For the little girl of my first experience did not die “simply” as a result of a brain hemorrhage and a fractured skull. Behind the skull trauma was the fury (and at that time some of my colleagues were naive enough to say, the wickedness) of her mother. But behind the mother’s violence, the social history subsequently revealed, was a background of alcoholism and marital discord that, when discovered, added a measure of commiseration to the universal reproof. But behind this history of frustration and maladjustment was a history of victimization of the mother, who herself had been abused by her father when she was a child. Hence, guilt was split in half, for the father, by promoting maladjustment of the aggressor-daughter, seemed to share some responsibility for her acts. But behind this truculence there were too remote to influence the actions of lawyers and police officers handling her case. And behind all these miseries, there stood a violent North American society, which is but a part of a world that is, and has been from time immemorial, violent par excellence. Thus the pathologist who wishes to know the “causes of death” sees the chain of causality extended by new links, daily lengthened by research, but is never close to “the truth,” never really knows the etiology of a child’s death. The pathologist must be content to look at proximate causes, must be satisfied with externals while research continues to reveal causes behind the causes in an unending chain of causality, as when a man holding a mirror looks at his own image in a set of confronting mirrors, and sees a man holding a mirror, and in this mirror the image of a man holding a mirror, and so on, in infinite repetition. So the ideal autopsy report on an abused child, the only one that would do justice to the thorough correlations demanded by a scientific spirit, would be like a narrative containing a subplot and the subplot itself developing a subplot of its own. My colleagues, I am afraid, would not take kindly to the ideal format; for to read it would be like reading one of those literary works that preceded the novel as a genre (of which I believe Don Quixote is the outstanding example), one in which the various characters tell complex stories apparently unrelated to the leading plot, and which the reader must sit through until the leading plot, at long last, is reestablished.
Francisco González Crussí, “Reflections on Child Abuse”, en Notes of an Anatomist.