Investigation Discovery
Investigation Discovery

9 Secrets of Coroners and Medical Examiners

Investigation Discovery
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.  


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.



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. 



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.


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.” 



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.


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.


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.”


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. 


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.”

Hulton Archive/Getty Images
10 People Whose Hearts Were Buried Separately From the Rest of Them
Richard the Lionheart
Richard the Lionheart
Hulton Archive/Getty Images

Though it may seem bizarre today, having your heart buried apart from the rest of your body wasn’t uncommon for European aristocracy of the Middle Ages and beyond. The practice arose in part during the Crusades, when high-ranking warriors had a tendency to die in “heathen” places that weren’t seen as desirable burial locations. But transporting a whole body back to Europe made things pretty stinky, so corpses were stripped of flesh and ferried back to Europe as skeletons, with the inner organs (including the heart) removed and buried where the Crusaders had died. By the 12th century, members of the English and French aristocracy also frequently had their hearts buried separately from the rest of them.

Heart burial became less practical and more symbolic by the 17th century, partly as a religious practice associated with the Jesuits and other Counter Reformation groups. (Some scholars think the heart’s powerful symbolism became particularly important while the Catholic Church was undergoing a moment of crisis.) In Western Europe, it became common for powerful individuals, such as kings and queens, to ask that their hearts be buried in a spot they'd favored during life. In more recent years, Romantic poets and other artists also picked up the practice, which has yet to be entirely abandoned. Read on for some examples.


Richard I, a.k.a. “Richard the Lion-Heart,” ruled as King of England 1189-99 but spent most of his reign fighting abroad, which is how he earned his reputation for military prowess. (He also may or may not have eaten the heart of a lion.) He died after being struck by a crossbow while campaigning in Chalus, France, and while most of his body was buried at Fontevraud Abbey, his heart was interred in a lead box at the Cathedral of Notre Dame in Rouen, France. The organ was rediscovered during excavations in the 1830s, and in 2012, forensic scientists examined it—now mostly reduced to a grayish-brown powder—to learn more about Richard’s precise cause of death (some think a poisoned arrow dealt the fatal blow). The crumbling heart was too decayed to tell them much about how Richard had died, but the scientists did learn about medieval burial rituals, noting the use of vegetables and spices “directly inspired by the ones used for the embalming of Christ.”


Robert the Bruce, King of Scots 1306-29, asked for his heart to be buried in Jerusalem. But it didn't get all the way there—the knight he entrusted it to, Sir James Douglas, was killed in battle with the Moors while wearing the heart in a silver case around his neck. Other knights recovered the heart from the battlefield, and brought it back to Melrose Abbey in Scotland for burial. Archeologists rediscovered what they believed to be the heart in 1920 and reburied it in a modern container; it was exhumed again in 1996, and reburied beneath the abbey’s lawn in 1998.


St. Laurence O’Toole, the second archbishop of Dublin and one of that city’s patron saints, died in 1180 in France. His heart was sent back to Dublin’s Christ Church Cathedral, where it rested inside a heart-shaped wooden box within an iron cage—at least until 2012, when it was stolen. The dean of Christ Church Cathedral has speculated that the heart might have been taken by some kind of religious fanatic, since it has little economic value, and much more valuable gold and silver objects were ignored. (Weirdly, the thief, or thieves, also lit candles on one of the altars before fleeing.) The item has yet to be recovered.


The prince-bishops of Würzburg (part of modern Germany) practiced a three-part burial: their corpses were usually sent to Würzburg cathedral, their intestines to the castle church at Marienberg, and their hearts, embalmed in glass jars, to what is now Ebrach Abbey. The practice was common by the 15th century, though it may go back as far as the 12th. Their funerals at the Marienberg castle also featured what may be one of history’s worst jobs: a servant was required to hold the heads of the corpses upright during the funeral, which featured the body seated upright and impaled on a pole. The funerals lasted for several days. There were more than 80 prince-bishops; a German cardiologist who made a special study of heart burial says "about 30" of their hearts found their resting places in the abbey.


According to legend, after Anne Boleyn’s beheading in 1536, her heart was removed from her body and taken to a rural church in Erwarton, Suffolk, where the queen is said to have spent some happy days during her youth. In 1837, excavations at the church uncovered a small, heart-shaped lead casket inside a wall. The only thing inside was a handful of dust (it’s not clear whether it was actually the heart), but the casket was reburied in a vault beneath the organ, where a plaque today marks the spot.


