The Death of Marilyn
External examination: The unembalmed body is that of a 36-year-old well-developed, well-nourished Caucasian female weighing 117 pounds and measuring 65-1/2 inches in length. The scalp is covered with bleached blond hair. The eyes are blue. The fixed lividitv is noted in the face, neck, chest, upper portions of arms and the right side of the abdomen. The faint lividity which disappears upon pressure is noted in the back and posterior aspect of the arms and legs. A slight ecchymotic area is noted in the left hip and left side of lower back. The breast shows no significant lesion. There is a horizontal 3-inch long surgical scar in the right upper quadrant of the abdomen. A suprapubic surgical scar measuring 5 inches in length is noted. The conjunctivae are markedly congested; however, no ecehymosis or petechiae are noted. The nose shows no evidence of fracture. The external auditory canals are not remarkable:. No evidence of trauma is noted in the scalp, forehead, cheeks, lips or chin. The neck shows no evidence of trauma. Examination of the hands and nails shows no defects. The lower extremities show no evidence of trauma.
Body cavity: The usual Y-shaped incision is made to open the thoracic and abdominal cavities. The pleural and abdominal cavities contain no excess of fluid or blood. The mediastinum shows no shifting or widening. The diaphragm is within normal limits. The lower edge of the liver is within the costal margin. The organs are in normal position and relationship.
Cardiovascular system: The heart weighs 300 grams. The pericardial cavity contains no excess of fluid. The epicardium and pericardium are smooth and glistening. The left ventricular wall measures 1.1 cm. and the right 0.2 cm. The papillary muscles are not hypertrophic. The chordae tendineac are not thickened or shortened. The valves have the usual number of leaflets which are thin and pliable. The tricuspid valve measures 10 cm., the pulmonary valve 6.5 cm., mitral valve 9.5 cm. and aortic valve 7 cm in circumference. There is no septal defect. The foramen ovale is closed. The coronary arteries arise from their usual location and are distributed in normal fashion. Multiple sections of the anterior descending branch of the left coronary artery with a 5 mm. interial demonstrate a patent lumen throughout. The circumflex branch and the right coronary artery also demonstrate a patent lumen. The pulmonary artery contains no thrombus. The aorta has a bright yellow smooth intima.
Respiratory system: The right lung weighs 465 grams and the left 420 grams. Both lungs are moderately congested with some edema. The surface is dark and red with mottling. The posterior portion of the lungs show severe congestion. The tracheobronchial tree contains no aspirated material or blood. Multiple sections of the lungs show congestion and edematous fluid exuding from the cut surface. No consolidation or suppuration is noted. The mucosa of the larynx is grayish white.
Liver and biliary system: The liver weighs 1890 grams. The surface is dark brown and smooth. There are marked adhesions through the omentum and abdominal wall in the lower portion of the liver as the gallbladder has been removed. The common duct is widely patent. No calculus or obstructive material is found. Multiple sections of the liver show slight accentuation of the lobular pattern; however, no hemorrhage or tumor is found.
Hemic and lymphatic system: The spleen weighs 190 grams. The surface is dark red and smooth. Section shows dark red homogeneous firm cut surface. The Malpighian bodies are not clearly identified. There is no evidence of lymphadenopathy. The bone marrow is dark red in color. Endocrine system: The adrenal glands have the usual architectural cortex and medulla. The thyroid glands are of normal size, color and consistency. Urinary system: The kidneys together weigh 350 grams. Their capsules can be stripped without difficulty. Dissection shows a moderately congested parenchyma. The cortical surface is smooth. The pelves and ureters are not dilated or stenosed. The urinary bladder contains approximately 150 cc. of clear straw-colored fluid. The mucosa is not altered.
Genital system: The external genitalia shows no gross abnormality. Distribution of the pubic hair is of female pattern. The uterus is of the usual size. Multiple sections of the uterus show the usual thickness of the uterine wall without tumor nodules. The endometrium is grayish yellow, measuring up to 0.2 cm in thickness. No polyp or tumor is found. The cervix is clear, showing no nabothian cysts. The tubes are intact. The right ovary demonstrates recent corpus luteum haemorrhagicum. The left ovary shows corpora lutea and albicantia. A vaginal smear is taken. Digestive system: The esophagus has a longitudinal folding mucosa. The stomach is almost completely empty. The contents is brownish mucoid fluid. The volume is estimated to be no more than 20 cc. No residue of the pills is noted. A smear made from the gastric contents and examined under the polarized microscope shows no refractile crystals. The mucosa shows marked congestion and submucosal petechial hemorrhage diffusely. The duodenum shows no ulcer. The contents of the duodenum is also examined under polarized microscope and shows no refractile crystals. The remainder of the small intestine shows no gross abnormality. The appendix is absent. The colon shows marked congestion and purplish discoloration. The pancreas has a tan lobular architecture. Multiple sections shows a patent duct.
Skeletomuscular system: The clavicle, ribs, vertebrae and pelvic bones show fracture lines. All bones of the extremities are examined by palpation showing no evidence of fracture.
Head and central nervous system: The brain weighs 1440 grams. Upon reflection of the scalp there is no evidence of contusion or hemorrhage. The temporal muscles are intact. Upon removal of the dura mater the cerebrospinal fluid is clear. The superficial vessels are slightly congested. The convolutions of the brain are not flattened. the contour of the brain is not distorted. No blood is found in the epidural, subdural or subarachnoid spaces. Multiple sections of the brain show the usual symmetrical ventricles and basal ganglia. Examination of and brain stem shows no gross abnormality. Following removal of the dura mater from the base of the skull and calvarium no skull fracture is demonstrated.
Liver temperature taken at 10:30 A.M. registered 89 F
Specimen: Unembalmed blood is taken for alcohol and barbiturate examination. Liver, kidney, stomach and contents, urine and intestine are saved for further toxicological study. A vaginal smear is made.
T NOGUCHI, M.D. DEPUTY MEDICAL EXAMINER 8-13-62