Amryn Cross: How to Research Your CSI or Detective

/ Jordyn Redwood / Leave a comment
Unless you’ve been living under a rock these past few years, you’ve probably seen an episode of the dozens of forensic type shows on television—all the varieties of CSI, NCIS, SVU, etc. They make the job look gritty and glamorous but hardly ever real. It makes for great entertainment, but not a lot of truth. This can be troublesome when you try to base your latest crime novel off something you’ve seen on television. 
Any writer writing outside their field of expertise knows some research is going to be involved, but in a field like forensics, it’s easy to be overwhelmed by the amount of information out there. I’ve compiled a short list of questions to get you on track when researching your CSI or detective character.

1.       Where does your story take place?

This is big one. If you’re going for authenticity, it’s better to narrow down your search to the area you’re looking at. For instance, New York City isn’t going to have the same structure to their police force or crime lab that a small town in the Midwest might have. If you’ve got a fictional setting, the good news is you can take bits and pieces from several places and make your own rules. Especially larger cities will have a website for the law enforcement agencies that might post job opportunities or a list of departments with descriptions. Utilize those.

2.       When does your story take place?

This may go without saying, but if your story is set in the 1980’s or 1990’s, having your detective catch the bad guy with DNA is not very believable. Technology and tests are always changing in forensics.

3.       What’s your character’s job title?

As cool as it looks on CSI, I can’t think of a place where the same person collects the evidence at a crime scene, determines the cause of death, runs the test on the evidence, interrogates the suspect, goes on stakeouts/undercover ops, and make the arrest. There are different jobs for each of these, and overlap will vary from place to place. In a small town, a detective might collect the evidence, interrogate the suspect, and make the arrest, but he or she won’t be determining the cause of death (that’s the medical examiner or coroner) or running the tests on the evidence (if it’s a small town, the evidence will probably be sent to the nearest crime lab.) At the same time, your CSI may collect evidence and nothing else if they work in a large city. Other places, the same people collect the evidence and test it.

4.       What agency does your character work for?

Research that specific agency and know what they specialize in. Most law enforcement agencies will work a variety of crimes, but many people are surprised to know that the FBI doesn’t typically get involved in murder cases or witness protection even though they’re often depicted doing just that. Find out how people within that agency are titled. Are they detectives, agents, inspectors, officers? Who carries a gun within that agency? You might be surprised. In some states, even the lab personnel are considered commissioned officers and carry a weapon.

5.       Don’t be afraid to ask questions.

There are lots of experts out there who are willing to answer questions about their experiences (myself included.) Most law enforcement agencies have a public relations person or department that can answer some questions for your specific region. One of my favorite online sources is the Crime Scene Writer’s group. This is a pool of people from all sections of law enforcement who are willing to answer writer’s questions. Make sure you search the messages first because there’s a lot to be gleaned from past questions.

Researching your law enforcement character doesn’t have to be scary. When in doubt, ask.
**************************************************************************
Amryn Cross is a full-time forensic scientist and author of romantic suspense novels. Her first novel, Learning to Die, will be released in September. In her spare time, she enjoys college football, reading, watching movies, and researching her next novel. You can connect with Amryn via her website, Twitter and Facebook.

Up and Coming

/ Jordyn Redwood / Leave a comment

Hello Redwood’s Fans!

How has your week been? I have to say, I have had another exciting week. My sophomore novel, Poison, has been nominated for another award! This time by Blue Ridge Mountains Christian Writers Conference. I really wish I could be there at the conference. It’s one I’ve definitely wanted to attend because I hear the mountains in Ashville, NC are amazing.

Today is Mother’s Day and here in Colorado it’s supposed to be cold, rainy and maybe even snowy. I say . . . bring. it. on. I LOVE days where I can stay inside and snuggle with my children who are growing up waaayyy too fast.

For you this week:

Tuesday: Forensic expert Amryn Cross stops by to talk about what real detectives do and how to write them authentically.

Thursday: Author question concerning the ER treatment of a domestic violence patient.

Hope you have a great week and Happy Mother’s Day!!

