Episode 7: One Pathologist Trumps Three Psychologists

Behind the Curtain: Preparing for the Courtroom with Dr. Roland Kohr

Welcome to another episode of Kohroner Chronicles with Dr. Roland Kohr, a forensic pathologist. In today’s story, Dr. Kohr delves into the complexities of preparing a homicide case for trial—emphasizing how thorough preparation and an understanding of basic medical principles are crucial not only to solving a crime but to securing justice in the courtroom.

The Case of the Innocent Victim

The case in question involved the tragic death of a five-year-old boy at the hands of his mother, a harrowing scenario that shocked even seasoned professionals like Dr. Kohr. The mother, a known drug user with a criminal record, drowned her son while under the influence of methamphetamine, an act as grotesque as it was heartbreaking.

“When it’s a child,” Dr. Kohr reflects, “you take it personally. You’re dealing with someone completely innocent, and it brings a certain righteous indignation to the case.” The boy’s remains were recovered from a shallow pond, and the case was referred to Dr. Kohr for autopsy.

One of the challenges Dr. Kohr highlights is that diagnosing drowning isn’t as straightforward as people might think. “There’s no magic test for drowning,” he explains. “It’s a diagnosis of exclusion. Water in the lungs isn’t proof positive—someone could be shot and dumped in water, and their lungs might contain water. Conversely, I’ve seen drowning victims with relatively dry lungs due to the body’s absorption of the water through the alveolar membranes.”

Transcript

Welcome to another episode of the Kohroner Chronicles with Dr. Roland Kohr. This is Dr. Roland Kohr forensic pathologist. And today we're going to talk about the necessary of thorough preparation and understanding, basic medicine, as being Keys. Sometimes not only to solve a homicide but to make the case presentable in court, Um, It's one thing to prove a homicide uh, to the satisfaction of other police officers myself.

And sometimes prosecutors, but making the jump where the jury is going to accept it Beyond Reasonable Doubt, and bring about sense of Conviction. Anyway, it's a homicide, sometimes takes a different level of communication. Different level of proof just to get over the barriers that jurors sometimes have Uh, certain situations make this even more difficult because you enter in, with other Specialists and then you get the jurors having to battle with the fact is, you know, which expert do we believe?

Do we believe Dr. Core the forensic pathology expert, who would believe these other experts, which might be another French pathologist, or a specialist in some other field. Particular case, we were dealing with the death of a child. Now, even though as a French pathologist, I try to look at all cases with equal, fervor and equal, enthusiasm in terms of trying to get to the bottom of things, When kids die it.

Not just things up just a little bit. You take it personally because you deal with somebody who is totally innocent and did nothing whatsoever necessarily hasten, their demise. And it tends to bring a certain sense of righteous indignation or anger. Teeter approached the cage that you want to make sure that nothing slips by and nobody gets away with anything.

The situation we had in this particular case involved a mother and her own 5-year-old child. Now the mom unfortunately had a bit of a track record. She had spent time in jail. She was a known drug user. And on one particular evening, for whatever reason she was high on methamphetamine, and in a semi-psychotic state took her five-year-old son.

Grabbing drugging down to a shallow Pond and held his face underwater until she drowned him. Now, I can think a few things more grotesque or gruesome as a way to die than Have someone ground you to death, but in this case, you even Notch it up more because it's the child's own mother.

Do you wish that you like to think of a mother child relationship as being one of the more sacred things in civilized society? And to think that a mother would do this to her own child is just unconscionable Well, of course this was immediately recognized. She was arrested taking into custody.

Child's remains were recovered. This was a county outside of Vigo. And uh, the case was referred to me for autopsy. Uh, one of the things about a, uh, Drowning diagnosis is not really appreciated by most laypersons but there is no magic test for grounding Uh, drowning is a diagnosis of exclusion.

If you find a body that's recovered from water and there's no other valid explanation for their death and you can say the death is consistent with drowning. Merely finding water in somebody's lungs is not proof positive of drowning because I could shoot somebody in the head. Dump their body in a body of water and they may have wet lungs.

