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Medical Examiner Works to Solve
Final Mysteries
By
Rick Rousos
The Ledger
June 26, 2006
Dr. Stephen J. Nelson is the last
guy you want giving you a real close look -- but when you die,
he just might. Nelson, Polk's medical examiner, will examine
your body if you die in Polk, Highlands or Hardee counties in an
accident, by criminal violence, a suicide, while in police or
jail custody, by poison or suddenly while in good health.
As one of 22 medical examiners appointed by Florida's governor,
Nelson recently celebrated his 10th anniversary as medical
examiner of the 10th Judicial Circuit.
He and an associate, Dr. Vera Volnikh, perform about 670
autopsies a year, 80 percent on people who die in Polk County.
About 225 cases each year focus on corpses with no external
injuries.
Nelson said he enjoys forensic pathology partly because it
presents "the challenge of putting together the pieces of a
puzzle."
He is well respected not just here, but statewide.
He's the chairman of the state Medical Examiner's Commission,
which oversees Florida's 22 medical examiners and has the duty
to discipline them when necessary.
Nelson and the commission will soon tackle a tough, highprofile
case, the January death of Martin Lee Anderson, 14, in the
state's Bay County boot camp. Anderson collapsed and died on his
first day at the boot camp run by the Bay County Sheriff's
Office and the Department of Juvenile Justice. A videotape
showed Anderson being manhandled by a half-dozen uniformed
guards.
A local medical examiner ruled the death natural, but Gov. Jeb
Bush ordered another autopsy. The second autopsy, on the boy's
exhumed body, concluded that he suffocated when guards shoved
ammonia tablets up his nose while covering his mouth.
It will be up to Nelson and the commission to decide which
medical examiner was right or whether there is another
explanation.
There are "bad apples" in every bunch, Nelson said, including
medical examiners.
Whatever the commission decides, he said, "will be based on
science, not emotion."
Q. What is the biggest challenge you face?
A. To try to put our findings into a language that's
understandable for families, the lay public and the media. We
deal with some very complex subjects.
Incidents like the one in Bay County, where the findings of two
autopsies are 180-degree opposites, hurt the credibility of
medical examiners.
Q. What preventable death do you see too much of?
A. A lot of people, particularly young people, are not
restrained in vehicles. Our young folks are being cut down in
the prime of their lives, and it's entirely preventable. We
don't see kids learning to drive in school anymore. When they
did, the first thing was, `Buckle up.'
After performing thousands of autopsies, Nelson said he shows
little emotion after examining an adult. But having a child on
his examining table is different.
When I walk in the door at home, my wife, Sue, takes one look at
me and she knows.
Q. What's it like to autopsy a decomposed body?
A. Smell is very important to us -- unlike "Silence of the
Lambs," where they shove Vicks VapoRub up their noses to conceal
the odor. The odors are real, unlike what comes over a TV
screen. It does stink, and you have to get used to it.
Nelson wears a scrub suit and a surgical gown and mask during
autopsies and washes thoroughly afterward. When he gets home,
Sue Nelson hasn't a clue he's been working on a decomposed body,
but not so with the family dogs.
They give me this `Where have you been?' look, and they won't
have anything to do with me until after I've taken a shower.
Q. Why are medical examiners necessary?
A. The state has a vested interest in knowing how and why people
die. If the government is going to spend money to fix a problem,
it needs to ascertain the degree of the problem. We also don't
want homicides to be missed or doctors to improperly certify a
death.
Q. How do you attempt to treat the families of the people you
autopsy?
A. People aren't beating down the doors to be here. They way we
look at it, a family is probably only going to have contact with
us once, and it's at one of the worst moments in their lives. We
don't want to make things worse.
Q. What's the advantage of having the medical examiner appointed
by the governor?
A. It means we're not restricted by anyone. We don't report to
the sheriff. We don't report to the state attorney. But we do
interact with law enforcement on a daily basis. It's a team
effort, but I'm not beholden to them.
Q. Do you treat a situation like the Anderson boot camp case
differently?
A. Whenever there's public scrutiny, there's a whopping amount
of time spent to make sure the decision is right.
Q. Are there ever religious objections to having an autopsy
performed?
A. Nelson said over the past several years, a handful of Jewish
families have objected. Jewish doctrine says human remains,
including blood and organs, should be treated with utmost
respect and disturbed as little as possible.
There was a boy killed in a motor vehicle crash, and the parents
were Jewish and said an autopsy was impossible. We told them how
we would treat the body and that a rabbi would be allowed to
observe the autopsy and say prayers. We wrapped a sheet around
the boy's body, which prevented blood from going down the drain.
We try to accommodate everyone.
The boy was buried with the sheet.
Q. What cause of death is the most difficult for you to
diagnose?
A. When we end up with a cause and manner of death
`undetermined,' it's very intellectually unsatisfying. We do an
autopsy, toxicology, slides under the microscope and we may have
sent specimens out to a consultant, and we're left with nothing.
The times this happens are few and far between. I can count on
one hand the times this has happened over the whole 10 years.
When it does, it's frustrating.
Nelson recalled such a case involving a boy a few years ago,
about 13.
He was found dead and obviously had some mental health issues
involving his parents. We tested for everything under the sun,
but found nothing. It's bothersome, especially in a young kid.
Those stand out in your mind. Whenever there's the latest
(scientific) advance, we resurrect the file.
Rick Rousos can be reached at
rick.rousos@theledger.com
or 863-802-7516.
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