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  1. #1
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    Questions for people with Medicine/Medical Knowledge

    DeeDee and others,

    Based on Kolar's book, an acute injury happens near JBR death. I'm assuming it was determine based on the evidence of the 'non-healed yet' process in the cells of the injured organ. Means, the injured cells have not all elements to start the healing process because the death occurs too soon and interrupts this process. Here is nice article on the subject of healing after skin injury.

    http://emedicine.medscape.com/article/884594-overview

    Question: Is it possible that JBR's vaginal injury healing process was delayed due to the fatal head injury (hence body shock, slow blood flow..etc)?

    I do hope this new thread can be used for MEDICINE/MEDICAL subject posts only. . IMO, it would be great as the future reference for everyone.

    Thank you!

  2. #2
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    otg is offline Reports of my death are greatly exagerated... but not completely unfounded.
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    Iím not sure, OM, if you would like to hear my answer since you have asked only people with medical knowledge to answer, but I think (if I understand correctly what you are asking) the answer can be fairly simple -- or it can be very complicated if you want to get into all the chemical and microscopic cellular changes that occur after an injury. But since there are only a handful of posters here who actually have medical backgrounds, you might not expect many responses. So... medically challenged as I am, Iíll attempt an answer so someone else might feel like jumping in and correcting me if Iím wrong.

    What most people seem to agree on based on what information we have is that there were vaginal injuries to JonBenet that can be classified into two types: acute and chronic (that is, recent and longer term -- in relation to the time of her death). Among the groups of ďexpertsĒ who were privy to more information than we have, there was disagreement on the time span of the chronic injuries as well as the number of times that it may have occurred. The only reference we have to the chronic injuries (other than what we have read about othersí opinions) is in the AR where it refers to ďvascular congestion and focal interstitial chronic inflammationĒ in the vaginal mucosa. It also says that ďacute inflammatory infiltrate is not seen.Ē Earlier in the AR the coroner describes the extensive hyperemia which is the result of the acute injuries.

    Referring to the article you linked, it notes the four overlapping phases of healing and it gives a time frame in which each phase is expected to occur.

    So the simple answer to your question (to which I always aspire but seem to fall short) is that her death happened too soon after the most recent sexual assault to have allowed any healing beyond the bodyís immediate response to the trauma, which can of course be considered part of the healing process. As to whether the head injury might have slowed down any of this I would say that yes it would -- but it would only have been a measureable difference had she lived longer than a day (MOO), in other words long enough for the inflammatory phase to develop more than it had a chance to in this case.

    For a more technical answer, we would need more information than we get from the coroner in the AR. Your linked article (bbm):

    The cellular aspect of the inflammatory phase occurs within hours of injury, and it includes neutrophils, macrophages, and lymphocytes.
    The neutrophils and macrophages happen first and continue for the first 48 hours after the injury. However, the inflammatory phase is still developing over the first 72 hours before the lymphocytes begin migrating into the wound. It is then 3 to 5 days after the injury before the third phase begins to occur -- the proliferative phase. All of these things occur microscopically in the cells, and I donít think the coroner even looked at them. If he did, he didnít address it in the AR, but I donít think it was necessary in determining approximately when the sexual assault occurred.

    All of this, of course, is just my uneducated guess.
    .

  3. #3
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    I agree with otg. In one sentence- she died too soon after the ACUTE sexual assault for there to have been evidence of healing.
    THIS time, we get it RIGHT!

    This post is my constitutionally-protected opinion. Please do not copy or take it anywhere else.

  4. #4
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    Quote Originally Posted by DeeDee249 View Post
    I agree with otg. In one sentence- she died too soon after the ACUTE sexual assault for there to have been evidence of healing.
    DeeDee249,
    Can we assume then that the acute sexual assault and the digital penetration are separate events?

  5. #5
    otg's Avatar
    otg is offline Reports of my death are greatly exagerated... but not completely unfounded.
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    Quote Originally Posted by UKGuy View Post
    DeeDee249,
    Can we assume then that the acute sexual assault and the digital penetration are separate events?
    Oh, come on, UKG. Are we really gonna go through that again? AGAIN?!!!

    http://www.websleuths.com/forums/sho...assault&page=9 (Posts 201 through 207)
    .

  6. #6
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    Quote Originally Posted by otg View Post
    Oh, come on, UKG. Are we really gonna go through that again? AGAIN?!!!

    http://www.websleuths.com/forums/sho...assault&page=9 (Posts 201 through 207)
    .
    otg,
    Your desire for exactness and accuracy is to be commended.

