When I first started, it felt a little odd going through the personal belongings of a complete stranger, but I soon learned that many times these searches yielded as many noteworthy—and sometimes unusual—findings as the bodies themselves.

Pill bottles and drug paraphernalia are two of the most common discoveries. The medications that are prescribed give some insight to the medical history of the deceased as well as the name of the person’s physician. A quick count of the pills can tell whether the deceased has been taking the medication as directed or not. Bottles of the same medication prescribed by different doctors within the same time period can indicate a history of “pill seeking.” Bottles of medication prescribed to people not residing at the scene can indicate illegally procured pills.

I recall one scene in particular where I had gone through four drawers of a chest of five and wished I had stopped. When I opened the bottom drawer, there were three Walmart sacks filled with old prescription bottles, each containing medication. Because I found them, I had to document them, take custody of them, and inventory them upon returning to the morgue. I also seem to recall the autopsy took less time than it took to count the pills.

Depending on the person’s lifestyle, drug paraphernalia may or may not be well-hidden. Thinking to myself, “If I were a doper, where would I put my stash?” has proved to be fairly successful. Using this method, I’ve managed to find all manner of objects that have been converted into drug devices.

I worked a scene where a man was being allowed to live in a camper trailer in his soon to be ex-wife’s driveway. She’d thrown him out because of his drug addiction, but allowed him to stay in the trailer provided he didn’t bring any drugs on the premises. Instantly suspecting that her husband failed to obey this condition, I searched the trailer anyway. Reaching into an odd hole punched in the wall, I removed a cigarette box containing two small bags of dope.

Other times the family waiting in the living room is genuinely surprised to learn that I found drugs or paraphernalia in their loved one’s bedroom. There’s nothing quite like being present when a family learns for the first time that grandma knew how to score some weed—or when they realize it was a family member that supplied it.

These searches sometimes reveal all manner of pornography and sexual devices. Perhaps the strangest thing I recall finding was a shoebox full of Polaroids that showed the bottom of hundreds of feet. In most cases, unless the death appears to have resulted from an autoerotic event or the pornography is illegal, I just shake my head, move on to the next drawer, and keep my mouth shut. I damn sure don’t want to be around when the family learns about that side of grandma.

• Dirty Little Secrets
• Crapped Out
• A Bloody Good Sign

But I’ve never seen a billboard advertising cleanup services until my brother-in-law sent me the following link:

Billboard Link

I’m not sure where Highway 11 is located, but I like to think this sign is someplace useful–like right on the outskirts of the little hamlet that the Sons of Anarchy call home.

• Knowledge is Power?
• Autopsy Technician / Pathology Assistant Employment
• I’m Not Dead

In hindsight, it may not have been a very introspective question after all because I almost immediately had an answer. I was–and often still am–most surprised at the number of suicide cases there were week in and week out. Self-inflicted gunshot wounds. Hangings. Overdoses. CO poisonings. Back then as well as now, suicides aren’t as common as natural deaths but certainly more so than homicides.

I think one reason I was surprised at the high number of suicides is that I never really had a point of reference for them before. Seems like there may have been some disturbed teenager back in high school many years ago that opted to check out early. For all I know it was simply a rumor and they left school because their dad was transferred to another city.

Another reason for my surprise is that, for the most part, suicides aren’t really considered to be newsworthy material, so there isn’t really a public concept of frequency like there is with the much more publicized homicides and accidents. If an elderly woman with an advanced stage of cancer shoots herself in her bed, the media isn’t lined up across the street outside. If a middle-aged man with a history of financial and legal issues hangs himself from a closet rod, the news stations aren’t running segments about it.

I suppose the various media outlets may consider it taboo to cover (and essentially profit from) suicides. Perhaps they consider a suicide to be a private family matter, unless of course the suicide is a public spectacle as in the case of a jumper. I’m reluctant to give the media a whole lot of credit for being compassionate in this area. Reason being, if the local affiliates don’t have any of the homicide or accident segments they like to run, they’ll show footage of a crash or shooting from three states away.

