IamA Medicolegal Death Investigator in a large county in the USA. AMA!

I’m a firefighter/paramedic and I see death all the time, but only seen obvious murders a few times (GSWs, stabbings, etc). I’ve always wanted to stick around after turning over the scene to PD to see it all play out.

What are the most common types of murder you encounter?

What should I be looking for as far as foul play goes that isn’t very obvious?

What should I do to preserve the scene if we are working it or not?

I like this question(s). First of all, thank you for what you do. Of course, we only respond when you...aren't successful (lol jk, sorry)

What are the most common types of murder you encounter?

Most common homicide wise, definitely gunshot wounds

What should I be looking for as far as foul play goes that isn’t very obvious?

This can be difficult. Asides from the obvious (forced entry, signs of a struggle etc), strangulations and suffocations are often difficult to tell right away. Unless of course you have a huge ligature furrow around the neck. Might have to come back to this when I think of a better answer.

What should I do to preserve the scene if we are working it or not?

First of all, don't worry about preserving the scene if there's a possibility of saving the individual. I mean, don't purposefully step in blood and track footprints, or turn over couches when it's unnecessary. The paramedics that I've dealt with so far have been pretty good at that. When they do move things, they do notify PD and/or OME. As for removing a firearm on scene, please do if it's for scene safety. However, please remember the location and position that it was removed from. That can be very important in determining if it's a suicide, or if someone else was involved.

One of the things that I often find myself asking PD/FD are the small "background" things (lights on or off? TV on or off? Blinds drawn? Glass of water within reach from table? TV remote or cell phone within reach?). Those aren't necessarily make or break in a homicide suspicious case, but it helps me and the FP determine a possible time frame of death. When paramedics respond, even to an obvious death and just to attach EKG leads, they don't remember if the TV was on, or if something was moved.

I would think police wearing cameras would help you a great deal. Do you get to request their footage if you need it?

Yes, it helps, and yes we do request the footage.

This just reminded me, a paramedic friend said that his team got to the scene of a suicide before police arrived and they had to clear out till PD gave them the go ahead because the person still had the gun in hand. Even though they were dead, they are required to clear out on the off chance that the person is not dead and still armed.

Correct, that is generally the case.

First rule of being a first responder: you can’t help anybody if you become a victim.

Yeah. Now all of a sudden, my single death scene becomes a double. No one wants that.

Your welcome. Thanks you for saying that. Don’t worry we don’t take it personal.

Thanks for taking the time out of your day to respond to all these questions.

We typically give a detailed report on what we moved, where they were found, and the position they were in to the first arriving officer.

I’m specifically interested in how much neglect plays into their death. Wether the family had been around much or if they were eating, drinking water, and taking their meds as prescribed. I have a soft spot for the elderly. It breaks my heart when I see elderly neglect/abuse.

Neglect cases are hard to deal with for sure. And the issue is, it's hard to back up. Of course, that's mostly up to law enforcement to deal with, and we just deal with the cause of death.

Is it a little concerning that old mate needs to ask this question? I mean I get there are nuances that might not be in the hand book but surely there would be extensive training?

Not really honestly. When paramedics respond to a scene, their mindset is to save the person in question. They want to get to the person as quick as possible in order to do what they need to do. It'll take a bit longer to make sure that they don't step or kick shell casings, or move a phone or turn on a light. It happens, it's understandable, it's just annoying haha.

Hi! What education you had to go through in order to do your work?

I have a Bachelor's in Biochemistry and a Masters in Forensic Sciences.

MDI requirements vary based on the office and location. Years ago, the requirements were very minimal. It used to be previous law enforcement, paramedics, EMTs, funeral directors etc. Depending on the office and whether they are NAME certified (such as my office), are requiring Bachelor's degrees in a Science (biology, chemistry, etc). However, because of high interest in the job, a Bachelor's may not be enough. The recent hires at my office has Masters, or a lot of previous experience in other smaller offices.

ok.. this fascinates me.. But curious about post mortem sounds (moans not farts) and body moving due to some physiological spasms.. ever heard/seen it?

Haha well farts....is definitely a thing. It's always a little bit of a "whoa" shocker, even though I know to expect it. Moans do happen occasionally, but it's more of just gases being expelled. Spasms and movements, not so much. But then that's also because I generally respond hours after the actual death.

I can only imagine the moans have to be emotional for the family within ear shot.. thinking their loved one is "still there"

I used to do body removals for funeral homes. Moans are definitely a thing, especially when rolling a body to move them or remove clothing and place blocks. If you move them too much, they will defecate. They'll do that eventually anyhow, but you try really hard not to get that going while you're working with them in gloves and a womens' dress suit! The best part were the looks and freak outs caused both by the hearse, and by an 18-20 year old woman in the front of a hearse lol. You wouldn't believe the number of people who threw the evil eye. I'm near Youngstown, Ohio. You meet all kinds of people, from pro athletes to everyday working folks to the poorest of the poor. You see some tough things. The one baby removal I did was awful, and so much worse in retrospect after losing one of my own children as a 4 day old infant. People my age were also hard, you don't wanna think you're vulnerable to death that young....

