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.

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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

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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

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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.

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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.

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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.

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Back then, I always wondered what it must be like to have a job so important that a cell phone was critical. One of those jobs that required a person to be available at all times. Something impressive like a corporate executive, a Hollywood mogul, or a government agent.

Now that I have one—the job and the phone—I don’t wonder about that sort of thing anymore. Now I hate my phone. Keep in mind that 95% of the time that my phone rings it means that somebody has died. I’ve even developed an aversion to answering my phone at home. The only people that call my home phone tend to be telemarketers, but I guess every now and then I like to talk on something that doesn’t accelerate the growth of the tumor on the right side of my head.

I don’t even know why I keep the land line. It’s like a dog that never gets played with, but the owner keeps buying food for it every month. Maybe it’s because it doesn’t tear up the furniture or crap in the house when I’m out later than usual. Everyone knows they can connect directly to my hip 24/7 and I’ll answer unless I’m gloved up or in the shower. Come to think of it, I’ve worked plenty of scenes where both conditions applied. (See my post “Suicide Foresight.�?)

The best part about cell phones–besides the fact I haven’t paid a cell phone bill in years–is that just about every cop has a cell phone. Gone are the days of trying to return a call to a private residence and getting a busy signal for an hour at 3 a.m. because the family has the phone tied up. The police are also able to use their cell phones instead of their radios on certain scenes in order to keep the media from hearing about the incident over their police scanners. Inevitably some citizen sees all the police activity and calls the local station’s “When you see news happen�? hotline using their cell phone.

For anyone going in to this line of work, I have a bit of advice–be sure you get the optional phone insurance. I’ve noticed that the smaller the cell phones get, the fewer impacts against the bedroom wall they seem able to withstand.

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Further apologies to anyone who has emailed me the last few months.  I’ve also learned that in my absence, the spam screener for both my email account and comments section has been overly agressive and rejected quite a few valid submissions.  With the help of my brother-in-law, that issue seems to be corrected now.  I’ll be working on posting comments and responding to emails as soon as my next post is up, which should be this weekend.

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Dianna writes:

My sister recently was discovered by her husband , hanging in the barn. She lived in a rural setting and was isolated. There was a 2 year history of spousal abuse and in fact her husband had been charged and was convicted of assult against by sister. He served 6 weeks in jail, was on probation and required to receive treatment for anger management. I recently returned from a meeting to speak with the law enforcement who dealt with the case. They informed me that they were aware of a 2 year history of spousal abuse. They stated that they were wary when they were called to the scene because of the history. They said they could find no evidence that there was foul play involved and that it was a simple suicide by hanging. There was table at the scene with a large plastic drum on top. They said they saw a footprint in the dust and oil on the drum but did not check to see that it matched her shoe size (which was small for an adult - size 5) They also said that one of her shoes lay approx 20 feet from the body. They assumed that she had kicked off the shoe in her struggle. They also stated that there was no rigor mortis of the body.

After phoning the coroner, I was told that I could not ask for a full autopsy and in fact they did only a superficial or external autopsy. They did say that there was no tissue under the finger nails and no scratches or marks on her neck other than the ligature mark.. My question is … if she struggled as she died enough to kick off her shoe would she not have had some sign of grabbing the rope or trying to loosen it from her neck. I understand that in a short drop hanging, regardless of how committed the individual is to taking their life there is an automatic response to preserving her airway. The only toxicology study they did was for blood alchohol level. Nothing else. My second question is why would they not do a complete autopsy when there was a history of spousal abuse, she was isolated and found by her husband. Why did they not do a full toxicology screen? They also did not estimate the time of death. I would really appreciate any answer you could provide me with especially in what they look for in a short drop hanging. Thank you so much.

Dianna:

Not having worked the scene myself or having access to all the information, I don’t feel comfortable commenting on the particular circumstances of the death. I can however shed a little light on your questions about how the case was handled based on the general procedures of most coroner and medical examiner offices.

The reason you were likely told that you couldn’t ask for a full autopsy is that the general public doesn’t have the legal authority to request an autopsy. In many cases where there is an obvious cause of death like a gunshot wound, a crushed chest, or in your sister’s case a ligature around the neck, an autopsy isn’t deemed necessary to determine why the death occurred. Reason being is that all an autopsy is going to accomplish is to verify that someone died as a result of their trauma. That is why the extent of the coroner/M.E. investigation may only involve an external examination.

The best comparison is to think of a vehicle in a car crash. A mechanic doesn’t need to tear down the motor to figure out why the car doesn’t run when the engine has been pushed into the cab of the vehicle.

If I were in your position, I’m sure I too would be shocked that no one felt a full autopsy was warranted when taking into account the spousal abuse and isolation that were involved. However in my position, I understand that forensic pathology is limited in its application. In cases with no sign of trauma or foul play, the coroner/M.E. determines both the cause and the manner of death. In traumatic or suspicious cases, they only determine the cause of death and rely primarily on the law enforcement agency’s investigation when classifying the manner of death.

