Crime Stories with Nancy Grace - Body Bags: Coroner Versus Medical Examiner

Episode Date: January 1, 2022

A body is found. Investigators are called, but who's going to show up? Will it be a coroner or a medical examiner? Today on Body Bags, former death investigator Joseph Scott Morgan answers the question: What's the difference? Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

This is an iHeart Podcast. Body Bags with Joseph Scott Morgan. Over the course of my career, I spent a lot of time working for the coroner or working with coroners and training coroners all over the United States. Now as a college professor, I study them. But many people don't know anything about that office. It's ancient and old. I'm Joseph Scott Morgan, and this is Body Bags. Back with me again is my good friend, Jackie Howard, executive producer of Crime Stories

with Nancy Grace. Jackie, we're going to talk a little bit about coroners today. Well, you're going to have to school me, Joe, because we know there are coroners and we know there are medical examiners. So which do you want to talk about first to explain to me what they are and what's the difference? We got to start with coroners, Jackie, because it's one of the biggest questions that folks, you know, they want to know, you know, what is a coroner? Because many people don't know. And of course, you know, it's like any great story. And trust me, the story of coroners is fascinating. You got to start at the beginning. I got to tell you, you know, the first time I ever heard the term, you know, when it was, Jackie, I was actually

a high school student. And in my high school, they offered a course that was called Thanatology. And I didn't really know what it was. And I took it as an elective. Wait, say that again. It was called what? Thanatology. Thanatology. Spell that for me.

Yes. T-H-A-N. Okay. Than. Okay. Go ahead. Thanatology. And actually, it's the study of death and all things involving death. We got to go to

graveyards. We got to go to funeral homes. And it kind of started an interest on my part about what was this world all about? And I heard them talk about the term coroner, and I didn't know what it meant. I just knew that it had something to do with the dead. And through my own elementary reasoning at that point in time, I thought, well, coroner probably has something to do with the dead. And through my own kind of elementary reasoning at that point in time, I thought, well, coroner probably has something to do with the heart, like coronary artery. I couldn't be further from the truth. And you have to go all the way back to a time in England before there was a Great Britain. It was actually the country of England, a standalone country, all the way back to the times of Alfred the Great,

one of the first kings of England. And there is evidence that the term coroner was mentioned, but it wasn't actually the word coroner. They actually were referred to back then as crowners. And over the years, that term evolved from the word crowner to coroner. And why crowner? I think that a lot of people would scratch their heads and wonder, well, they were actually the representatives of the crown. And they were there to hear the pleas. It was called hearing the pleas of the crown, if you will.

And there were these three knights that were assigned to this duty. They would travel around and they would essentially work as kind of de facto death investigators trying to figure out what had happened in that environment. But their purpose was not to necessarily solve crimes or try to find out rationales. It was to collect money. And that's, you know, some people point to this period in time is when the death tax actually began to be enforced and to take place.

And I think I have a lot of people that have come to me over the years and they'll say, you know, we've heard that it's illegal to commit suicide and that that had actually been on the books at some point in time. And, you know, interestingly enough, it was declared at one point in time that it was, in fact, illegal to commit suicide, but it had nothing to do with the destination of your eternal, immortal soul, as a lot of people think that it had some kind of connection to the church. The thing was, was that back during these times, if an individual took their own life,

that means that if this could be proven, then every bit of property that they had, guess where it would go? It would be forfeited to the crown. So they could collect. So there was like a motivation on the parts of these representatives of the crown to go out and certainly make a determination about the cause of death. I really wonder all those years ago if they kind of listed toward a manner of death that would have been qualified as suicide because all the money, all your property, all your livestock would be taken. And it didn't matter what station you held in life. So it would be reverted over to the crown. And, you know, you go forward, you know, a few years from there and people have heard

of Richard the Lionhearted. Well, he was kind of he's kind of the the if you will, the the spiritual father, I guess, if you will, or this ancient person that existed during that period of time that kind of formalized the office of crowner slash coroner, because he was all fighting crusades and he was not getting money or revenue from the sheriffs. You've heard of the evil sheriff of Nottingham in the Robin Hood legacy. And that can be traced back to that period of time and evil King John that was in place of King Richard. Well, King Richard needed a source of funds. And so he would send these crowners out

to collect money on his behalf so he could continue to prosecute these crusades and ransoms and all of these things that were taking place during that period of time. But after a period of time, the office began to evolve and it just became part and parcel of English common law. And still to this day, it exists. There's certainly quite a few years between those days and these. So what does a coroner do and how does a coroner get into office? Yeah, it's going to vary from state to state, essentially what the requirements are going to be to be a coroner. And still roughly about half the states in the United States still hold on to this office of coroner. Remember when the British colonies, you know, you think back to the Massachusetts Bay Colony and these sorts of things, they didn't just leave England behind.

