossom rain said...

Oh my, what a way to go. It's so incredible, the things that can happen to the human body.

lynnrush said...

Wow. That's some gore, huh? Great post, though. Yeah, holy cow the body is an amazing creation--a little gross sometimes, but amazing nonetheless.

Happy Monday!

Erica Mitchell-Spickard said...

You know I love you, but I had to skim becase I am drinking cranberry juice and having yogurt. I got to the second reasoning before my gag reflex told me to just scroll down and tell you "I'm sure this is awesome but I got quesy forgive me" ;) I hope you had a fantastic weekend! I'll come back when I'm not eating yogurt and re-read

Stina Lindenblatt said...

Love this. Love this. Love this. :D

I remember reading about this years ago, before I started writing. No idea why, though.

Jess said...

Ewwww...great job answering her question, though!

Tara said...

Well, um. Good morning. What a great place to come and learn how to kill off a character. Awesome.

Kerri Cuev said...

Erin you have a GREAT imagination. Lydia, sounded like a challenging question that you answerd very well. Very thought out and gory, eat your heart out CSI, lol.

Munk said...

How do you make this stuff all sound so very cheerful? Top 'o the morning to ya.

Solvang Sherrie said...

Fantastically gross! I love Medical Mondays!

Read my books; lose ten pounds! said...

NICE! I love it!

Karen Lange said...

Glad I had breakfast already. :) I know where to turn when I need blood and guts. You will be my go-to girl!
Thanks for your research!

Paul S said...

I'd actually just eaten my lunch when I read this, it's lucky I've got a strong constitution.
I've missed your Medical Mondays while I've been away these last few weeks Lydia, it's good to catch up!

Lenny Lee* said...

hi miss lydia! yikes! exploding guts!!! how yucky is that! i like how you just say it like it is. yucky but cool!
...hugs from lenny

Michael Offutt said...

This is the grossest post I've read. But I was riveted by the cold calculating way in which you described how these conditions could come about. It reminded me of an episode of Bones.

Jayne said...

Lydia- I near dribbled coffee from my lips while reading this! Sorry, it's just funny to think about what your researching these days, and how you express that here. Nothing like having a coffee with you while discussing blood and gore. I quite like the combustion idea. ;)

Olga said...

This is quite a post. My blood runs cold when I read these medical details. At the same time, if I wrote mysteries, it would be an invaluable resource for me.

Bryan Russell (Ink) said...

Interesting! Disturbing, but interesting!

Erin Cole said...

Wow! Isn't Lydia great? I've learned so much from her blog and am delighted to have her help with my character's unfortunate and gory death.
Thanks for all the comments and 'icks' : )

Heather said...

Now that's an interesting question with a gruesome answer! I love the idea of opening a book with a character dying of natural causes that look like murder though. Brilliant!

Tiana Smith said...

Medical Mondays are my favorite posts of yours :) Though, you're right, this one was a little ... gruesome. But I learned a lot!

Holly Ruggiero said...

Totally disgusting, yet completely fascinating.

Briar said...

Great post, disgusting but informative! Have you ever watched Bones? I'm obsessed. Its one of my favorite shows but I can never watch it while I'm eating! Lol. Your post totally reminds me of that.

Sarah said...

Fascinating and messy.

Tamara Narayan said...

Totally awesome carnage, dude! My thanks to Sarah Fine for sending me over here, and, uh, pass the prune juice.

Old Kitty said...

I just knew yoghurt was bad for you! LOL!!

Take care
x

Krispy said...

This was really gross but also quite fascinating. On the other hand, I did just see my friend who is currently in med school yesterday, and she delights in telling us the grossest things she's experienced on her recent rounds. So that might have prepared me for this. -__-'

Roland D. Yeomans said...

Yow! That last part about the compressed flying merde created a mental image that will be with me all day!

Thanks for another entertaining, engrossing (pun intended) post, Roland

Talli Roland said...

Oh my goodness, that last bit made me snort! Hitting the ceiling? Yikes!

The Golden Eagle said...

Despite the gore, this is interesting stuff! All the different ways you can set up a scene . . .

Sierra Gardner said...

Great post - I'm totally keeping this in mind when I do run across a medical question in my WIP.

M Pax said...

Wow. Disgusting and fascinating all at once.

DEZMOND said...

the last passage on constipation as a possible cause of death was seriously scary, and I'm not sure I will recover from picturing it in my head :))

L'Aussie said...

This was riviting Lydia. Makes me want to write a murder mystery, not! Ha ha. Maybe a cozy one? No, never. Fascinating all the same and your attention to detail is awesome doctor!

Denise<3

The Words Crafter said...

Whoa! Like several people said, interesting and cool, even if it is kinda gross.

Karen Elizabeth Brown said...

Thank you for visiting my blog. I'm glad to find you. I'm a retired nurse and your post didn't bother me too much. I found it interesting.
Writing... can't do without it!

Meredith said...

All right, I'm officially freaked out. Creepy! But awesome answers.

LTM said...

you know, I just like that there's not a single disgusting death scene that you can't happily find a cause for! LOL!!! :D

great, horrific stuff, my dear~ <3

Alleged Author said...

Vomiting Blood...now that would be a horrid way to die!

Tamara D Hanson said...

Oh my, Lydia, gross and informative. :)

Jennie Englund said...

So gory!

So good!

E.J. Wesley said...

These are always so gross ... AND AWESOME! My wife is a doc, and I have to tune her (and most of our friends) out when they talk about this junk at dinner.

Your blog, however, I find completely fascinating! Probably because I never read these with a sandwich in hand ... :0)

Melissa said...

This has to be my favorite medical monday...EVER. Such a fascinating post and what an interesting question!!!

AND OMG CONSTIPATION CAN CAUSE DEATH!!!!! Ugh. Totally eating more fibre to avoid THAT (not that I have issues now but...you know)

Lisa Gail Green said...

I love that you can answer that in such a professional way. You deserve applause for that. Fascinating as always. Though I hope I won't be using death by constipation in my writing anytime soon

runawaybride said...

This was very informative..

taio said...

gooooooooooood

Rachna Chhabria said...

This post is informative and interesting. I just read this after lunch. Next week onwards the monday posts will be read on an empty stomach. :)

Jack Edwards Poetry said...

Really interesting post.

Deniz Bevan said...

I'm with Laura - I love reading about this stuff! It's fascinating. Someday I hope to write a mystery. I wonder if I'd make it gory...

Jonene Ficklin said...

There's definitely room for the imagination there. Thanks for sharing your research!

Ghenet said...

Another fascinating post! Reading about this stuff doesn't bother me. Seeing it? A whole other story. :)

Jennifer Hillier said...

I love Mondays on your blog. I'm sorry I missed this yesterday!

Re: that bit about severe constipation - just goes to show it really is important to be regular. Yikes.

Paul C said...

You are absolutely fascinating on Medical Mondays. Perhaps you could be a scriptwriter/consultant someday for the networks.

Mayowa said...

I've missed these tremendously...great way to start a monday :)

J.C. Martin said...

Oh, ew, yet intriguing! I wonder if you can murder someone by somehow giving them a severe case of constipation? :)

lbdiamond said...

Hmmm, I think we have another Dexter in the making... ;)-

 
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