Grunching a bit here because I have to leave and want to subscribe to the thread first since this is right up my alley, so apologies if any of this is answered already... gloss over anything that's been touched upon. Thanks for doing this though.

What kind of workload are you typically looking at? I assume some days are busier than others, but is there typically a pretty steady flow of bodies to be examined? You examine one, is there another 10 waiting for you? Or are there times where you go several days at a time without having a body there waiting for you? If the latter is true, what else do you do at work to fill the time? Also, are you allowed to say what kind of population you would be covering with your place of work (one city? one county? one state? How many pathologists you work with?)

I assume mostly accidental or natural deaths? How many murders per year, on average?

Of all the murders you've done, are a lot of them slam dunk solves? Anybody stump you? I've read that out of every 100 murders in the US, only about 5 of them even make it to court without a confession, so I would guess that a lot of the ones that actually do make it to trial (i.e. people proclaim innocence to the bitter end/are wrongly accused) should be relatively easy solves.

Is there anything on TV shows (i.e. CSI-types) that is surprisingly accurate? Or do you even bother?

edit- one more. You know serial killers on TV shows like Criminal Minds, or in movies like Se7en? Where they have themes to their killings and offer little puzzle pieces that lead directly to the killer? Has that **** EVER happened irl?

You should do this on reddit, where many, many more eyes would see the thread and I'm sure more interesting questions would end up being asked.

TY for doing this thread.

After JFK was pronounced dead at Parkland Hospital in Dallas, Earl Rose, the Dallas ME tried to keep the body in Dallas. After a heated exchange with the Secret Service, they took the body, got on the plane and flew back to Washington. Mr Rose was subsequently bastardized in the media for his actions.

Are there any opinions among ME's on Mr. Roses actions that day and could you share? Seems to me like the SS stole the body since there were no laws covering the death of a president then.

Also, have you ever been in a dicey situation over the "ownership" of a body?

Voted thread 5*

great thread! How often do you see deaths caused directly by alcohol abuse, either acute alcohol poisoning or deaths from alcohol withdrawal?

If no one else is going to ask...

How would you do it?

Just like the mafia I suppose. Corpus delicti, most people don't know how to dispose of a body, the holes are never deep enough. Pretty famous case of a young Danish poker player doing something similar.

I had a case where the guy died of a shot gun wound of the head in Kentucky, they loaded him in the trunk of the car and drove south. Cut off his head, feet and hands. Threw the body in a little river here, head, feet, and hands at various locations over the county, went over the border and sold his car in the first big city.

Within 24 hours fishermen found the body, and passers by found all the other parts. The family reported him missing and the car stolen. They found the car within a day with the crime scene in the trunk. His fingerprints were still good so we IDed him right away, and he had a clear cut cause/manner of death even though his poor head wasn't in good shape. Alls they really needed to do was spend all that effort digging a 6 foot hole in a national forest in the next county, and use a little imagination with the car. The only bad part about it was I had to go to Kentucky for the trial.



As far as killing someone and no one figuring it out with the body at the scene, little harder, people try though, a little shove off the cruise ship at night (if you go on cruises, get up and walk around at 3:30am, pretty eerie), but watch for the video cams, or shove your new husband over a cliff in a national park etc.

Claus Von Bulow may have gotten away with it, it's very hard to prove insulin overdose. I guess it would depend on your level of psychopathy, a good homicide cop has a real sixth sense for this kind of stuff. The best way would be a simulation of suicide, accident or natural. But nothing is going to beat a real deep hole. And with that said, I am probably going to have to take back my yes, and say maybe.

Depends on where you are. I worked in Alaska for a while and it was very common. Here, the mixed Rx drug intoxications and mixed drug and alcohol combinations far out number the acute alcohol intoxications alone, but we get them, with or without the positional asphyxia that comes with passing out the wrong way.

Acute alcohol withdrawal (DTs) is very dangerous, but can't be anatomically or chemically diagnosed by autopsy, so we have to use it as a diagnosis of exclusion. It probably happens some in the hospital, the surgical patient doesn't tell the doctor his true habits and they do very poorly post-op. We had a pneumonectomy patient do very bad, until his wife mentioned his actual drinking history, we started him on an ethanol drip and he turned right around.

Alcohol is a common element in a much more nefarious way in our business though, it is highly associated with many of the homicides, suicides and accidents we see, way more than in and of itself.

I'm pecking on the iPad, so will address Dr. Rose when I have a keyboard.

