Interviews
I sent out emails to the offices of medical examiners across the country and internationally. To those who agreed to participate, I sent a list of questions inquiring about their education and various career experiences. Here are their responses in full:
Pedro Ortiz
Los Angeles, CA
- What education did you receive prior to becoming a medical examiner?
- After high school, I went to a 4 year college in Puerto Rico ( that’s where I am from ) and got a BS with a major in chemistry and minor in physics. Then I applied to med school. After graduation, I did a residency in pathology for 4 years and then I was did an extra training year in forensic pathology. After I finished, I was offered a job here as a deputy medical examiner. I have been here in LA for the last 25 years.
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
- I did not do nothing out of the ordinary, except study and follow the path to college and medical school. If you are referring to extracurricular activities, (like you have them now in school and college), they were very few and practically not available in Puerto Rico.
- How long have you been a medical examiner, and did you always know that this was the career you wanted to pursue?
- I have been working here for 25 years and frankly , I did not know that this will be my career path until I finished medical school. I never thought about forensic pathology until I was an intern in general medicine. (that is just after graduation from medical school). When I went to medical school. I have no idea what to do in medicine.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
- My job is medical. As a physician. I do work only the medical aspect of the cases. There is no interest at all on my part to “solve criminal cases” My only objective is to contribute the analysis of the medical data. As other individuals trained in different things, such as firearms, toxicological analysis of samples, scene reconstruction experts and others , I provide my perspective as to the medical aspects of the case like cause of death, mechanism(s) of death, any evidence(s) of disease (s) on the body etc.
Without exaggerating , I might say that my experience is that my contribution(s) to the resolution of a criminal case are very limited (maybe about 5% or less) of the total evidence examined. I know that your idea is different because of the way my job is presented in movies and TV. But reality is that it is a lot different! I do have to present my findings in any forum I am required by law. But my analysis has to unbiased and scientifically accurate as possible. I cannot be an advocate for anybody. I just have to present the evidence “within the realms of science”.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
- All cases leave an impression on you. First they remind you of your own mortality. Second you consider that the majority of cases are of young individuals , that frankly did not attain their full potential in life , because of their premature death. Some are worse, if you consider tragic deaths on children. Bu definitely, every case leaves something to you to meditate into it, Also with every case, you always learn something that can help you with your next case.
- What is an interesting or unusual case that you have been involved in?
- Among other, I have a case that involved the skeleton of a female, which was found in a well in Lancaster CA. Turns out that the perpetrator had killed her dog also and had placed it in the well. It was a little dog that have an advanced degree of arthritis and had a walker. After the remains of both owner and dog were recovered and examined and the cause of death were found, (the lady was the victim of a blow to the head, while the dog was strangled with a cord), there was no clue as to who was the woman. By checking the little dog’s orthopedic apparatus, we were able to find through the veterinarian who had prescribed the appliance, who the owner was. Turns out tha the lady have been reported missing by her boyfriend about 3 years before. The investigation was concluded as the boyfriend confessed to the crime and confirmed in his confession what the autopsies on the dog and her owner had shown.
- When you first began your job as a medical examiner, what was one aspect of your job that you weren't expecting?
- I was not expecting to go to court and be questioned by attorneys all the time. It is like taking a test all the time. (They do not allow you to look at your papers - Testimony is by memory only)
- What are the most prominent challenges and benefits of your job?
- Resolve the cases in the sense of explaining scientifically, how the individual died. Another challenge is presenting the information in a coherent way, so that lay people might understand. In relation to benefits, being a government employee has its perks (salary, benefits, job security etc.) which I enjoy.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy that you wish you could?
- Limitations on this job are many and important. First we are dealing with death, but it defies definition. Nobody can define death properly. Other issues are time of death which defy precise definitions, what was the individual doing at the time of his death, etc. There are many questions that cannot be answered by an autopsy, such as the ones already mentioned as well as some others like, what was the intention of the perpetrator? In criminal cases, did the accused commit the crime? Which weapon did he /she use? At what precise time was the crime was committed? You will be surprised how many questions under oath I am asked, to which my honest answer is “I do not know”.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
- I will check my facts and see if I have a good understanding of the main issues of the case. Then I would see if I am missing something and plan what else could I do to resolve the case. Sometimes , I need to reviewed medical history, police reports. Witness information. Also check on lab results. Do microscopic examination on tissue retrieved at autopsy, maybe consult a specialist like a surgeon, a psychiatrist or a criminalistics person ( firearms, blood spatters, etc.)
or consult more experienced colleague that might have done a similar case in the past
If after all that , there is no adequate answer, I can tell the word that I do not know.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
- I have not done too many , but usually second autopsies are more difficult to reach a conclusion because everything has been examined by another physician, Sometime I have found evidence of disease or trauma which was not evaluated properly by the initial autopsy surgeon, But that situation is rare, Most of the second autopsies I have done corroborates the initial findings.
- What traits are most important in someone who wants to pursue this career?
- As any career, honesty, discipline, patience and knowledge. One of my professors in this specialty, once told me that to be successful as an effective forensic pathologist, you have to have about 10% of medical knowledge. Surprised by his answer, I asked how about the other 90%? He answered – Common Sense. That is the key not only to survive but to thrive in this specialty.” As you probably know by now; Common sense is not a very “common” in many professionals.
- After high school, I went to a 4 year college in Puerto Rico ( that’s where I am from ) and got a BS with a major in chemistry and minor in physics. Then I applied to med school. After graduation, I did a residency in pathology for 4 years and then I was did an extra training year in forensic pathology. After I finished, I was offered a job here as a deputy medical examiner. I have been here in LA for the last 25 years.
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
- I did not do nothing out of the ordinary, except study and follow the path to college and medical school. If you are referring to extracurricular activities, (like you have them now in school and college), they were very few and practically not available in Puerto Rico.
- How long have you been a medical examiner, and did you always know that this was the career you wanted to pursue?
