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Investigation Discovery

9 Secrets of Coroners and Medical Examiners

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Investigation Discovery

Many true crime aficionados are familiar with the popular portrayal of coroners and medical examiners and their daily interaction with the dead. In the real world, their essential task—confirming a death and figuring out what caused it—is far more involved than what you see on television. Mental_floss spoke with Graham Hetrick, coroner for Dauphin County, Pennsylvania and star of Investigation Discovery’s show The Coroner: I Speak for the Dead, as well as several other medical examiners, to get some insights about their work on the autopsy table and elsewhere.  

1. THERE CAN BE A BIG DIFFERENCE BETWEEN MEDICAL EXAMINERS AND CORONERS.  

The coroner system dates to medieval England, when these officials, then called crowners, worked for the king investigating frauds, thefts, and deaths. These days, a coroner’s main duties are to confirm and certify a death, and to determine whether an investigation is warranted. Prerequisites for coroners vary widely from state to state, with some states requiring that they be certified pathologists while others allow jurisdictions to elect laypeople to the position. Other states, particularly those with large urban centers, have adopted systems employing medical examiners—who are always physicians, never laypeople.

But while coroners in a few jurisdictions may hold little more than a high school diploma, many are highly qualified professionals. Hetrick has a particularly varied background. He is also a medical legal death investigator (an expert in examining the manner and cause of death), thanatologist (a specialist in the scientific study of death), forensics consultant, and funeral director, with advanced training in blood pattern analysis, crime scene management, and forensic sculpting. Hetrick says that while Pennsylvania employs mainly coroners, his system is a hybrid one in which he works closely with a forensic pathologist.

2. MEDICAL EXAMINERS ARE DOCTORS—BUT FOR THE DEAD.

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Bruce Goldfarb, executive assistant to Baltimore’s chief medical examiner, explains that while all of the doctors in his department are board-certified forensic pathologists, other cities have had medical examiners who are obstetricians or dentists. But no matter what, Goldfarb says, medical examiners are still “doctors doing doctor work. When we go to the doctor, they do a physical exam, maybe send you for a chest x-ray, order a urinalysis or blood tests, and then they figure out what, if anything, is wrong with you. Our doctors do the same thing, except the patient is dead and they're trying to figure out why.” Unlike regular doctors, however, medical examiners don’t generally have to deal with medical insurance or malpractice suits. 

3. THEY MAY NEED TO CALL IN A BOTANIST. 

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Coroners and medical examiners collaborate closely with other experts, including forensic photographers, toxicologists, forensic anthropologists, and odontologists (dental experts). Hetrick compares his role as a coroner to that of an orchestra conductor, overseeing different instruments coming together to play “the music of the dead.” He notes that specialists from fields that might seem unrelated to his work—such as entomologists and botanists—can be very helpful in determining time of death based on the life forms that have taken root in a corpse. He describes one case, profiled in episode 4 of The Coroner, in which he called in a botanist to examine a plant growing through the eye socket of a skull in order to pinpoint how long the body had been in that spot.

4. THEY ADVOCATE FOR THE DEAD. 

Investigation Discovery

When most people think of advocacy, they think of efforts to protect the rights of disenfranchised populations among the living. But people who have died under mysterious circumstances or as a result of violence need advocates too. Dr. Marianne Hamel, a New Jersey-based medical examiner and one of the creators of the project Death Under Glass, says of her work: “It helps to look at the job as advocacy for the dead—they are, in many ways, the most disenfranchised among us. They can't testify for themselves or directly tell a jury the story of their suffering. That’s the job of a forensic pathologist.”

Hetrick expands on this outlook, seeing it as his duty to listen to the stories that the dead tell through their physical presence, including damage and decay to their bodies and their position in a crime scene. “I am a storyteller,” he says, “but they are not my stories.” 

5. THEY HAVE TO BE VERY CAREFUL AT A CRIME SCENE. 

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In addition to being connected to a wide array of forensic and other sciences, the work of coroners and medical investigators is closely tied to legal investigations into specific deaths. Hetrick stresses that forensics is “science applied to law,” meaning that all physical evidence uncovered during a forensic investigation must hold up in court. “Otherwise,” he says, “it’s just opinion.” 

In order for evidence gathered during a coroner’s or medical examiner’s investigation to hold up in court, the investigators must be thoroughly familiar with crime scene procedure and follow chain of evidence practices. Chain of evidence refers to proper collection and processing of crime scene evidence, including thorough, continuous documentation of who handled the evidence and when. Hetrick says that failure to correctly document handling of evidence affected the outcome of the O. J. Simpson case, making it impossible to convict Simpson in criminal court.