    I am asking about the motive, not the legal description of the events, there is a difference.


    .

  7. #7
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    Quote Originally Posted by UKGuy View Post
    DeeDee249,
    Can we assume then that the acute sexual assault and the digital penetration are separate events?
    No we cannot assume anything. We can INFER from the eroded hymen and other healed injuries that there was PRIOR digital penetration, as the coroner said.
    On the night of the murder we can INFER from the blood in and on her vagina that there was penetration- exactly with what is unknown. Possibly digital- possibly paintbrush. Possibly both.
    THIS time, we get it RIGHT!

    This post is my constitutionally-protected opinion. Please do not copy or take it anywhere else.

  8. #8
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    I've posted on other threads the opinion that she may have died after the vessels first constrict for a few seconds- minute or so but before the vaginal wound was able to start heavy bleeding with lots of red blood cells to form a mesh and clot. I think the noose could have been tightened first then the vag. Injury, but it took a few minutes to pass away from strangulation. BR doesn't really fit the scenario even if I have it backwards.

  9. #9
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    Round Abrasion?

    Any opinions on that blackish/purple round abrasion on the right cheek of JB not far from her ear?

    There is a photo of the rope taken into evidence in which the ends of it look "melted". If the rope ends were melted and hot, could one of them have been poked into her cheek, causing that type of an abrasion?
    We want the truth, but can we handle the truth?

  10. #10
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    Quote Originally Posted by DeeDee249 View Post
    No we cannot assume anything. We can INFER from the eroded hymen and other healed injuries that there was PRIOR digital penetration, as the coroner said.
    On the night of the murder we can INFER from the blood in and on her vagina that there was penetration- exactly with what is unknown. Possibly digital- possibly paintbrush. Possibly both.
    DeeDee249,
    mmm, not so sure that the coroner made the same inference. i.e. prior to what?

    excerpt from acandyrose.com
    Det. Arndt told Your Affiant that she personally observed Dr. John Meyer examine the vaginal and pubic areas of the deceased, Dr. Meyer stated that he observed numerous traces of a dark fiber.

    Detective Arndt told Your Affiant that she witnessed the autopsy of JonBenet Ramsey which was conducted by Dr. John Meyer on December 26, 1996. Detective Arndt told Your Affiant that she observed Dr. Meyer examine the vaginal area of the victim and heard him state that the victim had received an injury consistent with digital penetration of her vagina. Detective Arndt told Your Affiant that Dr. Meyer told her that is was his opinion that the victim had been subjected to sexual contact.
    Seems to me the Coroner was saying someone had sexual contact with JonBenet and that contact took the form of digital penetration?

    BDI anyone?


  11. #11
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    Quote Originally Posted by UKGuy View Post
    DeeDee249,
    mmm, not so sure that the coroner made the same inference. i.e. prior to what?

    excerpt from acandyrose.com


    Seems to me the Coroner was saying someone had sexual contact with JonBenet and that contact took the form of digital penetration?

    BDI anyone?
    Prior to that night.
    It doesn't just SEEM like he was saying it was digital penetration. He DID say it.
    The coroner TOLD Det. Arndt that the injuries he saw were consistent with digital penetration.
    THIS time, we get it RIGHT!

    This post is my constitutionally-protected opinion. Please do not copy or take it anywhere else.

  12. #12
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    Rust Colored Abrasions?

    Is it possible the marks on JB's body, initially thought to be from a stun gun, but shown to line up with a piece of toy train track in the Kolar book, could have been done earlier on Christmas day?

    As 'rust colored', could that indicate they had started to scab over?

    Could most of the 'rust colored' abrasions on her body have happened prior to the night of the crime, and because JB's clothing would have covered them, not be seen by anyone on Christmas evening at the Whites?

    The triangular shape "dried, parchment like rust-colored abrasion" on her neck would have been seen at the White's party if it had been done earlier, if JB was wearing the white Gap shirt instead of the red turtleneck sweater Patsy wanted her to wear, EXCEPT that in looking at the crime scene photos, lying on the bed alongside the black velvet clothing that might have been worn to the Whites, there is a multicolor fuzzy looking piece of clothing that might have been a scarf. If JB wore the Gap shirt, this scarf could have been put around her neck as an accessory in order to cover the triangular mark.

    Just wondering if a fight over toys on Christmas afternoon might have caused these other marks and Patsy had to make sure JB wore clothing to the party at the Whites that would have covered them up.
    We want the truth, but can we handle the truth?

