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Fort Wayne: CSI
For the Northeast Indiana Forensic Center, autopsies, toxicology, and trace evidence are all part of the routine
By Michael Summers
Fort Wayne Reader
In the mid 70s, the movie All the President’s Men triggered an avalanche of applications to the nation’s journalism schools. A decade later, Top Gun inspired young men to sign up for the Air Force in the hopes of becoming a pilot and, if they were really lucky, picking up a goofy nickname…
Now, in the first decade of the 21st century, the latest specialized field basking in the spotlight of popular culture is forensic pathology, the subspecialty of pathology that focuses on the medicolegal investigation of sudden, unexpected, or suspicious death.
And why are autopsies so hot? It’s all due to CSI.
If you’re among the 50 million viewers who tune into one or more of the CSI shows on CBS — CSI; CSI: Miami; CSI: New York; and CSI: Van Wert (actually, I made one of these up) — you’ll need no introduction. For the uninitiated, the letters stand for Crime Scene Investigation, and no matter what the locale, the template for each show is the same: a team of investigators (who look like they all moonlight as models when they’re not in the lab) examine the bodies of homicide victims in wince-inducing detail, piecing together critical clues from deaths caused by strangulation, poison, boat hooks, blunt instruments, buzz saws, waffle irons, and hand puppets. There’s rarely anything as mundane as a bullet or heart attack on CSI, and if there is, it usually comes with qualifications.
Whatever the show’s merits or faults, the CSI franchise has been credited with starting an unprecedented interest in the real-life profession of forensic pathology.
This has its benefits. For instance, before CSI, the only pop culture figures associated with forensic pathology were Igor and Quincy. But if forensic pathology is no longer perceived as a gruesome, arcane field strictly off-limits to the faint of heart or weak of stomach, being the subject of a top-rated TV franchise can also attract the kind of person who, after seeing Twister, bought a pick-up truck and a CB and started driving around during severe thunderstorms. According to Sarah Erwin, Chief Forensic Technician at the Northeast Indiana Forensic Center in Fort Wayne, the center constantly gets calls from people who want to volunteer there. “They have no experience or background in the field, but they think they want to do it because of CSI,” Erwin says. “They think it’s all gunshot wounds…”
It’s not all gunshot wounds, but if there was a Fort Wayne: CSI show, the part of each episode devoted to the autopsy would take place in the Northeast Indiana Forensic Center. Dr. Scott Wagner, director of the center, is the only board-certified forensic pathologist in Northeast Indiana. He’s aware that the CSI franchise has elevated his field’s profile, but ask him what the shows get right in terms of methods and procedures, and he admits that he’s never watched an entire episode, even though if you’re looking really closely, you might catch his name on one of the shows… “My textbook (Color Atlas of the Autopsy) is on the set of one of the CSI shows,” he explains. “I can’t remember which one.”
Despite forensic pathology’s new found fame, Wagner says one question people always ask is why, with all the areas of practice available to someone studying medicine, he chose this one.
His answer is simple: during medical school, he always found lab work interesting… to an extent. He says forensic pathology draws a lot of people who are very scientifically-minded. They like to sit in a lab, look in microscopes, and ponder. “I got fidgety sitting in the lab the whole time,” Wagner says, adding that he was the only one in his residency who didn’t mind doing autopsies. “So they said ‘okay, fine, if one comes in then you can do it.’”
He also liked the idea of the police or the DA “pulling the geek out of the lab” and putting the geek’s skills to practical use.
And for the record, he wasn’t particularly iron-stomached. “Actually, when I was a young lad, I was a little squeamish, but for me, the hardest thing was having live patients moving around and screaming while you’re trying to sew something up.”
One of the biggest misconceptions is that the Allen County Coroner performs autopsies. The people in the corner’s office work very closely with the Northeast Indiana Forensic Center. They go to the crime scene, take the pictures, and pick up the body; they contact the lab, and take the body to the morgue. The coroner’s office signs the death certificate, and serves an administrative role in coordinating the NIFC’s work with law enforcement and the prosecutor. But it’s Wagner and his staff that do the actual, hands-on autopsy and the extensive battery of tests that are an essential part of it. Indiana law states that autopsies must be performed by a board certified forensic pathologist, and Wagner is the only board certified forensic pathologist in northeast Indiana.
The Northeast Indiana Forensic Center doesn’t see every death in the area; only the unusual or suspicious deaths, which doesn’t necessarily mean their caseload is made up of homicides and mysteries. An “unusual or suspicious” death might include an elderly person who died in his or her sleep. Up to 60% of the cases they see are natural deaths like a sudden heart attack. “We see a lot of men between 45 and 60, who died of a heart attack,” says Sarah Erwin. “They usually hadn’t been to see a doctor in years.”