6. THEY ARE SLEUTHS.

Penn StateFaculty Cottages forensic science program via Flickr // CC BY-NC-ND 2.0

The job of a coroner or medical examiner demands endless curiosity and a desire to extract the truth from every case. This process can take years, and many of these professionals describe being haunted by cold cases that were never solved. Naturally, persistence and a strong problem-solving aptitude are desirable attributes. Goldfarb says one of the most challenging types of cases is also one of the most common—somebody “found dead at home, no obvious injuries, no signs of foul play. ... It could be anything; drug intoxication, heart attack/stroke, head injury ... could be suicide, could be accident, could be homicide. Every possibility has to be considered and run down.” Hamel adds that cases are not always what they seem at first, and that she may encounter a natural death that turns out to be a drug overdose, or a suicidal hanging that is actually an autoerotic asphyxiation.

7. THEY ARE NOT ALWAYS PORTRAYED ACCURATELY ON TELEVISION.

Hetrick says Investigation Discovery’s show captures many important aspects of his profession, particularly the science behind it and the interactions of coroners with the rest of the investigation. Fictional portrayals of coroners and medical investigators, however, are not always so accurate. Hetrick says the typical television pathologist, laboring in a laboratory in isolation, often strikes him as “kind of disturbed.” Goldfarb says that in real life, investigations usually do not wrap up as quickly as they seem to on television. Plus, homicides—which represent about 4 to 5 percent of the cases the Baltimore OCME investigates—are overrepresented. 

Hamel agrees that television is prone to bend the truth in the name of drama. “I don’t carry a gun, I've never interrogated a live suspect, and,” she says, “I don't perform autopsies in the middle of the night under a single, bare, swinging light bulb.”

8. THEY WORK WITH THE LIVING, TOO.

Paul Sableman via Flickr // CC BY 2.0

In addition to their interactions with law enforcement and forensics specialists, a big part of coroners’ and medical examiners’ jobs entails communicating with grieving family members. Hamel emphasizes the need to remain even-tempered and compassionate toward family members who may become understandably overwrought or angry. Goldfarb, who has a background in psychiatry and crisis intervention, concurs. “One of the challenges of the job is constantly keeping in mind that for me this is an ordinary Monday, but the people I speak with on the phone are having one of the worst days of their life,” he says.

Hamel adds that, contrary to the stereotype of the shy, solitary forensic pathologist, people in her field are often called on to testify before a jury or to lecture death investigators or police trainees—so it helps to be outgoing. 

9. DEATH INFORMS THEIR OUTLOOK ON LIFE.

Memento mori mosaic from Pompeii, Naples Archeological Museum via Wikimedia // Public Domain

Hetrick emphasizes that one of the main differences between The Coroner: I Speak for the Dead and other forensic investigation shows is its emphasis on what the dead have to teach the living. “The reason I’m doing the show,” he says, “is because of what the dead show us about how we live and how we should live.” For Hetrick, this means examining both the psychology of those who commit murders and what their actions say about society, as well as the impact that deaths have on living people. He describes his interactions with the family of the victim portrayed in the show’s first episode—a woman named Iris who was killed while trying to build a better life for herself—as emotional, but says it was gratifying to see Iris’s daughter motivated to pursue her dreams in part because of the untimely death of her mother.

On a more personal level, Hetrick says the constant exposure to death prompts him to constantly reevaluate his own life, and to avoid taking anything for granted. “It’s a very thin line [between life and death], believe me,” he says. “A lot of people on that autopsy table thought today was just another day.”

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T. Fernandes, M. Liberato, C. Marques, E. Cunha
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Stones, Bones, and Wrecks
Archaeologists Make Rare, Gruesome Find in Portugal
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Oblique cuts in the bottom third of the legs of a medieval skeleton found in Portugal.
T. Fernandes, M. Liberato, C. Marques, E. Cunha

In the small city of Estremoz, near Portugal’s border with Spain, archaeologists recently excavated three graves located at the edge of a medieval cemetery. They were intrigued by the graves' isolated location and odd burial style. Within, they found something shocking: All three people had amputated hands and feet.

Between the 13th and 15th centuries, Estremoz was an important village located between the kingdoms of Portugal and Castile. In the mid-13th century, Christians colonized the area, driving out the Moors. The famous castle of Estremoz, parts of which still stand, was built to house the royal court. The nearby cemetery of Rossio Marquês de Pombal dates to this period. It's on the edge of this cemetery that the archaeologists found the burials.

Writing in the International Journal of Paleopathology, researchers from the Universities of Évora and Coimbra describe the young to middle-aged men found in the graves with cut marks to their forearms and ankles. The cuts are clean through the bones but not quite at right angles, and appear to have happened just before or just after death. Even more interesting, the bones from the severed hands and feet were also found in the graves—but not in the right places.

