Friday, January 06, 2006

We begin...

I get numerous requests from students (from all across the country and even 1 from Canada) for help with a homework assignment along the lines of “interviewing a Coroner” or “interview someone with an interesting job”. So, I thought I’d post some of the answers to those questions as an introduction to the job of a Coroner and as my 1st post to my new blog.

Describe an average day:
There is no routine; it all depends on the cases we are working on. I meet frequently with my Deputies to discuss cases, review casework and paperwork, go to death scenes to supervise/assist with our office investigations, attend an autopsy (3-5 per week), watch the budget, and meet with outside agencies (e.g. police, State’s Attorney) regarding cases. Also, my day doesn’t end, I am on-call 24/7 to participate in cases (either scene investigation or over the phone with my Deputies).

Some details of my job: Administrative: Running office with 12 employees and a $1 million budget; Investigative: participating in and supervising medicolegal death investigations to determine the cause and manner of death, conducting inquests; Educational/Preventative: programs to work toward forestalling death at local schools and the like (topics like drinking and driving, violence, etc.)

It can be tough work (babies die, some of the cases are gruesome and/or can be repugnant or repulsive) so it is not work for just anyone. It is tough sitting down and talking about the death of a loved one with families. It is hard not to take some of it home in your head sometimes, but you have to deal with it, you have to develop a positive/productive way of dealing with it or it will eat you up.

What is an inquest?
Inquests are trials to determine cause and manner of death based on the evidence presented in “unnatural death” cases as required by state statute. I, the coroner, sit as judge and “questioning attorney” with facts of the case and investigation presented to a jury of 6 for their deliberation. The cause can be any of a multitude of things, for example head injury as the result of an automobile crash. The manner is limited to 4 choices: homicide, suicide, accident, or undetermined. From their verdict the final death certificate is completed.

What do you like most about your job?
I do enjoy my job. It is fascinating work; everyone dies from such a variety of causes each with a different story, and many of the deaths can be used in some way to prevent/forestall someone else from dying. I particularly like getting out in public and teaching about death “prevention”, anti-drunk driving, anti-violence, pro-health, and the like.

What are the academic requirements for the job?
In Illinois the only requirements for Coroner (an elected position) is to be 18 and a registered voter. I am the 1st Physician in this office since the 1940’s. My Deputies, for the most part, have 2 year Associate Degrees in Criminal Justice or a Healthcare field. All my Deputies (as well as myself) go through specialized training after hire through St Louis University and other sources. As populations grow the numbers of deaths also grow necessitating increasing numbers of medicolegal death investigations and the personnel to do them. I am sure that there will be an ongoing increase in “demand” for more “sophistication”, training and education among these personnel.

Our Toxicology Analyst has a B.A. with specialized training in forensic toxicology and the use of the equipment we have. I should note that we are the only Coroner’s Office in Illinois with its own toxicology laboratory.

Why did you decide to become a coroner? What was its appeal to you?
It has been an evolutionary process from ER Medicine and taking care of one individual at a time through running a free medical clinic impacting many individuals to becoming Coroner where I am using the Public Health aspects of the job to impact a great many individuals in forestalling death through education, advocacy and program development (for example, we are currently working on a local suicide prevention program), in addition to working in the fascinating field of medicolegal death investigations.

Describe you most interesting case:
Last winter we had an individual who died outdoors and was found 6 weeks later. When he was found he was badly decomposed, odiferous and consumed by nature and maggots. We could only identify him because his distinctive tattoo had “survived”. To find his cause of death required deduction and reasoning among all the staff. We suspected he had died of cocaine intoxication (based on circumstances and his history), but there was no blood or other body fluid available for testing. So we used a blender on the colony of maggots that was where his brain should have been (long before the somewhat similar CSI episode). On testing the resultant mass (which looked a bit like a chocolate malt) in our toxicology laboratory, we found that he had indeed died from the use of cocaine. The maggots were positive for cocaine that they had acquired by consuming him.


Anonymous said...

What is it like having to work on dead children? Must be tough.

Dr. Richard Keller said...

Children are tough (not that any case can't be tough at any age). One always thinks of the lost potential, what might have been. And always you compare them to your own kids, which brings it close to home.