Tales from a Pathologist

Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner, Judy Melinek and T. J. Mitchell, (Scribner), 272 pages

It seems to me that if one is sentient, one can’t help but think about death a great deal. We all think about death differently of course. Some of us flee it, some of us glorify it, some turn it into entertainment, some eagerly await the next life. But I think we have a shared reason for thinking about death. We cannot control death, so we compensate for that lack of control with a desire for understanding—whether scientific or spiritual.

Among those looking for understanding are forensic scientists, anthropologists, and technicians. They come to the human body after death has occurred in an effort tell the story, to provide certainty, if not comfort, for those left living. Julie Melinek, one of the authors of Working Stiff, has made a career of this search for truth. (I want to note here that the book is coauthored by Melinek’s Husband, T. J. Mitchell, but as Working Stiff is written in first person from Melinek’s perspective, I’ll be referring to her when discussing the book.)

A significant body of forensics-for-laypeople literature has emerged over the past few decades, and Working Stiff is an excellent addition to this genre. Melinek originally pursued a career as a surgeon before realizing that she wanted a specialty more conducive to a sane family life. As she noted at one point, almost every surgeon has a cot in her office for catnaps between emergencies, but a pathologist’s patients are already dead. That doesn’t mean that she doesn’t take her work seriously, just that she values being able to do her work when she’s at her best, rather than in response to the chaos of medical crises.

The work Melinek does is fascinating, a sort of problem solving simultaneously pursuing knowledge, justice, and compassion. She doesn’t treat some lives as more valuable than others. Death comes in many forms to many people, and in every instance Melinek is similarly focused on uncovering the narrative underlying each death. She writes about overdoses, accidental deaths, deaths resulting from medical error, murder (and her explanations of the differences among these categories is remarkably precise, much clearer than the brief list I’ve offered here).

Working Stiff succeeds not just informationally, but stylistically as well. Melinek’s voice is both professional and relaxed, conversational and informative. At work, she spends a great deal of time explaining complex physiological information to ordinary people, and this makes her an excellent writer. Books in this genre can feel like collections of disparate narratives, sort of a “if this is Tuesday, we must be in the brain case,” if that isn’t too irreverent. While Melinek does focus on different classes of deaths as she moves from chapter to chapter, the narrative thread of her book—the well-defined time span of two years’ work—keeps these topics from feeling isolated from one another.

The narrative flow becomes particularly effective—and particularly important—in the last few chapters, when she describes the process of working to identify human remains after the attack that caused the collapse of the World Trade Center. She gives us a sense of what this work is like over time: not just one challenging day, but months of such work. She describes moving between “ordinary” autopsies and mass casualties.

This book is precise, and it is graphic as a result of this precision. It doesn’t make for light reading, but it is compelling.