She found that one puncture was actually a wound on the forehead that came from the man scratching himself. The two others were puncture marks made by emergency personnel at the hospital when they tried to save him. These punctures were documented in the medical record. Melinek's evidence helped the woman get an acquittal.
Working With Nonmedical Experts
Unlike practicing physicians, who consult with other physicians, forensic pathologists chiefly consult with nonphysicians—experts in ballistics, tool-mark analysis, hair and fiber analysis, and blood spatter, and with forensic anthropologists, who examine skeletal remains.
Such teamwork is how Melinek helped overturn a wrongful conviction against an Oakland, California, rapper named Jamal Trulove. Trulove was convicted in 2008 of murdering a friend in San Francisco. A witness looking from a window onto a street said she had seen Trulove shoot the man from above him on the street.
In 2014, a California appeals court agreed to rehear the case, and Trulove's attorneys hired Melinek and a ballistics expert to reexamine the case. Looking at the entry and exit wounds on the body, they determined that the victim had been shot by someone below him, and not from above.
In part on the basis of this evidence, Melinek says, the jury acquitted Trulove, and he was released. Trulove sued the city of San Francisco for his wrongful conviction, and he was paid $13.1 million in a settlement.
Why Doctors Choose Forensic Pathology
Forensic pathology is not an obvious specialty choice for medical students. "People go into medicine to help people," Andrew says. "They don't usually see themselves working in a pathology lab."
Many forensic pathologists started out in other specialties. Andrew was a pediatrician, and a former deputy of his was a surgeon. Andrew says he switched over to forensic pathology in the 1980s, when HMOs seemed to be taking over and he didn't want to deal with them.
Andrew says doctors who choose pathology tend to like a slower, more methodical pace than what is possible in the rest of medicine. This was the case for Renee Robinson, MD, a forensic pathologist in North Canton, Ohio.
Robinson recalls that when she was in medical school, she decided that fast-paced specialties, such as emergency medicine, were not for her. She wanted to contemplate a case, not rush through it, she says. So she chose pathology as her specialty.
Part of her pathology residency involved performing required autopsies on patients who died in the hospital. She found that she liked the work. "Even though the cause of death is clearly stated in the patient's record, there are surprises," she says. "For example, you might find that the patient who died of a heart attack had a tumor on his kidney, and it would have eventually killed him."
Robinson took a 1-year fellowship in forensic pathology and began working as an ME. Now she has her own private business, where she teaches law enforcement personnel and medical students, consults in legal cases, and works as an ME on a locum tenens basis.
The Downsides of Being a Forensic Pathologist
When forensic pathologists turn their information over to investigators, they move onto the next case and may not find out how the last case was resolved. Asked about her role in solving crimes, Robinson doesn't know how any of her cases were resolved.
In one of her cases, a man's body was found hanging out of a window in a condo where there had been a fire, she says. The glass in the window had been broken, and there was blood near the body.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Leigh Page. Clues to Mysterious Deaths: Doctors Who Help - Medscape - Nov 06, 2019.