- I have been working here for 25 years and frankly , I did not know that this will be my career path until I finished medical school. I never thought about forensic pathology until I was an intern in general medicine. (that is just after graduation from medical school). When I went to medical school. I have no idea what to do in medicine.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
- My job is medical. As a physician. I do work only the medical aspect of the cases. There is no interest at all on my part to “solve criminal cases” My only objective is to contribute the analysis of the medical data. As other individuals trained in different things, such as firearms, toxicological analysis of samples, scene reconstruction experts and others , I provide my perspective as to the medical aspects of the case like cause of death, mechanism(s) of death, any evidence(s) of disease (s) on the body etc.
Without exaggerating , I might say that my experience is that my contribution(s) to the resolution of a criminal case are very limited (maybe about 5% or less) of the total evidence examined. I know that your idea is different because of the way my job is presented in movies and TV. But reality is that it is a lot different! I do have to present my findings in any forum I am required by law. But my analysis has to unbiased and scientifically accurate as possible. I cannot be an advocate for anybody. I just have to present the evidence “within the realms of science”.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
- All cases leave an impression on you. First they remind you of your own mortality. Second you consider that the majority of cases are of young individuals , that frankly did not attain their full potential in life , because of their premature death. Some are worse, if you consider tragic deaths on children. Bu definitely, every case leaves something to you to meditate into it, Also with every case, you always learn something that can help you with your next case.
- What is an interesting or unusual case that you have been involved in?
- Among other, I have a case that involved the skeleton of a female, which was found in a well in Lancaster CA. Turns out that the perpetrator had killed her dog also and had placed it in the well. It was a little dog that have an advanced degree of arthritis and had a walker. After the remains of both owner and dog were recovered and examined and the cause of death were found, (the lady was the victim of a blow to the head, while the dog was strangled with a cord), there was no clue as to who was the woman. By checking the little dog’s orthopedic apparatus, we were able to find through the veterinarian who had prescribed the appliance, who the owner was. Turns out tha the lady have been reported missing by her boyfriend about 3 years before. The investigation was concluded as the boyfriend confessed to the crime and confirmed in his confession what the autopsies on the dog and her owner had shown.
- When you first began your job as a medical examiner, what was one aspect of your job that you weren't expecting?
- I was not expecting to go to court and be questioned by attorneys all the time. It is like taking a test all the time. (They do not allow you to look at your papers - Testimony is by memory only)
- What are the most prominent challenges and benefits of your job?
- Resolve the cases in the sense of explaining scientifically, how the individual died. Another challenge is presenting the information in a coherent way, so that lay people might understand. In relation to benefits, being a government employee has its perks (salary, benefits, job security etc.) which I enjoy.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy that you wish you could?
- Limitations on this job are many and important. First we are dealing with death, but it defies definition. Nobody can define death properly. Other issues are time of death which defy precise definitions, what was the individual doing at the time of his death, etc. There are many questions that cannot be answered by an autopsy, such as the ones already mentioned as well as some others like, what was the intention of the perpetrator? In criminal cases, did the accused commit the crime? Which weapon did he /she use? At what precise time was the crime was committed? You will be surprised how many questions under oath I am asked, to which my honest answer is “I do not know”.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
- I will check my facts and see if I have a good understanding of the main issues of the case. Then I would see if I am missing something and plan what else could I do to resolve the case. Sometimes , I need to reviewed medical history, police reports. Witness information. Also check on lab results. Do microscopic examination on tissue retrieved at autopsy, maybe consult a specialist like a surgeon, a psychiatrist or a criminalistics person ( firearms, blood spatters, etc.)
or consult more experienced colleague that might have done a similar case in the past
If after all that , there is no adequate answer, I can tell the word that I do not know.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
- I have not done too many , but usually second autopsies are more difficult to reach a conclusion because everything has been examined by another physician, Sometime I have found evidence of disease or trauma which was not evaluated properly by the initial autopsy surgeon, But that situation is rare, Most of the second autopsies I have done corroborates the initial findings.
- What traits are most important in someone who wants to pursue this career?
- As any career, honesty, discipline, patience and knowledge. One of my professors in this specialty, once told me that to be successful as an effective forensic pathologist, you have to have about 10% of medical knowledge. Surprised by his answer, I asked how about the other 90%? He answered – Common Sense. That is the key not only to survive but to thrive in this specialty.” As you probably know by now; Common sense is not a very “common” in many professionals.
Gregory Conti
Miami, FL
- What education did you receive prior to becoming a medical examiner?
In order to become a medical examiner, one must complete four years of undergraduate study, four years of medical school, four years of anatomic & clinical pathology residency training (or three years of anatomic pathology training), and one year of subspecialty training in forensic pathology.
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
Most aspiring medical students spend time volunteering in a medical setting (physician’s office, hospital, etc.) in order to gain exposure to the medical field and to see what an actual work-day is like for a physician.
- How long have you been a medical examiner, and did you always know that this was the career you wanted to pursue?
Some practicing forensic pathologists knew before medical school that forensic pathology was the field of medicine in which they wanted to receive training. Others discover the field during their medical education and choose to pursue it as their chosen career path.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
Medical examiners determine the cause and manner of death for all cases in which they assume jurisdiction. The cause of death is the disease or injury which leads to death (atherosclerotic cardiovascular disease, lung cancer, gunshot wound of the head, blunt force injury of the torso, etc.). There are countless causes of death. The manner of death is the way in which the cause of death came about. There are only five manners of death – natural, homicide, suicide, accident, undetermined. One can certify the cause of death as “Gunshot wound of the head,” but depending on the circumstances of the case, the manner could be homicide, suicide, or accident.
Medical examiners are called to testify in various types of cases. Most cases in which the medical examiner is called to testify are homicides. The medical examiner is called as an expert witness and asked to describe his or her findings and to give his or her opinion on various aspects of a case.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
Medical examiners must always remember that the autopsy they perform is being done on someone’s loved one in order to help educate and counsel those still living.
- What is an interesting or unusual case that you have been involved in?
All cases are interesting and provide the opportunity to either learn something new or to confirm and help support something already known.