Ultimately I think I was most surprised because I’d learned there were so many people who were willing to choose suicide as a way out of their situation. I may not be an expert on the psychological aspects of suicide, but after years of working suicides I have to admit a degree of twisted respect for the incredible amount of self-discipline that suicide “victims” demonstrate when committing their final act. That is to say the acts that involve a chemically-uninhibited fatal decision. Passed out on the couch waiting for previously consumed pills to reach a toxic level doesn’t seem to have the same sense of “honor” as a suicide involving a trigger pull or a plummeting vehicle.

Maybe I hold these individuals is such “regard” as I do because I personally know I couldn’t do it. Not because I lack self-discipline or have just never been in that particular situation to find out (two rounds of Russian roulette at church camp when I was twelve doesn’t count). I just lack that particular strain of self-discipline, and I possess an overwhelming desire to remain among the living.

• Crapped Out
• Knowledge is Power?
• Autopsy Technician / Pathology Assistant Employment

The last year or more has been extremely busy at work and at home. 2008 was a record year for deaths and so far 2009 shows every sign of breaking that record, especially considering the holiday season is still to come. Like retailers, we see an increase in volume right around Thanksgiving but without the resulting economic prosperity. While these records are bad for the general public, they’re good for job security.

Job security is even more critical at home than it used to be because of the record number of births that occurred here the last few years. Two to be exact. A virtual population explosion by comparison. What little energy remained after a day (and many, many nights) at the office was devoted to cleaning up (or cleaning up after) whichever of the two needed it the most. If memory serves, the last year and a half has been a dead heat.

I’ve tried many times the last several months to sit back on the couch with a laptop with little or no success. It now seems clear the last thought entering a charging toddler’s head is, “I wonder how much daddy paid for that?”

Now that they’re a little older (and have actually started to play while they’re, fighting) I see little windows of opportunity opening up in which I hope to compose new content and respond to comments. But right now I have to go investigate a situation in my own home–an oddly disturbing silence.

• Top 10 Unique Things I’ve Done – Reposted
• The Girl of My DreamsPart I
• Autopsy Technician / Pathology Assistant Employment

1. Taken a deceased child from the arms of a grieving mother or father.
2. Done the above dozens of times.
3. Amassed more photos of naked people on my work computer than most people have on their home computer.
4. Driven a car with a dead body across the hood.
5. Collected and assembled the shattered remains of a 3-year-old’s head in order to figure out where it had been shot.
6. Climbed a tree to cut down a body.
7. Been stopped for speeding and given an apology instead of a ticket.
8. Examined a dead dog for signs of smoke inhalation.
9. Crawled about 50’ into a sewer pipe to drag out a body.
10. Been stopped by the state police with thousands of dollars worth of illicit drugs in the front seat and released (unrelated to #4).

I may add to this list in the future as I recall any more “out of the ordinary” stuff.

• Room to Breathe
• Bringing Out the Dead – Reposted
• Identification of Human Remains

A best-case scenario for body removal is a 100 pound little old lady that died in bed during the night on the first floor of her house. First, she’s easy to lift. In fact, it may be possible to collapse the gurney to the same level as the bed and just slide her over wrapped in a sheet. Second, she’s already laid out flat. No need to struggle with breaking the rigor mortis in order to buckle her to the gurney. Next, she died in the night. She hasn’t been dead that long, so there may not be any foul odor until her body is moved. And lastly, she’s on the first floor, so no more than one or two steps to go up.

Now for a worst case scenario—a 350 pound man that died in bed two weeks ago on the third floor of his apartment building. Obviously the increased weight changes everything and it’s only complicated by the fact that he’s been dead for some time. It is now necessary that he be placed in a body bag in order to contain the decomposition “juices” that have accumulated just under the surface of the skin. The rigor mortis has already gone away or “passed,” but his girth still makes it difficult to zip up the body bag and to strap him to the gurney.

The only redeeming element of this scenario is that the man is in bed and not directly on the floor or (God forbid) in the bathtub. As it stands, I would lay the open body bag on the floor next to the bed. Then I would throw a bed sheet over the body to catch any decomposition juices expelled from areas of concentration ruptured during the initial move. Next, I would grab the body through the sheet, pull it from the edge of the bed, and let gravity do the rest. It’s at this point that the decomposition juice is actually helpful. It makes for a slippery surface on which it is much easier to slide a body.