When I was an intern with the local PD's robbery/homicide section we had a three week old decomp. In July. So glad when the folks from the local funeral home showed up to take away the body. Thanks for doing what you do!

See, that's a case that the OME would get involved in for my county at least. Even though the person might have an extensive medical history, with nothing suspicious, leading to a natural death, we must verify and be 100% certain of the identification, especially if they aren't visually recognizable.

I had a week-old African American female in her 50s, poor health, found by family. Coroner agreed to sign off after talking to her doctor, who said he'd sign off. She was facedown in the pillow, no room to Breathe. Tshirt pulled up, exposing her breasts. Hips on the edge of the bed, crotch at the edge, legs spread wide and hanging off the bed. No underwear. Blanket thrown over her nude lower half when/near the time she died. (This is my theory. Her feces was dry, yet stuck to the blanket. She was dead long enough for extreme skin slip, so bad her hair was slipping off with her scalp. Left the skin of her face on the pillow, so I could see her whole face was IN it, not just face down sleeping with a breathing hole. She was as white as my English/Irish self when we were done.) Dinner with a bite on the fork still on a TV tray on the room, placed kinda haphazardly out of the way. Family said they moved nothing. Said room was messier than she usually kept it, way more stuff on the floor, and drawers were ajar or askew. Closet open when normally closed, per family. I didn't ask, they just offered the info. We took her straight to the funeral home, where she was placed in a casket, externally embalmed (for those not in the know, they just dump some embalming fluid over the body) and the lid was sealed. I think someone got away with a rape/murder.

I'm no death investigator, I was just a 19 year old woman deeply interested in forensics/forensic pathology. It never occurred to me until after that we should have never touched her without the coroner's investigator ok, in person. I look back and it bothers me. Makes me want to go back to school and actually do it. Just gotta let the kids get a little older.

I heard of one my coworkers went on, lady was scraped off the kitchen floor with a snow shovel by the coroner she'd been there so long. Her cats has eaten most of her.

I heard of one my coworkers went on, lady was scraped off the kitchen floor with a snow shovel by the coroner she'd been there so long. Her cats has eaten most of her.

Again, I would be responding to that because there's no way that person is visually identifiable. We would need to take jurisdiction of that to at least verify ID.

As for the story you mentioned, that...sounds fishy. Was there no law enforcement involved? Never mind the position that she was found (which is unsettling in itself), the scene findings are off too. If the individual is usually neat and orderly, why is it such a mess? Unless they were dealing with stress or a mental breakdown, it doesn't sound like you can rule out "suspicions of a struggle". The way she was dressed/no underwear, depends on if she normally wears underwear at home.

That's one of the big differences between a Coroner system and an ME system. A coroner might not have that background. So just because a person had a crazy extensive history in which any one of 10 medical conditions can cause death, are you able to rule out any suspicions of foul play?

Not to say that there's definitely stuff going on with that scene, but if I responded to a scene like that and have that background info per family, I would be looking much more into it.

My condolences to you. Even though we see and deal with deaths on a daily basis, you don't know how you would react if it was someone you know or love. And I agree with the people of your age, especially when it's like a car accident or something and not their fault. I can't imagine doing this job dressed in a suit haha.

Yeah it's definitely happened before. However, I tend to try and make sure that family is not within the same room (or as far away as possible) when I am doing my body examination. It's to avoid that, and to also avoid family seeing the body examination. I can only imagine it's unsettling for family members seeing me hold open their loved one's eyes so that I can take a photo, or palpate skulls/chest etc.

What if a family member asked to watch? Why not? Perhaps they're protective and want to make sure you're not doing or saying something disrespectful.

Yes they have. Or refuses to leave eye sight. I try to explain everything, about what I will do. If they still won't leave, I continue with my job, but at least they are now aware of what's going to happen.

How unrealistic are television shows about the entire process of investigating/recording a death?

It's mostly the "time" aspect and the personnel involved I think. If only overdose cases can be resolved, even within a day. But, as unrealistic TV shows are, I'll still watch it cause hey, it's entertainment.

Are you required to have counceling for the line of work you do? As desensitized as you are would it not be compulsory?

Nope, it's not "required". But it is definitely offered. Another type of "counselling" is just hanging out with coworkers, who get it, and occasionally have "morgue humor"

I understand, glad it's offered I'd imagine it's easier talking with coworkers and no doubt morbid/morgue humour is an excellent way to vent. I'd imagine an outsider hearing it would probably get offended. Keep up the good work stay positive around all the horrors you see.

I'd imagine an outsider hearing it would probably get offended.

Haha you...can't even imagine lol

What’s the biggest misconception from tv and movies about situations you work with daily?

First of all, it's not one person handling everything from the start to the end. Cause of death isn't found immediately. A scene (especially suspicious scenes) takes hours to complete. Toxicology testing can take weeks/months. So I think in a way, one of the "bigger" misconceptions is "time".

