Postmortem: How Medical Examiners Explain Suspicious Deaths

by Stefan Timmermans

As elected coroners were replaced by medical examiners with scientific training, the American public became fascinated with their work. From the grisly investigations showcased on highly rated television shows like CSI to the bestselling mysteries that revolve around forensic science, medical examiners have never been so visible—or compelling. They, and they alone, solve the riddle of suspicious death and the existential questions that come with it. Why did someone die? Could it have been prevented? Should someone be held accountable? What are the implications of ruling a death a suicide, a homicide, or an accident? Can medical examiners unmask the perfect crime?

Postmortem goes deep inside the world of medical examiners to uncover the intricate web of social, legal, and moral issues in which they operate. Stefan Timmermans spent years in a medical examiner’s office following cases, interviewing examiners, and watching autopsies. While he relates fascinating cases here, he is also more broadly interested in the cultural authority and responsibilities that come with being a medical examiner. How medical examiners speak to the living on behalf of the dead is Timmermans’s subject, revealed here in the day-to-day lives of the examiners themselves. “ Postmortem is a wake-up call to forensic pathology. . . .This book should be viewed as provocative, rather than threatening, and should be a stimulus for important discussions and action by the forensic pathology community.”— Journal of the American Medical Association

Genres: Nonfiction, Death, True Crime, Medicine, Science, Medical, Sociology

384 pages, Paperback

First published January 1, 2006

About the author

Stefan Timmermans is a professor of sociology at UCLA. He is the author of an award-winning scholarly book on forensic death investigations.

Reviews

[Aishe · Rating 3 out of 5]

I started reading this book last year, put it down numerous times and then picked it back up because I thought the subject itself was worthy of my attention. The author's writing is dry, it can be really dry especially in the first few chapters. This is after all, a textbook of medical sociology. There was a lot of theory to discuss, but I found that the theory was not as thick as I'd like it, I probably would have had some other perspectives to add to the pot, but it's sociology, not anthropology. I have to mention my copy smelled suspiciously as if it had been used by someone who worked in a morgue, so that could have also distracted me. I read the case studies, and I find the research sound and valuable. I am glad to have seen it through. If you picked this up with schadenfreude as your primary motivating factor, give up, there isn't that type of detail. This book is discussing theory, practice, and application. I do feel like the discussion of the organ procurement organizations was really thorough and invaluable and for that I am glad to have read the book. Actually, if faced with this challenge again, I would skip most of the book and read about the organ procurement and the final chapter and the afterword.

[Lobstergirl · Rating 4 out of 5]

This is an excellent book that examines the profession of medical examiners from a sociological perspective. The author spent several years observing the practices and methods of one (anonymous) urban medical examiner's office close-up, standing in at autopsies and conducting many interviews with all levels of staff.

The book looks at several topics in detail: coronary artery disease; shaken baby syndrome in the "Nanny Trial"; suicide; and organ and tissue donation.

The introduction is a tad jargony if you are not a sociologist or academic, but very interesting nonetheless. The author explains the difference between medical examiners (physicians) and coroners, who do not need any medical experience, are usually elected, and conduct public inquests. Much of the book looks at differences between various professions and explains why they may be competing with each other for authority and professional recognition. For example, forensic pathologists do not have the same goals as public health officials, as seen in the cases of coronary artery disease and suicide. Pathologists (looking at dead bodies) may come in conflict with clinicians (looking at the live patient), as seen in the case of shaken baby syndrome at criminal trials. The goals of pathologists are often at odds with those of organ and tissue donation advocates; the pathologist may need to do an exceptionally thorough autopsy in the case of a suspicious death or a homicide, while the organ donor advocate may insist that a patient in need of a liver should ethically take priority over the non-existent needs of a dead body.

The endnotes and bibliography are extensive and well worth reading.

[Cynbad · Rating 1 out of 5]

I tried. I read two chapters. But seriously, I've read textbooks that were more interesting. Very very dry writing.

[Jo · Rating 2 out of 5]

If you're looking for salaciousness then this isn't the book for you. It's a dry clinical analysis of postmortems and death investigation. Interesting enough but it does drag in parts

[Marika Lenee Kerr · Rating 5 out of 5]

This is from a guy with a sociology degree that goes into the forensic labs with different medical examiners to discuss different cases. It was interesting to learn about SIDS, Homicide, and other deaths that need to be investigated. Suicides that are suspicious. Medical examiners have to follow a set of rules, and at times the government puts too many restrictions on their jurisdiction. From reading this I really think if I could start school over I would have gone this rare and strange route in the medical field. This book took me a long time to read, because it was on my shelf and then picked up again later. Not an easy read but interesting if you plan to be a medical examiner for sure.

