Sunday, February 15, 2015

167. Chief Medical Examiner: A Grim but Necessary Job


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Protesting Eric Garner's death, August 2014.
Thomas Altfather Good
     Recently the refusal of a grand jury to indict a New York City policeman for the chokehold death on Staten Island of Eric Garner, an unarmed African American, unleashed a frenzy of protests in the African-American community, some of which turned violent.  But before this case could even be brought to the grand jury, Garner’s death had to be investigated and declared a homicide by the office of the city’s chief medical examiner, an important official whom most New Yorkers know little or nothing about.  So who is this official and what are his duties?  (Usually it has been a man, but at this moment it’s a woman, Dr. Barbara Sampson.)

     In the nineteenth and early twentieth century New York City had several  county coroners who investigated violent, sudden, or suspicious deaths – in short, any deaths not obviously the result of natural causes.  This was an elected office, and to become a coroner your political connections were far more important than your medical training, or lack of it.  As a result, the office of coroner became notorious for corruption and incompetence, and an outcry arose for reform.  In 1915 the state legislature abolished the office and replaced it with something new: the office of chief medical examiner (CME), an official with formal medical training and experience who was appointed by the mayor.  This new office was meant to be nonpartisan, objective, and completely free from political influence – a goal that, as shall become apparent, has not always been easy to achieve.

     So what does the chief medical examiner do?  He (or she) investigates all deaths resulting from criminal violence, accident, or suicide, and all that occur suddenly when the person is in apparent good health, and all occurring in any unusual or suspicious manner.  He takes possession of suicide notes and all objects useful in determining the cause of death, maintains records of all deaths investigated, and delivers to the appropriate district attorney copies of records relating to any death that may have resulted from criminal activity.  In a city the size of New York, such an office will have plenty of business.  It employs some 30 medical examiners – most of them women -- who perform an average of 5,500 autopsies a year. 

     Few New Yorkers know where the chief medical examiner’s facilities are located, and few, I suspect, would care to visit them.  The six-story headquarters building at 520 First Avenue, on the corner of East 30th Street, houses executive offices, the mortuary, autopsy rooms, and x-ray and photography facilities.  Another building at 421 East 26th Street has state-of-the-art forensic laboratories where technicians in white protective gear and purple gloves examine bloodstained clothing and half-smoked cigarettes from crime scenes; there is even a forensic garage to examine vehicles for evidence relating to a death or deaths. 

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The forensic lab on East 26th Street.  On the outside, well-scrubbed and neat.

     So what is it like to work in the medical examiner’s office?  Judy Melinek’s memoir Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner (2014), coauthored with her husband, gives some juicy details.  I’ll spare viewers her accounts of autopsies, but other reminiscences are colorful in the extreme.  She laughs at TV presentations of female examiners in stiletto heels and lots of cleavage, for at murder sites she wore sensible shoes and a windbreaker.  When considering where to launch her career as a medical examiner, she was told, “If you really want to learn forensic pathology, do a rotation in New York City.  All kinds of great ways to die there.”  Some of the weirdest deaths she investigated:

·      A hipster struck by lightning during a rooftop party in Chinatown, his body intact but his shoes blown off.
·      A suicide who jumped onto the subway tracks and was so smashed by a train that no blood was visible, it all having been absorbed into the bone marrow.
·      A worker crushed to death when an enormous machine used to make egg rolls in Chinatown exploded.
·      A man who in a fight got thrown down an open manhole into a pool of boiling water from a broken main and screamed for help, but was literally cooked to death before rescuers could reach him.
·      A man who was shot in the chest, the bullet getting flushed into the circulatory system and ending up in his liver.

     A trick she learned from the police:  When recovering a body from an apartment building, ask every tenant to make coffee; it covers the smell.

     And advice to those who live alone with a cat.  While a dog may sit next to your body for days, starving, be advised that your hungry cat will eat you right away.  “I’ve seen the result.”

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A heart perforated by a bullet in New York, 1937.
The sort of thing the CME's office deals with regularly.
     Which makes one wonder why anyone in their right mind would want to be a medical examiner, recover bodies, and perform autopsies.  But someone has to do it, and human motivation is diverse and mysterious.  I once heard a male hospital intern tell another intern, “When I saw my first surgery in medical school, I said to myself, ‘That’s what I want to do!’ ”  From surgery to save a life to doing an autopsy is probably but one short step.

