JO - Death of an icon
Death of an icon
Sunday, March 25, 2007
Every Jamaican is saddened by the sudden death of the Pakistan cricket coach Bob Woolmer. Born in Kanpur, India, of English parents, Woolmer was not only a talented batsman but also a successful coach for the South African and Pakistan teams.
By any definition, I submit that the classification of Bob Woolmer as a sports icon would no doubt be unchallenged. We mourn his loss.
Understandably, news of his death cascaded across the globe since the announcement was first made on Sunday, March 18. The local media reported that Woolmer died at the University Hospital of the West Indies at 12:14 pm, March 18, approximately 30 minutes after he was taken to the Accident and Emergency section of the hospital.
Since then, media houses worldwide have sought to ascribe varying causes of death. Some alleged suicide, others, murder, while a few blamed pre-existing medical conditions and prescription drugs. In the final analysis, Jamaica will be judged on the basis of its scientific and professional handling of this tragic incident.
Circumstances surrounding his death
WOOLMER. the plethora of allegations surrounding his death is unfortunate
News reports are that Pakistan media manager PJ Mir told journalists that Woolmer was discovered in his hotel room by workers at about 10:45 am on Sunday (March 18).
Reportedly, Mir further stated that when he reached the room, Woolmer was lying on the floor with his mouth wide open and there was blood and vomit in the bathroom, and signs of diarrhoea. All of this must be viewed in the context of Mr Woolmer's apparent healthy retirement to his room at 7:00 pm on Saturday evening.
As I recall, under the provisions of the Coroners Act, sudden, violent or unnatural death is subject to a post-mortem examination and a coroner's inquest. In practice, if a person is pronounced dead on arrival at a hospital, or dies within 24 hours of arrival at a hospital, such body must be subject to a post-mortem examination and a subsequent coroner's inquest.
My understanding is, if however, a medical practitioner certifies that the deceased had pre-existing condition/s up to 72 hours before death, which reasonably precipitated death, then such post-mortem and coroner's inquest can be waived. Mr Woolmer's body, he having died within 24 hours of arrival at the University Hospital, in the absence of a doctor's certification as previously mentioned, would be subjected to a post-mortem examination and coroner's inquest.
Attempts at resuscitation
Questions must be asked as to Mr Woolmer's physical state on arrival at the hospital. If he was dead on arrival, then the established protocol is that the post-mortem examination would have been conducted at the Spanish Town Hospital, where all such post-mortems are done, and not at the Kingston Public Hospital (KPH), as was done.
On the other hand, if he was alive, or even appeared dead but attempts were made at resuscitation, then the responsibility for the post-mortem would be that of the University Hospital. I question therefore, why the post-mortem was done at the KPH and not the UHWI or the public morgue at the Spanish Town Hospital. I will come to that answer later.
On Tuesday, March 20, news reports carried a press conference at which were present Deputy Commissioner of Police Mark Shields and other critical functionaries. There it was reported that the results of the post-mortem were inconclusive and that further medical investigations would be carried out. I am aware that the circumstances dictated that toxicological tests and microscopic examination of certain tissues be carried out.
These procedures cannot be conducted within hours, but rather, under even the most ideal conditions, will take days, weeks or even months.
Consider, therefore, my outmost surprise when within hours of the press conference, another press conference was called at which DCP Shields told journalists: "Having met with the pathologist, other medical personnel and the investigators, there is now sufficient information of the circumstances surrounding the death of Mr Woolmer, which we are now treating as suspicious" (Daily Observer - March 21).
In the circumstances, I find these comments unfortunate, considering the inconclusive post-mortem report and the fact that neither toxicology nor histology reports were available, which could reverse the inconclusive diagnosis. Further, should there be physical evidence at the scene where the body was recovered, which might give cause for concern, then, to avoid speculation (which has now surfaced worldwide), the preferred protocol ought to have been to withhold the 'suspicious' diagnosis until the scientific evidence is available.
Rumours of strangulation
The most recent reports at the time of writing state that "Woolmer's body had marks on the throat and that bones on the lower part of his face were broken.' (Daily Observer - March 22). Similar headline reports were carried in the Jamaica Gleaner).
As I understand it, strangulation is diagnosed at post-mortem by physical evidence on the body. For example, bruises on the neck, or broken bones in the neck. There are no other tests which would confirm strangulation.
The inconclusive report of the pathologist has therefore ruled out strangulation as these would necessarily be present and observed at the time of post-mortem examination.
If indeed the examining pathologist erred in the initial inconclusive report, this would indeed represent a grave and far-reaching error on his part.
I have sought explanations from medics as to reports that the body and hotel room showed signs of vomit, blood and diarrhoea. I am advised that in cases of sudden death, blood may pool in the lungs resulting in its frothing at the mouth. Also, that there, at times, is the tendency on dying to empty the bowels. (This is well-documented in cases where persons died by hanging.)
The reported presence of blood and diarrhoea on the body of Mr Woolmer and in its precincts, would not necessarily suggest violent or unnatural death.
Passing stool at the point of dying can occur in natural deaths and therefore in and of itself does not necessarily point to a manner of death, be it natural or unnatural. Further, the issue of the blood should be differentiated by the volume present.
Where we have failed
There has been much talk about putting medical personnel in place at Sabina Park and equipping the Kingston Public Hospital to meet the demands of Cricket World Cup. Sadly, we overlooked the possibility of persons dying and the need to show the world that we can handle this scientifically and professionally.
As at Wednesday (March 21), two visitors to the island for World Cup Cricket have died suddenly - Mr Woolmer and a well-known Irishman, Mr Bob Kerr.The fact is that this country is unprepared to handle the instances of sudden and unnatural death of its citizens and visitors.
Currently, there is no national morgue, and the morgue at the Spanish Town Hospital, as inadequate as it is, has been used to fulfil this function! This morgue is in a deplorable condition, lacking in equipment, staff and basic facilities. They dared not send the body of Mr Woolmer to that location. Yet, relatives of our citizens suffer the disgrace and indignity of their loved ones having to be 'post-mortemed' there. News broke on Wednesday that a pathologist is to be brought in from Florida.
Why is this so? My information is that there are five forensic pathologists in the island, all foreign nationals. Why have we not seen it fit to train our local pathologists in this specialty that is so badly needed? It cannot be that we daily promote Jamaica as a tourist destination when the country lacks basic facilities to treat the dead (be they citizens or foreigners) with dignity and internationally accepted medical and investigative procedures.
This brings me to the state of the national forensic laboratory and its inadequate staffing and facilities. When will a new institution be built and brought up to world-class standards?
One would have hoped that the speculations surrounding the death of Mr Woolmer would have been prevented had the police high command avoided issuing its 'suspicious death' allegations. In some jurisdictions, all reports would have been withheld until final investigations - medical and otherwise - were completed. Importantly, evidence for a coroner's inquest, such as post-mortem reports, should be privy only to the coroner. Dissemination of vital evidence prior to an inquest can prejudice the inquest.
It is my view that the plethora of allegations surrounding Bob Woolmer's death is unfortunate and their publication across the globe is an injustice to the family of Mr Woolmer and indeed harmful to the country. In the words of Mr Mir, the protocols to be followed are those which are legally, morally, realistically and logistically required. We have bungled it.