-Dr. Anil Aggrawal
When I was called at the factory, Kanti had already died.
Well, I didnt expect anything better. I am called only at such unfortunate moments. To be sure, I was called neither by the factory owner, nor the dead mans colleagues, but by the police! As you can perhaps understand, forensic pathologists are mostly called by the police, who want them to decipher the language of the dead.
Let me tell you the story. Kanti was a 36 year old technician, who worked as an electrician in a relatively small setup "DC Industries". The factory as well as the administrative office was located in Ghaziabad. The group comprised of about 100 people and was engaged in making some industrial gadgets.
|"...On 13th March, one day after Holi, Kanti came to work as usual. He started work on a heavy duty electrical appliance... at about 10 am. He was working on that appliance standing on a shaft, about 15 feet above the floor. At about 11 am, some labourers heard a heavy thud. When they rushed to the spot, they found Kanti dead. There was no doubt about that. Thus nobody felt the need to call the doctor. They called the police instead..."|
The management was not responsive to the workers genuine needs, to say the least. There were many safety hazards in the factory, which were dangerous to the life of the workers. The workers had raised this issue several times before the management, but it always turned a deaf ear towards their genuine demands. One of their genuine demands was to get the electrical installations renovated. Several points in the electrical installations were corroded and posed a serious threat of short-circuiting. The management had not shown any interest whatsoever in renovating the installations. It was perhaps understandable that the management didnt worry about the lives of the workers, but what was most surprising was that such a defective and outdated electrical installation could lead to fires resulting in destruction of their own property too, and yet the management had not shown any interest.
Well, that shouldnt worry us for the moment. There are all types of people in this world, and we have got to learn to live with them. But let us get on with the story. On 13th March, one day after Holi (an important festival of Hindus, during which people throw colors at one another. Also known as the "festival of colors", it is usually celebrated in March every year), Kanti came to work as usual. He started work on a heavy duty electrical appliance. I was shown that electrical appliance. It looked like a giant dinosaur but more than that, I couldnt make any head or tail of it. But what was important for me as a forensic pathologist was that it worked on heavy tension- I was told, it required 20,000 volts to work. Kanti started work at about 10 am. He was working on that appliance standing on a shaft, about 15 feet above the floor. At about 11 am, some labourers heard a heavy thud. When they rushed to the spot, they found Kanti dead. There was no doubt about that. Thus nobody felt the need to call the doctor. They called the police instead.
Meanwhile the factory was agog with rumours. The management had killed him, because he stood for workers demands...he got electrocuted while working on that defective gagdet...some stooge of the management had pushed him down....and so on. But the story that was doing the rounds most vigorously and with most conviction was that he had got electrocuted while working on that defective gadget. By the time, I had arrived, some labourers had even started shouting slogans against the management. One representative of the management, quite nervously was showing the police around. Most others were sitting like frightened does in their offices. Some were probably even contacting their lawyers. The managements version was that the gadget was fully safe, and Kanti had died because of a fall from the height. According to them, he was a very careless worker and was always prone to accident because of this carelessness. He probably fell from that lofty shaft because he was not working carefully.
By the time, I arrived at the factory, two major conjectures regarding Kanti's cause of death had emerged. One, floated by the workers was that Kanti had been electrocuted by that defective gadget. The other floated by the management, who undoutedly had been doctored by their lawyers by that time, was that Kanti had fallen from height due to carelessness and had died.
|"...electrocution deaths can be quite tricky. If you find electric entry mark (for the more technically minded, it is commonly known as the Joule burn), you could perhaps say with certainty that the person died of electrocution, but if you donít find any electrocution mark, you can not exclude electrocution. One of the situations in which you donít get electrocution mark despite having been electrocuted is if the bodyís area of contact with the electricity was very wide..."|
What the police wanted to know from me naturally was how Kanti had died actually. Did he die of electrocution or did he die of fall from height? We pathologists have a way if not foolproof- of knowing if a person had died from either. If he had died due to electrocution, he must show an electric entry and exit mark. And if he died due to fall from height, he must show fractures, head injury and so on.
