By Chet Yarbrough
Written by: Judy Melinek, MD, and T. J. Mitchell
Narrated by: Tanya Eby
In Judy Melinek’s and her husband’s book titled “Working Stiff”, a perspective on careers in forensic pathology is drawn in light of history’s worst single incident of lost American’ lives. Two months before 9/11, Doctor Melinek is working at the Office of Chief Medical Examiner in New York City at East 26th Street and 1st Avenue. Melinek remembers seeing a commercial plane on an odd flight path in lower Manhattan on September 11, 2001. American Airlines Flight 11 is the first plane to hit the World Trade Center.
Within 24 hours, the Chief Medical Examiner, Dr. Charles S. Hirsch, and his staff (including Doctor Melinek) are charged with identifying 2606 dead bodies (total deaths from 9/11 attacks were 2,996, including the 19 hijackers and those killed at the Pentagon).
Judy Melinek went to school to become a surgeon but, in the grind of surgical internship, Melinek reassesses her personal life and family’ interest and re-directs her career to forensic pathology. In her first two years as a forensic pathologist, Doctor Melinek examines 262 bodies. In the course of those two years, Melinek recalls what it is like to be a medical examiner in the midst of a regular work schedule and a monumentally tragic human disaster.
The last chapters of the Melinek/Mitchell’ book recount the 9/11 experience but beginning chapters explain interesting facts about a medical examiner’s job. Melinek explains that the most interesting cases are murder victims but only 10% of medical examiner autopsies involve homicide; the remainder is death by accident, aberrant behavior, disease, or old age.
All deaths require a death certificate signed by a medical examiner. The importance of death certificates is critical because copies of death certificates are necessary proof of death to financial institutions and government agencies. No bank accounts can be closed; no assets of the deceased can be sold, and no cause for death can be certified without a death certificate.
In homicide cases, Melinek reveals several interesting facts about processing a case. One, police are often more interested in closing a case than knowing that an investigation must be conducted to find a killer. Melinek notes that a determination of death by murder, rather than suicide or accident, requires active police investigation. Case files must be left open until a murderer is found or the case is determined unsolvable (a cold case). Some police press for suicide or accident determination to allow open files to be closed rather than investigated or cold cased. Melinek notes that tension is raised between police and a medical examiner’s office when some homicides are identified.
Melinek also exposes the misleading character of TV’ forensic investigation. An autopsy may take months to process before a cause of death can be clearly determined. Melinek reveals inter-departmental communications often slows important forensic information that gives context to an autopsy. A death certificate may not be signed for several months if questionable circumstances require further investigation.
Another interesting insight is the interference that comes from a family member that is convinced their son, daughter, husband, or wife is a murder victim rather than a drug overdose, accident, or suicide. A competent medical examiner that performs a careful autopsy will have overwhelming evidence that clearly determines cause of death. Some relatives will continue to refuse the examiners report and insist on further investigation.
Melinek explains her most difficult medical examinations are of dead children; particularly if death is from child abuse. Melinek recalls an autopsy of a young girl that appears to have been forcibly submerged in a hot tub of water by a parent. Even after testimony in court, the evidence given by Melinek fails to convince the court and the parent is released.
The gruesome details of maggot formation, bloating of submerged human bodies, and burn victims are described by Melinek. She recounts a time when she has to leave the room to settle her nerves and calm her indigestion.
The final chapters of “Working Stiff” suggest the New York Office of Chief Medical Examiner is an unsung recovery’ hero of the 9/11 Trade Center tragedy. The competence of the Chief Medical Examiner is revealed by Melinek in a speech the CME gives to his staff before bodies begin to arrive. He notes that the focus of the department’s job in the 9/11 tragedy is to identify victims; not determine specific causes of death. Each body part is to be bagged and tagged with its own number. He explains that duplication of body parts that belong to the same body is irrelevant. Any body parts that offer clues to identity; e.g. fingers, dental work, skin tattoos, bone pins, etc. are to be separated and numbered. The CME explains that the most important thing for everyone to understand is that all victims must be identified so families will know of their relative’s death. He goes on to explain that each body part is to be treated as an individual death, with dignity and solemnity.
Melinek, in her first two years as a Medical Examiner, gains more experience than many forensic’ doctors have in a life time. “Working Stiff” is a tribute and primer for those interested in the profession.