     Few New Yorkers know the name of the chief medical examiner or notice when one retires.  Especially averse to publicity was Dr. Charles S. Hirsch, the CME from 1989 to 2013, who retired quietly at age 75.  Mayor Bloomberg hailed him as a visionary and dedicated public servant to be especially remembered for his work in the aftermath of 9/11.  On that occasion he and six aides rushed immediately to establish an on-site temporary morgue.  When the first tower collapsed, he was hurled to the ground, bruising his body and breaking his ribs.  Covered with white dust, he returned to his office, a ghostlike figure, to oversee the immense task now facing them: to identify some 20,000 body parts of victims that were collected over the days, weeks, and months that followed.  Of the 2,753 people killed or missing, as of 2013 only 59 percent had been identified.  For years he kept on his desk a glass bowl containing dust retrieved from his pocket after he was knocked to the ground that day.

     Dr. Hirsch was respected for his refusal to bend to public opinion or the influence of the police, emphasizing his commitment to independent autopsies, “the only kind of autopsy I know how to give, whoever I may be working for.”  This was a sharp contrast to the behavior of a predecessor, Dr. Elliot M. Gross, the CME from 1979 to 1987.  In 1985 the New York Times ran a series of articles accusing his office of mishandling several cases of people dying in police custody, always to produce results favorable to the police.  Among the highly controversial cases involved were these:

·      Eleanor Bumpurs, an emotionally disturbed 66-year-old African American woman who brandished a 12-inch kitchen knife and was shot to death in the Bronx 1984 by six police officers trying to evict her.  When the medical examiner found that she was hit by two shotgun blasts, Gross had the cause of death reworded to suggest only one blast, as the police had reported.  The officer who fired the shots was tried for manslaughter but was acquitted.  The city later settled with Bumpurs’s family for $200,000.
·      Ralph Tarantino, a 29-year-old Brooklyn man high on angel dust who in 1980 was beaten to death by police officers summoned because of a dispute between him and his neighbors.  When an autopsy attributed the death to a fractured skull, Gross changed the finding to make the cause of death a procedure performed by doctors treating his injuries.  An independent pathologist called Gross’s finding “irresponsible.”
·      Mark Safdie, a 32-year-old Brooklyn storeowner, whose wife called the police in 1983 when he began acting irrationally.  The police forced him to the floor, handcuffed him, punched him, and refused to let his wife come near him.  Taken to a hospital, he was dead on arrival.  Gross’s autopsy report didn’t link his injuries to his death, which he attributed to “manic depressive psychosis with acute violent behavior.”  A lawyer for the Safdies called the report a “whitewash.”
·      Michael Stewart, a 25-year-old African American subway graffiti artist who was arrested by transit police in 1983 for spray-painting graffiti on a subway wall.  When he resisted arrest, he was beaten unconscious.  After being booked at police headquarters, he was transferred to Bellevue Hospital, where he arrived handcuffed and comatose and died without regaining consciousness.  Gross’s preliminary autopsy report asserted that he died of heart failure following a heart attack that put him in a coma – a report challenged by a physician witnessing the autopsy on behalf of the family.  Gross’s later report declined to state explicitly what caused Stewart’s death.  Six of the 11 white officers involved were tried on manslaughter and homicide charges and acquitted by an all-white jury. 

     A panel appointed by Mayor Ed Koch to study Gross’s conduct absolved him of misconduct but criticized his management.  In 1987, when a second mayoral panel reached similar conclusions and recommended that he be replaced, Koch fired him, citing a need for new leadership in the office.  Gross then sued the Times for libel, but in 1992 the Appellate Division of the New York State Supreme Court found in favor of the Times, declaring that the complained-of language did not constitute defamation of character.

