A voice for the voiceless: What it’s like to practice forensic medicine

When a young girl in eastern Pennsylvania was shaken and beaten to death by her mother’s boyfriend, forensics specialist Gregory McDonald, DO, testified on her behalf during the trial.

As the chief deputy coroner of Montgomery County, Pennsylvania, Dr. McDonald says this aspect of forensic medicine—serving as a voice for the voiceless—is what he finds most rewarding. When he exited the witness stand at the young girl’s trial, her mother thanked him.

“I was very humbled by that because I knew I did my job right that day,” Dr. McDonald says.

Dr. McDonald also chairs the Philadelphia College of Osteopathic Medicine’s forensic medicine and pathology department, where he teaches osteopathic medical students how the principles of structure and function can be applied to forensic pathology. Following is an edited interview.

What is a typical day like as a chief deputy coroner?

Investigators provide a morning report of what happened the previous night. We discuss each body and the circumstances surrounding the deaths.

I do the majority of my work at the morgue, but I am also called upon to testify for the deceased in court. Occasionally, I am also called out to particularly complicated crime scenes when a pathologist is needed to answer detectives’ questions quickly.

What cases do you find to be the most challenging?

Criminal cases aren’t always black and white. As chief deputy coroner, it’s my job to determine if a death was caused by another person’s actions, not whether that person is guilty of a crime.

Complicating factors can come into play when determining the cause of death for a victim with pre-existing conditions. For example, a physical altercation may result in too much weight being applied to a victim’s chest, causing cardiac arrest that may also have been brought on by heart disease or high blood pressure. In those cases, I have to examine the evidence and determine whether the health condition or the other person’s actions played a bigger role in the death.

What are some of the challenges of teaching forensic medicine?

Students want to have all the information they need to plug into an equation. In forensic medicine, our holy grail is finding out an exact time of death, but more often than not, you can only determine a range using scientific evidence and experience. Forensic medicine isn’t an exact science.

However, I’ve taught my students that their osteopathic training is an asset in this field because they’ll have a great understanding of the anatomical and structural aspects of the body.

I once helped determine a deceased man’s identity for the police department. Based on an osteopathic examination, I was able to recognize distinctive musculoskeletal issues, including significant degeneration of the hip and joint disease, to better understand what kind of gait this man would have had. The police thought the man was someone who had a limp, and when I relayed my findings, they put two and two together.

How do you prevent burnout?

Working in this field is a constant reminder to make the most of every day. As a forensic pathologist dealing with a very sobering part of life, I work hard to separate my career from my personal life. When my kids were younger, I would stop on my way home to get them a toy just so I could go home and play with them and love them.

As a professor, I remind my students that life is precious and they should cherish every moment.