They brought English common law with them. And so when they brought all of these offices together and kind of backing up a little bit, that ancient document, the Magna Carta, people don't realize how old these offices are. Actually, I think it's like in the 27th paragraph of the Magna Carta. You can still see it if you look at a copy of it. The word sheriff, bailiff, and coroner are all mentioned in the same line. That's how old these offices are. This goes back to the early 1200s when the Magna Carta was instituted. And so that law came over to the U.S. or to the colonies at

that point in time because they had no other framework to kind of go off of, you know, so they were going to maintain this. And so the coroners in the U.S., as we see them now, essentially evolved from those early days. And you can go from state to state, and every now and then you'll come across these weird kind of what we refer to as amalgams of coroners and medical examiners and all these sorts of things. And it's really of the knocks against the system that if you go to run for the office of coroner, that you don't have to be particularly degreed in a certain area. But I'll give you an example. As everybody knows, I started my career in Louisiana. Well, Louisiana is a coroner state.

That means that each one of the parishes, which are like counties, has its own corner. But in that state, in order to run for the office, you have to be a physician. You have to be a medical doctor in order to run for that office. But you go to other states, and in some places, they require nothing more than a GED in order to run for that office. So there's a desperate difference between the level of education that's going to vary from state to state in many cases. And that can leave the population wanting, you know, as far as thorough death investigations. And then on top of that, some states require coroners to have formal training.

And in other states, they essentially say, good luck. Here's a book of the laws. Best of luck to you. I hope you do well. And they give very little training. And so that's a problem nationwide that has been identified over the years. One of the tragic things here is that many people never really fully appreciate what the coroner does until perhaps a coroner or a coroner investigator shows up at their doorstep to deliver them individually bad news. Can you imagine that's the first time you ever hear about a coroner and then suddenly you're kind of plunged into this world where you have to understand what the office does and what service they're supposed to provide to families.

Once you get elected, is there a class, a certification? I mean, are you telling me there's nothing in some jurisdictions that I have to do other than run for office? Yeah. In certain jurisdictions, Jackie, it is mandated that you have to go to, say, for instance, in certain jurisdictions, a two-week course in order to be up to speed with the laws and the basics of medical legal death investigation. But when you compare that level of training to, say, for instance, what a physician has to go through that might become a medical examiner. We can get into that.

There's a huge gulf of disparity relative to education and being attuned to what the form and function is of the office. And, you know, we kind of have to understand, well, what does a coroner do? Well, they're actually referred to officially as the certifier of death. You know, when you say, God, that sounds kind of odd. What does that mean? Well, they're the person that, first off, can validate a death. Let's say that this individual has, in effect, died, all right, in this local community. And that's going to vary from place to place.

Some states require that a physician actually go to the scene or that the body be brought to a physician and they declare death. Whereas in certain locations, the coroner can declare death at a particular moment in time. So it's going to be heavily dependent upon state laws. But once that has taken place, it's the ball is going to be completely in the court of the coroner to make a determination as to what's going to happen after that. And their role is to determine, first off, what the manner of death is. And you've heard me mention this before, and we have five of them, which is natural. We have homicide, accidental, suicide. And then the fifth one that's kind of nebulous is called the undetermined. And if you'll kind of imagine those five manners of death

as a gigantic umbrella, the next step that coroners have to do is determine what the cause of death is. So that's going to be things like, say, an acute myocardial infarction, which is, you know, it's medical ease for a heart attack, okay? Part of the heart muscle dies as a result of a blockage, okay? Well, many people in this country, as a matter of fact, the number one killer in our country is actually heart disease, all right? Most people are going to succumb to that. But the question is, can someone, let's say, for instance, let's take let's take an acute M.I. as it's referred to in the vernacular. Can someone die of a heart attack and that be classified as something other than a natural death? Well, the question is, yeah, yeah, that can happen. I've actually handled a case where an individual shocked an old man by, you know, putting a shotgun in the old man's face.

