Thursday, October 19, 2006
Medical Examiner Ribowsky writes of 9/11 and other crime investigation work
LOOKING AHEAD by Wally Dobelis
Shiya Ribowsky, the Cantor of Brotherhood Synagogue and former Director of Special Projects of the NYC Medical Examiner’s Office, has written of his experiences as a medicolegal examiner (MLI) in a 262-page memoir, Dead Center: Behind the Scenes at the World’s Largest Medical Examiner’s Office, with Tom Schachtman (Regan/ Harper/Collins, new York 2006, $26.95)
For starters, this is the book for the fans of Law and Order, or any serious crime show. The author, a MLI for 15 years, describes police and ME’s office routine in professional detail. Thus, the time of death determination, an essential element in investigating actual or potential murder, takes into account rigor mortis, the chemical and physiological process of tightening the body, as well as algor mortis, its temperature of death, and livor mortis, its lividity or color (the blood in the capillaries turns darker in time).
You will learn that nails do not grow after death, and other physiological facts, such as the explanation of the terminal bradycardia that accounts for the deaths of people in the bathroom. The traces of residue of gunpowder familiar from many murder mysteries are detailed into “fouling” (soot) and “stippling” (embers), and and you may shiver at the matter-of-factly details of a full autopsy, the opening of the chest with tools not unlike those in a body shop.
The interaction of police, EMS and the ME’s office is intricate. When a body is found, the securing of the scene of death is the function of the uniformed precinct police. A suspected murder brings on the CSU, Crime Scene Unit, and nobody may touch the scene until they complete photographing and measuring. The first to touch the body should be the ME’s person, but there are the Emergency Medical Service people who have some functional authority to “declare,” that is to certify death. Add the homicide detectives assigned by the Borough office to manage the case, and you have the elements that have heightened the suspense in hundreds of TV dramas.
This story brings back the recent history of the New York City’s Medical Examiner’s Office, with the replacement of Dr. Michael Baden and his successor Dr. Elliot Gross by Mayor Koch, and the 1989 arrival of Dr. Charles Hirsh, the innovator of the MLI office, introducing PAs, Physicians’ Assistants, into its training program.
You might wonder how a cantor, with rabbis in the family background, an observant Orthodox Jew, member of a religion that does not allow the autopsy of the deceased (it bows to demands of the secular state, but requires attendance of rabbis, and the collection of every drop of blood, to have the body complete for the eventual day of judgment) came to be a ME. It is the story of a youngster with thirst for knowledge that exceeded the traditional Jeshiva immersion into the Talmud and its commentaries, with a limited exposure to the secular world. The author was in Yeshivas through his high school years, supplementing the schools’ curricula with outside readings, particularly the masters of science fiction, leading him into subjects that expanded his knowledge of science. To enroll in a secular college, with his parents’ approval, he had to spend two summers preparing for NYS Regents exams. After that, his interest in medicine took him into formal PA training, a 24 to 28 month abbreviated medical school, that enables the graduate to diagnose and treat, and assist in surgery. The practitioners are much in demand in hospitals, clinics and MD’s offices, performing the majority of medical functions at a fraction of the MD’s pay. After working in elder and neonatal baby care clinics while attending law school courses, moving into the ME’s office was a natural progression. There the youthful analytical PA succeeded, as chief investigator and Director of Special Projects - which brings us to the mass murder of 9/11/2001, the subject of the last half of the book, a virtual handbook of post-disaster organization.
The horrifying deaths of nearly 2,500 New Yorkers put the OCME to unprecedented tasks, with the DSP at the forefront, developing new techniques. The recording of postmortem (remains) and antemortem (descriptions of victims and items they wore or carried, from relatives, friends and employers) investigations and the critical crosschecking of some 60,000 documents, over 20 per victim, required new computer techniques, developed on the spot. Remnant recovery at the “Pile,” their cold storage, victim identification by new DNA protocols, victims’ property recording and crosschecking were the daunting new tasks. Mortician and ME volunteers rallied by DMORT (Disater Mortuary Operational Response Team, organized by FEMA) came from all states. A small town in NM collected donations to pay for their ME’s four-month stay in NYC; a British computer expert, in the US for a conference, stayed for two years to adapt his Dataease system for the demands of post-disaster work. After May 2002, when the last of the death ID documents were issued, most of the key participants moved out of the NYC OCME, physically and mentally exhausted, or unable to spend the rest of their careers facing the 9/11 scene and memories. Although humorous at times, this book is a stark reminder that we are a target, and must remain prepared for the worst.