Yes, a very famous reality TV show personality lost his daughter in a car accident in Alaska. Then the battle over her remains started with his ex-wife. I didn't hear about it until it was started but when I did, I stopped it, telling the office to immediately release the remains of that poor woman's daughter to her. Didn't hear anything else about it.

We do have occasional conflicts which we work out more diplomatically than that. Sometimes the next of kin is also the suspect. We do everything we can to release the body as quickly as possible. We don't hold bodies unless for a very good reason. Even if the case is pended as far as cause, we get everything we feel we need and they are usually out of our facility within 24 hours after the exam.

When you die the law says you stop being a person, and become property, the term is chattel. That is why investigating agencies can take possession of that property and have an autopsy performed, even against the families wishes. What I always keep in mind is, no matter what race or religion, or how gross the rest of the world thinks a dead body is, to the family it's a sacred vessel. If you forget that and get arrogant about your role in how a body is treated, you are gonna have bad day, may even have to pack your bags. So we identify legal next of kin as quick as possible, and release as quick as possible.

We have some very trying times with common-law marriages. They are not recognized in this state. Try telling a spouse who has been with someone ten years, and whose step-children hate her, that she has no rights to the body of who she considers her spouse. Not fun, I let our family liaison do it.

Dr. Rose, who recently died, is held in high esteem by the forensic pathology community. It is a small field, and the tree we are all connected with does not take long to get to the trunk of those giants who are responsible for the field, and he is near the bottom of the trunk.

What happened in Dallas wouldn't happen today, but in all likelihood (I'm not sure about the exact law) the Office of the Armed Forces Medical Examiner would have jurisdiction. That office didn't exist back then, but now they are some of the best forensic pathologists out there, have state of the art facilities, and have been very busy. Every set of remains taken off those planes in Dover get a comprehensive exam, and since the gulf war started, the planes come constantly.

With that said, in my opinion, Dr. Rose wasn't trying to protect his turf, he was very concerned about protecting the forensic integrity of the case, and he was very right. The autopsy was performed by navy pathologists with no training in the evaluation of gunshot wounds.

Evaluating gunshot wounds is not brain surgery, it just takes training, interest, and a lot of experience. I trained under the guy who literally wrote the book, Di Maio, and every forensic pathologist in America has no excuse not to be very good in looking at gunshot wounds, we are a gun society, much more than any other first world country, and I try to be better than just very good.

If you are interested in the subject, in the early '90s JAMA, the Journal of the American Medical Association produced I believe three articles interviewing the pathologists who did the exam, one of the only interviews they did. They are very informative, and worth the effort to obtain. If your town has a medical school you should be able to get them from the library, I don't know if they are on line. The basic conclusion by the pathologists was, they agreed they didn't have the experience, many thing were not done by how Dr. Rose would have done the case, and some of these things were errors, but their conclusions were correct.


After looking at everything I have been able to get my hands on, I agree. You have to understand things like how many frames per second the Zapruder camera used, how fast this rifle bullet was going, thus how far it could have traveled between frames, what pressure cavitation does to a skull, how fast fracture lines in the skull propagate (by the time the head reacts to the pressure, the bullet is out and long gone). In combining those things, and looking at everything I could about the exam, including medical intervention changes, I believe there were two posterior gunshot wounds, one to the back of the head, one to the back of the neck/back junction.

So Dr. Rose was vindicated in my opinion.

I presented all this in a journal club meeting during my residency. The Chief of my department, a very highly esteemed academic hospital pathologist, looked at me and said, I don't care what you say kid, I know some things you don't about this, he was shot from the front, there were people on that knoll who I have information about, and you will never convince me otherwise.

So there you go.

No questions at the moment but chiming in to add to the praise. This def ranks among the absolute best AMA threads I've seen.

Thanks for taking the time.

+1, thanks for your insight

A few weeks ago there was a half-hour interview on All Things Considered with a UCSF forensic pathologist. A highlight was her saying that she's seen people die in their homes and then get eaten by their pet cats. The sense was that it happened really fast too--you could tell by her voice that these cats weren't waiting to see if their owner was just in a coma, or taking a nap, or doing a wednesday crossword while petting the cat in a way that wasn't to the cat's liking. Do you see this every month or is it more of a once or twice a shift thing?

Considering how much training and work and expertise you're bringing to the table, and also that I think there's a general shortage of forensic pathologists, do you think the compensation/cachet is fair relative to other docs? Do you care? If you could rerun your education from med school Day One does it end up in Ask Me About My Favorite Labiaplasties?

