Part 4 in a multi-part series…chronicles of a LeeGROWS participant

Week 1 – Part 4: (not for the faint of heart or stomach)

My curiosity was laced with uncertainty. We’d been warned at lunch that the afternoon visit to the morgue could be difficult for some people, and we could opt out no questions asked. But the biologist in me really wanted to know what goes on in a morgue. All I knew, really, was that’s where they took dead bodies to do autopsies. I’d never given a thought to why or how and who was involved with those autopsies. I wasn’t sure what I’d be allowed to see and learn on this tour, but I can tell you it was more than I had anticipated…

The Lecture

Our tour guides were two of the three death investigators in the District 21 Medical Examiner’s Office, whom I learned were not doctors, but who work with the forensic pathologists to determine the cause and manner of death of any body brought under their jurisdiction. The death investigators go to the scene  to collect evidence and they assist with autopsies, but do not do autopsies without the pathologists. They work independent of any law enforcement agency. Death investigators can verify a death, but not certify one. The forensic pathologists make the decision as to when an autopsy is needed. The medical examiner certifies the death.

There are five official causes of death: homicide, suicide, accident, natural, and undetermined. There is no time limit on Medical Examiner cases. Under Florida statutes 406.11 and 406.12, any death that occurs under one of the following 14 circumstances must be reported to the Medical Examiner’s office:

1. By criminal violence of any type. Did you know that if a person dies as many as 20 or 30 years after sustaining an injury in a crime or accident, that death can still be ruled a homicide?
2. By accident, including delayed deaths and deaths resulting from medical complications following an accident. The most common form of this in District 21 is from hip fractures.
3. By suicide.
4. Suddenly, when in apparent good health. A sample story: A man dies of a sudden heart attack in his home. His wife says he’s always been healthy and never goes to the doctor. The death investigator walks to the bathroom and opens the medicine cabinet and finds it loaded with TUMS, Maalox, and other antacids. The man was having heart problems and treating them with antacids. Men – don’t be a tough guy. Go to the doctor now and then.
5. Unattended by a practicing physician or other recognized practitioner. Death without medical attendance is defined as ” occurring more than 30 days after the decedent was last treated by a physician except where death was medically expected as certified by an attending physician.” Nursing home patients and patients in Hospice are considered attended. Deaths from natural causes occurring within 24 hours of hospitalization are not reportable to the ME unless one of these 14 rules applies.
6. In any prison or penal institution. No surprise there.
7. In police custody.
8. In any suspicious or unusual circumstance.
9. By criminal abortion. (None have ever been reported in District 21)
10. By poison. These are usually accidental (children getting under the sink or in the garage) or by substance abusers looking for anything to get high.
11. By disease constituting a threat to public health. (West Nile Virus, meningitis, encephalitis, etc.)
12. By disease, injury, or toxic agent resulting from employment. Asbestos is the biggest culprit here.
13. When a dead body is brought into the state without proper medical certification.
14. When a body is to be cremated, dissected, or buried at sea. This one surprised me. But because these body disposal methods are so permanent, the medical examiner has to determine if there is any need for an autopsy first. They don’t usually need one but the M.E. must certify the death anyway.

The Tour

So, now you know why bodies come to the morgue. Now, what happens when they get there? The first thing you notice when you enter the back rooms is the smell. It wasn’t horrible, but it was distinctive. We were told that one of the bodies they’d autopsied that morning was decomposed so the smell was a little stronger than usual. OK, then – thanks for sharing…

First the bodies are brought to the “check-in garage” where they are weighed, measured, and all personal property and clothing on them is inventoried (they inventory the property twice at the scene and again at the morgue). The bodies are then placed in one of the refrigerated coolers or freezers (the decomposed bodies go in the freezers). The District 21 facility has the cooler capacity to handle a large number of bodies such as from a plane crash.

Much to my surprise, our guide opened one of the refrigerator doors and invited us in. He said they’d done three autopsies that morning, including the decomposed one. I was hoping that one was still in the freezer across the hall. But there were three bodies in this cooler, each obscured from view by a blue or white zippered body bag.  I was immediately grateful for the low light and the refrigeration to dull both the smell and my anticipated nausea. But it didn’t come, thankfully. And I didn’t linger, much as I wanted to.

The autopsy room was starkly bright compared to the refrigerators. A huge skylight in the center of the ceiling and fluorescent lights around the edges spotlighted the autopsy tables and tools. Here they could do five autopsies at a time if they needed to -a typical day was three. The most they could remember doing in one day was nine (usually on the weekends, go figure). Our guide lifted a bright white towel off one table to reveal the tools of the trade – dozens of medical tools, but also the Home Depot variety.

During an autopsy they collect samples of blood, urine, vitreous fluid, and a tissue sample from every single organ and keep it for five years. They “bread slice” each organ to be sure they don’t miss any possible cause of death – cancer, injury, disease. It takes 8 – 10 weeks to analyze the samples and get the results. Then they officially certify the cause and manner of death.

Once complete, the bodies are taken to the “outgoing cooler” where they await pick-up by funeral home directors. There were five bodies here on this day. As soon as our guide opened the door, I could see that one of the bodies  had been charred by fire. Toes could be seen peaking out of another bag.  My heart skipped a beat, and I backed away quickly. It was an eerie feeling, staring at those packages that contained once-living humans. It made me wonder about their lives, their families. It made me think about my own and what will happen to me once I die. It was a sobering moment.

The people who work in the Medical Examiner’s office are extraordinary folks. They have to be committed to the task and to serving the people. They have to be smart and strong, able to navigate a death scene and a courtroom. They have to be able to distance themselves from the emotional aspects while being able to talk to families of the dead.

One of our guides says when people ask him how to get into this profession, he steers people away from it. Why? “It may seem ‘cool’ to do autopsies and investigate deaths, but when you have to meet the mom of that one-year-old who died in a car crash, it’s no fun.” Besides, the competition for jobs is tough. Even with his military and mortuary science background, it took him nearly a year to land this job – application, weight test, written tests, interviews, connections. “You not only have to be very good at what you do, you have to be very lucky.”

As luck would have it, I was glad to be able to walk out of the morgue on my own two feet that day and come home to give my husband a hug. Life is short. Enjoy the moment. [tweetmeme source=”debh2u” https://debh2u.wordpress.com/2010/08/10/fact-fiction-in-the-morgue/%5D
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Next week in the LeeGROWS series: Circuit Court, Property Appraiser, Tax Collector, County Attorney