Post mortem of a suicide case

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Abstract

n addition, during the two weeks only, there were 3+ suicide by hanging cases. I live in a country (Sri Lanka) that has a very high suicide rate. The very first one, we observed and took part in, was that of a 16 y/o teenage girl who had used a saree scarf thing as the ligature.Her parents had gone out to pick their younger kid from nursery and when they returned they found her hanging in her room. When they brought her in for PM, the saree thing was still on her neck. Her eyes were open, blank, and staring. Face swollen. Rigor mortis had just set in. The stench was unreal as expected.Her skull was cut open, blood drained and brain examined. Her neck had the V-shaped imprint. A special neck dissection proved that she died by hanging. There were petechial hemorrhages on her brain and her eyes/conjunctiva. Blood had pooled down her hand and feet.When you die by hanging, the ligature compresses your jugular vein making your brain swell as blood can’t drain. Compressing your vessels disturbs blood flow causing brain ischemia. Compressing caro

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tid sinus can cause reflex cardiac arrest. Your airway will become blocked. These cause you to die in no time.You wonder if you could get access to her brain — her thoughts and pain that lead her to do what she did. Her parents had no idea why she took her life and there were little indications she was mentally disturbed. She appeared to be well physically and mentally until this very unfortunate day.What could have driven her to take her own life? Was it a broken love affair? A case of parental abuse? Sexual harassment and physical abuse were ruled out during the PM. Could she have been suffering from some unseen psychiatric disorder? The parents reported no signs of it. Even homicide and simulation were ruled out. We would never know her final thoughts at the end of her life. She left no suicide note.The other suicide by hanging cases were all young males. It’s a fact that males disproportionately take their lives more than females all over the world. We really under-appreciate the stress and struggles of young men.</article></body>

The haunting experience that I would like to share

What struck me the most was her blank staring eyes. They weren’t close. They were looking up at the ceiling. I believe that the eyes followed the soul at it leaves the body and stays as they were. They were sad eyes. Full of death.

During the two weeks forensic appointment (clinical rotation), for the MBBS Medicine course which I follow, we had to shadow a forensic pathologist. In addition to the usual medicolegal examinations and reports, we had to help with post-mortem (PM) examinations. There were all kinds of dead people from road traffic accidents to cases of homicide.

In addition, during the two weeks only, there were 3+ suicide by hanging cases. I live in a country (Sri Lanka) that has a very high suicide rate. The very first one, we observed and took part in, was that of a 16 y/o teenage girl who had used a saree scarf thing as the ligature.

Her parents had gone out to pick their younger kid from nursery and when they returned they found her hanging in her room. When they brought her in for PM, the saree thing was still on her neck. Her eyes were open, blank, and staring. Face swollen. Rigor mortis had just set in. The stench was unreal as expected.

Her skull was cut open, blood drained and brain examined. Her neck had the V-shaped imprint. A special neck dissection proved that she died by hanging. There were petechial hemorrhages on her brain and her eyes/conjunctiva. Blood had pooled down her hand and feet.

When you die by hanging, the ligature compresses your jugular vein making your brain swell as blood can’t drain. Compressing your vessels disturbs blood flow causing brain ischemia. Compressing carotid sinus can cause reflex cardiac arrest. Your airway will become blocked. These cause you to die in no time.

You wonder if you could get access to her brain — her thoughts and pain that lead her to do what she did. Her parents had no idea why she took her life and there were little indications she was mentally disturbed. She appeared to be well physically and mentally until this very unfortunate day.

What could have driven her to take her own life? Was it a broken love affair? A case of parental abuse? Sexual harassment and physical abuse were ruled out during the PM. Could she have been suffering from some unseen psychiatric disorder? The parents reported no signs of it. Even homicide and simulation were ruled out. We would never know her final thoughts at the end of her life. She left no suicide note.

The other suicide by hanging cases were all young males. It’s a fact that males disproportionately take their lives more than females all over the world. We really under-appreciate the stress and struggles of young men.