When Schäfer was present at an autopsy, his primary concern wasn’t the cause of death. Whether the person lying on the table had died from a fall, from suffocation, a heart attack or from a shot from a sawed-off shotgun—that wasn’t his main interest. He wanted to know about the manner of death. Had it been a natural death, an accident, a suicide, or a homicide? He had been in the job long enough to know that first impressions weren’t always right.

For the next hour, Schäfer watched while Ulrich Andersson was cut open with a Y-shaped incision from the neck down to his pubic bone. His ribs were cut, his organs removed and examined one by one.

“The face is cyanotic with numerous punctate hemorrhages,” the medical examiner said to the pathology tech next to him. Then he waved Schäfer over to the autopsy table.

“This wasn’t visible in the dim lighting at the scene, but here it’s very clear: there are pinpoint bleeds in the eyes and in the eyelids and here—can you see?”

He pointed with a pinkie finger behind the ears.

“And they are also inside in the mucosa of the mouth. If he hung himself with sufficient distance above the floor, which appeared at first glance to be the case, then we shouldn’t find petechiae like this,” Oppermann said. “On the other hand, if we’re talking about something tied around his neck—for example, let’s say someone tied a rope or a cord around his neck and pulled—then that would close off the veins bringing the blood from the head back to the heart but not the arteries taking the blood up to the head. In other words, the pressure in the blood vessels in the head would rise, which causes the thin little blood vessels—the capillaries—to burst, which results in the petechiae, which you can see here.”

Schäfer nodded.

“On the other hand, if he hung himself and was hanging freely,” the medical examiner continued, “then there would be so much weight on the rope that it would close off both the veins and the arteries, and then you wouldn’t see this petechia pattern.”

“So, you don’t normally see this with hangings?” Schäfer asked, scratching his neck.

“Well … only if someone has hung himself from, say, a doorknob and is lying relatively horizontally on the floor. Autoerotic asphyxiation deaths would result in these same punctate petechiae, but I’ve never seen it like this. Not when the individual in question has been hanging freely.”