- When you first began your job as a medical examiner, what was one aspect of your job that you weren't expecting?
Most forensic pathologists have a fairly good grasp of what the work in a medical examiner’s office will entail prior to starting. During medical school, pathology residency training, and forensic pathology fellowship training, medical examiners in-training get ample exposure to the field.
- What are the most prominent challenges and benefits of your job?
Determining the cause and manner of death for loved ones’ family members can be simultaneously a prominent challenge and benefit of being a medical examiner.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy that you wish you could?
The popularity of forensically-themed television shows has given rise to the “CSI Effect.” The public perception of what forensic professionals do and the amount of time they are able to do it in is vastly different than the reality. While a medical examiner can determine many things from performing an autopsy, the autopsy alone will never reveal the motives behind individuals’ actions.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
Medical examiners are constantly in contact with their fellow medical examiners, physician colleagues, forensic toxicologists, law enforcement personnel, state attorneys, and other professionals who all provide valuable information that aids in determining the cause and manner of death. The type of case a medical examiner has determines which other professionals would need to be consulted in order to arrive at a cause and manner of death.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
Additional autopsies performed after an initial autopsy allow for a second opinion. The medical examiner performing a second autopsy, however, does not see the body as it was in its original state at the time of the first autopsy. Due to that very important difference, the interpretive scope of subsequent autopsies is significantly limited.
- What is the protocol for performing an autopsy on someone registered as an organ donor?
The organs of individuals registered as organ donors may still be donated, even if an autopsy required by law must be performed by a medical examiner. Generally, medical examiners make all attempts to accommodate organ donation. So long as organ donation does not limit the examination a medical examiner would need to conduct in order to confidently arrive at a cause and manner of death, organ donation may take place. In those instances, organs are usually procured prior to autopsy. Tissue donation (corneas, long bones, ligaments, skin, etc.) may occur prior to or after an autopsy is performed.
- What traits are most important in someone who wants to pursue this career?
Individuals who are intellectually competent, open to growth, committed to doing justice, compassionate, organized, and self-motivated will do well in the field of forensic pathology.
In order to become a medical examiner, one must complete four years of undergraduate study, four years of medical school, four years of anatomic & clinical pathology residency training (or three years of anatomic pathology training), and one year of subspecialty training in forensic pathology.
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
Most aspiring medical students spend time volunteering in a medical setting (physician’s office, hospital, etc.) in order to gain exposure to the medical field and to see what an actual work-day is like for a physician.
- How long have you been a medical examiner, and did you always know that this was the career you wanted to pursue?
Some practicing forensic pathologists knew before medical school that forensic pathology was the field of medicine in which they wanted to receive training. Others discover the field during their medical education and choose to pursue it as their chosen career path.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
Medical examiners determine the cause and manner of death for all cases in which they assume jurisdiction. The cause of death is the disease or injury which leads to death (atherosclerotic cardiovascular disease, lung cancer, gunshot wound of the head, blunt force injury of the torso, etc.). There are countless causes of death. The manner of death is the way in which the cause of death came about. There are only five manners of death – natural, homicide, suicide, accident, undetermined. One can certify the cause of death as “Gunshot wound of the head,” but depending on the circumstances of the case, the manner could be homicide, suicide, or accident.
Medical examiners are called to testify in various types of cases. Most cases in which the medical examiner is called to testify are homicides. The medical examiner is called as an expert witness and asked to describe his or her findings and to give his or her opinion on various aspects of a case.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
Medical examiners must always remember that the autopsy they perform is being done on someone’s loved one in order to help educate and counsel those still living.
- What is an interesting or unusual case that you have been involved in?
All cases are interesting and provide the opportunity to either learn something new or to confirm and help support something already known.
- When you first began your job as a medical examiner, what was one aspect of your job that you weren't expecting?
Most forensic pathologists have a fairly good grasp of what the work in a medical examiner’s office will entail prior to starting. During medical school, pathology residency training, and forensic pathology fellowship training, medical examiners in-training get ample exposure to the field.
- What are the most prominent challenges and benefits of your job?
Determining the cause and manner of death for loved ones’ family members can be simultaneously a prominent challenge and benefit of being a medical examiner.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy that you wish you could?
The popularity of forensically-themed television shows has given rise to the “CSI Effect.” The public perception of what forensic professionals do and the amount of time they are able to do it in is vastly different than the reality. While a medical examiner can determine many things from performing an autopsy, the autopsy alone will never reveal the motives behind individuals’ actions.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
Medical examiners are constantly in contact with their fellow medical examiners, physician colleagues, forensic toxicologists, law enforcement personnel, state attorneys, and other professionals who all provide valuable information that aids in determining the cause and manner of death. The type of case a medical examiner has determines which other professionals would need to be consulted in order to arrive at a cause and manner of death.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
Additional autopsies performed after an initial autopsy allow for a second opinion. The medical examiner performing a second autopsy, however, does not see the body as it was in its original state at the time of the first autopsy. Due to that very important difference, the interpretive scope of subsequent autopsies is significantly limited.
- What is the protocol for performing an autopsy on someone registered as an organ donor?
The organs of individuals registered as organ donors may still be donated, even if an autopsy required by law must be performed by a medical examiner. Generally, medical examiners make all attempts to accommodate organ donation. So long as organ donation does not limit the examination a medical examiner would need to conduct in order to confidently arrive at a cause and manner of death, organ donation may take place. In those instances, organs are usually procured prior to autopsy. Tissue donation (corneas, long bones, ligaments, skin, etc.) may occur prior to or after an autopsy is performed.
- What traits are most important in someone who wants to pursue this career?
Individuals who are intellectually competent, open to growth, committed to doing justice, compassionate, organized, and self-motivated will do well in the field of forensic pathology.
Joanna Glengarry
Auckland, NZ
- What education did you receive prior to becoming a forensic pathologist?