Once he’s in the bag, there is still the issue of getting him to ground level. He’s already met the “250 Pound Rule” which states that “Anyone who dies in an apartment building above the first floor is guaranteed to weigh at least 250 pounds.” Hundreds of apartment buildings in this city and they seem to have all been constructed before the days of handicap accessibility.

Without an elevator, gravity is called upon once again. I am a firm believer in letting the floor do the majority of the work, so there is a lot of sliding involved—especially when it comes to stairs. Holding on tightly to the bag, I slowly allow it to slide down each flight of stairs to the ground floor. The drawback of this process in conjunction with the lack of rigor mortis results in the body slumping down into one end of the bag like an orange in a sock.

I’ve lost count of how many times I wished I had “body handlers” at my disposal like the ones that are often shown on television and in movies. Hollywood body handlers are typically two respectable looking actors with no lines that are shown moving the body from the scene on a gurney. Their manner of dress makes them look a lot like paramedics but without the sense of urgency burdening those with life-saving responsibilities.

In the real world—or at least my corner of it—the body handlers are myself, the mortician transporting the body, and anyone else willing to help. Needless to say, volunteers are usually hard to come by.

After reading the above, Douglas commented:

“You mention using the floor to do most of your work. And specifically describe a trip down the stairs. Is there not much concern that a bouncy trip down the stairs would produce new damage or obscure existing wounds making pronouncement that much more difficult?”

To which I responded:

As I reread my post, I can see where my description sounds like a scene from “Weekend at Bernie’s” with a body sliding uncontrollably down the stairs like a runaway toboggan. It’s more of a controlled slide as we ease the bag down with the help of gravity. It still requires some straining, but considerably less than carrying it the whole way down.

As such, there is minimal impact to the body. I have seen a head strike a concrete surface as a gurney fell over. There was a slight mark to the scalp but no underlying fracture present at autopsy and there was no swelling because there was no blood pumping.

About the only trauma that might occur would be an abrasion to the body from rubbing against the inside of the bag. In this case there would be very little “reaction” in the skin tissue–that is to say the abraded area of the skin would have a parchment-like appearance as opposed to the typical appearance of aggravated tissue that has started to heal itself.

As for obscuring the wounds, they should have already been documented before removing the body.

Couches are easier to move down stairs. They may be bulkier, but they are much more rigid and the weight is even distributed. Even a body in full rigor will sag in the middle making the body seem much heavier. I wouldn’t be surprised if an undertaker was the first person to coin the phrase “dead weight.”

Hope that answers your question…

A Douglas

• Autopsy Reports
• A Real Stiff
• A Day at the Spa

Found your site today as I tried to pursue information on ‘Forensic Autopsy Technician’ involving education required and position availability. I’ve been an RN for 30 years and this aspect of medicine has always intriqued me. Early in my VA career, they would call me down to autopsies to observe, because they knew I was so interested. I’m seriously considering this career detour. I haven’t found any concrete guidelines for educational guidelines in my research. Any advice? Thank you!

Maureen Santamaria

Maureen

I’ve gotten this question quite a lot over the last year, so I’ll respond to your comment in post form in case my answer is helpful to anyone else out there.

I’d start by calling your local Medical Examiner/Coroner office to find out if they hire their Autopsy Technicians/Pathology Assistants directly or if you have to go through a state or county agency. If they do there own hiring, pay them a visit to deliver a resume or fill out an application. This gives them a chance to see that you are professional and genuinely interested and aren’t someone just looking to meet their weekly unemployment application quota. It may make the difference between your application ending up on someone’s desk rather than the “to be shredded” bin.

There really isn’t any formal training available so it isn’t required in most cases. Reason being, even someone with minimal formal medical training can make equal or greater money doing something far less repulsive. If you start off with a salary in the low 20’s (even less in some parts of the country), you’re making the industry average. High school degrees or equivalents seem to be the norm because the pay is so unattractive. The only real financial benefit comes with the associated benefits and job security—total population and subsequent deaths only increase each year.

