Not Life or Death, but the Stakes Are Still High

When Md. Medical Examiners Dissect a Body, Tiny Clues Can Have Enormous Implications

The corpse of inmate 225597 lay on a steel gurney in the state medical examiner's basement lab. Beside the body was a plastic bag stuffed with pants issued by the Prince George's County jail.

Ronnie White, 19 and charged in the death of a county police officer, had been found alone and unconscious in his cell a day earlier. His autopsy would be critical in determining whether guards might have been responsible for his death.

In the corners of White's eyes, pathologist J. Laron Locke spotted petechiae, or tiny burst blood vessels: a clue that White died from a lack of oxygen, not natural causes. Locke turned to White's neck, searching for telltale bruising that can distinguish hanging from strangulation, suicide from homicide.

Finding none, he probed more deeply. At the top of White's neck, in a bone no larger than a curled-up pinky finger, he found it: a fracture.

"These findings are indicative of strangulation," Locke later wrote in a confidential report reviewed by The Washington Post.

Almost four months later, the fallout from that ruling continues. An attorney for the guards insists White committed suicide, and the broken hyoid bone remains the only publicly known piece of evidence pointing to homicide.

But with an average of 11 bodies arriving each day, David R. Fowler, Maryland's chief medical examiner, says he has little time to worry about the controversy. As evidenced in a series of interviews and in rare access granted to The Post, Fowler's team has reduced dissection of Maryland crime victims to a hauntingly efficient process.

The lab, one of the busiest in the country with more than 4,000 autopsies conducted annually, is a place where academic pursuits and strict adherence to procedure and protocol seem to insulate scientists and doctors from the death that surrounds them.

"We don't deal in hypotheticals. We deal in verifiable facts," Fowler said as he led a visitor through his offices, speaking with the crisp British-sounding accent he acquired as a youth in Zimbabwe and pathology student in South Africa. "We know everything we do will potentially be examined, challenged and cross-examined."

At the doorway to the lab, which is so crowded that the state broke ground nearby on a $43 million replacement this month, Fowler paused, gesturing toward a line of eight corpses in various stages of dissection. "We have to assume that every body here has some legal or public health implication," he said. "Every day, we have to be able to reconstruct a coherent account of what we believe happened."

Unbeknownst to most passersby outside, the work of dissecting yesterday's dead begins each morning at 8:30 in the basement of a nondescript stone building in downtown Baltimore. Next door to a blinking sign for souvlaki and subs, the building's sterile name -- Maryland Forensics Center -- reveals little of the graphic scenes that unfold inside.

Fowler granted a reporter access to the lab to show the process of checks and balances -- "quality assurance," as he put it -- that goes into every ruling. On any given morning, in a ritual that resembles hospital doctors' rounds, more than a dozen of the office's 16 pathologists cluster around the day's new bodies. They take turns reading the investigative reports that accompany the corpses and divvy up the dissection tasks.