symptoms of compassion fatigue

Cop Life – Compassion for Death

Cop Life PodcastCompassion v. Security. Police officers have the unique job of showing compassion to family and friends at the scene of a death while maintaining good scene security.  This can be a slippery slope if not approached correctly.  So what is your number one goal; compassion or security – and can you be successful in both?  In today’s “anti-police” environment, compassion is critical if you want to prevent or mend, bad community relations. But can this go to far?

What is Compassion ? 

Compassion is not a singular thing. Rather it is composed of five mental and emotional states.

  • Respect and Caring – these are mental and emotional attitudes associated with commitment, responsibility, and reverence towards others.
  • Empathy – is a deep understanding of the emotional state of another. It is what enables an officer to connect with others, which can lead to compassionate feelings.
  • Selfless and Unconditional – this is placing others’ before your own needs; this mental and emotional state does not expect reciprocity or equal exchange. It is giving unselflessly.
  • Committed Action – for compassion to exist, it must be characterized by a helping action, a willingness to act on the mental and emotional state.
  • Benefitting Others – this is action given without any thought of gain; an act to alleviate suffering and providing help without recognition.

The core of compassion is a heartfelt connection in situations where others are suffering and need help and the taking of action to provide help.

Why Protect the Scene – Even from family 

The most important aspect of evidence collection and preservation is protecting the crime scene. This is to keep the pertinent evidence uncontaminated until it can be recorded and collected. The successful prosecution of a case can hinge on the state of the physical evidence at the time it is collected. The protection of the scene begins with the arrival of the first police officer at the scene and ends when the scene is released from police custody.

In this episode 

This and much more is the topic of the discussion I have in this episode with Crpl. Keith Farley. Keith is also the host of the popular podcast -cop life podcast. Which can be found on iTunes or at the web site 

Cop Life Podcast




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Questionable convictions in “shaken baby” cases

Shaken BabyThe term “shaken baby syndrome” (SBS) was developed to explain those instances in which severe intracranial trauma occurred in the absence of signs of external head trauma. SBS is the severe intentional application of violent force (shaking) in one or more episodes, resulting in intracranial injuries to the child. Physical abuse of children by shaking usually is not an isolated event. Many shaken infants show evidence of previous trauma.

Frequently, the shaking has been preceded by other types of abuse.

Mechanism of Injury

The mechanism of injury in SBS is thought to result from a combination of physical factors, including the proportionately large cranial size of infants, the laxity of their neck muscles, and the vulnerability of their intracranial bridging veins, which is due to the fact that the subarachnoid space (the space between the arachnoid membrane and the pia mater, which are the inner two of the three membranes that cover the brain) are somewhat larger in infants. However, the primary factor is the proportionately large size of the adult relative to the child. Shaking by admitted assailants has produced remarkably similar injury patterns:

  • The infant is held by the chest, facing the assailant, and is shaken violently back and forth.
  • The shaking causes the infant’s head to whip forward and backward from the chest to the back.
  • The infant’s chest is compressed, and the arms and legs move about with a whiplash action.
  • At the completion of the assault, the infant may be limp and either not breathing or breathing shallowly.
  • During the assault, the infant’s head may strike a solid object.
  • After the shaking, the infant may be dropped, thrown, or slammed onto a solid surface.
  • The last two events likely explain the many cases of blunt injury, including skull fractures, found in shaken infants. However, although blunt injury may be seen at autopsy in shaken infants, research data suggest that shaking in and of itself is often sufficient to cause serious intracranial injury or death.



Questionable convictions in “shaken baby” cases?

Deborah Tuerkheimer is a Professor of Law at Northwestern University and the author of “Flawed Convictions: ‘Shaken Baby Syndrome’ and the Inertia of Injustice.” She also appears onSaturday’s “48 Hours” investigation into the case of Melissa Calusinski, a former day care provider who says she is wrongfully convicted in a toddler’s death. Here, Tuerkheimer weighs in on questionable convictions in child death cases. Her opinions do not necessarily reflect those of CBS News.

A few months ago, a 55-year-old Florida day care provider became yet another caregiver accused of shaking a toddler to death. The woman, who had worked with children for decades, denied harming the boy. But pediatricians concluded that this was a case of Shaken Baby Syndrome (SBS).

Even before an autopsy was performed, the state charged the woman with murder. She is being held in jail without bond and if convicted, she faces mandatory life in prison without the possibility of parole.

Based on the press reports, this case resembles many that I have written about in my book, Flawed Convictions: “Shaken Baby Syndrome” and the Inertia of Injustice. Without witnesses or external signs of abuse, the classic diagnosis of Shaken Baby Syndrome rests on three neurological symptoms, otherwise known as the “triad”: bleeding beneath the outermost layer of the brain, retinal bleeding, and brain swelling.

These symptoms are said to prove that a baby was violently shaken and, what’s more, to identify the abuser– whoever was present when the child was last lucid. Shaken Baby Syndrome is, in essence, a medical diagnosis of murder. In order to convict, prosecutors must rely entirely on the claims of science.

But the science has shifted. In recent years, there has been a growing consensus among experts that the neurological symptoms once viewed as conclusive evidence of abuse may well have natural causes, and that old brain injuries can re-bleed upon little or no impact.

In short, current science raises significant questions about the guilt of many caregivers convicted of shaking babies.

