The dead really do speak-at times in volumes. Their interpreter: The Forensic Pathologist. What is apparent to the eyes may not be what dwells within. The placid façade of the deceased can hide many internal truths.
- the swimmer found submerged who didn’t drown but had a heart attack
- the driver’s heart attack that caused the motor vehicle collision not drug or alcohol impairment or negligence
- the patient treated for a migraine who following discharge from the hospital succumbed at home to a ruptured brain aneurysm
- the young woman with a recent onset of shortness of breath with treatment for asthma and no further clinical workup despite the additional history of oral contraceptive use, is found at autopsy to have a pulmonary embolism
- the elderly man with chronic heart disease whose loosened tooth found obstructing his airway at autopsy led to an abrupt asphyxial death
- the tall and thin young man found at autopsy to have an aortic dissection and congenital aortic valve deformity; genetic screening for Marfan Syndrome is recommended for the man’s parents and siblings
- the frail elder found deceased with multiple bruises but by history was prescribed blood thinners for atrial-fibrillation, has senile purpura, and found at autopsy to have died from heart failure and not physical abuse
- the accidental fall victim with atlanto-occiptial dislocation and spinal cord injury who had no pain or suffering
- the gunshot wound victim with a perforating back wound was indeed running away from the suspect contrary to the suspect’s claim of self-defense
By way of medical training and practical experience, the forensic pathologist translates signs and symptoms of injury and disease into meaningful messages that impact the living (1,2). The messages and the mediums include:
- Cause-of-Death statements on the Death Certificate
- Expert medical testimony in courts of law
- Drug-related death trends compiled in statistical reports
- Case reports, case series, and original research published in medical journals
- Adelson, L. Forensic pathologist. “family physician” to the bereaved. 1977. JAMA. 237(15):1585-88. Available at: https://www.nhms.org/sites/default/files/Pdfs/Adelson_JAMA_Forensic_Pathologist_1977.pdf .
- Armstrong E J. Chapter 6: Forensic Pathology. In: Essentials of Death Reporting and Death Certification: Practical Applications for the Clinical Practitioner. 2017. Available at: https://www.amazon.com/Essentials-Death-Reporting-Certification-Applications/dp/0998533408 .