Forensic science: It’s not C.S.I.

I have been writing this column, “For Your Review,” in the Independent for about 13 years in an effort to clarify the often jumble of information which the media provides to the reading and viewing public about the real challenges of the field of health care in the United States. At the present time, these concerns are exemplified by the consistent and continuing conflicts about health care reflected in the professional, socioeconomic, political and consumer populations. In spite of major medical fields being ever topical, a specialty field of medical care has become very popular enhanced by the social and entertainment media in addition to the news outlets. The following gives background to the field of forensic medicine. In reality, the field bears little similarity to its dramatic depictions.

Several recent deaths in the news have accentuated the continuing interest in the field of forensic science. These news items are daily factors which add to the prominent role of “crime shows” that we see on television which attempt to depict the role of contemporary forensic science in police work, death investigation, scientific investigations, and research techniques. A column which I wrote nearly eight years ago about this subject merits review, and its information is even more valuable today for our contemporary society. The methods used in modern medical evaluations of theories and therapies own some of their logistics to forensic techniques.

When I was a second year medical student at the University of Minnesota in 1963, the late Dr. John Coe, the pathologist at the Minneapolis General Hospital (now Hennepin County Medical Center), presented a lecture to us on forensic medicine. At that time, discussion of this specialty was a rare occurrence in medical education in the United States since forensic medicine was neither a topical subject nor one of great interest in medicine. With the possible exception of the TV show “Quincy” of the 1970s, which created some popular interest in this field, the medical-legal-detective field was unappreciated and had little entertainment interest until the advent of the phenomenon of “C.S.I.,” other related shows, and the Court TV network in the past several years. The number of shows and the significant interest by the public in the field has been surprising to many of the professionals who have worked in forensic science for years.

The term, “forensics,” is related to those subjects discussed in a court of law; the origin of the word comes from the Latin “forum,” meaning an open court. Forensic science, especially forensic medicine, is “the application of medical knowledge to the investigation of crime, particularly in establishing the cause of injury or death.” In former times the study was called medical jurisprudence owing to its close association with the law. The first formal forensic medicine case is generally felt to be the investigation of the manner and cause of the death of physician Dr. George Parkman, which was directed by Harvard professor of medicine Dr. Oliver Wendell Holmes, Sr. in 1849. Physician and author Dr. Arthur Conan Doyle and his contemporary physicians received instruction in medical jurisprudence at the University of Edinburgh Medical School in 1880, and the role and impact of the forensic pathologist was illustrated in detective fiction by several writers, primarily by physician-author Dr. R. Austin Freeman, when he, realizing the success of the Sherlock Holmes and other contemporary “detective” stories, created the character of Dr. John Evelyn Thorndyke in 1907. The actual physician who first embodied the description and the role of the forensic pathologist was England’s Sir Bernard Spilsbury (1877-1947), who was called “the Scapel of Scotland Yard.” His prominence and influence throughout English criminal investigation and trials began with the Crippen case in 1910 (still being debated) and extended until the end of World War II.

In its basic role, forensic medicine has the duty to determine the manner and cause of death of persons in those situations where there is legal import to society; in other words, deaths that are unnatural. The manner of death can be classified as natural, due to accident, homicide, suicide, or undetermined. The field of forensic medicine now includes all the scientific and technological areas of expertise which can be utilized to determine the manner of death. Usually the cause of death is also studied at the time of the investigations. In Minnesota, we now have a medical examiner-coroner system in which all deaths are reviewed by a physician, and any unnatural or suspicious deaths are reviewed by physician-coroners and medical examiners.

Every year the Minnesota association of those physicians (and others) working in the field of forensic science (The Minnesota Coroners’ and Medical Examiners’ Association) meet for their annual forensic seminar. Two full days and one evening are devoted to presenting knowledge, expertise, and experiences in the areas of forensic medicine of interest to an audience which consists of forensic pathologists, other physicians working in the field, nurses, death investigation specialists, lawyers, law enforcement personnel and related technologists, forensic anthropologists (bone specialists), and morticians. Experts from several related fields also present topics from fields which interact with forensic science and medicine. These annual seminars have shown the personnel in the field the dynamic changes which mark this special medical field.