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Although it has ancient roots, forensic pathology is a modern science, with certification being given only in the last two decades.  Yet, most of America’s larger cities have converted from coroner (25) to medical examiner systems of death investigation.  The coroner is an elected or appointed official who may or may not be a doctor.  Usually he isn’t and must hire doctors to perform his autopsies.

Today there are about 100 certified full-time forensic pathologists in the U.S., most of them in larger cities.  (In rural and suburban areas, hospital pathologists often work part-time in this specialty.)  Every violent, suspicious or unnatural death is theirs to probe (26).  Working with an army of forensic scientists – investigators, toxicologists, biologists, firearms and ballistics experts, microscopists, dentists, anthropologists, even psychiatrists (27) – the medical examiner or coroner determines the cause and manner of death of more than half a million people a year, or approximately one out of every four who die.  From their findings come arrests and convictions, freedom for the falsely accused, crackdowns on public-health hazards (28), and new laws to prevent unnecessary deaths.

“In real life, we aren’t concerned with ‘who has done it’,” says Dr. Michael Baden, chief medical examiner for New York City.  “Our job is to find out ‘what has done it’ and ‘how’.”

That concern is what led Dr. Leslie Mootoo, chief medical examiner of Guyana, to the grisly scene of mass death at the People’s Temple settlement in Jonestown (29) in 1978.  The first physician on the scene, Dr. Mootoo autopsied 70 bodies and examined many others.  His startling conclusion, as related in a newspaper interview: more than 700 of the 911 persons who died at Jonestown did not commit suicide.  They were murdered.

The poison used was cyanide (30).  It can cause convulsions (31) and painful death.  Dr. Mootoo doubts that anyone watching the first poison drinkers flail about (32) and scream would voluntarily take the portion himself.  Also, he found hypodermic-needle marks (33) in the upper arms of several of the bodies of both children and adults that he examined.  Dr. Mootoo said it is virtually impossible for an adult to inject himself that part of the arm.

Although crimes resulting in death account for less than ten percent of a medical examiner’s work (suicides, accidents and natural deaths unattended by a physician account for the rest), the medical examiner is a vital link in the law-enforcement chain.  Often it is only the knowledge of forensic scientists that unmasks a murder..

Take the case of Howard Taylor for instance.  By the time an engineer saw Howard’s body on the railroad tracks, it was too late to stop the train.  Parts of Howard scattered for quite a distance.  The medical examiner was bothered by a bruise around the victim’s left eye and an abrasion (34) along the left side of the nose.  From the swelling and discoloration the forensic pathologist could tell the injuries occurred before the man died.  Within hours, after painstaking investigation, the stab wounds that killed the man before he was dumped on the tracks became evident.

On the other hand, forensic pathologists often find that what looks like murder is a suicide, an accident or even a natural death.  For example, Linda Richards had been flirting with one man after another at a party.  She and her boyfriend, Bob, had words, and he slapped her.  She staggered, fell and didn’t get up.  At the hospital emergency room, Linda was pronounced dead on arrival.

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