Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner

A year after the event, the Office of Chief Medical Examiner had issued 2,733 death certificates for the victims of the World Trade Center bombings—1,344 by judicial decree and 1,389 based on identified remains. The count of Members of the Service confirmed dead was 343 firefighters, 23 NYPD officers, and 48 others, most of these Port Authority police. The dead left more than 3,000 orphans. It was the largest mass murder in United States history.

Don't deny reality for the sake of objectivity.

During my two years training as a medical examiner in New York City, I was quick to learn that there is no such thing as a 'minor' surgery.

During the last shift, an X-ray had revealed a woman’s severed hand, complete with wedding ring, entirely embedded inside the chest wall of a man’s intact torso.

Everyone thinks “murder” when you say you work as a medical examiner, but homicides are rare. “Natural” is the most common manner of death and represents about a third of the cases that come to a medical examiner’s office.

Guns leave distinct types of wounds at different ranges. A contact wound, with the gun touching or pressed into the skin, can sear a round scorch mark called a muzzle stamp.

I enjoyed the intellectual rigor and scientific challenge of death investigation. Everyone there, from new students to the most senior doctors, seemed happy, eager to learn, and professionally challenged. None of the medical examiners had cots in their offices. “There are no emergency autopsies,” another resident pointed out to me. “Your patients never complain. They don’t page you during dinner. And they’ll still be dead tomorrow.

(I)f you try to treat the medical problem you *think* you see without fully exploring the differential diagnosis -- call(ed) "speculation on a foundation of assumption" -- you can kill your patient.

It's not about the bones," I told her in all honesty. "It's about the living. You and me. I do it for you.

Mine is a gruesome job, but for a scientist with a love for the mechanics of the human body, a great one.

Now I found myself at a windy crime scene in the middle of Manhattan rush hour, gore on the sidewalk, blue lights and yellow tape, a crowd of gawkers, grim cops, and coworkers who kept using the word “clusterfuck.” I was hooked.

of the remains you receive will be affected by this change.” Hirsch also revealed that our legal team had assembled a plan to issue death certificates for victims of the attacks based on two affidavits—one from the family and one from the employer of the missing person. “There will certainly be some victims who will never be positively identified, even by DNA,” he said. In those cases, the legal requirement for a death certificate would have to be met through sworn testimony of the people who last saw or heard from the vanished persons. “We will link the cases electronically once, and if, DNA or some other method identifies a missing person who has been issued a death certificate by judicial decree.” Dr. Hirsch finished his presentation that

Oh, yes—that thing about house cats is true. Your faithful golden retriever might sit next to your dead body for days, starving, but the tabby won’t. Your pet cat will eat you right away, with no qualms at all. Like any opportunistic scavenger, it will start with your eyeballs and lips.

Opening Yulia Koroleva's uterus was the most heartbreaking thing I'd ever done. When I saw that perfect fetus, when I took it in my hands, my vision clouded over with tears and my professional reserve fell away...[he] had fully formed organs each in its correct location, without any abnormalities. The foot length told me he had been nineteen weeks old, exactly halfway through gestation. I returned him to his mother's body, to be buried with her.

Remember: This can only end badly.” That’s what my husband says anytime I start a story. He’s right. So.

Staying alive, as it turns out, is mostly common sense.

The outer layer of epidermis slid off in my hand like the rind of a rotten fruit.

There are no emergency autopsies,” another resident pointed out to me. “Your patients never complain. They don’t page you during dinner. And they’ll still be dead tomorrow.

When you hear hoofbeats, think of horses--not zebras.' In other words, most things are exactly what they seem, and the simplest answer is usually the right one.