A career spent unlocking secrets

Web Posted: 12/30/2006 10:40 PM CST

Vianna Davila
Express-News
He was the last person to smell the perfume on the neck of a woman shot to death by her husband as she left for work.
He handled a baby's heart hours after it had ceased to beat and noted what she wore: a disposable diaper and a blue teddy bear-print one-piece bodysuit.

And during one recent autopsy rotation, he leaned over the remains of a heroin addict whose pockets, when he died, contained 32 cents, a cigarette lighter, bus schedules and his dentures.

"The most common thing we find on these people are cards for their probation officer," the doctor quipped in a thick Brooklyn accent as he rummaged in the dead man's chest cavity.

Most would go cold in an environment such as the morgue, where the temperature is chilly and much of the equipment made of stainless steel.

Here, the day's work is so messy and hazardous, autopsy technicians use giant hoses hanging from the ceiling to wash off the blood from the walls and floor.

For former Bexar County chief medical examiner Dr. Vincent Di Maio, this is the place where he made his life's work.

"You get used to everything in the end," he said.

A highly respected medical examiner and world-renowned expert in gunshot wounds, Di Maio could read in the imprint of a rifle muzzle on the skin the chain of events that brought the patients to his autopsy table, the things they could no longer tell him.

The doctor retired Friday after a quarter-century as the county's chief medical examiner. To the public, he was an expert scientist and staunch advocate for improvements in his field and office, a man who worked on cases of local and international notoriety, from the death of champion boxer Robert Quiroga to the 1981 exhumation of Lee Harvey Oswald.

Because of Di Maio, the dead finally could tell their secrets.

"We write the last chapter of that person's life," said Mary Fran Ernst, a death investigator out of St. Louis. "I really believe the dead person will talk to you. You have to listen very closely."

With every controversy ? false accusations of illegal bone tissue harvesting, to his willingness to testify against members of his own medical community ? Di Maio took the same approach he used in the autopsy room: Stay calm, stand by your conclusions, trust the evidence in front of you.

For all the ways he has intimately known his patients and the pain of their lives, Di Maio would be the last to let you know about his.

If he has ever asked for a shoulder to cry on in four decades of dealing with the dead, he wouldn't tell you.

"You go home and you just forget about it. You can't live expecting everyone to be a sociopath. You get mad, maybe, that people do such things," he said. "You just shake your head, and you go on with life."

A way of life


Di Maio grew up in the kind of world where he believed in what he could explain: the "things that make sense."
The legend goes that since the 1600s every man on his mother's side of the family practiced medicine, with the exception of one, who was a priest, according to his wife, Theresa.

His father, Dominick Di Maio, was at one time chief medical examiner in New York City. His mother was an attorney.

Vincent Di Maio and his three younger sisters grew up mingling with police officers who were constantly filing in and out of their Brooklyn apartment or pulling up to the building in squad cars to pick up their father. Occasionally, their mother wondered, "what the neighbors were thinking," said Ann Di Maio-Ricci, the medical examiner's youngest sister.

Dinner-table conservations when they were young consisted of "gore after gore," Di Maio-Ricci said. On one occasion, when the family lunched in a grassy area behind the Staten Island morgue Vincent Di Maio found a box containing a human skeleton next to the picnic basket in their car's back seat.

"To me, it was just a normal way of life," his sister said. "It was a sad side of reality, but it was reality."

Young Vincent Di Maio always had his nose in a book. He developed a lifelong love of firearms after once thumbing through a book on guns at his Catholic high school library.

After college, he attended medical school at the State University of New York and eventually pursued pathology.

Like all his passions, from gun collecting to the music of Cole Porter, Di Maio pursued it for one reason: It's interesting.

The years never diminished his enthusiasm.

Di Maio would often stroll through the morgue to see the day's cases, one of his fellow Bexar County medical examiners said. Whenever another doctor stumbled across an interesting gunshot wound, they would call Di Maio over to see it.

"If you talk with him, he still gets excited over things," said autopsy technician Roy Fields. "It's in his blood."

No flinching


As he recently prepared for a presentation on child homicides, Di Maio scrolled through the photos of dead children, beaten by broomsticks or burned in scalding water.
The doctor didn't flinch. That's the way it is, he said.

