Stiff compeition among pathologists

I first became familiar with the San Diego Coroner’s Office in the ’70s when I worked patrol for nearly 10 years. I responded to many dead body calls, some natural and a few suicides. The law dictated that a deputy coroner would respond to the scene, gather information on the next of kin, notify them, and decide if the coroner would take jurisdiction over the body.

If a doctor had seen the decedent in the previous 10 days and was willing to sign the death certificate as to the cause of death, the coroner would not take jurisdiction. Usually the body would be taken to the coroner’s office before being transferred to a funeral home or other place that the surviving family wanted.

I never went to the coroner’s office as a patrolman. I knew most of the deputy coroners and knew what information they needed. I always tried to be prepared before they arrived.

In the ’80s, as a homicide de­tec­tive, I went to the coroner’s office many times. It was then I learned about the history of the coroner in San Diego. I learned the coroner system in San Diego originated in 1850. There were 27 different coroners from then until 1995, when the medical examiner program was instituted.

The office I went to in the ’80s was built in 1963. It was small, cramped and smelled bad. The coroner was Dave Stark. His background was that of an embalmer. Because of funding, or lack thereof, the coroner’s office was a rather shaky organization by today’s standards. Stark did a good job with what he had, but he didn’t have much.

For example, there were no regular pathologists on staff. This means that the doctors who performed the autopsies were contract employees who were paid by the body. The doctors performed their duties and made their reports. But, they were still independent contractors. Some were very good, and some, as evidenced by historical problems, were not so good.

Defense attorneys regularly attacked the methods and procedures of some of the homicide autopsies. Sometimes the defense attorneys scored some points, but often their attacks were nothing more than defense smokescreens. However, where there was smoke, often there was fire. The coroner’s office needed a makeover. If you plan to remodel your house you have to have money. The county supervisors were tight fisted with dough.

One doctor was notorious for very fast, sometimes slipshod, post mortem exams. His accented speech was very difficult to understand, both in the autopsy exam room and on the witness stand. He was short tempered and became testy when asked to repeat a statement. He could do an autopsy in a half hour. Most doctors took nearly two hours.
Eventually the DA’s office asked that this doctor not do homicide autopsies. The request was granted and a major law enforcement headache ended. There were other problems associated with the physical plant, evidence and body storage, and other organizational problems.

Generally, the coroner’s office staff was friendly, competent, caring, and professional. They worked hard, had pride in what they did, and performed to the best of their ability with the tools provided to them. But, the tools provided were not the best.

In my youthful ignorance I didn’t even know the difference between a coroner and a medical examiner, and the difference was significant. A coroner is an elected position. One not need be a doctor to be a coroner. One only needed to get elected.

A medical examiner must be a physician. Not only that, a medical examiner must also know how to run a business because, not only are you a pathologist, you are also an administrator. A medical examiner is appointed by the County Board of Supervisors after a lengthy vetting and background procedure.

Next time I go to the new forensic center for a tour and to witness an autopsy.