‘I told the dispatcher there was a man on the Appalachian Trail with no tent, no sleeping bag, no serious camping gear of any kind. He’d been in the same place for 20 hours.’By Ken Mitchell But he himself went a day’s journey into the wilderness, and came and sat down under a juniper tree: and he requested for himself that he might die; and said, It is enough; now, O Lord, take away my life; for I am not better than my fathers. 1 Kings 19:4 When collecting bodily fluids and tissues for postmortem chemical analysis, the forensic pathologist may choose to draw vitreous fluid from one or both of a decedent’s eyes. For the purposes of detecting premortem drug and alcohol use, vitreous fluid is considered an ideal specimen because of its distinct properties and its isolation from stomach contents and blood. I learned this while working the Annalee case. Annalee was born in 1968. She lived nearly all her life in the same small town in southwest Kansas. She married in 1996. She had three sons, two daughters and a stepson. The names of her children suggest a whimsical streak, a playful disregard of convention. Annalee was involved in rodeo, 4-H and riding clubs. Her interest in horses was something she shared with her father. She worked as a pen rider at a large cattle feedlot located several miles outside of her town. The cattle feed lot is far removed from the open range of the late 1800s, that once-wild expanse of plains, mountains and badlands spreading from the Rio Grande to 49th parallel. Nor is it anything like the big ranches of today, with fenced pastures staked out on overgrazed short-grass prairie. A feedlot of any size is filthy and ugly. It is a grim, open-air meat factory, an industrial complex of stress, sickness and shit. The quantity of waste produced at a feedlot is staggering. The wastewater infrastructure at a large facility is of a scale appropriate to a small municipality. The shit piles up fast, requiring the constant deployment of bucket loaders and dump trucks to haul it out of the pens. If you are a woman who likes to ride, if you have limited prospects in your little town on the high plains, working as a pen rider could be a pretty good gig. It is not an easy job. You work in extreme weather, with the sun, rain, snow and wind beating on you. You wear the dust and the muck in your skin. The work requires fortitude, energy and good horsemanship. You go out with a team of other riders to look for injured and sick cattle; to separate individual animals from the group so they can be doctored; and to move large groups from one pen to another. For much of your day, you are teamed with a partner trained for the work, a good-natured animal you know and trust. Not a pet or ordinary companion, but a true working animal. Your animal partner is not on the payroll, but with her innate intelligence and natural fidelity, she earns at least half the credit for what you accomplish together. To be part of an interspecies partnership in an occupational setting is a unique thing in our times, a beautiful thing really. A close bond with a mute creature can pull you out of dark places. Eye contact, touch and simple gestures can be ways of expressing emotions that are beyond our readiness to describe with language. In 2001, Annalee got hurt on the job. She did not receive the best medical care from the doctor who performed her initial surgery. Fifteen months after the accident, she took her own life. I never met Annalee, but I came to know her through an assignment. For 12 years, while living in northern Colorado, I was a private investigator. I specialized in insurance defense work. In 2003, I was hired by the worker’s compensation carrier to investigate Annalee’s life and the circumstances of her death. The issue in question was this: was Annalee’s work-related injury a natural and proximate cause of her suicide? Her family argued that Annalee’s death was a compensable event under the state worker’s compensation statutes, and they sought a death-benefit award from the insurance company. The insurance carrier hired an attorney to prepare a defense, and they hired me to conduct an investigation. Annalee’s injury, pain, depression and disability were not in dispute. My job was to investigate her life: to look for circumstances, experiences and difficulties that may have caused or aggravated her depression. There was another important matter to be investigated. In Kansas, a work-related injury is excluded from coverage if there is proof that the injured worker was under the influence of alcohol or illicit drugs at the time of the accident. (To be clear, Annalee was not under the influence at the time of her accident at the feedlot.) But if she was drunk at the time of her suicide, the feedlot’s attorney was prepared to argue that, by law, her death was an event not covered by worker’s compensation insurance. Here is how you work the case: You review the materials the insurance company provides, which include the workplace accident report, file notes from the claims