Customer Reviews

Cause of Death: Forensic Files of a Medical Examiner

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Never having watched CSI, I was curious about why the daily goings-on of a medical examiner would merit a book. I did not have to read far to realize that this was fascinating stuff! Cause of Death demystifies what happens behind doors that no one ever wants to go through, but all enevitably will.
Dr. Cohle and Mr. Buhk allow the reader to see and smell the county morgue from an "over-the-shoulder" view. The authors present a perspective that preserves the sanctity of life, but damns some of life's behaviors and actions. The book does not sensationalize the macabre and sometimes horrible circumstances and details of death; it does reveal the bizarre, the terrible, and sometimes humorously ironic details that man (and woman)does to himself or others.
The writing style of the book allows the reader to learn more about individual victim cases. The reader can go along for the victim's last car ride all the way to the victim's last gurney ride; The reader can get a taste of the victim's last choice of poisen or the authors' last choice of music; the reader can experience how interminably long ten seconds is when a baby is being shaken by an angry father; and the reader can sense that the cause of death is not a television show to be wrapped up during a sixty minute time slot.
Great read!

Stephen D. Cohle, MD is the chief medial examiner for Kent County, Michigan. During his years as the medical examiner, he has performed thousands of autopsies. Some have been part of high-profile murder cases, but the majority are not fodder for the next episode of CSI but are instead of just men and women, and sometimes children, who met their end through normal, though still heart-breaking means.

Cause of Death is told from the perspective of the medical examiner, but is unique from some of the other books by well known forensic pathologists. This volume does not highlight sensational cases, like the Jon Benet Ramsey case, but are instead full of what are just regular folks who happened to find their way to the morgue in various ways. It also gives the reader more of a sense of what a real medical examiner's office is like. There are no exhibits of murder weapons from famous cases, but there is a display of alcohol, delivered with some of the bodies who so often meet their demise as a result of the contents of these bottles.

Along for the trip, and co-authoring the book, is Tobin T. Buhk, who once told Cohle that he should write a book about his experiences. Buhk joined him in the morgue over the course of several months, and was able to witness and sometimes participate, in the autopsies of several people. This gives the authors the chance to bring the reader into the stories as more than just a casual observer. We are able to experience the operations of the morgue through the eyes of the expert, Dr. Cohle, and the novice, Buhk.

The Kent County morgue is not what you see on CSI or Law and Order. It is a place that is a collection of contradictions. The bodies that are brought into the room are treated with the reverance and professionalism we would all hope they would. But contrasted with this is a constant-changing soundtrack which varies from Los Lobos to Crosby, Stills, and Nash. Music is always playing during the autopsies, sometimes providing a counterpoint to the tragedy before them.

Along with the surgical gowns, latex gloves, and face guards, humor is another prophylactic used in the morgue. It is brought in to protect, not against disease, but the melancholy that comes from spending day after day determining the various manners in which humans find to end one another's or their own lives. And Tobin discovers, after just a few trips to the morgue, that sometimes you have to laugh to keep from crying.

Each chapter contains one or two cases that came through the Kent County Medical Examiner's Office. Each contains a description of the case and the methods used by Dr. Cohle to determine, if possible, the cause of death. Unlike television, it is not an immediate process, done in moments. It sometimes takes hours to perform a complete autopsy, and even then it may be days before toxicology reports confirm the cause of death. This is truth of working in a morgue.

The book gives an honest account of what it really is like to work in a morgue. All of the sounds, smells, and there are a lot of smells, that make up the work of the medical examiner. If you ever thought it was glamorous to work in a morgue, take a glance through this book and you will qickly realize, it requires a high degree of training, long hours, and a willingness to look at the worst of humanity day after day. Kind, gentle people are not the majority of the traffic at the morgue, and even when they are, many times they arrived due to the actions of someone not so kind or gentle.

There is some interesting information here about the revelations made possible by properly performed autopsies - but that information often gets obscured in a haze of purple prose and blanketing attempts at poetic effect.