And the guy had a heart attack and died. And that young man was tried for murder and was convicted. So, yeah, that can happen. It can happen. But more commonly, you know, we begin to think about things like, well, gunshot wounds. Well, what classifications can gunshot wounds fall under? Well, we've got certainly homicide, we've got suicide, and then we've got accidental, and then you might have undetermined. So, it's up to the coroner to make a determination as to which one of these categories that the cause of death is going to fit under relative to manner.

And this can get pretty complicated, particularly when you have cases that go back years and years and years where you have a real hard time trying to come up with the specifics of what happened. And over a period of time, the individual may, for instance, be layered over with other disease process that have happened. One of the things that impacted me the most, I think, when I was a very young coroner investigator is I actually assisted in the autopsy of a gentleman that had been in a nursing home since, I think it was like 1946, stateside. And he had been in there since he was like 20, I believe. He finally died in the 80s and he had

been paralyzed essentially from his waist down or from his mid abdomen down and had constant care over all these years. And Jackie, one of the tragic things about this is that the reason this gentleman had wound up in the nursing home to begin with was the fact that he had sustained a gunshot wound. All those years back, multiple decades back, you know where he sustained that gunshot wound? At the Battle of the Bulge. And that round had actually lodged in his spine against his spinal cord and had paralyzed him.

And they didn't have the ability to extricate that round. They figured that it would cause greater harm. And you know that all of those years later, even though he had been in a nursing home, the coroner at that time ruled his death, ruled his death as a homicide. And so I was always fascinated by that. And I remember distinctly being there present for the autopsy. And I physically removed that projectile from his spine. And there I was holding that piece of history in my hand. And now, all of these years later, I think about

how everything that you do in life, many times relative to death investigation, is going to impact the future going forward. So, the coroner has to be equipped to analyze every bit of this data that comes in, particularly as it applies to people's medical histories and all this. Keep in mind, contrary to what you see on television, homicides only make up a very, very small percentage of the deaths that coroners and even medical examiners work. The lion's share of the deaths are going to be some kind of natural disease pathology. So you have to be really attuned to natural disease and kind of how it impacts the population at large.

Joe, you're making me shake my head because it's just kind of mind-boggling knowing that there are different regulations depending on where you live. So you could have a tremendous coroner, one who is highly qualified to handle death scenes, or you could have Joe Blow off the street who just has a GED. What do we do with this knowledge? Yeah, well, first off, let me qualify what I'm about to say by saying this. I've trained a lot of coroners over the course of my career. And I have to say, many of the best coroners, death investigators that I've ever worked with were people that were absent some

kind of high-flung college degree. They were just good, common-sense people that understood practical application. And when it comes down to it, death investigation is practical, common-sense knowledge. The trick is understanding and learning. You have to be self-taught in a lot of these areas about everything. I mean, everything from natural disease pathology, like we mentioned, to toxicology, to even DNA. And even the greatest physicians that are out there are not necessarily schooled in all of these areas. And much of the time, it comes down to how motivated the coroner is that is in office and how not they they have such a desire to serve their community, but yet they don't receive the appropriate amount of funding. The state might not provide the amount of training that would bring them up to speed, say, with their colleagues that are in medical examiner's office.

And they don't have the facilities. I've worked in, you know, with coroner's offices before where I've worked in some of the most deplorable conditions that you can imagine. And it's because there were no resources existent. And I think a lot of it comes down to many times politicians, they don't want to think about death. They don't want to sit around and talk about death. But isn't it interesting that it's going to impact everybody? It's going to touch everybody's life. No one, as they say, gets out alive. And that sooner or later, as it all kind of spins around and life goes on, people are going to be impacted by the services of the corner. And in my estimation, there is no greater service than helping families that have lost a loved one. I've worked in both coroners and medical examiners over the course of my career. And the one commonality that I have found is that in the offices I've worked in, that people always were striving for excellence.