My medical degree (Bachelor of Medicine and Surgery from the University of Otago, MBChB), my specialist anatomical pathology Fellowship (Fellow of the Royal College of Pathologists of Australasia, FRCPA) and a post-Fellowship Diploma in Forensic Pathology (Dip. Forens. Path) also from the Royal College of Pathologists of Australasia
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
When I applied, the admission to medical school was purely based on the marks received in the examinations sat in the first year of University. I had a 91% average over eight papers and the lowest average grade was 86% to get into medical school. It has now changed to both grades and interviews.
- How long have you been a forensic pathologist, and did you always know that this was the career you wanted to pursue?
I have practiced full time in forensic pathology since December 2012. In high school, I had considered it as a career as I enjoyed the books written by Patricia Cornwell, but I was told that it required many many years of training to become one, so I decided it sounded way too hard! At medical school I really enjoyed pathology, winning the class prize in it, but I always thought I wanted to be a surgeon. I even applied to the surgical training programme as a resident and sat surgical exams. But I soon realised it wasn’t for me, and pathology took over. Forensic pathology is the best mix of surgery and pathology.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
Both testifying cause of death for murder victims and determining cause of death in criminal investigations. Civil cases are rare in New Zealand as suing is extraordinarily rare as we have legislation to prevent this (quite different from the USA I believe)
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
I don’t enjoy cases that involve children of school age. Deaths in that age group are so rare that it is always particularly upsetting. One boy came in still in his school uniform and that really stuck with me – how peaceful he looked and just like he was off to school. I tend to debrief with my colleagues – talking about it rather than keeping it in really helps.
- What is an interesting or unusual case that you have been involved in?
All the cases are interesting to me! But I am always fascinated by the cases due to animal attacks (great white shark, tiger). They are so unusual and the injury patterns are a marvellous insight into how these apex predators hunt.
- What is the protocol for performing an autopsy on a deceased person who is registered and eligible to be an organ donor?
An agency called Organ Donation New Zealand facilitates both live organ donation and post-mortem tissue donation. If the case will come for autopsy, they liaise with us about the appropriateness of donation, in terms of the potential to limit our ability to determine cause of death. We are generally happy to agree to donation where we can. If a person is listed on their Driver’s Licence as an organ donor, the family can over-rule the deceased’s wishes, which is a tragedy in my view.
- When you first began your job as a forensic pathologist, what was one aspect of your job that you weren't expecting?
How little my fellow doctors know about what I do, what my training is and the value of the autopsy.
- What are the most prominent challenges and benefits of your job?
The interaction of medicine and the law, that is such an integral part of the job is quite different from other medical specialities. The focus shifts and the issues one must address become much wider. I enjoy this, but it has required a bit of readjusting from a purely medical mode of approaching an issue. The benefits are, that in my view, this is the best job there is! I love it – it is a truly humbling job and it is a privilege to be able to get such intimate insights into how the human body works and how it fails. To know that sometimes I am the first person to know what the deceased died from and to know what they would have felt at the time of death, is a very special thing.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy or toxicology screening that you wish you could?
Sometimes people die who don’t have as much disease as they should to cause death, or who have no detectable disease at all. Many of these we now know have genetic abnormalities such as the cardiac channelopathies. But I am sometimes awed about how much there is still to be discovered, It’s exciting.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
Double check all my findings before I close the body. Take a wide panel of tests – really cast my net wide in terms of the differential diagnoses. Think outside the square for anything odd! As long as I know I have done all the investigations I can, I am OK with not finding a cause of death. I am the pathologist that works in our Cardiac Inherited Diseases Group, so I know full well that sometimes people die without any obvious structural abnormality at the autopsy.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
I have performed about half a dozen of these and yes, they are always challenging. All the ones I have performed have been bodies repatriated from overseas, often from less developed nations. I have noted that the autopsy practises in some countries is not as rigorous as those I am used to. In one case I found three lungs in the body as the organs hadn’t been returned to the correct body! It is often hard to find a cause of death, but there is usually still a lot of valuable information to be found if you really look hard. It also helps the family to know that their loved one had been properly investigated too.
- What traits are most important in someone who wants to pursue this career?
A questioning mind. A sense of humour. Ability to think rationally but to also deal with irrational thinking in others. A strong stomach! A desire to find the answer to a puzzle. Compassion.
- What has your experience been as a woman in your field?
Mixed responses. My colleagues don’t treat me any differently but sometimes dealing with the Police (still fairly male-dominated) and lawyers is hard. They have never been rude, but most assume I am a nurse not a doctor. I get told a lot “you don’t look like a forensic pathologist” – which I have taken to mean that because I am a woman in her 30’s and not a middle aged male, I must be something else! They are always respectful when the realise that I know what I’m talking about, but, the initial assumptions they make (i.e. I’m not a doctor or a specialist) can be irritating.
- Are you aware of any differences in the protocol or practices of forensic pathologists in New Zealand in comparison to the United States, and if so, what are they?
The medical examiner system and coroner systems in the USA are quite different form the coroner system in NZ. All our Coroners are lawyers whose area of expertise is death investigation only. There are no lay Coroners. We don’t have the same input into the death investigation as the ME offices do – there is little autonomy. The Coroner directs autopsies or not, often without consulting us. In terms of the actual autopsies, we’re all pretty similar. I think post-mortem CT scanning is used more here than in the USA but otherwise, the way we actually conduct the autopsy is the same.
My medical degree (Bachelor of Medicine and Surgery from the University of Otago, MBChB), my specialist anatomical pathology Fellowship (Fellow of the Royal College of Pathologists of Australasia, FRCPA) and a post-Fellowship Diploma in Forensic Pathology (Dip. Forens. Path) also from the Royal College of Pathologists of Australasia
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
When I applied, the admission to medical school was purely based on the marks received in the examinations sat in the first year of University. I had a 91% average over eight papers and the lowest average grade was 86% to get into medical school. It has now changed to both grades and interviews.
- How long have you been a forensic pathologist, and did you always know that this was the career you wanted to pursue?