Shiya Ribowsky, the Cantor of Brotherhood Synagogue and former Director of Special Projects of the NYC Medical Examiner’s Office, has written of his experiences as a medicolegal examiner (MLI) in a 262-page memoir, Dead Center: Behind the Scenes at the World’s Largest Medical Examiner’s Office, with Tom Schachtman (Regan/ Harper/Collins, new York 2006, $26.95)
For starters, this is the book for the fans of Law and Order, or any serious crime show. The author, a MLI for 15 years, describes police and ME’s office routine in professional detail. Thus, the time of death determination, an essential element in investigating actual or potential murder, takes into account rigor mortis, the chemical and physiological process of tightening the body, as well as algor mortis, its temperature of death, and livor mortis, its lividity or color (the blood in the capillaries turns darker in time).
You will learn that nails do not grow after death, and other physiological facts, such as the explanation of the terminal bradycardia that accounts for the deaths of people in the bathroom. The traces of residue of gunpowder familiar from many murder mysteries are detailed into “fouling” (soot) and “stippling” (embers), and and you may shiver at the matter-of-factly details of a full autopsy, the opening of the chest with tools not unlike those in a body shop.
The interaction of police, EMS and the ME’s office is intricate. When a body is found, the securing of the scene of death is the function of the uniformed precinct police. A suspected murder brings on the CSU, Crime Scene Unit, and nobody may touch the scene until they complete photographing and measuring. The first to touch the body should be the ME’s person, but there are the Emergency Medical Service people who have some functional authority to “declare,” that is to certify death. Add the homicide detectives assigned by the Borough office to manage the case, and you have the elements that have heightened the suspense in hundreds of TV dramas.
This story brings back the recent history of the New York City’s Medical Examiner’s Office, with the replacement of Dr. Michael Baden and his successor Dr. Elliot Gross by Mayor Koch, and the 1989 arrival of Dr. Charles Hirsh, the innovator of the MLI office, introducing PAs, Physicians’ Assistants, into its training program.
You might wonder how a cantor, with rabbis in the family background, an observant Orthodox Jew, member of a religion that does not allow the autopsy of the deceased (it bows to demands of the secular state, but requires attendance of rabbis, and the collection of every drop of blood, to have the body complete for the eventual day of judgment) came to be a ME. It is the story of a youngster with thirst for knowledge that exceeded the traditional Jeshiva immersion into the Talmud and its commentaries, with a limited exposure to the secular world. The author was in Yeshivas through his high school years, supplementing the schools’ curricula with outside readings, particularly the masters of science fiction, leading him into subjects that expanded his knowledge of science. To enroll in a secular college, with his parents’ approval, he had to spend two summers preparing for NYS Regents exams. After that, his interest in medicine took him into formal PA training, a 24 to 28 month abbreviated medical school, that enables the graduate to diagnose and treat, and assist in surgery. The practitioners are much in demand in hospitals, clinics and MD’s offices, performing the majority of medical functions at a fraction of the MD’s pay. After working in elder and neonatal baby care clinics while attending law school courses, moving into the ME’s office was a natural progression. There the youthful analytical PA succeeded, as chief investigator and Director of Special Projects - which brings us to the mass murder of 9/11/2001, the subject of the last half of the book, a virtual handbook of post-disaster organization.
The horrifying deaths of nearly 2,500 New Yorkers put the OCME to unprecedented tasks, with the DSP at the forefront, developing new techniques. The recording of postmortem (remains) and antemortem (descriptions of victims and items they wore or carried, from relatives, friends and employers) investigations and the critical crosschecking of some 60,000 documents, over 20 per victim, required new computer techniques, developed on the spot. Remnant recovery at the “Pile,” their cold storage, victim identification by new DNA protocols, victims’ property recording and crosschecking were the daunting new tasks. Mortician and ME volunteers rallied by DMORT (Disater Mortuary Operational Response Team, organized by FEMA) came from all states. A small town in NM collected donations to pay for their ME’s four-month stay in NYC; a British computer expert, in the US for a conference, stayed for two years to adapt his Dataease system for the demands of post-disaster work. After May 2002, when the last of the death ID documents were issued, most of the key participants moved out of the NYC OCME, physically and mentally exhausted, or unable to spend the rest of their careers facing the 9/11 scene and memories. Although humorous at times, this book is a stark reminder that we are a target, and must remain prepared for the worst.
# posted by Wally Dobelis @ 3:46 PM 