I immediately got to work, and started postmortem on Kantis body. But try as hard as I would, I could not see a single electrocution mark on his body. Now dont begin to think that this excluded electrocution. In fact electrocution deaths are quite tricky. If you find electric entry mark (for the more technically minded, it is commonly known as the Joule burn), you could perhaps say with certainty that the person died of electrocution, but if you dont find any electrocution mark, you can not exclude electrocution. One of the situations in which you dont get electrocution mark despite having been electrocuted is if the bodys area of contact with the electricity was very wide. There are a number of other situations too, in which you dont get electrocution mark, but let us not go in unnecessary details. What is important to appreciate here is that the absence of electrocution mark didnt rule out electrocution.
A word about the other post-mortem findings on the body. Kanti showed a long linear fracture of the left parietal bone and there was an underlying extradural hematoma. You might think that this clearly indicated that he died of fall from height. But to opine on such matters is quite tricky, especially when such matters as compensation and criminal negligence on the part of administration are in question. If a person gets electrocuted and falls immediately thereafter, he would get injuries as shown by Kanti, yet it would be fallacious to say that he died due to fall from height. The fall occurred in the first place because of the electrocution, and if you dont mention that in the post mortem report, the management could get undue advantage of that report. So you can quite easily understand that I was keen on knowing how he actually fell- from his own carelessness or due to sudden jolt from the electrocution.
The workers were obviously very agitated and they wanted to see the word "electrocution" somewhere in the postmortem report. Well, if one would change the report merely from workers pressure, he wouldnt be doing justice, but in this case I was myself very much convinced that Kanti had indeed been electrocuted. My belief was substantiated when I called an expert electrician on my own and had that equipment checked on which Kanti was working. The electrician gave me the report that the equipment was indeed faulty and it was very liable to give shocks to people working on it. In fact he said, that it should have been replaced years ago.
I didnt hand over the dead body to the relatives for cremation, because I wanted to think more about the problem. When his wife, brother and other relatives came to me for the dead body, I requested them to let me have the body for a couple of days more, so I could think about the problem in detail. Since finding out the true cause of death was in their own interest, they understood and let me keep the body. I placed the body in the cold room, came home and kept thinking about the problem in the night.
When I slept, I kept dreaming of the metallic gray hue of the skin of Kantis brother who had come to collect his dead body. There was no doubt that his skin was of a distinct metallic gray hue, but I didnt know why that color should trouble me in my dreams. It was so disturbing that finally I got up from my bed, had a stroll in the park outside my house and then after about half an hour came back and slept. I had much better sleep after that.
Next day I called Kantis brother to my office. His name was Shashi and he was about 44 years of age. I looked at his skin more closely and found that it did have a distinct metallic gray hue. I couldnt make much of it. Without having the faintest idea of what I was doing, I started questioning him of his past life.
What caught my fancy was that Shashi was suffering from diabetes for the past 7-8 years of his life. A vague idea began emerging in my mind. I took him to my examination table and palpated his liver. As I had expected, it was enlarged. Things began becoming clearer in my mind now. I wouldnt insult your intelligence by telling that a person who has skin with a metallic gray hue, an enlarged liver and diabetes is most probably suffering from a peculiar disease. They used to call it bronzed diabetes at a time, but now it is more commonly known as Hemochromatosis. It is about 5-10 times more common in the males than females, and may be both genetic and acquired.
Kanti was living in a joint family, and most males of his family showed one or the other symptom of hemochromatosis. Some had testicular atrophy, some arthropathies, some cardiac involvements and still some others such symptoms as loss of body hair. In short every male of Kantis family was suffering from hemochromatosis. I wanted to be doubly sure and had their serum ferritin levels done. Now as you know, in normal males, the serum ferritin levels should be of the range of 10-200 micrograms per litre, but these individuals all had more than 4000 micrograms per litre! Some even had as high as 6000 micrograms per Litre of serum. There was no doubt now that they were all suffering from hemochromatosis.
I went to Kantis house and looked at their cooking utensils. As I had expected, they were all made of raw iron, and that is where they were getting their excess iron from. You might wonder why the females do not suffer from hemochromatosis. As far as I know, no one knows about it, but there are various conjectures, not the least impressive of which is the one which holds womens regular menstruation responsible for this. But let us not digress from the main story.
Now I think I am a reasonably good forensic pathologist, and I know how a persons internal organs should look like, if he were suffering from hemochromatosis. It was only reasonable to think that Kanti was also suffering from hemochromatosis. If this were so, he should have had an enlarged nodular liver and it should have had a strong ochre color. But it showed neither of the two features! That is what surprised me. To be sure, even his pancreas should be showing an ochre color, but I didnt remember his internal organs having any color other than normal. But I could reverify as I had his body in my mortuary.
