The work of a medical examiner (ME) is endlessly fascinating to the public, as evidenced by the many TV shows that feature forensic pathologists - like Quincy; Law and Order; CSI; NCIS; Rizzoli and Isles; Hawaii-Five-O and others. In fiction, pathologists often resolve their cases quickly - making lightning fast determinations, intuiting what happened, and (often) nabbing the culprit themselves.
This is very different from real life, where toxicology and DNA tests take months to process, coroners' findings are relayed to police detectives, and the cops (hopefully) nab the perp. Moreover, in reality, most deaths are due to natural causes, disease, accidents, undetected anatomical defects, mental illness, and so on - and no crimes are involved.
In this enlightening and entertaining book, Dr. Judy Melinek describes her two years as a forensic pathology fellow at the 'Office of the Chief Medical Examiner' (OCME) in New York, where she honed her chops as an ME.
Dr. Judy Melinek
The ME's job is to determine the cause and manner of death in cases where the deceased dies suddenly, violently, unexpectedly, in suspicious circumstances, etc.
When Melinek graduated from UCLA Medical School in 1996, she wanted to be a surgeon. The surgical residency was grueling, however, and Melinek feared making a mistake that would kill a patient. Thus, Melinek switched her specialty to forensic pathology. Melinek's interest in the field may have stemmed, in part, from the suicide of her father at age 38, when she was 13 years old - an event she discusses extensively in the book.
Melinek, her husband J.T. Mitchell (the co-author of this book), and their baby Daniel settled down in New York in 2001.
Dr. Judy Melinek and her husband J.T. Mitchell
There, Melinek began work at the OCME under the tutelage of Dr. Charles Hirsch - whom she describes as "a pipe-smoking, avuncular doctor out of a Norman Rockwell painting."
Dr. Charles Hirsch
Among other things, Hirsch held morning rounds and afternoon rounds, at which the medical examiners presented their findings and discussed what to write on death certificates about the cause and manner of death. These determinations were made using a variety of means, such as: the autopsy; visiting the death scene; reviewing medical records; speaking to witnesses; consulting detectives; and so on.....all while collecting evidence that might be used in court.
When assigned a body to autopsy, the first thing an ME does is examine the person's external characteristics, and make a record of bruises, cuts, scrapes, scars, tattoos, burns, needle marks, and so on. The ME then goes on to probe the inside of the body, and these procedures are thoroughly described in the book.
Medical examiner noting a body's external characteristics
During her two years at the OCME Melinek worked on a wide variety of cases, including victims of the World Trade Center disaster; people who contracted anthrax from a bioterrorism scare; and bodies from American Airlines Flight 587 - which crashed in NYC. To provide a feel for Melinek's job, I'll give examples of some of the cases she worked on or observed.
Cable Guy
A man dubbed 'Cable Guy' smoked crystal meth before walking his dogs, and accidentally locked himself out of his 9th floor apartment. Instead of calling a locksmith, Cable Guy tied his dogs to the doorknob, went up to the roof, tied a cable around his chest, and tried to rappel down to his open window one floor down. The cable broke and the man fell to his death. Melinek's autopsy showed a fractured skull and shattered ribs that cut through the victim's lungs, esophagus, aorta, and pulmonary artery. The death was ruled accidental. The dogs were fine.
Grisly Industrial Accident
An egg roll factory has a combination shredder-mixer that fills a whole room. The shredder in a Manhattan plant blew apart while spinning, and sent the central drum and blade flying. The blade amputated the arm of one worker, and shrapnel injured two other employees. The metal cylinder landed on the upper chest and neck of a fourth worker, who was pinned to the floor and crushed. Melinek found that the man's head was uninjured and he was fully conscious until he died of suffocation. The unfortunate victim's death was ruled accidental.
Alcoholism
Melinek performed scores of autopsies on people who died of acute or chronic alcohol intoxication. Melinek's last autopsy in New York was on a victim who died of acute AND chronic alcohol poisoning. A man's dead body was found on the steps of a church in winter. After getting the results of toxicological tests, Melinek determined that the deceased - a chronic alcoholic who had lived on the streets for 30 years - was fall down drunk when he fell asleep and died of hypothermia. The death was ruled an accident.
Drug Overdose
Deaths from a drug overdose are fairly common, the typical victim being young and otherwise healthy. To fill out the death certificate, Melinek would usually just wait for the toxicology report and write in the cause of death. Drug overdose autopsies were usually quick and easy.....unless the family of the victim couldn't accept the truth.
