Frequently Asked Questions…

We, the medical examiners of America… we are a junk drawer.

To date, there is no prime-time television show about medico-legal death investigators, and as a result, nobody really knows what we do. (And in case you’re asking, no, CSI, Dexter and Rizzoli and Isles don’t count.  Nor does any incarnation of Law & Order. Dick Wolf can suck a big fat one) It’s a shame. In my opinion we MDI’s (Or deputy medical examiners… or whatever) are actually a pretty fun bunch and I think we’d be a big hit if any network producers ever decided to take a chance on us. (I’m available for consultation and script-writing… you know… if you happen to BE or KNOW a network television producer. Forget what I said about Dick Wolf sucking a big fat one)

law

Anyway, because no one knows what we do, we are frequently asked questions.  People call our office all the time and lay a wide array of dilemmas at our feet.  Folks seem to think that if their conundrum involves a dead person in any way, it must be the medical examiner’s responsibility.

I’m guessing that, in the continental United States, the following exchange takes place every 0.3 seconds:

-SOME DUDE- He’s dead. What do we do now?

-SOME OTHER DUDE- I don’t know. Call the medical examiner.

hmmm.jpg

We do what we can.  We do what we should. We often take on puzzles that are decidedly not in our job description because we’re civic-minded folks and we want to help.  BUT a lot of the time, we punt these problems right back into people’s faces… because their dead monkey isn’t a part of our horror circus.  My coined phrase when I get these calls is this:

“Well, jeepers!  This sounds like a whole lot of ‘not-my-problem!'”

Don’t believe me?

Well take a gander at this-

We have a hospital in our county that doesn’t have a morgue. I’m not sure why.  No one has ever bothered to explain this architectural feature to me and all I can say is that I really admire the hospital’s optimism.  But sadly, their faith in their capacity to treat and save every life that walks through their doors is unfounded.  People die there.  It’s a fucking hospital.

Most often, when people die there and it’s not a death that falls under the jurisdiction of the medical examiner’s office, the decedent is removed from the hospital room by a funeral home that’s selected by the next-of-kin. Simple.

HOWEVER

Sometimes non-jurisdictional deaths happen at this hospital and the dead person has no next-of-kin.  This is when the hospital staff starts calling our office, attempting to coerce us into taking the body.  The conversations go something like this:

-ME- Hello, Medical Examiner’s Office

-HOSPITAL STAFF- Hi, we have a deceased person with no next-of-kin.

-ME- Ok… ummm… is this death a medical examiner case?

-HOSPITAL STAFF- (confused) He…  has no next-of-kin.

-ME- Right, I heard you.  Does anything about this death make it a medical examiner case?

-HOSPITAL STAFF- (louder) HE HAS NO NEXT… OF… KIN.

-ME- Why exactly are you calling me?

-HOSPITAL STAFF- Well… you need to come get him.

-ME-No.

-HOSPITAL STAFF- But… you’re the medical examiner. …

-ME- That’s not what we do. If the death isn’t a medical examiner case, we are not involved in the disposition.  We’re not your storage facility.

-HOSPITAL STAFF- But… what do I do with him?  We don’t have a morgue!

-ME- Listen, I don’t know how many times we have to tell you this, but just because someone has no next-of-kin does NOT make them a medical examiner case.  It’s not our fault that you don’t have a morgue and we’ve told you several times that hospital administration needs to come up with a plan for when this happens.

-HOSPITAL STAFF- (sniffling a little bit) Well… can you just come pick up this one?

dead patient

Now I’ve worked here for almost ten years and the answer to this question has never changed.  They always want us to take their dead bodies and we always say no.  They also want us to take the dead person’s stuff and then find the person’s elusive, long-lost family.

Speaking of family…

trauma

I get a lot of questions from families, too. And I try to be kinder to them than the hospital staff, who in my opinion, have no excuse for their dumb-ass calls. But answering questions from families is far more explosive and complicated, despite the fact that I try to be as delicate as an ice dancer with these interactions.

First of all, when I talk to families, they’re (justifiably) hysterical and only hear a fraction of what I say.  This means that they will frequently call back with a jumbled knot of misinformation in their heads.  They will claim that they were lied to.  They will claim that nothing that they’ve been told makes sense.  They’ll call me names.  They’ll threaten.

