THE MEDICAL EXAMINER
Medical Examiners in New York state must be licensed physicians and trained
in the specialty field of pathology- that's dealing with the scientific diagnosis
of human disease. Nicholas Forbes has been an ME since the late 1970s.
FORBES: To be a medical examiner you have to further sub-specialize in the field
of forensic pathology- which is a discipline incorporating the principles of
scientific pathology.. and using them to address certain legal considerations.
As medical examiner, they investigate certain deaths that occur in the community
in particulair those that are not natural and those not attended by a physician.
An individual's hospital and health records may help in determining the cause
of death. Examiners need to be aware of the many advances in the medical profession.
Forbes says the procedure for an autopsy hasn't changed much for a century and a
half. But the forensic autopsy goes a bit further.
FORBES: For the purposes that we operate in a medical-legal climate, our reports
are to really document issues that may be of concern to the civil and criminal
justice systems primarily. And then of course the data that we produce are of
public health importance.
The deaths that don't make the newspapers are frequently more difficult to
explain than cases involving crime- including homicide.
FORBES: For example: strangling.. I've seen so many over the years that the
constellation of findings that you come across have been quite familliar to me.
And some of the medically-complex cases are the most challenging. It might be the
case of a rare kind of heart disease where the cause of death is difficult to
establish because of inherrent medical problems. And a lot of scientific studies
may be needed as a follow up. And that can be rather rather lengthy and complex.
A medical examiner can testify to the frailty- or tenacity- of the human body.
FORBES: I see cases where little babies die of sudden infant death syndrome- something
that came like a thief in the night and took life away. And obviously that wasn't
anything very substantial that we can establish, that we can see either at autopsy or
microscopically. And on other occasions people have obviously sustained a great deal of
trauma before sucumming. I've seen cases where people have been shot through the heart
with medium caliber bullets and have been able to walk or run for a hundred feet or so.
I have a biased outlook because of the kinds of cases I get. I see all the cases where
people die suddenly before they, perhaps because of infectious disease, have time to get
Establishing the time of death, Forbes says, is an extremely difficult task.
FORBES: Things like drop in temperature, coloration of the body, extent of decomposition,
certain chemical changes in fluids behind the eye, where the stiffening of the body has
occurred- rigor mortis, contents of the stomach.. it varies. Of course, the circumstances
are extremely important: the undelivered newspapers, the watch that was struck by
lightning and so forth are the classics you might read about. Sometimes we can really
only give a range of years, sometimes months, sometimes hours, sometimes minutes and
The doctor prefers to keep a low media profile. He wants to do his job efficiently
FORBES: I tend to try and not take the work home with me. I very rarely discuss it
with my family. Some of the cases do get to you to an extent. So I think it takes a
certain kind of temperament to handle the case material. I still it find it interesting
nd challenging. I've never been bored by what I do. But I've really never gotten too
emotionally down by even some of the most heinous things that I come across.
Monroe County Medical Examiner, Nicholas Forbes. Bill Flynn, WXXI 1370.