I have practiced full time in forensic pathology since December 2012. In high school, I had considered it as a career as I enjoyed the books written by Patricia Cornwell, but I was told that it required many many years of training to become one, so I decided it sounded way too hard! At medical school I really enjoyed pathology, winning the class prize in it, but I always thought I wanted to be a surgeon. I even applied to the surgical training programme as a resident and sat surgical exams. But I soon realised it wasn’t for me, and pathology took over. Forensic pathology is the best mix of surgery and pathology.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
Both testifying cause of death for murder victims and determining cause of death in criminal investigations. Civil cases are rare in New Zealand as suing is extraordinarily rare as we have legislation to prevent this (quite different from the USA I believe)
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
I don’t enjoy cases that involve children of school age. Deaths in that age group are so rare that it is always particularly upsetting. One boy came in still in his school uniform and that really stuck with me – how peaceful he looked and just like he was off to school. I tend to debrief with my colleagues – talking about it rather than keeping it in really helps.
- What is an interesting or unusual case that you have been involved in?
All the cases are interesting to me! But I am always fascinated by the cases due to animal attacks (great white shark, tiger). They are so unusual and the injury patterns are a marvellous insight into how these apex predators hunt.
- What is the protocol for performing an autopsy on a deceased person who is registered and eligible to be an organ donor?
An agency called Organ Donation New Zealand facilitates both live organ donation and post-mortem tissue donation. If the case will come for autopsy, they liaise with us about the appropriateness of donation, in terms of the potential to limit our ability to determine cause of death. We are generally happy to agree to donation where we can. If a person is listed on their Driver’s Licence as an organ donor, the family can over-rule the deceased’s wishes, which is a tragedy in my view.
- When you first began your job as a forensic pathologist, what was one aspect of your job that you weren't expecting?
How little my fellow doctors know about what I do, what my training is and the value of the autopsy.
- What are the most prominent challenges and benefits of your job?
The interaction of medicine and the law, that is such an integral part of the job is quite different from other medical specialities. The focus shifts and the issues one must address become much wider. I enjoy this, but it has required a bit of readjusting from a purely medical mode of approaching an issue. The benefits are, that in my view, this is the best job there is! I love it – it is a truly humbling job and it is a privilege to be able to get such intimate insights into how the human body works and how it fails. To know that sometimes I am the first person to know what the deceased died from and to know what they would have felt at the time of death, is a very special thing.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy or toxicology screening that you wish you could?
Sometimes people die who don’t have as much disease as they should to cause death, or who have no detectable disease at all. Many of these we now know have genetic abnormalities such as the cardiac channelopathies. But I am sometimes awed about how much there is still to be discovered, It’s exciting.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
Double check all my findings before I close the body. Take a wide panel of tests – really cast my net wide in terms of the differential diagnoses. Think outside the square for anything odd! As long as I know I have done all the investigations I can, I am OK with not finding a cause of death. I am the pathologist that works in our Cardiac Inherited Diseases Group, so I know full well that sometimes people die without any obvious structural abnormality at the autopsy.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
I have performed about half a dozen of these and yes, they are always challenging. All the ones I have performed have been bodies repatriated from overseas, often from less developed nations. I have noted that the autopsy practises in some countries is not as rigorous as those I am used to. In one case I found three lungs in the body as the organs hadn’t been returned to the correct body! It is often hard to find a cause of death, but there is usually still a lot of valuable information to be found if you really look hard. It also helps the family to know that their loved one had been properly investigated too.
- What traits are most important in someone who wants to pursue this career?
A questioning mind. A sense of humour. Ability to think rationally but to also deal with irrational thinking in others. A strong stomach! A desire to find the answer to a puzzle. Compassion.
- What has your experience been as a woman in your field?
Mixed responses. My colleagues don’t treat me any differently but sometimes dealing with the Police (still fairly male-dominated) and lawyers is hard. They have never been rude, but most assume I am a nurse not a doctor. I get told a lot “you don’t look like a forensic pathologist” – which I have taken to mean that because I am a woman in her 30’s and not a middle aged male, I must be something else! They are always respectful when the realise that I know what I’m talking about, but, the initial assumptions they make (i.e. I’m not a doctor or a specialist) can be irritating.
- Are you aware of any differences in the protocol or practices of forensic pathologists in New Zealand in comparison to the United States, and if so, what are they?
The medical examiner system and coroner systems in the USA are quite different form the coroner system in NZ. All our Coroners are lawyers whose area of expertise is death investigation only. There are no lay Coroners. We don’t have the same input into the death investigation as the ME offices do – there is little autonomy. The Coroner directs autopsies or not, often without consulting us. In terms of the actual autopsies, we’re all pretty similar. I think post-mortem CT scanning is used more here than in the USA but otherwise, the way we actually conduct the autopsy is the same.
Constance DiAngelo
Washington, DC
- What education did you receive prior to becoming a medical examiner?
I have a B.S. in Biology, M.S. in Biology, and M.D.. After medical school, I then completed a 5 year Anatomic and Clinical Pathology residency, a one year hospital autopsy fellowship, and 1 year Forensic Pathology fellowship.
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
I did not enter medical school right out of college. I obtained a Master’s degree and I worked for the Environmental Protection Agency and as a research assistant associated with a medical school. As an older applicant, I was able to stress in my interviews that I really wanted to attend medical school and was giving up a career in research to attend medical school.
- How long have you been a medical examiner, and did you always know that this was the career you wanted to pursue?