  13. #13
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    Quote Originally Posted by midwest mama View Post
    Is it possible the marks on JB's body, initially thought to be from a stun gun, but shown to line up with a piece of toy train track in the Kolar book, could have been done earlier on Christmas day?

    As 'rust colored', could that indicate they had started to scab over?

    Could most of the 'rust colored' abrasions on her body have happened prior to the night of the crime, and because JB's clothing would have covered them, not be seen by anyone on Christmas evening at the Whites?

    The triangular shape "dried, parchment like rust-colored abrasion" on her neck would have been seen at the White's party if it had been done earlier, if JB was wearing the white Gap shirt instead of the red turtleneck sweater Patsy wanted her to wear, EXCEPT that in looking at the crime scene photos, lying on the bed alongside the black velvet clothing that might have been worn to the Whites, there is a multicolor fuzzy looking piece of clothing that might have been a scarf. If JB wore the Gap shirt, this scarf could have been put around her neck as an accessory in order to cover the triangular mark.

    Just wondering if a fight over toys on Christmas afternoon might have caused these other marks and Patsy had to make sure JB wore clothing to the party at the Whites that would have covered them up.
    The triangular, rust colored abrasion is commonly seen on victims of ligature strangulation. It did NOT happen earlier in the day. MOST, if not ALL, ligature strangulation victims will exhibit an identical mark, and it represents blood pooling under the skin at a pressure point in cases where the pressure is at the front of the throat. JB's garrote was pulled as she lay on her stomach, so the mark on her throat is in the expected place.
    As for the smaller marks, including the one on her cheek- we just don't know what made them. But I will tell you that any coroner would have been able to tell whether they were made before she died or were postmortem (if she lay against something after death, as in the ones on her back). He would also have been able to tell if they were BURNS, as from a cigarette, stun gun or anything that would have burned her skin. He noted NO burns.
    Of course, that did not stop Smit from jumping on the stun gun bandwagon, and that is the reason I feel the DA and the Rs did NOT want the body exhumed. They did not want it PROVEN that the marks did not come from a stun gun. AH didn't need the parents' permission, BTW. All he needed was a warrant.
    Is it possible the marks were there that day? Doubtful. Although WE haven't seen them, the police do have lots of photos taken at the White's that day, which of course, was right up to the time she went home. The one on her cheek would have been visible.
    After that is anybody's guess.
    It's too late now- there is no soft tissue left by this time, especially in a warm climate like Atlanta. We'll never know what made those marks. That's another thing we can "thank" AH for.
    THIS time, we get it RIGHT!

    This post is my constitutionally-protected opinion. Please do not copy or take it anywhere else.

  14. #14
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    Quote Originally Posted by DeeDee249 View Post
    Prior to that night.
    It doesn't just SEEM like he was saying it was digital penetration. He DID say it.
    The coroner TOLD Det. Arndt that the injuries he saw were consistent with digital penetration.
    DeeDee249,
    I completely agree. Arndt also stated: Dr. Meyer told her that is was his opinion that the victim had been subjected to sexual contact.

    There was nothing said about prior assault, from memory, not in the autopsy report either.

    That was a postmortem opinion arrived at by consensus. When Dr. Meyer consulted other medical professionals, sharing his photographs.


    .

  15. #15
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    Quote Originally Posted by UKGuy View Post
    DeeDee249,
    I completely agree. Arndt also stated: Dr. Meyer told her that is was his opinion that the victim had been subjected to sexual contact.

    There was nothing said about prior assault, from memory, not in the autopsy report either.

    That was a postmortem opinion arrived at by consensus. When Dr. Meyer consulted other medical professionals, sharing his photographs.


    .
    I believe Mayer's comments included the erosion and healing bruises. The erosion itself HAD to have happened from rubbing on multiple occasions. It would not happen from one instance.
    Keep in mind one thing. When a coroner writes a written autopsy report, he usually notes what he sees. He does not usually note what he THINKS about what he sees. He does not offer an opinion about who may have killed someone or why.
    The rest is up to a jury, and Mayer said at some point that he did not mention or note certain things because he fully expected to have to testify at JB's murder trial, and he expected to answer certain questions specific to her sexual molestation under questioning on a witness stand.
    I do not believe he was called before the Grand Jury.
    So it seems Mayer left some things unsaid because he thought he'd be subpoenaed.
    THIS time, we get it RIGHT!

    This post is my constitutionally-protected opinion. Please do not copy or take it anywhere else.

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