The Flame Broiled Doctor from Boyhood to Burnout in Medicine and Hippocrates:The Art and The Oath
Death is his job - literally - so how does his job inform his new foray into crime fiction? Many doctors will grumble at the unrealistic depictions of doctors in film and books. Doctors will grumble even more loudly at the depictions of patients and families - because that is the important part of medicine. So, does a coroner write crime fiction differently than a lay person?
• What is the actual job of a coroner?
“The core of the job is determination of cause and certifying the death.
“The cause of death is what killed you. The manner is part of the set of conventions we use to describe a death. The manner is what’s being referred to when a character on a cop show says, “the death was ruled a homicide”. That statement is screenplay silliness for two reasons. First, rulings come from judges, not Coroners or Forensic Pathologists. Second, the manner of death follows from the cause, rather than being determined independently.
“Unlike the myriad causes, there are only four manners by which a person can die: natural, accident, suicide, or homicide.
“Again, the manner follows from the cause. If somebody dies from a heart attack, that’s a natural death. If it’s a hanging, barring some very, very compelling evidence of foul play it’s a death by suicide. The old Coroner’s joke is calling a gunshot wound to the chest a natural death, because if you’re shot through the heart and lungs, naturally it will kill you.”
• Why would people want to read Coroners’ stories?
“Clearly there’s overlap between Coroner work and crime investigation. My job is quite literally the intersection between police procedural and medical procedural work.
“It’s hard to overstate how important the job of Coroner is and can be, speaking for the dead as the motto goes. Most untimely deaths are not the result of a crime, but rather workplace accidents, substance abuse, an individual’s traumatic upbringing, systemic problems in institutions, or failures by society as a whole. Obviously these stories matter to people in positions of authority and policymakers. But fictionalized, they can teach us a lot of truths about human nature and how far we still have to go. It’s a job that allows for genuine sober reflection, rather than just reacting to the daily noise of the news cycle.
“A former patient, who’s become a cherished friend since I left practice, had a daughter that died from an overdose after a long struggle with drug use. Happens every day, no question. But the young woman had been a repeat victim of sexual violence from a very early age. Worse still, she suffered years of trauma at the hands of a broken mental health care system the family desperately needed to work. We take it for granted that our institutions are the “good guys”, working only in the best interests of the sick and the vulnerable. That’s far from a guarantee, no matter what we’d like to think. Fiction is a perhaps a safer way to face these truths, because there are no real-life stakes to the story being told.
“Now that covers the interesting and important reasons to read Coroner stories, but I’d be remiss if I left out how entertaining, even funny, Coroner work can be.
“Setting aside gratuitous cartoon deaths you might find in a Quentin Tarantino film, death in and of itself isn’t entertaining. It’s death *investigation* I find entertaining. Some of the fun comes from the characters you meet – police, undertakers – that have personality quirks or morbid senses of humor you don’t find in health care settings. Sometimes it’s the loved ones of the dead who can throw you for a loop.
“And sometimes the investigation itself is full of absurdities, completely at odds with what we expect from all the highbrow detective stories we might read or see on TV. Closets full of Costco-size jars of weed. Bongs on display like sports trophies. Porn playing on a loop while you scour an apartment for medical records. You can’t make this stuff up.
“Earlier this year, I happened to attend six deaths in a row where the person had died on the toilet. To the individual families, those are tragedies. To the poor schlub Coroner – me – it’s a Saturday Night Live sketch, the absolute antithesis of the glamorous, high-tech investigations portrayed on CSI.
“Real life – or real death, I suppose – is stranger than fiction, and quite often funny as hell. These are the kinds of stories I’m now looking to tell, in short story form for the time being.”
• Thoughts on commercial success?
“You need your finger on the pulse of the audience to find fortune as a writer, and the only pulses I feel these days have stopped.”