Reflecting real movement in the direction of doubt, this past spring, a federal judge in Chicago issued a ruling of “actual innocence” in the case of Jennifer Del Prete, a caregiver accused of shaking a baby in her care. (My book describes this trial in detail.) Del Prete was able to show that, based on what doctors now know about alternative causes of the triad, no reasonable jury could possibly find Del Prete guilty of murder. Indeed, according to the reviewing judge, a lack of evidentiary support for the theory of Shaken Baby Syndrome means that the diagnosis is arguably “more an article of faith than a proposition of science.”

Our legal system has been slow to absorb this new reality. As a consequence, innocent parents and caregivers remain incarcerated and, perhaps more inexplicably, prosecutions based solely on the “triad” symptoms continue even to this day. The cautionary tale of Shaken Baby Syndrome shows that our system is too inclined to stay the course, and awful injustices can result.

Workplace Bullying



Workplace Bullying is repeated, health-harming mistreatment of one or more persons (the targets) by one or more perpetrators. It is abusive conduct that is :

This definition was used in the 2014 WBI U.S. Workplace Bullying Survey. Its national prevalence was assessed. Read the Survey results.

Workplace Bullying…

  • Is driven by perpetrators’ need to control the targeted individual(s).
  • Is initiated by bullies who choose their targets, timing, location, and methods.
  • Is a set of acts of commission (doing things to others) or omission (withholding resources from others)
  • Requires consequences for the targeted individual
  • Escalates to involve others who side with the bully, either voluntarily or through coercion.
  • Undermines legitimate business interests when bullies’ personal agendas take precedence over work itself.
  • Is akin to domestic violence at work, where the abuser is on the payroll.

Please know two things:

Bullying is a systematic campaign of interpersonal destruction that jeopardizes your health, your career, the job you once loved. Bullying is a non-physical, non-homicidal form of violence and, because it is violence and abusive, emotional harm frequently results. You may not be the first person to have noticed that you were bullied. Check to see how many of these indicators match yours.

Remember, you did not cause bullying to happen. We’ve broken down the major reasons why bullies bully. The primary reason bullying occurs so frequently in workplaces is that bullying is not yet illegal. Bullying is four times more common than either sexual harassment or racial discrimination on the job.

Should you confront the bully? If you could have, you would have. Instead, use the WBI-suggested 3-Step Method. Remember, put your health first. Don’t believe the lies told about you. Spend time with loved ones and friends. At times of debilitating stress like this, you must not be isolated. Isolation will only make the stress worse.

As we said, to date, no U.S. state has passed an anti-bullying law for the workplace.

* This article is a re-print if excerpts from  Workplace Bullying Institute   To read full article and see many more resources click over to there site.Anita Brook-corner talk-secondary stress

Todays guest is Anita Brooks  of 


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Professionalism – Respect is Earned Not Granted

What's the problem?!If you want to be seen as a professional, you must present a professional image and attitude that will command respect.   You WILL NOT get the respect you need simply by your title. Respect is earned not granted.    There has been a long history of perceived and actual unprofessionalism in the Coroner industry. This has spilled over into Medical Examiners office and police agencies as well.  But by and large many coroners struggle with being accepted as a professional.   Is it industry bias, or a reality of the image the coroner is projecting?

Five Areas You Must Address

1. Need for written policy

  •     All staff from top down
  •     Procedures for all to follow
  •        Victim families
  •        Property
  •        Report dealines 

2. Attitude of cooperation

  •    With co-workers
  •    Other Agencies    Stop power pulls
  •    Interactions with families        

3. Office Organization

  •   Office area appearance
  •   Filing
  •    Reporting
  •    Returning messages   Voice and Email

4. Dress code standards

  •    At office / morgue
  •    On scenes
  •            Proper Dress    Proper Id on clothing
  •     On duty and in public
  •             This includes automobiles
  •                   Is it marked
  •                   Even Magnetic logos
  •                   What type of vehicle

5. Training    

  •       How trained are you    
  •      Can you talk and understand the field
  •      Your responsibility  to get it
  •               This podcast
  •               Reading
  •               Courses     local Sheriff Office
  •               ABMDI
  •               Use your ME

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Training and courses designed by and for the death investigation community.

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Secondary Traumatic Stress – Getting Through What You Can’t Get Over

Anita Brook-corner talk-secondary stressSecondary Traumatic Stress (STS), also known as Compassion Fatigue , is a condition characterized by a gradual lessening of compassion over time. It is common among individuals that work directly with trauma victims such as coroners, police, nurses, psychologists, and first responders.  Sufferers can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, sleeplessness or nightmares, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self-doubt. This self-doubt can cause problems at work and home, and over time will effect all relationships.

Several personal attributes place a person at risk for developing compassion fatigue. Persons who are overly conscientious, perfectionists, and self-giving are more likely to suffer from secondary traumatic stress. Those who have low levels of social support or high levels of stress in personal life or job are also more likely to develop STS. In addition, previous histories of trauma that led to negative coping skills, such as bottling up or avoiding emotions, increase the risk for developing STS.

Many organizational attributes in the fields where STS is most common, such as the healthcare field and death investigators, contribute to compassion fatigue among the workers. For example, a “culture of silence” where stressful events such as deaths in an intensive-care unit are not discussed after the event is linked to compassion fatigue. Lack of awareness of symptoms and poor training in the risks associated with high-stress jobs can also contribute to high rates of STS.

