His report was not as detailed as I expected to see, but it is accurate and gets its point across. He did not write it for the layman. It is written for those in the medical field that understand the anatomy he is discussing. I'm not surprised that it is hard for some to make the conclusion that the bullet had to pass through the Dura Mater and the brain. He never comes right out and says it until he is asked in court. He does give you all of the data points to make the connection if you understand what he is saying or willing to put the extra effort in to some anatomy study on the side.
I'll will tryi to link a couple of pictures that should help, but I may screw this up. They come Frank Netters's website. He did anatomical drawing/paintings/slides that are considered to be the most accurate. They are also rather easy to see and understand.
<a href="http://www.netterimages.com/image/2005.htm"><img src="http://www.netterimages.com/images/vpv/000/000/002/2005-0550x0475.jpg" alt="Illustration of Normal Brain Anatomy as Demonstrated by Computerized Tomography (CT Scanning) from the Netter Collection" height="150" width="150" /></a> On the right, is a CT Scan of a normal brain. The bright white, glowing edge is the skull. There is not as much room between the brain and the edge of the skull. On the left, is Netter's drawing of the skull and the brain at the same level as the scan. Again, not much room between the two structures.
<a href="http://www.netterimages.com/image/2005.htm"><img src="http://www.netterimages.com/images/vpv/000/000/002/2005-0550x0475.jpg" alt="Illustration of Normal Brain Anatomy as Demonstrated by Computerized Tomography (CT Scanning) from the Netter Collection" height="150" width="150" /></a> This image is sagittal plane view of the right hemisphere of the brain and its relation to the skull. The bullet entered the Frontal Bone 3 inches from the crown or the highest point of his skull. It was also 1.5 inches from midline, so it was just outside the middle of his eyebrow, and roughly 1.5 inches above the eyebrow. So where the bullet entered is not viewable to us in the picture. If you feel around along the outside edge of your eyebrow you will find a ridge. The bullet entered within about 0.5 inch of this ridge and 1.5 inches above the brow ridge. Underneath the orange Frontal Lobe, you will see a thin bone with pink nasal tissue under the bone. That is the Ethmoid Bone and represents the midline of the skull, and specifically the inferior aspect of the Cranial Vault. It is through this bone that the bullet re-enters the facial skeleton. The Frontal Bone is considere part of the face, so in order to re-enter the facial skeleton, it had to exit the facial skeleton. All that area from the back side of the Frontal bone to just about where the orange and green meet at the top is the R Anterior Fossa. This Fossa is lined by all three layers you describe. Now when you are sitting and looking at these pictures keep in mind that the bullet is coming toward you and toward the Ethmoid Bone.
Now let's discuss his report appearing to state that the brain was not damaged. Since the Dura Mater lines the entire inside of the skull, once something passes through the anterior skull and transverses the r Anterior Fossa it had to pass through the Dura Mater. It has already went completely through the bone and entered into a different anatomical structure, in this case the R Anterior Fossa, which happens to be stuffed full of the R Anterior Lobe. How does something passe through the skull into a different structure and not pass through the Dura Mater which is glued to the inside of the skull. He does not come right out and say it, but he gave you all the clues to figure it out. The lack of intracranial bleeding is the reason some believe the gunshot was last, after he was essentially dead. Postmortem wounds don't bleed, so if there is no blood in the skull from the gunshot, then it came after he was dead. He does state that there does not appear to be any cerebral damage, but the add-on to that sentence gives the reason that he could not determine the amount of damage to the Cerebrum. The brain was decaying and liquifying, so the path of the bullet could not be accurately determined.
The second sentence is an easy explanation. You did the same thing Molly did. You left off the first sentence of the Internal Examination of the Nervous System. He talk about reflecting the scalp "in the usual fashion revealing the previously describe injuries". This sentence removes the injured area from the discussion of the rest of the nervous system. I know Molly threw out several other sections, but he says the same thing in each one where there were previous injuries described.
Now if you will go to the
ME Report: Discuss it here thread the first post by StephanieHartPI, you will see that she transcribed a good portion of the ME testimony. In line 14-16, he clearly states that the bullet did pass through the brain.
I don't know how else to explain this. I agree that he did not say it outright in his report, but the information to figure it out is right there in the report. In court, he was adamant that the bullet did pass through the brain.
I apologize if the pictures did not link correctly, I can't tell if they did until after I hit the reply button.
Captain, again thank you for another detailed and thoughtful response.
