Category Archives: Guest Posts

HOW DO YOU WANT TO DIE?

I’m thrilled to death to have Seth Godin do this guest post on DyingWords. Seth is an internationally known author, speaker, businessman, and all-around mover & shaker. He originally posted this on his own blog at www.sethgodin.com on June 13, 2013, and generously offered to share it here. Thanks Seth!

Seth3Let’s assert that you’re almost certainly not going to be the very first person to live forever. Also worth noting is that you’re probably going to die of natural causes. 

The expectations we have for medical care are derived directly from marketing and popular culture. Marcus Welby and a host of medical shows taught us about the heroic doctor, and more than that, about the power of technology and intervention to reliably deliver a cure.

It’s not a conspiracy — it’s just the result of many industries that all profit from the herculean effort and expense designed to extend human life, sometimes at great personal cost.

Seth4Hence the question: Do you want to choose whether or not you will be a profit center in the ever scaling medical-industrial complex? One percent of the population accounts for 30% of all health care expenditures, and half of those people are elderly.

Most of that care is designed to prolong life, regardless of the cost, the pain, or the impact on the family. A lot of doctors are uncomfortable with this, but they need you to speak up and make a choice (in advance) about what you’d like. Some people want the full treatment, intervention at all costs.

If that’s your choice, go for it. But be clear, in writing, that you’d like to spare no expense and invest in every procedure, even if it’s pointless and painful. Don’t be selfish and let someone else have to guess.

Seth5On the other hand, you have the right to speak up, and stand up, and clearly state if you’d prefer the alternative. Many people prefer a quiet dignity that spares them, and their family, pain and trauma. But you have to do it now, because later is too late.

The web makes it easy to generate and sign a simple generic form. Or even better, go find the forms by state or province. If those pages are down, try a search “health care proxy” and the name of your state or province. I suggest http://mydirectives.com and consider the “Five Wishes” at http://www.agingwithdignity.org/ .)

Seth6There are two critical components: assigning an individual to be your health care proxy, and then telling that proxy, in writing, what you’d like done (and not done) to you when the time comes.

If you’ve ever shared a post of mine, I hope you’ll share this one. If every person who reads this sits down with her family and talks this through (and then tells a few friends), we’ll make a magnificent dent in the cultural expectation of what happens last.

Seth8It’s free. It’s not difficult. It takes five minutes. Do it today, if you can, whatever your wishes are. Don’t make the people you love guess and then live with the memory of that guessing.

Some things are more likely to happen if you plan for them. In this case, the end comes whether you plan for it or not.

Planning merely makes it better.

Seth1SETH GODIN is the author of 17 books that have been bestsellers around the world and have been translated into more than 35 languages. He writes about the post-industrial revolution, the way ideas spread, marketing, quitting, leadership, and most of all, changing everything. You might be familiar with his books LinchpinTribesThe Dip, and Purple Cow.

In addition to his writing and speaking, Seth is the founder of squidoo.com, a fast growing, easy to use website. His blog at www.sethgodin.com (which you can find by typing “seth” into Google or click here) is one of the most popular in the world. Before his work as a writer and blogger, Seth was Vice President of Direct Marketing at Yahoo!, a job he got after selling them his pioneering 1990s online startup, Yoyodyne.

In 2013, Seth was inducted into the Direct Marketing Hall of Fame, one of three chosen for this honour.

Seth9Recently, Seth once again set the book publishing on its ear by launching a series of four books via Kickstarter. The campaign reached its goal after three hours and ended up becoming the most successful book project ever done this way. His latest, The Icarus Deception, argues that we’ve been brainwashed by industrial propaganda, and pushes us to stand out, not to fit in.

Thanks so much for generously sharing your wisdom, Seth!

7 CSI FAILS

Working Stiff is a new release and New York Times BestSeller by Forensic Pathologist Dr. Judy Melinek and co-authored by her husband T.J. Mitchell. If you want to know what it’s really like behind the morgue door, this is a fascinating read. I’m thrilled to death to have Dr. Melinek do this guest post on Dyingwords.

