Questions to Ask a Medical Examiner
Written for anyone with an interview booked at a medical examiner's or coroner's office: a forensics or health careers class, a novelist checking a scene, a reporter learning the beat. The 50 questions run in the order that conversation tends to take: the job and the training, the examination, cause and manner of death, court and who oversees the office, and what the work costs the person doing it. The last group is for a different caller, a family member who needs to know why the office is involved, when their relative will be released and how to get the report.
The questions
Each question, and why to ask it
The job
What does a medical examiner do, and how is that different from a coroner where you work?
Why ask it
The two titles mean different things from one place to the next: in some, the coroner is elected and need not be a doctor, while the medical examiner is an appointed physician. Find out which system this office runs under and who signs the death certificate, because every later answer depends on it.
Which deaths come to your office, and who decides that one should?
Why ask it
Only some deaths are referred, and local law sets out which, so the answer draws the edge of the job. Listen for the categories, then for who makes the call when the phone rings at three in the morning.
What did your training involve after medical school, and how long did it take?
Why ask it
For a careers class this is the answer to write down in years, stage by stage. A coroner who is not a physician will have a different path, so change the question to what the post requires there.
Why did you choose forensic pathology over treating living patients?
Why ask it
Expect a specific moment: a rotation, a teacher, one case. A writer should note whether the reason is about solving a puzzle or about speaking for someone who cannot, since those make two different characters.
What does a normal working day look like for you, from start to finish?
Why ask it
Students picture the examination room and nothing else. Count how much of the day goes to reports, phone calls and court instead, and it is fair to ask which part they would hand off if they could.
Who else works in the office, and what does each person do?
Why ask it
One case may pass through investigators, technicians, a toxicology lab and the front desk, and not all of those jobs need a medical degree. For a class, the part to write down is which of them a student could shadow or apply for first.
Do you go to the scene yourself, or does an investigator go for you?
Why ask it
Practice differs by office and by case, so the real question is what decides it. Whoever goes is looking for things the police at the scene are not, and a writer will want to hear which.
How many cases does one doctor here handle in a year, and what happens when that number climbs?
Why ask it
A reporter's question as much as a student's. Some offices measure themselves against a recommended caseload; if this one does, find out what gives first when it is passed: turnaround time, the share of cases examined in full, or staff.
Are there enough people doing this job, and what does that mean for hiring and pay?
Why ask it
Staffing differs by region, so treat the reply as a picture of this office and not of the whole field. Pay depends on the employer, and where the office is part of local government the salary scale may be published, in which case the examiner can say where to look.
What should a student be studying now to be ready for this work later?
Why ask it
Push past 'science' to named subjects and habits, such as anatomy, clear writing or public speaking. A tour, a volunteer post or a summer job would show a teenager the work before they commit years to it, so see whether the office offers any of the three.
The exam
Does every case get a full autopsy, and how do you decide when one is not needed?
Why ask it
Many people assume the answer is yes. The alternatives might be an external examination or a review of medical records, and the thing to pin down is whether the choice is set by law, by office policy or by the doctor on the day.
How long does an autopsy take, and how long before you can say what you found?
Why ask it
There are two clocks here. The examination itself may be a matter of hours, while the final answer can wait much longer on laboratory results, so get both figures and what stretches each one.
Can you take us through an examination from start to finish, in terms a class can follow?
Why ask it
Say beforehand how old the audience is, and ask for the order of the steps instead of the graphic detail. If the answer gets too clinical for the room, steer toward why each step is done.
What can an autopsy establish with confidence, and what can it not tell you?
Why ask it
The second half is where the interview gets good. A careful examiner will name limits readily, and a writer can build a scene on a question the body could not answer.
How do you estimate when someone died, and how wide is the honest range?
Why ask it
In a television script the time of death comes to the half hour. A real estimate is more often a window, and the parts worth hearing are what narrows it, what widens it and how much it leans on witnesses and phone records instead of the body.
Which tests are sent out of the building, and how long do the results take?
Why ask it
Toxicology is the example most people have heard of, and waiting on outside results is a common reason a case stays open. A family member can put this same question about their own relative's case.
How do you identify someone when nobody can do it by sight?
Why ask it
Dental records, fingerprints and DNA each need something to compare against, which is the part people forget. That leaves the harder case, where nothing is on file, and how long the office keeps trying.
What do crime shows get most wrong about your work?
Why ask it
Nearly every examiner has a reply ready, so use it to relax the room and then ask what a show got right. Writers should take notes on both halves.
Cause and manner
What is the difference between cause of death and manner of death?
Why ask it
The whole job turns on this distinction: cause is the injury or disease, manner is the category of circumstances it falls under. Which categories a certificate allows is decided locally, so have them list the ones used there and give one made-up example that shows the two apart.
What goes on a death certificate, and which parts of it do you fill in?