There are no known clinical treatment options for compassion trauma, but there are a number of recommended preventative measures

Personal self-care

Stress reduction practices have been shown to be effective in preventing and treating STS. Taking a break from work, participating in breathing exercises, exercising, and other recreational activities all help reduce the stress associated with STS. In addition, establishing clear, professional boundaries and accepting the fact that successful outcomes are not always achievable can limit the effects of STS.

Social self-care

Social support can help practitioners maintain a balance in their worldview. Maintaining a diverse network of social support, from colleagues to pets, promotes a positive psychological state and can protect against STS.



Screen Shot 2014-07-18 at 7.49.33Many thanks to  Anita Agers-Brooks  for her contribution  to our community and her research on this topic.  You can find more about Anita from the link in her name.  Her knew book can be found on Amazon.  





Trophy Kill

This first hand true account of one of the most horrific  murders in Canadian history gives us an insight rarely gained into the mind of a murderer  and the forensics and documentation that goes into the prosecution of a murder of this caliber.  Dan Zupanksy was a prime witness in this case because of his relationship and correspondence  with the killer.  In this conversation we talk about the details of the murder and how it was prosecuted.   Below you will see actual drawings the suspect sent to Zupansaky during their correspondence .  This book is one of the few books that actual helps investigators understand the dynamics of a criminal investigation.  Actual court documents and testimony along with real correspondence

Dan Zupansky is a podcast producer and author living in Canada.  His podcast True Murder is  widely popular and an  iTunes classic.  Rated best show in genre.  You can find links to his show and Trophy Kill TV  below…..

Listen to the audio version or podcast for the full story.

Links and Contact for Dan Zupansky


True Murder Podcast


Actual Drawings By the Suspect Used in Prosecution



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Determining Time of Death

Garry RodgersDefining Time of Death   
There are several times of death. Let me repeat that—there are several times of death. Time of death seems to be a simple and straightforward term that obviously means the exact time that the victim drew his last breath. Unfortunately, it’s not quite that simple.

There are actually three different times of death:

  • The physiologic time of death, when the victim’s vital functions actually ceased.
  • The legal time of death, the time recorded on the death certificate.
  • The estimated time of death, the time the medical examiner estimates that death occurred.

It is important to note that the estimated time of death can vary greatly from the legal time of death and the physiologic time of death.

The only absolutely accurate determination of the time of death is the uncommon circumstance in which a person died with a physician or other skilled medical professional present. The doctor could make the determination and mark the time, and even this is assuming his watch or the clock on the wall was accurate. But that little inaccuracy aside, a death witnessed in this fashion is the only time that the three above times of death would correlate with one another.

Otherwise, it is impossible to determine the exact time of death. But what if someone witnessed the fatal blow or gunshot or what if the event was recorded on a timed surveillance camera, wouldn’t that accurately mark the time of death? The answer is a qualified yes. If the witnessed event led to immediate death, then the witness would have seen the actual death. If not, the witnessed event is simply the trauma that led to death but not the actual moment of death. People can survive massive and apparently lethal injuries for hours, even days or years.

But most deaths are not witnessed. Natural death may come during sleep, and accidental and suicidal deaths often occur when the victim is alone. In homicides, the perpetrator is typically the only witness and he rarely checks his watch, and even if he did, he’s not likely to talk about it. This means that when the medical examiner must determine the time of death he can only estimate the approximate time.

These times of death may differ by days, weeks, even months, if the body is not found until well after physiologic death has occurred. For example, if a serial killer killed a victim in July, but the body was not discovered until October, the physiologic death took place in July, but the legal death is marked as October, since that is when the corpse was discovered and the death was legally noted. The medical examiner estimated that the time of death could be July, or it could be June or August. It is only an estimate and many factors can conspire to confuse this determination. But, it is critically important for the medical examiner to be as accurate as possible.

The Importance of the Time of Death
An accurate estimation of the time of death can lead to discovering the identity of the assailant. In criminal cases, it can eliminate some suspects while focusing attention on others. For example, a husband says that he left for a business meeting at 2 P.M. and returned at 8 P.M. to find his wife dead. He says that he was home all morning and that she was alive and well when he left. If the ME determines the time of death was between 10 A.M. and noon, the husband has a great deal of explaining to do. On the other hand, if the estimation reveals that the death occurred between 4 and 6 P.M., and the husband has a reliable alibi for that time period, the investigation will move in a different direction.

Notice that in the above example the ME gave a range rather than an exact time for his estimated time of death. He didn’t say 4:30 P.M. but rather said between 4 and 6 P.M. Simply put, that’s the best he can do and that’s why it’s called the estimated time of death. It’s a best guess.

The time of death is not confined to criminal investigations; it can also come into play in civil situations. Insurance payments may depend upon whether the insured individual were alive at the time the policy went into effect or if he died before the policy expired. Even a single day can be important. Likewise, property inheritance can hinge on when the deceased actually died. Suppose two business partners die near the same time. Their contract may read that the company assets go the survivor if one of them dies. In this case, the heirs of the one that died last would own the company assets. Similarly, the dispersal of property under a will might be affected by which partner died first.

Determination of the Time of Death
Determining the time of death is both an art and a science and requires that the medical examiner use several techniques and observations to make his estimate. As a general rule, the sooner after death the body is examined, the more accurate this estimate will be.