Melinek11The CSI effect is a term coined by attorneys for the unrealistic expectations created by television crime shows on the public. It’s a real thing.  As an expert witness in forensic pathology I see the CSI effect when I’m faced with questions like, “Why can’t you tell us the precise time of death down to the minute, like on TV?”

Potential jurors are now being asked if they watch NCIS, CSI, Bones, Law & Order: Criminal Intent, and a plethora of other shows that depict police and other forensic professionals doing their jobs. So how close are these shows to reality? I’m here to tell you. Here are 7 things these shows consistently get wrong:

1. Somebody Turn on the Lights! 

Melenik1The first thing the police do when they secure a crime scene outdoors is set up Klieg lights to illuminate the scene while we do our work there. When I get to an indoor death scene and the lights are off? Well, we turn on the lights. Television shows striving to effect an atmosphere of suspense portray the crime scene investigators looking around a death scene with flashlights. Back at the lab, it’s gloomy and dim. The scientist is wearing a headlamp while he pokes at something bloody but indistinct. Seriously? Forensic science is done in a clean and bright lab. My autopsy suite in the morgue has the same overhead lighting as a surgery suite, with good reason: I need to see what I’m cutting. You can’t find the evidence if you can’t see the evidence, and without evidence there is no forensic case.

2. Where Do You Shop? 

Melenik2Low cut blouses and high-hemmed skirts are not appropriate attire at a crime scene. Neither are stiletto heels, platform heels—any heels. You don’t want to wobble or trip when you’re negotiating your way around a corpse on the sidewalk, believe me. Police departments and sheriff-coroners have strict dress codes and grooming rules with restrictions on hairstyles and visible tattoos. You can lose your credibility as a forensic professional if you are not wearing business attire. And one more thing: No Louboutinson a government salary.

3. Don’t You Have Anything Else to Do?

Melinek3Most forensic science jobs, whether in an office or the lab, are nine-to-five. As we say in the morgue at quitting time, “They’ll still be dead tomorrow.” There is no need to come in at two in the morning to run a lab test because you just can’t sleep until you do, or to perform an entire autopsy, alone, in the middle of the night. In fact, most offices have restrictions on entering after hours, and any technician or employee who is poking around in the lab without supervision will encounter serious scrutiny. It’s true that police officers work unorthodox hours, but they do so on a shift schedule and overtime is monitored. When the shift ends they pass the case to another investigator, go home to their families, or to bed to sleep, or off to do ordinary things like normal human beings. Unlike their television avatars, they do not single-handedly conduct an investigation around the clock.

4. You’re Dating Who?

Melinek4Why are TV forensic scientists always flirting or sleeping with cops and co-workers? Dating someone you met on the job is taboo in most professions, and even more so in a field where your work is subject to legal scrutiny. If you are caught canoodling with a co-worker you could find yourself under investigation from—no pun intended—internal affairs, and if IA finds either of you has been influenced or biased by your fraternization you could both lose your jobs. Yes, television series need steamy subplots, but do they all have to involve intramural romance?

5. Lab Results!

Melinek5DNA results in crime shows come back while the body is still warm, and the toxicology report is ready before the bone saw is even fired up. Someone please tell me where these labs with five minute turn-around-times are, because I want to send my specimens there! Tox results take a minimum of two weeks in the best labs, and DNA can take months to come back. Meanwhile, the autopsy paperwork gets filed and we wait for the results to come back before we conclude anything.

