The Coroner Series

by Thomas T. Noguchi

  Eventually, however, we were able to identify every single victim of the crash, adding to the reputation of the work our office could do in mass disasters. It was one of the ironies of my career as Chief Medical Examiner that, in 1969, I had been accused of “praying” for such disasters. Unfortunately, they occurred—with no “divine” intervention from me. My prayer was only that the Medical Examiner’s Office would always be prepared to meet these tragic emergencies.

  9

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  A Passion for Science

  “Good morning, ladies and gentlemen. It is indeed my pleasure to welcome the medical examiners, members of law enforcement agencies, scientists and designers of forensic instruments to this, our first seminar on death investigation.”

  On May 22, 1972, I stood in the sunlight in front of a gleaming new four-story building on Mission Street—the Los Angeles County Forensic Science Center. To celebrate its opening, hundreds of experts in forensic science and law enforcement had come to the center from all over the country to participate in our first seminar, which would last for three days and climax with the ceremonies dedicating the building.

  I had fought hard for the new center, but I was by no means solely responsible for its construction. My predecessor, Dr. Curphey, had first envisioned such a forensic center and worked tirelessly to bring it into being, as had every forensic scientist compelled for years to work in overcrowded, ill-equipped quarters in the Hall of Justice. My outspoken demands on behalf of the center had been, in 1969, among the reasons given for my dismissal, and once I was reinstated I pursued the same goal somewhat more diplomatically, if no less insistently. But in the end it was no single voice that led to the construction of the center. Rather, it was the sheer volume of work the Medical Examiner’s Office had to perform in such a sprawling and populous metropolitan area, and the growing complexity of forensic science itself. Both necessitated more space, a larger staff, and the latest in technological equipment. Modern medical facilities are a far cry from the hospitals of only a few years ago. Forensic centers, too, once little more than morgues, were forced to change and grow with the times.

  The new building also represented the realization of a new approach to forensic science: the “total investigation” of a case. When I first joined the Los Angeles Medical Examiner’s staff, we didn’t even employ investigators. Deputy coroners merely picked up bodies after the police had conducted their investigations, then performed medical autopsies and associated laboratory testing—and relied on the LAPD, the Sheriff’s Office and other law enforcement agencies for all other necessary evidence surrounding the deaths.

  That had changed, thanks in part to my own efforts as well as those of other forensic scientists who shared the same vision of the total-investigation approach. Well before the construction of the new building, the Medical Examiner’s Office began to employ investigators to go to the scene of a death, collect evidence and interview witnesses. Autopsies had become medical-legal forensic investigations, including, if necessary, a reenactment of the episode of death and the careful analysis of laboratory results to determine its cause. We also prepared for trial and testimony in court, if that too was necessary. And, finally, we sought means to prevent similar fatal incidents.

  Modern technology had come to play an increasingly vital part in all those activities. Scientific techniques and equipment unknown to forensic scientists a decade before were now used as a matter of routine. In the new center, we would employ the most innovative computerized equipment to assist the scientists on our staff. And, continuing another trend in the total-investigation approach, we could reach beyond our staff into scores of other disciplines for expert consultants in cases on which they were needed.

  By 1972, our office had already utilized more than one hundred fifty multidiscipline consultants in almost every field imaginable to aid us in our work. And I was a leading proponent of the use of one category of specialists in particular: behavioral scientists qualified to conduct “psychological autopsies.” Stated most simply, if suicide was suspected as the cause of death, a psychological autopsy examined evidence of the victim’s state of mind at the time, thus helping to confirm—or disprove—that suspicion. If homicide had occurred, the psychological autopsy focused on the perpetrator as well as the victim, examining evidence at the scene in an attempt to analyze the personality and motives of one who would commit such a crime. Psychological autopsies had begun as an idea of Dr. Curphey’s in the uproar surrounding Marilyn Monroe’s death. And since Dr. Frederick Hacker’s report had proved literally prophetic in the Manson murders, I had made them a regular tool of our department in cases where they were appropriate.

  After concluding my opening remarks on that bright May morning, I led a tour through the new Forensic Science Center, in which the total-investigation approach would be conducted. It began in the sub-basement of the 55,000-square-foot building where evidence and property were labeled and stored. Also located there were a storage room for supplies, the huge refrigeration power source and offices for the maintenance staff.

  Almost all of our laboratory equipment was housed on the floors above, but perhaps the most ultramodern, sophisticated piece of equipment was installed in the sub-basement: the scanning electron microscope (SEM). Because the SEM was so sensitive that it had to be situated in an area with the least vibration, we housed it on this underground floor along with another sensitive device, the transmission electron microscope (TEM).