I went to the mortuary once again, took out Kantis body which I had preserved and had a look at his organs once again...No. There was no abnormality at all of the liver or of the pancreas.
You might think that I should not have worried about that at that moment, as my primary aim was to find out the correct cause of his death. Whether he showed signs of hemochromatosis or not wouldnt have helped me one way or the other. You are perhaps right, but I have this silly habit of getting to the root of all such peculiar problems, even if they have no bearing. To me they are like solving a crossword puzzle, and thats why I kept racking my brains about it.
I was not sure why he was not showing any of the classical findings of hemochromatosis. As we all know, in hemochromatosis, the excess iron is deposited in the liver, pancreas and the heart. In the spleen, kidney and skin the iron levels increase to about 5 times normal, in the heart 25 times, and in liver and pancreas, as much as 50-100 times than normal! I had his whole organs in my custody and I got down to work immediately. To my utter frustration, the iron levels in all his organs were completely normal.
You can imagine my frustration at this point. I went to Kantis house and asked his wife if he was eating food along with the rest of his family, and she said yes. That broke my last hope of solving the puzzle. If he was having food from the same source, undoubtedly he was ingesting extra iron along with the rest of his family. But while all his family members especially males- were showing signs of hemochromatosis, Kanti was cocking a snook at me even after his death by not showing the minimal signs of that disease. Where was his extra iron going?
I was so frustrated by this time, that I began having the wildest ideas. What about getting his total body iron done? There is a costly technique- Neutron Activation Analysis or NAA in short- by which the total body iron can be estimated. Now if you love me, dont ask me what this technique is all about. But I can assure you it is a genuine technique by which total body iron can be estimated. You would have to take my word for it, or if you dont believe me go to any physicist and ask him about this technique. He will tell you the mechanics of this in great detail.
NAA is obviously not available in our college and for this I had to take the help of National Physical Laboratory. When I approached the Director of NPL with this strange request, he thought I had gone mad. Perhaps I had, but at that time, my biggest concern was to have his total body iron done by whatever means. When he didnt agree to my request, I approached Dr. Bal Phondke, Director of the National Institute of Science Communication (NISCOM in short). I am doing a little monthly series called "Poison Sleuths" for their magazine "Science Reporter" for quite some time now and have good rapport with him. Before this I was doing yet another series "Crime Busters" for the same magazine and obviously had developed great ties with him.
I asked Dr. Phondke to phone the director of NPL and do this little favour for me. To tell you the truth even Dr. Phondke thought I was getting senile, but as a small favour to an old friend he somehow inveigled the director of NPL into doing this little test for me.
When the tests for the total body iron of Kanti came to me, I was in for a big surprise. His total body iron was about 25 g, - almost the same what a patient of hemochromatosis must have. A normal man doesnt have more than 5 g of iron in his body. Levels as high as 25 g are found only in patients of hemochromatosis. So here was Kantis body not showing an iota of hemochromatosis and yet his total body iron was at the same level as that of any hemochromatosis patient. Where was his extra iron hiding?
Now things had started becoming really complicated. Then suddenly I thought of a peculiar finding in such patients. They show very little iron in the testes (this is despite the fact that they all show loss of libido and testicular atrophy). Since Kanti was throwing surprise after surprises, I decided to have one more shock, and did his testes iron levels. As I had expected, it was unusually high.
Are you getting the picture now? Kantis body was somehow a mirror image of a normal hemochromatosis patient. All his organs which should have shown an increased iron level were showing the normal level, and all those organs which should show a normal iron level were showing increased levels. And this brings us back to our original question- death by electrocution.
What about Kantis nerves? Were they having extra iron too? You can well imagine, I couldnt resist myself at that level. I immediately cut a big chunk of Kantis sciatic nerve and put it to test. Expectedly it was very high in iron! In fact when I examined its sections in a microscope, its external sheath was so heavily laden with iron that I might as well have been looking at an iron wire! I took a longer piece of his sciatic nerve and connected it to a simple electric circuit. Strangely (well, not so strangely after what we have read now), it could keep the circuit going. There was so much iron in it, that the piece of sciatic nerve almost acted as an iron wire!
