Debate Over Duke Accuser's Bruises

 

    I was very happy to hear that all charges are expected to be dropped soon in the Duke Lacrosse case. I have felt that this was a travesty from the beginning. And, no, it wasn't because of the accuser's chosen occupation either. Or because of her race or socio-economic status.

     That meant nothing to me. We see patients of both sexes from all ages, races, occupations and socio-economic groups. Every single person who comes through our doors is treated with the utmost respect and compassion. 

     We once had a couple self-acknowledged prostitutes brought to our unit after they had escaped a killer. No one doubted their credibility. Why? Well, perhaps it was because pieces of the implements of their torture were still hanging on them. Or maybe it was their bruised and battered faces; or the fact that the perpetrator and his torture chamber were easily located based on their description. In other words, EVIDENCE.

   Now most people realize these days that rape doesn't always leave evidence behind. Nor is there always DNA. Often there isn't. But you have to look at the type of rape that supposedly happened and exactly what occurred.

     You would expect to see different types of evidence from a "simple" rape - meaning one (known) person and no beating, etc  - than from an extremely frenzied, violent attack from multpile unknown perpetrators, occurring in a small, enclosed room.

     One type of evidence you would expect to see from claims of a violent beating, kicking and choking, would be a certain pattern of injuries. I've discussed these before and won't go into detail too much again, except to address the latest photo that has been put out regarding the accused. Normally, I wouldn't put up photos of any accuser. However, I've been asked to address the supposed bruises on her face that were claimed.

 

     I've taken a good look at the recent photo of the accuser. Legally speaking, as far as I'm concerned, this photo by itself is useless. I have no way of knowing what type of camera or lighting was used. And there are no photos with scales.

     Here is a good link to an article about photographing injuries. In our exam room, we use a special camera and lighting to get the most natural appearance in our photographs. The wrong lighting can cause photos to appear differently, especially with someone who appears to have an uneven complexion like the accuser in this photograph.

     On the surface, it looks like a photograph of a normal, NON-INJURED female. Just looking at it, I'd say this is not the face of someone who has been recently beaten.  Let me explain why:

  First of all, consider the type of crime it [supposedly] was. The accuser claimed she was violently beaten and choked. If it was a right handed male who did the hitting, he's usually going to swiftly, angrily swing his right fist up and hit the outer right* side of her face - either up at the eye area or in the mouth. If he is left-handed, it will be the opposite.

   FYI: A woman will usually hit with an open hand; a male with either the back of his hand or a closed fist. The open hand usually indicates that the person is hitting out of pain. Someone has said something to hurt them and they slap them back. The back of the hand against a woman's face is immediate control and domination. The closed fist is rage. They are out to hurt somebody. When a male fist connects with the soft tissue of a female's face, it can do some serious damage.

   When a woman has been beaten on the face, we expect to find bruises, abrasions, and/or lacerations, primarily on one side of the face. You can have injuries on both sides but they won't be identical. You wouldn't expect to see two injuries exactly alike from this type of beating.

     If she has been beaten around the eyes, you would expect to see redness and swelling almost immediately, no matter what race the person is. While bruising can't be dated, it still goes through the normal progression of reddish to blue/purple to yellow/greenish in color. This can take days up to two weeks, depending on the type of bruise, where it's at, and how deep it is. It's not uncommon for bruises to take a day or two to start to show up.

   Bruising at times may be hard to see on a dark skinned person. The key word is MAY. I've had plenty of dark skinned patients with bruises showing - often when they haven't come in right away. I've also had a few times where the bruising was not that noticeable on the surface but I was able to see an outline with the UV light - so clear in fact, that I was able to draw the outline in ink. This usually happens with superficial bruises.

Bruising on dark skin  (warning: graphic!)

     Redness, however, shows up right away. I've never had any problem seeing redness on dark skinned patients. Due to the body's inflammatory response syndrome, this type of injury should be apparent to the SANE examiner, if the patient came in early enough.

   The other injuries we often see in facial beatings and choking are petechiae and redness (hemorrhaging) of the eyes.  Petechiae are tiny little red spots which can be anywhere. They are often seen in the eyes, the mouth, or on the skin. The following image shows what red eyes look like.

   From Google:

 

Red Eye Image

Conjunctival Petechiae   

Petechiae on skin

     As I said earlier, we also expect to find other injuries besides bruising, especially if they've been hit more than once. Abrasions and lacerations are often present. Split lips, injured, swollen nose and lacerated eyebrows are very common with this type of beating. Take a look at some good examples:

Facial Abrasions

Facial Lacerations

Severe Injuries (warning: graphic)

This is an excellent mixture of diagrams & photos. Although it's about child abuse, the accidental vs. non accidental injuries are similar. There's also some good info on child abuse injuries:

Child Abuse Diagrams & Pics

      I think, with these photos, readers can get a good idea of what we typically see with these types of injuries. Now, by comparison, looking at the accuser's photograph, taken two days after the claimed beating, what would we expect to see? What do we see?

   Two days after such injuries as claimed, I would expect to see more than just bruised, swollen eyes. In fact, I would not expect to see two identically bruised, swollen eyes - as was described by the accuser's father.

     I would expect to possibly still see some swelling and redness. I would expect to see abrasions and lacerations caused by fists. I would expect to see bruising start to develop. In the sane exam, I would have expected to see hemorrhaging in the white of the eyes and petechiae; probably a busted lip and eyebrow. If the fist (s) that hit the accuser wore a ring, there should have been a patterned abrasion left on the accuser.

     What do I see?

     I see a young black female with an uneven complexion. I see what appears to be two faint, old scars - apparently from scratches long ago- on the left side of her nose. I see dark areas above her eyes. I can't determine if that is from eye shadow or her natural skin tone. They appear to be identical. I don't believe it's from bruising. You're not going to find any two bruises that look exactly alike. I see nothing, in this particular photo, that I would classify as an injury.

   What's important?

    What's important to me are the photos taken by the SANE nurse. I've asked this question before, and keep stressing it because it's important: How many photos were taken by the SANE nurse? That will tell me a great deal. If there are no injuries, there should only be two photos taken : 1) The face shot and 2) The complaint #.

     If there were injuries seen by the SANE nurse, there should be a diagram, as well as the photos, showing and describing all injuries and findings. A finding may be an old bruise, so it wouldn't be classified as a related injury. I have not heard that there was any diagram sheet. This is important. No diagram sheet, no injuries!

Addendum:

Choking:

  Did the accuser wear any type of necklace the night of the party? I couldn't tell by the photos. If so, I would expect to see a patterned injury left by the necklace. I see none in this photo.

*corrrection: "Left" first written by mistake
Modified 3/26/07

Comments

[guanxi]

Hello,

Those are interesting points.

Do you have a good source for those photos, which indicates when/where they were taken? I ask because editors of the Wikipedia page on the issue are trying to decide what to do with the photo on the left, but so far we have no reliable source for it or for the time/place/etc it was taken.

If you're interested, here's the Wikipedia page and its discussion page:
http://en.wikipedia.org/wiki/Talk:2006_Duke_University_lacrosse_team_scandal
http://en.wikipedia.org/wiki/2006_Duke_University_lacrosse_team_scandal