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As the Bodies are Counted

A New York medical examiner on the necessary, horrifying process of identifying the dead in New Orleans.

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A few months after becoming a forensic pathologist, I noticed something strange: I no longer suffered from terrible nightmares. And the few I had (only four over the past fifteen years) were surreal rather than realistic: a country-house murder where the suspect was a woman with the head of a fox, a violently shaking bathtub filled with blood.

I suspect that what has happened is that my relationship with death—even in sleep—has changed, has become more purely symbolic. It’s a natural defense mechanism for those who see death every day. But sometimes, the walls aren’t high enough, or thick enough, and the ramparts fail. Often it’s the intensity of a particular death—a particularly violent homicide or the death of a child. But these situations are manageable; the next day brings another case, something different and more bearable.

But in disasters, there’s no moving on to something easier. Forensic pathologists define a disaster as an event that produces so many bodies that your morgue can’t hold them all. Like many New Yorkers, for me, the scenes in New Orleans have tremendous resonance—the images of people fleeing, bodies being recovered. The last major disaster we faced here was, of course, 9/11, an experience that was more damaging than anything I’d ever had before. When it was finished, I thought I’d gotten through it okay, but a year and a half later I realized that I was pretty messed up. And that is what the responders in New Orleans should know in advance: that this recovery process will likely be even more demanding, making it all the more crucial to plan for the psychological aftermath.

The first challenge will be the sheer chaos of the situation: In the face of such horror, reliable facts are hard to come by—from the truth about the violence to the actual number of fatalities. But whatever the final body count, accurate identification will be the priority, not just because it provides desperately needed information—families need to know that a loved one is dead, rather than being taunted by other possibilities—but because declaring someone dead is the first step in the bureaucratic resolution of that life, from filing for insurance to settling the estate. And by foiling the fraud attempts that ride on the back of a disaster like ticks on a dog, identification helps the state too.

At present, it seems likely that much of the forensic work will be done by DMORT, federal disaster mortuary teams drawn from a national roster of veteran pathologists, dentists, anthropologists, and funeral directors. Recoverers and analysts alike will face grueling hours in unimaginable conditions—sweltering heat and humidity, the stench of putrefaction and toxic water.

Although the bodies are intact in New Orleans, they will be in a terrible state. They’ve been more than a week in the heat, and many will be recovered from water contaminated with gasoline, which acts like a solvent, stripping away the outer layers of skin. Almost none will be visually identifiable. The forensic teams will describe, photograph, and retain clothing and jewelry, make note of identifiable features like tattoos and birthmarks, take fingerprints and X-rays, look out for medical devices—like pacemakers and breast implants—that are likely to have a serial number, and take DNA samples. At this stage, it might be difficult to get blood, so bone or muscle tissue will probably be used.

What has made the aftermath of Katrina particularly horrifying has been the visibility of death in the city—the bloated corpse floating under an overpass on the front page of the Times, the interviewees at the Superdome gesturing to wrapped bodies lying near them. Watching CNN, I was reminded of Cicero’s description of Etruscan pirates torturing prisoners by chaining them face-to-face with rotting cadavers. And as the foul floodwaters are pumped back into Lake Pontchartrain, it’s only going to get worse.

Many forensic pathologists were just in New Orleans in February, for their annual meeting, back when the city was still a cheery blur of crawfish and Mardi Gras beads. I worry about my colleagues in the warehouse morgue. But I worry more about everyone else, who spent a week living with the dead. More than a thousand miles away from the heat and the smell, the misery and the destruction, I know what a hard time I’m having with it, even with the practiced distance of my profession. I don’t know how they’ll manage.


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