A Grain of Salt

By Joe Cline

AuthorHouse

Copyright © 2009 Joe Cline
All right reserved.
ISBN: 978-1-4389-8628-9

Chapter One

The Baby Dies

The baby was a sixteen-week-old boy who weighed twelve pounds. He had facial signs consistent with downs syndrome and extremity changes including shortness of fingers. His development was otherwise normal and healthy in appearance. On this day his look was that of a baby about to die. He was flaccid, unresponsive and did not react to any stimuli. His extremities were dark in color and shook as if he was cold. It is hard to believe that his greatest enemy was a few teaspoons of salt. Salt that had invaded every cell of his body and was tearing the life out of him.

The baby took his last breath while his mother, held him in her arms. He never had much of a chance in life and now at just over three months old his life was over. Stricken with severe downs syndrome, liver disease and a hole in his heart put him against all odds of survival from his very first day in the hospital. Nevertheless, he seemed to do very well and after a week was able to go home to live with his mother, father and three year old brother. Every day of his life was a major undertaking for his mother. He was very hard to feed and had trouble keeping food down because of the medications he was on for his liver disease. It was even difficult to get him to feed from a bottle. The deformities caused by downs made it necessary to position his tongue in a certain way just to get him to accept a bottle. Even though the baby's mother had support from her family, especially her mother, it became more and more difficult to care for her family. Her husband was always either working or going out to drink and party with his friends. The recreational life that her husband led used to include her but now with a sick baby and a three-year-old toddler to care for she was never able to go along. Instead, she was left at home with a three-year-old child running around the house and a new baby that required constant attention and care. Even when he was at home her husband was disconnected from his family. He would spend hours working outside on his truck or other projects and would do little to help with the chores around the house.

The home belonged to her husband's friend who invited them in after they became homeless. It was a run down house in a run down neighborhood. The neighbors were mostly very poor and the environment was one of drug dealing, fights in the streets, noisy neighbors and filthy conditions. There was never enough money to go around and the only entertainment provided to her was the occasional affray that could be witnessed through the front window. This was definitely not the life that she had envisioned for herself, especially not at the young age of twenty-four. The baby's mother had lived through three pregnancies, the adoption of her first child, and the continual allegations of the abuse of her children, and the constant abuse of drugs and alcohol by those around her. She had more than one chance to straighten out her life and it seems as if every one of them went in the same direction. All of her problems were shared by her mother and stepfather and caused a lot of stress on their family.

It is often very hard for middle and upper class people to understand the way people live in a very low-income setting. There is very little joy in the daily lives of people who live like this, at least joy, as most people know it. There is never enough food and seldom any new clothes to wear. It is an everyday struggle just to put food on the table. There is the constant complaining to your family who live a lot better than you do. It is hard to get any sympathy from them given that you put yourself in this position when you were a teenager, and continued the same path after they tried to help you on many occasions. You made life decisions that should have been made by someone with maturity. The joy you get is often derived from drug or alcohol abuse and usually leads to even more sorrow in the end. The most common thought about people who are in this position is that it is their fault since they made the decisions that put them there. The truth is that sometimes circumstances cause things to happen and we sometimes take the easy road instead of working hard to improve. A human frailty that I think we are all guilty of now and then. I am not trying to say that any of this excuses wrong, bad or illegal behavior. I just think that it is important for you to understand a little about underlying causes. It is easy for me to understand them. I grew up in the ghettos of Baltimore City, eating welfare food when we had it and little or nothing when we did not. This was my environment until I was twelve years old and my father retired from the military. My parents were divorced and he had little control or interest until then. When he took me away to live in a middle class neighborhood of Virginia I thought I had died and gone to heaven. I was one of the lucky ones I guess, but I still have vivid memories and can sympathize with someone who is living the life I once had.

The baby's mother could be seen breathing a sigh of relief through the tears on her face. The social worker and the nurses that watched as the baby died in her arms felt sympathy for her yet they too felt the underlying relief of freedom from the never ending task of caregiver to such a sick little baby. There was some common curiosity about why the baby's father was not there and why she did not want to notify him that the baby was being taken off life support. It was almost as if she did not want him to know what was happening. She seemed to have an indifferent feeling about the entire situation that day and seemed to just want to get it over with as quick as possible. The previous two days were nightmarish for her to live through. The baby's condition when the ambulance arrived was very poor and the paramedic was very concerned. He was lethargic, unresponsive, and warm to the touch but shaking as if he was cold, his soft spot was sunken in and his hands and feet were dark in color. When the baby arrived at the Hospital the doctors in the emergency room were equally concerned. Then there was the helicopter flight to Children's Hospital and her long drive there while wondering what was happening with her baby. Finally, the words no mother should have to endure. "He is not going to make it and we suggest that he be removed from life support systems." Although, the reaction from the baby's mother was not as expected, she almost immediately responded with what seemed to be indifference and agreed to the doctor's suggestion. When she was driving home that day she had to contemplate what life was going to be like now that the baby was gone, and she had to try to deal with the guilt of what she had done.

The baby's mother never dreamed that during the next year she would see her man leave her and her oldest son adopted, after a lengthy investigation by Social Services into his abuse. She was again alone in life and left with no responsibilities. It was a return to the party lifestyle that she had become so accustomed to prior to the baby's birth. She moved back in with her mother and found a new job and returned to the bars and nightclubs that she knew so well. This was the lifestyle that seemed to suit her best. The only thing different was the everyday thoughts of the baby, his horrible death after such a short painful life, and the ever-present guilt.

