The future of Forensic medicine in Kerala

Future Of Forensic Medicine In Kerala 

I have learned the subject both theory & practical aspects;  from Veterans in this field like Dr.V.K. Jayapalan &;Dr.P.Sivasankara pillai. I always consider them as my role models. Working with them was a memorable period & I tried to copy down their disciplined behaviour  strictness, punctuality & boldness in every day medico-legal work. Till my retirement in April.2007 from Government Medical College,Trichur ,I tried to uphold all these qualities of good work I imbibed from them. I have got a question to my colleagues  Can any body point out a role model that can be projected?  I may say nobody. Only those people who had acquittance with them agree that they are benevolent & great. Other friends may stare among themselves when I described them as role models; just like Alice in wonderland.

Now the whole scenario is changed. Each person in the department is an individual department himself. The official work is carried out daily according to their whims & fancy. Some people are more interested in giving details of confidential matters to the press &media. .Higher authority is not having any hold on these kind of people. The HOD can't open his mouth to correct them. You may think WHY? I may say that if the HOD wants to control their colleague, he should be an ideal person with a vision  sincerity & devotion towards his profession; that is lacking .The HOD visits the department once in a blue moon & mark his presence in the attendance for those days he was not actually present. 

Now with regards to teaching in government colleges there is day by day degradation except in certain colleges. Nobody is interested to take classes for the undergraduates or postgraduates in certain colleges. During the training period irrespective of undergraduate or postgraduate they should be led in the right track so that each one of them follows the routine work they studied under good guidance. This was found lacking &whom to blame?

Another shuddering event that is being carried out in certain colleges is BINAMI POSTMORTEM  The poor post graduate student is doing out the post mortem work on behalf of HOD. The HOD is not having any knowledge about the case &;he put the signature in the detailed notes &certificate without knowing the findings & its interpretation to find out the cause of death. The only motive behind  is getting the remuneration for the post mortem done by the post graduate on the behalf of HOD. Iam asking a question to the readers WHO IS AT FAULT?

With regard to Binami post mortem I want to narrate a real incident that happened years back in one of the centres  A very senior professor ordered the PG to do the post mortem on his behalf. The PG very politely did it & came with a post mortem diagnosis of snake bite. The tissues preserved for chemical analysis proved negative for snake venom. In the mean time police arrested a person for having done criminal abortion on the said woman. The truth was revealed to the professor by the perpetrator of the crime by himself. Just imagine the mental condition of the said professor!!!!

There is another group of persons who conducted the autopsy with out giving any due respect &regards to the dead body &tried to twist/ omit the findings & form opinion that suited the police history or misled the police in their investigation by coming out with wild ideas & guess. By their action  justice is denied to the concerned.

There is yet another group who steal the findings given by  their true colleague &makes necessary changes in the certificate & dispatch these certificates to the concerned authority in their name by suppressing the evidence in the original post mortem detailed notes &certificate. The original post-mortem related documents are kept in abeyance.

One more group is there who gives age certificate according to the needs of the applicant not involved in a Medico-legal case.

By going through all these I may point out that corruption has already started & it is going to be in full swing in the years to come. Actually One senior professor clearly predicted the emerging corruption years back. 

Apart from this I want to narrate certain recent events occurred in my college. The students have to be taken for witnessing autopsy to government colleges outside Kerala because the government colleges here are forbidden to those students secured admission in private colleges including government merit seats.

The rate one of the senior professor dictating was astonishing  & heart breaking.

Each student should pay 1000 Rupees to the concerned MC office. You will get proper receipt from respective college office.

In addition to that 1)1000/student x number of Asst professor in the forensic department

                2)1500 /student x number of associate professor

                3)2500 / student x number of professors.

A group of students consisting of 100  may have to pay Rs 100000 + (another 75000 if there are asst & associate 2 each & one professor) + traveling charges+ hotel accommodation+ food. This may  come to four lacks  if the students are going to be taken in batches of 4 consisting of 25 numbers in each batch.

Now the medical education has become more of business in  nature & the concerned person  can fill their pockets with money made out from unscrupulous method.

