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Becoming a forensic pathologist


Linda Liebenberg tells QUEST what it takes to become a forensic pathologist in South Africa.


I


Figure 1: Poor man: stabbed, shot, axed, poisoned. Some examples of unnatural death.


am a forensic pathologist. For a living, I examine dead people and come to conclusions as to the way they died. I assist the police and the courts in establishing whether somebody or something should be held accountable for the death of these


persons.


Polite dinner conversation, for me, hiccups when a fellow diner puts forth the dreaded question: ‘And what do you do?’ I venture, in a cowardly way: ‘I am in the medical profession’, hoping that it will stall the inevitable. It rarely does. ‘Oh, so where do you practice?’ – I can feel the ‘I-need-to-ask-you-a-quick-question- about-my-medical-problem’ coming up. Swallow and sigh. ‘I am a forensic pathologist and I work at a mortuary.’ Count one, two, three ... and the reaction is there. Half my dinner companions are gagging on the meat they were so enjoying, the other half put down their cutlery in fascination, loaded with questions, ‘so you cut up dead people for a living?’ Considering that death is the ultimate disease, it is understandable that medical doctors will go beyond treatment of living patients and fight the ultimate disease by examining deceased patients.


Death is not a nice topic at a social event, so I do try and avoid the job-specific question at dinner tables. And no, I am not a vegetarian.


Forensic pathology in South Africa The Inquest Act of South Africa, Act 58 of 1959 is the major legislation instructing the performance of forensic post-mortem examinations.


Forensic post mortem examination defined


Figure 2: A body with a an identification tag attached to the toe. Image: Linda Liebenberg


The Locard principle


The scene of a crime, the perpetrator of the crime and the victim of the crime all leave traces of themselves on each other. In Figure 3, it is clear that a motor vehicle’s tyre hit and imprinted a mirror image of its markings during a collision.


Forensic: for the purpose of presenting evidence to a court of law Post: after Mortem: death Examination: a process of answering questions by means of looking at, studying, and describing what was found.


In a nutshell: answering legal questions by examining a dead individual.


The Forensic Pathology Service falls under the Department of Health and deals with all cases of unnatural and unexplained deaths. Many of the unexplained death cases turn out to be due to natural causes, such as undiagnosed heart disease or an infection.


South Africa is burdened with a huge load of outright unnatural deaths due, for example, to road traffic accidents and homicides, to mention but two of the main culprits.


Figure 3: A tyre imprint on the trouser leg of the victim of a road traffic accident. Image: Linda Liebenberg


20 Quest 8(2) 2012


The number of unnatural deaths in South Africa in 2008: the National Injury Mortality Surveillance System (NIMSS) recorded the total as 36 795.


What does a forensic pathologist do? Post-mortem examinations Assisted by a Forensic Pathology Officer, the pathologist examines dead individuals to accurately establish their identity, the day of death and the cause of death. We consider the body of the deceased to be a crime scene that we, as medical detectives, process in order to find and preserve evidence to present in future court evidence.


External examination This reveals tell-tale signs on clothing, such as blood spatter or gunshot soot. The deceased’s body may exhibit signs of a medical condition such as emaciation, indicating a severe disease like cancer or AIDS. The body is examined from top to toe and special test samples can be taken to assist in a variety of ways: toxicological analysis, microbiology to identify infections, chemical analysis, anthropology, odontology – the list of possibilities is very long.


Anthropology: this is the scientific study of people from all periods of time and in all areas of the world. Odontology: this is forensic dentistry, which is the examination and evaluation of dental evidence, which is then presented in court.


In the Western Cape two of the big mortuaries have Lodox X-ray


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