  The TEM was an electronic version of that age-old tool of scientists, the microscope. In a conventional microscope, light waves pass through a specimen and a sequence of lenses to form a magnified image; this type of microscope can magnify any object up to twenty-five hundred times its normal size. In the TEM, electrons take the place of light waves, and electromagnetic lenses replace the glass lenses. Powerful indeed, the TEM can magnify more intensely than any other instrument—a virus in a single cancer cell, for example, and internal structures of the body such as blood cells. For that reason, it is a very useful device in determining natural causes of death, as well as detecting changes caused by drugs or poisons in cells.

  But forensic scientists are often more interested in changes in the surfaces of tissue—minute, telltale evidence left by, for example, a bullet, a knife or a blunt object. The SEM employs different technology to accomplish this. Electrons scan back and forth across a specimen, and the image, with a magnification of up to fifty thousand times the size of the specimen, is projected onto a television screen, permitting the viewer to see its surface in three-dimensional detail. Used in conjunction with X-ray and fluorescent equipment, the SEM was a boon to forensic science because it could precisely identify microscopic bits of metallic elements in bullet-wound paths. It could also tell us whether a burn was caused by a cigarette, a fire or torture, and whether a cancer was caused by asbestos. There are four different kinds of asbestos crystals; the SEM could tell which asbestos was present.

  The next stop on my tour was the security and service floor on the level above the sub-basement. Three autopsy rooms were located on that floor. Room A, the main autopsy room, contained six stainless-steel tables, each with the necessary appliances, such as a weighing scale and a sink with running water. The tables were deliberately placed close to each other so that medical examiners could confer, if necessary. Because of the noise from electric saws and other equipment, there was a soundproof booth in a corner of the room where forensic pathologists could dictate their notes.

  Room B had only one autopsy table next to the X-ray-facilities area. That room was for cases where more meticulous study had to be done. Our staff called it the VIP Room. But actually it would be utilized for cases of special medical difficulty or significance.

  Room C was a larger room specially designed for cases of infectious disease, or for bodies in advanced decomposition. It was airtight, with a special air-conditioning system which sucked infected gases from the body and transferred them to an incinerator on the r
oof, where they were destroyed by fire.

  A large staging room, the investigation division, the color-photo-processing, photo-file and X-ray rooms, the forensic-dental offices and the neuropathology laboratory were also located on this level. It was the floor on which the bodies arrived at the center. The processing of a decedent began in the staging room, where the body was placed on a gurney and weighed on a huge scale. Meanwhile, a personal-effects inventory was taken. The investigator who had been to the scene of the death turned in a receipt for all evidence and personal property he had recovered there. The inventory had to be signed not only by our investigator but by a member of another agency, such as the LAPD.

  Then our staff photographers, under the direction of the medical examiner in charge, carefully took photographs of the body, first fully clothed if that was its condition, and continuing as layer after layer of clothing was removed. Fingerprints were taken routinely, in case a homicide might be involved.

  After being photographed, the body was stored in our huge walk-in refrigerator on the same floor, awaiting autopsy if appropriate. The victim’s property was also stored.

  Identification of the body was usually accomplished at the scene of death through witnesses, as well as through the personal effects of the victim. But if there was no such identification, relatives were asked to come to the center.

  An autopsy, if necessary, generally took place the next day. When it was completed, the body was sutured and prepared for release to a funeral home. The body was embalmed, if the family wished, and this was done also in cases where the body had to be stored for long periods of time because of lack of identification.

  The next stop on my tour was the public floor at ground level, where the lobby and the reception desk for visitors were located. Also on this floor were the offices of the chief deputy medical examiner and the chief of the forensic-medicine division, and a suite for resident pathologists who were sent from various hospitals on a rotating basis to be trained in forensic pathology.

  Finally, this floor contained the clerical offices where the myriad details of a forensic-science center were handled, from coordinating subpoenas in court cases to entering all relevant data concerning each case into computers so that it could later be retrieved. The public has the right of access to information concerning medicolegal investigations.

  A special feature of the new building, a closed-circuit-television room, was also located on this floor. Formerly, bereaved relatives would have to view a body close up for identification—an emotionally wrenching experience. Now they could sit in this room upstairs and view the face of the victim on a television screen, thus aiding the process of identification with less pain to relatives and friends.

  The second floor of the building was laboratory country, in particular the toxicology lab, which was equipped with the latest technology, including the basic device for analyzing chemicals in the blood, the gas chromatograph (GC) machine. In the days of Marilyn Monroe, blood analysis was done on a primitive piece of equipment called a UV spectrometer which analyzed blood in liquid form. An extract was exposed to ultraviolet rays to measure the types and amounts of the chemicals. Then the extract was absorbed in a vertical filter paper. The height of absorption determined the identity of the chemical in the blood. For example, among barbiturates, Seconal was the highest, Nembutal second and phenobarbital the lowest.

  The GC machine provided a much more accurate analysis. In that device, blood heated in a tiny oven emitted gas which contained the various chemical elements in the blood. As each element of the gas moved up a column along with a flow of inert gas such as helium, the speed of its movement was measured. And because we know the precise speed with which each element moves, we can thus identify the element.