They wanted to be there as medical legal death investigators. But the problem is, is that many times many of them lack training and they don't necessarily have all the resources that other people have. So you've explained to me what a coroner is. Of course, you know, I'm going to show my age here and say, you know, I used to watch Quincy all the time. It was my favorite show with Jack Klugman. So what is the difference between a medical examiner and a coroner? Well, you know, I'm glad that you mentioned the show Quincy.

I get that comment a lot. Did you know that coroners out in, and this is one of the little interesting little factoids about coroners, in certain areas of California, the coroner and the sheriff, listen to me very carefully, the coroner and the sheriff are one in the same in the office. And there's a lot of people that have a problem with that, that they see that as a conflict of interest between these two offices. And yet they will employ a medical examiner to actually do the examinations. Now, it kind of makes your head spin when you begin to think of it.

You know, Jackie, there's actually a couple of states out there where the coroner is also a prosecutor, which I find fascinating. You can go down to Texas. They don't have coroners. And you go to the big cities, they'll have a medical examiner in cities. But do you know who actually does the job of the coroner in Texas and many of those counties? The justice of the peace. It's just one of these things that's all over the board. So when we begin to talk about medical examiners commonly, and not in every single case, I think that Michigan is probably one of the best examples where you'll have a physician that is not necessarily a pathologist or forensic pathologist, but they are a physician and they kind of handle individual counties in that region. But by and large, when you think about medical examiner, you think about this term that people hear in the media all the time, this forensic pathologist. And to give you an example, for instance, if you're going to be, if you have kids that come to me all the time at university and they say, I want to be a forensic pathologist, I want to be a medical examiner. And I explained to them what they have to do.

And this is what you have to do. This is the simple recipe. First off, you got to go to medical school. Well, how long is that? Well, that's four years after you graduate with your undergraduate degree. And then if you want to go into forensic pathology, first off, you have to go through a pathology residency. That's five years, Jackie. So we're talking about right now at this point, nine years after you graduated with your undergraduate degree. And then if you make it through the pathology residency, which is all the stuff that they do, looking at tumors and then managing a lab and all those sorts of things in hospitals, then you have to find what's referred to as a forensic pathology residency.

Now, when I was working in Atlanta, we had a, it's actually a fellowship. We had a fellowship program there. You know, we only selected two people per year that would come in and they were from all over the world. So it's highly competitive to get one of these positions as a as a forensic pathologist. And then you have to make it through all of the training. And it's very, very intensive. So you have all of these years of training that an individual has to go through to become a medical examiner. And then you compare that to what many states use their system as a

coroner system where they don't have a medical examiner. So, you know, we talk about the level or lack thereof of education and the resources that are made available to coroners. And it's a real head scratcher, isn't it? Because you can go to a place like, say, for instance, I'll give you a great example, the state of Oklahoma. The state of Oklahoma doesn't have coroners. That's a statewide medical examiner system. Same thing in New Mexico, statewide medical examiner system. You go down to Florida, the state is broken into districts where you have a statewide medical examiner system. You go down to Florida, the state is broken into

districts where you have a district medical examiner for all these various areas down in Florida, Virginia, the same way. But you go to New York, and New York still has county coroners in that area, but they have a state medical examiner. It's very confusing. They have a state medical examiner. And then they have, of course course, New York City, they have the office of the chief medical examiner. So you get these amalgams that are thrown in on top of it. And it leaves people sitting back. And no wonder they get so confused because the media, I think many times, uses these terms interchangeably. I think you're right. And I also think that you just gave me a whole new respect for the people that I work with day in and day out. I did not realize that it was that

intensive to become a forensic pathologist. Now, do you have to be certified to be a medical examiner? Well, that's going to be dependent upon the state in order to become a medical examiner. There's it's not necessarily termed that way as a certification. It is there is a board certification. So let me kind of break it down for you. First off, you have to be an M.D. OK, if we're going with a kind of a classic model here, you have to be an MD, a medical physician. Then you have to be a pathologist, which means you have to do that five-year residency. Well, at the end of that five-year residency, these people have to go through this just intense, intense board certification. And they get certified in what's referred to as anatomical pathology

