Anatomy of a Bullet Wound : People are shot in Southern California every day. But, experts say, few of us comprehend a bullet's impact. Here, the last 58 seconds in the life of a gunshot victim.


Juan Antonio Mendez never felt what hit him. A bullet does that. The small lead plug moving close to the speed of sound shocks and deadens the tissue and organs it crushes. Fear and confusion heighten the torpor of a gunshot wound. And at this point in his armed robbery of an electronics store in Koreatown, Juan Mendez is in full panic.

The plan has come apart. A young Brinks guard, Ramiro Garcia, isn't showing scared. Mendez's partner was able to grab the canvas cash sack from Garcia's left hand. But the guard isn't flinching, and that could mean he is ready to shoot it out.

Mendez has no time to change moves, to control the next moments of his life, to run, to yelp, to back down or cancel his commitment to violence.

He does have one moment to cock the hammer of his own gun, a museum piece--a rusted, single-action, frontier-style .44 six-gun made by Remington in the 1890s.

But the guard is faster. Garcia's left hand sweeps the barrel of Mendez's handgun aside. His own revolver, a Brinks-issue Smith & Wesson with a four-inch barrel and a full load of six .38 Special rounds, clears its black leather holster.

Boom! Garcia's first shot hits Mendez high in the left chest. The range is so close that flakes of unburned gunpowder are forced through Mendez's brown sweater. They tattoo the edges of the chest wound.

Boom! Mendez fires, but it is more of a reflex. The shot goes wild and slaps sideways into a store wall.

Boom! A second bullet hits Mendez's chest, dead center. He stumbles, turning. Boom! A bullet in the right arm, from triceps through biceps and into the left knee. Mendez falls.

Flat on his back, eyes fading, Mendez's dirty sneakers twitch against a display case of home security systems. "Double Entry Security" promises the sign. "Because Your Security And Peace of Mind Are Important."

Mendez flops an arm across his bleeding chest.

It is three days before Christmas.

Juan Mendez has just 58 seconds to live.

Massad Ayoob is a former police officer and, as founder / director of Lethal Force Institute of Concord, N.H., a guru of combat competition shooters.

From South Africa to Long Beach, police departments seeking to improve their effectiveness--and ordinary civilians afraid that police will never be able to do enough--pay up to $500 per person for Ayoob's courses in self-defense by pistol and shotgun, knife, night stick and Kubotan baton.

He blames the media--from George Peppard's fully automatic "A - Team" on television to Mel Gibson in gun-toting newspaper advertisements for "Lethal Weapon II"--for fitting America with a "an insulating, subconscious callous that keeps us from recognizing the horror of it.

"The guy (on television) gets hit in the head with a club and he passes out. He never retches, never vomits, never sees double, never goes into grand mal seizures . . . all of which occurs with people who have been struck in the head with blunt instruments. If they don't die.

"With gunshot wounds, the guy swoons and falls to the ground. There is no blood. Probably the height of the bull was the old Mannix series. At one point, Mannix is shot in the shoulder with a .458 elephant rifle by the millionaire villain. In the next scene, Mannix has got his arm in a little black sling and is hugging his new girlfriend.

"In real life, nobody has been shot with a .458 elephant rifle. But we have one case where a subject with a 45/70 (hunting) rifle shot a police officer wearing a bulletproof vest.

"The rifle was so powerful that it carried the vest into the wound channel, halfway through the body. The bullet struck at the right nipple, and there were ruptured blood vessels in the brain just from the backed up shock waves through the cardiovascular system.

"Of course, death was instantaneous. This is a whole lot more in line with what happens when you get shot."

After Juan Mendez falls, there is a second of silence at ITC Electronics, 2772 W. Olympic Blvd. Minds respond in the pause, trying to understand and deciding what might be next. The stench of gunpowder is everywhere. Then shouts and movement.

Garcia is crawling and sliding toward the store's counter. His bravery has been expensive. While rapid-firing against Mendez, the armored car guard put one round through his own knee. Garcia desperately needs cover and time to reload.

Mendez's partner, however, isn't waiting for a rematch. He has the sack holding more than $20,000 in cash and checks. He sprints and shoves through shocked shoppers to an open door and the crowded street.

By this time, even the flutter of Mendez's breathing has stopped.

The first bullet, a flat-nosed lead slug weighing 10.2 grams, or less than 1/2 ounce, went into his chest angling down. It fractured the fifth rib on the way in, bored through both lobes of the left lung, and fractured the seventh rib on the way out.