"It gets to you, alright," Di Maio said as he briefly glanced away from his computer screen filled with grisly pictures of babies. "By the time you get to 200 photos, you won't even look at it because you'll be so bored."

Every day as medical examiner he saw what humans were capable of doing to each other. So he sought resolution in the answers his cases revealed.

"You never see Dr. Di Maio lose it," said Martin Castro, another technician. "He just works through it."

During one autopsy, Di Maio watched as his assistants drilled through a body, pulling back the top of the head like a lid, cutting open the chest and the abdomen.

He didn't wince at the sounds of a scalpel against the skull cavity or a drill carving into the body. Instead, he took over and in one careful movement sliced through the brain.

"Look," he said and beamed as he held up a cross-section of the gray matter. "The cerebellum. The tree of life."

Humor becomes a necessary part of a medical examiner's day-to-day life, said Hamo Meguerditchian, a Dallas County autopsy technician who worked with Di Maio from 1976 until he left to become chief in San Antonio in 1981.

"When you're working on dead, mangled bodies, that's our way out," said Meguerditchian, who assisted Di Maio with the Oswald exhumation. "Otherwise, it starts working on your mind."

The doctor found satisfaction in logical explanations: When he wanted to teach his young daughter about the dangers of tobacco, he showed her the blackened lung from the body of a lifelong smoker.

He approaches life with the same mentality.

When discussing his brief marriage to his second wife, who fired a gun on him but missed, Di Maio described it as annoying rather than frightening. The couple divorced. He remarried his first wife, Theresa, and they have been together for the past 21 years.

All of it rolls off Di Maio. He'd rather quote Winston Churchill ? "'There is nothing more exhilarating than to be shot at without result'" ? or joke than talk about it.

"If you had an issue, you dealt with it and that was it," said his son Dominick Di Maio, a surgical pathologist in Nebraska. "You didn't go on and on."

A rough start


All of Vincent Di Maio's training led to March 1, 1981 ? his first day as chief medical examiner of Bexar County.
"What am I getting into?" Di Maio recalled thinking.

The same day he began, soon-to-be District Attorney Sam Millsap Jr. issued a statement that "a time bomb (was) ticking in the medical examiner's office" because of the mishandling of narcotics.

Di Maio's predecessor, Ruben Santos, had been fired because he wouldn't stop accepting fees for performing private autopsies in other counties. The medical examiner's office was in disarray, behind on a year's worth of death certificates and dogged by insufficient funding. At least 15,000 drug exhibits needed to be destroyed.

"San Antonio was the armpit of forensic pathology," said Ernst, the St. Louis death investigator.

Di Maio aggressively pursued better standards and financial compensation for his staff in a field that traditionally pays less than other medical careers.

Over the years, he convinced county commissioners to separate the Bexar County crime lab from the medical examiner's office and move both organizations to the South Texas Medical Center. Realizing DNA was the next major scientific breakthrough, in 1988 he petitioned the commissioners to allow him to open a DNA fingerprinting lab at the medical examiner's office.

The commissioners gave money for the equipment, but not extra space, so Di Maio's then-administrative assistant, Patricia Hitch, converted the women's restroom into the lab.

Today, the office is one of only 30 to 40 accredited by the National Association of Medical Examiners. Where autopsy reports once languished unfinished in storage, today the backlog is minimal. Now all the medical examiners sign every autopsy report that comes through the office ? what Di Maio called "quality control."

His attention to detail and tireless pursuit of standards paid off for families of victims and in criminal trials, said Tom Vickers, a county judge from 1984 to 1991.

"I have a feeling there are less criminals getting away with things today than there were some time ago in the old days because of the work Dr. Di Maio and his staff have done over the years," Vickers said.

Never backing down


No criminal was more notorious than "killer nurse" Genene Jones.
Early in his tenure as chief, Di Maio began to hear rumors about dozens of infant deaths at Medical Center Hospital, now University Hospital, never reported to the medical examiner's office. Information implicated Jones, a former hospital nurse known to sing to the bodies.

In January 1983, Di Maio took the information directly to Millsap, who was just two weeks on the job as the district attorney.