Unfortunately, the changes that a body undergoes after death occur in widely variable ways and with unpredictable time frames. There is no single factor that will accurately indicate the time of physiological death. It is always a best guess. But when the principles are properly applied, the medical examiner can often estimate the physiologic time of death with some degree of accuracy.

To help with his estimation, the ME / Coroner utilizes various observations and tests, including:

Body temperature
Rigor mortis
Livor mortis (lividity)
Degree of putrefaction
Stomach contents
Corneal cloudiness
Vitreous potassium level
Insect activity
Scene markers

The most important and most commonly used of these are body temperature, rigor mortis, and lividity. French physician Dr. Alexandre Lacassagne (1843–1924), director of Legal Medicine in Lyon, France, wrote extensively on algor mortis (the temperature of death), rigor mortis (the stiffness of death), and livor mortis (the color of death).

Body Temperature
Normal body temperature is 98.6 degrees Fahrenheit. After death, the body loses or gains heat progressively until it equilibrates with that of the surrounding medium. Since corpse temperature can be easily and quickly obtained (see page XX), the search for a formula that uses this parameter to define the time of death has been sought for years. As early as 1839, English physician John Davey undertook the study of corpse heat loss in London, and as late as 1962, T.K. Marshall and F.E. Hoare attempted to standardize this analysis when they established a computerized mathematical formula known as the Standard Cooling Curve. In the intervening years, and even since Marshall and Hoare, many others have attempted to devise similar schemes. Unfortunately, none of these have proven to be any more accurate than the current formula for heat loss of 1.5 degree per hour.

The formula is:

Hours since death = 98.6 – corpse core temperature / 1.5

This approximate rate of heat loss continues until the environmental temperature is attained, after which it remains stable. That sounds simple enough.

Unfortunately, it’s not quite that straight forward. The 1.5-degree-per-hour factor varies, depending upon the environment surrounding the body, the size of the corpse, clothing, and other factors. For example, a body in a temperate room will lose heat much more slowly than will one in an icy, flowing stream. And a body in a hot environment, such as an enclosed garage in Phoenix, Arizona, in August, where the ambient temperature could be 125 degrees Fahrenheit or more, will gain heat. The key is that the corpse will lose or gain heat until it reaches equilibrium with its environment.

The coroner’s technician who processes the corpse at the scene takes a body temperature, and also measures the temperature of the surrounding medium—air, water, snow, or soil (if the body is buried). Ideally, the body temperature is taken either rectally or by measuring the liver temperature, which may be a more accurate reflection of the true core body temperature. This requires making a small incision in the upper right abdomen and passing the thermometer into the tissue of the liver. This should only be done by a trained individual and under the direction of the medical examiner. Care should be taken not to alter or destroy any existing wounds on the body. Some people have suggested measuring the core temperature by inserting the thermometer into a knife wound or gunshot injury to negate the need to make a new incision. This should never be done because the introduction of any foreign object may contaminate or alter the wound, which can be key evidence in the case. For practical reasons, the rectal temperature is usually taken.

The sooner after death the body is found, the more accurately time of death can be assessed by this method. Once the body reaches ambient temperature, all bets are off. But even if done correctly and soon after death, body temperature determination is subject to several sources of inaccuracy.

One assumption made in the calculations is the initial body temperature. The normal 98.6 degrees Fahrenheit is an average and varies from person to person. Some people have higher normal temperatures than others. Women tend to run higher temperatures than do men. Illnesses associated with fevers can markedly elevate the temperature of the person at the time of death, while chronic illness, dehydration, or the presence of prolonged shock may lower initial body temperature. There is also some diurnal (basically morning versus evening) variation in body temperature in most people. All this means that the calculation begins with some degree of error.

A dead body looses heat passively by three distinct mechanisms: radiation (heat lost as infrared heat rays), conduction (heat passed on to any object that contacts the body), and convection (heat lost into the moving air). The state of the corpse and the environmental conditions greatly affect the rate of heat loss.

Obesity, heavy clothing, warm still air, exposure to direct sunlight, and an enclosed environment slow heat loss. Fat and clothing make good insulators, so an obese person in a sweater will lose heat much more slowly than would a thin, unclothed corpse exposed to cold or moving air, water, or shade. Children and the elderly tend to lose heat faster, as do those who are chronically ill or emaciated. If the body is in contact with cold surfaces such as marble or cool concrete, heat loss will be greater.

There’s still one more curve ball: Several days after death, as fly maggots begin to feed on the corpse, their activity and internal metabolic processes can at times raise the temperature of the corpse. This should not be a problem for the forensic investigator, though, because once this insect activity is that far advanced body temperature is no longer of use.

As you can see, heat loss is fraught with inaccuracies. Still, with early and careful measurement of the core body temperature and consideration for the conditions surrounding the corpse, a reasonably accurate estimate can often be made.

Let’s say two people are murdered in a home in Houston, Texas, during late summer. The bodies are discovered four hours after death. One body is left in the garage where the ambient temperature is 110 degrees Fahrenheit, while the other is in the living room where air conditioning holds the temperature at 72. The corpse inside would lose heat at about 1.5 degrees per hour, so that if the medical examiner had evidence that the death had occurred four hours earlier, he would expect to find a core body temperature of approximately 92 to 93 degrees.

