Perspective is personal and can prove problematic. I am a glass-half-full thinker, but I work with glass-half-empty personalities. I suppose working for a forensic pathologist and receiving a daily dose of death overtime may create a sophist or worse-case-scenario theorist. On the other hand, maybe pessimism is prerequisite for employment by the medical examiner, and maybe I’m not as optimistic as I thought I was. It’s all about point-of-view.
Regardless of whether skepticism is created by working with “Doctor Death” or is part of the attraction, if left unchecked, problems can ensue. Let me share with you two stories illustrating the problems associated with opposing perspectives.
One day I was working with the medical examiner, as I often do. I had just surgically removed a liver and placed it in the weighing pan. The pan dangled precariously by a hook from a large round analog scale that hung from the ceiling as to rest directly over the autopsy table. A 10-inch, slender, red needle spun around the center of the face of the scale and bounced a few times until it rested its thread-like point on 1450 grams – or so I believed.
From my perspective the long red needle stopped five tick marks short of fifteen-hundred grams, (each tick mark represents 10 grams.) I shouted out the weight so that another assistant, who was clean, could inscribe the number on the autopsy worksheet.
At this point the doctor turned around to retrieve the liver from the pan and hesitated. He stared up at the pale face of the scale and exclaimed, “Well actually, it’s the other side of fifteen-hundred. The actual weight is 1-5-5-0 grams.”
The doctor’s perspective from the other side of the two-faced scale provided the correct weight. It may not seem like a big deal. It’s only 100 gram difference. (That’s about 3.5 ounces.) No big deal, right? Maybe not, but it annoyed the doctor all the same.
Now let me share a story that will illustrate true problems that can arise from differing perspectives. Imagine a cool, dry, August afternoon in southern Utah. Investigators arrived on-scene of what appeared to be a violent homicide. There were tracks leading into the scene, but no tracks out. This fact disturbed investigators. Before them laid the body of a young person, dead, due to a gunshot wound of the chest. Blood surrounded the body and stained the upper clothing. The most disturbing clue of all was lack of a weapon.
The body was transported to Salt Lake City to the Office of the Medical Examiner for further examination. Upon further examination the medical examiner discovered injuries and wound characteristics consistent with close-range, even close-contact weapon firing. The medical examiner informed detectives that the lack of defensive injuries and existence of close-range wound characteristics suggested a self-inflicted gunshot.
Investigators continued to search the scene for any evidence of foul play. Evidence of suicide eluded crime scene techs at the scene until news of the medical examiner’s findings reached them. They took a new approach. Instead of looking solely above ground for evidence they turned below ground. Using a metal detector investigators were able to unearth a weapon from directly beneath the dead body outline.
Test firing of the newly discovered weapon was performed. Markings on the test-fired projectile were compared to the projectile recovered from the body by the medical examiner. The ballistic fingerprinting matched!
According to medicolegal death investigators the decedent was known to have suicidal thoughts. The weapon found at the scene-or should I say below the scene-belonged to the decedent. Autopsy findings including wound characteristics would support a self-inflicted wound. The question remains, was this an intentional act or was this an accident? You be the judge.
A possible scenario: individual arrived alone in a remote place in southern Utah with the intent to commit suicide by handgun. The person dug a hole and after shooting self in the chest dropped the weapon into the hole. The wound wasn’t immediately fatal which provided the person enough time to bury the weapon and lay on top of it. This type of wound also caused the person to flail around long enough to create a bloody mess all over the immediate area before coming to rest atop the shallow gun grave.
You can see the problems that might ensue from limited information or lack of cooperation from all perspectives involved. Alone, homicide detectives might have wasted precious hours searching for an independent shooter that didn’t exist due to the immediate information recovered from the scene. However, forensic information from the medical examiner combined with medicolegal death investigation and forensic specialists such as ballistic experts provided re-focus. Independent perspectives together painted a complete picture of the situation and saved hundreds of extra tax dollars and unnecessary man-hours.
Let us return to “the other side of fifteen-hundred.” Why are accurate weights important? Answer: In order to properly diagnose disease. The forensic pathologist compares accepted weights of healthy organs to those of the dead. Even the slightest difference in either direction might suggest disease. Therefore, although from my point-of-view I don’t see the ‘big deal’ in a few ounces, the doctor DOES see the importance.
In closing, I would like to share an anecdote. One of the pathologists has a canned response whenever his assistants comment during autopsy.
For example, the assistant might say, “Doctor, this man’s heart looks enlarged.”
The doctor replies, “Sure, to the untrained eye.”