I was a paramedic for a long time and I’ve been mother-fucked by a wide array of people in the back of the ambulance.  I’ve learned not to take it personally.  But still, it wears on you.  I think what’s so hard about it is the seemingly universal assumption that the medical examiners are all malicious ass-holes who are always trying to hide something.  We never get the benefit of the doubt.  People never seem to consider the possibility that, in their devastated, grief-stricken state, maybe they didn’t hear me quite right…

My last shift, I investigated the death of a woman who choked to death.  It wasn’t awesome.  She was developmentally delayed and had been in the care of an adult day-care program.  They take these folks on field trips to the mall or the park.  It’s a chance for these folks to get out and socialize and it gives their families a break from 24/7 caretaking.  This group had been picnicking on the shores of a local lake when this woman choked on her lunch. No Heimlich Maneuver or chest pumping could get the piece of meat out of her airway and she was pronounced at the scene. (It was a little more complicated than that, but you get the idea.)  The following day, the decedent’s sister called me up and the second I answered the phone I could tell she was primed for a fight.

“My sister died yesterday and we just don’t feel like our questions are being answered!”

“Okay,” I said.  “How can I help? What do you need to know?”

She delivered every question as though she was kicking me in the shins as she spoke.  She was using the you’d-better-not-mess-with-me voice as though I, inexplicably, intended to mess with her.  I gave her all the same information I gave her the day before, hoping that maybe this time she’d remember.  Things seemed to be going well right up until she hit me with this one:

“Why wasn’t my family notified that my sister would be going to the lake?”

Now. let’s all remember that I don’t work for the adult day-care program.  I am completely ignorant of their policies and I cannot answer questions on their behalf.  I didn’t have any fucking clue why the family didn’t know that a picnic at the lake was on the docket for the day.  But I understood that they had been blindsided by the death and wanted an explanation for every detail. But that didn’t mean I had one for her.

“Ma’am, I’m sorry. I don’t work for the day-care program and I don’t know anything about their policies.  I’m thinking you should probably get in contact with them because I don’t feel like I can speak for them-”

And she hung up on me.

Also, on my last shift, I had a guy who was electrocuted while installing lighting in a commercial space.  That whole situation was just dodgy as fuck because as far as I could tell no one bothered to turn off the power and the dude had minimal experience with electricity.   But it’s not my place to say what should or should not have happened in that situation.  Imagine me as Dr. Bones on Star Trek- “I’m a medical examiner, not an electrician!”  And I certainly don’t regulate safety practices on electrical jobs.  But that didn’t stop the family from demanding that I explain why the decedent wasn’t wearing “appropriate safety gear” (as they put it)

Honestly, how am I supposed to answer that question?  I have no idea what’s considered “appropriate safety gear” in those circumstances, nor do I have any clue why he was or was not wearing it… but that didn’t stop them from being plenty pissed when I told them so.

“What the hell are you people DOING out there? Why isn’t anyone doing their JOB?”

scream

I don’t blame them for wanting answers. I really don’t. I don’t want to sound glib or calloused.  The fact is, I wish I was MORE calloused. When families lose their shit on me, I feel a completely unreasonable sense of guilt.  I stare into the hungry, chomping mouth of their grief and wish I had something to feed it other than, “We’re doing what we can.”  That answer felt so insufficient to me for such a long time that I nearly killed myself trying to satisfy people’s insatiable need for an explanation for their tragedy.

But sooner or later, in this job, you have to learn some boundaries and understand that you don’t owe every question an answer…

For example…

I had a funeral director call me other day…

-IDIOT FUNERAL DIRECTOR- So, we have a decedent here and I’m doing his death certificate.  When we picked him up, You guys told us he was transient.

-ME- Ok

-IDIOT FUNERAL DIRECTOR- Well… if he’s transient, what do I put for his home address?

-ME- Well, I expect you’d put “transient”

-IDIOT FUNERAL DIRECTOR- (huffing indignantly) Don’t you have anything else?

-ME- If he’s transient, then I suppose you’d list transient as an address on the death certificate.  It’s how we complete our case files. Why? Is that not allowed?