"We literally had no idea where to start," Millsap said. "I'm sure he (Di Maio) had an answer, because Vince is somebody that always has an answer, even when he's wrong."

The lead opened a massive investigation. A Kerr County judge eventually sentenced Jones to 159 years in prison after she was convicted for murdering a baby in Kerrville with a muscle relaxant and later for injuring a child in Bexar County with a blood thinner. She was also a nurse at the hospital in Bexar County when more than 20 other baby deaths occurred.

The same year the Jones case broke, Di Maio also resigned from the University of Texas Health Science Center faculty partly because he contended some members of the hospital staff failed to report "suspicious deaths" to the medical examiner's office.

"If he thought a doctor was wrong, he would stand up and say it," said attorney Stephen Lazor, who used Di Maio as an expert witness in a medical malpractice suit. At various times Di Maio came under fire for testifying against doctors in other malpractice cases.

"I think he rubs people the wrong way because he does say what he thinks," said Suzanna Dana, a former Bexar County medical examiner. "He doesn't hold a lot back."

His family still bitterly recalls the media attention Di Maio received in 1988 regarding his contract with the Bone Bank Foundation to harvest bone tissue. Several families filed lawsuits that claimed Di Maio harvested their children's bone tissue without their permission.

Di Maio immediately called a news conference and laid out all of the documentation that showed the Commissioners Court had authorized him to harvest the tissue during his free time. Eventually, the contract was dissolved and Di Maio stopped harvesting.

When Lazor brought in an outside medical examiner to challenge Di Maio's ruling in the 1997 New Year's Day death of Mexican national Eli Montesinos Delgado, the doctor "took it as a personal affront," according to the attorney.

"When he's challenged, he won't concede anything," Lazor said, describing him, "like a bulldog with a bone."

After a long career spent bringing bad news and telling people things "they don't want to hear," Di Maio learned to confront anyone ? from county commissioners to the families who begged him to change a suicide ruling to an accident ? in order to do what he felt was right, an adage his father imparted to him growing up.

"If it was the right thing to do, you did it, no questions asked," said his sister, Di Maio-Ricci.

Behind Di Maio's gruffness, there also lived a willingness to help by using his extensive knowledge.

When Hitch, the administrative assistant, told him her father was diagnosed with inoperable cancer, Di Maio immediately went to his shelf and pulled out medical textbooks and journals so he could help her understand the disease.

"He's a big softy," said his daughter Samantha Di Maio, now a prosecutor with the district attorney's office. To her, he was a great scientist, a leader in his field. But he was also devoted to his wife and children, a man who loves guns but can't bear to kill an animal and was upset when his cat "Sweetkins" passed away.

"I want people to understand that he's just like their father," she said.

Quiet departure


By early afternoon Friday, he had already changed his voicemail message ? "This is the office of former medical examiner Vincent Di Maio." The next day, the number was inactive.
His last weeks had been quiet, spent mainly packing the remnants of his gun collection in the office and the candle on his desk of the Grim Reaper.

Now that he's retired, he plans to continue consulting privately on cases around the country and the world.

He'll still write books, go to gun shows, read and enjoy the songs of Cole Porter.

He'll still yell at the TV when the next episode of "CSI" airs because they just never get it right.

He left having filed away the thousands of cases he's investigated, some unsolved: a prostitute found partially skinned, her slaying most likely the work of a serial killer; the women with long brown hair who were killed in Dallas when he was a medical examiner there.

Some cases do have a happy ending. He remembered James Weddell, an American Indian from South Dakota sentenced to 80 years for manslaughter. The conviction was later overturned partly based on Di Maio's review of the evidence and testimony, which he gave after the inmate wrote him a letter.

"I prayed and prayed and prayed (for help)," Weddell said. "And folks like this great man came along."

Di Maio recalled receiving a gift of thanks from Weddell, a handmade blanket he sent from South Dakota.

He may not be expecting much else, from Weddell or anyone else.

"A couple of years from now, no one will remember me," Di Maio said.

Weddell would disagree. He wishes there was some way he could one day help Di Maio.

Weddell would give him a kidney, an eye.

He'd even give him his heart.

[This message was edited by JB on 12-31-06 at .]