I'm a forensic pathologist - AMA

[slightlybrownbanana]

I do autopsies every week on a range of different type of deaths, not just homicides. People are often fascinated when I tell them what I do and it is very interesting but not like on the telly.

I thought we used the words post mortem and murder not autopsy and homicide.
when did these terms change and why??

I tend to use the former more frequently but also use the latter terms interchangeably. Autopsy and homicide are more American and I guess like many American terms they tend to creep into our language usage in the UK.

Weirdly since I started following this thread my YouTube recommendations are all postm ortem related and lots of stillbirth baby journeys.

VERY TRIGGERING

OP in the stillbirth babies their lips and nails are very dark red, almost black although their skin is a good colour. Why is that? Also some of them have skin grazing and quite severe peeling, would that start quite quickly after death?

Thank you so much for your fascinating answers OP!

I particularly wondered about the sids / cold because its a known phenomenon in babies as much as sids is 'without known cause', and I had drawn a parallel.

Also..my wonder was about the brain being 'lost' out the ears (that was what I'd seen), but you say its still there but just turns to porridge, so it would only be the fluid elements that would be lost through the ears, etc.

How well represented are women in FP?

Thanks, banana

OP in the stillbirth babies their lips and nails are very dark red, almost black although their skin is a good colour. Why is that? Also some of them have skin grazing and quite severe peeling, would that start quite quickly after death?

What you are describing is called maceration, which are the changes after death when the baby dies in utero. The difference to decomposition is that the process is not driven by bacteria as the amniotic sac is an aseptic environment and babies don't have bacteria in their gut until they ingest milk after being born. The longer a baby has been dead in the womb the greater these changes will be and can be graded from early to severe maceration, allowing a paediatric pathologist to roughly estimate the time of death.

How well represented are women in FP?

It used to be a very male dominated speciality but in the last 20 years or so that has changed and the ratio of male to female trainees is now about 50:50 which I think is a good thing.

are the pm reports a pain in the arse lengthy and cumbersome?
I sometimes receive some for work and they are rather short (couple of pages of pictograms and test results and a page of written summary)

are the pm reports (a pain in the arse) lengthy and cumbersome?

Some reports take half an hour to write and others can take days, if not weeks, with endless drafts and associated literature searches. Obviously cases vary a lot in their complexity and that is reflected in the time and effort involved in writing the reports.

Are there any memorable deaths that you've dealt with?

You mentioned things going on behind closed doors and family dramas. I assumed your work was solely focussed on the physical body in front of you and finding a cause. I'm a private person and hate to think that in addition to something possibly bad happening to me, my life might make a good story. So my question is: what sort of 'background' things do take into account? Do you interview family members, go through phone records and diaries ect?

Absolutely fascinating AMA Banana, thank you. No questions but I am avidly absorbing the discussion!

This has to be one of the best AMA threads

Thank you Banana

The SIDs / cold death parallel? How would one tell the difference is there one? Sorry if I've misunderstood your explanation and you've commented already. Will go and double-check.

Are there any memorable deaths that you've dealt with?

Yes, so many; some because they were brutal, some desperately sad and I remember all the children. I don't want to go into detail in case the people involved are recognisable.

I am guessing the same then for the ' you couldn't make it up ' ones?

what sort of 'background' things do take into account? Do you interview family members, go through phone records and diaries ect?

The police provide us with the deceased person's past medical history, prescribed medication and occupational history. We also need to know what happened in the lead up to the death such as was the person well or ill, had they been taking drugs or alcohol, did they fall or were they assaulted etc. All these things and more are very important as we need to interpret the findings at PM in the context of how the death occurred, this is called clinicopathological correlation.

How much do your children know about your work, and what do they think of it?

Fascinating thread, thank you.

It really is totally fascinating.
Thank you.

Do you ever have to do night shifts or weekends?

you ever have to do night shifts or weekends?

OP already detailed her week Basil

Is there any difference between ethnic groups say in decomposing? With darker skinned people bruises may not be immediately obvious. Would you look beneath the skins top layer for signs of trauma?

How much do your children know about your work, and what do they think of it?

My youngest is too little to understand but my eldest is at primary school and knows that Mummy is a special type of doctor who finds out how people died. We've not discussed the nitty gritty but it is understood that I have to cut open the people to do my job. One question fairly recently from eldest was "mummy, do you ever find out how children died?" to which I answered "occasionally, yes". I try to answer all questions honestly but at a level of detail appropriate to age and that won't be upsetting.

If you get called to a murder scene what is the reason for you attending the scene? You obviously don't do the PM until back inside.....so is it to tell the police if you think it's a murder or not before they move the body?

Do they call you out to most unexplained deaths or just the ones they think are murders?

Is there any difference between ethnic groups say in decomposing? With darker skinned people bruises may not be immediately obvious. Would you look beneath the skins top layer for signs of trauma?

There's no difference in the rate of decomposition but you're right in that darker skin makes both decomposition and bruises more difficult to see. Even with white people we will sometimes put a cut in the skin to determine if bruising is genuine (you can see the blood beneath the skin if it is) but we would be more inclined to do that with a darker skinned person.