department, and medical records. You make preliminary phone calls and set up meetings. You drive six hours across the Great Plains, curse the big rigs and the glare, fling the speeding ticket onto the floor mat with the empty coffee cups, and book a room at the only motel in town. You make the rounds and search all the available public records, starting with the sheriff’s office, the police department and the courts. You check municipal, county, state and federal courts, and all of their various divisions: civil, family, criminal, bankruptcy. You also conduct dozens of interviews. You start with the general manager of the feedlot, supervisors and co-workers. You ask everyone you interview to give you names of other people to contact. The circle widens to include current and former neighbors, old friends and ex-friends, bartenders, drinking buddies, members of rodeo and riding clubs, the pastor and his wife, the patrol cops and detectives, the chief of police, the ladies at the beauty shop, the folks at the trailer park. The only people who would not talk to me were members of Annalee’s family, a few others who were close to them, and medical personnel restricted by privacy rules. You try to establish rapport with the people you interview. You want them to be comfortable talking to you, to feel they can speak freely. You have to be mindful of your demeanor and your tone, and you have to choose your words carefully. You’re asking about events that are painful to recall. You are asking someone to talk honestly about a friend/neighbor/parishioner/co-worker who lived out her final months dealing with pain, anxiety and depression. The court records and the official reports from the police, coroner and medical examiner are dry and factual. These are documents devoid of nuance or style. Yet there is truth in every detail. The full story of a young mother’s life comes out in the records and in the telling. Annalee had troubles. She had a history of substance abuse, and seven months before her accident, she had been diagnosed as having “intermittent explosive disorder.” There were domestic disputes, and somebody would call the cops. Her marriage was unraveling, and in the last months of her life she lived apart from her husband and children. Her husband wanted a divorce; Annalee did not. She missed her children. She struggled to pay her bills, and had financial judgments against her. She had troubles with the law. She once had been required to stay clean while on probation, and she could not wait until her sentence was over so she could party again. Annalee’s accident occurred on a wet, overcast day in September 2001. As she was riding across a concrete drainage trough, her horse slipped and fell on her. Her left leg was injured and she was transported to a regional hospital. Dr. K. performed surgery on her knee. In addition to the worker’s compensation case, the family also brought a wrongful death case against Dr. K., alleging medical malpractice. The judge in that case ably summarized the facts:Following the surgery, Annalee began having difficulty with depression, inability to sleep, anxiety and pain. Dr. K. prescribed Paxil, Xanax, Ambien, and Darvocet. On November 7, 2001, Annalee had not regained flexion and extension in her toes, but defendant [Dr. K.] noted that she had regained “almost normal” sensation, instructing Annalee to continue her physical therapy with additional weight bearing. A month later Dr. K. increased plaintiff’s dosage of Paxil. At some point in December, plaintiff was seen by a psychiatrist, Dr. M., who made a primary diagnosis of severe depression. On December 14, 2001, Dr. K. took X-rays of Annalee’s left ankle, revealing a fracture. On January 8, 2002, Dr. K. performed surgery to repair the fracture. On March 25, Dr. J. examined Annalee and noted that she had an insensate foot and informed her of the possibility of amputation. On April 16, Dr. J. performed surgery on Annalee’s left knee to remove hardware that remained after Dr. K.’s surgery. On October 10, Dr. Y. performed surgery to release compression of various nerves. Dr. M. has opined that plaintiff committed suicide as a result of her intoxication, divorce and depression. He asserts that the depression was a result of the significant pain in her leg. Dr. M. thinks that Dr. K.’s treatment was a factor in her alcohol consumption. In the absence of one of the three factors, Dr. M. does not believe that Annalee would have committed suicide. “Failure to examine and identify the full extent of this woman’s injuries was a significant factor in her suicide,” said Dr. M. “There are certain things that we’re all expected to do. An analogy would be if I see somebody who’s had a head injury, I always have to be concerned about the cervical spine. If you see somebody that’s got a knee injury, you always have to be concerned about problems distal to that. His lack of picking that up was a very significant factor in this woman’s extreme, extreme hopelessness that I saw when I did the consult with her in