Most of the training for eviscerating bodies comes after you’ve already gotten the job. It helps to have some past experience in working on or around dead bodies or some exposure to some pretty nasty sights and smells. I guess that’s why individuals with previous employment in funeral services or as medical orderlies seem to succeed where others might quit before becoming “acclimated” to the tasks the job demands.

The moral of the story is if you’re looking for a job that:

–requires direct physical contact with some of the more questionable members of society as well as the potentially life threatening infectious diseases their tissue and fluids may contain…

–requires you to see and do things that common sense dictates you not share with the general public for fear of being regarded as an insensitive monster…

–causes many people to quit the minute they are faced with making their first cut on a decomposed body…

–provides a unique learning experience on a daily basis and allows you to feel as though you are contributing to an investigative process that is bigger than any single person or agency, then this is the job for you.

Good luck to you.

A Douglas

• Bringing Out the Dead – Reposted
• Whatever Happened To
• Suicidal Thoughts

I also never knew so many people committed suicide. Unless there’s an article in the paper discussing suicide rates, they really aren’t that publicized. Family members and funeral directors are understandably reluctant to include this detail in someone’s obituary. Unless someone takes their own life in a public setting or a very unusual way—like jumping off a building or “Suicide by Cop,” the news media seems fairly reluctant to cover suicides.

But the category that has continued to amaze me the most is one that you won’t find listed among mortality statistics—toilet deaths.

My assumption is that we as a civilized people are naturally inclined to head for the toilet whether our intestinal discomfort is heading north or south. It’s quite common for family members to offer that their loved one had been experiencing nausea, vomiting, or diarrhea in the days preceding their death. Unfortunately, this history is usually evident upon entering the bathroom. Even drug users exhibit this behavior with drugs on board. I’ve moved plenty of bodies from bathrooms that still bore tourniquets or syringes in their veins. Others have left vomitus on or around the toilet containing macerated pills.

If I never again have to work a scene where someone is dead on the toilet, in front of the toilet, in the toilet, or wedged between the toilet and tub or cabinet it will be too soon. I’ve never seen a cop run from anything, but when a toilet comes free from its base and tips over, you’d think the contents of the bowl were filled with hot lava.

I’ve just about come to the conclusion that there should be federally mandated warning stickers placed on toilet seats—“If you are over 40—don’t fight it!” In a world where manufacturers feel legally compelled to tell people not to use a blow dryer in the shower, they should feel equally compelled to warn people about the risks of breath control and steady pushing or educate them on the benefits high-fiber diets.

• Suicidal Thoughts
• Autopsy Reports
• Violent and Unnatural

When I first started, it felt a little odd going through the personal belongings of a complete stranger, but I soon learned that many times these searches yielded as many noteworthy—and sometimes unusual—findings as the bodies themselves.

Pill bottles and drug paraphernalia are two of the most common discoveries. The medications that are prescribed give some insight to the medical history of the deceased as well as the name of the person’s physician. A quick count of the pills can tell whether the deceased has been taking the medication as directed or not. Bottles of the same medication prescribed by different doctors within the same time period can indicate a history of “pill seeking.” Bottles of medication prescribed to people not residing at the scene can indicate illegally procured pills.

I recall one scene in particular where I had gone through four of a chest of five drawers and wished I had stopped. When I opened the bottom drawer, there were three Walmart sacks filled with old prescription bottles, each containing medication. Because I found them, I had to document them, take custody of them, and inventory them upon returning to the morgue. I also seem to recall the autopsy took less time than the inventory.

Depending on the person’s lifestyle, drug paraphernalia may or may not be well-hidden. Thinking to myself, “If I were a doper, where would I put my stash?” has proved to be fairly successful. Using this method, I’ve managed to find all manner of objects that have been converted into drug devices.

I worked a scene where a man was being allowed to live in a camper trailer in his soon to be ex-wife’s driveway. She’d thrown him out because of his drug addiction, but allowed him to stay in the trailer provided he didn’t bring any drugs on the premises. Instantly suspecting that her husband failed to obey this condition, I searched the trailer anyway. Reaching into an odd hole punched in the wall, I removed a cigarette box containing two small bags of dope.