Field drawing of the skeletons. The arrow points to one of the men's right hand lying below his left elbow.
T. Fernandes, M. Liberato, C. Marques, E. Cunha

In the case of a late-teenage male, both of his feet and his left hand were buried under his left hip, while his right hand was under his left elbow.

In another grave, they found evidence that one amputation took more than one try to complete. The man's right leg had a second set of cuts, likely inflicted after a failed first attempt to cut off his foot. The researchers think that a sharp implement such as a machete, sword, cleaver, hatchet, or axe was used to deliver the blows swiftly and with high force.

The archaeologists believe the cuts were made while the men were still alive—or very near death—and almost certainly restrained. Lead author Teresa Fernandes tells Mental Floss that “due to the absence of any artifact, we cannot state for sure that the feet were bound; yet considering the historical evidence, prisoners were normally bound with the legs straight while hung."

Why had the men been treated like this?

Generally, amputations occur throughout history as the result of a medical therapy, accident, ritual, intentional violence, or punishment. While there is evidence from the same cemetery for foot disease, these particular men had no other indications of problems with their bodies, meaning medical treatment can be ruled out. So too can ritualistic post-mortem amputation, since there are no historical or archaeological accounts of amputation of hands and feet after death. And their injuries were clearly not the result of an accident.

The researchers think these amputations were a punishment.

Historical records of amputations related to criminal cases are relatively rare. But medieval kings in the Iberian peninsula had the discretion to mete out capital punishment—including hanging, drowning, and even boiling someone alive—as they saw fit. They could also use mutilation as punishment. The researchers found one mention specifically of the amputation of both hands and feet of traitors during a civil war in 14th-century Portugal.

“These skeletons may represent the testimony of vigorous application of justice as an act of royal sovereignty in a peripheral but militarily strategic region,” Fernandes' team writes.

Other researchers agree with this interpretation. Piers Mitchell, a palaeopathologist at the University of Cambridge, tells Mental Floss that because "the amputations are all at similar locations, and are symmetrically placed on the limbs, deliberate amputation as a punishment seems the most plausible interpretation."

Lost to the ages, however, is what these men may have done to merit this extreme punishment. Execution "could be enforced in the event of treason, theft, making false currency, or myriad sexual crimes," Fernandes says. “But the form of execution isn’t stipulated by law."

Archaeological evidence of judicial amputation is extremely rare, according to Jo Buckberry, a bioarchaeologist at the University of Bradford who has done similar studies on ancient British skeletons. "The evidence of cut marks and the inclusion of severed hands and feet make this Portuguese case especially compelling,” she tells Mental Floss. Mitchell explains that often, "the extremities are absent in the graves of those who underwent amputation," which makes it noteworthy that these graves contained the spare body parts.

The fact that amputees were all young men also intrigues scholars. "This pattern has been seen in execution cemeteries in Anglo-Saxon England,” Buckberry says, “leaving us wondering if young men are more likely to commit crimes, or to be caught doing them, or if punishments are especially harsh for this demographic group."

These three unfortunate men may never tell us exactly what they did or who they are. But their bones show the most severe case of amputation as judicial punishment to date, revealing just one of the extreme penalties for committing a crime in medieval Portugal.

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Weird
7 Famous People Researchers Want to Exhume
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This week, the surrealist painter Salvador Dali is being exhumed from his grave in Figueres, northeastern Spain, where he has lain beneath the stage of a museum since his death in 1989. Researchers hope to collect DNA from his skeleton in order to settle a paternity suit brought by a tarot card reader named Pilar Abel, who claims that her mother had an affair with the artist while working as a maid in the seaside town where the Dalis vacationed. If the claim is substantiated, Abel may inherit a portion of the $325 million estate that Dali, who was thought to be childless, bequeathed to the Spanish state upon his death.

The grave opening may seem like a fittingly surreal turn of events, but advances in DNA research and other scientific techniques have recently led to a rise in exhumations. In the past few years (not to mention months), serial killer H. H. Holmes, poet Pablo Neruda, astronomer Tycho Brahe, and Palestinian leader Yasir Arafat, among many others, have all been dug up either to prove that the right man went to his grave—or to verify how he got there. Still, there are a number of other bodies that scientists, historians, and other types of researchers want to exhume to answer questions about their lives and deaths. Read on for a sampling of such cases.

1. LEONARDO DA VINCI

An international team of art historians and scientists is interested in exhuming Leonardo da Vinci's body to perform a facial reconstruction on his skull, learn about his diet, and search for clues to his cause of death, which has never been conclusively established. They face several obstacles, however—not the least of which is that da Vinci's grave in France's Loire Valley is only his presumed resting place. The real deal was destroyed during the French Revolution, although a team of 19th century amateur archaeologists claimed to have recovered the famed polymath's remains and reinterred them in a nearby chapel. For now, experts at the J. Craig Venter Institute in California are working on a technique to extract DNA from some of da Vinci's paintings (he was known to smear pigment with his fingers as well as brushes), which they hope to compare with living relatives and the remains in the supposed grave.