the intensive care unit and she felt that she was gonna lose her leg,” said Dr. M. “I mean, that’s not a very high level of medical expertise to know that you check the whole limb.”On November 5, Annalee overdosed on Ambien, and in a hospital interview stated that she had a lot of stress, severe pain, difficulty with ambulation and was involved in stressful relationships. On December 8, Officer D. responded to a disturbance at the residence of Annalee’s husband. Officer D. testified that Annalee was drunk, angry, sad and “not happy at all.” Annalee returned to her residence, called a neighbor and asked for a gun or knife. Annalee committed suicide in her trailer later that evening. Years ago, I learned a choice bit of aviation slang while having lunch with my friend Steve in a crowded Runza restaurant. A stranger approached with a tray and asked if he could take the empty seat at our table, so we made room for him. We learned the stranger owned a motel in Yuma, the prairie chicken capital of Colorado. He had recently retired from a career flying small airplanes. He had logged many hours doing aerial inspections of gas and oil pipelines, which my friend (also a pilot) understood to be hazardous work. The job required going up when conditions were not ideal. When the ceiling was low, you had to fly UFS. I asked, “What’s UFS?” Steve said, “Means you fly under the fucking stuff.” Not just below the clouds, but often below the FAA minimum safe altitude of 500 feet. Annalee’s horse fell on her and she was never the same. She spent the next 15 months flying UFS: the ceiling above her was low, black and turbulent. She tried to fly out from under it. She had no choice but to try. Just keep flying. Don’t run into the ground, and don’t get too high and lose your way. You cannot keep this up for very long before you need a break, a change, a glimpse of a landing strip somewhere. If you don’t keep it together – if you cannot find some peace and solace – sooner or later you’re going to crash. While the Annalee investigation wasn’t my first death case, when I read the reports of the coroner and the medical examiner it felt like getting thumped in the solar plexus. I had to go outside and walk around in the cold. I looked out at a mass of tumbleweeds tangled in a barbed wire fence, and I barked at the wind. Where was God? The analysis of the vitreous fluid confirmed that Annalee spent her last night on Earth drinking heavily. She went to her husband’s place. Things got heated, and he called the police. She was not arrested, but got a ride to her trailer and went inside alone. She called her next door neighbor, spoke to a teenager and asked him for a gun or knife. In the early morning hours, before daylight, she found a piece of stiff wire and rigged it to a light fixture in the kitchen ceiling. She put her neck through the loop and strangled herself. Where was God’s love and mercy? She died with a coat hanger around her neck, drunk and alone. Nobody should have to end their life that way. On a few occasions over the past several years, I spoke to my wife about the Annalee investigation. And I thought about it many more times, but without dwelling on it for very long. That is, until one night in January of this year. I went to Vermont and spent a couple days at my mother’s place in Proctorsville. When we visit in the summer, you walk in the door and you can smell the blueberry buckle. Usually, I park my motorbike and go in to find the old folks doing crossword puzzles or watching tennis on the TV. But when you go up there alone in January, there’s no backgammon, no dogs begging for an ice cube when Howie goes to pour himself a vodka, no barefoot cocktail hour on the patio. The place is dark, quiet and cold. I had dinner by myself. I left the television and the stereo off. I am not sure why, but I found myself thinking about Annalee. I spent a few hours reviewing my memories of the assignment, and tried to recall every detail. I went back home to New York and felt a little out of sorts for a couple days. On Saturday, I went for a hike in the woods. We live in a rural area, on top of a mountain – at least it qualifies as a mountain in our part of the state. At the end of our road is a 500-acre piece of land owned by the town. They call it a park, but it is essentially a forest preserve with a lake and creeks, and a network of old logging roads and foot trails. The preserve adjoins the Appalachian Trail corridor to the east, and a state forest to the south. It is not wilderness exactly, but altogether these parcels constitute a big patch of woods. Over the years I have seen black bears, coyotes, timber rattlesnakes, wild turkeys, beavers and abundant deer. In the colder months, when the snakes are in their dens, I like to go off the trails. I’ve been to places that have never been touched by chainsaws or vehicles. I’ve crawled through acres of wild rhododendrons, climbed ledges and scrambled down piles of loose shale to discover remote swales where old oaks and weather-scarred hemlocks