18 Tiny Deaths, page 14
Lee resolved the impasse. She proposed to Burwell that Brickley be appointed an instructor in the Department of Legal Medicine. Brickley would be called upon to give two or three lectures a year and would have students to assist with postmortem examinations. Lee would provide a reasonable compensation out of her own pocket. However, she said, the appointment of Brickley should not be made unless all case records, lantern slides, negatives, photographs, microscope slides, and all other material accumulated during Magrath’s career were deposited in the Department of Legal Medicine.
“If Dr. Magrath is to write his book, which is the ardent hope of his friends, it will be imperative that he have this, the sum of his life’s work, ready at his hand in his medical school quarters,” Lee said to Burwell.37
Brickley agreed. From then on, Brickley and Dr. Timothy Leary, the medical examiner for the Southern District of Suffolk County, had appointments as legal medicine faculty at Harvard, with their salaries paid by Lee.
7
THE THREE-LEGGED STOOL
May 23, 1936
LEE SENT A FORMAL PROPOSAL for a Department of Legal Medicine to Burwell, the medical school dean. It would be a full, well-equipped academic department, involved in teaching and research and producing a supply of qualified medical examiners.
Lee intended to give Harvard a total of $250,000 in the form of 1,050 shares of International Harvester preferred stock, a smaller amount of other stocks and bonds, and $12,319.44 in cash. By her figuring, dividends from the stock would produce about $15,000 a year to support the department, supplemented by funds provided by Harvard.1 Lee indicated that she would also leave Harvard an additional $250,000 in her will for ongoing support of the department. Privately, her plans were grander. A contemporaneous will—drafted but not executed—allocated $1 million for Harvard.
In her proposal, Lee offered to pay Magrath’s personal salary until his retirement as well as continue paying for a part-time secretary and a librarian. Lee’s gift had two stipulations: “First, that it shall remain anonymous until I release you from this provision, and second, that the name of Dr. George Burgess Magrath shall be attached to [the department] in perpetuity, in whatever manner your good taste shall dictate.”
The proposal included Lee’s request that she remain actively involved in the Department of Legal Medicine. “It would give me pleasure to reserve unto myself the privilege of adding more volumes to the Library, from time to time, and possibly giving some item of necessary equipment when a specific need for such shall arise,” she wrote.
Lee’s senior by seven years and approaching his sixty-fifth year of life, Magrath was suffering from rapidly declining health. He had increasing difficulty with mobility and his mental faculties and had been hospitalized repeatedly at Phillips House. Lee knew the amount of productive time her friend had left was running out. She told Burwell and Gregg that no more money would be forthcoming for Harvard unless the medical school made a good-faith effort and invested the resources necessary to develop the Department of Legal Medicine.2
The ultimatum worked. Medical school dean Sidney Burwell convened a committee to consider the prospect of legal medicine at Harvard, chaired by Dr. S. Burt Wolbach, the medical school’s chief of the Department of Pathology. At their first meeting, the committee unanimously agreed that there were opportunities for pioneering work in legal medicine. The scale of the task seemed overwhelming, requiring recruiting of specialized faculty, creating new laboratories, and finding enough space for everything in the existing medical school buildings. If it developed in accordance with Lee’s plans, the Department of Legal Medicine would probably eventually need its own building on the Harvard campus.3
Wolbach wrote to Gregg at the Rockefeller Foundation, soliciting support for his mission. “It is my unfortunate luck to be the Chairman of a committee to consider the future of legal medicine in Harvard University,” Wolbach wrote. “You, of course, know the reason, which is a very good chance of securing considerable endowment from Mrs. Lee, possibly even as much as a million dollars. The problem of the committee, however, is to satisfy Mrs. Lee and construct and arrive at an organization suitable for a University.”4
A department or institute of legal medicine at Harvard could provide a public service to communities across Massachusetts and influence the field throughout the nation. However great the potential, Wolbach expressed doubts about the scale of the work involved in developing a new practice of medicine. “Even with a million dollar endowment, the problem seems hopeless,” he said.
At the committee’s second meeting, on December 11, 1936, the panel concluded that their efforts to search for a successor to Magrath “gave no promise of securing a person with all the necessary qualifications,” according to minutes of the meeting. “In all probability it will be necessary to select a young person and provide him with the means for travel and study abroad.”5
In 1937, Alan Richards Moritz was a bright and ambitious young pathologist looking to make a name for himself. A native of Nebraska, Moritz spent a year studying in Vienna before going to Cleveland for his residency in pathology at Lakeside Hospital. By age thirty-eight, Moritz was pathologist-in-charge at University Hospitals of Cleveland and associate professor of pathology at Western Reserve University’s illustrious Pathology Institute, working as the right-hand man for director Dr. Howard Karsner.
Moritz felt that his career had hit a wall of sorts. His dream job—director of the Pathology Institute—seemed out of reach. Karsner didn’t show any signs of retiring soon, and the institute’s deputy director, Dr. Harry Goldblatt, was young enough to serve for many years as Karsner’s successor. “I was third man on the totem pole,” Moritz said. “It would be a long time before I got the job I wanted, which is the one that Dr. Karsner had.”6
Moritz’s name appeared on a short list of candidates to develop a Department of Legal Medicine at Harvard Medical School. No pathologist in the United States at the time had the background and expertise necessary for the task, so Burwell and his advisory committee decided to find the best pathologist available and have him trained in legal medicine.