The baby's mother continued her daily routine of work and nightly activities of partying for almost three more years. Then she met the father of her next child. This was yet another man with a drinking problem, but he served her needs well until she became pregnant. The birth of her next son presented her with responsibilities that were not unfamiliar. She refused to get tied down again and she had her mother baby-sit while she continued her way of life. These conditions went along pretty well until her man found another woman that he liked better than her. Now she was back in a familiar situation, living alone with a baby to care for and new visits from the Department of Social Services. It seems that more anonymous reports of abuse had surfaced and a social worker was there again to investigate. This led to yet another court hearing and a subsequent order that she could not be alone with the baby until a complete investigation could be completed. The baby's mother was optimistic about the outcome but little did she know that I was looking at her very hard during this time, and that chances were that she would never have custody of this child either.

Chapter Two

The Autopsy

To the layman an autopsy is a terrible thing to experience. The foul odor of decaying flesh fills the air. It is an odor that you never forget once you experience it. If you try to imagine, and I doubt you can, the autopsy of a three-month-old infant has even a greater impact on your emotions. I have never been able to completely understand how someone can do this kind of work every day. It is a very difficult thing just to handle the experiences of a police officer let alone those of a medical examiner. I do understand the ability to become hardened, something we all have to do. I have never seen the autopsy of an infant and I can only imagine how difficult that must be to witness. The medical examiner sees many strange and confusing cases in a large metropolitan area especially with the large number of criminal homicides that seem to come in on a daily basis. The baby presented her with a very new and almost unheard of condition for a three-month-old victim. Hypernatremic Dehydration due to Salt Intoxication is what the autopsy report would read as a primary cause of death. The first question that came to mind was how a three-month-old baby's sodium level could reach 197 when it should be 145. A level of 160 would most likely be fatal to an infant. This led to an intense investigation into the medical records of Children's Hospital by the medical examiner. The first thing noticed was that the baby had been transferred from another hospital and that both hospital labs with identical results performed all of the tests. This is a very unusual circumstance to have a second hospital's records to confirm those of another. It did make it easy to conclude that the tests were accurate and that the likelihood of a mistake was unlikely.

When the baby was presented at the local hospital one of the first test administered revealed his high sodium level and immediate treatment was administered to rectify this. This course of action was continued after his arrival at Children's Hospital. Unfortunately, none of the treatment was effective due to the high level of sodium and its already devastating effect on such a small baby. It was fairly easy for the medical examiner to conclude what the primary cause of death was in this baby. The chance for survival of a three-month-old baby with a sodium level of 197 is almost none. It was also very easy for her to conclude that the cause of death was homicide. Someone had to feed the salt to the baby since a three month old is incapable of feeding itself. The only question that remained would have to be answered by the police, "intentional or accidental".

The medical examiner had not yet made her first incision on the body and it seemed as though the rest of the autopsy would be very routine. In some regards it was routine though, if this would have been a case of shaken baby syndrome. If the medical examiner did not know about the salt and was completing the autopsy as usual, she would have routinely uncovered all the symptoms of shaken baby and it may have been listed at the primary cause of death instead of a secondary cause. The retinal hemorrhages throughout both eyes, the subarachnoid hemorrhage, the falcine and intradural hemorrhages and the cerebral edema that were present in this baby screamed shaken baby syndrome. It was also very evident to the medical examiner that these injuries were very recent and that they occurred within six hours of the baby's presentation to the hospital.

Shaken baby syndrome is a very common occurrence in our society. It is a sad thing to think of someone shaking a baby to the extent that this baby was shaken. In a lot of cases shaken baby results from someone losing their temper and the control of their emotions. It seems that they don't even think of the damage they are doing to a poor defenseless baby. It almost always occurs in infants due to the lack of muscular development in the neck and shoulders and is often blamed on things such as falls or accidental dropping. It is fortunate for law enforcement that the signs of shaken baby are very definitive in nature and unmistakable when they appear. It is also very fortunate that the courts recognize this during criminal trials. If you can show with certainty the person who had custody of the baby when the shaking occurred, you can almost always convict them of child abuse. This case had its own set of complications in that area though. Primarily shaken baby did not cause the death. Even though you can show that it occurred, a jury may be confused by this autopsy report and the primary cause of death.

Chapter Three

The Report

The social worker had seen many cases like this one. A very young baby that was semi-conscious and unresponsive with no visible sign of injury. Her gut feeling was correct from the very start when she called the Police Department to report the abuse. Unfortunately the social worker did not have a grasp on police procedures and felt that the police department in her jurisdiction would be handling the investigation of this victimized baby. She thought that all she had to do was contact homicide and local Police to report the incident. She did not know that this department would take no action in the case, not even write a report. She also did not know that the local Police where the baby came from would not know that this was a homicide investigation for almost six months later when the autopsy report finally made its way through all of the red tape and bureaucracy and arrived in the hands of the Department of Social Services. This was long after any crime scene could be examined. This was long after the mother and father of the baby had broken up and moved from their residence. This was long after all the interviews of the investigating social worker and the Police. It was also long after they concluded that they probably had a case of shaken baby syndrome but did not have the evidence to convince the prosecutor to allow an arrest to be made. There were too many possible suspects involved and no way to eliminate them. There was also the polygraph of the baby's mother, the most likely suspect, the polygraph that she was supposed to have passed. At least that is what the police were told on the day that she took the test.

(Continues...)

Excerpted from A Grain of Saltby Joe Cline Copyright © 2009 by Joe Cline. Excerpted by permission.
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