Not always a fatal wound. Not if the round avoids larger blood vessels. Not if the bullet hole seals itself and air doesn't enter the chest cavity and the lung does not collapse.

The killer was the second shot.

It hit the bone and cartilage of the sternum. That flattened the round a little, increasing its diameter and widening the wound channel it punched through the left ventricle chamber of Mendez's heart. The bullet left the heart, went into the left lung and exited Mendez's back.

In its passage, the slug stretched and displaced for milliseconds the heart muscles, valves and chambers, forming what trauma surgeons know as the "temporary cavity." It created a temporary space the size of a baseball in Mendez's heart.

But the heart continued to pump.

Now it is squirting blood from the bullet holes in the heart wall, filling the pericardium and pouring into the chest cavity itself. At a rate of about five quarts a minute.

But there is no pressure to carry blood through the aorta and a network of arteries to Mendez's brain. Not even to the blood vessels near the gunshot wounds in his right arm and left knee. So there is no bleeding there.

No blood, no oxygen. No oxygen, no working body cells. Then veins collapse. Electricity and neuromuscular activities stop.

Barely a minute after the first shot, the only movement connected to Mendez is a puddle of blood creeping from two exit wounds in his back.

It shines like maroon glue on the store floor.

As life finally leaves Juan Mendez.

Jim Monaghan is full of holes. He can close his eyes, point to arms, legs and chest, and finger - count 11 wounds from bullets and shrapnel. A former Green Beret captain and veteran of five combat tours of Vietnam, Monaghan, 51, now a technical consultant and scriptwriter to movie studios, has survived four gunshot wounds.

The worst, he says, was in 1966.

A Viet Cong soldier shot him in the left shoulder with an AK-47 assault rifle.

"Then I killed him," Monaghan says. "But his shot hit my M-16, blew the upper hand guard apart and pieces of the weapon were flying everywhere. One piece killed the man standing next to me, ripped his whole face off, and the bullet ricocheted and went into my shoulder.

"It smashed the clavicle, the thing that holds the muscle leads from the tendon and the biceps muscle . . . and as a result, the muscles, the biceps muscle and then the left chest muscle, the one that guards the heart, began falling down.

"And it burns. That's the first thing that happens to you. It's just like a red hot poker or an ice pick burning into you. Then it knocks you down. It is like somebody swinging at you with a baseball bat. As hard as they can.

"But the burning. I remember thinking that if I had time to pour a canteen of water on it, everything would be OK. But it didn't quite work out that way. I went for about 10 more minutes and then I just passed out from loss of blood and pain.

"I was out (in the hospital or convalescing) for eight months. And it still hurts. It's a private pain, but it ain't easy. There are times when I'm in bed and dreaming, and I'll begin jumping and I can feel those bullets hitting. If I move my arm the wrong way, that sudden, searing pain feels like the round is still entering, still moving in.

"I've been down to the (Long Beach) Naval hospital several times and up to the Presidio (Letterman Army Hospital), and they keep telling me that there will have to be operations done on the thing again. I'm postponing it. I'll take Advil or aspirins or, once in a while if it really hurts, I'll take some codeine.

"But I can just feel that fire in there. All the time."

At 5:34 p.m., four minutes after death, official hands are attending Juan Mendez. A uniformed officer from LAPD's Rampart Division, who was patroling nearby and made it to the store while gunpowder smells are still hanging, touches his fingertips to Mendez's neck. No pulse.

The six-gun--a souvenir of a supposedly wilder West--is recovered and taken to the trunk of a police car. "Who did he think he was going against?" an officer mutters. "Clint Eastwood?"

Fire Department paramedics from Engine Co. 13 deliver their boxes and monitors. Some attend guard Garcia and his knee. Others stare down at Mendez.

Scissors cut away his brown sweater.

The red-black bullet holes are obvious.

Especially one in the center of Mendez's chest.

"Just the right place," says paramedic George Balleweg. "Great shooting."

Three electrodes from a Lifepak 5 monitor are attached to Mendez's trunk. It is probably a formality. A six-inch strip of tape hisses from the machine and the line is quite straight. There is no electrical activity in the body.

Balleweg crumples the tape and tosses it.

Police officers--lieutenants and sergeants and street cops from this volatile area of town--peer at Mendez before a sheet is pulled over his body and face.

"Anybody recognize this guy? . . . looks like a rock smoker, one of those dirt bags from down the street . . . nobody I know . . . probably an illegal . . . you want to look, Jim?"

