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March 25, 1998
Yoknapatawpha County Sheriff's Department
Oxford, Mississippi
CAPS/Homicide Division
Detective Terrence Nelson
Case #: 129152-36A-1998
Investigative Analysis Report Contract: Wilma Martin,
M.D.
Contract #: YCSD-034856
RE: Post-mortem analysis of medical records of Crystal
Margaret Taylor, SS# 427-35-4326
This analysis report was prepared by Dr. Wilma Martin,
private consultant under contract with the Yoknapatawpha
County Sheriff's Department. Dr. Martin's work relevant to
the investigation of childhood sexual abuse includes five
years as an emergency room physician at the Abbeville
Hospital, where she treated many abuse victims, including
children, and assisted in numerous criminal investigations
of childhood sexual abuse, other physical abuse and
negligence; 12 years as senior physician at the Abbeville
Family Clinic, where she treated similar cases; and her past
nine years' service in various leadership and advisory roles
for the North Mississippi Childhood Abuse Prevention
Coalition.
Dr. Martin was retained after the investigation into the
murders of Crystal M. Taylor and Dale J. Taylor yielded new
information from Crystal's diary. Several diary entries
indicated a need for investigating possible childhood abuse.
Dr. Martin reviewed subpoenaed medical records to provide an
expert medical opinion on the possibility that one or both
of the Taylors were abused.
SUMMARY
I have made a detailed analysis of the late Miss Crystal
Taylor's medical records for signs of abuse. It is my
professional opinion that her files point to a pattern of
chronic childhood sexual abuse dating at least from age
seven, possibly earlier. A similar examination of the
medical records of her brother, Dale Taylor, showed no signs
of sexual abuse for him; all of the following comments,
therefore, pertain only to Miss Taylor's records.
Cross-checking with Megan Rhinehart, a caseworker with
the Yoknapatawpha County Child Protective Services, revealed
no record of abuse investigations on Crystal's behalf. This
is not uncommon, unfortunately; ambiguous cases are often
not pursued aggressively. Physicians are required to report
clear signs of abuse, but young victims can be overlooked
when symptoms are subtle, plausible explanations are offered
and the physician fails to elicit any incriminating comments
from the child. That appears to have been the case with
Crystal Taylor.
The Taylor family's physician, the late Dr. Daniel
Welter, passed away when Crystal was 13. Her new physician,
Dr. Alisa Woesh of Internal Medicine Associates in Oxford,
and her OB/GYN, Dr. Mark Seinger, also of Oxford, may not
have seen a need for an exhaustive review of Crystal's
previous records and therefore did not notice the abuse
pattern. That is particularly likely since no subsequent
records of Crystal's medical visits indicated new signs of
sexual abuse. It is possible, even probable, that the abuse
stopped around the time Crystal reached puberty; national
studies have shown that some sexual predators prefer only
certain age groups, and she may no longer have fit the
prepubescent sexual model her predator preferred. Another
fact about sexual abuse nationwide is that it is often
familial, and by that age she may have become able to evade
or deter her abuser.
RECORDS ANALYSIS
- Age 7: Feb. 4, 1986, child's maternal
grandmother took her to Dr. Welter for a lingering
complaint of an "itchy bottom." Dr. Welter performed a
brief external vaginal examination and diagnosed a severe
yeast infection. He prescribed an ointment for treatment.
A notation by Dr. Welter's senior nurse, Mary Elizabeth
Dalton, R.N., also stated that the patient became
hysterical at the mention of being examined for
diagnostic purposes; she further stated that the child
calmed down after Dr. Welter administered a mild
sedative, and her grandmother remained with her
throughout the exam. Nurse Dalton noted that future
appointments for Crystal should be scheduled at off-peak
hours and that Dr. Welter had indicated a mild sedative
be offered for future vaginal area examinations.
Analysis: Yeast infections are much more common
in sexually active adults than in young children.
Crystal's severe agitation at the prospect of having a
private part of her body examined also is indicative of
psychological trauma related to sexual abuse.
- Ages 8, 9 and 12 (respectively, Oct. 17, 1987;
Jan. 29, 1988; and July 6, 1991): Repeat visits to Dr.
Welter for yeast infections. The child was brought by her
mother for treatment of severe vaginal itching after
over-the-counter medications had failed to relieve
prolonged discomfort -- labial inflammation, burning and
itching. Dr. Welter performed external vaginal exams
during the visits when Crystal was 8 and 9, using mild
sedatives to calm her; at age 12, he performed a pelvic
exam with the child also sedated. Dr. Welter notes that
he questioned the child at age 12 about any unhygienic
practices or sexual activity that may be introducing the
yeast infections; he also warned the child that any
sexual partner of hers could be sent to jail for
statutory rape. She refused to comment. His notes also
indicate that Crystal was "listless" and "dispirited"
during the exams at ages 8, 9 and 12.
The pelvic exam showed normal results aside from the
yeast infection. Dr. Welter noted that Crystal's hymen
was torn. He also noted multiple bruises on the child at
all three visits. Dr. Welter noted that Crystal
attributed the bruising to her own clumsiness or to
slips, poor grips and other accidents during "lifts" and
other ice skating practice with her brother.
