What it's really like to be a crime-solving doctor

Nobody likes dealing with death, let alone having to confront the spectre of grim mortality every single day.

Yet there are people whose livelihoods revolve around solving the grisly mysteries that most people can't stomach or even think about.

Business Insider talked to Dr. Judy Melinek, CEO of PathologyExpert Inc. and a practicing forensic pathologist in the San Francisco Bay Area, to learn about what really happens in the lab behind closed doors.

200 autopsies a year

Melinek was one of the 30 doctors who identified the remains of the victims of the World Trade Center attack on the days following September 11, 2001. One month later, she found herself working on the case of Bronx resident Kathy Nguyen, the only fatality victim of the anthrax bioterrorist attack in New York City.

For Dr. Melinek, her whole career has revolved around performing autopsies and investigating cases of sudden, unexpected, or violent death. Though she doesn't work on living beings, she's a medical doctor for a reason:

"An autopsy is the last, most thorough, physical examination you will ever have. First, I scrutinize the outside of the body for signs of disease or injury, and then I make a series of surgical incisions. I remove the organs, weigh and measure them, and examine each individually."

That's not even the hardest part. Beyond dissecting and analyzing dead bodies, the job "involves explaining the medicine of death to police officers, to family members of the deceased, to lawyers, to judges, and jury members."

On average, she performs 200 autopsies a year, and has performed over 2,500 autopsies to date, using common surgical instruments like forceps and scalpels, as well as tools "you would recognize from your kitchen or shed, like loppers for cutting ribs."

Getting into forensic pathology

Why would anyone become a forensic pathologist?

Melinik was fascinated by medicine as a child (her father was a doctor), and was angling toward a career as a surgeon. However, upon entering med school and seeing the long hours surgical residency required, she switched to pathology for "the better lifestyle." From there, she "fell in love with the excitement and challenge of forensic pathology."

She goes on: "Most doctors should be able to stomach what we see in forensic pathology, but few are exposed to it in medical school. If it were a required medical school rotation I am certain we wouldn't have so few medical students entering the field."

Not like on TV

What is it like in the field?

For starters, forensic pathologists are trained to analyze the trajectory of a bullet in an autopsy. Melinek explains:

"The entrance wound is generally a round, punched-out hole, and may have burned gun powder around it if inflicted at close range. The exit is generally star-shaped or lacerated. Bullets don't bounce around in the body - they may change vector slightly if they hit bone, but otherwise they travel in a straight line until they exit the body or stop somewhere inside it."

The process is like this:

"First, I X-ray the body to try to find bullets left inside it. Then, during the autopsy, I identify and describe the external wounds. The track of the bullet inside the body will be bloody if the victim was shot while alive. This is called vital reaction. During the internal examination of the body, I will dissect the bloody path between the entrance and exit, or between the entrance and the bullet's point of lodgement. Most importantly, I document everything I find, photograph the autopsy in stages, and collect all the evidence."

The reality of the situation is different from hit shows like CSI, which tend to romanticize the work of forensic pathologists, without depicting the long hours and emotional toll built up in the lab.

Melinek thinks it's unbearable: "My husband won't let me watch the shows because I start throwing things at the television."

It isn't just the dimly lit labs, stiletto heels at crime scenes, instantaneous lab results, and the absence of personal protective equipment, it's the fact that these type of shows' "popularity is starting to affect the public perception of what I do for a living and, worse, to influence how juries think about forensic evidence in real courtrooms."

Beyond that gripe, she has a more positive outlook on the profession. DNA technology has progressed to the point where forensic pathologists are able to "sample more extensively at crime scenes" as well as identify victims "even when the bodies are badly burned or decomposed."

She thinks forensic pathologists are uniquely skilled, combining the "school-smarts of a doctor and the street-smarts of a detective."

Melinek notes that for a forensic pathologist to be successful, they must not lose their ability to feel. She isn't referring to it in the physical sense, either:

"You learn to suppress your emotions doing routine tasks: in the morgue, at a death scene. You also learn to embrace and include your own emotional responses when communicating with the decedent's families and with a jury. As we write in Working Stiff, 'To confront death everyday, to see it for yourself, you have to love the living.'"

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