James Brady, press secretary to President Ronald Reagan, died last month at 73.
A Virginia medical examiner certified his death a homicide – a consequence of the gunshot wound to the head he sustained when John Hinckley tried to assassinate Reagan in 1981.
The public reacted with shock to the medical examiner’s certification, which was widely covered by online news sources and called a “surprise determination” by The Wire.
One reader’s comment: “It boggles the mind.”
Others called the opinion “ridiculous,” “ludicrous” and “bizarre.”
The “manufactured” determination, which “will be used for some form of anti-gun campaign,” was made by a medical examiner with an “obvious agenda” who “would lose his job if he made this ‘surprise determination’ for anyone else.”
I know the concept of delayed homicide is unfamiliar, but I’m dismayed by the virulence of readers’ comments and by the utter failure of the press to explain why the determination was made and what it means.
A homicide ruling by a medical examiner is an administrative classification that isn’t binding on courts or other agencies and doesn’t necessitate “a colossal waste of resources” to try Mr. Hinckley again.
Readers also misunderstood “proximate cause” of death. One dictionary definition of proximate is “near to.” A cause that occurred 33 years before death is hardly “near to.”
But in the legal parlance used by medical examiners, the “proximate cause” is the disease or injury which initiates an unbroken chain of events, brief or prolonged, that leads to death. This definitional discrepancy may explain why some readers insisted that “Brady survived the gunshot wound” and “died of old age.”
The fact that Brady lived for years after being shot doesn’t mean he didn’t die because of it. Brady was partially paralyzed, mostly confined to a wheelchair and had repeated life-threatening blood clots as a result.
Brady had seizures caused by his brain injury. Seizures can kill when they affect vital parts of the brain.
He had bouts of pneumonia and mysterious fevers that may have been signs of other occult infections common among people who are paralyzed.
I don’t know what the medical examiner determined Brady’s immediate cause of death to be – seizure, blood clot, infection or some other complication – but clearly the autopsy established to his satisfaction that no unrelated cause interrupted a chain of physiological events initiated by the gunshot wound.
Why wasn’t Reagan’s death a homicide?
Because Reagan died of Alzheimer’s disease. No physiological chain links a gunshot wound to the chest with Alzheimer’s disease. Another difference: Reagan recovered from his injury while Brady did not. To medical examiners, recovery from an injury means that the person returned to his pre-injury state of health.
“I need help getting out of bed, help taking a shower and help getting dressed,” Brady said years after his injury, “and – damn it – I need help going to the bathroom.
“What I was, I am not now. What I was, I will never be again.”
I agree with the medical examiner’s certification.
email@example.com. Dr. Carol J. Huser, a forensic pathologist, served as La Plata County coroner from 2003-12. She now lives in Florida and Maryland.