     It is generally thought that the CME’s office under Dr. Hirsch has undergone a vast improvement unless, of course, one believes the New York Post, a tabloid specializing in sensationalist headlines.  In an article of July 20, 2014, it chronicled these problems:

·      The office has received $19.6 million in federal Homeland Security grants since 2005, but refuses to explain how it has spent the funds.
·      One official has traveled at taxpayer expense to conferences in Las Vegas, the Hague, Hong Kong, and Israel, and another to Croatia and Thailand.
·      The number of investigators who examine bodies at death scenes has been cut from about 40 to 20, and the work is suffering.
·      Examiners have removed brains and other organs from bodies without informing the next of kin retrieving the bodies for burial.
·      A body had to be dug out of a grave in New Jersey because it had been delivered to the wrong funeral home.
·      A body was sent to the wrong crematorium not once but twice.
·      Another body was lost, causing the office to dig up 300 graves in a Bronx potter’s field in an unsuccessful attempt to recover the remains.
·      The body of an 85-year-old woman was sent by mistake to a medical school to be used in anatomy classes, even while her son was making funeral arrangements; it was returned with embalming devices attached, blood spatters, and stitches on her lips and neck, causing trauma for her grieving son.

The Post concludes that the office has a history of criminality, waste, and incompetence, while millions of dollars of taxpayers’ money have been spent on plans and equipment useful only in a mass disaster, even though medical examiners are not first responders.  Serious charges, but charges requiring verification from a more reliable source.  But the current CME, Dr. Sampson, acknowledges that mistakes have occurred and emphasizes steps taken to avoid similar mistakes in the future, while stressing that the science performed in the lab was never in question.

     And what happens when the Office of Chief Medical Examiner receives an unidentified body?  The body is fingerprinted and photographed, and the fingerprints are sent to state and federal law enforcement agencies for comparison with their records.  If the body’s condition makes fingerprinting impossible, or no matching records are found, dental X-rays are taken and compared with X-rays from the decedent’s dentist, if available.  If a skeleton is recovered, it is analyzed to determine age, race, sex, and other characteristics.  And if the remains are still unclaimed or unidentified, they are interred in the city cemetery on Hart Island, a forbidden island where living visitors are most unwelcome, as described in a previous post (#49, New York Hodgepodge, March 3, 2013).

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Burying coffins on Hart Island, circa 1890.  A Jacob Riis photograph.

     The Chief Medical Examiner’s office also tries to locate missing persons.  On November 8, 2014, it sponsored a first-ever Missing Persons Day, meeting with over a hundred families trying to locate a missing family member.  Families provided information to relevant professionals, and volunteers were on hand to offer emotional and spiritual support.  Big cities like New York are often viewed as bottomless dark holes into which individuals can vanish without trace.  Using an array of state-of-the-art techniques, the CME’s office is trying hard to combat that impression.

     But for all its efforts, many bodies remain unidentified.  Yet a novel program is now under way to help cope with this problem.  An article in the New York Times of January 21, 2015, tells how in room 501 of the New York Academy of Art in Manhattan a roomful of sculpture students are molding clay into faces that look almost alive.  But the people represented in the sculptures aren’t just anyone; they are people who had met ugly deaths, usually by violence, and whose remains were found in desolate places throughout the city: on train tracks, in wooded areas, in dark basements.  What’s going on?

     These victims are all unidentified, and this is a workshop where fine art students are trying to recreate their faces so as to help the CME’s office identify them, comfort relatives, reopen cold cases, and in cases of homicide  perhaps find the killers.  Each student is given the replica of a skull and then,  using any available information regarding age, sex, height, hair type or style, and clothing sizes, as well as a knowledge of anatomy, molds a block of clay into a lifelike face that, with marbles for eyeballs, slowly takes shape.  Artistic license is not allowed, only accuracy.  “I felt like he was talking to me,” said one student, “and that he’d be happy I was doing this for him.” 

     This is a unique and pioneering last-ditch effort, combining art and forensics, to identify these remains; if successful, it will be expanded to include more of the 1,200 bodies still unidentified by the CME’s office over the past 25 years.  Photos of the sculptures will be turned over to New York police investigators and posted on an online public database of missing persons run by the National Missing and Unidentified Persons System.  Will identifications result?  The class instructor, whose own sculptures of anonymous skulls for another organization in Virginia have yielded 30 hits, thinks so, but only time will tell.


     Coming soon:  Two posts on Thomas E. Dewey – one on him as a fearless gangbuster who brought Lucky Luciano, the Mafia kingpin, to trial (and then released him), and one on him as a politician who lacked one quality necessary to get into the White House.  After that, a short, dumpy hostess who said she belonged to the world and used Marilyn Monroe to snub the Duchess of Windsor. 


     ©  2015  Clifford Browder 

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