1.5 degrees / hour x 4 hours = 6 degrees
98.6 – 6 = 92.6

If he found a different core temperature, he would revise his estimate. But what if the victim were very old or young, thin, unclothed, or lying on a cold tile floor near an air conditioning vent? Under these circumstances, the heat loss would be more rapid. The core temperature could be 88 to 90 degrees, perhaps even less. If the medical examiner failed to consider these mitigating factors, an erroneous estimate of the time of death could result. For example, if the core temperature was 88 degrees and he failed to adjust for the environmental conditions around the body, he could estimate that approximately seven hours had elapsed since death.

98.6 – 88 = 10.6 / 1.5 = 7.1 hours

An estimate of six to eight hours is quite different from an estimate of three to five hours. The killer may have an iron clad alibi for the former time period, and easily could since he hadn’t arrived at the crime scene at that time. He could have been having lunch with twenty people. But only four hours later, he might not have such an alibi.

What of the body in the garage? The ME would expect the corpse to gain heat at the same rate of 1.5 degrees per hour. Thus, the core temperature should be approximately 104 degrees Fahrenheit, or perhaps even higher.

  Time since death: …. Changes observed

1-2 hours: ………Early signs of lividity.

2-5 hours: ………Clear signs of lividity throughout body. Fixed in 6-10 hours

5-7 hours: ………Rigor mortis begins in face.

8-12 hours: …….Rigor mortis established throughout the body, extending to arms and legs

12 hours: ……….Body has cooled to about 25°C internally.

20-24 hours: …..Body has cooled to surrounding temperature.

24 hours: ……….Rigor mortis begins to disappear from the body in  roughly the same order as it appeared.

36 hours: ……….Rigor mortis has completely disappeared.

48 hours: ……….Body discoloration shows that decomposition is beginning.

Critical Roles Managing ME & Coroner Offices

Critical Role of Managers and Administrators in a Medical Examiner/Coroner Office

Paul ParkerPaul R. Parker III, B.S., D-ABMDI


There is no greater honor than writing the last chapter of someone’s life story. As medicolegal death investigators, that is what we do and, for the most part, we do it well. With seemingly innumerable courses, electronic mailing lists, and forensic science discussion groups, there is a plethora of available information on how to investigate just about every possible death scene and circumstance. Unfortunately, there is not a major focus on the management and administration of offices and personnel in the medicolegal death investigation field. With the exception of those offices under the law enforcement umbrella, many medicolegal death investigation managers and supervisors lack basic managerial training and the “big picture” purpose and role of a Medical Examiner/Coroner (ME/C) Office is often forgotten or overlooked not only by its employees, but by its administrators. The lack of managerial training and resulting substandard managerial performance; misguided managerial focus; and managerial inaction, to include the ignoring and/or avoidance of problem issues and personnel; ultimately results in the creation and maintenance of a toxic work environment and the “big picture” becomes foggy, if not completely invisible. In this environment, “cancerous” employees infect the environment to the point that good employees either leave or lose the motivation and dedication to a job well done.

The primary focus of most medicolegal death investigation managers, administrators, and supervisors is to ensure ME/C personnel properly determine jurisdiction, document deaths reported to the office, conduct scene investigations, perform death notifications, conduct postmortem examinations, certify deaths falling under its jurisdiction, and document the investigative efforts in comprehensive and factual reports, in addition to many other ancillary functions. We are fortunate to work with many outstanding death investigators and support personnel who choose to do the most noble of jobs in an under-paid, under-appreciated, and overly-stressed work environment.

  • How much of their great work is being undermined everyday by inefficient and ineffective Division/Office management or frontline supervisors?
  • How many employees would say that their managers/supervisors care about them, effectively communicate, set expectations, hold problem employees accountable, and actually treat employees as humans, not just a name or number covering a shift?
  • How many front-line supervisors and managers lose more sleep over the performance, or lack thereof, of a problem employee than over investigating traumatic deaths and performing death notifications?
  • Do the employees care about the job they do and the office’s role and how it is perceived by the public and its customers?

Despite the existence of these issues, job satisfaction surveys of ME/C employees almost universally reveal that the employee’s actual job brings high levels of satisfaction. It is, in part, the above-listed issues that undermine true job satisfaction on par or even more so than low pay and inadequate staffing levels.

In addition to an emphasis on managerial competency, there needs to be a focus on improving interpersonal relationships among co-workers, emotional well-being in the workplace, and the importance of communication, expectations, accountability, and rewarding performance. In addition, it is critical that all death investigation employees are constantly reminded about the “big picture,” which is centered upon the interactions we have with everyone, especially families and next-of-kin, how we present ourselves to and in the public, how our reports reflect our level of competence, and how we have many customers, not just the pathologists. The painting of the “big picture” starts “at the top” of every organization and is filtered down through the managers and frontline supervisors.