They also see a lot of accidental deaths such as car crashes and prescription drug overdoses. The latter, says Wagner, is almost an epidemic in our area. “People don’t realize how dangerous prescription drugs can be,” he says. “People sell them, or give them to someone they know, or mix them with alcohol… they think ‘it’s legal, so it must be safe.’”
The typical autopsy for a natural death might take 45 minutes, not including tissue samples and toxicology testing; for homicides, autopsies can last five or six hours. If a victim was shot, they need to account for all the bullets and exit wounds. “There have been cases where we haven’t found them, like when (the bullet) hits a really hard bone and disintegrates, and you can’t find a piece big enough to do ballistics tests. Sometimes they get into the blood system and get moved around.” In one case, a victim was brought in with six bullet wounds. They found five bullets from the same gun in the body; the sixth never turned up, even after a trip to the radiology department.
That’s hardly the strangest homicide case Wagner has seen. One of the first cases he worked on involved a ritualistic killing in 1991. Three “carnies” killed a fourth man and, in an effort to conceal the man’s identity, dismembered the body, burned the pieces, and left the remains on a farm in Dekalb county. Ironically, two of the things that could most easily identify the victim weren’t destroyed. “The guy had one tattoo, and that one piece of skin was still intact,” Wagner recalls. “He had two or three fillings, and the only teeth we could find were those fillings.” During the trial, the defense claimed the victim died of a drug overdose. A forensic anthropologist from Indianapolis that Wagner works with was able to put the ribs back together. Knife marks on the ribs, concentrated around the area of the heart, demonstrated that the victim was stabbed.
Wagner says he is always asked why cause of death needs to be established when it seems obvious. Wagner explains that a lot of insurance cases (for example) might require an autopsy, or in the case of a sudden heart attack or an aneurism, family members might want to know exactly what their relative died of, in case it’s a hereditary condition (in cases like that, Wagner says they have a referral program for family members).
In the case of homicides… “We have to get trace evidence, we have to get bullets, we have to do toxicology, we have to confirm the cause of death…” Wagner says. “We also have to fingerprint the individual and we have to confirm the identity of the individual in order to prosecute the case. I don’t know of a case of where they tried someone for killing an unknown person.”
Besides, what seems obvious may not be so obvious. There’s always the chance that the bullet wounds were superficial, and a stab wound or something else was what actually killed the victim. It’s rare, but it does happen.
Only in a very small percentage of cases does the cause for death remain unconfirmed. The Northeast Indiana Forensic Center puts their unconfirmed rate at around 2%, meaning after a complete autopsy and toxicology, no specific anatomic cause for death is found. “Most of those cases are maybe young people who have something wrong with, say, the electrical system in the heart and they have a sudden arrhythmia,” Wagner explains.
“It’s rarely anything mysterious,” adds Emily Cowan, who works part time at the Northeast Indiana Forensic Center. “You’ll find out why they died, you just have to plod through.”
It probably won’t surprise you to know that the Northeast Forensic Pathology Center doesn’t get a lot of people popping by the lab to just to hang out. The most common visitors are medical students, prosecutors, or police officers directly involved in a specific case. The state police have to watch an autopsy as part of their training, a holdover from an older philosophy that Wagner doesn’t agree with. “It seems like if it’s in the course of their job, then they do fine,” Wagner says. “But if somebody is forced to come in, you know they’re going to have trouble. Every once in a while we get a new cop or prosecutor, and I really watch them, because I don’t want them to pass out. I’m really not a ‘learn while you burn’ type person.”
Heightened public awareness of forensic pathology may have helped the profession shed some of the mystery attached to it, but popularity has its downsides, too. Wagner is often asked to testify in court, and he says juries sometimes have unrealistic expectations of what he does. “Jurors expect us to do DNA to solve everything,” he says. “In most cases, DNA would have nothing to do with it.” Besides, a DNA test can take months to get back.
“They also think we can solve things right away, which in the real world, you can’t,” he continues. Results from toxicology tests, for example, can take from 4 – 6 weeks. “I remember — and this goes back to Quincy — if he had a question, he’d just pull the body out. Three days later, the body would still be there. That just doesn’t happen. In the real world, as soon as we’re done, the funeral home picks up the body and gets ready for the funeral.”
And, he offers one final observation, based on the small bits of CSI that he’s seen. “In the lab, they have that purple lighting. I know it’s for TV, but… you can’t see anything if the lights aren’t turned up. We want as much light as possible. That’s what our job is all about: putting light on a dark subject.”