Anatomy of an autopsy: Real forensic work nothing like TV shows
Area coroner's caseload daunting
When Dr. Erik Mitchell arrived at a Lawrence residence on the morning of July 28, 2004, he already knew there was a possibility a woman had been strangled.
Lawrence Police had called Mitchell, the Douglas County coroner, because they found small, pinpoint bruises in the eyelids of 46-year-old Mary Miller. It was an indicator of possible strangulation.
But it also was possible that during the night Miller had suffered a heart attack.
“The police had a higher degree of suspicion than I did,” Mitchell said this week about the 2-year-old case.
During an autopsy, Mitchell found the woman’s heart to be healthy. It wasn’t until he found a 1/8-inch-wide, 1-inch-long bruise on her neck muscle as well as other small bruises on her voice box and scalp that Mitchell became confident he had a murder victim.
“It was the only thing that made sense,” he said of the beginning of an investigation that resulted in Miller’s husband, Martin Miller, being convicted of first-degree murder.
Mitchell has been the Douglas County coroner since 1996. He also is the coroner for Shawnee, Lyon and Chase counties. He is the deputy coroner for Wyandotte and Johnson counties.
A forensic pathologist, Mitchell, a Syracuse, N.Y., native, came to Kansas after working as a medical examiner in Syracuse, Chapel Hill, N.C., and Dade County, Fla. He won’t say what launched him into a career of performing autopsies and conducting death investigations. He says only that it was a series of coincidences.
“It happened. There was no master plan,” he said. “A little thing here. A little thing there.”
Nor is he specific about what he likes about the job.
“I’ve never worked a day in my life,” he said. “Whatever I’m doing I’m enjoying. I cleaned septic tanks. That was enjoyable. It’s a matter of attitude.”
Mitchell also is a private forensic pathologist who helped start the firm Frontier Forensics in Topeka after arriving in Kansas in 1994. His partner in the business since 1997 is Dr. Don Pojman, also a forensic pathologist.
In addition to coroner duties, Mitchell and Pojman, through Frontier, are called on by rural county coroners to conduct autopsies for unattended deaths or homicides. As many as 50 Kansas counties call on them for help.
In 2005, Mitchell and Pojman did a total of 818 autopsies, including 71 for Douglas County. Mitchell did about 500 of those. Mitchell routinely does about 60 to 65 percent of the autopsies, Pojman said. So far this year, the two have conducted more than 450 autopsies, of which 41 were for Douglas County. Many times, but not always, they will go to a crime scene, they said.
The length of time it takes to do an autopsy varies considerably, Mitchell said. Some chief medical examiners he’s worked under encouraged him to “hit the high points and go on” because of the workload, he said. But in addition to checking a wound or injury, Mitchell said he also prefers to make as complete of an examination he can on other disease or medical problems a person might have.
How is an autopsy performed?
In many deaths, an autopsy will be performed to determine the cause of death or to assist in a police investigation. Here is the process a coroner, such as Dr. Erik Mitchell, uses to determine these causes:
REVIEW previous medical records of the deceased. This allows the pathologist to take into consideration previous diseases or injuries that may exist on the body.
EXAMINE the outside of the body. Any tattoos, scars or other marks help with confirming the victim’s identity. Ears, eyes, nose and mouth also will be checked.
DOCUMENT what the body looks like. Thorough records are kept in order to assist the coroner in his or her final ruling on the death.
COLLECT any visible evidence and take photographs or X-rays. Trace evidence, blood samples or tissue samples all assist in providing the coroner with an accurate view of how the individual died.
EXAMINE the body internally. In a surgical fashion, the coroner examines the interior of the body to assist in the determination of cause of death.
Sources: Dr. Erik Mitchell, Victorian Institute of Forensic Medicine
“As I get older, I’m making sure we cover all the bases for the good of human welfare,” he said. “It also depends on the time and resources.”
In addition, Mitchell and Pojman testify in court about their investigations.
That is a tremendous caseload, considering the National Association of Medical Examiners recommends that one person do 250 autopsies a year. Frontier has been looking for six months for a third partner to ease the caseload, Pojman said.
More time to spend on paperwork as well as the investigations would be nice, too, Pojman said. When Pojman came to Frontier, Mitchell was without a partner.
“He basically was working 24 hours a day,” Pojman said.
At 55, Mitchell says that he is slowing down and that some of the work takes longer. But he doesn’t complain.
“I still see my wife every day,” he said.
One thing Mitchell doesn’t like, however, is the plethora of popular crime scene investigation and medical examiner shows on television. He doesn’t watch them.
“They are absolute fabrications that are convincing the public of complete falsehoods,” he said.
The shows make it look easy to solve a crime through forensics and exaggerate what can be done, he said. Juries, therefore, are looking for definitive or exact evidence that convinces them of someone’s guilt without doubt, instead of without a “reasonable doubt,” Mitchell said.
He noted the O.J. Simpson murder trial as an example.
“If the average prosecutor had one-tenth of the evidence that existed in the O.J. trial they’d be happy,” he said.
“TV is a propaganda tool of incredible power,” he said.
Turning the switch
The first day working on a cadaver in medical school will determine whether someone is able to work with dead bodies, Mitchell said. Emotions have to give way to business, he said.
“When I was faced with that, something within me was turned off,” he said. “It was just like you’ve gone over to the wall and turned a switch.”
There are some cases that have bothered him, he said.
“You can’t say what it is or when it will grab you, at least momentarily,” he said. “You just walk away and let someone else handle it. But that’s pretty rare.”