Near Death Experiences

/ Jordyn Redwood / Leave a comment
If you’re a frequent reader of this blog, then you know I’m fascinated by near death experiences. I’ve reviewed some of the most popular non-fiction titles that deal with the phenomenon.
A recent article posted at Salon.com takes on the phenomenon of near death experiences combined with a relatively new treatment protocol– hypothermic cardiac arrest. The use of hypothermia is gaining acceptance to save brain tissue from anoxic injury– which means injury as a result of a lack of oxygen. Common ways it is used today is after delivery and after cardiac arrest.
In this case, it was used to intentionally “arrest” a patient for brain surgery.
The story centers around a patient, Pam Reynolds, who had a brain aneurysm that was about to rupture. Leaving it alone was not an option but the surgery to decompress it was equally as risky. To save brain function, her surgeon wanted to cool her body to the point where her brain would no longer be active but would hopefully preserve its function. What’s also interesting is that the cooler brain temperature would “soften the vessels” and make them less likely to rupture. This is something I’d not heard of before. After the procedure they would slowly return her body to normal temperature.
At first, while under anesthesia– she has an out of body experience and is able to describe precise details about the surgery even though her eyes were taped shut and she wore noise producing ear phones– which evidently were used to re-engage her brainstorm upon reperfusion. When blood flow to the brain stops, measurable EEG waves (which measure brain activity) stops after 10-20 seconds. Despite this, 15% of NDE survivors have memories from the time they were clinically dead.
The crux of the story is what happened when her brain and heart no longer had electrical activity. Tunnel of light. Meeting deceased relatives. A warm and loving light she believed to be God. These aspects are fairly consistent among most NDEs. Another consistent phenomenon of NDEs is the positive life change that happens after the experience.
According to the Salon piece, interest in NDEs resulted from a published book Life after Life by Raymond Moody and I don’t think interest has waned considering how often these non-fiction books hit the bestseller lists. There is also an International Association for near-death studies.
The issue from a medical standpoint is independent corroboration of these events. To be of value, statements need to be verified by more than just the individual. This happened with an individual named Maria who was able to describe, very precisely, a shoe that was stuck on a ledge outside her hospital room. Hospital staff retrieved the shoe and the doctor involved in her case was convinced of the NDE.

Still not satisfied, a different group of researchers interviewed people who were blind, some since birth, who reported the same type of experience. This is leading researchers to think something is occurring outside the brain/body.

However, controversy exists and not all scientist are on board with the brain/spirit being serparate from the physical body. A few case studies report out of body experiences (OBEs) during brain surgery for seizures and some view them as momentary brain dysfuction. NDE supporters insist that just because you can induce an OBE like experience using electrodes doesn’t mean OBEs are illusions.

Also, in denial of the illusion theory, Parnia reasons . . .

“When oxygen levels decrease markedly, patients whose lungs or hearts do not work properly experience an “acute confusional state,” during which they are highly confused and agitated and have little or no memory recall. In stark contrast, during NDEs people experience lucid consciousness, well-structured thought processes, and clear reasoning. They also have an excellent memory of the NDE, which usually stays with them for several decades. In other respects, Parnia argues that if this hypothesis is correct, then the illusion of seeing a light and tunnel would progressively develop as the patient’s blood oxygen level drops. Medical observations, however, indicate that patients with low oxygen levels do not report seeing a light, a tunnel, or any of the common features of an NDE we discussed earlier.”

What is known is that the controversy surrounding NDEs is not going away because, in the end, what would it mean to science if it was proven that the mind/spirit can exist separately from the body? What would it mean regarding our understanding of religion– particularly when people from different religions have similar NDE experiences?
Only time or death will tell.
Click here to read this in-depth piece regarding NDEs (from which the information for this piece was gathered) for yourself and check out the book Brains Wars for further discussion on the topic.

Veterans Die While Waiting . . .

/ Jordyn Redwood / Leave a comment

Honestly, I wish this was fiction. As a nurse– I wanted to call attention to this.

Imagine . . . you have served your country faithfully and just need to see a doctor. The VA system requires patients be seen in a timely manner of 14-30 days. Evidently in Phoenix, there was a system in place to hide the fact that 1,500 veterans were waiting months to see a physician and according to this CNN piece— 40 died while waiting.

There were two lists. One that was shown to auditors to prove that they were meeting this appointment criteria. What was really occurring is that a veteran would make a request and would be electronically placed on a “secret list”. When their appt came up under the 14 day mark, it would be registered, when if fact they were waiting several months to be seen.

With the government assuming more control over healthcare I fear more and more of these stories are going to come to pass.  Doctors are leaving traditional practices and opening up concierge services. My own primary care physician did this. We chose not to pay him out of pocket for “access” on top of our normal insurance rates. We had to find a new physician.