An administrator/manager/supervisor must ALWAYS:


  • with the exception of what is already documented in personnel files, start with a “clean slate”
    • this is more difficult when promoted from “inside” as opposed to being brought in from outside of the agency.
  • have a willingness to immediately identify and handle performance or interpersonal issues
    • never “look the other way”
    • “back the play” of personnel without jumping to conclusions
    • “toxic” or “cancerous” employees
    • “toxic” interpersonal relationships that negatively impact the work environment
  • be able to effectively communicate, communicate, communicate
    • via various means, e.g., in person, email, etc.
      • use caution with email (keep it short)
    • clear (and documented) expectations
    • vision
    • upcoming changes and the rationale for the changes
    • “No Surprises”
      • keep employees in the loop, whenever possible, and be kept in the loop
    • be committed to continuous improvement
      • of the manager
      • of the employee
    • be consistent
    • be responsive
    • be dedicated to the mandate that everyone is accountable, all the time
    • believe in the importance of documentation
      • If it’s not documented, it did not occur
    • understand the perception that reports/documentation are a direct reflection of an employee’s competence
    • believe that the emotional well-being of medicolegal death investigation employees is paramount
      • truly care about the employee, even if the employee doesn’t want you to
        • acknowledge the difficulties of shift work
        • understand need for work/life balance
          • family emergencies, etc.
        • acknowledge birthdays, accomplishments, jobs well done, etc.
      • be available when on-duty and off-duty, when applicable
      • be willing to:
        • “roll up the sleeves” and jump in, whether that means assisting at scenes, counting medications, communicating with next-of-kin, or even covering shifts, if need be.
          • This action results in the highest levels of credibility and respect, as people trust and believe in someone who is willing to not just “talk the talk” but also “walk the walk” by coming out of the office and getting down in the trenches, so to speak.


An administrator/manager/supervisor must NEVER:


  • compromise on integrity issues, e.g., lying, falsification of reports, timecards, etc.
  • show favoritism
  • gossip
  • bully
  • violate an employee’s confidence
  • take credit for the work of others
  • act in a way that contributes to or creates a hostile work environment
  • micromanage


Additional Management Priorities


Upon hire/promotion, a new manager must hold a mandatory meeting attended by all persons reporting to the new manager. During the meeting, the new manager should provide an overview of the following:

  • manager’s background
  • manager’s core beliefs
  • plan of action (0-60 days, 61-90 days, 90+ days) to include:
    • meeting/riding with/shadowing each employee
    • assess procedures, operations, staffing and personnel allocation
    • solicit feedback (after all, the people doing the job usually know what’s working and what isn’t)
    • building relationships with all applicable parties


Management personnel must be committed to:


  • ensuring the office and its personnel are viewed as professionals, not merely “body snatchers” or a transport company
  • justifying appropriate staffing levels
  • implementing an appropriate employee selection process
    • recruit
      • to include written and emotional well-being components
    • train
      • remedial training
    • maintain
  • using an employee’s probationary period to assess the employee but also allowing the employee to assess the office and his/her role in it
    • we want to identify those folks that do not or cannot do the job during this period
    • we also want them to assess whether we have created an environment in which they’d like to work
  • fostering positive and productive relationships with:
    • Human Resources representative
    • other Department/Division head
  • implementing and maintaining:
    • current and comprehensive policies and procedures
    • training manuals/guidelines
      • new employees, e.g., field training program, etc.
      • current employees, e.g., report guidelines, feedback/review of every report, training bulletins, external training opportunities, ABMDI certification, etc.
    • providing timely performance appraisals and appropriate goal setting
      • the content of an employee’s appraisal should never be a surprise and unveiled for the first time when reviewing the appraisal
        • constant communication during the rating period is essential and fair to the employee
      • establishing a work environment that exhibits and is built upon consistent practices
      • conducting outreach efforts to law enforcement, health care providers, mortuaries, etc.
      • implementing and monitoring workplace safety programs (physical and emotional well-being)


Chief Medical Examiners, Deputy Medical Examiners, Directors, and Administrators must be proactive and establish lines of communications and continual educational opportunities for and with:


  • appointing authorities, i.e., Boards of Supervisors, State Legislators, etc.
  • other Department Heads within the same entity, i.e., State or County level
  • media representatives.
    • Yes, media representatives.
      • Who better to present positive, proactive stories about the office and its real mission and duties, as opposed to the public perceptions promulgated by the CSI Effect?
      • If outreach is conducted with the media, when a “problem” arises, allegations of misconduct are made, or if the office actually “drops the ball” on an issue, having fostered relationships with the media and your entities media liaison will “soften the blow”


Managers and employees are equally responsible for the success of employees and the office

Employers must ensure that the employee is provided the skills, knowledge, resources, guidelines, and tools to successfully perform the job; employees must ensure they are dedicated to using them with the ultimate goal of providing the best possible service in conjunction with continuous personal and professional growth. It is easy for employees to blame management for whatever ails them but it is helpful for truly dedicated employees to consider and act upon the following issues:


Each employee must place an emphasis on value, specifically how to add value in every interaction while on-duty and representing the office.

  • What is employee’s value to other office personnel?  To next-of-kin?  To law enforcement?  To hospitals?   To funeral homes?
  • How does the employee highlight, capitalize, and increase his/her value to co-workers and customers?
  • How does the employee minimize his/her personal biases and treat all customers professionally and with respect?  If s/he does not, what needs to be done to do so?

Dedication to continuous improvement

Each employee must be dedicated to this concept. Truly successful people embrace continuous improvement and are always educating/improving themselves, however possible, as opposed to maintaining the status quo.

  • What does an employee do to continually improve his/her investigative and customer interaction skills?
  • If the employee does not, when will s/he start, as there is no choice but to do so!

Dedication of office’s roles/responsibilities/mission/vision

Each team member must be dedicated to these issues.