Destructive crticism by defence lawyer

In the year 1994 I appeared before the Honarable I additional sessions court ,Palakkad to give evidence in a case of stab injury. During cross examination the defence counsel did not get any points in favor. There were seven accused in this case. He was trying to convince the court that there had occured a scuffle between the deceased & the accused & at last the deceased got multiple stab & cut injuries. In order to make his point stronger he was saying that " A SCUFFLE IS BETWEEN A GROUP OF PERSONS & IT IS NEVER ENDING" The judge asked me whether I did agree on the statement. I said I disagree. The judge was telling " IN THAT CASE YOU CAN DEFINE SCUFFLE". With in a fraction of second I uttered the following." SCUFFLE CAN BE DEFINED AS DEFENSIVE & PURPOSEFUL MOVEMENT BETWEEN TWO PERSONS, & THE ACT SCUFFLE ENDS WHEN ONE PERSON IS OVERPOWERED BY THE OTHER." On hearing this the defence counsel was commenting, You will say not only this & something beyond, because your association is with dead bodies. I was prompted to say something in return & the judge prevented me & himself came out like this. See Mr defence counsel, in a number of cases I used to give capital punishment & would you call me as the executioner?. After that comment the court was adjourned . I came behind the lawyer & told him you should respect each & every profession, for this he replied "Go to hell". I waited for an opportunity to give him something in return in that day itself. The counsel for the prosecution prevented me from further actions. I waited there near his car. with in short time he with his assistants & the accused persons came. I approached towards & told that You should respect each & other profession & it is their bread & butter. For this he retorted you go man& Iam having some other business to attend. I said I will go & before myself departing I may say that you are neither having any hair on your head & nor a brain inside your head & you are an imbecile . After that I went towards the jeep where the circle inspector of police in that case was waiting for me. The defence counsel came towards the jeep & lamented. See inspector tell him that I have seen so many other great police surgeons other than him. immediately the inspector was replying what ever you want to convey to him can be done directly to him.

Even though I said like that to the defence counsel directly over his face & I presume no body will dare to do it, I was not able to sleep during the night because the place where I was staying was very close to the place of accused

PROFESSIONAL RIVALARY

This particular case underwent autopsy at Calicut Medical college during the year 2004.The deceased was a 30-35 yr old female admitted at district hospital Calicut for elective tubal ligation. The surgery was over & later on she was referred to IMCH,Calicut for expert management. Subsequently she died. The autopsy was conducted by Dr.Ajay under my supervision. We were able to notice a handful collection of purulent blood stained fluid in the pelvic cavity. The internal organs showed petechiae with congestion. Histopatholgical examination of the internal organs revealed some findings in favor of septicaemia. The opinion was given as "the possibility of death due to septicaemia could not be ruled out." The HOD was very much vehement to forward the certificate to concerned court & police& asked me to change the opinion as the deceased died of dehydration. I said no & later informed me that the opinion of the HOD will be tagged along with the certificate. She also harassed the DMO,Calicut ,who happened to be my friend. The DYSP Calicut harassed me during my working at Medical college,Trichur & after retirement. I gave a statement to the above DYSP with regard to her death & at that time he was made aware that for want of nothing the HOD instigated all the untoward events.According to him out of professional jealousy all these misfortune happened. The HOD also brain washed the husband of the deceased to make him believe that the doctor who attended his wife did not give treatment in time & the doctors who conducted the autopsy were not able to find out the exact cause of death. I came to know recently that there is a move to sue the doctors concerned with this case in court of law.

The case came before sub judge Calicut three years ago. The HOD was not able to withstand the cross examination because of lack of clinical exposure. The complainant himself submitted before the Hon judge that "I AM WITHDRAWING MY CASE" & no harm should come for the HOD. 
My comment  TRUTH ALWAYS PREVAILS

WHIMS & FANCY OF STATE MEDICO-LEGAL EXPERT

During the year 1995, I conducted a post mortem examination on the body of 35-40 yr old woman with the history of formic acid poisoning. The post mortem findings as well as chemical analysis turned out to be +ve for formic acid&I gave the opinion as well as statement also to the police; that based upon the the post mortem findings ,clinical history & chemical report that it was a case of poisoning due to formic acid & I didnot suspect any foul play. During 1997 while I was working at TRICHUR MEDICAL college I went to PARIYARAM Medical college as examiner. I happened to attend a phone call made by the public prosecutor Thalassery sessions during my stay at Dr. SGK'S house. He was ridiculing a doctor who conducted the post mortem examination in a case. and he was in need of an expert opinion from Dr.SGK in the above said case.Later on I made him to realise that It was the same person who conducted the autopsy to whom he was talking. He was pleading to see that at the time of giving evidence "I SHOULD SAY THAT IT WAS A CASE OF HOMICIDAL POISONING". To this request I said NO. Later Dr. SGK came & I narrated the whole event. HE informed me that out of political interest the police approached the State medico-legal expert(DR.MRC)& requested that in the absence of injuries to mouth & lips whether it could be a case of homicidal poisoning? The expert opined that it could be ,because formic acid was poured into the mouth of the person using a funnel & that was the reason for the absence of injuries around & inside the mouth? How silly & foolish it was.Dr SGK disagreed with the opinion of the medico-legal expert. But when the case was heard in the court both Dr.SGK & myself gave evidence on the same day in Thalassery sessions. He gave an opinion that some abrasions on the hands could be due to restraint injuries & the possibilty of homicidal poisoning could not be ruled out. The defence asked only one question to him . You are giving this opinion after reading the certificate issued by another doctor. When comparing the findings &opinion noted by the doctor with your expert opinion which is more reliable & correct? He was made to say that opinion given by the doctor should be relied upon.