The government is also becoming the largest payer to hospitals through Medicaid, Medicare and now the ACA. When you have one primary customer– that customer will dictate how your hospital runs. Right now, hospitals are cutting back staff, staff incentives and such because they are worried about reimbursement from government agencies. My own hospital has done these things.

What about you? How do you feel about the current state of our healthcare system? What changes have you seen take place that you like or don’t like?

You can check out lengthy pieces on this subject here and here.

https://youtube.googleapis.com/v/RZVP0Vo-7RU&source=uds

Up and Coming

/ Jordyn Redwood / Leave a comment

Hello Redwood’s Fans!

What’s new in your neck of the woods. I have to tell you that I’m finding it a little too chilly for May in Colorado. I am ready for some sun and new flowers. Anyone else?

I’m excited to announce that my sophomore novel, Poison, made the short list for the 2014 INSPY award. Wow– so honored to be named amongst such well-known authors like Brandilyn Collins, Steven James and Randy Singer. I am definitely the underdog but what great company!

For you this week.

Tuesday: A truly horrible story that I wish was fiction but sadly is not– veterans in Phoenix, AZ dying while waiting for healthcare.

Thursday: More on NDEs. With the movie, Heaven is for Real, now in theaters it seems that interest is not waning in this phenomenon. What do you think? Are they medical? Are they spiritual? Or are they both?

Have a great week.

Mothers Behaving Badly: 2/2

/ Jordyn Redwood / Leave a comment

April was Child Abuse Prevention month. Obviously, this holds a place close to my heart as I deal with victims of abuse with needless frequency. Needless because these injuries are 100% preventable.

Image Link

I’m continuing my series on infanticide cases of note that have happened recently. You can read my last post here on the Megan Huntsman case.

This story from People magazine caught my eye because the prosecution involved in this woman’s case alleges she breastfed her baby to death.
 
In short, during the infant’s first month of life, it only gained four ounces. Average weight gain is 0.5-1 oz per day for around 15oz on the lighter side.
 
Then: At 6 weeks old, she died, and an autopsy found enough morphine in her brain, liver and blood to kill an adult. With no puncture marks or other trauma, Alexis – authorities concluded – could only have gotten the drug through breast-feeding.
 
Question #1: Does morphine pass through breast milk? Yes, it does. The concerning issue for me is that one of the major side effects of opiate ingestion is bodily systemic depression. Everything slows down. The patient gets sleepy and their HR, respiratory rate and heart rate can be lower. You need a somewhat awake infant to feed. Seemingly, it is alleged the baby became toxic through breast milk ingestion only because of the lack of trauma. However, I think it should be considered that she also could have directly given the baby medicine.
 
Question #2: Is the sole source of breast milk enough to cause this level of poisoning? I do have issue with this statement. I think it should be considered that she also could have directly given the baby morphine. It turns out the baby’s mother, Stephanie Greene, is a nurse. She would have the know how to directly give the baby morphine and I wonder if this was considered during her trial. Evidently, her nursing “skills” were brought up during the trial in the fact that she doctor shopped for all her scripts. I think this is common among drug users and I don’t think her nursing knowledge was particularly helpful in this area– but it could have been with the administration of the drug to her baby.
 
More attention should be paid to this, especially considering her attorney states there’s never been a US death associated with breast feeding and morphine. To me, this makes direct administration more plausible and sadly, it would not be that difficult to do.
 
She has been sentenced to 20 years in prison.
 
In light of April being Child Abuse Prevention month– please remember you might be the only one to save a child’s life. Report suspicion of child abuse. 
 

Mothers Behaving Badly: 1/2

/ Jordyn Redwood / Leave a comment

I would be remiss as a pediatric ER RN to not mention that April is Child Abuse Prevention month. Every April comes around and I think I shouldn’t talk about child abuse this year. Haven’t we overcome this as a society? I delayed it most of the month until we had a significant child abuse case come in to our emergency department.

It appears we still need to talk about it. People are still injuring and killing their children.

I thought I would discuss two interesting cases of recent note.

One is the case of Utah woman Megan Huntsman. I know– ironic last name, isn’t it?

Ms. Huntsman is accused of murdering six of seven infants and then disposing of them in her garage in cardboard boxes. Authorities think one of the babies was stillborn. They were discovered by her ex-husband as he was cleaning out the home in order to move in. Authorities think this happened over a 10 year period from 1996-2006. What’s interesting is that Megan evidently hid her pregnancies from everyone. Neighbors noticed that her weight would vacillate between wearing baggy clothes and tight clothes. They never imagined she was hiding pregnancies. DNA testing is pending to ensure these are her children.