Toxicology testing can take weeks/months

I've always wondered about this. Why does it take so long?

Method of testing, prepping of testing, extensiveness of testing (not testing for 3 things), limitations of equipment (or size of lab), and...backlog.

If there were one thing you could change about the timeframe what would it be? Like...is there a common thing that you think "Oh shit, it's been two weeks and we just found X out. If only we could go back to the time of the crime and check on Y" what would it be?

That happens. Sometimes I have cases where it appears completely normal. But a toxicology test comes back positive for X Y Z. In that case, the COD is known, so no need to "go back". Probably didn't find any drugs because, well, all gone. The initial scene finding is important because it gives us an idea on what to test for, instead of testing for "a lot of things". Saves time, saves money.

• What is the most unusual/obscure cause of death you have seen?
• If you don't mind me asking (and if you're allowed to say), where in the US do you work?

What is the most unusual/obscure cause of death you have seen?

Hard to say, mainly because I/we do so many cases that it's hard to remember. Off the top of my head right now, suicide by ingestion of sodium azide. This answer may change as we progress through this AMA and as I remember more.

If you don't mind me asking (and if you're allowed to say), where in the US do you work?

I'm probably "allowed" to say, but for now, I'm only gonna say West of the midline of USA.

Why was that so obscure? (Dont know what sodium azide is)

It's basically an explosive caused by gas formation. I believe it's often used in car air bags.

You are correct, it's often used to generate the gas in airbags quickly. Sodium Azide is also extremely toxic.

EDIT: correct in that it's used in air bags, it's not made by them activating.

How would a body like that be prepared for a funeral then? Would cremation be out of the question? Like could they bury him/her in a special coffin?

Unfortunately, no idea what happened after release from the office.

I dont even.. but.. how?! So the poor lad/girl blew up? Would not want to investigate that scene...

Luckily, the person didn't blow up. But that was definitely the concern for us. Not sure how they didn't blow, won't question it haha.

So did it even blow them up a little internally?

I'm not sure, we didn't end up doing the exam because it was too dangerous.

What other exams were unable to be performed because they were too dangerous?

None so far that I'm aware of.

I remember a train being held up for hours due to a death on the tracks. What's it like doing your job when there's pressure to finish up fast, e.g. to get the train moving again?

Unfortunately, we do get a ton of pressure. When I respond to motor vehicle deaths, often highway patrol has to close the highway to all traffic. Once highway patrol is done with their own investigation (which, sometimes doesn't seem like they rush themselves), they expect us to get there, do a "body pick up" and leave so that they can open the highway. Unfortunately, we have to do our own investigation, our own photographs, our own examination, and it takes a while. While I understand that this is causing a big hold up, it's still part of my job.

How did you get into this line of work? Was it always something you wanted to get into or was there something that pushed you towards the idea of becoming a MDI?

I'll admit that I started being interested in forensics through TV shows. I wanted to get into forensics, but not sure which "area". So I went to school, tried lab work, cause it's "forensics", but found that's not my thing. I'm always a very curious person and wants to know stories about what happens with things. Considered being an FP, but wasn't up for that much more schooling. So MDI was the next best thing. I enjoy this a lot though, because even though you have very similar cases (ie: 20 year old, out partying, did drugs, died), every scene is so different. It never gets boring.

I have another question too, do certain organs reveal certain things that only that tissue can show?

Also, I hate embalming autopsy on babies and deaths in prison. Those types of posts are so much more time consuming cause of how y’all filet them.

Autopsies on babies are very difficult. It's sad that there's specialized miniature autopsy equipment.

As for the question, can you re-phrase it? Not sure what you exactly mean.

Like I know y’all pull humor out of eye to determine glucose/hydration, right?? What about other organs... what are you looking for w specific tissue. Can’t all the work just be determined by drawing blood. ?

Embalming has miniature baby instruments too.

Ohh yes. We pull vitreous humor out of the eye for electrolytes and other toxicology. Mainly because vitreous is less affected by decompositional changes. Other than that, liver is often used for toxicology testing as well. Stomach content is often used in testing as well. And rarely thigh tissue, bone or hair for toxicology. You can't just work with blood/urine because chemicals/drugs go through the body at different rates. Drugs don't stay in urine for long, same with blood as it gets filtered.

Most toxicology work is done on blood. Tissue is rarely tested unless requested or if its the only sample available. Urine is not tested often because its fairly useless information.

Correct, most is done with blood. If it's a delayed death, we attempt to get urine and blood from the initial hospital admission, and test that. Liver testing is the most common of the tissue testing, but otherwise correct, rarely done. It's kept because it gives the option if necessary.

Thanks for doing this.

What’s the messiest death you’ve seen? What was the cause of death?

I think those intra-oral shotgun deaths are definitely one of the messier ones. As well as pedestrian versus semi, at 40mph.

So, when a pedestrian is struck by a semi and biology turns into physics, what do you investigate? Are you checking to see if the truck tried to stop? I mean, it sorta sounds like cause of death isn't a tough question.

