Forensic Fridays: All About Autopsies

February 22, 2013July 21, 2016 / Jordyn Redwood / Leave a comment

Most living people never visit the morgue.

Most never speak of the morgue, except during shows like CSI, Bones, or Hawaii 5-0. The popularity of forensic TV series, however, is social proof that there’s hidden interest in finding out just what goes on behind the autopsy suite’s closed door.

The word autopsymeans ‘to examine for yourself’. It’s a medical procedure that sounds simple in principle – taking a look at the outside and inside of a cadaver to establish cause of death. In practice, a post mortem (PM) examination can be highly complicated and time consuming; employing leading-edge scientific expertise.

There are three types of PM’s. A hospital autopsy is a non-legal process where the cause of death is known, but the caring physician wants to confirm a specific issue – such as a cancer tumor. A routine autopsy is conducted when the cause of death is not known, but foul play is not suspected. Then there’s a forensic autopsy – the one that’s going to be torn apart in a murder trial.

All autopsies follow a standard protocol. It’s the nature of the investigation that determines just how in-depth the procedure gets. The deceased arrives at the morgue and is catalogued with personal details and a registration number. Yes, they really do use toe-tags. The body is then placed in a refrigeration unit and waits its turn for examination. In a busy morgue this can take several days.

Usually two people conduct the autopsy. The pathologist, or medical doctor who is trained in the study of death and disease, is assisted by the deiner (German word for helper). Often there’s observers present; police officers, students, or technicians who come and go. The length of time varies – fifteen minutes to confirm a tumor, two hours routinely, and up to eight for a complicated forensic ordeal.

External observation can take a good portion. The body is removed from its shipping shroud, stripped, photographed, X-Rayed, weighed, measured, and identifiers such as race, age, hair and eye color, markings, abnormalities, as well as evidence of trauma or medical intervention is recorded. In homicide cases, the bulk of the evidence can be recovered in the external exam – clothing perforations, gunshot residue, lacerations, abrasions, hair, fiber, DNA, chemical contamination, or foreign objects. The observations are recorded on notes, diagrams, photos, and verbal dictations.

The corpse is placed supine, on its back, on the examining table which is an angled stainless steel tray draining fluids to a disposal sink. A plastic block is placed under the back to elevate the chest and recline the head and arms, making internal operations practical. A Y-incision is sliced from the tip of each shoulder, horizontally to the center of the chest, then vertically down to the pubic area. The skin is scalpeled back in a butterfly pattern accessing the thorax and abdomen, then the ribcage is removed exposing the upper and lower organs.

The major ones are removed, weighed, and cross-sectioned – lungs, heart, liver, kidneys, spleen, stomach, and intestines. Tissue sections are exscinded and fluids are extracted – blood, urine, vitreous humor, and digestive contents. These can be of immediate visual interest, or may tell later tales in toxicology and microscopic processing.

Cranial examination is the part that most newbies find difficult. The neck is now propped to elevate the head and the scalp is cut from ear to ear, peeled over the face and down the neck, then the skull cap is severed with a vibrating saw. The brain extracts easily and is often preserved in formalin to gel for later sectioning.

Completion involves returning the organs to the central cavity and sewing the incisions before releasing the body to a funeral home. Tissue and liquids are retained for histology and toxicology. In forensic cases, exhibits such as bullets, trace evidence, DNA standards, and clothing are transferred to the crime lab.

Often the cause of death is conclusive at autopsy. Occasionally nothing is known until the lab results come in. And sometimes… it’s never determined just why the subject died.

Our scientific understanding of life and death is extensive, but it’s far from perfect.

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Garry Rodgers has lived the life that he writes about. Now retired as a Royal Canadian Mounted Police homicide detective and forensic coroner, Garry also served as a sniper with British SAS–trained Emergency Response Teams and is a recognized expert-witness in firearms. A believer in ‘What Goes Around, Comes Around’ Garry provides free services in helping writers throughhis crime and forensic expertise. Garry’s new supernatural thriller No Witnesses To Nothing is based on a true crime story where many believe that paranormal intervention occurred. An Amazon Top 10 Bestseller, it’s available on Kindle and print on demand. You can connect with Garry via his Website: www.dyingwords.net

Do Do I Need a Coroner, Medical Examiner or Pathologist?

February 15, 2013July 21, 2016 / Jordyn Redwood / Leave a comment

I’m so excited to have Garry Rodgers join my honored team of medical experts. To be honest, I’ve been looking for someone on the “other side of life” to offer their insights because I do see a fair number of forensic questions and this is not my area of expertise. I try to keep the living from crossing over.

Garry will be here on a regular basis doing Forensic Fridays and I’m so glad to have him. I hope you’ll check out his novel, No Witnesses to Nothing.

Welcome, Garry!

Hi. I’m Garry Rodgers and I’m delighted to be a guest on Redwood’s Medical Edge.

For over three decades I’ve been involved in the death business. I’ve been a Royal Canadian Mounted Police homicide detective, served as a sniper on Emergency Response Teams, and finished up my forensic career as a Coroner. So I’ve seen my fair share of bodies.

Everyone knows what a homicide cop does, and most would rather not be in the sights of a sniper, but there’s a lot of misunderstanding about the role of a Coroner as opposed to a Medical Examiner (ME) and to a pathologist. A bit of a history here.

All civilized jurisdictions have a judge of the dead whose duty is to find fact. Not fault. The facts to be determined are the Who, When, Where, How, and By What Means that the deceased expired. Once these facts are determined, the death must be classified into one of five categories; Natural, Accidental, Suicide, Homicide, or Undetermined. This method of fact-finding and classification is universal, whereas the structure of appointing the judge is not.

The office of the coroner dates back to 10^th century England when the Crowner of the King (hence the word coroner) investigated any number of matters, including sudden and unexplained human deaths. This evolved into an inquisitional role where the coroner would conduct simple inquiries, or in cases of public interest, would hold inquests and compel witnesses to testify. Coroner appointments generally went to upstanding citizens of the community, not necessarily to those of a medical, legal, or investigative background.

As science progressed, it became prudent to retain the expertise of medical professionals, particularly in the clinical areas of autopsy and toxicology. This coincided with the massing of population in urban areas. Out of practicality and economics, the cities would employ full time medical doctors as examiners who’d delegate field investigations to lesser qualified persons. The rural areas, having a lower caseload, adopted the reverse where they’d contract out the specialties.

A pathologist, on the other hand, is a medical examiner who’s been specifically trained in the study of death and disease. The term pathologist dates back to ancient Greece; pathos meaning suffering, and logos meaning writing. Taking it a step further, a forensic pathologist signifies a specially-trained medical doctor who’s qualified to testify in court.

I can’t say the Coroner system is any better or worse than the Medical Examiner system. The professionals may have inverse roles, but all are exceptionally well trained. Both speak to the deceased’s interests and that’s what’s important. Death investigations have become more complex as science advances and, regardless of the administrative issues, having the right people doing the right jobs is key to determining the proper cause and classification of death.

Just a note on the personal qualities required to investigate deaths. First you need an inquisitive mind. Often things aren’t what they seem on the surface, and it’s through attention to detail that the facts rise. Second – empathy. You deal with those in the world which the deceased suddenly left; families, friends, co-workers, and to them it’s not just another case. Last, you need a strong constitution. Some of the death scenes can be exceptionally unpleasant.

In an upcoming sequence of posts, I’ll take you deeper into the world of a coroner. We’ll follow a true case which I investigated that employed the spectrum of forensic techniques. I was able to correctly classify the death, but I’ll assure you… it wasn’t what it seemed on the surface.

So stick around. I promise to be interesting!

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