  The GC machine recorded this information in the form of peaks on a graph. The distance between peaks showed the speed of movement, identifying the chemical element or drug in the blood. The height of the peak showed us the amount of the drug which was present.

  Our laboratory had all types of GC machines for various special purposes. But by far the most sophisticated was the GC mass spectrometer connected to a computerized data system. The mass spectrometer utilized a technology different from that of the GC. It subjected the chemical elements in a gas to electron bombardment, which broke them down into molecules. A computer then measured the molecular weight of each molecule, comparing it with a library of data to determine the chemical in question. All chemicals have different molecular weights, so the chemical could be precisely identified. With the conventional GC, such identification was not always precise. The computerized GC mass spectrometer, on the other hand, was one hundred percent accurate.

  Our laboratories were equipped with many different kinds of spectrometer, such as light, ultraviolet, infrared and atomic-absorption devices for special purposes, which included analyzing organic compounds that are not gaseous and detecting and identifying metallic elements.

  In addition to the toxicology lab, elsewhere on the second floor were other labs specializing in histopathology, with equipment for analyzing tissue structure; in serology, equipped to analyze biological fluids such as semen in rape cases and blood and bloodstains for typing; in forensic biology, with equipment to analyze trace evidence such as broken glass, paints, soil, plankton in drowning cases, botanical materials and digested food; in odontology for bite-mark identification and matching of teeth; and in anthropology to study skeletons to determine age, sex and race. This floor also held the offices of the senior members of the staff, including my own. And there I demonstrated the closed-circuit color-television system through which I could monitor various functions in the building. I was especially proud of the system which used cameras suspended directly above the autopsy tables. Through it, a pathologist conducting an autopsy could communicate any questions (or surprises) directly to me and I could see what he was referring to. My pride was misplaced, however, and the system was later removed for a very practical reason: the pathologists kept bumping their heads on the cameras.

  As time went on, we would find other “bugs” in the building. But I was certain that with its completely up-to-date facilities and equipment, not only could the Medical Examiner’s Office better perform its mandated function, but my associates and I could also continue our experiments with new techniques, thus enlarging our knowledge of the causes of death.

  The media, however, seemed frankly skeptical. On hand for dedication day, May 25, 1972, were Joseph Busch, the District Attorney of Los Angeles; Liston Witherill, director of the Department of Hospitals; Dr. Theodore J. Curphey, my ex-boss; and various members of the Los Angeles County Board of Supervisors, along with representatives of the press and television sent to cover the event. Some of the press appeared a bit shocked at this “monument to death” which had arisen, sphinxlike, in their city. In the weeks preceding the dedication, they had bombarded me with questions which revealed the public’s lack of knowledge of the real mission of forensic science even as late as 1972. Was such a modern and expensive facility necessary? they asked. What were my plans to utilize it? Why so much sophisticated equipment?

  If the tide of homicides and unexplained deaths kept rising in Los Angeles, I told them, an even larger building with more sophisticated equipment might someday be necessary to accomplish our duty under law, a statement that was to prove even more prophetic than I knew at the time. And I went on to explain some of the projects I had in mind to expand the scope of the Medical Examiner’s Office and its contributions to the community.

  Organ transplants can save lives, I told reporters, and I wanted to make certain that our office worked with physicians and hospital administrators to assist them in locating donor organs. (Eleven years later, in 1983, I would be invited to the wedding of Cynthia Jelkman, twenty-five, who had received a heart for organ transplant from the Forensic Science Center. We became acquainted, and one day I introduced her to a friend of mine, Wesley Parker, a master chef. He was the man she married.) />
  I also told reporters that the Medical Examiner’s Office should be a watchdog for the quality of life in the community, aiding those who sought to curb the pollution of our environment. And because drugs and alcohol caused so many deaths, our office would work strongly on community programs to curb their abuse. Our office, I said, would address itself to the prevention of unexpected and unnecessary deaths by such drugs.

  Many of those programs were already under way; others remained for the future. For example, I wanted our office to help establish guidelines, in conjunction with hospitals and physicians, in regard to the termination of life-support systems in cases of patients with irreversible brain damage. It wasn’t until 1982, through joint committees of the Los Angeles County Medical and Bar Associations, that such guidelines were established. And in 1983, the joint committee began to address similar guidelines for cases of patients in a prolonged vegetative state.

  Because Los Angeles is on the sea and ideal for underwater diving, I had long been active on underwater-safety committees. In the years ahead, our office would pioneer in the investigation of underwater deaths. I was also interested in the very young and the very old. I wanted our office to be in the forefront of efforts to curb child abuse and battered-children deaths, surely the most pathetic decedents to enter our facility. Years later, Los Angeles County established ICAN, the Interagency Council on Child Abuse and Neglect, to deal with this problem. The council included law enforcement and social-service agencies, together with the Medical Examiner’s Office.