2. MERIWETHER LEWIS

A portrait of Meriwether Lewis
Wikimedia Commons // Public Domain

As one half of Lewis and Clark, Meriwether Lewis is one of America's most famous explorers, but his death belongs to a darker category—famous historical mysteries. Researchers aren't sure exactly what happened on the night of October 10, 1809, when Lewis stopped at a log cabin in Tennessee on his way to Washington, D.C. to settle some financial issues. By the next morning, Lewis was dead, a victim either of suicide (he was known to be suffering from depression, alcoholism, and possibly syphilis) or murder (the cabin was in an area rife with bandits; a corrupt army general may have been after his life). Beginning in the 1990s, descendants and scholars applied to the Department of the Interior for permission to exhume Lewis—his grave is located on National Park Service Land—but were eventually denied. Whatever secrets Lewis kept, he took them to his grave.

3. SHAKESPEARE

A black and white portrait of Shakespeare
Hulton Archive/Getty Images

Shakespeare made his thoughts on exhumation very clear—he placed a curse on his tombstone that reads: "Good frend for Jesus sake forebeare/ To digg the dust encloased heare/ Bleste be the man that spares thes stones/ And curst be he that moves my bones." Of course, that hasn't stopped researchers wanting to try. After Richard III's exhumation, one South African academic called for a similar analysis on the Bard's bones, with hopes of finding new information on his diet, lifestyle, and alleged predilection for pot. And there may be another reason to open the grave: A 2016 study using ground-penetrating radar found that the skeleton inside appeared to be missing a skull.

4. JOHN WILKES BOOTH

A black and white photograph of John Wilkes Booth
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The events surrounding Abraham Lincoln's death in 1865 are some of the best-known in U.S. history, but the circumstances of his assassin's death are a little more murky. Though most historical accounts say that John Wilkes Booth was cornered and shot in a burning Virginia barn 12 days after Lincoln's murder, several researchers and some members of his family believe Booth lived out the rest of his life under an assumed name before dying in Oklahoma in 1903. (The corpse of the man who died in 1903—thought by most people to be a generally unremarkable drifter named David E. George—was then embalmed and displayed at fairgrounds.) Booth's corpse has already been exhumed from its grave at Baltimore's Greenmount Cemetery and verified twice, but some would like another try. In 1994, two researchers and 22 members of Booth's family filed a petition to exhume the body once again, but a judge denied the request, finding little compelling evidence for the David E. George theory. Another plan, to compare DNA from Edwin Booth to samples of John Wilkes Booth's vertebrae held at the National Museum of Health and Medicine, has also come to naught.

5. NAPOLEON

A portrait of Napoleon
Hulton Archive/Getty Images

Napoleon has already been exhumed once: in 1840, when his body was moved from his burial-in-exile on St. Helena to his resting place in Paris's Les Invalides. But some researchers allege that that tomb in Paris is a sham—it's not home to the former emperor, but to his butler. The thinking goes that the British hid the real Napoleon's body in Westminster Abbey to cover up neglect or poisoning, offering a servant's corpse for internment at Les Invalides. France's Ministry of Defense was not amused by the theory, however, and rejected a 2002 application to exhume the body for testing.

6. HENRY VIII

A portrait of Henry VIII
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In his younger years, the Tudor monarch Henry VIII was known to be an attractive, accomplished king, but around age 40 he began to spiral into a midlife decline. Research by an American bioarchaeologist and anthropologist pair in 2010 suggested that the king's difficulties—including his wives' many miscarriages—may have been caused by an antigen in his blood as well as a related genetic disorder called McLeod syndrome, which is known to rear its head around age 40. Reports in the British press claimed the researchers wanted to exhume the king's remains for testing, although his burial at George’s Chapel in Windsor Castle means they will need to get the Queen’s permission for any excavation. For now, it's just a theory.

7. GALILEO

A portrait of Galileo
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The famed astronomer has had an uneasy afterlife. Although supporters hoped to give him an elaborate burial at the Basilica of Santa Croce, he spent about 100 years in a closet-sized room there beneath the bell tower. (He was moved to a more elaborate tomb in the basilica once the memory of his heresy conviction had faded.) More recently, British and Italian scientists have said they want to exhume his body for DNA tests that could contribute to an understanding of the problems he suffered with his eyesight—problems that may have led him to make some famous errors, like saying Saturn wasn't round. The Vatican will have to sign off on any exhumation, however, so it may be a while.

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