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Medical Examiner: 'Staying Alive Is Mostly Common Sense'

Aug 17, 2014
Originally published on August 18, 2014 8:03 am

Judy Melinek trained as a surgeon, and she originally focused on saving the lives of the sick. But after one too many 36-hour shifts, she collapsed from exhaustion. Disillusioned with the surgeon's 24-hour lifestyle, Melinek decided to shift careers: Instead of preserving lives, she started investigating deaths.

Her new book, Working Stiff: Two Years, 262 Bodies, And The Making Of A Medical Examiner tells the story of her training as a medical examiner — which began just two months before the Sept. 11 attacks — and the hundreds of deaths she investigated during her time in training in New York City.

Melinek, who now works as a forensic pathologist in San Francisco, hopes her book will debunk some of the myths created by crime TV shows. In real life, she says, most deaths are accidents. And when there are crimes, medical examiners do not always end up with answers, and not every case gets solved.

Despite having to face death every day, Melinek loves her job. "I think it is the most exciting job in the world," she tells NPR's Arun Rath. "I look forward to it every day."


Interview Highlights

On the inspiration for the book

The reason I wrote the book is because if you watch the nightly shows, CSI, Bones, all the forensic dramas, they tend to give the impression that the forensic pathologist is all-knowing and springs from the womb knowing everything. And the reality is that there is a training process, and it's a gradual training process — it's on the job. And we make mistakes, and not all crimes are solved, and not all deaths are crimes. In fact, most deaths are naturals, are accidents.

On how the job changed how she views death

The more you know about death, actually, it demystifies it. I just realized staying alive is mostly common sense. If you are smoking, stop; if you haven't started, don't start. Stay healthy, get exercise. That yellow line on the subway, it's there for a reason — stay away from that. Look both ways before you cross the streets. The majority of deaths I saw were mundane. Just by standard health and safety behaviors, we can avoid them.

On the emotional challenges of being a medical examiner

There are cases that really get to you personally. I'm a physician, but I am also a mommy: I have three kids. So when a child dies — and especially when a child dies from inflicted injury, from abuse — that is very hard, emotionally, because you know by looking at those injuries what the child had to suffer through.

That said, it's important that we objectively document everything, and that we're rigorous in documenting it, because when and if that case goes to litigation ... we need to be able to testify objectively to those findings.

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Recently Arun spoke to another doctor who left the hospital for a new career. Instead of saving lives in the operating room, former surgeon Judy Melinek decided to investigate death in the morgue. She spoke to Arun about her new book "Working Stiff - Two Years, 262 Bodies, and the Making of a Medical Examiner"

DR. JUDY MELINEK: Well, I first trained as a surgeon. So I was going to be a general surgeon, and that involves quite a bit of trauma. But it's very different when you're working at a medical examiner's office because you get to see the cases that even the surgeons don't get to see. In fact, I once went to a conference where a forensic pathologist was speaking. And the pathologist put up photos of injuries that I had gotten used to seeing - gunshot wounds and really damaged bodies. And I saw the clinicians wincing. And I thought - what's wrong with these guys? Why are they so insensitive? And then it hit me - they never get to see this stuff. This comes straight to the coroner's office.

ARUN RATH, BYLINE: And how do you make the transition from being - obviously you know how to dissect the human body, but adding in that extra level of being a sleuth, a detective in that way? How do you learn that?

MELINEK: That's what you learn on the job. So the reason I wrote the book is because if you watch the nightly shows - "CSI," "Bones," all the forensic dramas - they tend to give the impression that the forensic pathologist is all-knowing and springs from the womb knowing everything. And the reality is that there is a training process, and it's a gradual training process. It's on the job. And we make mistakes, and not all crimes are solved, and not all deaths are crimes. In fact, most deaths are naturals or accidents. So it's a training process and the book focuses on the training.

RATH: Now, you write in the book you're not a ghoulish person, but at the same time, you talk about being basically fascinated and entranced with death in a way, which is kind of the definition of ghoulish. How do you - how do you reconcile that?

MELINEK: I can't say that I'm - I wouldn't agree with you in terms of saying I'm entranced with death. I am fascinated by the human body. I think the human body is an amazing structure. It's incredible to look at how well it works and how it fails as well and to learn from that. To me, that's life-affirming because when you can look at the body and after the person is already dead, and they are no longer suffering, you can take lessons from that body that then have relevance to the living - to the family members of the person who died and also to the public at large in terms of what hazards are out there. That's why coroners and medical examiner records are public records. Because when people die suddenly and unexpectedly, there's a civic need to know. It's a public health hazard.

RATH: Are there some cases that even with a professional detachment, with depersonalizing and so on, that still kind of haunt you?

MELINEK: There are cases that really get to you personally. I mean, as a - I'm a physician, but I'm also a mommy. I have three kids, so when a child dies, and especially when a child dies from inflicted injury from abuse, that is very hard emotionally because, you know, by looking at their injuries what that child had to suffer through. That said, it's important we objectively document everything and that we're rigorous in documenting it because when and if that case goes to litigation, whether it's criminal or civil litigation, we need to be able to testify objectively to those findings.

RATH: After living in this world, you're - you talk about your attitude, your feelings and fears about death, about dying. You know, you might expect that seeing all of these deaths, you might be thinking all the different - all the million ways that could kill you - because you know better than anybody the million things that can kill you.

MELINEK: But it's the opposite.

RATH: Right.

MELINEK: It's the opposite. Yeah. So basically, the more you know about death - actually it demystifies it. I just realized staying alive is mostly common sense. If you are smoking - stop. If you haven't started - don't start. Stay healthy. You know, get exercise. That yellow line on the subway, that's there for a reason. Stay away from that. Look both ways before you cross the street. The majority of deaths I saw were mundane. And just by standard health and safety behaviors, we can avoid them.

RATH: I'm curious because you said that you set out originally - you were going to be a surgeon. How is your sense of yourself professionally different now that you've had this career now as a death investigator?

MELINEK: I'm thrilled about it. I think it's the most exciting job in the world. I look forward to it every day. It's really exciting to be able to work with great folks and figure things out. And then later on in the afternoon - before I came here, I was on the phone with the family and I gave them answers. And that just gives me so much hope and so much satisfaction that I can help people find the closure, that I can help people understand what happened. They're my patients. The family members of the deceased - they have a right to know what happened.

RATH: Dr. Judy Melinek is a medical examiner. Her book about her experiences is "Working Stiff." Thank you so much.

MELINEK: Thank you. Transcript provided by NPR, Copyright NPR.