"It's a bloody interesting case, wouldn't you say? Besides, Arizona's my home state, Doctor," he replied coolly. "And another besides, I'm a board-certified forensic medical examiner, and Page operates under the old coroner system. The coroner here is Doctor Porter, a fine man, yes, but he's not highly trained in forensic science. He's a hospital pathologist with a number of years under his belt, but hardly qualified in forensics."
Jessica understood this language all too well. In fact, much attention had been placed on the continuing problem of the old coroner system, which still operated in most municipalities in the nation. With two general types of medico-legal investigative systems in the United States, the coroner system and the medical examiner system, there remained a great deal of confusion in the public mind about the differences in the terms "coroner," "pathologist," and "medical examiner." Twelve states had coroner systems at work that employed politicians and sometimes hospital pathologists to do the work of a medical examiner. Twenty-two states and the District of Columbia employed the medical examiner system, while sixteen states had both systems at work. The coroner system, the older of the two, dated back to a time when kings and dukes employed a man to determine cause in suspicious deaths, in an attempt to confiscate the holdings of suicide victims, who had blatantly wronged Mother Church, and murderers, who had blatantly wronged the Crown by reducing the taxable public by one or more members. To some degree, the coroner system remained a political arm of the legal system, and it was under this undue pressure and conflict of interest that the elected official with the title "coroner" performed his duties. It had for centuries now allowed barbers, butchers, and candlestick makers who ran for the office to pronounce cause of death in cases ranging from suspicious to ordinary, without the coroner having the slightest knowledge of medicine or forensics-medicine as it applied to law. The system had improved over the years, most jurisdictions now insisting that the coroner at least be a board-certified pathologist, but not even an anatomical pathologist-a generalist-had the training the medical examiner took years to acquire. The only training the coroner received for the position still ranged from absolutely none to a few hours to one or two weeks at best. This was an unforgivable sin as far as Jessica Coran was concerned, for therein lay hundreds upon hundreds of people getting away with murder every day. Jessica had heard Karl speak out against the antiquated coroner system on many occasions, and in fact he was scheduled to do so in Vegas today, back at the convention.
"I thought you were scheduled to speak at the convention today, Karl."
"There are more important things than shooting off my mouth on a subject no one in the forensics community wants to hear me fire off on again," he joked.
"You're sure there's no other reason that you are following
… this case?'' she asked again.
"As I said before, I offered my services to the FBI-Bishop, to be exact, and he encouraged me to help in any way possible. So here I am."
She pressed it further. "And you're sure there's no other motive at work here?''
"My, but you've become suspicious over the years, Jessica. Look, my office got word of a suspicious fire death here in Page, and they knew of what had happened in Vegas because I was in contact with them. They put it together and called me back. Bishop's office informed me where you were. It was either come here or remain at that dull convention. Which would you have chosen, Jessica?"
"All right, Karl. Let's have the truth now, okay?"
He squirmed, thinking her goddamned persistent. He looked down at his feet, fidgeted with the tails of his surgery gown, and finally admitted, "Phoenix is screwing around with the medical examiner system that I created there. They see it's cheaper to run a coroner's office than a medical examiner's office; they think cheaper is better, even more efficient."
"Christ," she moaned in sympathy for Karl. "My office is being seriously challenged by a referendum on the ballot to make death investigation cheaper in the jurisdiction. Cheaper, do you believe it? You have no idea how close to the bone we run the office as is, but death investigation still doesn't come cheaply enough for the budget cutters."
It was an all-too-familiar lament among forensics experts. "I'm sorry to hear it, Karl." She sounded like a person giving condolences to a friend who'd contracted an incurable disease, but she didn't know what else to say.
Repasi shrugged and said, "There's the usual complaint about lack of money, which has led to inadequate staffing and salaries, and we struggle along with antiquated operations and equipment."
"Resistance to acquiring new technology, resistance to change," she sounded the mantra. "And a failure to appreciate, even understand, the M.E.'s mission. I got the same nonsense when I was M.E. in Washington, and when I was an assistant M.E. in Baltimore before that."
Finally, something she did understand. It made sense for Repasi to have shown up uninvited here. "How many ways do we have to show people that the coroner system produces inferior and inaccurate results?" she rhetorically asked. "Nonphysicians can't make accurate medical decisions, no matter how many weeks of training you give them."
"Nor can general pathologists in many cases. Sure, they can mull their way through most common cases, but the difficult ones, the cases they often don't even recognize as difficult… Fools in Phoenix are taking the death stats to heart, you see. They say only twenty percent of our cases involve suspicious deaths, so a pathologist could handle the eighty percent that we do not need to investigate."
Jessica understood the enormous hole in this logic, and she nodded knowingly.
"How does a pathologist know which is the twenty percent if he isn't trained to recognize that twenty percent? What judge would take his pregnant wife to a dermatologist for obstetrical care? But the same politician will permit an individual with zero forensic training to testify in a case involving life-and-death decisions."
"Yeah, agreed," began Jessica. "A major characteristic of the unqualified expert in forensics is that rare ability to interpret a case in absolute and exquisite detail when there are no forensic details to be had in a case."
"Worse still is the practice of contract pathologists."
"Yes, the very notion sets my teeth on edge." Jessica's mind fumed at the idea of a pathologist paid by the case, so that the more cases he or she put away, the more money the pathologist made. "What about the local coroner here in Page? How does he work?"
"Modified coroner, M.E. system. Sends a lot of his cases up to Salt Lake City, others to me in Phoenix."
"Oh, so you two know each other well."
"Yes."
"So, he's okay with you taking charge, Karl?"
We've talked at length. He's happy for the interference."
"That's a refreshing change. I usually meet with resistance with the natives. Good for you."
"Perhaps I'm better with my people skills than you, Jessica?''
She let this pass, saying, "Well then, let's get to work, shall we?" She returned to the body, what remained of Mel Martin: a greasy, soot-covered, creosoted lump of charred flesh an autopsy could do little or nothing for. This they all knew, but protocol mandated an autopsy be performed.
And so, Jessica, how do you approach a fire victim such as this? She heard Dr. Holcraft's voice, her mentor, now long dead, filling her thoughts.
She inwardly, silently answered, The same way that any physician approaches any patient. In medical school, Jessica was taught that to make a correct diagnosis, she must first take a history, perform an examination, and order relevant laboratory tests. They'd gotten only a smattering of Martin's history, knowing much less about the man than they had Chris Lorentian in Vegas. But there were no family members at hand, and time was fleeting. They were prepared to make their examination now and order necessary tests.