January 3, 2023 • 45 mins
When Joseph Scott Morgan was on his first date with his wife Kim she asked him what he did for a living. When he responded by telling her that he worked for the Medical Examiner, essentially the coroner, examining dead bodies and performing autopsies, she looked at him with a puzzled expression…
We all have aspects of our lives that are unusual, whether it’s our family, our habits, or our jobs. But when we do these things every day, they become so normal to us that we don’t even question them anymore.
In this special episode of Body Bags, forensics expert Joseph Scott Morgan and Jackie Howard go into depth on the touchstone of forensic death investigation: autopsies. They discuss what an autopsy is, who can order one, the different kinds, and how Joe ended up in this unique profession.
Show Notes:
0:00 - Intro
2:07 - What is an autopsy?
4:10 - Who determines when an autopsy is done? Why would you not do one?
7:40 - Can an autopsy be done even if the family doesn’t want it?
9:58 - Gloria Satterfield’s cause of death
12:45 - Are there different kinds of autopsies?
17:55 - Joe’s experience in the autopsy room
18:56 - What is a full autopsy and how long does it take?
26:50 - Can certain autopsies be prioritized?
30:22 - Is an autopsy considered surgery?
34:05 - How did Joseph Scott end up working in a morgue?
38:50 - Seeing bodies in all different kinds of states
41:40 - How does Joe’s family deal with his line of work?
43:45 - Joe’s take on his career
45:21 - Wrap up
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:08):
Body Backs with Joseph Scott Morgan. Early in the morning
on October nineteenth, nineteen, in a little town in Idaho,
a lady who was in her late forties was found
(00:32):
de ceased and for whatever reason still remains a mystery
to this day, the decision was made for an autopsy
not to be performed. And Letty's name is Tammy day
Bell and her case is critical and a much broader
investigation that's going on. As a matter of fact, the
(00:54):
absence of an autopsy in that case could have severe
repercussions moving forward. Today, we're gonna be discussing autopsies, what
they are, who makes a determination as to when they occur.
And I'm gonna tell you a little bit about my
background with autopsis. I'm Joseph Scott Morgan and this is
(01:20):
Body Bags. I've been involved in death investigation for the
majority of my adult life, either working in the morgue,
out of the field as an investigator or now as
an academic talking about medical legal death investigation every single
(01:40):
day that I walk into school. And my friend Jackie Howard,
who is the executive producer of Crime Stories with Nancy Grace.
Jackie We've talked about autopsies a lot, haven't we we have, Joe,
And the more that we talk about it, the more
that I want to know. Was as we laid out
our plans for what we wanted to discuss the day,
(02:01):
the questions just started pouring. So I figured the best
place to start is with a simple question, what is
an autopsy? An autopsy is essentially, there's another way to
put this, it's essentially a post mortem examination. And that's
in a very very broad sense. But when you hear
(02:22):
the term autopsy, it conjures up images of an old,
dilapidated morgue. You've got more personnel running about, there's coolers
where bodies are stored in generally a stainless steel table,
and that's that's not too far off the mark. But
we have to understand that when we conduct an autopsy,
(02:47):
we're trying to determine what exactly happened, what brought about
the death of an individual that was not necessarily otherwise explained.
And so when you begin to go down this owd
in the autopsy suite, you know some people, interestingly enough,
historically they've they've referred to in the historic record as
(03:08):
doctors that do autopsies, they will refer to them as
surgical pathology, and surgical pathology now means like you've got
a doctor that goes up to surgery that's a pathologist
and they look at frozen sections of tumors that have
been removed from people. They'll look at them instantaneously and
try to give you a diagnosis. But there is a
part to surgical pathology that goes along with autopsy examinations
(03:31):
where the pathologists will engage in literally the dissection or
pro section of human remains to try to determine what
exactly brought about the death. Because absent those clinical diagnoses
that you arrive at by virtue of doing these examinations,
you don't actually have a final or fatal diagnosis. The
(03:57):
biggest questions that families have, that can unities have is
absolutely what happened, How did they die, When did they die,
what was the mechanism that brought about their death, and
hopefully through an autopsy you can make that determination. One
of the things that you said just Sin Joe really
caught my attention, and it was having to do with
(04:19):
when an autopsy has done and when is it not done.
I find it really interesting in the Tammy Day Bell case.
As you mentioned that an autopsy was not initially done.
Who determines that and why would you not? I mean,
I know, in certain especially in the elderly, when it's
(04:39):
thought to be natural causes, they don't necessarily do an
autopsy to try to figure out why this person died.
So who makes that determination and why? Well, ultimately it's
going to be the lead medical legal authority in a jurisdiction.
And you got to back up and understand that in
the United States in particular, we have two separate of systems. Here.
(05:02):
You have corner systems, which are elected officials and they
they're not necessarily always physicians. As a matter of fact,
most of the the time they're not physicians. People will be
surprised to hear that. And then you have medical examiner systems,
which are essentially run by physicians who many times are
in fact forensic pathologists. So it really varies from state
(05:26):
to state who's going to make the determination. Most of
the time, the state statute, that is, the state law
will dictate who has the authority to make a decision
about an autopsy. And contrary to popular belief, I hear
and famously with the Tammy Daviel case, it was stated
that it was the family's wishes not to have an
(05:48):
autopsy performed in her case, and kind of sitting there
scratching your head and saying, I got a healthy young
woman here that's out and running every day and seems
vibrant and healthy. Why in the world would you not
one an autopsy? And there's a many layers to that.
Families don't want to think about their their family members
(06:09):
undergoing this procedure. They don't want to think about everything
that's involved with it. They just want to go to
the funeral home with the remains. But unfortunately, if it's
not done, and it's not done in a timely fashion,
one or two things is going to happen. Either you'll
never have answers to those questions, or in Tammy Davel's case,
she had been in bomb transport to another state and
(06:31):
had been buried. Even after her body is exhumed in
that case, any kind of findings that there may have
been originally, they're going to be so compromised by the
time it's really gonna be difficult to make heads or tails.
So most of the time it will be depended upon
what the medical legal authority again back to medical exam
(06:54):
or corner views as the best interest at that point
in time to come up with an answer, scientific valid
answer to try to determine what brought about this person's
sudden death. And it is not dependent upon what the
family wants. Okay, now that sounds cruel, but you know
(07:18):
most of the time families are in no position to
make that decision. And also there are a greater interest
at work here, and we can go down the list.
You got a homicide, this happened. Family is not going
to have any weight given to their their protest about
an autopsy not being performed in that case because it's obvious,
but you have to document it if you're going to
prosecute a case. And then you have these kind of
(07:39):
mysterious circumstances where you don't have any answers. And let
me ask you something you're in relating to what you're
talking about, CANNA can and autopsy be done even though
the family doesn't want it to be. I mean like
in this in this case, the family said that an
autopsy was not necessary here, it could the corner or
the medical personnel have said, then we're doing an autopsy anyway,
(08:01):
they have authority under state law to do that. They
can say, well, I respect what you're saying, I understand
why you might not want one done, but there's bigger
interest at work here. We have to make a determination
about manner and cause of death here and find out
what exactly happened, and there's there's reasons why you do that.
First off, it's a mystery that you have to have
(08:23):
an answer for the corner or the medical examiner is
going to be the one that actually, you know, you
hear the term death certificate. People don't think about that.
That means the death is being certified. Okay, Well, if
you don't have a reason that is put forth as
a result of a pathology finding where you're looking for
disease or some kind of mechanism of death, what are
(08:45):
you gonna list as a cause of death gunshot wound
or mio cardial infarction or lung cancer, leukemia, or whatever
it is the person has going on in dwelling within
their body or some kind of external event that occurred
bring about their death. If you don't go in and
actually examine that and and make a note of that
(09:06):
and make an absolute diagnosis, how are you going to
do that? How are you going to list the cause
of death? I mean, you can't just like it doesn't
just come to you psychically out of the air. You
have to see it. It's it's a scientific procedure, it's
a it's a study. And then how are you going
to list the manner of death? We've only got five
that choose from natural, suicide, homicide, unexplained, undetermined. You've got
(09:32):
all of those that you have to choose from as well.
So if you have nothing to put on the death certificate,
you're gonna have a death certificate. It's going to remain
probably incomplete for a protracted period of time because you're
asking for the official to put down an official diagnosis
in an official manner of death that they don't have
(09:52):
any insight into. And of course the autopsy itself is
the best way to do that. Glorious sadder Field having
to do with the case of the Myrtles over in
South Carolina, Gloria Sadderfield, the Myrdals housekeeper reportedly tripped over
dogs going down the stairs outside the home the brick stairway,
(10:15):
Yet her cause of death, if I'm not mistaken, was
listed as natural causes. Yeah, it is super bizarre, you know,
particularly the case of Glorious Sadderfield. You've got a woman
that had obviously sustained some type of very specific head
trauma that brought her to the hospital. And one of
the ways I teach my students, there's that old point
that we talk about and I don't know, folks, I'm
(10:36):
not going to recite the whole thing. I'll spare spare
the audience that the old the old point that goes,
you know, for the one of a nail, the shoe
was lost. For the one of the shoe, a horse
was lost. For the one of a horse, a rider
was lost, a message was lost, and so forth and
so on. So you have a genesis in the beginning
as to how all of these dominoes begin to fall.