In other the words the coroner speaks for why the person died and law enforcement speaks for how the person came to be injured in the first place. The point here is that the coroner can only account for the cause of death. Neither an external exam nor an autopsy are going to tell how a person came to be injured or whether they were “helped along‿ with the circumstances leading to their death. Many law enforcement agencies have felt your frustration when their request for a full autopsy on an individual with a ligature or a hard contact gunshot wound to the head is denied. They are told what many families are told—an autopsy is only going to confirm that which is already known. Beyond that, any involvement on the part of anyone else is a criminal matter and by law falls under the jurisdiction of law enforcement.

The coroner/M.E. could have interviewed the husband on issues related to the how your sister was found, but does not have the legal authority to treat him as a suspect. Typically the end result is that in traumatic cases, the coroner/M.E. isn’t likely to officially classify a death as suspicious when it conflicts with the investigation of law enforcement. That’s not to suggest a conspiracy though. It’s just that the coroner has no evidence to prove otherwise. They may have a different opinion or a gut feeling, that something is amiss, but they can’t (or at the very least shouldn’t) base their conclusion on speculation. On the other hand, law enforcement tends to rely heavily on the impression of the coroner—if the coroner isn’t comfortable then law enforcement generally isn’t either.

As for the toxicology study, in cases where there is an obvious external cause of death a full tox screen is rarely done—the reason being that positive test results won’t do anything to change the manner of death. If someone puts a gun in their mouth and pulls the trigger, a likely cause of death is “Intraoral Gunshot‿ with a manner of “Suicide.‿ There may in fact have been drug or alcohol involvement that affected the person’s sense of reason, but the bottom line is that the person took their own life and the death is therefore ruled a suicide. Using the mechanic analogy again, the wrecked car may have had faulty brakes which played a major role in the crash, but the reason the car no longer runs isn’t damage to the brakes, it’s the damage to the car.

I understand that the presence of foreign substances in a person’s system may be of key interest to a family member who is trying to come to terms with what their loved one’s state of mind may have been when committing suicide, but for medicolegal investigative purposes it is essentially irrelevant. Specimens are typically held by a tox lab for a certain period before they are destroyed. If the family wishes to obtain samples for private testing, they can usually do so with a court order.

For information on the time of death issue, here’s a paragraph from “Agencies, Answers, and Assumptions.‿

Among the countless ways that crime scene dramas misinform the general public, “time of death‿ is perhaps the most misleading. In most cases there simply aren’t enough solid physiological markers to establish an accurate time of death, and the longer someone has been dead, the more difficult it is to be as accurate as Hollywood portrays. As such, it is not uncommon for a person’s “time of death‿ to be listed as the time that they were found. The time of the original call to 911 is usually the first documented time and serves as a solid “found‿ time. Please refer to my post on “Postmortem Interval‿ for more information on the subject.

Hopefully this information helps you in some way.

A Douglas

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Jayne wrote:

I think it’s creepier going under the house than finding the bones. I’m very claustrophobic. I have a question for you: Back in 1991 (in Hermann, MO) my dad bought this old general store that also had a ballroom and small stage. My brothers and I were exploring the ballroom which was filled with all sorts of neat things left behind years ago. I got the fright of my life when I found a box, opened it, and three skulls on top of a pile of costumes were staring up at me. Although we called the police, they sent over the coroner who just picked up the bones and left. We did find out that they were human, but that was it. It seemed odd that we never heard anything more and there seemed to be no investigation. Neither was there any mention in the news. I know you don’t have the answer, but would just like your point of view on this. Was this handled normally? Or was it small town indifference toward old bones? How would such a discovery be handled (such as the bones under the house) if bones were human?

Jayne:

I hate to make assumptions without knowing all the particulars of the case, but since you asked for my point of view it sounds fairly normal to me. In many cases, about the only thing a coroner/medical examiner can do with certain skeletal remains is determine the sex, race, gender, and age of the deceased based on certain skeletal traits and measurements. A dental comparison or DNA extraction might be possible, but unless there are dental records or an existing DNA profile from a suspected individual to compare with, then all the dental restorations or genetic material in the world is of little value.

Unless there was an apparent traumatic injury to one of the skulls, chances are there was very little the coroner/medical examiner could do to determine the cause and manner of death when the rest of the remains are absent. As such, the investigation—which is really just a partial examination—may not yield anything worth reporting and give the impression that no investigation was conducted. I would guess that the skulls were sealed up and stored at the morgue until a positive I.D. could be made.

Unless the media knew specifically that the skulls were discovered, they wouldn’t have had a reason to call the morgue and ask for information regarding them, so it’s likely there was nothing ever reported in the news.

When it comes to the scene detailed in “Them Bones‿, if I had determined that the bones were human, I would have backed out of the scene immediately and contacted the police department’s crime scene unit to see if they wanted to document the scene before I proceeded. From there, we would work the scene as thoroughly as we would any other suspicious death. Believe it or not, bones are found quite frequently. Fortunately they are almost always determined to be non-human.

A Douglas

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