1 00:00:08,000 --> 00:00:12,800 Speaker 1: Y'all, welcome back to pathology with doctor Pria. Let me 2 00:00:12,840 --> 00:00:18,440 Speaker 1: tell you something, doctor, it is just one of those 3 00:00:18,440 --> 00:00:23,160 Speaker 1: things every single time that I've got to go to 4 00:00:23,200 --> 00:00:28,000 Speaker 1: the Medical Examiner's office, whether it's to participate in the 5 00:00:28,000 --> 00:00:32,440 Speaker 1: autopsy process, pick up evidence, or go and just have 6 00:00:32,479 --> 00:00:35,080 Speaker 1: a conversation about what we think is going on with 7 00:00:35,120 --> 00:00:40,680 Speaker 1: an investigation. The lobby, I mean it is just awful. 8 00:00:41,280 --> 00:00:45,559 Speaker 1: It's like sterile and the walls are just barn and 9 00:00:45,640 --> 00:00:50,800 Speaker 1: maybe have a photograph of you know, something just generic. 10 00:00:51,000 --> 00:00:54,280 Speaker 1: I don't know, and you just think these poor families 11 00:00:54,280 --> 00:00:58,560 Speaker 1: that are coming there and they're already suffering with trauma, 12 00:00:59,120 --> 00:01:02,080 Speaker 1: they're scared to they don't understand what's going on. They're 13 00:01:02,080 --> 00:01:05,960 Speaker 1: trying to process the worst information that they've only been 14 00:01:05,959 --> 00:01:09,560 Speaker 1: given a very short time ago, and now it's just 15 00:01:09,680 --> 00:01:16,160 Speaker 1: this I don't know, heartbreaking process that everybody is now 16 00:01:16,200 --> 00:01:19,880 Speaker 1: involved in. So I here's what I would love to 17 00:01:19,959 --> 00:01:25,800 Speaker 1: happen today with your expertise, just talk about general family 18 00:01:25,840 --> 00:01:30,080 Speaker 1: communication and how that relates to the autopsy process. 19 00:01:31,080 --> 00:01:34,399 Speaker 2: Wow, well that's a big one, okay. And I can 20 00:01:34,440 --> 00:01:37,400 Speaker 2: only speak for myself obviously. This is our sort of 21 00:01:37,480 --> 00:01:41,360 Speaker 2: you know, off the beaten path experience, but and not 22 00:01:41,520 --> 00:01:45,679 Speaker 2: everybody's meat. You know, some people don't like interacting with families. 23 00:01:45,840 --> 00:01:50,440 Speaker 2: And you know, it's funny because the overarching impression of 24 00:01:50,480 --> 00:01:54,440 Speaker 2: medical examiners and even pathologists are that we're some sort 25 00:01:54,480 --> 00:01:57,320 Speaker 2: of like grim reaper, basement dweller, right, that all we 26 00:01:57,520 --> 00:02:00,240 Speaker 2: like to do is, you know, look at the dead. 27 00:02:00,440 --> 00:02:03,720 Speaker 2: But we are isolated and we don't interact with anybody, 28 00:02:03,720 --> 00:02:07,520 Speaker 2: which is the farthest thing from the truth. You know, 29 00:02:07,680 --> 00:02:11,959 Speaker 2: we're always talking to law enforcement, right. That goes about 30 00:02:12,000 --> 00:02:15,800 Speaker 2: saying my investigators and I are communicating all the time 31 00:02:15,840 --> 00:02:19,160 Speaker 2: about a case. But then you know, external to that, 32 00:02:19,280 --> 00:02:22,200 Speaker 2: you have to think about it. We're talking to families 33 00:02:22,280 --> 00:02:28,280 Speaker 2: to get history. We're talking to other treating physicians, doctors, nurses, anybody, neighbors, right, 34 00:02:28,360 --> 00:02:33,760 Speaker 2: like anybody that potentially knew about this, you know, individual 35 00:02:33,800 --> 00:02:37,800 