(10:59):
And in sadder Field's case, well, what brought her to
the hospital. Was it that she had a cardiac event?
Was that that she had a stroke, Was it that
she got struck by lightning? Well, none of the above.
She fell and sustained head trauma. But yet they're listing
this whole event as a natural event. And here's here's
(11:21):
what's crazy about that case. Is that a private attending
physician signed her death certificate, and this case was never
reported to the corner. Listen, if a person rolls into
the hospital as a result of a traumatic event and
they don't exit that hospital and they die inside the walls,
(11:42):
and I don't care how long they've been in the hospital.
If they come in as a result of trauma and
that trauma is directly related to their death, that is
a reportable case. And it's my understanding the case was
never even reported to the corner. And that's a problem
because the corner is not aware. They can't make a
decision about whether or not an autopsy should be performed,
(12:04):
or she had been in for a while, so they're
going to request the records and examine the records, all
of the imaging, everything that comes along with that, and
they'll sign the death certificate. But you know, a private
physician can't list a traumatic cause of death, and they
can't qualify a traumatic cause of death. So priva physician
can't say blunt force trauma and the manner of death
(12:26):
is homicide or accident, that will get rejected most of
the time, that's going to be rejected by the state
Health department. Whoever handles all of the paperwork, the public
health agency that handles a paperwork for the state, and
that's why it always goes back to the corner. But
if the corner is not aware of it, the death
has not been reported, it's gonna be a problem going forward.
(12:46):
So then the question begs to be answered once a
decision is made to do an autopsy, is what kind
of an autopsy is there going to be? If it's
an autopsy is always the same you start with A
through Z or are there truly different kinds of autopsies?
(13:07):
There are different degrees to autopsies. When you bring a
body into a morgue, for instance, you can do what's
called an external examination, which means that the body will
be completely photographed as is upon arrival. That means with
clothing on. Okay, some places actually do X rays just
(13:29):
so that they have them. You disrobe the body, the
pathologists and their assistant do a complete and total examination
of the body unclothed. Then, in addition to that, you're
going to draw samples for toxicology, and what these are
gonna be is you'll draw what's referred to as heart blood.
Most of the time you're gonna try to and this
is externally and it's drawn from the A order. So
(13:51):
folks will find their collar bone on the left hand
side and go down the intercostal spaces, which is kind
of the muscle in betwe each rib group and go
down about the third intercostal space in the ribs on
the front side, okay, adjacent to the sternal. There will
be a needle inserted there and it will go into
the A order, which is the big the big vessel
(14:13):
that comes off the curved vessel that comes off of
the top of the heart. And it takes practice to
learn how to do this, but over a period of
time there's we do it by touch. It's something that
we can do, and then you draw blood out of
that area and then we take another needle and we
draw externally. We will draw urine, and finally we'll draw
vitreous fluid which comes from the eye, and all of
(14:35):
those fluids are submitted for toxicology and we'll run the
entire panel. But to the the broader question here, that's
the first kind of stop along the continuum where we're
doing an external examination and it doesn't rise to the
same level as a full autopsy or even a partial autopsy,
which I'm not a fan of. But you just do
(14:57):
the external examination. You draw the fluids, and then those
are submitted generally to either a local hospital or state
crime lab, and you run a drug panel, and you
already have a suspicion. If you're going to do an
external examination, you already have a suspicion that you might
know what caused death is, but you just want to
rule out everything else and kind of external trauma. Maybe
the person died and they weren't found for a while,
(15:19):
and then you'll move forward. Maybe you can even get
the private physician if it's a natural death, which if
you're not doing an autopsy, it's probably a natural death.
The private physician can sign the death certificate and the
list of specific cause of death. Again, back to acute
mild cardial infarction, which is essentially a fancy way of
saying a heart attack, and that is a natural classified
(15:40):
as a natural death. Now you'll have events that pathologists
will make a decision or the enemy of the corner
will make a decision. We're only going to a partial autopsy.
And I have a problem with this because it's like
you've got one foot in the water and one foot
in the boat. If you're gonna do it, commit to it.
Do it. And they're even cases like if you have suicides,
(16:03):
for instance, subject has sustained a gunshot woman the head,
they might only in certain jurisdictions they might actually only
only open the head, for instance, and retrieve a projectile,
and then they don't touch the rest of the body.
And that's a problem. It can be a problem everybody
needs to understand. Foundationally, in the medical legal world, our
(16:25):
supposition is this, and everything that we do we work
under this big banner that says every death, not some deaths,
not a few deaths. We from jump Street. We go
forward with this idea that every death is in fact
a homicide until we can prove otherwise. Okay, Because if
(16:47):
you start out at that really intense high level of
trying to make a determination about homicide, as you kind
of make your way through these checklists that we have,
you get to the next level maybe accent or suicide,
and then you get to maybe natural and you've kind
of checked the boxes along the way. You have to
(17:08):
be able to effectively rule all these things out. So
back to this idea of partial autopsy. If you're only
gonna do a partial autopsy, why why not go ahead
and do the entire autopsy? In that way, it's complete.
It's only gonna take you maybe another forty five minutes
to an hour to get everything done, and it can
lead to problems down the road. You'll have people saying, well,
(17:28):
they had this problem or they had that problem, why
didn't you look at this? And while you have the
body there in front of you, you go ahead and
you do the whole thing. I engage in these discussions
(17:57):
many times with my students at Jaxsuals Prod teach and
they'll say, how you know, Professor Morgan, how did you
get into this environment? How did you start doing this?
How did you start working the more? Why did you
choose to be in the Morgue? Let me tell you
something and hear me right. The best classroom that I've
ever been in, and I've paid a lot of money
for tuition over the years, the best classroom that I
(18:20):
was ever in that I was actually paid to be
in as opposed to having to pay tutition for it
was the autopsy room. I learned more about death investigation
than I ever did out on a scene with a
deceased person or sitting around having coffee with an old
investigator and they're telling war stories. I've learned more in
the autopsy suite, actually getting my hand sturdy and being
(18:44):
there to actually see these things before me demonstrated, to
see the mechanisms that are involved, to see all of
the underlying disease. You can't have a better environment in
which to learn in Okay, then lay this out for me. Joe,
you were talking for about a full autopsy. Explain that
to me. And how long does an autopsies take? Remember
(19:09):
how I mentioned when we talked about an external examination. Well,
every autopsy starts off with an external examination. Now, in
some cases where you have what you suspect is natural disease,
it might begin and end with that and then the
body will be released. However, a full autopsy will in
fact start with an external examination, and you go from
stem to stern relative to the overall status of the body.
(19:34):
All of this is made not of throughout the examination.
I mean measurements. We go into great detail relative to measurements,
and a lot of this is actually dictated by particularly
if you've got traumatic cases, say for instance, like with
Ellen Greenberg, where she was stabbed. Some people have said
twenty times. Some people have said more than twenty times.
You've got so much trauma there that each individual insult
(19:56):
that she has externally has to be measured in orient
it anatomically. Say, for instance, if someone has been let's
just say somebody has been shot to the right of
their sternal, which is the hard plate of the breastbone
on the anterior chest. They've been shot to the right. Well,
just for that gunshot wound alone, you would have to
get a measurement first off of the overall circumference of
(20:20):
the wound itself, and then you have to measure Some
people do from two points, some people do from three,
like from if it's on the right side of the stern,
you would do a measurement from the center of the
wound to the apex of the right shoulder, and then
maybe from the center the wound to the apex of
the left shoulder, and then from the center of the
wound to the top of the head. That takes time.
(20:41):
And then if you have somebody to stabbed multiple times,
shot multiple times, each one of those injuries dictates the
speed at which you can do is because you want
to do a thorough examination. I've had people that have
been stabbed in well in excess of of a hundred times,
and you can just imagine the external examination I'll loan
it is a herculean task, to say the least, and
(21:04):
then you might have three or four other autopsies that
you're going to have to do that day. But once
you get done with the external examination, then the body
is of course, you're on a stainless stel autopsy table
and these are either fixed on the floor or their
own rollers where the and they're kind of set at
a pitch because you're gonna lose fluid, and the fluid
will run down the stainless steel table either into a
(21:28):
pre established drain that you have on a fixed table
or into this big kind of catch I'll sink it's
a working station that you have, and all of that
fluid is washed away and you'll have multiple autopsy stations.