On the other hand, I've had several cases over my career as is every other forensic pathologist of bodies that are known be witnessed drownings and when you get the bodies out of the water, the lungs are well, relatively dry. And that's just basic medical physiology water is absorbed through the alveolar, membranes much the way that gases are oxygen and carbon dioxide so that it will be absorbed into your bloodstream and not really stay behind in the lungs.

Unless, uh, there's this extreme amount. Now, there are some subtle differences between salt water, groundings and fresh water, groundings or not going to get into that today because that's not really Germain to the story.

Time, they committed the crime. Now, just so happened this woman, uh, who was charged with drowning her son had come into a sum of money because of a settlement, uh, related to something totally unrelated. And she therefore had access to adequate funds to actually pay for a very good criminal defense attorney as opposed to having to settle for a public defender or whoever could be assigned of the case.

Are getting a run-of-the-mill. Public defender, who again, not to disparage these people, but often there are people right out of law school, still trying to build their practice, she got one of the top criminal defense attorneys in this entire part of the state. Incidentally, if I ever get myself in a load of trouble, he's the guy.

I would hire because he's that sharp Uh and of course uh like people in his profession, he's a bit confident of his own abilities, uh, won't say arrogant. But he, uh, he knows that he's good at what he does but at the same time, I knew that I was pretty good at what I did.

Another Factor about this case was, The prosecutor for that particular County. Really had not done too many homicide prosecutions, let alone. One of this type of nature and so he'd reach out for assistance and A special prosecutor been named from a different county in the southern part of the state who was Very good.

And, Surely after he was named, he phoned me up and uh, I'm going to be working the case so we need to get together meet and go over what we've got. I said okay, fine guy pick a time discuss times and then he brought up one other issue. He said now.

Know who the defense attorney has? It's been named. I said yes. I know he says, and from what I've heard through Word of Mouth I don't know if you're friends with this guy, but I know you're acquainted with him and I've heard that you have lunch with him. On a regular basis is that going to cause any problems?

My answer said, well, yes, we do have lunch at the same cafeteria or same Cafe in town on a somewhat regular basis. Uh, but I can assure you, this is in no way going to influence me because Business, that is social. And the two are not going to cross paths.

It will not be an issue. So we got down to work. Well, one of the very first things that this criminal defense attorney did was as expected. He hired a psychiatrist to examine this woman. Uh, his whole approach. At this point, the most logical approach would be for her defense.

He is that she was temporarily insane, and so he was going to go with an insanity defense. In truly logical approach and it made sense because you know, again, Jurors are going to say. I can't imagine a woman with, you know, drown her own son, unless something was really, really off, and she was temporarily insane or, you know, just half a rocker.

So, Island. Well, Battling experts. Given that scenario. The prosecutor is saying. Well, you know, if he's going to hire a psychiatrist to examine this woman, I'm going to have to get my own to at least rebut or at least give me an independent opinion of what the defense expert is saying.

So he then hires his own Shepherd So we now have two separate psychiatric evaluations ongoing to this case. The judge becomes aware of this whole issue going on. And he says, okay, There's a good chance that one side character is going to say insane, the other one's going to say, not insane.

I'm going to need a tiebreaker So the judge went out and through the courts hired, a third psychiatrist, so we'd have a tie breaker. We now have three psychiatrists each independently examining this woman each independently, issuing the report lies to her mental status at the time of this, which hopefully is going to answer the questions that the jury has.

And of course, I was made aware of all this and this some of these cases tend to drag on for a while. You know, we don't jump in with both feet and do everything at once because it takes a while for these evaluations to occur for the reports to be written up, for the opinions to be analyzed by the attorneys.

But bottom line was within a couple of months of all this. I get a call from the attorney, the prosecutor saying, well we got a problem. This woman was temporarily insane. How are we going to proceed? Because right now? Three experts are saying. Yeah, the defense theory is proper.

I said, give me, let me work on this. Again, I'm not a psychiatrist. Uh typical medical school. Curriculum people that are not going to psychiatry you spend one month on a psych rotation and that's it. And you cross paths with crazy people from time to time. But in terms of a true psychiatric rotation, you know, no formal training for me, you know, I was originally going to be a surgeon then I switched pathology so no no psychiatry

There are resources, I can teleport because one of the things I was aware was this woman at the time of this incident was high in methamphetamine. Well, there was practicing in our hospital. A colleague that was not involved with this case in any way, shape, or form. And I got talking to him and I asked, is there any way I could borrow one of your psychiatric textbooks, just to research on my aunts and thoughts and he said not a problem.