  • Is the employee dedicated to positively impacting where the office’s direction and service?  If not, the supervisor must meet with the employee immediately!
    • Remember, not everyone is cut out to work in the medicolegal death investigation field. I am always dedicated to helping people find jobs for which they are most suited; if that’s not in the medicolegal death investigation field, so be it. We need to ensure that only people who want to positively impact the office continue to work at the office, as co-workers and the family members of the decedents will either reap the benefits of a dedicated employee or suffer the consequences of an employee who should not be in our line of work (in the case of family members, those negative consequences may last a lifetime).
  • How does the employee demonstrate dedication to the office?  To co-workers?  To law enforcement?  To next-of-kin?  To hospitals?  To funeral homes?
  • Does the employee do anything that may demonstrate s/he is not dedicated to where the office is going, what it is supposed to be doing, its mission, or its vision?


Performance competence/skills/knowledge

Each employee must display competence in his/her respective area.


  • Does the employee strive to be best the (job title) s/he can be?
  • What is s/he doing to attempt to attain that goal?
  • Is the employee flexible in thought and conduct?  Is his/her way the only correct way?


Documentation competence/skills

Each employee must be willing and able to document, in writing, what it is they do pursuant to the guidelines/instructions provided.


  • Does the Investigator document every death reported to him/her?
  • Does the Investigator document the deaths in a timely fashion?
  • Does the Investigator thoroughly document the deaths pursuant to standardized guidelines?
  • Does the documentation make sense? Does it tell a legible, coherent story? Are pertinent negatives addressed, etc.?
  • Is the documentation complete before going off-duty?
  • Are Investigative Narrative Report Performance Measures in place and, if so, does the Investigator meet those measures?


Investigative scene response

Each Investigator must appropriately triage and respond to scenes and, upon arrival, act in a professional, appropriate, and confident manner.


  • Does the Investigator respond to scenes in an expeditious, yet safe, manner?
  • Does the Investigator prioritize/triage multiple scene responses appropriately?
  • Does the Investigator “think outside of the box” when confronted with competing interests?
  • While on scene, does the Investigator conduct himself/herself in a professional manner?
  • Does the Investigator view himself/herself as the expert in medicolegal death investigation or does s/he allow others to dictate how to conduct himself/herself and/or the investigation?


Interaction with customers

Each employee must act in a compassionate, professional, competent, and appropriate manner when interacting with an office’s various customers.


  • Does the employee model professional conduct during every interaction with every customer?
  • Does the employee provide accurate information to customers?
  • How does the employee “come off” to co-workers?  To next-of-kin?  To law enforcement?  To funeral homes?
  • Does the employee sound compassionate, professional, competent, and appropriate during telephone conversations with various customers?
  • Does the employee allow biases to “bleed through” and become obvious to those with whom s/he is talking to or interacting?

Maintain a Focus on the “Big Picture”

 While it is true that ineffective management results in ME/C personnel losing sight of the “big picture,” as the focus is ultimately placed on those problem areas/personnel not being addressed but left to create the “toxic” environment in a workplace already made stressful enough by the basic responsibilities of the job, it’s possible to lose sight of the “big picture” even under the most ideal of circumstances and best management practices due to the inherent nature of the job. With a focus on professional appearance, interaction with next-of-kin, professionally authored reports and an understanding that they are obtained and read by numerous entities not just the pathologist, and emotional well-being, the “big picture” should remain clear.


 One of the most important “big picture” ME/C issues is the appearance of those employees who interact with the public (primarily the Investigators but also employees who work at the front counter, property clerks, chaplains, etc.)

  • Do they look sharp or like they just rolled out of bed?
  • Do they walk with confidence or slouched over dragging their feet?
  • Are their verbal public interactions and over the phone with all customers professional and respectful or do they come off as uncaring, inflexible, dispassionate know-it-alls (or maybe even worse, crass or vulgar)?

 My training and experience revolves around a concept called command presence, which is basically presenting oneself as a confident and competent authority that can be trusted and respected.  Physical appearance, body language, and verbal skills contribute to this command presence and people are oftentimes viewed, positively or negatively, based upon one’s overall grasp and control of those attributes.

 Investigators are the visible representation of an ME/C office and are the basis for the public’s, law enforcement’s, and hospital’s perceptions or beliefs about the office. Investigators must exude command presence, confidence, and pride when observed (and heard) in public at all times, whether that is at a scene, re-fueling a vehicle, walking into a convenience store, etc.

 We are responsible for investigating the death and subsequently taking custody of a decedent.  When you look professional, you tend to act professional, and are subsequently treated as a professional.  I’ve found that wearing professional or uniform attire appropriately, i.e., tucked in, clean, pressed/shined, etc., not only results in increasing both the level of respect shown to ME/C personnel and positive thoughts of their professionalism before saying one word to an officer or family, but it also results in ME/C personnel being more respectful to customers and the decedent.  I know it may be difficult to keep clothing in that condition after a scene call or two but that doesn’t mean personnel should begin the shift looking as if they have already been to several scenes.  Dedicated ME/C personnel must be provided the opportunity to shine in the eyes of the families, officers, hospitals, and the general public without the automatic formation of a less-than-ideal opinion of them as soon as they are seen or heard.  First impressions are very hard, if not impossible, to change.