You go to one of these really big shops in
large metropolitan areas, and they might have the ability to
have five five autopsies, say for instance, going on at
(21:49):
one time, and you might have multiple physicians, multiple autopsy assistance, photographers,
everybody doing these examinations. All at one time, particularly if
you're talking about like a mass casual event or if
it's a really really busy day. And so after the
external examination is done, essentially the chest and the abdomen
are opened and we use what's referred to as a
(22:12):
standard ye incision, and so it forms a y where
you make a diagonal cut from the apex of the
left shoulder the apex of the right shoulder down to midsternal. Well,
because it enables us to effectively remove back or retract
(22:33):
that external layer of tissue, which includes skin, the subcu fat,
all of the muscle tissue that's in dwelling, and it
reveals everything. And also the body is on what's called
it's blocked in the back. You have kind of these
rubber blocks. You put them beneath the shoulder blades and
it hyper extends hyper extends the chest so that the
shoulders kind of fall to the side. The body really
(22:55):
opens up and you can appreciate once you get the
body open, you can appreciate a all of the viscera
and that's the internal structures very well. They can all
be visualized in place, and you want to be able
to see it. I mean just just imagine, if you will,
you've got someone that has been shot, and let's say
(23:15):
they're shot in the left side. If people will put
like there their finger beneath their armpit on the left side,
and that bullet travels from the left and it travels
maybe slightly upward from below to above, and it almost
transacts the body, which means it cuts across the entirety
(23:36):
of the middle line of the body, and it exits
out beneath the right armpit. You've got all of these
structures that are impacted. Let's think what structures might be. Well,
you've got the left lung, which has only two lobes
because the hearts on the left side. It may go
through the heart, then it's gonna go through the right lung,
which has got three lobes, and then it's going to
(23:56):
exit through all of that tissue. And you have to
track that wound and see what structures are impacted by this,
because what you're looking for is when you make that
final diagnosis of what led to death, was it simply
the lung that was impacted, was it the heart, or
was it in total all of these structures being impacted, Say,
(24:17):
for instance, if it penetrated the heart. Was that injury
that was sustained as a result of that gunshot when
sufficient to cause more of an instantaneous death, or did
this individual linger. What you're describing for me here is
an autopsy is a lengthy procedure. Oh yeah, yeah, particularly
when you've got these highly complex cases where you've got
(24:38):
multiple trauma. Now you might if you have a case,
for instance, where an individual is say, this is very sad,
but we do more of these than anything else. I
would imagine as far as trauma goes, and those are suicides, Well,
you've got a single self inflicted gunshot when, or at
least you you think that it might be. But remember
our starting point is every death is a homicide until
(24:59):
we prove otherwise. You've got a single bullet in that case,
and you track that bullet, and let's say it's a
self inflicted gunshot wound to the head. Well, maybe they're
right handed. It went from the right side of the
head to the left side of the head, Maybe it
stayed in, maybe it exited. You're gonna track that wound
and beyond that, there's not too much more to discover.
You're gonna try to rule out any other kind of
(25:20):
trauma that may or may not be present. And this
again goes to another underlined principle within forensics, negative findings
are just as important as positive findings. So an absence
of trauma is significant. Okay, all right, So if I
can say autopsy that there's no trauma to the neck,
(25:42):
well that's something that has to be made note of.
You cannot just assume that people will understand there was
no trauma to the neck, because if this thing were
to go to court for whatever reason, one of the
questions that's going to be asked of the person conducting
the autopsy is, well, you don't say any thing about
what you saw with the neck. Does that mean that
(26:03):
it didn't examine the neck or does that mean that
you didn't see anything? Why? Why? Why would you fail?
I mean the next pretty significant, right, and you wind
up looking like an idiot on the stand. So you
you cover that, you have to document that there was
no trauma to the neck or that there was trauma
to the neck. All of it is part and parcel
of a bigger picture. So you're right when you say
(26:24):
that these things take time. It's not just the individual
trauma that you can see. You also have to document
those things that are not there, and that's quite fascinating
when you think about it. There's not too many other
things in life that you document the absence of something
in that sense. I've always been fascinated by that, that one,
that one little point that's very significant in forensic pathology
(26:45):
in particular, you are describing autopsy suites in larger areas
where they can have multiple tables and autopsies going at
the same time. Given the amount of time that it
seems to take for each autopsy, and given how many
deaths unfortunately that most CDC every day, the idea that
(27:08):
we see in some cop shows that, hey, can you
push this to the top of the line? Does that work?
I'm gonna be I guess kind of cheeky here. I'm
gonna say that all depends on how many politicians called
the official. Most of the time you'd want to think no,
everybody awaits their turn. But if there are particular high
profile cases that are going on that particular day. You
(27:29):
look back historically, I think, and you think about cases
like Ron Goldman for instance, and Nicole Brown Simpson. Well
that was at the l A County corner where those
examinations were done. You would like to think that that
particular forensic pathologists and their team that was involved in
(27:50):
that case would have been on those two cases, in
those two cases alone, and that they would have been
given as much time as possible. However, I don't think
that people appreciate the volume of cases that come through
a shop like l A County. That same day, they
may have had twenty other autopsies that had to be done.
(28:12):
And there is a finite number of forensic pathologists out there,
as a matter of fact, depend upon who you who
you ask. At any point in time, you'll hear numbers
like five fifty or six hundred board certified forensic pathologists nationwide. Okay,
just let that sink in. There's and I'm not saying
forensic pathologists are smarter than a neurosurgeon, but there are
(28:37):
more neurosurgeons out there practicing than there are forensic pathologists.
And if you want that level of skill to be
performed for an autopsy, you're gonna have to really look
for these people and attract them to work in a
particular area, because, let's face it, you go to the
large urban areas, people will apply for those jobs. And
they will have availability, they'll have a need for forensic pathologists.
(28:58):
But you go to a more rural area, they're not
going to have access necessarily to a forensic pathologist because
there's so very few. It's just the numbers just dictate that,
and so it's it's really an odd position to be in.
And then even if you have a full staff, you
get to these areas, these big urban areas where they
have huge volumes of deaths and autopsies that have to
be performed, those staffs are overworked many many times, and
(29:22):
it's hard to get people to come into the field.
It looks really sexy on TV and people talk about it,
and I have kids that come to me all the
time say they want to be a forensic pathologist. But
what's fascinating is of talk to people over the years,
and one of the interesting things is is that when
friends of pathologists go through their training, it's one of
those unique kind of educational journeys where the more education
(29:44):
you get, essentially the less you get paid. Okay, so
if you just stop at a fellowship or an internship,
will being a clinical pathologist and anatomical pathologist work in
a hospital. You're gonna make a lot more than the
guy that goes on beyond that training and doesn't one
year fellowship and forensic pathology, and you're gonna wind up
working animal work in a city, in an urban area
(30:06):
most of the time, dealing with most unpleasant cases you
can imagine, and then traveling around and go into court,
and you're gonna get paid as a government employee. That's
kind of one of the little dynamics that you know,
kind of that you're kind of faced with in the
medical legal community. Joe, you mentioned surgeons just a second ago.
Is an autopsy considered surgery? I think for years it
(30:28):
has been regarded as a type of surgery, and you
will hear the term autopsy surgeon, particularly going back years
and years. I love history, and what's really kind of
fascinating about the trajectory that you see with gross anatomical
dissection is that even up until I guess probably the
(30:49):
early eighteen hundreds, the first part of the nineteenth century,
it was illegal in many places to do dissections on
human remains period. And you know, there's all kinds of
stories about rape robbers that would go and disinter bodies
and that would bring them back to medical schools and
by the light of waloa lamp or whatever, medical students
(31:09):
in order to try to learn anatomy would dissect these
bodies that have been removed from the ground just to
try to understand anatomy. And so it has not been
something that has been done for centuries and centuries and
centuries because it was so prohibited for so long. Now
through the twentieth century and obviously into the autopsies are
(31:31):
are common, they are a necessity. A very small percentage
of the cases that a medical examiner corner deal with
are homicides, and that's what you always think about with
people in my field, and that's not the case. It's
just not the lines share cases we deal with are
some kind of of natural event. If you don't have
(31:52):
an interest in natural disease pathology looking at bodies where
you're trying to make a determination about manner and cause it,
it's not gonna be gunshot wounds most of the time.
You're gonna be dealing with natural disease and trying to
make a determination. And there's bigger considerations here. Number one
is the community in which these people live. Did this
person suddenly die? Because there's some kind of public health issue.
(32:14):
I was in Atlanta when we were at the height
of one of the biggest TV scares in the nation.
We were like the TV capital of the nation and
like the nineties or something, and we had all of
these people that were homeless and other people that were
dying of TV, and that's a public health concern, and
then you you think about broad ranging other diseases that
(32:35):
are out there. I started my career at the height
of the AIDS epidemic, and we were terrified to be
in the morgue because we didn't know what was going
to happen if we stuck ourselves with a dirty needle
or cut ourselves with a dirty scalpel. And that does happen.
We've all been nick in the morgue. It's not as
clean as people think. It's not as necessarily precise. It's
like a standard surgery, you know, when you go into
(32:55):
these environments because you're doing multiple cases, you're doing them quickly.