Robert Ward was a 28-year-old white man with a history of alcoholism and drug abuse. One day Robert went out with friends, and was later found dead in his apartment. His mom, Mrs. Ward, didn't want her son autopsied: "Don't touch my baby." An autopsy was required by law, however, and the toxicology report took four months to reach Melinek's office.
During that time Mrs. Ward called Melinek at least twice a week, insisting 'Bobby didn't do drugs', and offering other theories for his death. These included: bad sushi, poisonous beer, misuse of a friend's asthma medication, anthrax, NyQuil, and dust mites.
When the toxicology report was finally completed, it showed a lethal concoction of heroin, cocaine, and the sedative diazepam.....and Melinek ruled Ward's death an accident. However Mrs. Ward couldn't let it go, and now insisted that Bobby's death was a homicide, the fault of the dealer who sold him the drugs.
The Bucket Bugaboo
A police officer brought the OCME a goop-filled bucket that looked like it might contain a dead fetus. An ME carefully emptied the pail, which contained a statuette of kissing angels, maraschino cherries, and a couple of two-foot-long donkey dongs. No fetus. The consensus was that this was probably a Santeria love potion.....not a case for the OCME. (LOL)
Suicides
Melinek saw many suicides. These cases were fairly easy to diagnose, especially when they required premeditation and planning - like suicide by hanging, which causes ligature marks on the neck and purple hands and feet. Other suicides during Melinek's tenure at the OCME included people who jumped into the East River, and victims who leapt from the balcony of the Marriott Marquis Hotel in Times Square. The hotel jumpers might have expected a smooth fall to the ground, but they generally pinballed and bumped into structures, severing their limbs and scattering their brains all over.
Sometimes apparent 'suicides' were actually homicides or accidents, and the ME's final determination depended on investigation of the death scene; information provided by families and police detectives; a suicide note; and so on.
Attack on the World Trade Center
On September 11, 2001 - nine weeks after Melinek started work at the OCME - two planes collided with the World Trade Center, causing thousands of deaths. The bodies of the victims came to the OCME, and Melinek was one of 30 doctors who worked to identify the remains and assemble evidence of mass murder. Many of the victims had been smashed to bits, and the MEs had to treat each specimen - be it a hand, a toe, a scrap of tissue, etc. - as if it were an entire body.....the goal being to identify the deceased.
The bodies and body parts arrived by the truckload, and after DNA was collected, each 'specimen' was assigned to an ME. Melinek's first 'body' was a smashed head and torso - limbs gone, body missing below the naval - which was burned black and smelled of jet fuel. The MEs' sole task was identification, so each doctor tried to use fingerprints, distinguishing marks, personal possessions - whatever they could find - to ID the victims. This was a daunting task that took eight months, during which 'ordinary' autopsies also had to be done. Needless to say, Melinek and her colleagues were overwhelmed.
Anthrax Scare
The World Trade Center situation was exacerbated by the anthrax scare, which began a week after 9/11. Someone started sending letters containing anthrax germs to news agencies in New York and Florida, and to politicians in Washington DC. Several people died, and the OCME began to get myriad phone calls from frightened citizens. Moreover, the OCME's technicians were too scared to assist with autopsies, so Melinek and the other MEs had to work alone (or assist each other).
Plane Crash
As if 9/11 and the anthrax scare weren't bad enough, New York experienced a major plane wreck in November, 2001. American Airlines Flight 587 crashed soon after taking off from JFK International Airport, killing all 261 souls aboard, as well as five people on the ground. Again the victims' remains were taken to the OCME, where the mauled, twisted, charred, kerosene-contaminated body parts were identified. The cause of the crash - at first thought to be terrorism - was determined to be pilot error.
In spite of it all, Melinek enjoyed her job and the 'trial by fire' she endured while working at the OCME. During her time there, Melinek performed 262 autopsies, made 13 court appearances, and had another baby. After completing her two-year fellowship in forensic pathology in 2002, Melinek did a one-year fellowship in neuropathology, then took a job in San Jose, California. Since then Melinek has performed thousands more autopsies.
In summary, Melinek notes that she loves the work, the medicine, and the science; she also loves the non-medical aspects of the job, including counseling families, collaborating with detectives, and testifying in court. Sounds good to me!
I enjoyed the book, which contains numerous compelling stories about Melinek's - and her colleagues - work, as well as amusing tidbits about the authors' personal lives. I'd recommend this memoir to everyone interested in forensic pathology.
Rating: 4.5 stars
No comments:
Post a Comment