A background in pathology was a good foundation for a medical examiner, but legal medicine required specialized knowledge that wasn’t taught in other areas of medical practice. Training in the effects of trauma—blunt-force injuries, stabs and bullet wounds, crushing injuries, drownings and fire victims, asphyxia and poisonings—was a key element of the legal medicine discipline that was often brushed over in the traditional medical school path. To a doctor, a laceration was a wound to stitch up and heal. He didn’t need to know how to identify the direction in which it was made. Medical school curricula didn’t include how to tell whether a gunshot wound was self-inflicted, postmortem changes, stages of decomposition, or examining skeletal remains.
Moritz was intrigued by the prospect of a career pivot into legal medicine. It was still a fairly new field and presented the opportunity to plow new ground. With the resources of Lee backing the program, Harvard could do something no other medical school had done before.
“There were several schools where it was called a Department of Legal Medicine, but there was just a man who had occasional lectures and had some part-time interest,” Moritz said. Harvard “was the only medical school in America that was really giving legal medicine the attention it deserved.”7
Moritz visited Harvard in February 1937 to meet with Burwell and Lee. “I knew little or nothing about the legal aspects of the frontiers between law and medicine,” he said. “Harvard was aware of this, and so was the Rockefeller Foundation.”8 Nonetheless, Moritz was offered the job.
The prospect of creating a Department of Legal Medicine at Harvard was tempting. “The more I have considered it, the more attractive such a development has appeared,” Moritz wrote to Burwell after their meeting. “I know of no better place in America to undertake pioneer work in medicine than at Harvard where so much of the progress of American medicine has received its impetus.” Still, he had to think about making such a major decision. Without some assurances from Harvard, moving his family to another city in order to start a new department from scratch was a huge risk. “I have some accomplishment and a large investment of time and work in the field of Pathology and I would be gambling with my future to leave the field of General Pathology, to give up a good position in a good medical school, to spend two years study abroad and then be faced with the insecure tenure of an Associate Professorship, an income considerably lower than my present one and no assurance of a budget adequate to build up a department,” Moritz wrote to Burwell. “In short, I believe that such an offer indicates a lack of confidence in me or the lack of a means or desire to establish a new department as I feel that it should be established and under these circumstances I cannot consider the offer.”9
With a full professorship and a pledge to provide adequate financial support to develop the Department of Legal Medicine, an agreement was struck for Moritz to take the job.
Lee’s first impression of Moritz was tepid, although his competence as a pathologist was not in question. Moritz was an accomplished researcher, most recently involved in studies of vascular disease. Most who met Moritz were impressed by his knowledge of pathology and his engaging personal qualities, but Lee felt Moritz lacked a political sensibility. She wondered how he would hold up in the crucible of public pressure in which medical examiners often found themselves.
In short order, however, Lee warmed up to the new chairman of Harvard Medical School’s Department of Legal Medicine, and they would soon come to form an enduring partnership.
September 1, 1937
Moritz was appointed professor of legal medicine and chairman of the department at Harvard. He departed almost immediately for a two-year traveling fellowship to survey legal medicine practices in the major cities of Europe. For the two-year sojourn, during intensified conflict leading to World War II, Moritz was accompanied by his wife, Velma, and their two young daughters. In his absence, the activities of the department were halted. No doctors were being trained as Magrath’s crippled hands limited his ability to teach. Moritz faced the task of recreating a department from scratch.
Moritz’s fellowship began with six months of study with Dr. John Glaister, professor of forensic medicine and public health at the Glasgow Royal Infirmary Medical School, and Dr. Sydney Smith, professor of forensic medicine at the University of Edinburgh. Both highly regarded forensic scientists, Smith and Glaister were involved in the investigation of Dr. Buck Ruxton, a British doctor convicted of the 1935 murders of his common-law wife, Isabella, and her housemaid, Mary Jane Rogerson. The bodies of Isabella Ruxton and Rogerson had been dismembered and mutilated to remove fingerprints and facial characteristics to hinder their identification. It was the first time forensic photography was used as evidence in a murder trial.
It didn’t take long for Moritz to arrive at some fundamental conclusions about his new field of study. “Last summer I had a hazy idea about the organization and function of a department of legal medicine,” he wrote to Burwell. “Although I have been studying for less than two months and that entire period here in Glasgow I have come to some conclusions which I do not believe will be modified by additional experience.”10
One obvious conclusion was that a department of legal medicine would need a steady supply of material—dead bodies. It would be difficult to teach postmortem examination without a body to examine. Neither Moritz nor Harvard had any official affiliation with a medical examiner office, so some sort of relationship needed to be made with existing agencies that could provide such material.