Speaker 2: who's passed. And so that to me is really like 36 00:02:39,360 --> 00:02:41,600 Speaker 2: the one of the key misconceptions. You know, It's like 37 00:02:41,639 --> 00:02:45,040 Speaker 2: you go into it, everybody you know said, oh, there's 38 00:02:45,080 --> 00:02:47,320 Speaker 2: no way you're going to be a pathologist, you are 39 00:02:47,360 --> 00:02:51,000 Speaker 2: so outgoing, And I said, now, you know, I really 40 00:02:51,120 --> 00:02:53,720 Speaker 2: like doing this work. This is my calling. And then 41 00:02:54,600 --> 00:02:57,160 Speaker 2: you know, I think my other strength is being able 42 00:02:57,240 --> 00:03:01,680 Speaker 2: to like talk to people at their worst times. Like, 43 00:03:01,840 --> 00:03:04,440 Speaker 2: you know, no one goes to the medical examiner for 44 00:03:04,600 --> 00:03:08,480 Speaker 2: fun usually, right, it's always families are interacting with me 45 00:03:09,200 --> 00:03:13,359 Speaker 2: at their worst possible moment, you know. And personally, I've 46 00:03:13,360 --> 00:03:16,520 Speaker 2: been there over the last few years. My mom died 47 00:03:16,560 --> 00:03:20,120 Speaker 2: and prior to that, my dad died unexpectedly in India 48 00:03:20,200 --> 00:03:23,720 Speaker 2: while on vacation. So I have been through the personal 49 00:03:23,800 --> 00:03:29,000 Speaker 2: ringer of Okay, they don't care that I'm an emmy 50 00:03:29,040 --> 00:03:31,880 Speaker 2: in America, you know what I mean that in India, 51 00:03:32,000 --> 00:03:33,880 Speaker 2: I'm not their emmy, and I had to go through 52 00:03:33,919 --> 00:03:36,440 Speaker 2: all this rigamar role State Department. I don't even want 53 00:03:36,440 --> 00:03:38,600 Speaker 2: to get into that, but you know, I've been on 54 00:03:38,680 --> 00:03:44,280 Speaker 2: the other side, very personally. And then you know, of course, 55 00:03:44,280 --> 00:03:46,520 Speaker 2: my mother in law died not that long ago, so 56 00:03:46,800 --> 00:03:50,200 Speaker 2: again our family has been through it. So and it's 57 00:03:50,320 --> 00:03:53,040 Speaker 2: hard to be on that side, okay, And I don't 58 00:03:53,080 --> 00:03:54,720 Speaker 2: know if it's you know, I don't want to make 59 00:03:55,160 --> 00:03:58,160 Speaker 2: like one upmanship, like it's harder for me than you, 60 00:03:58,280 --> 00:04:01,880 Speaker 2: but it is. You know, doctors make the worst patience, Well, 61 00:04:01,960 --> 00:04:05,200 Speaker 2: I make the worst customer because normally I'm the one 62 00:04:05,240 --> 00:04:09,240 Speaker 2: in charge right signing the papers, you know, and when 63 00:04:09,280 --> 00:04:12,600 Speaker 2: I'm now the customer, if you will, the family where 64 00:04:12,640 --> 00:04:15,240 Speaker 2: I don't have the power but I'm heartbroken and need 65 00:04:15,320 --> 00:04:19,760 Speaker 2: things done. That's the hardest place to be in because 66 00:04:20,600 --> 00:04:22,400 Speaker 2: you see it from both sides. And I think I 67 00:04:22,480 --> 00:04:25,359 Speaker 2: try to carry that with me, like what did I 68 00:04:25,440 --> 00:04:27,320 Speaker 2: want to know? What did I you know, what answers 69 00:04:27,320 --> 00:04:29,719 Speaker 2: did I want? What did I need done to make 70 00:04:29,760 --> 00:04:33,599 Speaker 2: me feel better? You know, my daughter went to school 71 00:04:33,640 --> 00:04:37,479 Speaker 2: seeing my mom, you know, basically passing away, and how 72 00:04:37,520 --> 00:04:40,200 