August 22

Reviewed by Douglas Starr

Our appetite for all things forensic is such that every few years, a medical examiner or forensic anthropologist writes about what it’s really like in a CSI lab. Some rehash celebrity cases, others analyze famous cases from history, others discuss their day-to-day experiences, which utterly debunk what we see on TV.MAYBE AN EXAMPLE OR TWO OF SUCH BOOKS?

Now comes “Working Stiff,” a memoir of a young medical examiner. In July of 2001, Dr. Judy Melinek began a two-year stint as a medical examiner fellowshipin New York City, and she chronicles her introduction to the profession. There’s an advantage to reading about the adventures of a newbie: Her learning process also becomes ours. It also turns out that by an accident of circumstance, Melinek gives us an insider’s view of one of the most significant forensic investigations in American history.

Melinek didn’t set out to become a medical examiner. Her first choice was surgery, but she found the schedule of double and triple shifts too brutal for herself and her future husband. She knew she was hitting bottom when, obligated to work despite having the flu, she operated onin a woman with raging appendicitis whose fever was actually lower than hers.

Pathology offered a more reasonable schedule. There’s no such thing as an emergency autopsy, she explains. The patients never complain and don’t call you during dinner. After training in Los Angeles, she signed on with one of the busiest and most interesting labs of its kind: the CChief MMedical EExaminer’s OOffice in New York, led by the dignified and cerebral Dr. Charles Hirsch. There she saw all manner of deaths, from accidents to overdoses to crime and malpractice. (In contrast, Los Angeles was forensically boring, offering mostly traffic fatalities.)


“Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner” by Judy Melinek and T.J. Mitchell. (Scribner)

She learneds the routines of professional practice and explains them through in a series of vivid cases. She describes how, before the first cut, medical examiners must document everything they see, starting with the clothes and skin. If there’s the slightest mistake — overlooking not seeing a scar, not accounting for a missing finger or toe, or misreading a tattoo — families become frantic and question the entire procedure. We watch as she takes fluid from an eyeball and blood from a vein behind the collarbone for toxicology tests. Then she moves on to more invasive techniques — lopping open ribs with a pair of pruning shears and emptying stomach contents with a soup ladle. She describes how bodily liquids provide clues: Green fluid around the lungs shows probable infection, clear indicates heart failure, blood signals trauma. Normal lungs should be pink and spongy; smokers’ are black and hardened. “The worst ones crunch when you handle them,.” she writes.[29]

Contrary to what we see on TV, toxicology and DNA reports can take months, not minutes, to come back from the lab, which leaves cases undecided for long periodsof time. Melinek reports this and other small aggravations, such as the arguments she sometimes gets into with detectives who, overloaded with cases, prefer that she’d rule a death an accident so they can quickly move on. She also describes reports certain tricks of the trade — how, atwhen responding to an apartment where a body has been found rotting, for instance, her colleague asks the neighbors to start boiling coffee. “Oldest trick in the book, and a good one,” he tells her. [88] It’s about the only thing that will cover up the smell.

Although graphic at times, the book is not a horror-fest. Admittedly, some cases are cringe-inducing, such as that of Jerry, a drug abuser who fell to his death through a window and suffered massive internal damage, despite a reasonably intact outward appearance. “When I wiggled Jerry’s hips they felt — and sounded — like a bag of marbles,” she tells us. [51]Yet in others we see the idealism Melinek brings to the job, the sense of justice and closure that a competent autopsy can providebring. She discusses the case of a pregnant young woman who was killed by a hit-and-run driver. Contradicting the suspect’s version of events, the dead woman’s her injuries revealed the true nature of the accident. contrary to the suspect’s version of events. Then there’s the story of Veronica Rivera, a 28-year-old woman whose death in a hospital was written off as a drug overdoseaddiction. Months of investigation and waiting for lab results showed that she actually died from as a reaction to a transfusion. It meant much to her survivors that she had not been a drug addict, and it alerted the hospital to a dangerous situation.

“It’s not about the bones,” she tells the family of another deceased person, whose identity she determined after he’d been lying in an unmarked grave for 15 years. “It’s about the living. . . . I do it for you.”[102]

Part of what makes this book enjoyable is the wiseacre tone Melinek often affects. It’s hard to tell whether that’s her ownnatural speaking voice or a the result of the collaboration with her writer husband, T.J. Mitchell, but it works to move things briskly along. She sometimes uses her husband as a foil — his job is to be appalled at what she describes to him — and sometimes brings in her toddler son as well. It’s done with a light touch; they come into her memoirs at times that seem appropriate, not as props. So, too, does the story of her father’s suicide, which clearly informs the way she treats survivors. She knows what it is to experience loss.

Melinek was on her way to work when the twin towers went down on 9/11, and the chapters that describe the aftermath are the most dramatic. Hours after the attack, explosions, truckloads of body parts began to arrive — tens of thousands of fragments, some as small as the tip of a thumb. Even the serene Dr. Hirsch seemed shaken. By a year later, after the attack, explosions, when her office had identified nearly 1,400 bodies based on the remains and brought closure to thousands of survivors, it’s clear why Melinek has become devoted to this career.

“Working Stiff” is not a ground-breaking book: It joins a long list of memoirs by Melinek’s her colleagues. But it’s readable, fun, sentimental where appropriate and full of smart science. Fans of CSI — the real kind — will want to read it.

Douglas Starr is co-director of the graduate program in science journalism at Boston University. His most recent book is “The Killer of Little Shepherds: A True Crime Story and the Birth of Forensic Science.”

WORKING STIFF

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

By Judy Melinek M.D. and T.J. Mitchell

Scribner. 258 pp. $25