It's a a different world to kind of be a
part of. But absolutely grateful that that I was part
of that world because I learned more. Now I have
an opportunity to teach when people found out what I
(33:30):
did for a living. I'd get one of two reactions.
Either people would lean in and want to hear more,
because by our nature as humans, we have morbid curiosity
about things. Or I've actually answered the question of what
(33:50):
I did for a living at a party and had
people immediately turn on their heel and walk away. They
don't want to hear anything else about death. There's rarely
middle ground when that conversation starts. You know, I never
thought that I had a morbid curiosity about me, but
I have been proven wrong. The more I talk about you,
(34:11):
the more I want to know. So let's play twenty questions,
so to speak with Joe Scott Morgan. What makes a
person want to deal with dead bodies? And how do
you get into that profession? How do you get to
work in a morgue? For me, it was a curious
set of circumstances. Now it's really actually difficult to get
(34:35):
into more to even view an autopsy because of all
of the health considerations and all these sort of things.
But I happen to be working at a hospital in
security and working also as an e R tech. While
the morgue in our parish down there was being renovated
and they started bringing bodies to our hospital to do
the autopsies for the parish, which is the same as
(34:57):
a county. And I became friends with the people at
the corner's office, and I would be the one that
would shuffle bodies in and out the door, and they
were a huge volume of them, and I just became
friends with these folks and started, believe it or not,
I started attending autopsies on my free time, not getting paid,
but I was just fascinated by it because I've always
been a science guy. And the next thing I knew,
(35:18):
I was taking notes for them, and eventually they allowed
me to participate in autopsy. Await wait, taking notes for them?
What does that mean? Well, I would work as a
scribe for the forensic pathologist. If you can imagine the
stupid young kid who had no background in it, but
was willing to sit there with bloated, decomposing remains. Horrible
(35:41):
traumatic cases, the worst of the worst cases you can
possibly see. And I didn't necessarily retract or retreat from it.
And that's not always a circumstance when people go to
an autopsy for the first time. I've had one of
my best friends that became a fantastic homicide investigator. I
was in the middle of opening a gunshot wound victim's
(36:01):
head in the middle of it, and he, my friend
just kind of back up. My friend was actually a
burglary detective in the jurisdiction where I was working, and
he and I played golf together over the years and whatnot,
and he wanted to transition the homicide. One of the
requirement says you had to go to autopsies. He'd never been,
and famously I had. I'd used that kind of high
(36:22):
pitched saw. It's called striker saw and agitating saw. Its
like cas saw, and I was open to the skull
and the friends of pathologists looked up at me over
his mask and he said you better check on him.
And I looked over and my friend was turning green.
And he stood up. And he's a big guy, I
mean just really big, bold, tough guy's kind of guy
(36:42):
you'd worn on your side. There was a fight, and
he's always dressed to the nines. And he begins to
back up and retreat away from the autopsy area down
a little hallway and he collapsed and went up against
a tiled wall in this old hospital and slid down
the wall. I look back now and I as at
it because I was covered. You can't imagine. I was
(37:03):
doing autopsy, had blood on me, and we used to
wear these big yellow gloves that just made the blood
pop even more. And he's my friend. I was concerned.
I thought he'd hurt his head. And I was approaching him,
walking toward him, saying, are you okay? Are you okay?
And he automatically still nauseated, and Dizzy throws his hands
up like I'm a monster, and he says, no, no,
(37:24):
back away, back away, because I'm coming at him and
I've got blood all over, and it was just it's
one of those curious environments that only certain people have
the ability to be able to to go into and
maintain their focus. Well, that that's the key. It's hard
to kind of measure that until you've been in in
(37:46):
that environment. Some people think they want to do it,
but then they get in there and they realize from
jump Street that they don't have the And it's not
a judgment of them, it's just some people react differently
to seeing a human being that is being opened on
a table. And I think that that's that's natural. But
(38:08):
you kind of. I think I've said that you kind
of develop a callous to it, And I don't mean
you become callous. You just develop almost like if you're
a carpenter and you're swinging a hammer, your hands are
suited to that. After period of time, you you build
up a callous on your hands so you can handle
the hammer. And for us, we build up a kind
of a callous to those things that are required of
(38:30):
us to do because who else you're gonna get to
do it? You know, people say they want to do it,
but there's one thing about saying you want to do it,
and there's no part to doing it. You know. Over
the course of my career, I wound up participating in
over seven thousand autopsy so I stuck around a little while.
That is a lot of bodies. You've seen those bodies
(38:51):
in all stages of things that would fit inside a
horror movie. Yeah, yeah, you have. And and sometimes if
I happen to watch horror movie, which I generally don't,
I look at it immediately and said that doesn't look real.
All right, I'll say, wow, somebody really did the research this,
This looks very accurate. It's weird. How you kind of
judge things like that when you know you've been involved
(39:12):
in the field, but yeah, you you really do. They
run the gamut. I talked about in my memoir Blood
Beneath My Feet. I talked about a horrible kind of
event where we had a barge that capsized in the
Gulf of Mexico. They were trying to outrun a hurricane
that was inbound and they didn't make it, and I
think we had sixteen sixteen men that lost their lives,
(39:34):
and they came in slowly. They were able to be
recovered because they some of them weren't still on board
when the thing capsized. They went over, and of course
the bodies were sitting in the heat in the Gulf
of Mexico, subject to everything that's in the Gulf of Mexico,
and so you get partial remains, then you get intact
remains that are severely bloated and compromised. We had a
(39:57):
very small facility and did a highball lume of cases,
and we still had our other cases we had to do,
but we had to bring in a refrigerated truck and
store these bodies, and we had to do all kinds
of intense exams. I mean everything to removing the jaws
on the bodies, to do odent, to logical examinations to
try to determine who these people were. And I was
(40:19):
around these bodies for so long, and this is not
the first time that had happened to me or one
of my one of my colleagues. I was around those
bodies for so many days, and in that environment, I
couldn't get rid of the smell. I couldn't. I literally
wound up having to shave my entire body because no
matter how much showered and bathed and all these sorts
(40:41):
of things, even using vinegar and all those things that
they tell you, I couldn't get rid of it. I
think that part of that goes to there's an actual
physical thing that happens, but there's a scarring. I think
that happens emotionally with that too, where you kind of
bear that along. And and we had this kind of
weird culture in the medical legal community. We would walk
(41:01):
up almost like you see these apes in these National
geographic documentaries where they pick at knits and that sort
of thing, and we had this We would check one
another before we would go out. Maybe we've gone out
on a case where we had a decomposing body, and
we would smell each other. Would say, I've got to
go talk to a family. How do I smell? And
that's a weird Just think about that dynamic within an
office and you become friends with these people you know
(41:23):
and say, yeah, do I smell bad? And it's not
because you haven't bathed or used the odorant, But if
you've been in the presence of a decomposed body, you
don't want to expose the public to that. And so
that's that's kind of a weird little nuance that we
have in our community. Joe, you were talking about your
friends and getting to be friends with these people and
how they deal with it, but how did your family
(41:44):
deal with it? Well, interesting little aside. My wife Kim,
that you know and have met. We've hung out and
y'all have friends. We actually met on a blind day,
and of course being on a blind day, it's very
unconfortably anyway. And when I look on a little side here,
when I saw her, she's the most beautiful quick sa
(42:05):
in my life, and I'm thinking, you better make the
most of this, boy, or you're you're never gonna have
another shot with a woman that is this beautiful and okay,
enough with the brownie, enough of the brownie points. Jack. Well,
we we went on We went on a date, and
after we went to a ballgame together, and afterwards we
we go to a restaurant, actually a pizza place, and
(42:26):
we're sitting across from one another having a conversation and
she's saying, now, tell me again, what is it that
you do for a living. And I'm sitting there and
I'm describing to her that I worked for the Medical Examiner,
which is like the corner and we go out and
examine the dead and make determinations about who they are
(42:48):
because they might be unidentified, and we also do autopsies.
That's that's the way we go about this. And she's
kind of sitting there with this open jawed expression on
her face, and I'm thinking, oh my gosh, I've really
blown this. And then all of a sudden, she looks
at me and she says, until I met you, I
(43:08):
never thought about death. And you know, you can take
anything you want to away from that story, but it's
not a good beginning to a blind date. But she
found it interesting because most people, most people out there,
they don't think about death. They think about their life,
and the same with my wife. She didn't think about death.
(43:30):
But when you're sitting there with someone that engages in
in this work every single day, it suddenly comes to
full form before you and you have to consider it
one way or another. This is the bottom line for it.