Yellow plastic tape is unrolled to seal the aisles and area where Mendez fell. There are blood smears here. Unspent cartridges there. Physical evidence that must be protected.

Detectives Larry De Losh and Joe Getherall, partners from LAPD's robbery-homicide division, arrive from Parker Center downtown to build the foundation of another investigation. For these men, the end of Juan Mendez is only a beginning.

Mendez's face is uncovered for Frank Giles. He's a city photographer. Giles has lost count of the bodies he's photographed.

"I don't have many emotions about it," Giles says. "But sometimes I look at a guy like this one and I think that we probably got up about the same time today, in the same city, had breakfast and went our separate ways. Then we meet like this.

"The big difference is, I get to take the pictures of him and he doesn't get to see the New Year."

Coroner's investigator Tom Ratcliffe bends over Mendez.

He stabs him lightly with a scalpel. On the right side, just below the rib cage, Ratcliffe inserts a thermometer, pushing it down and then hard up and into the liver, where its temperature will set the official time of death.

Mendez is carrying no money, no identification. Just a comb, an empty leather billfold and a stainless steel digital watch. His name and Salvadoran citizenship will be established later through fingerprints.

Yet there's no guarantee that he really is Juan Antonio Mendez. That's just the name he gave when arrested in June on two counts of possessing and selling crack cocaine.

Ratcliffe grabs the cuffs of Mendez's pants. An assistant holds Mendez's wrists. The body is jackknifed and tugged onto a collapsed gurney, wrapped and strapped down, and wheeled through the store to an unmarked county van.

A policeman says something. Very quietly.

The words hold anger for an enemy. Yet their tone carries one fragment of empathy for the death of a human being.

"Feliz Navidad, knucklehead."

Dr. Martin Fackler was a combat surgeon in Vietnam and is director of the Wound Ballistics Laboratory at the Letterman Army Institute of Research, Presidio of San Francisco. He also is an Army colonel who wages constant war against the mystique and misinformation surrounding weapons and wounds.

An AK-47 assault rifle, he states, is not as deadly as the public believes. And many more children might have died in a Stockton schoolyard last year had Patrick Purdy used a hunting rifle or a 12 - gauge shotgun instead of an AK-47 .

The severity of a gunshot wound, Fackler explains, has little to do with the velocity of so-called "high-powered rifles" but is heavily influenced by "the mass of the projectile (bullet), how heavy it was, the construction, the shape, the type of tissue it hits, did it hit the liver or the intestines, did it hit anything to disturb its path before it hit this person?

"Do you realize," he asks, "that the muzzle velocity of the AK-47 is less than the muzzle velocity of the weapon that was adopted by at least three European armed forces in 1891?

" There are simply two mechanisms, basically, as the bullet penetrates the body. It makes a bullet hole (permanent cavity); in other words, the bullet hitting the body tissues destroys, disintegrates and crushes what it hits. There is a second (mechanism) that is much more dramatic and has been emphasized far out of proportion--the temporary cavity.

"This (temporary cavity) is the same thing as a splash in water. You toss a rock into water, the water parts momentarily and then comes back.

"The temporary cavity (inside human tissue) does increase with the velocity of the projectile (bullet), but (it) increases a lot more with changes in projectile shape. Think of a diver going off a 10-meter board . . . going into the water with an excellent dive. High velocity. Very little disruption of the water.

"Now, same diver, same mass and everything . . . but going off a two-meter board at much lower velocity. If he does a belly flopper, he makes a much bigger splash. And bullets do the same thing.

"As long as they (bullets) are going through tissue . . . straight ahead, and not yawing at all, they make very little damage . . . after the bullet starts yawing (in tissue), it will go to 90 degrees and is likely to go to 180 degrees (tumbling) . In other words, have its path exactly reversed.

"The (United States) M-16 projectile tends to yaw after about five inches. The AK-47 round, using the (7.62 millimeter) standard Chinese or Russian military ball ammunition, doesn't generally yaw until it goes about 12 inches.

"Some of the stuff that has been coming out of Los Angeles in the aftermath of this Purdy shooting (where Purdy used 7.62 mm military-type ammunition) has been really unbelievable.

"You've got (hospital) people that are quoted as saying: 'Assault rifles are so bad that if a person is hit in an extremity it must be amputated and if he is hit in the trunk he is dead.' And another guy saying: 'The chances of you dying if you're hit by an assault rifle are 50 % .' These things are absolutely ludicrous, absolutely non-factual.

