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Articles » Medical Examiner
Quincy Lives: Examining the Medical Examiner
Alejandro H. Cruz
Dr. Charles Hirsch, MD, the Chief Medical Examiner for the City of New York starts his speeches by telling people exactly what his title, forensic pathologist, means. At a recent lecture at the Mt. Sinai School of Medicine, his first visual aid was a slide of the derivation of the word, "forensic", coming from the Latin word for public. He begins, "I am your public pathologist," better known to some as the medical examiner. Yet, to some, the job of a medical examiner remains unclear, merely the title of a '70's T.V. character who would comfort families, name the bad guy and still be home in time for dinner. Granted there is some truth to this perception. It does take a rather peculiar personality to make a good medical examiner, one who can solve problems, enjoys a little detective work and, in some cases, is ready to witness the ramifications of man's inhumanity to man.
The medical examiner, a medical doctor trained as a pathologist and further trained to identify causes and factors involved with unnatural death, claims legal jurisdiction over all death that is suspected of being unnatural, accidental, unexpected or violent. For the most part, the most important part of the job of a medical examiner is to perform the medical/legal autopsy to answer a number of different questions. This process of "questioning the dead" is often referred to, lightheartedly, as the "Dialogue with the Dead" or an "Interrogation of the Inarticulate".
The first question to be answered in many cases is the most vital, "WHO ARE YOU?" Proper and accurate identification is of utmost importance in not only criminal cases, but in matters of civil law, such as settling estates and claiming insurance, when it must be proved that a person is actually dead. Answering this question can also help the loved ones of the deceased to be sure that it is actually their friend or family member who is dead.
Following an identification of the deceased, the medical examiner will try to answer the next to questions of relevance, "WHERE" and "WHEN" did the person die? Following the "where and when", the doctor will try to determine the CAUSE OF DEATH, which in some cases is easy and in others exceedingly difficult, depending on how subtle the signs are. This part of the process usually relies on a lot of teamwork between the medical examiner's office, the police and the district attorney to make sure that the body has been properly removed from the scene so that it can be as undisturbed as possible when seen by the forensic pathologist.
After determining the circumstance of the death, the medical examiner will try to reconstruct the death to visualize what, in fact, happened to the person lying on the autopsy table. In reality, this is as far as the medical examiner will go. The "Who done it?" is usually left to the police, for the job of the medical examiner is simply to provide an objective evaluation of the facts.
Yet, in addition to autopsies, the job of the medical examiner's office extends further into the realm of public service. After examining the dead, the medical examiner is expected to provide vital statistics and accurate death certificates, report cases of child abuse and neglect, and alert the appropriate agency of any public health hazards. Also, the medical examiner is obliged to report any finding of fault in consumer products. This might come in from a baby swing that drops the baby, causing death. This office is also responsible for reporting any observed adverse conditions in prisons and health care facilities.
Forensic pathologists take their occupation very seriously. Many feel that they have the privilege of being the last to hear the stories told by the dead; that they have mastered the art of conversing with those who have no one left that can listen. Above all, the job of a forensic pathologist is one of public service that requires compassionate, sensitive professionals who are willing to serve not only the dead, but the living who are suffering the loss of a loved one.
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