I have been a medical examiner for 18 years. I knew that I wanted to be a forensic pathologist since I was 11 years old. I became interested by reading biographies of forensic pathologist in England and the US. When doing rotations in the third and fourth years of medical school, I knew that forensic pathology was the right field for me. I couldn’t understand how the other students would decide what field of medicine to go into after just 1 month exposure to different areas in medicine (surgery, pediatrics, ER medicine, etc.). I was also able to do two 1 month rotations in different medical examiner offices and those rotations confirmed my choice as I didn’t even mind decomposed bodies.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
As a medical examiner, for deaths that are reported to the office, one of the first duties is to determine if the death falls under ME jurisdiction. The criteria are determined by lawmakers and put into code or regulations. If the death is under ME jurisdiction, the next step is to determine the type of examination needed. This can range from reviewing medical records (if the body is already buried) to a complete autopsy. After the examination, a death certificate is issued which states cause and manner of death. As part of the job we speak to interested parties such as legal next of kin and any parties the next of kin authorizes us to speak to, prosecutors, defense attorneys, etc. We testify in civil and criminal cases and are subpoenaed to testify.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
All of the deaths are tragic and to me the infant and child deaths can be hard to deal with. You have to try not to personalize any case but rather channel your energy into determining what factors may have contributed to the death and then educate the parents and public so that these deaths will be less likely to occur.
- What is an interesting or unusual case that you have been involved in?
Each case has something unexpected; no two examinations are exactly alike. I have been involved in thousands of cases and a few have been published such as the anthrax cases in the early 2000s and a malaria case in a toddler. The unexpected findings are what make the job interesting and challenging even after 18 years. Some cases are once in a life time such as someone killed by a snake so if a case is one I have not dealt with before, I will ask to do the examination. I think of it as my ME ‘bucket list’.
- When you first began your job as a medical examiner, what was one aspect of your job that you weren't expecting?
There are political pressures that a chief medical examiner faces daily whether it is trying to get or maintain proper funding for the office to dealing with finishing a case on a ‘high profile’ decedent. With the latter example, if you performed the examination, you may have to finish the case before another case that was done before the high profile case so that the less vocal family will have to wait awhile longer for results.
- What are the most prominent challenges and benefits of your job?
The challenges are to determine the cause of death which encompasses the scene investigation, autopsy, toxicology, histology (looking at tissue samples under the microscope), ancillary tests (such as determining glucose level or if there are bacteria in the blood), speaking to family, friends, etc. and then putting all of the information together. The benefits can be that you identify a pathologic entity that may affect other family members and you can alert them to this so that they can follow-up with a doctor.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy that you wish you could?
We don’t do genetic testing or map the DNA of decedents. We don’t have magical machines that we inject a blood sample into and it tells us all the drugs or toxins in the body. If a sample has any hemolysis (break down of red blood cells), the laboratory that we use to test for insulin will reject the sample so we can’t prove an insulin overdose. Some special anesthetic agents or potassium chloride or helium as cause of death could be missed due to lack of ways to test for them, or they are found in the body, or they are metabolized very quickly.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
If there isn’t an obvious cause of death at the end of the examination, the cause and manner of death will be ‘pending’. Samples will be sent for toxicology, histology and other ancillary tests as needed.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
I have not performed a second autopsy. I know that I retain pieces of organs and tissues such as heart and brain and include areas that look normal and abnormal. If an autopsy is performed it will include opening the head and removing and examining the brain and also taking the tongue, neck organs, chest organs and structures and abdominal/pelvic organs and structures. Tissues of the back and extremities might also be examined.
- What is the protocol for performing an autopsy on someone registered as an organ donor?
Different jurisdictions have different rules for the organ procurement organization (OPO). Where I have worked, if the case falls under ME jurisdiction, the medical examiner will discuss the case with the OPO and the ME will try to grant the procurement of organs so long as any evidence or future prosecution is not jeopardized.
- What traits are most important in someone who wants to pursue this career?
An open mind and curiosity; again, each case is different and may not be as it was initially presented to you.
I have a B.S. in Biology, M.S. in Biology, and M.D.. After medical school, I then completed a 5 year Anatomic and Clinical Pathology residency, a one year hospital autopsy fellowship, and 1 year Forensic Pathology fellowship.
- What was one thing you did or participated in that set you apart and gave you an advantage when you applied to medical school?
I did not enter medical school right out of college. I obtained a Master’s degree and I worked for the Environmental Protection Agency and as a research assistant associated with a medical school. As an older applicant, I was able to stress in my interviews that I really wanted to attend medical school and was giving up a career in research to attend medical school.
- How long have you been a medical examiner, and did you always know that this was the career you wanted to pursue?
I have been a medical examiner for 18 years. I knew that I wanted to be a forensic pathologist since I was 11 years old. I became interested by reading biographies of forensic pathologist in England and the US. When doing rotations in the third and fourth years of medical school, I knew that forensic pathology was the right field for me. I couldn’t understand how the other students would decide what field of medicine to go into after just 1 month exposure to different areas in medicine (surgery, pediatrics, ER medicine, etc.). I was also able to do two 1 month rotations in different medical examiner offices and those rotations confirmed my choice as I didn’t even mind decomposed bodies.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
As a medical examiner, for deaths that are reported to the office, one of the first duties is to determine if the death falls under ME jurisdiction. The criteria are determined by lawmakers and put into code or regulations. If the death is under ME jurisdiction, the next step is to determine the type of examination needed. This can range from reviewing medical records (if the body is already buried) to a complete autopsy. After the examination, a death certificate is issued which states cause and manner of death. As part of the job we speak to interested parties such as legal next of kin and any parties the next of kin authorizes us to speak to, prosecutors, defense attorneys, etc. We testify in civil and criminal cases and are subpoenaed to testify.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
All of the deaths are tragic and to me the infant and child deaths can be hard to deal with. You have to try not to personalize any case but rather channel your energy into determining what factors may have contributed to the death and then educate the parents and public so that these deaths will be less likely to occur.
- What is an interesting or unusual case that you have been involved in?
Each case has something unexpected; no two examinations are exactly alike. I have been involved in thousands of cases and a few have been published such as the anthrax cases in the early 2000s and a malaria case in a toddler. The unexpected findings are what make the job interesting and challenging even after 18 years. Some cases are once in a life time such as someone killed by a snake so if a case is one I have not dealt with before, I will ask to do the examination. I think of it as my ME ‘bucket list’.
- When you first began your job as a medical examiner, what was one aspect of your job that you weren't expecting?
