Well, its already been shown that there was dissenting opinion on prior abuse and that the pro-prior abuse experts were not able to rule out other, less nefarious explanations. Its also been shown that findings often attributed to sexual abuse are found in many normal children, and, that nearly all the findings attributed to sexual abuse are present in non-abused children. So, the matter is not as clear cut as some seem to believe.
...
AK
Your quote from above
(bbm) is correct and can be attributed to Dr. John McCann who I wrote about in [ame="http://www.websleuths.com/forums/showpost.php?p=10165938&postcount=163"]
this post[/ame]. You may remember that Dr. McCann was one of the experts called in for consultation on the evidence of genital injuries to JonBenet. In my previous post, I pointed out how McCann had demonstrated his reluctance to attribute individual pieces of evidence to sexual abuse. But the above quote from him is referring to individual signs of injury that had previously been considered by doctors as evidence of abuse. Taken by itself, any one of those signs (which is what he diligently worked to document) can be misinterpreted. However when there exists in one victim
numerous signs of abuse, the totality of evidence
(theres that phrase again) paints a more complete picture of whether or not there was actual sexual abuse. And Dr. McCann (who you quoted above) reached a very definite conclusion about JonBenet's injuries. Here is (in part) what he is reported to have said about what he based his opinion on:
According to McCann, examination findings that indicate chronic sexual abuse include the thickness of the rim of the hymen, irregularity of the edge of the hymen, the width or narrowness of the wall of the hymen, and exposure of structures of the vagina normally covered by the hymen. His report stated that there was evidence of prior hymeneal trauma as all of these criteria were seen in the post mortem examination of JonBenet.
There was a three dimensional thickening from inside to outside on the inferior hymeneal rim with a bruise apparent on the external surface of the hymen and a narrowing of the hymeneal rim from the edge of the hymen to where it attaches to the muscular portion of the vaginal openings. At the narrowing area, there appeared to be very little if any hymen present. There was also exposure of the vaginal rugae, a structure of the vagina which is normally covered by an intact hymen. The hymeneal orifice measured one centimeter which is abnormal or unusual for this particular age group and is further evidence of prior sexual abuse with a more recent injury as shown by the bruised area on the inferior hymeneal rim. A generalized increase in redness of the tissues of the vestibule was apparent, and small red flecks of blood were visible around the perineum and the external surface of the genitalia. It was his opinion that the injury appeared to have been caused by a relatively small, very firm object which, due to the area of bruising, had made very forceful contact not only with the hymen, but also with the tissues surrounding the hymen. McCann believed that the object was forcefully jabbed in not just shoved in. Although the bruised area would indicate something about the size of a finger nail, he did not believe it was a finger, because of the well demarcated edges of the bruise indicating an object much firmer than a finger. McCann was not able to see any fresh tears of the hymen which he thought might be due to the lack of detail in the photographs. It was unclear where the blood on the perineum originated, since there were no lacerations visible in these photos. McCann also noted that in children of this age group the labia, or vaginal lips, remain closed until literally manually separated. In order for there to be an injury to the hymen without injuring the labia, the labia would have to be manually separated before the object was inserted. The examination also indicated that the assault was done while the child was still alive because of the redness in the surrounding tissue and blood in the area.
McCann stated that this injury would have been very painful because the area of the injury as indicated by the bruise was at the base of the hymen where most of the nerve endings are located. Such an injury would have caused a six year old child to scream or yell. The doctor also stated that he assumed the object did not have jagged edges because there were no evidence of tears in the bruised area.
McCann also noted that there appeared to be a bruise on the inner right thigh which he though might represent a thumb imprint from forcing the legs apart.
Dr. McCann explained the term "chronic abuse" meant only that it was "repeated", but that the number of incidents could not be determined. In the case of JonBenet, the doctor could only say that there was evidence of prior abuse". The examination results were evidence that there was at least one prior penetration of the vagina through the hymeneal membrane. The change in the hymeneal structure is due to healing from a prior penetration. However, it was not possible to determine the number of incidents nor over what period of time. Because the prior injury had healed, any other incidents of abuse probably were more than 10 days prior.
In discussing perpetrators of sexual abuse on children, McCann stated that the majority of children this age are molested by someone with whom they have close contact most commonly family members. He explained that if the molester is a stranger or someone else with whom the child is not close, the child will usually tell someone or psychological problems appear which create behavior changes observed by their parents. Common symptoms would be eating disorders, nightmares or a variety of behaviors indicating that something is bothering them. Commencement or increased bedwetting is also commonly seen in sexually abused children. When asked about JonBenet's sexualized behavior during her pageant performances, McCann said that this was not necessarily a sign of abuse, since this was taught behavior for the pageants. Also, with children's exposure to sexually explicit television programs, sexualized behavior is no longer considered to be an indication of possible sexual abuse.
Lets look at the different levels of information that some of the experts had to base their opinions on. (1) Drs. Meyer and Sirontak viewed first-hand the injuries on the body (during autopsy) and had access to all the microscopic evidence developed in the case. (2) Drs. Rau, Monteleone, Krugman, and McCann were asked to view the autopsy photos and slides of microscopic tissue samples that were pertinent to the injuries. They were also allowed to consult with one another on all their findings (peer review). (3) To the best of my knowledge, anyone else who has weighed in on the subject (Wecht, Spitz, Krugman, etc.) had only the same evidence we have that has been made public (essentially, the AR) to base their opinions on.
I cant believe that after all the previous discussions on the subject of the genital injuries that were found at JonBenets autopsy, here we are with people still trying to dispute what has been determined by the doctors who actually either saw first-hand the injuries or saw the photos of the injuries and the microscopic slides used to analyze what happened. JonBenet was sexually assaulted on the night she died. She had also been sexually molested prior to that night. That was determined by the medical examiner (Meyer), an associate with more expertise in that area who worked at Childrens Hospital in Denver (
Dr. Andrew Sirotnak, who also viewed the body), and a team of experts called in for consultation (Drs. Virginia Rau, Jim Monteleone, Richard Krugman, and John McCann) who were shown autopsy photos and the microscopic slides of tissue samples that were pertinent to that determination. The only thing that could not be determined with any certainty was exactly
when the prior abuse had happened (or how many times). And there is good reason for that.
Our bodies heal at different rates. Doctors might be able to guess at the approximate age of an injury based on what they know; but because of all the different factors that might influence the rate of healing, they just cant put an exact time period on it and are reluctant to try. Additionally, some injuries that may have completely healed by the time of death might not be evident, so their presence would not be seen (
if they had occurred).
(PS: Can I get credit for number of words, instead of just number of posts? :wink: )