It's it's horrible, horrible business, and you have to make
a decision of your own free will if you want
(43:51):
to be there or not. And if you decide to
be there, then you do the job to the best
of your ability, and you understand that you have a
unique space that you occupy providing a service that a
few other people are equipped to deal with. It doesn't
mean that we're any better than anybody else. It just
means that we have a set of skills that enable
(44:12):
us to tolerate that environment within reason. But on the
human side of it, and this happened to me, it
wears on you. The human mind is only equipped to
deal with so much horror. You're you're not We're not
(44:32):
created that way, We're not equipped that way. You hit
tolerances and I know personally, I can't speak for any
of my colleagues, but I know personally I paid a
tremendous price with constant nightmares, you know, panic attacks and
all those things that came along with a diagnosis of
PTSD at the end of my career. But even though
(44:54):
I went through all of that, I wouldn't trade it
for anything in the world because now I'm at a
point where I get to talk about it, where I
get to teach about it, and it is quite possibly
the best thing in the world for me. I'm Joseph
(45:18):
Scott Morgan and this is body Bags M
Body Backs with Joseph Scott Morgan. Early in the morning
on October nineteenth, nineteen, in a little town in Idaho,
a lady who was in her late forties was found
(00:32):
de ceased and for whatever reason still remains a mystery
to this day, the decision was made for an autopsy
not to be performed. And Letty's name is Tammy day
Bell and her case is critical and a much broader
investigation that's going on. As a matter of fact, the
(00:54):
absence of an autopsy in that case could have severe
repercussions moving forward. Today, we're gonna be discussing autopsies, what
they are, who makes a determination as to when they occur.
And I'm gonna tell you a little bit about my
background with autopsis. I'm Joseph Scott Morgan and this is
(01:20):
Body Bags. I've been involved in death investigation for the
majority of my adult life, either working in the morgue,
out of the field as an investigator or now as
an academic talking about medical legal death investigation every single
(01:40):
day that I walk into school. And my friend Jackie Howard,
who is the executive producer of Crime Stories with Nancy Grace.
Jackie We've talked about autopsies a lot, haven't we we have, Joe,
And the more that we talk about it, the more
that I want to know. Was as we laid out
our plans for what we wanted to discuss the day,
(02:01):
the questions just started pouring. So I figured the best
place to start is with a simple question, what is
an autopsy? An autopsy is essentially, there's another way to
put this, it's essentially a post mortem examination. And that's
in a very very broad sense. But when you hear
(02:22):
the term autopsy, it conjures up images of an old,
dilapidated morgue. You've got more personnel running about, there's coolers
where bodies are stored in generally a stainless steel table,
and that's that's not too far off the mark. But
we have to understand that when we conduct an autopsy,
(02:47):
we're trying to determine what exactly happened, what brought about
the death of an individual that was not necessarily otherwise explained.
And so when you begin to go down this owd
in the autopsy suite, you know some people, interestingly enough,
historically they've they've referred to in the historic record as
(03:08):
doctors that do autopsies, they will refer to them as
surgical pathology, and surgical pathology now means like you've got
a doctor that goes up to surgery that's a pathologist
and they look at frozen sections of tumors that have
been removed from people. They'll look at them instantaneously and
try to give you a diagnosis. But there is a
part to surgical pathology that goes along with autopsy examinations
(03:31):
where the pathologists will engage in literally the dissection or
pro section of human remains to try to determine what
exactly brought about the death. Because absent those clinical diagnoses
that you arrive at by virtue of doing these examinations,
you don't actually have a final or fatal diagnosis. The
(03:57):
biggest questions that families have, that can unities have is
absolutely what happened, How did they die, When did they die,
what was the mechanism that brought about their death, and
hopefully through an autopsy you can make that determination. One
of the things that you said just Sin Joe really
caught my attention, and it was having to do with
(04:19):
when an autopsy has done and when is it not done.
I find it really interesting in the Tammy Day Bell case.
As you mentioned that an autopsy was not initially done.
Who determines that and why would you not? I mean,
I know, in certain especially in the elderly, when it's
(04:39):
thought to be natural causes, they don't necessarily do an
autopsy to try to figure out why this person died.
So who makes that determination and why? Well, ultimately it's
going to be the lead medical legal authority in a jurisdiction.
And you got to back up and understand that in
the United States in particular, we have two separate of systems. Here.
(05:02):
You have corner systems, which are elected officials and they
they're not necessarily always physicians. As a matter of fact,
most of the the time they're not physicians. People will be
surprised to hear that. And then you have medical examiner systems,
which are essentially run by physicians who many times are
in fact forensic pathologists. So it really varies from state
(05:26):
to state who's going to make the determination. Most of
the time, the state statute, that is, the state law
will dictate who has the authority to make a decision
about an autopsy. And contrary to popular belief, I hear
and famously with the Tammy Daviel case, it was stated
that it was the family's wishes not to have an
(05:48):
autopsy performed in her case, and kind of sitting there
scratching your head and saying, I got a healthy young
woman here that's out and running every day and seems
vibrant and healthy. Why in the world would you not
one an autopsy? And there's a many layers to that.
Families don't want to think about their their family members
(06:09):
undergoing this procedure. They don't want to think about everything
that's involved with it. They just want to go to
the funeral home with the remains. But unfortunately, if it's
not done, and it's not done in a timely fashion,
one or two things is going to happen. Either you'll
never have answers to those questions, or in Tammy Davel's case,
she had been in bomb transport to another state and
(06:31):
had been buried. Even after her body is exhumed in
that case, any kind of findings that there may have
been originally, they're going to be so compromised by the
time it's really gonna be difficult to make heads or tails.
So most of the time it will be depended upon
what the medical legal authority again back to medical exam
(06:54):
or corner views as the best interest at that point
in time to come up with an answer, scientific valid
answer to try to determine what brought about this person's
sudden death. And it is not dependent upon what the
family wants. Okay, now that sounds cruel, but you know
(07:18):
most of the time families are in no position to
make that decision. And also there are a greater interest
at work here, and we can go down the list.
You got a homicide, this happened. Family is not going
to have any weight given to their their protest about
an autopsy not being performed in that case because it's obvious,
but you have to document it if you're going to
prosecute a case. And then you have these kind of
(07:39):
mysterious circumstances where you don't have any answers. And let
me ask you something you're in relating to what you're
talking about, CANNA can and autopsy be done even though
the family doesn't want it to be. I mean like
in this in this case, the family said that an
autopsy was not necessary here, it could the corner or
the medical personnel have said, then we're doing an autopsy anyway,
(08:01):
they have authority under state law to do that. They
can say, well, I respect what you're saying, I understand
why you might not want one done, but there's bigger
interest at work here. We have to make a determination
about manner and cause of death here and find out
what exactly happened, and there's there's reasons why you do that.
First off, it's a mystery that you have to have
(08:23):
an answer for the corner or the medical examiner is
going to be the one that actually, you know, you
hear the term death certificate. People don't think about that.
That means the death is being certified. Okay, Well, if
you don't have a reason that is put forth as
a result of a pathology finding where you're looking for
disease or some kind of mechanism of death, what are
(08:45):
you gonna list as a cause of death gunshot wound
or mio cardial infarction or lung cancer, leukemia, or whatever
it is the person has going on in dwelling within
their body or some kind of external event that occurred
bring about their death. If you don't go in and
actually examine that and and make a note of that
(09:06):
and make an absolute diagnosis, how are you going to
do that? How are you going to list the cause
of death? I mean, you can't just like it doesn't
just come to you psychically out of the air. You
have to see it. It's it's a scientific procedure, it's
a it's a study. And then how are you going
to list the manner of death? We've only got five
that choose from natural, suicide, homicide, unexplained, undetermined. You've got
(09:32):
all of those that you have to choose from as well.
So if you have nothing to put on the death certificate,
you're gonna have a death certificate. It's going to remain
probably incomplete for a protracted period of time because you're
asking for the official to put down an official diagnosis
in an official manner of death that they don't have
(09:52):
any insight into. And of course the autopsy itself is
the best way to do that. Glorious sadder Field having
to do with the case of the Myrtles over in
South Carolina, Gloria Sadderfield, the Myrdals housekeeper reportedly tripped over
dogs going down the stairs outside the home the brick stairway,
(10:15):
Yet her cause of death, if I'm not mistaken, was
listed as natural causes. Yeah, it is super bizarre, you know,
particularly the case of Glorious Sadderfield. You've got a woman
that had obviously sustained some type of very specific head
trauma that brought her to the hospital. And one of
the ways I teach my students, there's that old point
that we talk about and I don't know, folks, I'm
(10:36):
not going to recite the whole thing. I'll spare spare
the audience that the old the old point that goes,
you know, for the one of a nail, the shoe
was lost. For the one of the shoe, a horse
was lost. For the one of a horse, a rider
was lost, a message was lost, and so forth and
so on. So you have a genesis in the beginning
as to how all of these dominoes begin to fall.
(10:59):
And in sadder Field's case, well, what brought her to
the hospital. Was it that she had a cardiac event?
Was that that she had a stroke, Was it that
she got struck by lightning? Well, none of the above.
She fell and sustained head trauma. But yet they're listing
this whole event as a natural event. And here's here's
(11:21):
what's crazy about that case. Is that a private attending
physician signed her death certificate, and this case was never
reported to the corner. Listen, if a person rolls into
the hospital as a result of a traumatic event and
they don't exit that hospital and they die inside the walls,
(11:42):
and I don't care how long they've been in the hospital.