There are political pressures that a chief medical examiner faces daily whether it is trying to get or maintain proper funding for the office to dealing with finishing a case on a ‘high profile’ decedent. With the latter example, if you performed the examination, you may have to finish the case before another case that was done before the high profile case so that the less vocal family will have to wait awhile longer for results.
- What are the most prominent challenges and benefits of your job?
The challenges are to determine the cause of death which encompasses the scene investigation, autopsy, toxicology, histology (looking at tissue samples under the microscope), ancillary tests (such as determining glucose level or if there are bacteria in the blood), speaking to family, friends, etc. and then putting all of the information together. The benefits can be that you identify a pathologic entity that may affect other family members and you can alert them to this so that they can follow-up with a doctor.
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy that you wish you could?
We don’t do genetic testing or map the DNA of decedents. We don’t have magical machines that we inject a blood sample into and it tells us all the drugs or toxins in the body. If a sample has any hemolysis (break down of red blood cells), the laboratory that we use to test for insulin will reject the sample so we can’t prove an insulin overdose. Some special anesthetic agents or potassium chloride or helium as cause of death could be missed due to lack of ways to test for them, or they are found in the body, or they are metabolized very quickly.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
If there isn’t an obvious cause of death at the end of the examination, the cause and manner of death will be ‘pending’. Samples will be sent for toxicology, histology and other ancillary tests as needed.
- Second autopsies seem more difficult and much more limited than the original autopsy. Have you ever performed one and, if so, how often do you find something important during a second autopsy?
I have not performed a second autopsy. I know that I retain pieces of organs and tissues such as heart and brain and include areas that look normal and abnormal. If an autopsy is performed it will include opening the head and removing and examining the brain and also taking the tongue, neck organs, chest organs and structures and abdominal/pelvic organs and structures. Tissues of the back and extremities might also be examined.
- What is the protocol for performing an autopsy on someone registered as an organ donor?
Different jurisdictions have different rules for the organ procurement organization (OPO). Where I have worked, if the case falls under ME jurisdiction, the medical examiner will discuss the case with the OPO and the ME will try to grant the procurement of organs so long as any evidence or future prosecution is not jeopardized.
- What traits are most important in someone who wants to pursue this career?
An open mind and curiosity; again, each case is different and may not be as it was initially presented to you.
Kimberly DiLeo
Portland, OR
- What education did you receive prior to becoming an investigator?
I attended Louisiana State University and graduated with a Bachelor of Arts degree in Anthropology with a Minor in Sociology
- How long have you been an investigator, and did you always know that this was the career you wanted to pursue?
I have been an investigator for 13 years. Upon taking my first Anthropology course as an elective in college, I was immediately drawn to forensic science. I switched my major and continued on to graduate with an Anthropology degree. While in school, I was not sure which avenue I would pursue in Forensic Science. I was extremely interested in pathology but reluctant to go to medical school. Upon graduation, I began researching the medical examiner field and searching for job openings, while obtaining employment that would build my resume. I obtained two lab jobs, which along with my degree helped me to obtain a position in death investigation.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
The investigator is tasked with determining the manner of death on scene and through investigation. Manner of death includes Natural, Accident, Suicide, Homicide and undetermined. The pathologist is tasked with the cause of death. Examples: Myocardial infarction, blunt force injuries to the head, gunshot wound of head or undetermined homicidal violence. Investigators are called to testify in court on a wide variety of cases. We often give dispositions to attorneys as well. Testimony includes aspects of the scene investigation, our report content, body positioning and questions on the scene photography.
- What is your jurisdiction, and how do cases get assigned to you?
Oregon is a State Medical Examiner system. There are 36 counties in Oregon and all report to the State ME. I am the Chief for Multnomah County, which is physically located in the State ME building. The jurisdictions are designed by county. Other states have county coroner systems and some have state systems that cover the entire state without the county separation. For example. New Mexico is a State Medical Investigator system whereas Louisiana has coroners in each county.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
Of course there are cases that are sad and very unfortunate. I have a great deal of empathy for the families and for their loss; however my job entails that I conduct a very thorough investigation to help the families understand why their loved one died. In this field, we approach investigations from a medical and investigatory mindset rather than an emotional one. There have been cases where after I left the scene, I cried on the way back to the office. We are human and seeing people grieving the loss of a loved one can at times be emotional. It helps to discuss the case with coworkers, who understand the intricacies of death investigations.
- What is an interesting or unusual case that you have been involved in?
Please watch the Dateline episode for the West Mesa Serial Killer, in Albuquerque, New Mexico. I was at the Medical Investigator’s Office in Albuquerque for 10 years and in 2009 we located 11 graves in the desert. I believe it was Dateline, but if you google West Mesa Serial Killer, you will find significant information on this case.
I was also involved in another Dateline case, where a man was buried under the concrete slab of his home for 9 years. If you watch that one, I am in a bunny suit in the hole where the body was recovered.
- What is the protocol for performing an autopsy on a deceased person who is registered and eligible to be an organ donor?
The pathologist has the final determination as to if an autopsy will be performed. If it is a homicide with multiple injuries, the pathologist will most likely only let recovery take place after autopsy. Recovery after autopsy includes donation of long bone, skin. In a case where someone is on life support in the hospital and the injury is well documented, the pathologist will most likely let organ donation take place prior to the autopsy.
- When you first began your job as an investigator, what was one aspect of your job that you weren't expecting?
Paperwork and the amount of medical records that I would be reviewing. As an investigator, we are tasked with finding and reviewing all pertinent medical records to get a good idea of someone’s medical and mental health history to assist with manner of death.
- What are the most prominent challenges and benefits of your job?
One challenge would be locating next of kin on families that are estranged. It involves extensive use of background checks through accurint and ancestry, as well as a ton of phone calls across the country to locate possible family members. Most people have cell phones, and there is not a cell phone directory. Often times, we have to call law enforcement in another state to drive to a possible address to locate family. The benefits are that I am thanked daily by the families that I serve. They are so appreciative to have a kind and knowledgeable person help them to understand why their loved one died, and to help with the process of what to do next (how to obtain reports, death certificates, etc).