6. Where Are Your PPEs?

Left - Television   Right - Real Autopsy Gear

Left – Television Right – Real Autopsy Gear

PPE is personal protective equipment: gloves, face shields, masks and Tyvek suits, gear worn by forensic professionals while performing autopsies to keep themselves safe from blood-borne pathogens and potentially transmissible emerging infectious diseases. But PPE is notably absent on most shows, probably because directors want to see the actors’ faces. Showing emotion with your eyes, body language and tone of voice is not sufficient? If I am pissed off at someone in the morgue that’s what I do, and it seems to work just fine. OSHA would shut down these imaginary TV labs in a New York minute over these high-risk and needless violations. Nobody eats in the lab anymore either. That was something they did back in the days of Quincy ME, but it can get you fired nowadays.

And, finally…

7. Where Can I Get Me One of These?

Melinek7Most crime labs and autopsy facilities in the United States are underfunded. We are lucky to be working with basic equipment, like an X-ray machine that works reliably, and we don’t have access to the highfalutin gadgets these lucky TV scientists enjoy. Things like 3-D holographic reconstructions exist in digital-simulation labs at academic institutions, and may be used to publish papers on virtual autopsies in foreign countries, but such doodads are not available to the forensic civil servants who are doing the actual, daily work in the real world. In my autopsy suite I handle tools you will recognize from your kitchen. It’s the ultimate in hands-on investigation. I love my job. And I’d love to see it portrayed in fiction with more accuracy—because the reality of forensic death investigation is even more riveting than the fantasy as seen on TV.

Melinek11For more about real death investigation don’t miss “Working Stiff: Two Years, 262 bodies and the Making of a Medical Examiner” by Judy Melinek, M.D. and T.J. Mitchell. It’s been available on-line and in stores since August 12, 2014. For updates check in with Facebook/DrWorkingStiff or at www.drworkingstiff.com. Follow @drjudymelinek and@tjmitchellws on Twitter.

Get Working Stiff at http://www.pathologyexpert.com/working-stiff-book/

AMAZON LINK for Print, eBook & Audiobook at http://www.amazon.com/Working-Stiff-Bodies-Medical-Examiner-ebook/dp/B00GEEB8GQ

Here’s an excerpt from Working Stiff –

Chapter One – This Can Only End Badly

“Remember: This can only end badly.” That’s what my husband says anytime I start a story. He’s right.

So. This carpenter is sitting on a sidewalk in Midtown Manhattan with his buddies, half a dozen subcontractors in hard hats sipping their coffees before the morning shift gets started. The remains of a hurricane blew over the city the day before, halting construction, but now it’s back to business on the office tower they’ve been building for eight months.

As the sun comes up and the traffic din grows, a new noise punctures the hum of taxis and buses: a metallic creak, not immediately menacing. The creak turns into a groan, and somebody yells. The workers can’t hear too well over the diesel noise and gusting wind, but they can tell the voice is directed at them. The groan sharpens to a screech. The men look up—then jump to their feet and sprint off, their coffee flying everywhere. The carpenter chooses the wrong direction.

With an earthshaking crash, the derrick of a 383-foot-tall construction crane slams down on James Friarson’s head.

I arrived at this gruesome scene two hours later with a team of MLIs, medicolegal investigators from the New York City Office of Chief Medical Examiner. The crane had fallen directly across a busy intersection at rush hour and the police had shut it down, snarling traffic in all directions. The MLI driving the morgue van cursed like a sailor as he inched us the last few blocks to the cordon line. Medicolegal investigators are the medical examiner’s first responders, going to the site of an untimely death, examining and documenting everything there, and transporting the body back to the city morgue for autopsy. I was starting a monthlong program designed to introduce young doctors to the world of forensic death investigation and had never worked outside a hospital. “Doc,” the MLI behind the wheel said to me at one hopelessly gridlocked corner, “I hope you don’t turn out to be a black cloud. Yesterday all we had to do was scoop up one little old lady from Beth Israel ER. Today, we get this clusterfuck.”