"Look at Mr. Purdy's kill rate. Thirty-five hits and five deaths. That's not a high kill rate. If you wish to add up massacres, not only of Mr. Purdy but of Mr. Wesbecker (Joseph T. Wesbecker) in Louisville and a few others, you will find that when an assault rifle is used as the primary weapon . . . you have more than twice as many wounded as are killed.

"When a shotgun is used, you have more than twice as many killed as are wounded. This summer there was a fellow over in France who used a shotgun and killed 14 and wounded seven.

"You don't want to be hit with a short - range shotgun. It takes a lot of tissue and makes mush out of it. And this tissue doesn't work very well afterwards."

Juan Mendez has a new identity. He is 89-12450.

That means he died in 1989 and is the year's 12,450th victim of an undetermined or violent end in which the Los Angeles County Medical Examiner's Office assumes physical jurisdiction over the body.

Part of that authority is the decision to perform an autopsy. Ten thousand corpses were opened and examined by the county last year. It is decided Mendez will be one.

Autopsy, by necessity, is a detached and indelicate process. But then, the 11 physician-pathologists handling 800 autopsies each month have no time for surgical delicacies, fancy incisions or needlework. Nor need they work with post-operative concerns for those wheeled into these grim and smelly basement operating rooms between the Southern Pacific railway yards and County-USC Medical Center.

In one room, all six stainless steel tables often are occupied. Dead by the dozens are waiting. Some incoming addicts, derelicts, traffic victims, male and female, the stabbed, beaten and shot of our county, must wait stiff and uncovered on gurneys in the hallways.

Mendez, unwashed and naked but for the blue 89-12450 identification tag wired to his big toe, is brought in.

Dr. Christopher Rogers, 31, will do the autopsy.

Detectives De Losh and Getherall are observing.

Doctor and detectives wear disposable masks, gowns and paper bootees. That wasn't always standard. But then came AIDS.

Rogers says he is fascinated by the work. Sure, he could earn more in private medicine. But, he says, he enjoys the puzzle-solving of being a forensic pathologist.

He starts work, and it is not subtle.

An ordinary pair of pruning shears are used as rib cutters. A soup ladle collects blood samples from Mendez's thorax. Washing off instruments, not constant sterilization, is the rule. Then some are dumped in a cardboard box; the hand-written sign on it states: "Knives To Be Sharpened."

This case isn't much of a puzzle for Rogers. Guided by X-rays, he finds a bullet in Mendez's left knee. The joint, quite bloodless, is opened and the slug pried out for De Losh.

It is a flat-nosed .38 and clearly from guard Garcia's gun.

Rogers measures the bullet holes in Mendez's chest. He marks their positions, their angles and their passages on a diagram of a man; the chart will become evidence. Then Rogers inserts a steel rod through each wound channel.

"We have potential entrances one, two and three, and potential exits one, two and three, and one here in the knee . . . now, one through the sternum, right through the heart, through the left lung and exits . . . and that is the rapidly fatal wound.

"This one here, left chest, came in at intermediate range because we see the (gunpowder) stipling . . . it fractured the fifth rib and then it goes through both lobes of the left lung, then out, fracturing the rib, left seven.

"I guess we'll make the cause of death multiple gunshot wounds."

It is a 90-minute task, and as with all daily routines, there is chatter unrelated to the work. Of whether the Vatican will give up Manuel Noriega. Of a Christmas gift of tickets for "Phantom of the Opera." Of old friends and new cars, living in Los Angeles and dead villains.

When it is done, Mendez is sutured; the stitches are huge and made with waxed twine. His hair is given a final shampoo. He is wrapped in plastic with arms and legs trussed tight by lengths of rope.

He is wheeled to a crypt, and in storage at 35 degrees, Mendez joins the county's permanent population of 300 corpses in processing.

It has been a while since robbery specialists De Losh and Getherall have witnessed an autopsy. They say it doesn't bother them.

"Unless it's a kid," De Losh says.

"Or a cop," Getherall adds.

Evan Marshall was a homicide investigator and a Detroit cop for 20 years. He has shot suspects, had suspects shoot at him, and now directs the criminal justice program at Kirtland College, Ross Common, Mich. A columnist for Combat Handguns and Guns & Ammo magazines, he sees himself as "a student of ammunition construction and effectiveness."

Marshall knows that poison-tipped rounds and explosive bullets are effective only in Ian Fleming novels. But he also knows the serious attention law enforcement agencies are giving two radical handgun bullets.