Things began emerging clearly in my mind now. Kanti had indeed been electrocuted. But his nerves were such good conductors of electricity that they hardly offered any resistance to it. Electric entry mark, or Joule burn as we call it, is caused by the generation of heat in the body by the flow of electricity through it. But if the body were not to offer any resistance to its flow, no heat is going to generate in the body and there would be no burn or electric entry mark. That was the reason Kanti was not showing any electric entry mark despite the fact he was electrocuted. And now I had rigorous scientific proof to show it.
But you may ask why Kanti died if the current safely got earthed via his superconducting nerves. Well, most of the current did find its way into the earth, but some also travelled via his superconducting nerves again- to such sensitive areas as the heart and brain stem. These little organs as you know, work by little currents of body electricity. Such large currents as industrial electricity are going to play havoc with their normal functioning, and the person is going to die very quicky. The mode of death could be cardiac fibrillation if the heart was affected more or stoppage of respiration if the brain stem were affected more.
You may also ask why Kantis body behaved in this particular way, i.e why it showed a reverse pattern of iron deposition. To be honest with you, I dont know the answer. But what I do know is that there is an entity called genetic hemochromatosis too. In this disease there is an abnormal gene sitting on chromosome 6. Many cases of acquired hemochromatosis (the one shown by Kantis family) are having an associated genetic disorder too. I am personally aware of several people taking medicinal iron for years, who start showing symptoms of hemochromatosis after some time. But all their symptoms can not be explained by the excessive intake of iron. Many of them have an associated genetic abnormality too. It is quite likely that Kantis family also had that abnormal gene on chromosome 6. But Kanti's gene had an additional anomaly. Somehow it coded for excess iron deposition not in the normal organs but in the ones which are normally saved. It was a kind of mirror gene, so to say. Well, I am no geneticist, and I can not comment on it more than that. Kantis family was pestering me for his body- I had already kept it for more than a week, so ultimately I handed the body over to them. But I made it a point to preserve large pieces of his various body tissues in my custody. I have submitted them to Mr. Lalji Singh, a senior scientist at the Centre for Cellular and Molecular Biology at Hyderabad, and am waiting for his report. He is reportedly preparing his genetic profile, and as soon as his report comes to me, I will inform you regarding it. Meanwhile dont forget to look at the latest (June 1998) issue of the Journal of American Medical Association for a brief scientific report of this strange case.
One last question that may be lingering in your mind. Finding "nerves of iron" does not in itself prove that electricity had passed through Kantis body. No doubt if electricity were made to pass through his body, it would not show Joule burn, but what if it hadnt passed through the body in the first place. In that case too, Kantis body wouldnt show any Joule burn.
I solved this problem in another way. If electricity passed through those nerves, body chloride would be attracted to it, and would form iron chloride. On the contrary, if no current passed through those nerves no iron chloride would form. Obviously the easiest way to test for this was to test for a thin film of iron chloride over the nerves. Yes, you got it. When I examined the nerves in detail, I found a thin film of iron chloride over the nerves while the core was mostly pure iron.
What pleased me was that the court accepted my findings and awarded damages to Kantis wife. The management of DC industries was asked to cough up Rs 20 Lakhs to Kantis wife as damages. Obviously DC industries was not happy with me. Well, who cares as long as I have more dead bodies to look after!
I read your story with interest.
I disagree with a number of points. First, the presence of electrical burns does not mean electrocution. Dead bodies have identical electrical burns as live persons. These are not vital reactions. You can test this yourself in the morgue with ordinary household current applied to a deceased person. (do be careful) As to the hemachromatosis and super conductivity of the body, I must respectfully disagree. The skin is the most unconductive and therefore most heated of the body parts. Here Kanti's skin was not a site of ferrous deposition and thus irrespective of the condition of his nerves, his skin would not conduct more than others. As to whether ferrous metal increase does reduce resistance of organs, I do not know with certainty, having not tested it. However, I would doubt it based upon what I know of these things.
Nice story though.
***IMPORTANT NOTE: THIS MATERIAL IS COPYRIGHTED BY THE AUTHOR AND MAY NOT BE REPOSTED, REPRINTED OR OTHERWISE USED IN ANY MANNER WITHOUT THE WRITTEN PERMISSION OF THE AUTHOR
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