No it's not a "tough question" per say. But as /u/gliotic mentioned below, there's more to it. Did the truck try to stop? Hit and run? Was the driver under the influence? Speeding? Distracted driving? Was the pedestrian suicidal? Was he/she high on something? Were they pushed?

While all of those lead to the same ending, cause of death of blunt force injuries, it can still vary between accident/homicide/suicide. And although it doesn't matter to us, findings affect the decedent's life insurance, stuff like that as well.

Has the smell set in by the time you arrive to the crime scene?

MDIs will have a higher "tolerance" to smell than, say a nurse or a PD officer, who doesn't smell death much. If I respond to a scene 4 hours after death, no, I don't smell anything. Others might. If it's 2 days+ and decomposition had started/really at it, you bet.

As a nurse myself, I’ve smelled some heinous things. Tip: peppermint oil in your mask.

Yeah supposedly helps, but I don't bother anymore, used to it.

What exactly does a dead body smell like?

Heh, I can never describe that properly. Sometimes just BO smell. Sometimes blood/feces/GI smell. As for decomp....I can't begin to describe it.

my grad forensic's professor called it a "carnival of smells" haha

That...could work lol. It's just really impossible to describe. However, once you experienced it, you will never forget it.

Have you ever been pressured to report an incident a certain way? Say for an example, if a politician accidentally killed himself with auto-erotic asphyxiation; I'd imagine that you'd be asked by someone to omit that detail for publicity reasons.

I have not, and I definitely hope that does not happen.

You see when Senator Colin’s tripped on the carpet his belt must have flew off and wrapped itself around the bed post. Then while falling down the belt wound around his neck. With no belt to hold his pants up, they obviously fell to the ground. His pants must have gotten caught on his underwear and pulled those down as well. That’s what must have happened... right. Your report could say that?

Yup! sounds very reasonable I think.

Do you ever form opinions of those whom you examine? Like assume what kind of person they might have been?

I may or may not judge a person living in a hoarder house and with 20 cats and cobwebs covering all t he walls...

Did you like Dexter?

It was a good watch (first few seasons). Not a fan of the ending. Unrealistic of course, but it's TV. I don't care haha.

Your second bullet point - determining jurisdiction based on type of death based on the first phone call that comes in - sounds like it'd have a lot of room for error. How often do deaths end up not being what the first report sounds like? If so when/how do people start figuring that out?

Oh for sure. Most of the time when we take reports from PD/RN, they don't really know the person. Occasionally, the person would be pronounced deceased, PD responds, "interviews" family or whoever, and relays the medical history to us. However, and nothing against PD, they don't look at the scene very well. Sometimes the person might have a ton of medical history, but hey, there's a syringe next to him. If that syringe isn't immediately found, or if the reporting party "forgot" to mention it, we would never know via a telephone call.

As to when or how do we start figuring that out. Well sometimes after we "decline" the death due to extensive medical history and PD "not finding" anything to suggest otherwise, family members might go through their house, find a syringe, and call us. Or when PD says that the person is "visually recognizable" but when a funeral home picks them up, they are decomposed and "not visually recognizeable", the funeral home reports the death. Or when a primary care physician signs the death certificate after we decline jurisdiction, they mention that there's a "history of polysubstance abuse". Our FPs always reviews every death certificate signed in the state, and "flags" them so that we can do some more further investigation.

Unfortunately, I know a lot of cases slips by and we miss it. Ideally, investigators would respond to EVERY scene and do our own investigation (since we operate separately from PD/Hospitals etc). And that's possible in a smaller county. We have over 1000 deaths REPORTED per month in our county. It's not possible for us to respond to everything.

Not sure if that answers your Q, but that's what I got!

Hey, thanks for doing this. I have two questions:

1) Do you have to respond to infant cases as well? If so, how do you manage to overcome the shock of finding yourself across such a situation? I don’t know why but I find everything - hell, even when depicted on TV - to be far more difficult to deal with if it involves children.

2) how do you decompress at the end of a work day. I can’t imagine that seeing dead bodies and dealing with such situations is easy on the mind. Or maybe it is and it’s just not my line of work. But do you just go home and have a beer, watch some TV, and remind yourself that this is just one more line of work and one you happen to enjoy? I have a friend who’s a funeral home director and he just goes out to dinner whenever he has a funeral. His logic? After awhile (he’s been doing this for well over two decades) you grow desensitized to it. Is it the same in your line of work?

1) Yes, we do respond to infant cases. In fact, we respond to 95% of all infant cases (unless there was a birth defect, or something like that). There's a lot of co-sleeping or unsafe sleep environment deaths. Those are difficult to deal with, mostly because it's a simple "accident". The parents weren't specifically negligent, it just...happens. The worst cases are the child abuse cases. You just have to remember to remain professional and that you are doing your job. I've had a few child abuse cases, and the way I think of it is this. As pissed and angry I am at the parent/babysitter/friend/whoever for doing this to a child, doing my job allows the "child to speak" in a way. If I can do my job right, document the appropriate injuries, build a time line, complete the story, I can help build evidence to do justice.