One , the Glaser , is a thin, copper-jacketed round that flies like a conventional bullet and bursts on impact. It releases miniature lead shot and creates broad penetration similar to a shotgun blast.

The other is a super-light, plastic plug weighing less than a quarter of a conventional .38 bullet. Muzzle velocity of the Thunderzap is more than twice the speed of sound--faster than a bullet from an M-16 assault rifle--but the light weight of the projectile allows total dissipation of energy at 100 yards. Before that, however, the round fragments on impact and, according to current advertising, creates "vicious flesh destruction . . . shatters ribs and blows rib pieces into lung tissue."

Marshall has also studied the Army's Advanced Combat Rifle (ACR) program and its evaluation of a bullet embedded in a bullet, so-called "duplex rounds" that are relatively unstable and designed to tumble immediately upon impact.

Another ACR ammunition contender fires a small steel arrow, a flechette, and there's a French round of solid brass said to have penetrated 37 layers of the Kevlar used in bulletproof vests.

But their effectiveness is easily argued, Marshall says, and the truth of the ammunition matter hasn't changed much since the days of cannon and musket balls.

"I've seen instances where people were shot with a standard .38 Special, round nosed, lead ammo, and other people shot with a 125 grain, .357 magnum hollow-point. You dissect both wound channels and the differences are very subtle. You don't open up the person shot with a .357 magnum and their organs are all turned to jelly, and they don't all slide out of the body. It just doesn't happen.

"Bullet placement is really the key. As I used to tell my (police) academy classes: 'The three most important things to remember when talking about ammunition are--bullet placement, bullet placement, bullet placement.

"I routinely tell people that anyone who takes any handgun to a lethal confrontation isn't very wise. Because handguns, by and large, don't stop people very well. Generally, with handguns, to produce incapacitation, we've got to produce death.

"We carry handguns because they offer concealability and portability, and in the area of law enforcement, police generally end up relying on handguns because people in this country have got used to seeing police officers carrying handguns. In other countries, police routinely walk around with submachine guns and nobody gets really excited about that. But I guess we're not quite ready for that yet.

"Law enforcement requirements are quite different from military attitudes. They (military) want to wound people because that ties up medics and many other support personnel. In law enforcement, the aim is to stop.

"There are only two ways to get what we (police) call 'instant incapacitation.' One is to sever the spine, which, of course, produces death. The other is a brain shot.

"But it is extremely difficult to produce incapacitation without producing death. What we have seen (with handguns) is countless instances where people have taken hit after hit after hit and not gone down.

"Once the adrenaline gets dumped in the system . . . (many) people don't feel getting hit the second, third or fourth time. We've seen instances where basically, in order to stop people who are bent on killing other people, you sometimes almost have to shoot them to pieces.

"That justifiably horrifies people.

"But as far as the technology of a bullet itself . . . the only humane bullet is one that is never fired."

Several hours after death, Juan Mendez, 28, makes one contribution to life. His corneas are removed, sent to the Doheny Eye Bank and will be implanted to restore sight in others.

But no one has asked for the rest of Mendez.

His police record shows no address or names of family. He is presumed to be an illegal alien. Just in case, his description and fingerprints will be checked through the Veteran's Administration, Federal Bureau of Investigation, the Criminal Identification and Information office of the state Department of Justice and other official clearing houses.

In about 60 days, if no leads are found, Mendez will be declared "Indigent Dead."

He will be taken to the county crematory in East Los Angeles. His ashes will be held for two years. Then they will be scattered at a common site.

The bullets that took his life will be sealed in plastic envelopes and held in LAPD's property room until no legal considerations surround the case.

And a few small, impersonal, inanimate, valueless lumps of lead will outlive Juan Mendez by many years.


The first shot fired at Juan Mendez was at close range, striking him high on the left side of the chest, angling down and fracturing the fifth rib. That bullet continued on, penetrating both lobes of his left lung before fracturing the seventh rib and exiting the back close to the spine.

The bullet that killed Mendez entered his chest cavity through the sternum, striking downward through the left ventricle of the heart before exiting his back. It crushed and destroyed tissue by forming a wound channel known as the permanent cavity, which would likely be further widened if the bullet flattened out after striking the sternum. For milliseconds after passage of the bullet, the walls of the permanent cavity, including within the heart, are stretched outward. This lateral tissue displacement forms a temporary cavity that may have no effect on elastic muscle but can cause devastating disruption of soft organs.

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