“Watch your step,” a police officer warned when I got out of the van. The steel boom had punched a foot-deep hole in the sidewalk when it came down on Friarson. A hard hat was still there, lying on its side in a pool of blood and brains, coffee and doughnuts. I had spent the previous four years training as a hospital pathologist in a fluorescent-lit world of sterile labs and blue scrubs. Now I found myself at a windy crime scene in the middle of Manhattan rush hour, gore on the sidewalk, blue lights and yellow tape, a crowd of gawkers, grim cops, and coworkers who kept using the word “clusterfuck.”

I was hooked.

See more at: http://books.simonandschuster.com/Working-Stiff/Judy-Melinek-MD/9781476727257/excerpt#sthash.ToVVB0WO.dpuf

About the Authors

Melinek8Judy Melinek, M.D. is a graduate of Harvard University. She trained at UCLA in medicine and pathology, graduating in 1996. Her training at the Office of the Chief Medical Examiner in New York is the subject of her memoir, Working Stiff, which she co-wrote with her husband. Currently, Dr. Melinek is an Assistant Clinical Professor at UCSF, and works as a forensic pathologist in San Francisco. She also travels nationally and internationally to lecture on anatomic and forensic pathology and she has been consulted as a forensic expert in many high-profile legal cases, as well as for the television shows E.R. and Mythbusters.

Melinek9T.J. Mitchell, her husband, graduated with an English degree from Harvard and has worked as a screenwriter’s assistant and script editor since 1991. He is a writer and stay-at-home Dad raising their three children in San Francisco. His consult practice, T.J. Mitchell Consulting, offers advice to aspiring screenwriters. Working Stiff is his first book.

Dr. Melinek is a American Board of Pathology board-certified forensic pathologist practicing forensic medicine in San Francisco, California as well as an Assistant Clinical Professor of Pathology at the UCSF Medical Center.

Dr. Melinek trained in Pathology at University of California, Los Angeles and then as a forensic pathologist at the New York City Medical Examiner’s Office from 2001-2003. She has consulted and testified in criminal and civil cases in Alaska, Arizona, California, Florida, Illinois, Louisiana, Maryland, Mississippi, New Mexico, New York, Oregon, Pennsylvania, Texas and Washington.

Dr. Melinek has been qualified as an expert witness in forensic pathology, neuropathology and wound interpretation. She has had subspecialty training in surgery and has published and consulted on cases of medical malpractice and therapeutic complications. She trains doctors and attorneys on forensic pathology, proper death reporting and certification. She has been invited to lecture at professional conferences on the subjects of death certification, complications of therapy, forensic toxicology and in-custody deaths. She has also published extensively in the peer-reviewed literature on subjects of surgical complications, death following gastric bypass, forensic toxicology, opioid overdose deaths, immunology, neuropathology and transplant surgery.

Past clients include the Santa Clara County District Attorney, Office of the County Counsel County of Contra Costa, Marin County Public Defender, the Court Appointed Attorney Program of the Alameda County Bar Association, the Attorney General of the State of California, the United States Military, and many private civil plaintiff’s and defense attorneys. Dr. Melinek travels locally in Northern California to testify in and around the Bay Area including San Mateo, Santa Clara, Marin, Monterey, Napa, Lake, Shasta, Solano, Sonoma and Stanislaus Counties. She has also been called to Southern California to review cases in Los Angeles, San Bernadino, Riverside, Ventura and San Diego Counties.

Melinek11

 Available in Print, eBook, and Audiobook at http://www.amazon.com/Working-Stiff-Bodies-Medical-Examiner-ebook/dp/B00GEEBGQ8

HOW DO YOU GET INTO CSI, THE CRIME LAB, OR THE MORGUE?

This guest post is by Kelly Elkins, PhD, a forensic scientist and author of Forensic DNA Biology: A Laboratory Manual.

Students ask me this all the time.

CSI 4I guess this makes sense. I am a college professor. I teach at one of the places that has a strong track record in forensic science education, research and post-graduate employment.

You might think there is an easy answer. But actually, the answer is complicated. The “forensic sciences” encompass many diverse specialties. Many require specialized training. So the real question for students is: what do you want to do?

