One of the things I was hoping you'd be able to do as a forensic pathologist is to kind of "read" the injuries like you're Sherlock Holmes or something.

(I was kind of hoping I would be sitting there in the witness box in a sharp suit peering astutely over my glasses asserting articulately that "Clearly, this teeny tiny little mark that a lesser person would have missed demonstrates that blah blah blah trajectory blah blah blah blood spatter and blah blah blah therefore..." So I'm always on the lookout for those sorts of things.)

Yesterday, one of the professors called us over to take a look at a ring fracture of the skull base. (So far, skulls seem to be a great place to look for injuries full of little clues about the mechanism of injury...) Basically, if you pick up a skull to say "Alas, poor Yorrick" your hand is on the skull base. There's a big hole in the bottom for your spinal cord to fit through. If you draw a circle around that hole-- but draw it wide, so it goes up the sides a bit-- you've drawn yourself a ring fracture of the skull base. (This is based on my vast days of experience in the field, so be prepared to revise your initial opinion.) Apparently, you can get these if a whole lot of force is applied to the skull in an up-down direction (like if you're hit on the top of the head or if you land really hard feet-first.)

Flash forward to today: different professor, different case. I'm off dissecting the heart or lungs or something when the tech calls me over to take a look at the skull. She's been at the head and has reflected the scalp forward and there's a collection of blood in the scalp and stuck to the skull on the top of the head. I was kind of expecting a head injury, as there was blood around the ears and nose, which shows up when there's fracture (of any shape) in the skull base. She lifts off the top of the skull and the brain has a bit of swelling and a little bit of bleeding (subarachnoid, for the medical folks) but nothing special. My tech asks what I'm thinking the cause of death is because the abdomen and chest weren't too banged up (this was a trauma case) and she was expecting to see more damage to the brain and I say basilar skull fracture because of the ears and nose thing. We reflect the brain and there's a bunch more blood at the base of the brain. As we deliver the brain and there's a ring fracture of the skull base (which looks nearly identical to yesterday's) and she says "hey, you're right" in that very satisfying hey-this-one's-pretty-good way that's so nice to hear when you're a fledgeling. So my professor walks up to sign out the case and asks me the mechanism of injury and I say blow to the top of the head ('cuz of the blood at the top of the head combined with the ring fracture) and I'm feeling like the border collie that caught the frizbee.

So maybe it's not dazzling brillance swooping in to save the day in a hushed courtroom, but, hey!, score one for the rookie...