Actually, the reason I was pounding on lack of any direct evidence that Travis' brain was injured, as well as lack of
any reference to brain injury in Horn's report, was not because I necessarily believe that Travis' brain was untouched by the bullet, but rather to draw attention to the lack of specifics around this point and Horn's lack of detail in his autopsy.
In fact, I
do think it likely that the bullet penetrated Travis' right frontal lobe. Indeed, waaaay back in posts #258 and #269 (page 11 of this thread, my very first posts on Websleuths btw!), I argued the scenario in detail, as well as pulled some expert references to support the notion that Travis could very well have defended himself after sustaining a gunshot wound to a frontal lobe. I invite readers to go back to post #269 for more on gunshot wounds to the frontal lobes.
Now, the issue I continue to have is all this faith being heaped on select parts of Horn's testimony and autopsy report. I think we can all agree that his autopsy report did
nothing to directly address whether Travis' brain had been penetrated by the bullet (and thus support his being incapacitated, a key point). As you've done above, the thoughtful reader has to go through gymnastics and arm-waving to support even this basic notion. There is also little to directly support a knife-first scenario. Indeed, I would suggest there is contradictory information which weakens the pillar that every gunfirster inevitably points to: lack of hemorrhaging in the brain cavity.
I return to Horn's autopsy report in describing Travis' lungs and the severe stab to the chest:
The lungs weigh 340 grams left and 280 grams right. The upper and lower airways are patent and of normal caliber. The pleural surfaces are smooth and glistening. The parenchyma is autolyzed dark re-purple, exuding moderate amount of blood and intermixed frothy decompositional fluid. There are no areas of induration, consolidation, hemorrhage, or gross scarring. The pulmonary are patent and of normal caliber.
and
A 1 1/2 inch oblique stab wound of the paramidline right chest, with penetration/perforation of the costochondral junction near the sternum at the level of the 3rd and 4th right ribs; the wound extends to a max depth of 3 1/2 inches with penetration of the superior vena cava near the base of the heart, with a small amount of surrounding hemorrhagic in the mediastinal soft tissues and the pericardial sac of the heart.
Doesn't sound like much blood in the lungs or chest cavity. We imagine a stab wound penetrating the vena cava and the right lung would have resulted in a large amount of blood. We would expect Travis' right lung would have had a substantial amount of blood.
Now, as danzin16 kindly pointed out, Horn was questioned about this on the stand (post 1390):
I guess you missed the part of the ME's testimony that said it was possible the lungs were punctured and he couldn't tell because of decomp. I guess you missed the part about how it was possible the knife stabs could have entered so deeply they entered the body cavities but decomp made it difficult to tell.
Based on Horn's testimony, five days of decomposition of Travis' body had a major impact on the level of detail and certainty Horn could ascertain around the wounds and the extent of hemorrhaging. However, everyone
knows that this stab wound to the body's largest vein must have caused extensive hemorrhaging. And every knifefirster
knows that Travis must have been coughing up blood at the sink.
Now, let's return to every knifefirster's favorite passage from Horn's report:
The wound track perforates the anterior frontal skull near the superior orbital bone and the traverses the right anterior fossa, without gross evidence of significant intracranial hemorrhage or apparent cerebral injury (although examination of the brain tissue is somewhat limited by the decomposed nature of the remains).
So in this famous line, Horn, to his credit, offers a caveat to the reader and to the court: here are my observations (one of which we already agree is inaccurate: lack of cerebral injury!), but understand that the area is extensively decomposed, limiting the certainty of my observations. This is the one time Horn feels compelled to comment on the extent of decomposition in his report. I would say we should probably take Horn at his word: the area was decomposed making it difficult to make an accurate assessment.
Now knifefirsters may parse this further in support of their theory, but the fact of the matter is that Horn
himself is cautioning us not to put too much weight on these observations. Given the fact that Horn testifies similarly with respect to the chest injury, and given that the extent of hemorrhaging from the chest wound can't be accurately reported due to extent of decomposition, is it reasonable that we now pick out this one piece of Horn's report, the one piece that Horn himself cautions us about, as
the key piece of support for a knife-first scenario?
I would suggest that this evidence, while consistent with a knife-first scenario, is insufficient to rule out a gun-first scenario.
In other words, if Horn were asked in court "Is is
possible that the decomposition of the area made it difficult to ascertain with certainty whether Travis was alive when he was shot?"
How do we think Horn would answer?
Dave
