Thursday, May 24, 2012

Medical Examiner Independence

This week the Supreme Court in Minnesota overturned the conviction of a 17 year old girl for the murder of her infant as a result of interference into expert witness testimony in her trial. The prosecutor was reprimanded by the State Bar for his conduct when he wrote a letter to the supervisor of a forensic expert stating that her involvement in defense work for a criminal case was a "conflict of interest." He has subsequently apologized.

I am glad to see the courts affirm that forensic science is objective and neutral and that its practitioners should be protected from influence and intimidation. Unfortunately, one overturned conviction in Minnesota is not going to correct a national structural crisis. In most cases, forensic scientists are not independent, but work for Sheriff Coroners: the same government entities that supervise law enforcement. Many forensic crime labs are under the auspices of police or prosecutors, and their employees are discouraged from sharing their expertise with defense counsel since they are considered "prosecution witnesses" and their reports are "testimonial," i.e. created to further prosecution. Many forensic scientists who train in institutions like these are not used to working with defense counsel and therefore their only contact with defense attorneys is when testifying, creating a clearly adversarial relationship. Although there are only about 500 forensic pathologists who are board certified practicing in the United States, many choose not to do defense work, and there have been several other cases, besides the Beecroft case, where experts who have done consult work for other counties or have come to opinions that were not politically popular were disciplined, restricted or retaliated against. We have a long way to go before we can correct the situation, and the first step would be for the major forensic and legal institutions and professional associations to step up and affirm that structural changes and policy changes have to occur on a national scale, as outlined in the recent NAS report on forensic sciences in the United States. Unfortunately, since law enforcement, death investigation and prosecutions are funded by each county, and local agencies are still trying to deal with the current economic downturn, I am not hopeful that there will be any significant changes occurring any time soon.

Sunday, May 20, 2012



My 12 year old friend is interested in forensic science. Can you recommend any books or sites that would be good for someone that age?

I would recommend "Forensic Science" by Alex Frith. I bought it for my son and he is 12. 

The DK Eyewitness book series is also spectacular:

Friday, May 4, 2012

Frequently Asked Questions

I sometimes get e-mail from high school and college students asking to interview me about what I do. Here are my answers to some of their frequently asked questions:

Q. Why did you decide to become a forensic pathologist?

A. I wanted to be a doctor ever since I was a kid. My dad was a doctor (a psychiatrist) and from him I was exposed to medicine as a career early in life. I spent a lot of time going through his anatomy textbooks and really wanted to know how the body worked. During medical school the Department of Pathology was responsible for training all the students in anatomy (the parts of the body), physiology (how those parts all work together) and pathology (what goes wrong in the body). The teachers were excellent and they encouraged me to go into pathology.

Q. What education do you need to become a forensic pathologist?

A. In order to be a forensic pathologist in the United States, you need to go to college, medical school and then do residency training in pathology (3 years minimum) and then fellowship training in forensics.

Q. What do you generally do each day?

A. When I get to work, in conjunction with my colleagues, I review the cases that were brought into the office over the previous 24 hours, and I decide which cases I will autopsy. I typically do one or two autopsies a day. After the morning review, I go into the morgue and perform the autopsies. Each one typically take me 45 minutes to an hour. It takes longer if the case is complex, like a homicide. In the afternoon I type up my autopsy reports, call the families of the deceased and let them know what I found, and that is usually when I am scheduled to testify in court.

Q. What is the most memorable experience you've had as a forensic pathologist?

A. September 11, 2001. I was one of the doctors in New York who recovered the remains of the people who died in the World Trade Center attack. It was an overwhelming experience, and certainly the most memorable; it will be part of who I am for the rest of my life.

Q. About how much on average does a forensic pathologist get paid per year?

A. Salaries vary based on location and experience but they range between $120,000 and $300,000 a year.

Q. Has the technology or methodology changed since you began working as forensic pathologist?

A. Not by much. Most of what we do in an autopsy room is no different from what was done, technically, for hundreds of years. What has changed is the complexity of the science: the radiology technology is a lot more advanced and the breadth of knowledge one needs in order to assess all the different kinds of ways people die has most certainly expanded. There have also been advances in clinical chemistry, toxicology and molecular biology that affect the tests we rely on the diagnose diseases, poisonings and to identify individuals (i.e. through DNA).

Q. What most surprised you about forensic pathology?

A. That I would get used to the smell, not even mind it at all over time.

Q. Is there anything you know now that you wish you had known when you began working as forensic pathologist?

A. I wish I knew how political it could be. Not that it would have changed my choice, but it would have prepared me for many of the stresses that stem from dealing with the demands of governmental cost-cutting measures and the political pressure when dealing with high-profile cases.

Q. What do you like most about being a forensic pathologist?

A. Helping families with their grief and explaining to them what happened to their loved one. I find it gives them the closure they need and sometimes I am the only one who has taken the time to explain the medicine to them in a way they understand, even following their loved one's long hospitalization. I also like testifying in court and seeing the eyes of the jury light up when I explain what happened and they "get it." I also really like teaching students for the same reasons. A jury needs to understand the scientific basis for my opinions in order to render a just decision, so it gives me a lot of professional satisfaction to be able to play that important role in the legal system, whether it be to testify on behalf of the prosecution or the defense.

Q. Is there a lot of work in your field?

A. There are many job openings for forensic pathologists. According to the National Association of Medical Examiners there are only about 500 board certified FPs practicing forensic medicine in the U.S. We need about twice that. That is why many forensic autopsies are done by hospital pathologists lacking the specialized forensic training that I have.

Q. How many autopsies do you perform?

A. I have performed over 2,000 autopsies and I have been in practice nearly 10 years. I average 200-250 cases a year. On a typical day I do 1 or 2.

Q. How long does it take you to start performing autopsies after being certified?

You do autopsies as part of your training in medical school and residency. You need to do 50 autopsies as a resident (a pathologist in training) in order to be allowed to sit for the Board Examinations, so that's before you are even board-certified.

Q. What schools did you attend? How long have you worked in this field?

A. My resume is on my website and it documents my schooling and professional accomplishments. See

Q. What was your major in college? What major would you recommend for someone interested in forensics?

A. I majored in biology in college. I didn't know I wanted to be a forensic pathologist until I did the required rotation throught the medical examiner's office in my residency in pathology. I would recommend majoring in any field you love but making sure you take the prerequisite courses for medical school admission. Depending on the college you attend, you can sometimes be a "pre-med" major, though in many cases students interested in medical school major in the sciences, like biology or biochemistry.

Q. What would you say was the hardest obstacle while heading towards your major?

A. I found that applying to medical school was a "numbers game" and it didn't matter where I had gone to college or that I had done all these extra-curricular activities (like theater, or working in a lab). On applying to medical school all they wanted to know was my GPA and MCAT scores. If I didn't hit the magic cut-off, I didn't get an interview. My best advice to you if you are pre-med is to take easy courses where you can get straight A's and take practice courses for the MCATs so you score high. I found medical school a bit boring too: lots of memorizing. It got a lot more interesting in 3rd and 4th year when you finally got to see patients and behave like a doctor.

Q. How were you able to pay the cost of schooling?

A. Paying for college and medical school in the United States is very expensive. My father passed away when I was a teenager, and had left me a modest inheritance. That was just enough to pay for (private) college and (state) medical school. Most of my friends and colleagues took out a lot of student loans to pay for medical school. May of them are still paying off the debt.

Q. Are you happy with your career choice? Is the reward worth the work you do?

A. Absolutely!

Q. What do you think you would be doing if you weren't doing this?

A. Either teaching medicine or writing or both. Actually, I am already teaching and writing as well.