Worst non-cat-related death you've ever seen?

Steady flow, except on Mondays, we haven't worked weekends until lately, and now I have to work a Sunday every 5 weeks and snag a day off later to compensate, so that has helped the Monday load.

I'm in a State referral ME office. The county coroners and law enforcement agencies can send what they want, we have to take them. We cant tell them to send in a case they don't want to. Just one of the many different type of death investigating systems in the country, but I like it here, and we deal with what we have. State has 2.5 million, have 5 doctors now, but usually staff for 6, one just left. About 1300 cases a year, going up, so about 250 cases/doctor, which is not too bad, except with that population we should have 10 doctors, and 2500 cases, so are cases are skewed to the more difficult ones, the others don't get sent in, lay elected coroners sign them out, and we have no jurisdiction. About 250 homicides a year, and of those I end up doing 40-50/year, go to court an average of 12 times a year. Many plea out, about 25% are not solved by law enforcement, others they don't have a strong enough case. 6 on average/year police shootings, some homicide suicide cases, self defense cases etc, all homicides, but no court load.

Got to go for a bike ride, I can feel my heart clogging and Quads flabbing. I will ski in Big Sky this New Years, even if it kills me. So will finish your questions later.

Are you a spiritual person, do you believe in God?

I would best be described as a deist, with the hope that the Toltecs got a few things right.

We see this, technical name anthropophagy, commonly, whether by wild animals out in the woods feeding on human carrion, or in the house when no one has heard from the cat lady in a few days. It ranges from ants, flies, roaches, mice, rats, to the mid sized carnivores, including domestic. I have never seen evidence that someone has been alive while the feeding started, except maggots. Fido is pretty good at recognizing the state of death.

Doctors make money because they generate income. But I don't, so our salaries are based on demand by government agencies which tend to try and lowball as much as they can. Many many agencies are finding that to solve the problems caused by the turmoils described in a previous post, they are having to up the pay scale to attract qualified talented people. You have to have a calling for this field, but you also need to have a decent lifestyle and be able to handle education debt, which can be overwhelming. Leaving many with the calling to go into hospital pathology instead. In the future, agencies are going to have to answer these needs, I have big concerns for that future. With that said, my salary is fine. I could easily do private work on top of it and add another 50% of it a year, but don't feel the need. I work 40 hour weeks, little call, and most weekends are free, I like that lifestyle.

I assume your last question refers to anthropophagy. After a year or two in the woods all that is left is gnawed bones. Worst case I've seen is one in which I was only able to review the file and photos, and listen to the tape. The case occurred a couple of years before I got to Alaska, Grizzly Man and his girlfriend. Either there was more than one bear feeding there, or a bear has a very big stomach.

One of my favorite things to say in the morgue, to lighten things up: This is no boating Accident!

No, I found the thing I was meant to do, will keep labiamanipulation in the hobby category.

Could you explain the term excited delirium? I understand it to be reflexive like when you see a lion take prey down and as it grabs the neck the prey just gives up and dies, no more fighting for life, no fighting for air, nothing it just dies.

Mary Jo K, that drown in the car Edward Kennedy was driving never got an autopsy because the body crossed state lines on a stretcher and not a casket. Has this type of technicality been taken care of now?

I know you get used to the smell but when you go home and shower, hydrating the nasal membranes, have you ever noted an after smell?

I have seen several autopsies and thousands of surgery procedures and the only thing that has ever turned my stomach is necrotic tissue in the OR, any thoughts why this might be?

The pathologist who did my fathers autopsy was kind enough to get to it as soon as he could. It was an unattended death but looked like a MI. The COD was a circle of willis aneurism. It sure made the loss and guilt easier to handle for the whole family. No question but the info you guys find can assist in the healing for the family, thanks.

That's really interesting. I took a class with our state's chief medical examiner and asked if he always wanted to do what he does/did. He said how he wanted to be a surgeon entering med school but ended up loving the process of being a medical examiner.

