For many Jews, the Day of Atonement marks a time for solemn reflection. After all is said and done—sins tallied, forgiveness asked, the Book of Life sealed shut—how did they measure up? As a forensic pathologist, Judy Melinek’s concerns are a little different. “It always makes me a bit worried,” says the San Francisco physician and bestselling author of Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner. “Does this mean I’m going to have more work next week?”
Readers, be prepared: Melinek’s book teems with bodies in dumpsters, New Yorkers boiled alive and maggots doing backbends. When you’re handling 20 corpses a month, it seems, the mysteries of life and death become a little less mysterious. Here, the Israeli-born Melinek, M.D., speaks to Moment about “kosher autopsies,” what it was like to be San Francisco’s only Jewish assistant medical examiner, and why studying death ultimately affirms life.—Rachel E. Gross
Your father was a psychiatrist and a medic in the Yom Kippur War. He passed away when you were 13. Did his work influence your path into medicine?
I knew I wanted to be a doctor since I was two. I wanted to be like him. I would go to him for advice and for textbooks and for research, and we would talk about how the human body works. In elementary school, every single science fair project was something related to anatomy, if I could get away with it.
My father was also ever-present for his patients. He worked long hours; I remember him being on the phone on weekends or holidays to try to talk somebody down. I have that mission as well: to be there for my patients. And by patients I mean the families of the deceased. I give them my phone number, I make myself available when they’re grieving. I’m a total softie.
Your mother was born to Polish refugees who escaped the Holocaust, and all your family who stayed behind were killed. Did your personal connection to this tragic event influence your attitudes toward death?
I grew up knowing that my entire family on my mother’s side was decimated by the Holocaust, and that I had no extended family. All of my “aunts” and “uncles” on my mom’s side are other Holocaust survivors that became an extended family but they weren’t actually genetically related to us. I grew up knowing that there’s this gap. That there’s this thing that’s missing.
More importantly, I knew what it was like to grieve. Grief was a part of my life from youth: hearing my grandparents talk about their early lives, and of course, when my father died. I felt that it was important for me to help people find closure when they grieve, to be a part of that process.
The other thing to keep in mind is that, as medical examiners, we often see people who haven’t seen a doctor in their entire lives, because they don’t have any insurance. They might be found dead in the street instead at home or in a hospital. The people who we serve tend to be the underserved. Coming from a family of immigrants and refugees, I have a tremendous capacity to understand what people are going through when they’re under stress and when they are poor and don’t really have any resources. They’re strangers in a foreign land.
Some people who watch forensic dramas think it’s all about handling dead bodies, but much of what you do is to help communities grieve and find closure. Have you been particularly active within the Jewish community?
When I was working in San Francisco, I was the only Jewish assistant medical examiner. So any time there was a religious objection to an autopsy because of the prohibition of autopsies, I was the one assigned to talk to them on the phone and explain the laws in the state of California that pertain to it.
In general, when there is a religious objection to autopsies, even though the law says you’ve got full authority, most offices will try to work with the families and pick the path that is least invasive. Maybe we can certify this death using the medical records, or with a CT scan. Or maybe we do need an autopsy but we can do it in a respectful way so that the blood’s not draining down the table, so that we can collect the blood and put it back in a pouch with the body, which is what we do for “kosher autopsies.” In many cases when I call and explain to the family what the consequences are—that I can either not do an autopsy and there will be financial consequences, or I can a do respectful autopsy, and as a Jew myself, I know what the restrictions are and will just do the minimum we need to answer the question—then they usually go along with it.
Of course the prohibition is still there, but at the same time you have to honor the laws of a particular country. In New York, for instance, there is also a religious prohibition, but it has a severe financial penalty. Families who object on religious grounds get a death certificate that says “undetermined” and don’t end up collecting on life insurance. But you’re always going to do an autopsy if there’s any foul play, if there’s any suspicion that the person died at the hand of somebody else, because you’re trying to prevent the death of other people. In California the family cannot object. In Israel, you actually need to get the permission of the family to do an autopsy.
Many people who watch TV dramas like E.R., CSI and Law and Order have a glamorized idea of what forensic science is like. As an expert consultant for some of these shows, what would you say is the biggest misconception viewers have?
First, people assume that everything we do is a homicide and everything can be solved in 45 minutes. In reality, the overwhelming majority of typical autopsy cases are accidents or natural deaths. Homicides make up 5 to 10 percent of a forensic practice.
The television dramas also make us sound like we’re absolutist. Sometimes the science just isn’t there. I’ve had situations where I was on the stand and I testified first for the prosecution and then, a few days later, I was called on the same case and testified for the defense. What was at issue was which story was accurate, the defendant’s or the plaintiff’s. And the physical findings on the body would have been identical no matter which story was true. There are a lot of things forensic science can’t tell you—like who was lying and who wasn’t lying.
In Working Stiff, you describe the details of death with a certain bluntness—some have called it irreverence. In fact, your husband and co-author, T.J. Mitchell, is often seems appalled by the sanguine way in which you depict some of your cases. Where do you get this irreverence?
I don’t like the word irreverence. I would say it’s really matter-of-fact. And it comes from having to be honest about what the findings are when I testify before a court. I have a tremendous amount of reverence for the family and for the person who suffered and died. Sometimes when I’m being blunt and matter-of-fact, it can be perceived as irreverent, but it’s not out of disrespect for family members. It’s out of a tremendous amount of respect.
Would you say that while the book is about death, it’s also ultimately about life?
It is. A lot of people will pick up the book thinking, “I love forensic science, I love all the gory details.” Really, it’s as life-affirming as you can imagine. I know when I go to the morgue and see three or four bodies every single day, not only do I learn lessons of not taking drugs and keeping myself healthy and buckling my seatbelt, but I also learn to appreciate every single day that I can walk into that morgue. That I can go home to my family and hug my kids. I love my job.
Melinek will be presenting her book and answering questions at the Katz JCC Book Festival in Cherry Hill, New Jersey on November 9.