Other times the family waiting in the living room is genuinely surprised to learn that I found drugs or paraphernalia in their loved one’s bedroom. There’s nothing quite like being present when a family learns for the first time that grandma knew how to score some weed—or when they realize it was a family member that supplied it.

These searches sometimes reveal all manner of pornography and sexual devices. Perhaps the strangest thing I recall finding was a shoebox full of Polaroids that showed the bottom of hundreds of feet. In most cases, unless the death appears to have resulted from an autoerotic event or the pornography is illegal, I just shake my head, move on to the next drawer, and keep my mouth shut. I damn sure don’t want to be around when the family learns about that side of grandma.

• Always Searching for Something
• Crapped Out
• Top 10 Unique Things I’ve Done – Reposted

I do understand that sometimes other investigative agencies other than the coroner are relied upon to determine manner of death, but let’s say someone has a gun shot wound. All agencies know who shot this person. The question is “was it justifiable or not?” Doesn’t the coroner list the manner as homicide regardless of the justifiability?–Terri

Terri:

It depends on the particular agency or in some cases the individual that is certifying the death. Some agencies have policies on how they rule certain deaths based on a literal interpretation of the circumstances or on the charges that are likely to be filed. In some situations, the element of “intent” may help determine the manner of death.

Let’s say someone breaks into my house and I shoot them before they shoot me. I admit to the police that I’m the one who shot the intruder. Upon examination, the victim is found to have a distant range gunshot wound to the chest. When it comes to certifying, the Medical Examiner/Coroner (ME/C) is primarily focused on how the decedent died and not the issue of justifiability. That’s an issue for the law enforcement agency and the district attorney’s office to sort out when they decide whether or not to press charges.

Additionally, U.S. death certificates typically only have six options for classifying the death with no provision for justifiability. These are as follows:

–Natural
–Accident
–Suicide
–Homicide
–Pending Investigation (or Pending Further Studies)
–Could not be determined (or Undetermined)

In my shooting scenario, there’s a gunshot wound involved so Natural is out. I intentionally discharged the weapon, so Accident is out. The victim didn’t pull the trigger, so Suicide is out. The certifier may elect to classify the death as Pending Investigation/Further Studies, but at some point they have to place the death into one of the other categories when the investigation is officially completed. “Could not be determined” doesn’t apply because we know what happened.

Let’s say the above victim was actually found dead in his front yard with the same distant range gunshot wound to the chest. Without knowing the particular circumstances of the shooting, we can infer that someone else pulled the trigger and the death should therefore be classified as a Homicide.

Now, let’s say I was out hunting with some friends of mine, my shotgun accidentally discharged, and one of my friends was fatally shot. Two separate investigations would then follow. Law enforcement would investigate the shooting incident and the ME/C would investigate the resulting death. Regardless of my intent, our policy would have been to classify the death as a Homicide because we use the literal definition of Homicide—the killing of one person by another.

Even though the manner of death is listed as Homicide, law enforcement may conclude that the shooting was indeed accidental and the prosecutor may decline to press charges. The end result is that the ME/C has taken law enforcement’s investigation into consideration but ruled differently. Conversely, the ME/C may classify a motor vehicle fatality as accidental, but the agency and prosecutor may elect to pursue manslaughter charges because the surviving driver was intoxicated.

The reliance of the ME/C on other investigative agencies to accurately classify the manner of death is really quite common. The postmortem examination can verify that someone died from a hard contact gunshot wound to the head, but—in the absence of obvious physical evidence—such an examination will not indicate unequivocally that the wound was self-inflicted. It is typically law enforcement’s investigation that provides the information necessary to distinguish between a suicide and a homicide. Details such as recent personal loss, severe depression, or suicidal ideation are common indicators of suicidal intent.

I should also point out that there’s a reciprocal element to this reliance. Many times the law enforcement agency may treat a death as a natural event pending any information to the contrary from the ME/C.

None Found