It definitely takes a certain breed to shut off your brain knowing you are going to have to see multiple dead bodies everyday. He walked us through the freezer where the bodies waiting to be examined were housed. The smell didn't bother me as I worked years in a lab, but the thought of all that death around me was a bit unnerving. Not so sure I'd be able to leave work at work doing that everyday. Much respect to be able to do what you do and lead hopefully a full and ordinary life.

haha, thanks for the thoughtful answers. Enjoyed the boating accident reference too! Hooper killed that scene. Would be interested hearing any stories of unusual or grisly deaths you might have encountered. The forensic pathologist interviewed by NPR said that her most memorable was a guy who was pushed into a manhole, which broke his legs on account of the 18 ft drop, where he unfortunately landed in a pool of boiling water from a broken pipe. According to the story he boiled to death, it was 300 degrees in the tunnel and when the responders arrived they couldn't climb down to help. The doc compared the body to a lobster, outer skin had peeled off, viscera had been cooked, etc.

But that was in NYC which is probably a pretty exciting/dreadful place to be a forensic pathologist! Btw have you ever heard of a bullet embolism? No idea if that's a common thing, seems unlikely.

Do you have any thoughts on Phil Spector shooting/suicide case out of curiosity? Defense, at least in movie, made plausible case that she was holding gun.

You picked an interesting field. I run a fairly large medical practice and you chose something that I guess provides job security but caps your income. But the plus side is you don't have to deal with the nightmare of insurance paperwork/prior auths.

You've mentioned private work a few times now. Can you explain what you mean by that and what it would entail? I'm guessing that would be outside the scope of cadavers, yes? If so, what kind of crossover work can you do drom your background?

My god that is horrific.

Very insightful thread.

Best OOT thread I've seen in a long, long time. Great job, OP.

My question: Does this ever happen in your office?

ASSISTANT: I'm 90% sure.

(CGSW abruptly turns and heads towards the door)

ASSISTANT: Hey, where are you going?

CGSW: (stops in doorway, turns back to deliver his line) To get the other 10%!

I ask this because "walking out and stopping in the doorway to turn back and deliver a big line" happens in every episode of Quincy--no, make that "every scene in Quincy"--and I couldn't let you be the only one to make Quincy jokes ITT.

(An Odd Couple or Quincy came on the tv in the poolroom back in the day, and a bunch of us agreed that we all loved Jack Klugman. Then an old guy dissented, saying, "That guy over-acts in everything he does." Looking at him through that lens, I was sad to see that the old guy was 100% right. Watch JK in anything, and he's overdoing it.)


We all know that if we can't afford an attorney, one will be provided for us by the court. Are you saying that if we can't afford forensic experts, the court will provide us those as well???

(Yes, I know that that is exactly what you are saying, so I guess my question is: WTF?)

^^^My biggest take-away from the thread. Eye-opening!

The nit who called him out for that should already know that...but he doesn't know what it's like to be distracted by, you know, thoughts and concepts and stuff.



LOL at all the younger people in the lab (and ITT!) who have no idea what you're talking about.

I presume he means being paid to be the expert witness to rebut the other side's expert witness.

(One last shout-out for this great, great thread. OP is a long-time 2+2'er--I go back to rec.gambling.poker, too--and one of the best.)

So this means you can eat the rankest pussy in the world. There really is someone for everyone!

What State line did she cross on a stretcher? She died in MA, but was from PA.

I promise I will get to the rest, but am pecking again, so "relatively" short answers. Currently, because of many of the issues I described above, the adjoining state has inadequate forensic coverage, so, in a private facility, after work I have the opportunity do those autopsies. I've done a rare private autopsy besides that. I have testified in a civil case against BMW, and learned my lesson there, that Beemer lawyer was one of the smartest lawyers I've ever run up against, not a fun experience, they won, not my fault, but he still tore me up. I have consulted in a med-mal case, for the doctor being sued, and actually figured everything out, it was Addison's Disease. But that didn't stop the other side, and the guy doing the autopsy, which I just reviewed, did not want to admit he was wrong. It settled, but for a lot less money than real mal-practice (many case do, which upsets doc's to know end, but it's a financial decision). I have friends that testify against MDs in med-mal, I won't do it. That's about it. I have never testified in a criminal trial as a defense expert.

Testifying as a consultant is lucrative, $400/hr to review the case minimum (some guys with a proven track record, many times that), much more for a deposition, and if you have to go to court, the clock starts running door to door. I was paid very well/hr to sip good bourbon at the Captain Cook hotel the last civil case I went back to Alaska for. Our rule is, if it's a case I did in this State going to civil court, I don't see a dime, I'm still working for the State, we charge the lawyers a discounted rate of $225/hr in civil cases, goes straight to the State General Fund. But I do charge for my own pocket in places I used to work. All criminal work in this State, as far as court, is considered part of the job, me nor our office receives any extra money.