-IDIOT FUNERAL DIRECTOR- (eye-rolling) WELL, I was hoping you could offer a little guidance…

-ME- Listen, we medical examiners don’t fill out death certificates. I have NEVER filled out a death certificate in my life.  You know why?  Because that’s the FUNERAL DIRECTOR’S JOB.  I have no idea what state vital records will or won’t accept for a decedent’s address.  I only know what they will and won’t accept for cause and manner of death because that’s the MEDICAL EXAMINER’S JOB. Maybe try talking to your manager.

The idiot funeral director hung up on me… I guess because she was insufficiently trained and I refused to do her job for her.

lazy

I’m not sure what the hell is going on. But apparently this is a growing trend.  People are more and more in the habit of asking the wrong people the wrong questions.

Today while I was working out at the gym, one of the televisions above my treadmill was tuned to “The 700 Club”.  If you’ve never heard of it, this show is basically an Evangelical Christian version of a news program.  Something like 20/20, but for religious fanatics for whom Fox news isn’t quite skewed enough.  I’m familiar with this program because I was raised in an Evangelical home in which my mother watched “The 700 Club” all the damned time… when she wasn’t attending prayer meetings and casting demons out of our appliances (not joking).

fridge

So, much like rubber-neckers at the scene of an accident, I just couldn’t bring myself to look away as the program entered it’s Q & A segment.  During this time, the quintessential old-white-dude televangelist answers questions that viewers have emailed in.  Typically, the questions are about theology, scripture, ethics, etc. etc. Also people ask him how he managed to fit all those animals on to one boat… because this guy has GOT to be as old as the flood.

pat

So, imagine my surprise when THIS little gem flashed across the screen.  Some blithering moron sent in the following question:

“Dear Pat, If we say grace over our food before we eat it, asking God to nourish it to our bodies, do we still have to be concerned with the sugar and cholesterol in it?”

I didn’t see Pastor Pat’s answer… probably because I nearly fell off the treadmill in astonishment that Pastor Pat somehow managed to get an email from the Dark Ages. Honestly , this reminded me of centuries ago when people sincerely believed that the Eucharist (the wine and communion wafers of Holy Communion) LITERALLY turned  into the body and blood of Jesus Christ… Making early Catholics a bunch of zealous cannibals who didn’t know the meaning of a metaphor. Even more so, I was reminded of those charismatic nut-bags who demonstrate the depth of their faith by dancing around, waving poisonous snakes in the air. It’s right up there with “praying the gay away,” I was legitimately astonished that someone out there was asking this question of a televangelist as opposed to… say a nutritionist or a doctor.   And I was even more astonished that the producers of this show thought this was a legitimate enough question to put it on the air. Never mind doctrinal issues like predestination or the cannonization of scripture.  People want to know if they can pray their way out of heart disease, diabetes and obesity.

junk2

I barely had time to stomach this whole situation when the next question flashed across the screen:

“Pastor Pat, Why is it that some dead people look really terrible, while other dead people look normal and healthy… almost as if they’re still alive?”

What

The

Fuck

I couldn’t help it.  Right then and there I actually went to the 700 Club website, and then looked up this “Pastor Pat”. I wanted to see if he had any kind of advanced degrees or training that might qualify him to answer such questions.  There wasn’t a thing about medicine or death investigation… nothing to indicate this guy knew anything about human physiology in the living or the dead.

I watched in amazement while Pastor Pat  reeled off some drivel about how morticians put make-up on dead bodies to make them look more alive… which is true.  Morticians do that. HOWEVER, there’s a little more to what, exactly, makes dead people look the way they do.  So many factors affect post-mortem changes that you see in a dead body.  The body’s position, the post mortem interval, heat, air-movement, fat-to-muscle ratio… not to mention the fact that if people don’t look great when they’re alive, death probably isn’t going to make it any better.  Pastor Pat totally copped the fuck out of that question… a question to which I could have actually delivered a concise and thoughtful answer, based in both personal experience and science.

But of course, nobody asked me.

dead

So from here on out, I’d like to offer my services to you, your televangelist hero, your wacky podcast… whatever.  If you have a MEDICAL EXAMINER question.  Feel free to ask it.  And if you’re not sure if your question is a medical examiner question… you can ask me that too, and I’ll tell you. Just stop asking people questions that they’re not qualified to answer.  And if you’re not qualified to answer a question… don’t just answer it anyway

For fuck sake

Somebody needs to put and end to this madness.

 

 

 

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