2) Honestly, yes, that's exactly how it is to me. I don't carry things home with me. I leave work at work. If I'm not on shift, I'm able to block out everything and continue on as normal with life. Go out with friends, go to a restaurant, eat, Netflix, game, whatever. Occasionally there's a few cases that would be on my mind, or that I will never forget. But then I think as I mentioned above. Somehow, I am desensitized and that it doesn't really affect me.

Please take care of yourself. Vicarious trauma is a thing, and seeing bad stuff can get to you without you realizing it.

Yeah for sure. Thank you

Thank you so much for your answer. I don’t think I’d realized this before, hell I wasn’t even sure your line of work was a formal one (I figured something like it existed but didn’t know it was a specific thing, idk how much sense that makes). But reading this AMA has made me realize what an important job you do - specially with what you mentioned in regards to “helping the [victim] speak”. As the other person mentioned above, take care of yourself. Thank you for your answers and I hope you enjoy the rest of your day off.

Thank you. In some smaller places, this job doesn't specifically exist. Some places it's handled by law enforcement, or an elected coroner, or people with various backgrounds. I love what I do. It can be tough, but its important.

How easy is it to tell if a chemical is the cause of death? An ex who worked in a T1 research institution made a couple of jokes about murdering me and getting away with it; he specifically said because he "knew which chemicals to use."

Could someone actually easily do that? It just seems like an over the top Hollywood plotline but I've always wondered about how realistic his little "joke" was.

Theoretically, it's possible. However, he would have to get to you, give you whatever "chemical" it is, and remove all traces possible from the scene, and make sure there's no way it's traced back to him. If we have a person who died of no obvious reason and suspect a possible overdose/poisoning, we would test for A LOT of chemicals. However, there's no way we can get everything. We don't test for things that we don't really have a suspicion of being present.

Hi! I’m a journalist who has been covering medicolegal death investigators in relation to OPOs in America for the last six months. Would you want to chat with me sometime about your relationship with your OPO? I’d be thrilled.

organ procurements? You can PM me sometimes and we can see what we can do. Not right away though, it's gonna get lost in my inbox haha.

Thanks for doing this AMA.

How is your work/life balance?

What is the salary range, and do they pay or offer overtime? I’m assuming plenty of on-call assignments.

Do you also do blood spatter analysis, or any other environmental analysis along with body inspection?

I keep my work and life quite separated. I don't take things home. I continue life on as normal outside of work, going to movies, hanging out with friends, traveling, etc.

I work hourly, but the pay sucks. Especially for the hazards that we deal with on a daily basis. It's part of "government" work, so pay isn't great, but stability and benefits help. We do have overtime pay, but still. My office is a big office, so we are staffed 24/7. With that, there's minimal "on-call" assignments, if at all. However, in smaller more rural places, they aren't operating 24/7. However, you...kinda can't tell "hey don't die at 2am". Or leave a body from 2am until 8am shift start. So yes, on-calls in those smaller places.

I don't specifically do any blood spatter analysis, but we do have educational training in that once in a while. I have a bit of background from schooling. Same with like gunshot range analysis etc. A lot of it we "learn as we go". I know very little engineering, but when there's a crane tipping over, or something a crane is holding drops and crushes a person, we go with it and learn. Same with trains deaths, all I know is that trains are cool. You learn as you go.

Ever heard of people transitioning from medical laboratory science to this field? It sounds extremely interesting and right up my alley.

Not in my office. But...I came from a chemical analysis lab. I worked there for about 2-3 years prior to going into forensics and MDI. And if you work in a medical lab, you have a science background, so that's already a step in the right direction.

First of all, many thanks for the interesting topic for an AmA.

You are used to it now, but how was it when for the first time you had to report a suspicion of an unnatural death to the police? I can imagine you were either excited or scared of what was to come. Relatedly, what course of action is taken from there? That means: Does a new team get to the body, or is your team's examination used as - so to speak - "final" proof?

It was an interesting experience. I felt excited that I know something and reporting something important that requires investigation. But at the same time, worried that "what if I get asked questions I don't know?" In the end, that's part of the investigation, it's an ongoing process. We frequently have a person brought to the hospital with a potential overdose. Ideally, hospital staff should report it to PD so that they can do a scene investigation. But, that doesn't always happen.

If we report a suspicious death to PD, it really depends on what type of suspicions. If it is a delayed overdose (ie: person presented to hospital with a positive urine drug screen five days ago), PD will not do much because there is no "scene" to investigate since everything had changed so much. In those cases, yes, much of PD's involvement is through the OME. However, if it is a recent thing, or like suspicions of neglect or a son possibly injecting something into his mother, then yes, PD will either send a patrol detective, death detective, or a homicide detective to initiate their own investigation, in conjunction with the OME.

How has your mental health been since starting this job? Has it affected you at all?

