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Surrounded by death
The job of a medical examiner can be tedious, but to an observer, it's a trip down life's many roads, all ending in the same place

Monday, June 02, 2008
Chicago Sun-Times
by NEIL STEINBERG

'It is difficult to take fingerprints of the dead," says Dr. Nancy Jones, the Cook County medical examiner. "They really are not that cooperative."

She immediately reconsiders this.

"These are the best patients in the world," she corrects herself, as if reluctant to criticize broadly people she sees by the thousands, though they don't see her. "If you come to me as a clinician, and I tell you to quit smoking, you don't. I tell you to take your medicine, you don't. It's the living patients who don't do what you tell them to."

Here, in an autopsy room at the county morgue, however, the patients stay put, quietly waiting their turn on rolling steel tables, their lightless eyes half open. Technician Tiffany Gregoire helps arrange the body of a large, muscular young man, then gently washes him with a sponge. He was found face-down in a roadway, a bullet hole in his back, the latest victim this year of heightened violence, one of a dozen corpses to arrive in the previous 24 hours.

"A little lighter load," says Dr. Jones. The average is about 16 cases a day. She reads off today's list: "A drug death, a gunshot, an unknown bone that may or may not be human, a couple of elderly people without families, a pedestrian . . . . Actually, it's not a bad day."

Unconventional tools

Dr. Jones examines a 24-year-old who hanged himself with a shoelace -- one of two suicides on today's schedule. Suicides are up. "We always know when the economy goes sour," says Dr. Jones, who suspects hard times might also explain the spike in child murders they saw in April and May.

At the next table, Dr. Larry Cogan examines the gunshot victim. With a potential murder trial in mind, he inserts a steel rod into the wound and Sherry Davis photographs it, so a jury can see the bullet's trajectory.

After the victim is rolled over, Gregoire takes a scalpel and cuts across the big man's chest, just below his collarbone, and down his sternum, making a rough "T." Below the brown skin is a beige layer of fat, then deep red tissue that looks disconcertingly like steak. In short order, his heart is on an electronic scale. It weighs 374 grams.

Dr. Jones has short, coiffed red hair and frameless glasses. She was born in Aliquippa, Pa., a small steel town; her father worked in the mill there for 40 years. Though she has lived in Chicago since 1970, she is, she admits, a small-town girl at heart, and she brings a certain practicality to her job. Her medical kit includes carpet needles and a regular pair of pliers instead of a medical dura stripper costing four times as much. The cutting instrument she uses for autopsies is not a scalpel, but a fancy kitchen knife -- a Henkels with a 10-inch blade, the kind found in upscale kitchens.

"The reason I have this is because they hold their edge, and they're a lot less expensive," she says.

Gregoire struggles to reach up into the murdered man's throat and pull out his tongue. It is hard, physical work, and while she utters an occasional expletive, her face is placid, expressionless. This is routine. When is it difficult?

"I would have to say when the bodies come in with roaches," she says. "I don't like that. I'd rather see maggots than roaches."

After weighing the man's heart, liver, lungs and other organs, then dumping them into a red plastic biohazard bag that will later be inserted into his chest, Gregoire turns her attention to opening his skull. Pulling away the dura inside the skullcap sounds like fabric ripping.

"This is the part of work that gets a little tiresome," Gregoire says.

The weight of each organ is recorded on a chalkboard. The photographs are shot on film, leading to "racks and racks and racks" of slides.

Dr. Jones uses carbon paper to fill out multiple death certificates. The modernization that led hospitals to bar-code every last pair of Tylenol hasn't reached here yet. Dr. Jones -- who joined in 1986 but only became medical examiner last year -- is planning to bring the office into the modern age as fast as possible, assuming the money can be found.

'It's a lot of stress'

She also hopes -- someday -- to have enough staff to give them breaks from the routine, because "it gets to everybody." Some time away from the autopsy room, maybe an occasional month doing paperwork, filing slides, perhaps educating hospitals and funeral homes, which sometimes forget that certain deaths -- suicides, infants, industrial accidents, murders -- are required by law to be sent to the medical examiner.

"It will make a huge improvement, to have relief, and not do the same thing day after day after day, month after month after month," she says. "It's a lot of stress."

Despite the county budget crisis, she is hopeful.

"I've been getting a lot of help from downtown," she says. "They really do understand my issues here."

Beneath Dr. Jones' no-nonsense demeanor beats a warm heart. She likes riding horses, owns two, and adopts rabbits from a rescue group. When a friend, a police officer, died, the officer's wife asked Dr. Jones to perform his autopsy. She did so with her usual professionalism, crying only later, as she dictated her notes. Dr. Jones is 55 and proud of it.

"Getting old is a privilege that many people don't have," she says. "Every time you get up in the morning and feel those aches and pains, you should thank the Lord."

Her job has strengthened her faith.

"I believe in God, very, very much," she says. "Doing autopsies on human beings, you see how intricate we are. The wonder of the human body. How well it meshes together, and how little it takes to stop a person's existence. One little thing."

A few feet away, Dr. Cogan has removed the bullet that killed the man. A mangled lump of whitish metal, no bigger than a fingertip.



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