Another thing Moritz found was a lack of consensus on the scope of medicolegal practice. In some places, legal medicine encompassed industrial hygiene, which today would be regarded as workplace safety or occupational medicine. Some authorities in Europe and the United States as well considered legal medicine to include the study of the psychological and behavioral aspects of crime. These days, questions about insanity and criminal responsibility are within the purview of forensic psychiatry, not forensic medicine.
Some departments of legal medicine were involved in all scientific aspects of criminal investigation. They performed autopsies and had toxicology and blood typing laboratories and also did fingerprinting, ballistics, and analysis of trace evidence.
“I have forced myself to dig into many of the heterogeneous activities that constitute the practice of Legal Medicine,” Moritz wrote to Wolbach, the chairman of pathology at Harvard Medical School. “These have ranged from finger print classification on thru to juvenile delinquency. The result of this is that I am more firmly convinced than ever that the centralization of the practice of Legal Medicine robs the practitioner of his usefulness by making him a jack-of-all-trades.”11
So what exactly was or should be the practice of legal medicine in the United States? Moritz began to formulate his thoughts.
“My greatest problem to date has been to arrive at some more or less definite idea as to what a department of legal medicine at Harvard University should be,” Moritz wrote to Lee.12
It is pathology because the determination of the cause of death is of fundamental importance. It differs from the ordinary practice of pathology in that in addition to facts of medical importance all medical evidence likely to be of importance to the law must be ascertained… The pathological diagnoses of multiple wounds to the scalp, a comminuted, compound fracture of the skull and laceration of the brain would meet the ordinary medical requirements in a given case. The medico-legal expert might add to such a diagnosis the opinion that the decedent was under the influence of alcohol at the time of his death, that he had been dead for between four and twelve hours, that he had not died where his body was found, that his death represented homicide rather than suicide, that he was killed by being struck by a heavy blunt instrument and that the assailant was a woman whose hair was dyed black and whose skin had been deeply scratched by the decedent.
The medical legal expert should function as a medical examiner representing the state and as such should investigate all cases of violent, suspicious or sudden death as completely as the circumstances warrant. He should be responsible for the examination of medical exhibits for the police and he should investigate all cases of death in which the state may be responsible for compensation of the estate of the decedent. He should be the adviser to and the witness for the court in the medical aspects of litigation before it.
A warm rapport blossomed through the correspondence between Lee and Moritz while Moritz was in Europe. They exchanged letters several times a week, sharing news and updates about developments in the Department of Legal Medicine. Lee had big plans to push forward in his absence. While Moritz was overseas, Lee was busy on the home front getting things in order for his return. Having recovered from her medical scare, she oversaw the cleaning and renovations of the offices and continued to aggressively acquire books for the Magrath Library.
Lee sent letters to book dealers across the East Coast with purchase orders and requests. She wanted any text or periodical that might be remotely relevant to criminology or forensic medicine. Moritz suggested contemporary books for the library. Lee also arranged for books that were only available in foreign languages to be translated into English. On more than one occasion, the medical school library expressed the desire to incorporate the Magrath Library into its larger collection so all reference materials would be available in one building on the Harvard campus. Lee was adamantly opposed to her collection being subsumed by the medical library.
“I had a letter from Miss Holt, Librarian at the Harvard Medical School,” she wrote to Moritz. “Miss Holt is anxious to take our departmental library completely in charge, even to move it over to her own quarters and I am, of course, against that… Be forewarned so that our library will not be taken away from us.”13
Lee had strong feelings about the books she had invested so much money and effort to collect. She didn’t even want any of her books to be borrowed from the Magrath Library. Her collection included many rare and valuable volumes and irreplaceable original documents. Having spent so much time to accumulate the collection, the incompleteness of a missing volume was intolerable. “Without wishing to be arbitrary, I greatly prefer that no books should go out from the premises of the Library to any other premises, or to any other person, under any circumstances or at any time,” she told Burwell.14
As a compromise with Miss Holt and the medical school library, three complete sets of catalog cards were created—one for the Magrath Library, one for the main medical library, and one for Lee to keep at home at The Rocks. Lee reimbursed Harvard $66 for the cost of duplicating the card catalog for her.
Burwell wrote a memorandum about his conversation with Lee regarding the Magrath Library. “She approved of the idea of linking it more closely with the general Library, but expressed quite clearly her reasons for desiring not at the moment to be joined to the main Library,” he said. “She proposes to write me a letter putting on record her request that the Magrath Library shall always remain a unit, although at some time in the future it may be placed in a special part of the main Library. I consented to this because of the fact that this is a group of books on relatively unified subject matter.”15
Burwell’s final comment in this memorandum was an update on Lee’s status as a donor. “She led me to believe that from time to time she would be available to do small things in the near future and that within a year or two there would be a sizable gift to the endowment.”
In the fall of 1938, Lee’s thoughts turned to the upcoming World’s Fair planned for New York City from 1939 to 1940.16 She saw the upcoming fair as a chance to educate the public about the modern medical examiner system. Lee reached out to Dr. Thomas Gonzales, who had succeeded Norris as chief medical examiner for New York City, to learn whether his agency planned on having an exhibit at the World’s Fair.17