Interaction with Next-of-Kin

 The next-of-kin and families of decedents are probably the most important ME/C customer.  ME/C personnel should be the primary contact with next-of-kin and meet with them at scenes—to obtain information tending to assist in the thorough documentation of that “last chapter” and to provide them information about “the next steps” and making them aware of the appropriate resources, grief or otherwise—or immediately call them if they were not at the scene (after they are notified, of course, but being able to effectively and compassionately interact with them if they happen to call the ME/C office “cold”).  As the “point” people and the sole external face of the Office, Investigators primarily experience this oftentimes stressful interaction.

We are not Grim Reapers swooping in to collect “a body” and then disappear back into the ether, leaving no trace of our existence.  We are professional independent medicolegal death investigators, who should be more knowledgeable in reactions to death, the grief process, and the importance of communication (as information not provided to families and unanswered questions of families will result in them filling in, on their own, with what may or may not be true).  Everyone we come into contact with should somehow be educated about the role of the ME/C office.  Whether it’s as they watch us professionally perform our legal duties or during the conversations we have with them while performing those duties, every contact matters, every time.

  • Management should strive to publicize to all personnel the positive comments received from next-of-kin. I was always amazed how many next-of-kin took time, despite all they were experiencing, to write a “Thank You” note to an Investigator or any employee who treated them (and the decedent) with compassion, dignity, and respect. To me, that spoke volumes about the level of service provided and the content of those notes were oftentimes heartfelt, touching sentiments that truly painted the “big picture” of why we do what we do.

Reports/Documentation – Direct Reflection of an Employee’s Competence and Numerous Readers

 An Investigator can be the best one in the agency but if his/her reports contain spelling errors, misused words, and grammatical errors, no one will ever know it and, worse yet, the credibility of and confidence in the medicolegal death investigation will be undermined.

Many times an Investigative report is drafted with the pathologist in mind. It is true that the pathologist will rely upon the content of the report to determine the extent of the examination and to focus it accordingly. There are, however, numerous other customers who will obtain, read, and rely upon the report to include, but not limited, to the following:


  • Toxicologists
  • Forensic anthropologists, odontologists, neuropathologists, and other forensic specialists
  • Fellow investigators and other ME/C personnel when fielding calls from next-of-kin, etc.
  • Next-of-kin (who will read it often and pass it on from one generation to the next)
  • Law enforcement
  • Prosecutors
  • Defense attorneys
  • Insurance companies
  • Health care providers
  • Medical facilities
  • Fatality review committees/teams
  • Media outlet
  • Managers must ensure there are documented expectations for report content and that reports are reviewed and feedback provided.

Emotional Well-Being

 There are only a handful of people operating under the same laws and circumstances as medicolegal death investigation personnel, and therefore, only a handful of people who can even begin to relate to this job’s stressors.  In all probability, significant others, spouses, parents, children, and friends cannot begin to comprehend what it is we do, see, hear, smell, and experience every day. Think about it…if a normal person happens to come upon just one suicidal shotgun wound to head once in their lives, they would probably be traumatized, need counseling, and never forget the image.  I would bet each of you can’t even remember how many of these you’ve seen and dealt with.  Dead infants and children…forget it.  Yet, we deal with these situations on an all too regular basis.

In addition, it’s not one thing just to see a dead body, but we are the only ones who have regular personal interaction with grieving, traumatized, and devastated families and friends.  I guess it’s possible to have some kind of detachment or desensitization when just looking at a dead body or just talking to the loved ones over the phone days after the death, but when having to also personally interact (sometimes within minutes of the death or immediately after being notified of the death) with those folks who had strong feelings (one way or the other) about the decedent, the ability to distance ourselves from their pain and grief becomes nothing less than impossible.  On top of all that, we are left to cope (or at least attempt to cope) with the pain and grief that “normal” people experience in their lives in addition to the depression, grief, and pain that comes along with the inappropriate coping mechanisms (and their consequences) many of us “learned” over time.  I learned a long time ago that what we experience will not destroy our emotional, mental, and physical well-being and ruin our family life, friendships, and social structure; how we respond to what we experience determines the extent of damage inflicted or survival attained.

Unlike our traditional first responder partners, i.e., law enforcement, fire department, EMS, many times medicolegal death investigation personnel are overlooked when it comes to debriefings and other related services.  Although we usually do not have to make split-second life-or-death decisions, we are tasked with dealing with what is arguably the most sensitive of issues—death.  For us to do our jobs someone has to die and, about half the time, those deaths are not natural or expected.  We see just about every form of death imaginable (some not even imaginable) and yet we are expected to continually perform our jobs with the same proficiency and professionalism as we did during the first days of our careers.  In addition, it is assumed that we are capable of living “normally” when outside (and even inside) of the workplace.

 Treating people like humans, and not numbers or shift coverage entities, shows employees they are actually cared about and, in turn, will help them maintain balance, well-being, and focus on providing compassionate and professional death medicolegal investigation services. Unfortunately, I have witnessed first-hand an almost “burn ‘em out, throw ‘em away, and bring in someone new” mentality. Without proper management, guidance, and nurturing, I believe medicolegal investigation personnel have an effective “shelf life” of five to seven years, depending on call volume and that may be overly generous.

  • A manager must constantly assess his/her own views and actions as it pertains to the emotional well-being of personnel.
  • Managers should model and encourage the positive responses to the incredible stress experienced in this line of work and encourage participation in debriefing events and confidential counseling sessions.



Paul R. Parker III, B.S., D-ABMDI

Parker Medicolegal Services, LLC

P.O. Box 20525

Fountain Hills, Arizona 85269


Telephone: 480-298-4981







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