If they come in as a result of trauma and
that trauma is directly related to their death, that is
a reportable case. And it's my understanding the case was
never even reported to the corner. And that's a problem
because the corner is not aware. They can't make a
decision about whether or not an autopsy should be performed,
(12:04):
or she had been in for a while, so they're
going to request the records and examine the records, all
of the imaging, everything that comes along with that, and
they'll sign the death certificate. But you know, a private
physician can't list a traumatic cause of death, and they
can't qualify a traumatic cause of death. So priva physician
can't say blunt force trauma and the manner of death
(12:26):
is homicide or accident, that will get rejected most of
the time, that's going to be rejected by the state
Health department. Whoever handles all of the paperwork, the public
health agency that handles a paperwork for the state, and
that's why it always goes back to the corner. But
if the corner is not aware of it, the death
has not been reported, it's gonna be a problem going forward.
(12:46):
So then the question begs to be answered once a
decision is made to do an autopsy, is what kind
of an autopsy is there going to be? If it's
an autopsy is always the same you start with A
through Z or are there truly different kinds of autopsies?
(13:07):
There are different degrees to autopsies. When you bring a
body into a morgue, for instance, you can do what's
called an external examination, which means that the body will
be completely photographed as is upon arrival. That means with
clothing on. Okay, some places actually do X rays just
(13:29):
so that they have them. You disrobe the body, the
pathologists and their assistant do a complete and total examination
of the body unclothed. Then, in addition to that, you're
going to draw samples for toxicology, and what these are
gonna be is you'll draw what's referred to as heart blood.
Most of the time you're gonna try to and this
is externally and it's drawn from the A order. So
(13:51):
folks will find their collar bone on the left hand
side and go down the intercostal spaces, which is kind
of the muscle in betwe each rib group and go
down about the third intercostal space in the ribs on
the front side, okay, adjacent to the sternal. There will
be a needle inserted there and it will go into
the A order, which is the big the big vessel
(14:13):
that comes off the curved vessel that comes off of
the top of the heart. And it takes practice to
learn how to do this, but over a period of
time there's we do it by touch. It's something that
we can do, and then you draw blood out of
that area and then we take another needle and we
draw externally. We will draw urine, and finally we'll draw
vitreous fluid which comes from the eye, and all of
(14:35):
those fluids are submitted for toxicology and we'll run the
entire panel. But to the the broader question here, that's
the first kind of stop along the continuum where we're
doing an external examination and it doesn't rise to the
same level as a full autopsy or even a partial autopsy,
which I'm not a fan of. But you just do
(14:57):
the external examination. You draw the fluids, and then those
are submitted generally to either a local hospital or state
crime lab, and you run a drug panel, and you
already have a suspicion. If you're going to do an
external examination, you already have a suspicion that you might
know what caused death is, but you just want to
rule out everything else and kind of external trauma. Maybe
the person died and they weren't found for a while,
(15:19):
and then you'll move forward. Maybe you can even get
the private physician if it's a natural death, which if
you're not doing an autopsy, it's probably a natural death.
The private physician can sign the death certificate and the
list of specific cause of death. Again, back to acute
mild cardial infarction, which is essentially a fancy way of
saying a heart attack, and that is a natural classified
(15:40):
as a natural death. Now you'll have events that pathologists
will make a decision or the enemy of the corner
will make a decision. We're only going to a partial autopsy.
And I have a problem with this because it's like
you've got one foot in the water and one foot
in the boat. If you're gonna do it, commit to it.
Do it. And they're even cases like if you have suicides,
(16:03):
for instance, subject has sustained a gunshot woman the head,
they might only in certain jurisdictions they might actually only
only open the head, for instance, and retrieve a projectile,
and then they don't touch the rest of the body.
And that's a problem. It can be a problem everybody
needs to understand. Foundationally, in the medical legal world, our
(16:25):
supposition is this, and everything that we do we work
under this big banner that says every death, not some deaths,
not a few deaths. We from jump Street. We go
forward with this idea that every death is in fact
a homicide until we can prove otherwise. Okay, Because if
(16:47):
you start out at that really intense high level of
trying to make a determination about homicide, as you kind
of make your way through these checklists that we have,
you get to the next level maybe accent or suicide,
and then you get to maybe natural and you've kind
of checked the boxes along the way. You have to
(17:08):
be able to effectively rule all these things out. So
back to this idea of partial autopsy. If you're only
gonna do a partial autopsy, why why not go ahead
and do the entire autopsy? In that way, it's complete.
It's only gonna take you maybe another forty five minutes
to an hour to get everything done, and it can
lead to problems down the road. You'll have people saying, well,
(17:28):
they had this problem or they had that problem, why
didn't you look at this? And while you have the
body there in front of you, you go ahead and
you do the whole thing. I engage in these discussions
(17:57):
many times with my students at Jaxsuals Prod teach and
they'll say, how you know, Professor Morgan, how did you
get into this environment? How did you start doing this?
How did you start working the more? Why did you
choose to be in the Morgue? Let me tell you
something and hear me right. The best classroom that I've
ever been in, and I've paid a lot of money
for tuition over the years, the best classroom that I
(18:20):
was ever in that I was actually paid to be
in as opposed to having to pay tutition for it
was the autopsy room. I learned more about death investigation
than I ever did out on a scene with a
deceased person or sitting around having coffee with an old
investigator and they're telling war stories. I've learned more in
the autopsy suite, actually getting my hand sturdy and being
(18:44):
there to actually see these things before me demonstrated, to
see the mechanisms that are involved, to see all of
the underlying disease. You can't have a better environment in
which to learn in Okay, then lay this out for me. Joe,
you were talking for about a full autopsy. Explain that
to me. And how long does an autopsies take? Remember
(19:09):
how I mentioned when we talked about an external examination. Well,
every autopsy starts off with an external examination. Now, in
some cases where you have what you suspect is natural disease,
it might begin and end with that and then the
body will be released. However, a full autopsy will in
fact start with an external examination, and you go from
stem to stern relative to the overall status of the body.
(19:34):
All of this is made not of throughout the examination.
I mean measurements. We go into great detail relative to measurements,
and a lot of this is actually dictated by particularly
if you've got traumatic cases, say for instance, like with
Ellen Greenberg, where she was stabbed. Some people have said
twenty times. Some people have said more than twenty times.
You've got so much trauma there that each individual insult
(19:56):
that she has externally has to be measured in orient
it anatomically. Say, for instance, if someone has been let's
just say somebody has been shot to the right of
their sternal, which is the hard plate of the breastbone
on the anterior chest. They've been shot to the right. Well,
just for that gunshot wound alone, you would have to
get a measurement first off of the overall circumference of
(20:20):
the wound itself, and then you have to measure Some
people do from two points, some people do from three,
like from if it's on the right side of the stern,
you would do a measurement from the center of the
wound to the apex of the right shoulder, and then
maybe from the center the wound to the apex of
the left shoulder, and then from the center of the
wound to the top of the head. That takes time.
(20:41):
And then if you have somebody to stabbed multiple times,
shot multiple times, each one of those injuries dictates the
speed at which you can do is because you want
to do a thorough examination. I've had people that have
been stabbed in well in excess of of a hundred times,
and you can just imagine the external examination I'll loan
it is a herculean task, to say the least, and
(21:04):
then you might have three or four other autopsies that
you're going to have to do that day. But once
you get done with the external examination, then the body
is of course, you're on a stainless stel autopsy table
and these are either fixed on the floor or their
own rollers where the and they're kind of set at
a pitch because you're gonna lose fluid, and the fluid
will run down the stainless steel table either into a
(21:28):
pre established drain that you have on a fixed table
or into this big kind of catch I'll sink it's
a working station that you have, and all of that
fluid is washed away and you'll have multiple autopsy stations.