Why ask it
A blank certificate explains more than a description will, so see whether they can bring one or put it on a screen. Note who completes the remaining boxes, and where the form goes once it is signed.
How do you decide the manner when the physical findings could fit more than one?
Why ask it
The answer usually leaves the examination room for the scene, the medical history and what witnesses said. A reporter will also want to know how sure the doctor has to be, and whether that standard is written down anywhere.
When do you rule a death undetermined, and how does it sit with you to leave it there?
Why ask it
Offices differ in how readily they reach for that category, so it helps to hear how often it comes up in this one. The personal part of the question may take a moment, and it is fine to let a silence run before the answer.
What does the word homicide mean on a death certificate, and how is that different from a criminal charge?
Why ask it
Examiners often apply the term to a death at another person's hands without saying anything about guilt, which is a court's question. Have them define it for their own office, because it is an easy place for a news story to go wrong.
How much do you know about the police theory before you start, and does knowing it help or hurt?
Why ask it
There is a real tension here between needing context and being steered by it. Listen for what the office does about it, such as who briefs the doctor and what gets written down first.
Can you describe a case, with the identifying details left out, where the first impression turned out to be wrong?
Why ask it
This is the safe way to ask for a story: no names, no dates, and the choice of case is theirs. Whatever changed the picture, a test result, an old hospital record or something at the scene, shows the method better than a general description of it.
Have you ever changed a ruling after new information came in, and what does that process involve?
Why ask it
A yes need not count against them, since a ruling rests on what was known when it was made. Leave with three details: who can request a second look, what counts as new information and how the certificate gets amended.
What does your office learn from its cases that helps the living?
Why ask it
A cluster of overdoses, a faulty product or an outbreak can show up in death records early. If the office passes its figures to a health department or publishes an annual report, a student or reporter has something to read after the visit.
Court and oversight
How often do you testify, and what is a day on the witness stand like?
Why ask it
Few students see the public speaking coming. A case can be years old by the time it reaches trial, so the follow-up is how they prepare to talk about work done that long ago.
How do you explain a finding to a jury with no medical background?
Why ask it
Ask for a demonstration: have them explain one term to you as they would in court. You see the skill directly, and you leave with a quote that readers can follow.
What do you do when a lawyer pushes you to say more than the evidence supports?
Why ask it
The stock reply is some version of 'I stay within my findings'. What that sounds like in the moment is better material, and the exact words they use to decline are worth writing down.
Who does your office answer to: the police, the prosecutor, the county, or none of them?
Why ask it
Independence is arranged differently from one jurisdiction to another, and it matters most when a death involves the authorities themselves. Three facts settle it: who hires the head of the office, who funds it and who can remove them.
How is a death in custody or one involving police handled, and is anything done differently?
Why ask it
A reporter should ask this before a case makes it urgent. Find out whether an outside office is ever brought in and who makes that decision.
What happens when another pathologist reviews your case and disagrees?
Why ask it
Two qualified doctors reading the same findings differently is not unusual in a courtroom. Notice whether the answer treats the other doctor as a colleague or an opponent, and whether this examiner takes on outside reviews too.
Which of your records are public, and which are kept back?
Why ask it
This depends on the law where the office sits, so get the rule and the name of whoever handles requests. A reporter is better off learning the fee, the usual wait and what the office will confirm about an open case on a quiet day than on deadline.
The toll
What is the hardest part of the job, and is it the part outsiders would guess?
Why ask it
Most visitors assume it is the examination room. Leave space for a different answer, such as a phone call with a parent or a case that never got one, and if the reply turns to children, do not press for detail in front of a class.
What do you do after a hard case, before you go home?
Why ask it
The answers tend to be small and concrete: a drive, a run, a rule about not talking shop at dinner. For a writer those habits are character, and for a student they are a preview of what the job asks.
What support does the office offer its staff, and do people take it up?
Why ask it
A program nobody turns to changes little, so the take-up is the real answer. Remember the investigators and technicians as well, who see the same cases with less say over them.
Has the work changed the way you think about risk in your own life?
Why ask it
The reply may be as practical as a rule about seat belts, where medicines are kept at home or swimming alone. It can be the lightest answer of the interview, so it works well straight after a heavy one.
How did you learn to speak with families who have just lost someone?
Why ask it
Listen for whether it was taught or picked up on the job, from a colleague they watched or a call that went badly. Then ask what they say first, and what they have learned never to say.
On a bad week, what makes the job still feel worth doing?
Why ask it
Save it for near the end, when there is some trust. The reason given, whether answers for a family, a prevented death or the science itself, makes a strong closing line for an article or a class report.
What would you say to a student who is interested but not sure they could cope with it?
Why ask it
This lands better from the student who is actually wondering than read off a sheet. Two follow-ups get honest replies: whether squeamishness fades with exposure, and what the people who left the field had in common.
Families
Why was my relative's death referred to your office?