For example, Cohle and his co-author start by deploring how TV depictions of forensics "clog the arteries like plaque." Then when describing his co-author's distress at realizing he might have been exposed to Hepatitis B in the process of observing an autopsy, Cohle says that a stone began to pitch "in the acids washing against his stomach like waves crashing on a beach." He attributes poetic meaning to the fact that it was raining outside when he started an autopsy by saying this rain was like a writer (perhaps Edgar Allen Poe?) "setting a scene."

Also, Cohle (or his co-author) surprisingly mix up the words supine (lying on one's back) and prone (lying on one's stomach). That would ordinarily be a minor quibble, but the exact position of a dead body can be crucial to discovering who or what caused the death, and so the distinction is something anyone involved in forensics should know.

Then the authors glance off into the irritatingly irrelevant when they describe what piece of music Cohle has playing in accompaniment to each autopsy.

The authors do achieve some apt passages. For example, they credit alcoholic beverages with the ability to "resurrect what should be resurrected and bury what should be buried; they make jokes sound funnier and bill collectors irrelevant; they bring out the humor in things & suppress the stress that often envelops adult life."

But then the co-authors lapse back into over-reaching for poetic import when they philosophize, "In mathematics, parallel lines never meet, but in human society, they do. While they did not live parallel lives, Marvell Green & Jim Michaels died parallel deaths." I kept wondering what constituted the railroad tracks of these men's deaths - until I finally realized it was merely the fact that both men's bodies ended up in the same hospital.

So if you want to read about the science of forensics, on a dark and stormy night, with the wind howling outside your door like the banshee escape of the last breath of a dying man - this might be the book for you.

CAUSE OF DEATH: FORENSIC FILES OF A MEDICAL EXAMINER isn't just for college-level students of forensic medicine: it's a pick for any interested in forensic investigations, which will include many a legal reference collection as well as public library patrons. Chapters from a veteran medical examiner and forensic pathologist document the case histories and real-life challenges of autopsies, pairing detailed autopsy notes with insights on victims, murder methods and more. Perfect not only for health libraries but for law libraries and general-interest collections.

R. Shultz's review pretty much nails it. This is not a bad book, but I was a disappointed to find the authors trying to paint a picture of ... well, everything. When I read a book like this, I want to learn medical stuff; I don't want to hear what music was playing in the morgue, and there are only so many times you can read about wintergreen oil before you start to wonder what this guy's editor was thinking (actually, whoever edited this book should probably be fired). Lots of repetition; you're told several times that the author is really into weightlifting, chess and Kinky Friedman, and more than once you're reminded that people working in the morgue and use wintergreen oil to mask the smell of death tend to develop an aversion to wintergreen flavored things. It's also very poorly organized and jumps around a lot, you'll be in the middle of learning about what happened to Patient X and suddenly he's telling you about another patient from 5 years ago for apparently no reason. He'll build up suspense - for example (and this is just an example I made up, this isn't from the book, I'm just trying to give you an idea of what's in there) - he'll set up a scene where the patient appeared to have died from a stroke, then throw in the question "but was it REALLY a stroke, or was it something more sinister?" build things up a bit and then it turns out no, they died of a stroke. That's fine and all, but it would have been more interesting to see at least a couple of cases where the cause of death turned out to be radically different from what it appeared to be in the beginning. I ended up having to skim quite a bit of it, looking for stuff about autopsies that were actually performed.

So ... meh. Not terrible, but in retrospect I probably should have passed on it. I wish I could recommend buying this book, but I just can't.

I came here to write a review, only to find that R. Shultz of Chicago had already written it! I agree completely, and I don't think I can say it any better than Mr/Ms Shultz did. I wanted to like this book, but I could just not get through the extraneous drivel, repetition of cliches, poor organization of the chapters, inane jokes, and the author's pompous apologies for the inane jokes. I ended up doing a lot of skimming because I just didn't care what music accompanied each autopsy. The book should have been interesting, but it was boring. It would have greatly benefited from a good editor.

Forensics is my passion (as I am studying to be a medical examiner) and I would recommend reading this book. The authors are very well educated and informative with their creativity and writing. This has been a most wonderful reading and would definitely state that anyone interested in forensics (even if your not going into it career wise) check out this book.