As "bad" as it may sound, not at all, at least not to my knowledge. I keep work at work, and outside life with outside life.

Can you explain the difference between what you do, the forensic team that collects/processes the crime scene and the detectives who lead the investigation? I see a lot of the things I believed to be done by one or more of those three actually performed by you, but Ive never heard of a MDI - only forensic teams, detectives, FP!

Edit: I am not from the US, so we might have different procedures and R&Rs here.

Sure thing. There's...a lot of different people involved. Obviously, I don't know exactly who is involved from a police perspective, but here goes.

Police patrol officer - respond to initial 9-1-1 call, secure scene, brief interview, determines suspicious or not

Paramedics - arrive on scene, pronounce death, or transport to hospital

Detectives - there's different detective teams, some specialized in drugs, some specialized in homicides, some specialized in car accidents. They re-interview, extensively. Talk to neighbors, apartment managers, obtain camera footage, etc. In homicide cases, there's often more than one detective as there's A LOT of work. There's usually one or two lead detectives, sorta takes control of everything, and directs others to help.

Crime Scene Technician/Specialists - they work with PD. They photograph the scene as is, when things are moved, take measurements, do latent prints, collect cartridge casings and other evidence, do trace evidence swabs etc

Judge - if search warrants are needed

MDI (me) - I work only with the dead body, but gather circumstance information. My work as described previously. Then transport the body to the OME

Forensic technicians - helps the FP with the evisceration process, helps to collect evidence, inventory evidence, maintain chain of custody etc

FP - examines the body, externally and internally, organs, report, determine COD/MOD

What’s the most “interesting” case you’ve dealt with?

Answered before, but "interesting" is difficult to say. Interesting can always be "blow head up with shotgun" or gory scenes. But also unique cases, like body stuffed in a barrel, or religious killings, or blowing self up with an IED.

body stuffed in a barrel
religious killings
blowing self up with an IED

So, just the one case?

Ha no, they are all different cases. And thats what I mean, it's difficult to selected the most interesting one case.

Has anyone ever not actually been dead when someone thought they were dead?

Nope, thankfully. If anyone wakes up when im doing the exam, may be my last day on the job lol

Hi! I'm a student in a masters in Biomedical Forensic Science and am interested in the field. I'm a little confused on how different is your job from someone working as a CSI? I've had that confusion for the past week and you're clearly the expert.

MDI and the OME only has jurisdiction of the body. We work together with police and others in obtaining circumstances and information related to the case. I don't collect evidence (asides from the body and what's on the body). I don't respond to any other scenes. However, when it comes to the body, that's my jurisdiction and no one elses.

A typical CSI usually works for the police department. Their job is less the body, but rather collecting evidence (blood swabs, shell casings, developing latent prints), preserving the evidence, and maintain chain of custody. Depending on the department, some CSIs in different agencies don't only respond to death scenes. They also do burglaries, assaults, theft, etc.

What’s the procedure with car wrecks? Do you wait for the body to be pulled out or while everything is still intact?

Depends on the agency. MDIs prefer to everything remain undisturbed, so the body still within the vehicle. In that case, we respond, take overall photographs, photos from initial start to ending location, and as-is photos of the body. And then we have PD call out FD to extricate, if necessary, or we do it ourselves. That way, we get ALL the information. Unfortunately, PD often pulls the person out, and moves the vehicle, prior to me getting there. In those cases, just a body on the road for us. We lose a lot of information though, like who knows, maybe the person survived the initial collision, but died because of positional asphyxia. Won't know easily.

What’s the weirdest thing you’ve found in a dead body?

I've found my fair share of cucumbers up....there.

... would they be considered pickles by that point? (I’m sorry I had to)

:D :D

Do you believe in the afterlife? If so, have you ever felt creeped out or like there’s something else (i.e. spirits) in the room with the body?

I do not. Have not felt that way, and I hope I don't.

In a homicide investigation, where are the most common places to find evidence? Anything you've ever caught that others missed that brought justice?

Hard to answer, all the "homicide" cases I've responded to, law enforcement officials have done a pretty good job overturning everything and finding everything. It's the lower profile cases, such as a potential drug overdose, that law enforcement officials often miss. I would respond to what was initially believed to be a 30 year old sudden unexpected death, until I open a drawer, and hey, a straw, burnt foil, white substances.

Are you pro-gun? I am curious about this because you see deaths due to guns and in theory deaths that could of been prevented if a gun was used for protection. I am by no means trying to start a debate but to hear (read) your viewpoint.

I am. In my mind, it's more of the person behind the gun than the gun itself. Sure, I've seen domestic arguments when one shoots the other with a gun. And sure, person may not have died if the gun wasn't in the picture, but....still.

Hello, medical student here considering pathology as a career. Thanks for humoring my curiosities.

1) Have you ever had a case where foul play was suspected but the cause of death was never elucidated?

2) When an ingestion is suspected as the cause of death (intentional or otherwise), what chemicals are tested for?