Why ask it
The reason is often routine, such as a death at home or one with no recent doctor's visit, and hearing it can settle a lot of worry. Get the case number during this call, since later requests go faster with it.
What can you tell me now about how my relative died, before the final report?
Why ask it
Offices differ on how much they share before results are back, and on who may be told. If what you most need to know is whether your relative was in pain, say so plainly and ask to speak with the doctor who did the examination.
Will there be an autopsy, and can the family object to one or ask for one?
Why ask it
What the office must do and what it may do are set by local law, and the staff can say which applies to this case. A religious or personal objection should be raised at once, together with the question of how objections are handled there.
When will my relative be released to the funeral home, and what do you need from us first?
Why ask it
Funeral plans wait on this answer. The office may need a signed form or the name of the funeral home before it can act, and it can say whether the date depends on a test still outstanding. Anyone hoping to see their relative first should ask whether that happens at the office or at the funeral home.
What does 'pending' on the death certificate mean, and when will it be updated?
Why ask it
It generally means the office is waiting on results before stating a cause. Find out how the amended certificate will reach you, and check with any insurer or bank whether they will accept the pending version in the meantime.
How long will the final report take, and what is it waiting on?
Why ask it
Turnaround differs a great deal between offices and between cases, which is why the reason behind the estimate matters as much as the date. Write down who you spoke to and when it is reasonable to call again.
How do I request a copy of the report, who is allowed to have one, and is there a fee?
Why ask it
Rules on next of kin and public access differ by place. Knowing what proof of relationship is required, and whether the request has to be in writing, means you only have to make it once.
Once the report is ready, who can go through it with me in plain language?
Why ask it
Autopsy reports are written for doctors and courts. Some offices will arrange a call with the pathologist; where that is not offered, your relative's own doctor may be willing to read it with you.
Were any belongings or samples kept, and how are they returned?
Why ask it
Personal effects may be held by the office, the police or the hospital, each with its own release process. A list of what was taken in shows which of them to contact about anything missing.
Getting a useful hour with a medical examiner
Practical guidance for the conversation itself
Before you walk in
Learn which system the office is
Read the office's website before you write a single question. It will usually say whether the head is a medical examiner or a coroner, appointed or elected, and which area the office covers. Anything already posted there, such as an annual report or a records request form, is a question you can skip and a better follow-up you can prepare.
Tell them who is listening
An examiner who knows the room is fifteen-year-olds will pitch the talk differently from one briefing a crime novelist. Say the age of the audience, how long you have and how much physical detail you want. Most guests are relieved to be told.
Send the list ahead
Many offices route visits and interviews through a spokesperson or an administrator. Eight or ten questions sent in advance show what the visit is for, and they let the doctor bring a blank certificate, a redacted sample report or slides that answer several of them at once.
During the interview
Ask about process, not a named case
An examiner generally cannot discuss an open case and may not want to discuss a closed one that involves a local family. 'How would a case like that be handled?' gets a full answer where 'What happened to that person?' gets a refusal. Offer a made-up example and let them work through it.
Keep the answers that end in doubt
'We could not tell' and 'it depends on the scene' are not dodges in this field. They are how the work is actually reported. Write those down as carefully as the confident answers, and ask what extra information would have settled it.
Choose a route through the groups
Fifty questions will not fit in one visit. A class might take three from the job, three from the exam and the cause and manner question, then finish on the toll. A reporter may spend most of the time on court and oversight. Mark your ten before you arrive and hold the others in reserve.
Turning the notes into a report or a scene
Check the vocabulary
Cause, manner, autopsy, external examination, pending, undetermined: each has a narrow meaning, and swapping two of them is the mistake examiners notice first in print. Before you leave, read back one sentence from your draft that leans on those terms and ask whether it is right for that office.
Do not carry one office's rules to another
Who qualifies for the post, which deaths are examined, what is public and how long reports take all change with the jurisdiction. In a class report, name the office you visited. In fiction, set the story somewhere specific and check that place, not the one you happened to interview.
Confirm what is on the record
A reporter should settle at the start whether the conversation can be quoted and by name. A student should ask before recording or photographing anything in the building. Afterward a student can send a thank-you with the passage that quotes the examiner, which doubles as a last check for errors, and a reporter can read the technical terms back before leaving.
If you are calling about a relative
Have the details in front of you
The office will usually ask for your relative's full legal name, the date of death and your relationship to them. Once you are given a case number, lead with it on every call and write it on every form.
Keep a running log
Note the date of each call, the name of the person you reached and what they said would happen next. Offices are busy and staff change shifts, so a log lets you pick up where you left off instead of starting the explanation again.
Know what the office can and cannot answer
Staff can usually tell you what was examined, what is still outstanding and how to get documents. Questions about insurance claims, estates or legal action belong with the insurer or a lawyer, and what you are entitled to see depends on the law where the office sits, which may not be where you live. If a finding is hard to read or hard to hear, ask whether someone can go through it with you by phone.