What’s curious is that she had a daughter born during this time frame that was allowed to live. What was the choice behind allowing this child to grow-up?

Huntsman evidently has told police that she is responsible for their deaths either by strangulation or suffocation. What she doesn’t say is why.

What’s frustrating from a medical/human perspective is that Utah has a Safe Haven law which allows a person to drop off newborn infants without fear of prosecution if the infant is unharmed.

I’m guessing– but I think this likely would have been a short car ride down the street.

You can read more about Megan Huntman’s case here and here.

https://youtube.googleapis.com/v/3Vev2rx_AGI&source=uds

Up and Coming

/ Jordyn Redwood / Leave a comment

April is Child Abuse Prevention month. Every year I try not to talk about it but then quickly realize that we as a society haven’t overcome this issue.

We are still injuring and killing our children intentionally.

In light of this, this week I’ll be discussing two infanticide cases of note.

Tuesday: The Megan Huntsman case.

Thursday: The Stephanie Greene case.

And please, if you suspect child abuse, please report it. You might be the only one to save a child’s life.

New Medical Device: NAVA

/ Jordyn Redwood / Leave a comment
Breathing on a breathing machine is not like you or I breathe. One time, when I was doing an ICU rotation, they allowed us to put the end of ventilator tubing inside our mouth and attempt to breathe as the machine delivered a breath. All of us spat that thing right out.
We breathe via negative pressure. We activate our diaphragm and when it contracts it pulls air in via negative pressure. A ventilator delivers a breath via positive pressure– by basically shoving air into your lungs.
Although at times a patient needs a ventilater– just being on a vent adds a whole other set of potential complications which is why some of these other “bridge” strategies have become more popular (like CPAP and BiPAP) which are positive pressure but delivered via mask. It is not uncommon for patients to wear these at home.
One of the problems with ventilators is getting it to deliver breaths when the patient breathes. This allows patients to be more comfortable without requiring a lot of sedation. Ventilator manufactorers began developing different modes of ventilation to achieve this goal.
What was available to patients up until now was synch mode but it basically waited until a patient triggered a breath and then would force the breath in after that. The patient and the vent were more coordinated but still not perfectly synchronized.
What’s new is a system called NAVA (Neurally Adjusted Ventilator Assistance) which uses a cathether passed down the esophogus to sense when electrial impulses are travelling down the phrenic nerve (which is what stimulates the diaphragm to contract) and delivers a breath at that time– which is much closer to the timing of when a patient would naturally breathe. 
I know– perhaps this is just exciting for medical nerds like me but keep this technology in mind if you’re writing an ICU scene in a big-metro hospital. They are likely using this technology already.

Pneumatic Syringes: Fact or Science Fiction?

/ Jordyn Redwood / Leave a comment

I had an interesting question from fellow author Eric J. Gates about what medications could be given via pneumatic syringe.

Now, my suspense author mind went to exactly where he was thinking (what kind of toxic medication can I give on the fly without having to actually inject someone with a needle.) Sadly, with current medical technology, the scenario doesn’t translate into real life.

First, you have to consider the way medications are given route wise because this is how they will end up working. They are as follows.

IN: Intranasal (up the nose.)
IM: Intramuscularly (into the muscle.)
IV: Intravenously (into the vein– blood.)
Oral
SL: Sublingual (under the tongue.)
SQ: Subcutaneous (into the fat tissue just under the skin.)

And then we can talk other orifices but they really don’t apply here.

When you give something via pneumatic syringe you’re pushing the medication under pressure into the tissue underneath which is fat tissue. Few medications work well when given into fat. One of the medications given consistently this route is insulin.

That’s author problem #1– the route in which a pneumatic syringe would work doesn’t work with a lot of devious medications.

Author problem #2– pneumatic syringes aren’t really used in human populations for anything at this moment. The closest possibility I could come up with is what we call a J-tip. This is a device that will force medication under the skin using high pressure caused by a chemical reaction. When the medication is delivered, it sounds like three pop cans opening simultaneously. The only use for it now is to inject Lidocaine (which is a numbing agent) painlessly under the skin to numb the site for IV starts.

Even though it may be a great thing in the future as a delivery method for medications and could be used at some point to kill off a fictional character– right now I would consider it outside the realm of possibilities and more in the realm of science fiction.