The case was made homicidal out of political interest because the husband of the deceased resigned from one party to another.& he was made a scapegoat. One interesting fact to note was that the police never approached me with the homicidal theory.

A case of ligature strangulation,head injury

In the year 2005 I conducted postmortem examination on the body of one 11year old girl involved in valappad crime. There were finding in favor of ligature strangulation as horizontal ligature marks, soft tissue injury on the neck, head injury. Examination of the anal orifice reveled that she is used to the act of sodomy. Anal swab & smear proved +ve for semen & spermatozoa.The accused was arrested & he faced trail in the children's court, Ramavarmapuram during the middle of 2007. I took the photographs at the time of conducting the autopsy,but did not include the photos in the certificate. That was a mistake on my part. At the time of cross examination I showed the photographs to the Hon: Chief judicial magistrate & requested to include the same as evidence. The defence objected it & at last it was taken as evidence. No idea regarding the verdict given

Public prosector takes the role of defence lawyer

I did one murder case registered under OLLUR police station limits. The accused for brought to the department for taking the nail clippings & blood. DR. N.G.Revi was in charge of the department on that day. Since the department was not having a nail cutter & disposable syringe ,we requested the accompanying police constables to buy the required things. They did not like the request fro us & more over in the request they have shown the arrest of the person at 1200hrs & in fact he was brought at 1030 hrs.The above said matter was highlighted by Dr.N.G.Revi. We had a big quarrel after that . In the end they bought the materials & we did the needful. The police gave a report in the evening daily a report like this. "Dr.N. Rajaram is humiliating the police force & he is very ,quarrelsome,arrogant & action should be taken against him". The above said daily was brought by my friend Dr. P.C.Ignatius. I did not pay ant attention to it.
After few years when the case was posted at I additional sessions court, TRICHUR,before my court appearance I met the prosecutor Sri. Francis in his office. The first comment from him was that when Iam going to ask you regarding whether the investigating officer had questioned you in this case ,you should say "YES". I said "NO". Under that circumstance Iam going to declare as hostile. I said proceed. When I was about to leave from his room & he again put forth another request " Iam having certain doubts to clarify? I replied back "anyway you are going to declare me as hostile & the answer to your question will be given by me in the witness box.
The Hon: judge was Sri. Bhavadasn Nampoothri. After swearing in the box,the first question asked by the prosecutor "have you been questioned by the police"?I replied "NO". He was referring me as liar &was making a comment that I used to treat the police very badly& therefore he is going to declare me as "HOSTILE"
The judge opposed & informed that he new me well & there is no point against me to declare as hostile. I gave a deposition of what had happened at the time of examining the person. After taking down my explanation he was criticising the police & informed the prosecutor that it is unfair on his part to raise unnecessary comments against me

Miscarriage of justice

A political assassination with respect to Guruvayoor police station was posted at I additional sessions judge's court at TRICHUR years back. There were some ten accused persons who were facing the trail. The Special public prosecutor was none other than Sri. Veerachandra Menon. The defence lawyer was Late Sri. Kunjirama menon.It is acustom to meet the public prosecutor in each & every case in which we used to appear as witness. In this case also I met Sri. Veera chandra menon at the morning hours in his office. One request put forward by him is that "when I ask a particular question You may please answer in this way"!!. I replied back like this. Since your the Special prosecutor for this case you may tell like this & once that is over I will be facing you in another occasion as a defence lawyer & you may highlight the precedence at that time. I do not want that to happen & please excuse me.I had a very good time in the court with these eminent advocates & all the accused were sent to jail.

After few years it was reveled in another investigation ordered by high court that the real accused in that particular case were living as respectable citizens. A re-trail of the case was not undertaken so far