Analysis: Sexual partners often "trade" yeast
infections; the male partner may not show symptoms and
may re-infect his partner. Crystal's refusal to comment
after the jailing threat also is a red flag. Children
typically protect their sexual predators if they are
close friends or family members. For the July 1991 pelvic
exam, there was no notation of any signs of vaginal
tearing or the vaginal wall's roughening and thickening
-- signs that I would expect to see in a child if she
were being forced into vaginal sexual activity at this
age.
The torn hymen could have reasonably been interpreted
as normal; athletic children such as Crystal often have
hymenal tears that happen without any vaginal
penetration. It also may happen if a sexual predator is
digitally stimulating a child vaginally. In the light of
Crystal's unusual frequency of yeast infections at an
early age, I believe that the torn hymen is a sign of
escalating sexual abuse.
I disagree with Dr. Welter's assessment of Crystal's
bruises; the marks he noted (see highlighted portions of
attached medical records) are not consistent with skilled
athletic activity, particularly in light of her other
signs of sexual abuse. Several of the marks are
consistent with a pattern of sexual abuse. Of particular
note are the inner thigh bruises in a hand-print pattern
and one large bruise that may have been made by a knee
forcing her thighs apart; the neck bruises; and the
bruising or chafing of the wrists, forearms and upper
arms, indicating forcible restraint.
- Ages 9-11: March 28, 1988; April 21, 1988;
Aug. 4, 1988, Dec. 20, 1988; May 9, 1989; Oct. 11, 1989;
and Feb. 15, 1990; Crystal complained of rectal pain when
sitting and having bowel movements, and she was brought
in by her mother for check-ups. Dr. Welter examined her
and treated her for a recurring problem of rectal
hemorrhoids and once for a minor rectal tear (Jan. 14,
1990). Dr. Welter diagnosed constipation as the cause of
the problems. Stool-softening medication,
anti-inflammatory creams and a high-fiber diet relieved
the pain in each incidence; no surgery was needed.
Analysis: These injuries could indicate
repeated anal penetration, particularly when the child's
records indicate no history of previous problems with
constipation.
- Age 13: Aug. 21, 1992: Crystal's mother
brought her in for a gynecological exam by Dr. Mark
Seinger, an Oxford obstetrician/gynecologist. Mrs. Taylor
indicated the reason for the visit was that her daughter
was reaching puberty and needed a baseline examination.
Dr. Seinger noted that signs of vaginal sexual activity
were uncovered during the pelvic exam. The girl's
previously torn hymen was stretched, and Crystal's
vaginal walls were roughened and thickened -- all signs
of premature sexual activity. Dr. Seinger counseled the
girl privately on birth control methods and prevention of
sexually transmitted diseases. He also urged her to stop
being sexually active. His notes state that Crystal began
crying and replied, "But he loves me. He wouldn't hurt
me."
Analysis: Crystal is obviously sexually active
by this age. The signs of vaginal trauma and her verbal
denials and protection of her abuser are consistent with
the profile of a sexually abused child.
- Ages 14-18: Aug. 20, 1993; Aug. 25, 1994; Aug.
17, 1995; Aug. 21, 1996, Aug. 14, 1997: Crystal returned
to Dr. Seinger's office for annual pelvic exams. All
pelvic exams showed normal results during these visits.
Dr. Seinger noted there were no new signs of sexual
activity or the presence of any STDs at either of these
exams. He also noted a behavioral change in Crystal for
her visits at age 14 and 15: Crystal's speech was
slurred, her gaze was unfocused and her walk was uneven
and swaying when she came into the office for her annual
pelvic exams; there was no smell of alcohol, but her
breath smelled strongly of cinnamon gum. No similar notes
are found for any of her other office visits during this
period.
Analysis: Abuse may have ended by this time
since no new signs of sexual trauma were evident.
However, the psychological trauma could have lingered, as
evidenced by the signs of inebriation for her first two
return visits. The fact that she apparently chose to numb
herself with alcohol before returning for routine
gynecological examinations indicates an unusual degree of
aversion to the invasive nature of this procedure,
indicative of traumatic sexual experiences.
RECOMMENDATIONS:
Miss Taylor's medical records clearly indicate that
further criminal investigation is needed in the case of her
childhood sexual abuse. I believe it would be helpful for
you to interview Miss Taylor's close childhood friends,
teachers, art teachers, camp counselors, parents of her
childhood friends, or others who may have had the
opportunity to know the child well and observe her closely
during the years when Crystal's sexual abuse apparently was
most active. They may be able to provide you with additional
background on physical signs of abuse or comments that
Crystal made about her abuse. I would also suggest
individual interviews with family members, focusing on her
relationships with older male relatives. Please contact me
for an appointment and I can provide your office with
guidelines for points you would need to cover in such
interviews.
//Wilma Martin, M.D.
cc: Megan Rhinehart, YCCPS
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