Twenty-two hearts from various popes—from Sixtus V in 1583 to Leo XIII in 1903—are kept in marble urns at Santi Vincenzo e Anastasio a Trevi in Rome. Traditionally, the hearts were removed with the rest of the organs as part of the postmortem preservation process, and kept as relics just in case the pope became a saint.


Romantic composer Frédéric Chopin died in Paris in 1849, and most of him is buried in that city’s Pere Lachaise, but he asked for his heart to be buried in his native Poland. His sister carried it back to their home country, where it is preserved in alcohol (some say cognac) within a crystal urn inside a pillar at the Church of the Holy Cross in Warsaw. In 2014, scientists conducted a late-night examination of the heart to make sure the alcohol hadn’t evaporated, although their secrecy frustrated scientists who hope to one day examine the organ for clues about what killed the composer.


The burial place of Thomas Hardy's heart in Dorset
Visit Britain, Flickr // CC BY-NC-ND 2.0

The English poet and novelist Thomas Hardy wanted to be buried in his hometown of Stinsford, Dorset, but friends insisted that a burial in Westminster Abbey was the only appropriate choice for someone of Hardy’s literary prominence. But when town officials found out that Hardy’s body was destined for the abbey, they threw a fit, and so a compromise was reached—most of Hardy went to Westminster, but his heart was buried in Stinsford churchyard (where it has its own grave marker). A persistent, but unproven, story has it that a cat ate part of the heart when the doctor who was removing it got distracted; a gruesome addendum says the animal was killed and buried alongside the organ.


When the poet Percy Shelley died sailing the Mediterranean in 1822, local quarantine regulations dictated that his body had to be cremated on the beach. But his heart allegedly refused to burn, and a friend, the adventurer Edward Trelawny, supposedly plucked it out of the flames. After a custody battle among Shelley’s friends, the heart was given to Percy’s wife Mary, who kept it until she died. Her children found it in a silk bag inside her desk, and it is now said to be buried with her at the family vault in Bournemouth, England.


The powerful House of Habsburg practiced heart burial for centuries, with many of the organs buried in copper urns in Vienna's Augustiner Church. In 2011, Otto von Habsburg, the last heir to the Austro-Hungarian Empire (which was dissolved in 1918), had his heart buried in the Benedictine Abbey in Pannonhalma, Hungary. The rest of him was buried in Vienna. The erstwhile crown prince said he wanted his heart buried in Hungary as a gesture of affection for the country—one half of his former empire.

Additional Sources: "Heart burial in medieval and early post-medieval central Europe"; Body Parts and Bodies Whole.

This story originally ran in 2015.

Smoking Just 1 Cigarette a Day Can Significantly Damage Your Health, Study Finds

Cutting back on smoking is a noble goal, but simply decreasing the amount of cigarettes you smoke—rather than quitting entirely—isn't as helpful as you might think when it comes to the health risks of tobacco use. ABC News reports that new research published in the BMJ finds that smoking just one cigarette a day still increases the risks of heart disease and stroke significantly.

Led by researchers from University College London and King’s College London, the study found that compared to not smoking at all, smoking one cigarette a day resulted in a 46 percent greater risk of heart disease and a 25 percent greater risk of stroke for men, and for women, a 57 percent greater risk of heart disease and 31 percent greater risk of stroke. Even if a person cuts down from smoking 20 cigarettes a day to one, the study found, the risks of developing heart disease and stroke are only halved—not reduced by 95 percent, as would be proportional. (Previous research has found that lung cancer risk, by contrast, decreases proportionally depending on the number of cigarettes smoked per day.)

The researchers examined 141 previous studies, reported in 55 publications, analyzing the risks of heart disease and stroke among men and women who smoked. The studies each examined risks of light smoking (defined as one to five cigarettes a day) and the risks associated with heavy smoking, or 20 cigarettes per day. The researchers adjusted for whether the studies considered factors like age, cholesterol, and blood pressure, all of which can also impact a person’s risk of heart disease and stroke.

The findings show that any amount of smoking carries high risks. While one cigarette a day might seem like nothing to a heavy smoker, its impacts on the body are significant, and shouldn't be underestimated, either by smokers or by their doctors.

[h/t ABC News]


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