enforce the silence. Sometimes, these spots will draw me into a reflective or meditative state. But other times, I have felt like an intruder in such places, as though I have trespassed onto grounds reserved for spirits. On that Saturday in mid-January, I did one of my regular loops. It was about 30 degrees with snow flurries. The route includes a section of the A.T. that climbs out of a little gulch to the top of an impressive rock which forms the northern end of a long ridge that runs south into New Jersey. At a certain angle from the floor of the gulch, to my eye, the formation resembles El Capitán. The scale is not nearly so grand as what you find in Yosemite, so I call this rock Le Caporal. I stopped to drink some water and watch the snow fly, then continued along the top of the ridge. I came upon a duffel bag and a blue tarp beside the trail, at the edge of a 12-foot cliff and beneath a pine tree growing on top of the flat ledge. I paused and looked around for a hiker, saw none. Then I realized the hiker was under the tarp, which was coated with an accumulation of light snow. I heard snoring and I bent down to try to peek under the tarp. I called out a few times, my voice growing louder. The snoring continued, so I poked the sleeper a few times with my walking stick. He suddenly pushed the tarp back, sat up and turned his face to glare at me. He wore eyeglasses, a knit hat and a red parka with the hood pulled over his head. He did not get out from under the tarp, just stared at me from behind his foggy lenses. He seemed alarmed and a little offended that I had disturbed him. We had a short conversation. I asked if he was all right. He said that he was. I asked if he needed any help. He said, “No. I’m good.” I couldn’t tell if he had a sleeping bag or a pack under the tarp. But he was alert and coherent, so I left him and finished my hike. Something about the encounter nagged at me. I got home and mentioned it to my wife. We called our friend and neighbor, Deborah, to see what she thought. Deborah has hiked the entire A.T. and she knows better than I do how people live on the trail. She thought it was unusual for an ultra-light backpacker to be this far north in the wintertime, but she didn’t think it was particularly strange. I poured a beer and started thinking about making dinner. I went out again on Sunday afternoon. I found the duffel bag and the tarp in the same location. The man heard me coming and he folded back the tarp as I came along the ledge. We had the same conversation as the day before. He said, “I’m good.” I got a better look under the tarp, and I could see that he did not have a sleeping bag or a backpack. I asked his name. He told me it was John. I said, “What’s going on, John?” He said, “I’m just taking a break. My knee is sore.” Taking a break for 24 hours, with no tent and no sleeping bag. I went up to Le Caporal, sat for a couple minutes and then went by John once more. He said he didn’t need any help, didn’t want a ride anywhere. I left him, walked to the next overlook and called the police. The police and fire departments in our town have equipment for search and rescue. Sometimes, you see them out on training exercises. I told the dispatcher there was a man on the Appalachian Trail with no tent, no sleeping bag, no serious camping gear of any kind. He’d been in the same place for 20 hours. I started to describe his location to her. She did not seem familiar with the trails, and told me that the police officers on duty were not going to go walking around the woods to go find somebody. I said he wasn’t hard to find, and started again to describe John’s location. She wasn’t interested in directions. I told the dispatcher that I didn’t know if the man had mental health issues, but he was ill-equipped to be outdoors and it was going to get down to 14 degrees overnight. She asked for my call-back number.I went home and charged up my phone. I expected a phone call from the police, the ambulance corps or the fire department, but it never came. I woke up around two a.m. The stars were out in a clear sky. I didn’t sleep well. I texted Deborah in the morning, and asked if she wanted to walk up the mountain. She brought her Basset hound along. As we neared the top of the blue trail, I could see John’s red parka in a new location. He was still on the ridge, about 20 yards from his pine tree. As we got closer, we could see that he was lying on his side in the sunlight with the tarp beneath him. Deborah and I paused a few yards away and watched for what seemed a very long moment, waiting to see if he was breathing. The breaths came slowly, and then he twitched. A moment later he raised his head and looked at us. On the rock near him was a plastic bottle, empty except for a few chips of ice. He sat up and Deborah began to talk to him. He seemed to be on the verge of severe hypothermia. His thinking and responses were sluggish, his speech was slurred. When he tried to stand, he exhibited poor coordination. Deborah asked John if he would accept