Do you want to investigate crime scenes and collect evidence? Do you want to work in the lab? Do you want to analyze DNA evidence or fingerprints or firearms?

DNA 2You may be surprised to learn that all of these positions now require a solid education in a natural or physical science, like chemistry or biology or forensic chemistry or forensic biology. The Forensic Education Programs Accreditation Committee (FEPAC) has put their stamp of approval on some forensic science programs that meet their requirements.

Don’t worry if you don’t live in the U.S. There are accredited programs in Canada too and other programs world-wide. Most of the FEPAC-accredited programs are housed in Chemistry or Biology departments so you’ll learn the science with the rest of their majors. You will take specialized forensic science courses that will prepare you to work in the crime lab. For example, to work in the DNA Unit, your transcript must list biochemistry, molecular biology, genetics and statistics, among other courses.

Crime SceneBack to the crime scene. You just want to investigate crime scenes and send the evidence back to the lab? Great. You still need to know how the lab works and the analyses they perform so you don’t send them the kitchen sink if you don’t need to. So enroll in a FEPAC-accredited program just like your friends that aspire to work in the lab, and major in (forensic) biology or chemistry with them.

I always tell students I won’t place you in an internship in a coroner’s office or with a medical examiner if they don’t want to work with dead bodies.

CSI 7But, if you think this is something you’d like to do, try it out. If that’s where you are dying to work, you should major in (forensic) biology. Minor in chemistry. Or minor in criminalistics. Or even death investigation, if that’s an option. Take courses in anatomy and physiology, biochemistry, toxicology, and crime scene investigation. Apply for jobs as a death investigator or pathology assistant. These will all serve you well in your choice. If you later decide you want to perform the autopsies as the pathologist, you have the prerequisite education to continue further.

Do you want to be a coroner?

Dead Body 5You may need to run for office. In many states, you have to select a party affiliation and become (gasp) a politician. But don’t worry, the dead don’t care which you choose. You also need only a high school diploma or GED in many states. Of course, most of the people interested in the position have significant prior experience in law enforcement or forensic science. You just need to be willing to run the office, hire awesome staff to help you, make ethical judgments and make everyone in your city or county happy.

Do you want to be a pathologist?

PathologistThis is a not for the faint at heart. For this, you first need to take the MCAT. This requires you to lay out some cash and time to study for and take the test. After that, you can apply to medical school. For this, you need more cash and more time. Once you get in (that’s it, right ?!?), you need to study medicine for four years including specialized coursework and clinical rotations in all specialties, including working with living people. Finally, you graduate. Take your boards. Complete your residency.

That’s it, right?

Almost. You must now do a pathology fellowship. After toiling for more than a decade, you may now apply for positions as a pathologist or medical examiner.

Whatever you choose, Good luck!

Kelly ElkinsKelly Elkins, PhD, recently became assistant professor of chemistry in the chemistry department and professional Masters of Forensic Science program at Towson University in Towson, Maryland. Prior to that she was Director of Forensic Science and assistant professor of chemistry at Metropolitan State University of Denver in Denver, Colorado where she oversaw the FEPAC-accredited forensic science program, and internships and undergraduate research program in criminalistics. Her areas of research include low template or trace DNA recovery and quantitation and chemical forensics. Her research has been published in journals including the Journal of Forensic Sciences, Journal of Chemical Education, and Biochemistry and Molecular Biology Education.

Forensic DNA BiologyKelly is also the author of Forensic DNA Biology: A Laboratory Manual, which was recently published by Elsevier Academic Press and is available on Amazon at http://www.amazon.com/Forensic-DNA-Biology-Laboratory-Manual/dp/0123945852/ref=sr_1_1?s=books&ie=UTF8&qid=1375391454&sr=1-1&keywords=forensic+dna+biology . She may be reached at kmelkins@towson.edu.