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy or toxicology screening that you wish you could?
Cardiac arrhythmias are not found at autopsy. Some cases do not have any findings. For example, SIDS is simply and exclusion of everything else. DNA takes months, rather than the 2 hours on TV.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
As an investigator, I would gather more detailed information from the family and attempt to locate any medical records that may assist with the autopsy or circumstances of the death.
- What traits are most important in someone who wants to pursue this career?
Investigative mind, strong background in medical terminology\anatomy, patience and a sincere want to help people.
- What has your experience been as a woman in your field?
My experience is that the women can work circles around the men. I find that the women seem better equipped at multi-tasking and work at a faster pace.
I attended Louisiana State University and graduated with a Bachelor of Arts degree in Anthropology with a Minor in Sociology
- How long have you been an investigator, and did you always know that this was the career you wanted to pursue?
I have been an investigator for 13 years. Upon taking my first Anthropology course as an elective in college, I was immediately drawn to forensic science. I switched my major and continued on to graduate with an Anthropology degree. While in school, I was not sure which avenue I would pursue in Forensic Science. I was extremely interested in pathology but reluctant to go to medical school. Upon graduation, I began researching the medical examiner field and searching for job openings, while obtaining employment that would build my resume. I obtained two lab jobs, which along with my degree helped me to obtain a position in death investigation.
- What is your involvement in the legal aspect of your job, such as testifying cause of death for murder victims, determining cause of death in criminal investigations, etc.
The investigator is tasked with determining the manner of death on scene and through investigation. Manner of death includes Natural, Accident, Suicide, Homicide and undetermined. The pathologist is tasked with the cause of death. Examples: Myocardial infarction, blunt force injuries to the head, gunshot wound of head or undetermined homicidal violence. Investigators are called to testify in court on a wide variety of cases. We often give dispositions to attorneys as well. Testimony includes aspects of the scene investigation, our report content, body positioning and questions on the scene photography.
- What is your jurisdiction, and how do cases get assigned to you?
Oregon is a State Medical Examiner system. There are 36 counties in Oregon and all report to the State ME. I am the Chief for Multnomah County, which is physically located in the State ME building. The jurisdictions are designed by county. Other states have county coroner systems and some have state systems that cover the entire state without the county separation. For example. New Mexico is a State Medical Investigator system whereas Louisiana has coroners in each county.
- Have you had cases that had an emotional impact on you, such as a young person or an especially tragic death, and how did you personally deal with that?
Of course there are cases that are sad and very unfortunate. I have a great deal of empathy for the families and for their loss; however my job entails that I conduct a very thorough investigation to help the families understand why their loved one died. In this field, we approach investigations from a medical and investigatory mindset rather than an emotional one. There have been cases where after I left the scene, I cried on the way back to the office. We are human and seeing people grieving the loss of a loved one can at times be emotional. It helps to discuss the case with coworkers, who understand the intricacies of death investigations.
- What is an interesting or unusual case that you have been involved in?
Please watch the Dateline episode for the West Mesa Serial Killer, in Albuquerque, New Mexico. I was at the Medical Investigator’s Office in Albuquerque for 10 years and in 2009 we located 11 graves in the desert. I believe it was Dateline, but if you google West Mesa Serial Killer, you will find significant information on this case.
I was also involved in another Dateline case, where a man was buried under the concrete slab of his home for 9 years. If you watch that one, I am in a bunny suit in the hole where the body was recovered.
- What is the protocol for performing an autopsy on a deceased person who is registered and eligible to be an organ donor?
The pathologist has the final determination as to if an autopsy will be performed. If it is a homicide with multiple injuries, the pathologist will most likely only let recovery take place after autopsy. Recovery after autopsy includes donation of long bone, skin. In a case where someone is on life support in the hospital and the injury is well documented, the pathologist will most likely let organ donation take place prior to the autopsy.
- When you first began your job as an investigator, what was one aspect of your job that you weren't expecting?
Paperwork and the amount of medical records that I would be reviewing. As an investigator, we are tasked with finding and reviewing all pertinent medical records to get a good idea of someone’s medical and mental health history to assist with manner of death.
- What are the most prominent challenges and benefits of your job?
One challenge would be locating next of kin on families that are estranged. It involves extensive use of background checks through accurint and ancestry, as well as a ton of phone calls across the country to locate possible family members. Most people have cell phones, and there is not a cell phone directory. Often times, we have to call law enforcement in another state to drive to a possible address to locate family. The benefits are that I am thanked daily by the families that I serve. They are so appreciative to have a kind and knowledgeable person help them to understand why their loved one died, and to help with the process of what to do next (how to obtain reports, death certificates, etc).
- What are some of the technological or scientific limitations of your job; what can't you find or determine from an autopsy or toxicology screening that you wish you could?
Cardiac arrhythmias are not found at autopsy. Some cases do not have any findings. For example, SIDS is simply and exclusion of everything else. DNA takes months, rather than the 2 hours on TV.
- What steps do you take if a case stumps you and you cannot initially determine cause of death?
As an investigator, I would gather more detailed information from the family and attempt to locate any medical records that may assist with the autopsy or circumstances of the death.
- What traits are most important in someone who wants to pursue this career?
Investigative mind, strong background in medical terminology\anatomy, patience and a sincere want to help people.
- What has your experience been as a woman in your field?
My experience is that the women can work circles around the men. I find that the women seem better equipped at multi-tasking and work at a faster pace.
Reflection
All of the medical examiners interviewed seem to have a respect for the profession. They enjoy helping people and using their medical expertise to determine cause of death and bring justice to grieving families. An underlying similarity among all of the medical examiners was an annoyance with the misrepresentation of their occupation in the media. In crime dramas, the medical examiner is able to run extensive toxicology tests in minutes, rather than the weeks it takes in reality. By learning this truth, I have gained even more respect for the important work that these professionals do. The traits valued in a successful medical examiner seem to be curiosity, open-mindedness, compassionate, open to growth, and strong thinkers.