our help, and he said he would. I gave him a bottle of water, and he drank it while swaying back and forth. I held onto his arm, while Deborah folded up his tarp. He stared at me while he sipped the water. “You come up here every day?” “You remember me from yesterday?” John nodded. “And Saturday.” He had only a few things in his duffel: toilet paper, a few packets of powdered drink mix and instant oatmeal, a baseball hat. No camp stove, no clothes. His cell phone was dead. Deborah asked him about his situation. John was in his late 50s. He was from a town in Passaic County, New Jersey. He had lost his job and been evicted from his apartment. He no longer owned a car. He was divorced. His daughter was a college student; he’d last talked to her on Christmas. On Saturday, he’d taken a New Jersey Transit bus to the top of Mount Peter. He got off near the ski area and walked five miles south on the A.T. “Why?,” one of us asked.“Just to go.” He came to the ledge with the pine tree and set his duffel bag down. He spread out his tarp, crawled under it and went to sleep. Edwin Shneidman, a clinical psychologist and founder of the American Association of Suicidology, identified several psychological commonalities of suicide. They include the following: The common stressor in suicide is frustrated psychological needs. The common goal of suicide is cessation of consciousness. The common action of suicide is escape: “the ultimate egression.” The common cognitive state of suicide is ambivalence: suicidal people “wish to die, and simultaneously wish to be rescued.” Annalee’s phone call to the neighbor to ask for a weapon was an indication of her ambivalence. She could not have expected the teenager to come over and hand-deliver a pistol or knife. She likely wished that the neighbor would respond to her call by taking action to stop her from ending her life. John’s ambivalence was evident in his choice of a place to escape. He had picked a location directly on the hiking path where other people would certainly see him. I believe he went there to reach a cessation of consciousness by letting his body succumb to thirst and cold. At the same time, he wanted someone to help him. It took us an hour to walk a mile down the blue trail to Cascade Lake. John was slow and unsteady, and I held his arm as we walked. He had to rest a number of times, and on each break he would tilt his head back, take a gulp of air and sigh. I tried to keep the conversation light. I told John he’d missed a great football game last night. Green Bay and Dallas were tied at 31 late in the fourth quarter. Green Bay had the ball, third down and 20, with 12 seconds left. They completed a 35-yard pass, and then the kicker made a 51-yard field goal as the clock ran out. John said, “The Packers are on a roll.” Deborah hung back on the trail and sent text messages to my wife to arrange for an ambulance to meet us at the parking lot by the lake. When we crossed Longhouse Creek, John looked up at the water spilling over the dam and said it looked delicious. The volunteer EMT is a man I know, a friendly, genuine and humble person. He is a retired lieutenant colonel, and he defines through his actions the term “squared away.” I was glad to see him coming along the trail to meet us. He asked me for a quick briefing, then he took John by the arm and helped him into the warm ambulance for transport to the regional medical center. That night I spoke with my friend, Steve. Steve, who knows how to fly UFS, also has been haunted by investigations. I don’t get to be with him as much as I would like (he lives in Nebraska), but he came to New York when I turned 50. During that visit we sat on the patio and I watched him weep while he discussed a recent death case he’d worked involving an infant child. Steve is a man of faith, a dutiful Roman Catholic. I told him about my experience on the A.T., and then mentioned my remembrance of Annalee in the preceding days. He said, “God was getting you ready to say Yes.” I’m not wired for that type of faith, but I find myself asking questions. I have many doubts, no answers. I even struggle to properly phrase the essential questions. Shall I ask, What is God? or Who is God? Is God a person? Does he exist independent of his creation? Does God send us out to travel the dark woods? Does he tap us on the shoulder with his walking stick and choose us for his work? Do we have any say in the matter? Do we have the power to tell God, Sorry, I got to get off the mountain and go home to feed the dogs? I just don’t know. And besides God, there is this: I am beginning to understand that, 14 years after her death, I am grieving for a woman I have never even met. Faites attention, mes amis. Even while the sun is shining, the dew clings to the rocks. Whether you are climbing El Capitán or Le Caporal, preparation and mindfulness will not make you into a mountain goat. When you think you have mastered the fundamental mechanics of friction, this life will take a swipe at your boots and knock you flat on your ass.