You go to one of these really big shops in
large metropolitan areas, and they might have the ability to
have five five autopsies, say for instance, going on at
(21:49):
one time, and you might have multiple physicians, multiple autopsy assistance, photographers,
everybody doing these examinations. All at one time, particularly if
you're talking about like a mass casual event or if
it's a really really busy day. And so after the
external examination is done, essentially the chest and the abdomen
are opened and we use what's referred to as a
(22:12):
standard ye incision, and so it forms a y where
you make a diagonal cut from the apex of the
left shoulder the apex of the right shoulder down to midsternal. Well,
because it enables us to effectively remove back or retract
(22:33):
that external layer of tissue, which includes skin, the subcu fat,
all of the muscle tissue that's in dwelling, and it
reveals everything. And also the body is on what's called
it's blocked in the back. You have kind of these
rubber blocks. You put them beneath the shoulder blades and
it hyper extends hyper extends the chest so that the
shoulders kind of fall to the side. The body really
(22:55):
opens up and you can appreciate once you get the
body open, you can appreciate a all of the viscera
and that's the internal structures very well. They can all
be visualized in place, and you want to be able
to see it. I mean just just imagine, if you will,
you've got someone that has been shot, and let's say
(23:15):
they're shot in the left side. If people will put
like there their finger beneath their armpit on the left side,
and that bullet travels from the left and it travels
maybe slightly upward from below to above, and it almost
transacts the body, which means it cuts across the entirety
(23:36):
of the middle line of the body, and it exits
out beneath the right armpit. You've got all of these
structures that are impacted. Let's think what structures might be. Well,
you've got the left lung, which has only two lobes
because the hearts on the left side. It may go
through the heart, then it's gonna go through the right lung,
which has got three lobes, and then it's going to
(23:56):
exit through all of that tissue. And you have to
track that wound and see what structures are impacted by this,
because what you're looking for is when you make that
final diagnosis of what led to death, was it simply
the lung that was impacted, was it the heart, or
was it in total all of these structures being impacted, Say,
(24:17):
for instance, if it penetrated the heart. Was that injury
that was sustained as a result of that gunshot when
sufficient to cause more of an instantaneous death, or did
this individual linger. What you're describing for me here is
an autopsy is a lengthy procedure. Oh yeah, yeah, particularly
when you've got these highly complex cases where you've got
(24:38):
multiple trauma. Now you might if you have a case,
for instance, where an individual is say, this is very sad,
but we do more of these than anything else. I
would imagine as far as trauma goes, and those are suicides, Well,
you've got a single self inflicted gunshot when, or at
least you you think that it might be. But remember
our starting point is every death is a homicide until
(24:59):
we prove otherwise. You've got a single bullet in that case,
and you track that bullet, and let's say it's a
self inflicted gunshot wound to the head. Well, maybe they're
right handed. It went from the right side of the
head to the left side of the head, Maybe it
stayed in, maybe it exited. You're gonna track that wound
and beyond that, there's not too much more to discover.
You're gonna try to rule out any other kind of
(25:20):
trauma that may or may not be present. And this
again goes to another underlined principle within forensics, negative findings
are just as important as positive findings. So an absence
of trauma is significant. Okay, all right, So if I
can say autopsy that there's no trauma to the neck,
(25:42):
well that's something that has to be made note of.
You cannot just assume that people will understand there was
no trauma to the neck, because if this thing were
to go to court for whatever reason, one of the
questions that's going to be asked of the person conducting
the autopsy is, well, you don't say any thing about
what you saw with the neck. Does that mean that
(26:03):
it didn't examine the neck or does that mean that
you didn't see anything? Why? Why? Why would you fail?
I mean the next pretty significant, right, and you wind
up looking like an idiot on the stand. So you
you cover that, you have to document that there was
no trauma to the neck or that there was trauma
to the neck. All of it is part and parcel
of a bigger picture. So you're right when you say
(26:24):
that these things take time. It's not just the individual
trauma that you can see. You also have to document
those things that are not there, and that's quite fascinating
when you think about it. There's not too many other
things in life that you document the absence of something
in that sense. I've always been fascinated by that, that one,
that one little point that's very significant in forensic pathology
(26:45):
in particular, you are describing autopsy suites in larger areas
where they can have multiple tables and autopsies going at
the same time. Given the amount of time that it
seems to take for each autopsy, and given how many
deaths unfortunately that most CDC every day, the idea that
(27:08):
we see in some cop shows that, hey, can you
push this to the top of the line? Does that work?
I'm gonna be I guess kind of cheeky here. I'm
gonna say that all depends on how many politicians called
the official. Most of the time you'd want to think no,
everybody awaits their turn. But if there are particular high
profile cases that are going on that particular day. You
(27:29):
look back historically, I think, and you think about cases
like Ron Goldman for instance, and Nicole Brown Simpson. Well
that was at the l A County corner where those
examinations were done. You would like to think that that
particular forensic pathologists and their team that was involved in
(27:50):
that case would have been on those two cases, in
those two cases alone, and that they would have been
given as much time as possible. However, I don't think
that people appreciate the volume of cases that come through
a shop like l A County. That same day, they
may have had twenty other autopsies that had to be done.
(28:12):
And there is a finite number of forensic pathologists out there,
as a matter of fact, depend upon who you who
you ask. At any point in time, you'll hear numbers
like five fifty or six hundred board certified forensic pathologists nationwide. Okay,
just let that sink in. There's and I'm not saying
forensic pathologists are smarter than a neurosurgeon, but there are
(28:37):
more neurosurgeons out there practicing than there are forensic pathologists.
And if you want that level of skill to be
performed for an autopsy, you're gonna have to really look
for these people and attract them to work in a
particular area, because, let's face it, you go to the
large urban areas, people will apply for those jobs. And
they will have availability, they'll have a need for forensic pathologists.
(28:58):
But you go to a more rural area, they're not
going to have access necessarily to a forensic pathologist because
there's so very few. It's just the numbers just dictate that,
and so it's it's really an odd position to be in.
And then even if you have a full staff, you
get to these areas, these big urban areas where they
have huge volumes of deaths and autopsies that have to
be performed, those staffs are overworked many many times, and
(29:22):
it's hard to get people to come into the field.
It looks really sexy on TV and people talk about it,
and I have kids that come to me all the
time say they want to be a forensic pathologist. But
what's fascinating is of talk to people over the years,
and one of the interesting things is is that when
friends of pathologists go through their training, it's one of
those unique kind of educational journeys where the more education
(29:44):
you get, essentially the less you get paid. Okay, so
if you just stop at a fellowship or an internship,
will being a clinical pathologist and anatomical pathologist work in
a hospital. You're gonna make a lot more than the
guy that goes on beyond that training and doesn't one
year fellowship and forensic pathology, and you're gonna wind up
working animal work in a city, in an urban area
(30:06):
most of the time, dealing with most unpleasant cases you
can imagine, and then traveling around and go into court,
and you're gonna get paid as a government employee. That's
kind of one of the little dynamics that you know,
kind of that you're kind of faced with in the
medical legal community. Joe, you mentioned surgeons just a second ago.
Is an autopsy considered surgery? I think for years it
(30:28):
has been regarded as a type of surgery, and you
will hear the term autopsy surgeon, particularly going back years
and years. I love history, and what's really kind of
fascinating about the trajectory that you see with gross anatomical
dissection is that even up until I guess probably the
(30:49):
early eighteen hundreds, the first part of the nineteenth century,
it was illegal in many places to do dissections on
human remains period. And you know, there's all kinds of
stories about rape robbers that would go and disinter bodies
and that would bring them back to medical schools and
by the light of waloa lamp or whatever, medical students
(31:09):
in order to try to learn anatomy would dissect these
bodies that have been removed from the ground just to
try to understand anatomy. And so it has not been
something that has been done for centuries and centuries and
centuries because it was so prohibited for so long. Now
through the twentieth century and obviously into the autopsies are
(31:31):
are common, they are a necessity. A very small percentage
of the cases that a medical examiner corner deal with
are homicides, and that's what you always think about with
people in my field, and that's not the case. It's
just not the lines share cases we deal with are
some kind of of natural event. If you don't have
(31:52):
an interest in natural disease pathology looking at bodies where
you're trying to make a determination about manner and cause it,
it's not gonna be gunshot wounds most of the time.
You're gonna be dealing with natural disease and trying to
make a determination. And there's bigger considerations here. Number one
is the community in which these people live. Did this
person suddenly die? Because there's some kind of public health issue.
(32:14):
I was in Atlanta when we were at the height
of one of the biggest TV scares in the nation.
We were like the TV capital of the nation and
like the nineties or something, and we had all of
these people that were homeless and other people that were
dying of TV, and that's a public health concern, and
then you you think about broad ranging other diseases that
(32:35):
are out there. I started my career at the height
of the AIDS epidemic, and we were terrified to be
in the morgue because we didn't know what was going
to happen if we stuck ourselves with a dirty needle
or cut ourselves with a dirty scalpel. And that does happen.
We've all been nick in the morgue. It's not as
clean as people think. It's not as necessarily precise. It's
like a standard surgery, you know, when you go into
(32:55):
these environments because you're doing multiple cases, you're doing them quickly.
It's a a different world to kind of be a
part of. But absolutely grateful that that I was part
of that world because I learned more. Now I have
an opportunity to teach when people found out what I
(33:30):
did for a living. I'd get one of two reactions.
Either people would lean in and want to hear more,
because by our nature as humans, we have morbid curiosity
about things. Or I've actually answered the question of what
(33:50):
I did for a living at a party and had
people immediately turn on their heel and walk away. They
don't want to hear anything else about death. There's rarely
middle ground when that conversation starts. You know, I never
thought that I had a morbid curiosity about me, but
I have been proven wrong. The more I talk about you,
(34:11):
the more I want to know. So let's play twenty questions,
so to speak with Joe Scott Morgan. What makes a
person want to deal with dead bodies? And how do
you get into that profession? How do you get to
work in a morgue? For me, it was a curious
set of circumstances. Now it's really actually difficult to get
(34:35):
into more to even view an autopsy because of all
of the health considerations and all these sort of things.
