Death investigation in America: Our current reality

In case no one told you, you’re gonna die. Now don’t worry, this doesn’t mean you will necessarily find yourself chained in the dark putrid basement of some sadist who is slowly draining you of your life force. Most of us will finally pay the price for one too many fried chicken dinners, more than a reasonable number of “adult beverages”, subjection to environmental toxins, or just simple old genetic predispositions. By the time most of y’all finish this article, the CDC estimates that 25 people will have died in the United States, unless of course you read really, really, really, slow.

For much of my adult life, I bore witness to the ends of countless lives in New Orleans and Atlanta. There, in those southern cities, I was death’s scribe, working as a medicolegal death investigator for the coroner and medical examiner offices respectively. During my time I saw families dazed by the unexpected jolt that only death brings. When coupled with the confusion and desperation which only the heartbroken know, the daily landscape is bleak for most in my profession.

One night, well into my career, I was on a date with my future wife. We sat in a greasy little pizza joint on Peachtree Street in Atlanta, as we chatted over a half-eaten pizza and a pitcher of PBR, she looked at me and said, “Ya know, I never thought about death until I met you.”  I grinned uneasily not knowing if this was my last date with her; maybe she was gonna jump through the plate glass window and run out into traffic or bury a fork in my skull. Her query had not so much to do with my viability as a potential mate but it was a bigger question that most never consider or don’t want to dwell upon….what becomes of all that remains?

What happens at death to you and your loved ones? Like most things in life, this is not simply answered. Unlike courts, police departments, sheriff’s offices, and fire departments, which have similar templates nationwide, death investigation systems vary not just state to state, but in some cases county to county. The services provided by these medicolegal agencies and the quality of those services vary greatly as well. For instance, in some places the chief medicolegal office is administered by an elected official called a coroner; the requirement to hold this office can be as simple as receiving a majority of the popular vote, have no felony convictions, and possess a high school diploma or equivalency.

In some jurisdictions an individual must, at minimum, be a licensed medical or osteopathic physician, but even where these esteemed scholars are concerned, there is not necessarily a prerequisite for formal forensic education. This brings us to other locales where there are no coroners but medical examiners; For the most part these individuals, who are typically physicians, are appointed by cities, counties, or states.  Most medical examiners have not only completed medical school, but also a five year pathology residency, and finally, a one year forensic pathology fellowship.

After years of working, teaching, and researching in the field of medicolegal death investigation, I can say that both coroner and medical examiner systems have their up sides. For instance, county coroners live among those they serve and families value the idea that they can turn to a familiar face under horrific circumstances. Medical examiners offer unmatched scientific expertise in highly complex medical and forensic cases.

However, conversely, the community might be saddled with a system where their elected coroner has little or no access to forensic training and are essentially tasked with learning one of the most complex skill sets all on their own.  In many locations the office of coroner, unlike medical examiner, is a part time position; rural counties in many cases just cannot justify the expense of a fulltime medicolegal office and worse, some of these don’t even have morgues.

At the end of the day we are left asking….how much do we value the dead and their families? Do our government officials assume that just because a death occurs in a less populated locale or a poorer area that those deaths need less of an investigation? The answer of course is a resounding NO; we all have value, even in death. Government owes it to their citizens to answer the most troubling questions of all by the most competent means available in our modern society. These are not new questions. In a 2011 Frontline documentary, former New Orleans Coroner Dr. Frank Minyard quipped,  “Just remember, dead people don’t vote” shocking, but a telling reality about the priorities of politicians funding of medicolegal services.

The most trying of all cases that the medicolegal community is tasked with solving…. are homicides.  At the core of medicolegal practice indwells the mantra “ALL deaths are homicides until proven otherwise” in other words, there are no do overs, and the investigators get one chance to get it right. As soon as the medicolegal investigator crosses the threshold of a scene containing the body they begin seeking signs of foul play either on the body or the surrounding scene.

On February 13, 2016 Associate Justice Antonin Scalia was pronounced dead after being found deceased at a West Texas hunting lodge. It’s unknown if Justice Scalia died on the 12th or 13th; it appears that he died while he slept; we know this because the person or persons who found him said so. This left many of us in the medicolegal community scratching our heads because as it turned out the scene was never attended by a medicolegal official. Adding to the intrigue, the rest of the world soon discovered Texas counties don’t have coroners, but each county’s justice of the peace acts as the defacto coroner. When asked why the justice of the peace had not attended the scene of the death of arguably one of the most powerful persons in the United States the answer was……… geographic inconvenience.

Rear Admiral Brian P. Monahan, Justice Scalia’s attending physician, related to media outlets that he had underlying natural disease conditions which probably contributed to his death. But Admiral Monahan never saw the Justice’s remains…… as a matter of fact…. neither did the Justice of the Peace Cinderela Guevara….. she pronounced Justice Scalia dead over the phone.  This, in a nutshell, is the reality which faces many communities across this nation.

In cases such as the death of Justice Scalia this should give every citizen pause to ask that question we all try to avoid, what happens to all that remains? The way we treat our dead….not just at the funeral home, but at the scene of their passing; speaks volumes about our priorities as a nation.  As for me, my wife is calling me to the dinner table…smells like my favorite…..fried chicken….again.