Now, people who are in medicine and various Specialties know that each specialty kind of has their own individual. For lack of a better term Bible. It's it's the authoritative text in their field. In pathology training when you were in medical school. It's the textbook by Robbins. It's viewed by medical schools all over the country.

If you're studying internal medicine, when I was in medical school, it was the textbook of internal medicine by Harrison. The surgeons almost all use the textbook by Schwartz for Pediatrics. It was the textbook by Nielsen and each of these textbooks Was essentially about a 4 to 5 inch thick textbook, that was an exhaustive reference for that particular spelling.

If you would go to any pediatrician's office you say you got you know Nielsen on your shelf. Oh yeah, it's right there. Can you get a, you know medicine dock. Do you have Harrison? Yeah, it's right there. Well. There was a similar textbook existed in Psychiatry and I can't remember the name of the author now because I've never really had to use it on any other occasion.

Whereas the others I used as part of my medical school studying. Uh, he loan me, that book, and as I researched this book, I came across some very interesting references when I cross cross-referenced methamphetamine within the table of contents. A very interesting passage that said that people that are high on methamphetamine present with a clinical State indistinguishable from acute paranoid schizophrenia,

And that was kind of a key bit of information to come across. So I shared that with the prosecutor, I said, you know, we got a way here and I think we could Trump each of these psychiatrists Uh, as we're playing these cars down and impeach their testimony. Uh now the other things we did, he wanted to also be able to present just how horrible the drowning experience would be especially coming from their own mother.

So he asked me to do research on drowning. Course, my testimony, I was able to present that. You know, studies that involve it turns out dogs. These were studies done by the French back in the 1930s that nobody would get away with now. But French researchers have actually taken dogs and wire cages, and he burst them in water and then observed their reactions.

And there's certain reactions. I mean, the initial reaction of the body submerged is to hold their breath. And then you get to a point where you can't hold your breath any longer and you involuntarily gasp. When you gasp, you bring water into your mouth, your throat and it comes into your lungs.

Goes into your stomach. You swallow, you start coughing violently and then you involuntarily continue to gas because you need oxygen, which you can't get Consciousness, you know, anywhere from 30 seconds to sometimes, 45 seconds or longer. But it's a very unpleasant way to go. Chum research that laid out in a brief timeline said you know based upon my best estimates from all this research.

I've done it's probably about 45 seconds from the time faced first in the water until loss of consciousness. Nation of awareness. Well. Month or so later. We finally go to the courtroom. And um, I testify. Hey Andrew, of course in my testimony is part of the prosecution case. I'm brought up He asked me various questions.

Of course, I describe my autopsy findings. And then he wants to say, I I want to just explain to the jury what takes place in drowning and he asked me to explain the sequence of events. And full-time on doing this. The defense attorney makes no objection, he's not sure where this is going or what relevance it has.

But he doesn't really think it's going to impact his case at all. But I describe a 45 second period of They should be Terror in the case of this child, you know, here, this child is the person he trusts most in life his own mother suddenly grabbed him showed his face under water Uh, he held his breath as long as he can, then after so many seconds can't hold any longer he gasped in.

And the whole time he's thinking why's my mommy doing this to me. Yeah, the prosecutor would officially after hearing all this testimony in his closing arguments brought this back up but we'll get to that in a moment. Well, when we were done with all, I had to say and there had been no difference to any of my testimony.

Which included bringing in the fact that postcology showed this woman had methamphetamine in her system, they you know, fairly high level. It's turned for the defense to present their case. And of course, after some basic Witnesses, they start calling witnesses to the stand. Which are not one. Not two, but all three psychiatrists And here's where the prosecutor was able to Ambush.

Because after they went through direct questioning by the defense, attorney about how, you know, what's your opinion was this woman, you know, temporarily insane. Yes, that is my opinion. Well, then, it's time, cross-examination. And we brought the copy of that textbook to the courtroom with us. So, as at the start of his cross-examination, the crosshair said Dr.

