I’ve been meaning to post about coroners, and since I recently toured my local coroner’s facility, now seems like an appropriate time.

Like sheriffs, coroners can be traced back to shortly after the Norman Conquest of England—roughly the 11th century. As the name suggests, coroners were appointed by the crown and charged with protecting royal financial interests in local issues. For example, when someone died, fees might be due to the king. Sheriffs often couldn’t be trusted in these matters because they had a personal interest—or were corrupt. To make coroners more immune to temptation, they were required to be wealthy. They had several duties, and one of them was investigating causes of death. Not so much to see wrongdoers punished as to make sure the crown got its due. The particular task of finding cause of death was eventually imported to coroners in the United States.

In the US today, coroners are often affiliated with or a subdivision of the local sheriff’s department, although they may also be part of the district attorney’s office or other agencies. And here’s another place where I have to repeat this warning: laws, policies, and procedures vary a great deal across jurisdictions. If you want to be accurate about a specific jurisdiction, consult the authorities there.

The titles of the people involved can be confusing and do vary. Some jurisdictions use the term medical examiner—and that person, unlike the coroner, is usually a physician. The autopsy itself is conducted by a physician, usually a forensic pathologist, who’s assisted by autopsy technicians. Other professionals may also get involved when needed, such as experts in forensic odontology (teeth), anthropology (bones, mostly), and so on.

Coroners are usually called in under specific circumstances of death. My local policy is typical. The coroner will investigate cases of suspected homicide or suicide, cases involving accidents, cases with no known family, and unaccompanied deaths (when someone dies alone) where a doctor can’t confidently sign off on cause of death. If a person dies while receiving treatment at a hospital or other facility, the coroner usually won’t get involved because the doctors there already know why the person died. Even if a person dies elsewhere—at home, in public, at work—a coroner isn’t needed if a doctor knows the medical history and can attest to cause of death.

The job of a coroner is usually to determine cause of death. Heart attack. Overdose. Gunshot wound. Anoxia (lack of oxygen). Not who caused the death or why—that’s the job of law enforcement. Just how. I recently watched the autopsy of a bicyclist who was struck by a train. Even I could discern the extensive damage to his internal organs and spine. I’m guessing official cause of death was blunt force trauma.

The job of collecting evidence related to the death, such as fibers, gunshot residue, and so on, is generally up to the responsible police agency, not the coroner. However, the forensic pathologist will take blood and tissue samples for toxicology and other purposes.

Some things I learned about my local coroner, which may or may not apply to yours:

• While awaiting autopsy and, later, while awaiting pickup by a funeral home, etc., bodies are kept in body bags on shelves. There are no drawers like in TV morgues. Most bodies are kept in refrigerated rooms (where the smell is pretty awful), but the most decomposed ones may be kept in a freezer.
• Coroners use multiple methods and checks to ensure that bodies don’t get confused with each other and to ensure they’re examining the right one.
• They use ankle tags, not toe tags.
• The police department, not the coroner, takes photos of the body before the autopsy.
• The scent of decomposing human remains is distinctive and awful.
• The police tech person who had to take photos spread Vick’s VapoRub under her nose. But the coroner teased her about it. He says Vick’s just opens up the nasal passages and makes everything smell like mentholated death. When the smell is especially bad, he puts a tea bag inside his mask.
• In a non-homicide case, the autopsy takes about an hour. Homicides take longer because they require more care in recording and preserving evidence. For example, the size, depth, and angle of a stab wound may prove critical in a homicide but less so in an accident.
• Internal organs (including the brain) are removed and weighed, and samples are taken. Then the organs are placed in a bag and sewn into the body cavity.
• Pruning shears are used to fracture the ribs, allowing the chest plate to be removed for access to the internal organs. The chest plate is returned before the body is sewn back up.
• Before the top of the skull is sawn off and the brain removed, the coroner peels back the scalp. (It will be put back in place after the autopsy, and the cut marks won’t show at the funeral.) Part of the saw cut includes a notch so that the removed piece sits back neatly when they’re done. This eerily reminded me of making a jack-o-lantern.
• While people’s own mistakes often cause or vastly contribute to their death, the coroners understand that it’s devastating for families. They do their best to treat the families with respect and compassion.
• Predictably, the hardest cases emotionally for the coroners involve child victims.
• While coroners don’t investigate the circumstances behind a death, they may alert police when a suspected accident looks more like homicide. The coroner I spoke with told me about a case in which a young child died from a head injury supposedly caused by a fall. The hospital believed the parents’ claim that it was an accident, but the forensic pathologist told police it would be almost impossible for a simple fall to cause the extensive damage he found.
• Families are not brought in to ID bodies. In fact, while I’ve talked to agencies elsewhere that occasionally have families ID the deceased via photographs, my local agency doesn’t use family IDs at all. The coroner said there are much more reliable alternatives (medical and dental records, tattoos, serial numbers on joint replacements, etc.).
• Breast implants have serial numbers and have been used to ID a body.
• Evidence is not stored at the facility; bodies are released for burial, etc., and other evidence is given to families or law enforcement.
• Unclaimed or indigent deceased people are cremated and the ashes scattered at sea.