But I happen to be working at a hospital in
security and working also as an e R tech. While
the morgue in our parish down there was being renovated
and they started bringing bodies to our hospital to do
the autopsies for the parish, which is the same as
(34:57):
a county. And I became friends with the people at
the corner's office, and I would be the one that
would shuffle bodies in and out the door, and they
were a huge volume of them, and I just became
friends with these folks and started, believe it or not,
I started attending autopsies on my free time, not getting paid,
but I was just fascinated by it because I've always
been a science guy. And the next thing I knew,
(35:18):
I was taking notes for them, and eventually they allowed
me to participate in autopsy. Await wait, taking notes for them?
What does that mean? Well, I would work as a
scribe for the forensic pathologist. If you can imagine the
stupid young kid who had no background in it, but
was willing to sit there with bloated, decomposing remains. Horrible
(35:41):
traumatic cases, the worst of the worst cases you can
possibly see. And I didn't necessarily retract or retreat from it.
And that's not always a circumstance when people go to
an autopsy for the first time. I've had one of
my best friends that became a fantastic homicide investigator. I
was in the middle of opening a gunshot wound victim's
(36:01):
head in the middle of it, and he, my friend
just kind of back up. My friend was actually a
burglary detective in the jurisdiction where I was working, and
he and I played golf together over the years and whatnot,
and he wanted to transition the homicide. One of the
requirement says you had to go to autopsies. He'd never been,
and famously I had. I'd used that kind of high
(36:22):
pitched saw. It's called striker saw and agitating saw. Its
like cas saw, and I was open to the skull
and the friends of pathologists looked up at me over
his mask and he said you better check on him.
And I looked over and my friend was turning green.
And he stood up. And he's a big guy, I
mean just really big, bold, tough guy's kind of guy
(36:42):
you'd worn on your side. There was a fight, and
he's always dressed to the nines. And he begins to
back up and retreat away from the autopsy area down
a little hallway and he collapsed and went up against
a tiled wall in this old hospital and slid down
the wall. I look back now and I as at
it because I was covered. You can't imagine. I was
(37:03):
doing autopsy, had blood on me, and we used to
wear these big yellow gloves that just made the blood
pop even more. And he's my friend. I was concerned.
I thought he'd hurt his head. And I was approaching him,
walking toward him, saying, are you okay? Are you okay?
And he automatically still nauseated, and Dizzy throws his hands
up like I'm a monster, and he says, no, no,
(37:24):
back away, back away, because I'm coming at him and
I've got blood all over, and it was just it's
one of those curious environments that only certain people have
the ability to be able to to go into and
maintain their focus. Well, that that's the key. It's hard
to kind of measure that until you've been in in
(37:46):
that environment. Some people think they want to do it,
but then they get in there and they realize from
jump Street that they don't have the And it's not
a judgment of them, it's just some people react differently
to seeing a human being that is being opened on
a table. And I think that that's that's natural. But
(38:08):
you kind of. I think I've said that you kind
of develop a callous to it, And I don't mean
you become callous. You just develop almost like if you're
a carpenter and you're swinging a hammer, your hands are
suited to that. After period of time, you you build
up a callous on your hands so you can handle
the hammer. And for us, we build up a kind
of a callous to those things that are required of
(38:30):
us to do because who else you're gonna get to
do it? You know, people say they want to do it,
but there's one thing about saying you want to do it,
and there's no part to doing it. You know. Over
the course of my career, I wound up participating in
over seven thousand autopsy so I stuck around a little while.
That is a lot of bodies. You've seen those bodies
(38:51):
in all stages of things that would fit inside a
horror movie. Yeah, yeah, you have. And and sometimes if
I happen to watch horror movie, which I generally don't,
I look at it immediately and said that doesn't look real.
All right, I'll say, wow, somebody really did the research this,
This looks very accurate. It's weird. How you kind of
judge things like that when you know you've been involved
(39:12):
in the field, but yeah, you you really do. They
run the gamut. I talked about in my memoir Blood
Beneath My Feet. I talked about a horrible kind of
event where we had a barge that capsized in the
Gulf of Mexico. They were trying to outrun a hurricane
that was inbound and they didn't make it, and I
think we had sixteen sixteen men that lost their lives,
(39:34):
and they came in slowly. They were able to be
recovered because they some of them weren't still on board
when the thing capsized. They went over, and of course
the bodies were sitting in the heat in the Gulf
of Mexico, subject to everything that's in the Gulf of Mexico,
and so you get partial remains, then you get intact
remains that are severely bloated and compromised. We had a
(39:57):
very small facility and did a highball lume of cases,
and we still had our other cases we had to do,
but we had to bring in a refrigerated truck and
store these bodies, and we had to do all kinds
of intense exams. I mean everything to removing the jaws
on the bodies, to do odent, to logical examinations to
try to determine who these people were. And I was
(40:19):
around these bodies for so long, and this is not
the first time that had happened to me or one
of my one of my colleagues. I was around those
bodies for so many days, and in that environment, I
couldn't get rid of the smell. I couldn't. I literally
wound up having to shave my entire body because no
matter how much showered and bathed and all these sorts
(40:41):
of things, even using vinegar and all those things that
they tell you, I couldn't get rid of it. I
think that part of that goes to there's an actual
physical thing that happens, but there's a scarring. I think
that happens emotionally with that too, where you kind of
bear that along. And and we had this kind of
weird culture in the medical legal community. We would walk
(41:01):
up almost like you see these apes in these National
geographic documentaries where they pick at knits and that sort
of thing, and we had this We would check one
another before we would go out. Maybe we've gone out
on a case where we had a decomposing body, and
we would smell each other. Would say, I've got to
go talk to a family. How do I smell? And
that's a weird Just think about that dynamic within an
office and you become friends with these people you know
(41:23):
and say, yeah, do I smell bad? And it's not
because you haven't bathed or used the odorant, But if
you've been in the presence of a decomposed body, you
don't want to expose the public to that. And so
that's that's kind of a weird little nuance that we
have in our community. Joe, you were talking about your
friends and getting to be friends with these people and
how they deal with it, but how did your family
(41:44):
deal with it? Well, interesting little aside. My wife Kim,
that you know and have met. We've hung out and
y'all have friends. We actually met on a blind day,
and of course being on a blind day, it's very
unconfortably anyway. And when I look on a little side here,
when I saw her, she's the most beautiful quick sa
(42:05):
in my life, and I'm thinking, you better make the
most of this, boy, or you're you're never gonna have
another shot with a woman that is this beautiful and okay,
enough with the brownie, enough of the brownie points. Jack. Well,
we we went on We went on a date, and
after we went to a ballgame together, and afterwards we
we go to a restaurant, actually a pizza place, and
(42:26):
we're sitting across from one another having a conversation and
she's saying, now, tell me again, what is it that
you do for a living. And I'm sitting there and
I'm describing to her that I worked for the Medical Examiner,
which is like the corner and we go out and
examine the dead and make determinations about who they are
(42:48):
because they might be unidentified, and we also do autopsies.
That's that's the way we go about this. And she's
kind of sitting there with this open jawed expression on
her face, and I'm thinking, oh my gosh, I've really
blown this. And then all of a sudden, she looks
at me and she says, until I met you, I
(43:08):
never thought about death. And you know, you can take
anything you want to away from that story, but it's
not a good beginning to a blind date. But she
found it interesting because most people, most people out there,
they don't think about death. They think about their life,
and the same with my wife. She didn't think about death.
(43:30):
But when you're sitting there with someone that engages in
in this work every single day, it suddenly comes to
full form before you and you have to consider it
one way or another. This is the bottom line for it.
It's it's horrible, horrible business, and you have to make
a decision of your own free will if you want
(43:51):
to be there or not. And if you decide to
be there, then you do the job to the best
of your ability, and you understand that you have a
unique space that you occupy providing a service that a
few other people are equipped to deal with. It doesn't
mean that we're any better than anybody else. It just
means that we have a set of skills that enable
(44:12):
us to tolerate that environment within reason. But on the
human side of it, and this happened to me, it
wears on you. The human mind is only equipped to
deal with so much horror. You're you're not We're not
(44:32):
created that way, We're not equipped that way. You hit
tolerances and I know personally, I can't speak for any
of my colleagues, but I know personally I paid a
tremendous price with constant nightmares, you know, panic attacks and
all those things that came along with a diagnosis of
PTSD at the end of my career. But even though
(44:54):
I went through all of that, I wouldn't trade it
for anything in the world because now I'm at a
point where I get to talk about it, where I
get to teach about it, and it is quite possibly
the best thing in the world for me. I'm Joseph
(45:18):
Scott Morgan and this is body Bags M
Host
Joseph Scott Morgan
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On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
Ridiculous History
History is beautiful, brutal and, often, ridiculous. Join Ben Bowlin and Noel Brown as they dive into some of the weirdest stories from across the span of human civilization in Ridiculous History, a podcast by iHeartRadio.