Behind Closed Doors
At the Office of the Chief Medical Examiner in Maryland, AFSCME members perform an essential — though mostly invisible — job.
By Clyde Weiss
Baltimore
Wearing the garments of his trade — a white hospital mask that covers his nose and mouth, thick blue rubber gloves and a white apron — Larry Smith carefully takes a syringe and draws blood from the remains of somebody's loved one, laid out on a cold steel table.
An autopsy assistant for 29 years, Smith is one of about 20 members of City of Baltimore State Employees Local 1535 (Council 92) who work for the Office of the Chief Medical Examiner. This is the state's only facility for performing autopsies. What goes on here is not pleasant to imagine — let alone to see — but it is an essential job, and the workers are proud to perform it.
Solving mysteries
Communities need to know why someone dies. If that's unclear, other lives may be threatened. Was the individual the victim of a serial killer who may have left clues that toxicology tests reveal? Did the person die of a communicable disease, necessitating a search for everyone who recently was in contact with him or her? Was it an unsuspected congenital condition that makes informing relatives important?
Each year approximately 4,000 autopsies — about 10 percent of the annual deaths in Maryland — are done at this facility. The chief medical examiner (a physician) and the assistant examiners actually determine the cause of death. The autopsy assistants — several of whom belong to Local 1535 — perform the preparatory work that allows the medical examiners to do their job.
During an autopsy, organs are removed by an autopsy assistant, dissected by a medical examiner and then replaced. The body is then sewn up and sent to a funeral home. Every person who dies without explanation requires an autopsy. Those who die in a hospital from a known cause, or at home while attended by a physician for a life-threatening disease, do not.
Also, says Dr. David Fowler, chief medical examiner, any young person "who has not seen a physician for any length of time, or has not seen one for any life-threatening disease," also would probably end up here. Exceptions are permitted if a family member objects because of religious beliefs. Then the chief medical examiner must determine whether circumstances make it necessary to over- ride those objections. A court sometimes becomes involved.
Detective work
"I was always afraid of dead people when I was little," recalls Larry Smith, who began his medical career as a hospital nurse 12 years before coming to the Forensic Medical Center here in 1973. He even remembers crossing the street to avoid walking by a funeral home. "Now, it's not frightening to me. It's fascinating."
Smith is an ordained Baptist minister whose faith has enabled him to keep doing this work in the face of terrible realities — sometimes, too terrible. "I had a couple of nephews [who were in their 20s] come through this building," he says matter of factly. "One was in a traffic accident. One was shot. I did the work on them myself. I wanted to make sure they were done right."
Another nephew, Bryant Smith, came here to work — first as a driver and then as a forensic investigator, a job he describes as "somewhat similar to being a detective." At the scene of an accident or homicide, for instance, he works with police to determine what he calls the "who, what, when and why."
This day, Smith and fellow forensic investigator Aaron Hearn drive to a local hospital to collect the body of an infant. Hearn has worked for the medical examiner for a decade, but that may change if his talent for acting surpasses his investigative skills. He played the part of a forensic technician on the old NBC drama, "Homicide: Life on the Street," and will play a forensic detective for an upcoming HBO series, "The Wire," for which he will also be a technical adviser.
Safety is critical
Autopsy assistant Boyd Burton removes blood from a body that will be checked for HIV, hepatitis and other infectious diseases. Dead bodies are biohazards. Those suspected of carrying disease, or those that are decomposed, are autopsied in a special, isolated room with better air circulation.
The medical examiners and assistants receive hepatitis shots every three years and get medical checkups every three months from the University of Maryland. Despite the hazards, Burton enjoys working with people he calls his family. "When I'm here, the whole building is family to me, and I look at the victims as someone else's loved ones," he says. "We take care of them."
Office Service Clerk (and AFSCME steward) Adrian Golder processes data from the investigations and autopsies. Even though she doesn't directly deal with the dead, Golder says the work "can be heartbreaking. It can make you see life totally different — it has for me." But death is "an everyday part of life, and somebody has to take care of the dead as well as the living. That is what we do. We find out evidence that the body can't tell us verbally. It answers a lot of questions, even in death."