and then clinical pathology. And then after that, there's subdivisions. You can go into blood banking, you can go into histopathology, or you can go into, say, for instance, forensic pathology. And that's a one-year fellowship. That's another 365 days of training you have to endure. And then you have to go through another test for that. And there are many people that go through all of that training and they get to the forensic pathology training and that might sit for those boards. Jackie, if you can imagine this, I've known of people that have sat three and four times and they never pass it

because it's that intense. So, you know, when, at the end of the day, at the end of that process, you really produce a high quality practitioner at the end. But here's the downside. If after you've gone through all of this training, now, if you're working as a forensic pathologist, you're going to go to work for the government. And you can imagine that you're not going to get paid as well as many of your colleagues say that just stopped with general pathology. And you're going to be undergoing the rigors of court. You're going to be doing autopsies day in and day out. You're going to have to see some of the most horrible things that you can possibly imagine. And right now,

there is a real desperate lack of board-certified forensic pathologists out there. I've actually talked to a couple of people that always bring it to my attention. They'll say, you know, there are more board certified neurosurgeons than there are forensic pathologists in this country. And just kind of wrap your mind around that just for a second, because there's not a lot of people that go into the field, but yet there's such a need. You know, when you think about, you know about the big cities that require this constant tending to the dead, if you will, and examination of these bodies, you go to places like New York and LA and Detroit and Chicago and Miami and Atlanta, you've always got an influx of bodies that need to be examined. They need to be examined by professionals. Well, what do you do if you're in a coroner state and you don't have access to a forensic pathologist?

Well, those bodies have to be transported to a location where you can get access to somebody that can effectively do an autopsy. And it creates a real, real problem. So let's throw a monkey wrench in this, Joe. Where do you come in in this hierarchy? The death scene investigator. Well, you know, people have asked me that before. And, you know, they they say, well, you say you work for a corner, you work for a medical examiner. Well, yeah, I'm I'm what's referred to as a medical legal or was was I'm a college professor now. But, you know, you I worked as a medical legal death investigator. And essentially what that means is that just like homicide detectives go out and they are the eyes and the ears of the chief of police, or you can even extend that to the prosecutor because they're looking to prosecute a case of homicide. People like myself are the eyes and the ears of the forensic pathologists in the field.

So, you know, you see it on TV where you have these doctors, you know, these forensic pathologists that go out to these scenes and these dramas and all that stuff. There's not enough of them to do that, Jackie. It just, it doesn't happen. Now, I've been out on scenes with forensic pathologists before, trust me, it does happen every now and then. But for the most part, day in and day out, it's going to be people like myself that go out and they go and observe the bodies at the scene. Remember, one of the most important parts of death investigation is seeing the body in its natural, pristine state,

that place where you live, you indwell, where you go about your business with your family, where things happen to you in that environment. When you take that body out of context and you don't go out to the scene to examine the body, it can wind up creating major problems. So for the medical legal people like myself, the investigators, we go out, take photos at the scene, just like the police do. We do our measurements. We do our examinations. And then we make a decision at the scene as to whether or not we're going to release the body from the scene to a funeral home, or if we're going to bring the body in for further examination back at the county

morgue. And that's the long and short of it, that's what we do. The difference between a medical legal death investigator and, say, for instance, a homicide investigator is that homicide investigators are specifically focused on homicide. Well, homicides make up a very, very small percentage of the totality of all the deaths that occur. We still have to go out and examine natural deaths and, of course, suicides and accidents and all these things. But our working premise, and this is something that I teach my students and always have and always will, is that our working assumption is that every death, every death is a homicide until we can prove otherwise. And the reason we do that is because

if you assume that everything that you go out on is a homicide, that's the most intense investigation that you can conduct. And that way, that ensures that you're not going to miss anything, that you're going to assume that something nefarious has happened to this individual. And then logically, you begin to go down your checklist and you're whittling things away until you come to a conclusion that it's something other than homicide, for instance. And then you can move forward with the investigation. You can get medical records or you can go back and get psychiatric records, for instance, if you're dealing with a suicide. And it all fits into one gigantic piece, which should be a complete investigation relative to manner and cause of death.

I'm Joseph Scott Morgan, and this is Body Bags. This is an iHeart Podcast.