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arrived.”
“What happened when you entered?”
“Chapman led me through the vestibule into an adjacent room, like a small sitting area with several armchairs and a sofa. In the middle of the floor, on the carpet, was the body of Amanda Quillian.”
“Would you describe for us what you observed?”
Genco faced the jury box and gave a clinical description of the scene. “I saw the body of a Caucasian woman who appeared to be in her midthirties, fully clothed, lying on her back, apparently dead.”
He was more artful than Tim Denton in talking about the grotesque bruising on the slim neck of the victim, the protruding tongue hanging to the side of her mouth, and the pinpoint hemorrhages that dotted her still-open eyes.
Genco carefully described what he set about to do to pronounce the manner of Mrs. Quillian’s death, the legal classification that made it a homicide, rather than a natural event. The causation — the medical finding of the mechanism responsible for the death — was fairly obvious to anyone looking at the victim’s throat, but not able to be legally confirmed until autopsy.
This was not like the many cases in which the determination of the time of death played a critical role in the case, making measures of postmortem rigor, lividity, body temperature, and ocular changes significant. Here, instead, the parameters were tightly drawn by the hour and minute stamped on the digital photograph taken at the end of the ladies’ lunch, the phone records from Amanda Quillian’s cell as she was confronted by her killer, and the 911 call from Kate Meade.
So Dr. Genco moved his audience from the exquisitely appointed parlor in which he first saw the body of the deceased to the formaldehyde-scented room decorated only with a cold steel gurney in the basement of the morgue.
He described photographing his charge, undressing her, washing her body, and autopsying it. He didn’t need a receipt from the tony bistro where the friends had dined to assert that the victim’s last meal had been a Cobb salad with blue-cheese dressing. Stomach contents visible to the naked eye underscored that death had occurred within a short time after the ingestion of food. The two glasses of white wine she had sipped might have made it even more difficult for her to resist her attacker.
“Were you able to determine, Doctor, to a reasonable degree of medical certainty, what caused the death of Amanda Quillian?”
“Yes, Ms. Cooper, I was.”
“Would you please tell the jury about your conclusions?”
“Mrs. Quillian died as a result of asphyxia, and in particular in this matter, by compression of the neck — or strangulation.”
“What is asphyxia, Dr. Genco?”
“It’s actually a broad term referring to conditions that result in the failure of cells to receive or to utilize oxygen, along with the inability to eliminate carbon dioxide. Body tissues simply cannot function without oxygen. Most especially the brain, since it uses twenty percent of the body’s total available oxygen.”
“Is there more than one category of asphyxia?”
“Yes, in general there are three. One would be chemical asphyxia — things like carbon monoxide or cyanide poisoning, which operate by excluding oxygen from the brain. A second would be suffocation or obstruction of the airways.”
“Let me stop you here for a moment, Dr. Genco, at these first two categories. In the case of both chemical asphyxia and suffocation, is it correct to say that the resulting death might occur homicidally?”
“Yes, Ms. Cooper. You’re right — in some circumstances. But in both instances death might also be accidental. And in the case of suffocation, it’s frequently self-inflicted.” Genco went on to give examples of each to the jury. “One may have a choking fatality because of the unintentional inhalation of an object — a wine cork or the cap of a pen that someone puts in his or her mouth temporarily, but then it gets sucked in and occludes
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