HJAR Nov/Dec 2021

DIALOGUE 10 NOV / DEC 2021 I  HEALTHCARE JOURNAL OF ARKANSAS   Dianne Hartley, Editor What is forensic pathology? Theodore “Ted” Brown, MD Forensic pathol- ogy is a field of medicine that ultimately seeks to determine the cause and manner of death, especially when deaths occur under the following circumstances: deaths due to violence, known or suspected non-natural deaths, unexpected or unexplained deaths when in apparent good health, unexpected or unexplained deaths of infants and chil- dren, deaths occurring under unusual or suspicious circumstances, death of persons in custody, deaths known or suspected to be caused by diseases constituting a threat to public health and deaths of persons not under the care of a physician. There are many (hundreds) causes of death, exam- ples of which include a myocardial infarc- tion (heart attack), cerebrovascular accident (stroke), blunt force injuries from a motor vehicle accident, or a gunshot wound. On the contrary, there are only five manner of deaths, which include natural, accident, homicide, suicide and undetermined. In order to be able to determine and opine a cause and manner of death, foren- sic pathologists work alongside other pro- fessionals to ensure a thorough medicole- gal death investigation is completed, which may include correlating facts and circum- stances related to the death, establishing or confirming the identity of an individual and completing ancillary testing such as toxi- cology studies. Given the circumstances of the death, forensic pathologists may be asked to ensure proper recovery and pres- ervation of evidence and testify in court on their findings. Editor What does one study to become a forensic pathologist? Brown I advise students who want to pur- sue a career as a forensic pathologist to not feel obligated to choose the, perhaps, more obvious major in college, such as biology or chemistry. Rather, I advise students to choose a major in college that most excites them and challenges them to become a well- rounded person (which may very well be biology or chemistry) while ensuring that they excel in all of the classes required for medical school matriculation. After college, successful completion of four years of med- ical school is required followed by three or four years of training at a pathology resi- dency program. The last step before becom- ing a forensic pathologist is the completion of one year of training at a forensic pathol- ogy fellowship program. Editor How did you become involved in this field? Brown When I was in medical school at Indiana University School of Medicine, I was fortunate to have Joseph Prahlow, MD, who is a forensic pathologist, as my pathol- ogy professor. He introduced me to the field of forensic pathology and the oppor- tunity forensic pathologists have to serve their communities. I soon learned that in the United States, there is a critical short- age of board-certified forensic pathologists who can help lead high-quality medicolegal death investigations for our communities. The opportunity to give back to my com- munity led me to pursue a career in foren- sic pathology. During my forensic pathol- ogy fellowship training at the Miami-Dade County Medical Examiner Department, I learned from the late former Chief Medical Examiner Bruce Hyma, MD, that one of the important roles forensic pathologists have is to provide answers to families during the worst days of their lives. I remind myself daily of the impact we have on the com- munities and families we serve. Editor How does the medicolegal death investigative systemwork in the state of Arkansas? Kermit B. Channell II, director of the Arkansas State Crime Laboratory, reached out to us excited about a new hire that he thought “will make Arkansas one of the best forensic pathology programs in the country.” Kermit explained that since Arkansas’ coroners are elected officials, most are not MDs and therefore rely more heavily on the state’s crime lab for death rulings and investigations. We thought you would enjoy meeting Ted Brown, MD, as we welcome him to the Arkansas healthcare community.