Fellow Medicolegal Death Investigator (Medical Examiner) here. Not sure what state OP works in, but I know in my state (NC) we will run a wide range of tests looking for various pings and will then focus in the results after to identify specific compounds/chemicals. A good resource if you want to see what we look for/can look for: https://www.ocme.dhhs.nc.gov/toxicology/index.shtml

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Edit: To answer question #1, at least in NC, "Foul play" is a law enforcement issue, we tend to cover COD/MOD only. I.e we may list "Complications of a subdural hematoma" as the cause of death. It is law enforcement's job to help determine where the head trauma came from. Another good example would be if a hunting accident happens and someone shoots their buddy in the head. When we list "Gunshot wound of the head" as a cause of death with "Homicide" as the manner we are simply stating one person killed another, not the law enforcement side.

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Hope that helps

Completely right on the foul play being law enforcement issue. We aren't here to press charges or anything. That's law enforcement's business. We just care about how the person died, and through what methods.

1) Yes. Some of those are like mummified remains. Not necessarily "foul play suspected", but the COD can never be determined. Also in some baby SIDS deaths, sometimes you just don't know.

2) It depends on what's ingested. And that's why a scene investigation is so important. If someone ingests a bottle of something, we would photograph and document the complete ingredient list. We would then test for certain things within that list. If it's literally just a glass of something sitting there, it's more of a crap shoot (but the FP might have more knowledge). If there's a sample of an unknown liquid available, we might collect it and test for the contents (GC-MS or the like).

First off thank you for your work and taking the time to answer questions! You are, as you described "desensitized" to the kind of morbid pulp you deal with day to day. Do you have anything to say to people who are less desensitized, or who have the media cushion, about the nature of reality?

People can "imagine" what some scenes can be like, and honestly it's better for some to not know exactly what it's like. For example, if someone's loved one had died of a car accident and they weren't there, I think it's better to not know the exact scene findings. Not every scene is gruesome, but some are.

How do you feel that your badge number is one off?

Haha I'm not the newest investigator, so someone's isn't one off.

Do you ever drink pickle juice straight from the jar?

I wouldn't say "drink", maybe "sip"

Blood spatter analysis, too?

real, live Dexter right here

I'm definitely not an expert in that. Although it does bug me when people say "blood splatter".

How hard is it to get a second date after telling someone what you do? I bet its made for some interesting how was your day stories.

Haha. People's interest in what I do, are on polar opposites. I have some friends that want to hear story after story after story. While some others, pretend to not know what I do lol

How do you deal with the concept of death on such a routinely manner? Do you ever deal with anxiety or stress seeing a state of someone and thinking how you’ll die sometime as well?

I've become desensitized with it, from the very start actually. I'm able to leave work at work. I've been able to do that from the very start, even with school and other personal matters. I'm in a stable mindset, so I don't really think of how I'll die, yet haha. But then at the same time, someone dying from a drunk driver, completely not their fault. It does make you wonder "that...could have been me".

Do you regret this line of medicine over another?

What do you think the future of murder will look like?

Do you regret this line of medicine over another?

Not really. I initially planned Forensic Pathology, but, wasn't up for med school. I've always been interested in solving problems and being nosey, so this works for me.

What do you think the future of murder will look like?

Tough question, not really sure. I'm sure people will be more creative in finding ways, and may think that they can get away with stuff based on TV findings.

Why does it take so long to get lab tests back (like to rule out drugs as a cause of death)?

Many reasons, testing for MANY substances is time consuming, prepping the samples takes time, but most importantly, is the back log of testing, especially if the lab has limited equipment/personnel. Also, once the results do come back, it has to be reviewed and interpreted by the pathologist. The number of cases for them keep piling up as well, so again, backlog.

I'm one of the unlucky ones that had to deal with a parent passing away - father had a progressive neurodegenerative disease that went on to the point of nearly no cognitive function. Doctors and his advance directive led to him being transferred to hospice care where he passed.

In the eyes of someone in your line of work (and possibly the law), is this considered natural causes or would it more grey of an area?

First off, my condolences to you.

In my office, it would be considered a natural death based on the two sentences you provided. However, there's a lot more questions that I would ask the hospice nurse who reported the death. For example, had there been any recent falls? Someone with an extensive medical history, may have a fall two days prior to death. They were alert, and oriented after the fall, but didn't go to the hospital or do any imaging. We would take jurisdiction in a case like that in case the fall caused a head bleed. In that case, we think that the death "may not have occurred", at least at that time, had the fall not happen. Was there a past history of head trauma, that could have led to seizures, that could have led to suffocation? Not necessarily in this case, but something like that would cross my mind.

Of the cases you've worked, what are some of the more memorable ones and why?

Unfortunately, most of the "memorable" ones are the sad ones (ie: double homicide/suicide, child abuse etc).

But of the "cooler" memorable ones, had a guy make an IED, lay on top of it, and boom. Other memorable ones are some motor vehicle accidents where they are very "gruesome". Or decapitation by train. Or body stuffed in a barrel.