[Robert Bogue]

It’s not a morbid curiosity (or maybe it is). One of the key aspects of suicide work is the psychological autopsy or fatality review. It’s an attempt to understand the intent of someone who died to determine whether their death was an accident – or if it was intentional. If I was going to understand the psychological autopsy, I felt I needed to understand how the overall autopsy process worked, which led me to Postmortem: How Medical Examiners Explain Suspicious Deaths.

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[Snarky Reader · Rating 3 out of 5]

I kind of skimmed this. I wasn't sure if the audience was the author's fellow sociologists, or the general public. Could be an interesting book for people curious about what happens at a medical examiner's morgue and interested in some philosophical and public policy ethical issues around ME examinations. Probably a bit too academic for light reading, though, the reason I picked it up.

[Miss Fluffykins · Rating 4 out of 5]

A detailed ethnographic. Well researched.

[Isa · Rating 4 out of 5]

read for sociol136 death dying and the afterlife timmermans is my prof fascinating stuff

[dejah_thoris · Rating 2 out of 5]

This book was more of a slog than I had anticipated. The Introduction should have made the majority of its text on the construction of authority in suspicious death investigation a separate chapter. The first chapter was also more social science theory than real-world descriptions. So, if you can skip, skim, or survive the lackluster opening, the rest of the chapters on suicide, homicide, infanticide, and organ donation have some very interesting case studies and anecdotes.

[Megan Mitchell · Rating 4 out of 5]

This was nonfiction, and clearly not written for young-adult entertainment purposes. Probably not even for adult entertainment purposes. But, the young adult wanted to read it and she did.

It was really interesting, with cases and how they were ruled and autopsied, and examples of certain things. I picked up a lot from the book, not just about autopsies but about professions and processes. Postmortem was really hard to read, with tiny font, big legal words I don't know, and some of it was talking about "forensic authority", which I have to say I do not really understand because the author clearly did not expect a middle schooler to pick it up at the public library and therefore feel the need to explain stuff in comprehendible terms.

But it was still informative and interesting. Four stars just because it was hard to understand, but if I were older, then it'd be five.

[Wren · Rating 3 out of 5]

This book is very theoretical. It's the most like Foucault's Archaeology of Knowledge (or Birth of the Clinic). It details how knowledge is created by medical examiners and how they work in the intersection of medicine, law, health and psychology. If I were a sociologist looking at public health or legal evidence, I would have adored this book.

However, I am more interested in learning about the death industry through case studies. The book would describe a case briefly and then spend the majority of the time analyzing the epistemology of the field in fairly abstract terms.

It's probably 4 stars if assessed on its own terms. I have a lot of background in theory, but it was so dense that I struggled to read more than 10 pages at a time. It just wasn't worth the time investment, since I was reading it for pleasure rather than for research.

[Laura Gurrin · Rating 3 out of 5]

A sociological examination of the construction of forensic authority, and how that authority, in turn, structures society's understanding of categories like 'suicide', or 'natural causes'. Overall a fine read, if you're looking for sociology. I wasn't, but that's okay. I don't know the breadth of the literature on medical sociology, but I imagine this book may serve as a specific addition to the whole. It's well-written and nicely documented, with a nice amount of anecdotes drawn from the author's long-term direct observation of a medical examiner's team at work.

[Sue · Rating 4 out of 5]

I was disappointed because it only detailed ONE autopsy, and not one single picture. Though well-researched and well-written, it was not what I expected. My studies included watching autopsies at the County Coroner's of the Sheriff's dept. and I can definitely agree on a certain comment Mr. Timmermans made: page 54, " . . . forensic pathologists . . . anticpate the scientific puzzle to be solved . . . frustration comes from a lack of significant findings."

[Joyce · Rating 2 out of 5]

In spite of two tries, I never got beyond the first three chapters. I expected and was okay with the amount of technical detail. However, Timmermans managed to make even suspicious deaths and their investigation boring. Also, I really could have done without his moral judgements on "death investigators" and their work.

[Matt · Rating 5 out of 5]

What can I say. I'm making a movie about a man who had two autopsies.

[Will Sin · Rating 3 out of 5]

..........

[Lauretta]

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