Smith from whoever it was Uh, you've been practicing Psychiatry for so many years. Yes. And you've practiced most your career here in Indiana. Yes. Uh, when you trained, um, Were you at all familiar with this particular textbook, which I have here? And of course, his answer was going to be well, yes.

So was that a textbook he used frequently that maybe you still have on your bookshelf in your office? Well, well, yes, Is this one that is widely used in your profession throughout the country? Well, well, yes it is. Doctor, would you go so far to say this would be considered an authoritative text in your field?

Of course she said well well yes, thank you doctor. I want you to turn to page 537 or whatever the page number was And he handed in the book. And of course, the doctor turned that page. So, doctor, I want you to read aloud for the jury this paragraph right here, which I've marked with a Little flag here.

And then he proceeded to read in front of the jury that Managed upon psychiatric standards. It is impossible to tell the difference between acute paranoid schizophrenia and methamphetamine intoxication. It's okay. Doctor you've just read that for the jury. Now, you are aware from previous testimony and evidence applied to you that this woman was intoxicated with methamphetamine at the time of this act.

Are you not? Course. Now he's starting to realize he's paying himself in the corner. He said well yeah. Okay. Doctor, um, Let me ask you given the fact that this textbook was you yourself, acknowledge is an authoritative text says, it's impossible to tell the difference between Being high on meth and being Temporarily insane.

Who are you to believe you? Who practices in the state of Indiana or the authoritative textbook that's used throughout the country? If not even in countries around the world. At that point, he pretty much shut him back off can see well, Yeah. Well I I uh you know what was he going to say?

I said so doctor then would it be fair to say that there really is no way to say conclusively that this woman was Experiencing symptoms of schizophrenia based upon her methamphetamine in her system. Is that a fair statement? Well, yes it is. Thank you. No further questions. Next, I just got up.

Did the exact same sequence with him? Third psychiatrist got a same sequential thing. I mean, all three basically had to concede. Well, I guess my diagnosis really can't be supported based upon what the textbook. That we've already conceded. Is the authoritative work in the field says, Well. So now it's time for closing arguments.

Of course, the prosecution jumps all over these. You know we have three psychiatrists Which is the root of the entire defense case that all have. Now conceded, there's no way to be certain with what they claimed when they first started talking And that there's just as highly unlikelihood that she was experiencing symptoms of methamphetamine transcation as anything else.

And the fact that she voluntarily chose to take, methamphetamine is certainly not an excuse for her being able to justify marrying her child. But before we close, I want to share with you the last 45 seconds of her little boy's life. There's a clock on the wall and which hits the 12s with the second hand.

I want to start narrating but we're going to stop at 45 seconds but just let's go. And so he starts off said, okay. It's showing right now. His face is shut underwater by his own mother. And of course, the cold water hits his face. He holds his breath guests.

He's wondering what's going on. What's going, why is my mommy? So mad at me? They let a period of about five seconds of dead silence pass. Okay. Now, since he really wasn't prepared for this, he didn't take a deep breath. He's the point where he really can't. Hold his breath much longer.

They finally has to involuntarily gasped and take in a breath while he's taking a mouthful of water into his lungs. Which of course causes even further Panic. And again, he's thinking why is my mommy doing this to me? And that was followed by another five symptoms or so of dead silence.

And the fight says we're getting near the end the 45 seconds. He is barely staying conscious and he's about to lose Consciousness for the last time. In his last thought to go through his mind is, why is my mommy doing this to me? In silence. By the time he'd finished his closing unit must have the journey was crying.

Uh, didn't take him long and a verdict of guilty was rendered and the whole Psychiatry and defense was thrown out the window. And this extremely sharp and competent defense, attorney came out of that courtroom wanting what he just been hit with. Because he'd gone in thinking he had a slam dunk case and came out.

He had his butt handed during that particular day. But um, it was all about preparation. You know I didn't make any, you know, earth-shattering forensic finding at the autopsy again, diagnosis inclusion. This was basically a normal autopsy but by doing the homework and relating, medical facts, understanding toxicology and where it overlapsed with Psychiatry and so forth.

We are able to reach a conclusion that the injury found uh very compelling and resulted in Justice being done.