Have you read Dirk Gently's Holistic Detective Agency, by Douglas Adams? I ask because it features a particularly memorable manner of death, and a particularly improbable judgement of "suicide" by investigators.

Speaking of which... I occasionally hear on Reddit of some death that was ruled a suicide when that seems unlikely (i.e. one imagines the authorities are covering something up). What's your take on that sort of thing?

As for that book, no I have not, but that sounds like something I would be interested in. Saving this and will come back to it, thanks!

As for stuff we hear on here, take it with a grain of salt. We don't know the whole circumstances here. Even if it's something reported in the media, that's only a portion of the story.

Care to share your favorite recipe?

Can't pinpoint one at the moment. I am a food addict, love everything. Just...too lazy to cook myself, usually.

Are you in some sort of a union?

How much do you get paid?

No union. Pay by hour. My office starts at about $20/hr.

Did you ever witness with something extraterrestrial?

Not yet...

How often do you find unused drugs and how easy would it be to steal them?

How often? very often.

How easy? Usually not very, because I'm rarely alone in the room with the decedent. There's usually an officer with me in the room, as part of securing the scene, or I have ride-alongs, volunteers etc

Not sure if this was asked before.

As someone who has struggled with suicide thoughts, sometimes I thought about the people that find/examine the bodies of someone who committed suicide.

Is the scene of a suicide different than other scenes? What’s the first thing that goes through your mind when arriving at a such scene?

Thank you very much!

Hi. First off, if you've had a history of suicidal thoughts and ideations, please reach out to someone. I'm free to talk with you as well via PM.

For me, every scene starts as a homicide. As I go through the scene, I go through different findings to prove otherwise. Processing the scene/body wise, it's still the same. If I am dealing with a suicide, I pay attention to "why". When talking to family/friends, I inquire about recent stressors, breakups, depression, job loss etc. I guess that may be different because I may not ask those specific questions if say someone was with friends and did a bit too much drugs. When arriving at those things, I pay attention to a lot of things, like living condition, who they lived with, how they lived, look through a phone to see if they reached out to anyone, expressed suicidal comments, past hospitalizations for behavioral health etc. Also, fewer people leave notes than one would think.

What would be the best way to get into this line of work? I have always wanted to be a forensic pathologist helping solve the puzzle. I looked into forensic science with am online uni course but I had to do a social science course first which I didn't get on with as they worded things in such a way it made no sense which I thought was just me and my dyselexic brain but even my fiance didn't have a clue. So I ended up leaving the course.

Keep in mind that Forensic Pathology (FP) is a medical specialty degree. Includes med school, residency, fellowship etc. I, don't have that, at all. But regardless, look into a science based background. Forensic Science in undergrad is great if you want to get into CSI/MDI jobs. However, if you have a FS degree, it'll be a bit difficult with med school.

How did your first case go? Was there anything that shocked you or you weren't expecting?

Not really, I don't really remember the first case I did by myself. Probably because I spent over a year in autopsy exams. While in exams, I learned about the cases too. I do remember the first body I saw though, which if I'm not mistaken, was a young female involved in a violent head-on collision.

I have a zillion questions, so many that I can't think of one intelligent one. Sigh. My 23 year old son died of an accidental overdose in June. There was coroner and a small police dept and the larger pd. There were seperate instances that each entity looked at but they never put their heads and stories together to see possible foul play. Is this a normal occurrence? Also do you have any unexplained or supernatural type experiences?

First off, my condolences to you.

Different areas operate differently. We do our own investigation separate from the PD, but we do work with the PD a lot and do get a lot of info from PD directly. However, we will always verify with family etc. For us, if I get additional information from family that PD did not have, we would look into that. We would also relay that to PD so that they can look further into it. After all, no one department has all the resources to do everything. Everyone SHOULD work together, if at all possible. Technically, the OME (or coroner) should be able to obtain enough information themselves in order to determine a COD/MOD. To me, and to most investigators and OME, everything is a homicide until proven otherwise.

As for unexplained and supernatural type, nothing that comes to mind at this time.

I'm starting a FP fellowship in July. What's some common sense stuff I should know before going to my first crime scene?

Since you are now a fellow, I imagine you are somewhat accustomed to the sights and smells, especially of a decomposed body. As for scene wise, living conditions of houses. Man, some hoarder houses, you can't even describe. You will say "and...someone used to/still lives here?"

But more importantly, have respect. If you are going to a scene, no matter if a suicide, accident, natural, homicide, whatever, there's likely family or neighbors or friends on scene. They are dealing with (one of) the worst days of their lives.

What are the credentials required? Education level?

Answered previously, but i have a BA in biochemistry, MS in forensic science, and ABMDI certified. Different offices have different requirements.

Is handling corpses still creepy even after doing it for a living?

Nope, not anymore.

Do you ever tweak your reports in order to look good to the prosecution?

Never have, never been asked to, never will.

What is your name and in what country are you working?

My name is ****** and I am in the USA.