Speaker 2: shocking that was to her. She was much younger obviously, 73 00:04:40,760 --> 00:04:46,240 Speaker 2: and so like you know, you have to think about 74 00:04:46,600 --> 00:04:50,159 Speaker 2: you know, we are very medical, We're very procedural. We're 75 00:04:50,320 --> 00:04:54,840 Speaker 2: very calculated, right because evidence and documentation and you know. 76 00:04:55,440 --> 00:04:59,240 Speaker 2: But that's how I think we have to be in 77 00:04:59,360 --> 00:05:02,560 Speaker 2: the more right to make make sure that cases are 78 00:05:02,560 --> 00:05:06,640 Speaker 2: handled properly, step by step, thoroughly. But I think it 79 00:05:06,680 --> 00:05:09,719 Speaker 2: also helps us cope, right, Like when you emotionally remove 80 00:05:09,760 --> 00:05:16,400 Speaker 2: yourself and you know you're not connected to that individual 81 00:05:16,440 --> 00:05:20,120 Speaker 2: that you're autopsying in an emotional way, right, That's why 82 00:05:20,240 --> 00:05:22,760 Speaker 2: doctors don't treat their own family, right, It's the same thing. 83 00:05:23,240 --> 00:05:26,200 Speaker 1: Yeah, I think you definitely have to protect yourself, there's 84 00:05:26,200 --> 00:05:27,320 Speaker 1: no question, right. 85 00:05:27,480 --> 00:05:30,520 Speaker 2: But I had a very close friend pass away in 86 00:05:30,560 --> 00:05:32,839 Speaker 2: a car accident and I remember seeing her and I 87 00:05:32,880 --> 00:05:34,640 Speaker 2: had talked to her Monday, and it was a Wednesday. 88 00:05:35,839 --> 00:05:38,200 Speaker 2: We rode the Peloton bikes together and we would video 89 00:05:38,320 --> 00:05:40,960 Speaker 2: each other before we rode, and we would high five 90 00:05:41,000 --> 00:05:43,400 Speaker 2: each other throughout the ride. So two days I talked 91 00:05:43,400 --> 00:05:46,200 Speaker 2: to her and then she was dead and I remember 92 00:05:46,720 --> 00:05:49,400 Speaker 2: bursting out into tears. I had to leave the beating, 93 00:05:49,960 --> 00:05:52,560 Speaker 2: and like, her card's still in my office to this day, 94 00:05:52,560 --> 00:05:56,080 Speaker 2: her funeral card. So like, you know, obviously you can't 95 00:05:56,120 --> 00:06:01,160 Speaker 2: be removed. You know, you can't be as independent when 96 00:06:01,360 --> 00:06:05,400 Speaker 2: your emotions are in play, and I think that's easy 97 00:06:05,440 --> 00:06:08,680 Speaker 2: to forget. And that's where sometimes I think we I 98 00:06:08,720 --> 00:06:12,040 Speaker 2: don't want to say fail families, but we're not as 99 00:06:12,120 --> 00:06:17,680 Speaker 2: communicative as possible. I really do think though, like the 100 00:06:17,760 --> 00:06:20,440 Speaker 2: old office I used to work with, and multiple offices 101 00:06:20,440 --> 00:06:23,159 Speaker 2: that I've worked with, you know, throughout New England and 102 00:06:23,279 --> 00:06:28,080 Speaker 2: Vegas and whatnot, I think the front staff, like the 103 00:06:28,480 --> 00:06:32,120 Speaker 2: you know, people facing staff, the secretaries, the investigators, they 104 00:06:32,120 --> 00:06:36,600 Speaker 2: don't get enough credit because they're often the ones who 105 00:06:36,640 --> 00:06:40,760 Speaker 2: are interacting the most. What's that you know, and they 106 00:06:40,800 --> 00:06:44,200 Speaker 2: are really I remember my now you know, at my 107 00:06:44,279 --> 00:06:46,599 Speaker 2: old office. This guy has become an investigator, but he 108 00:06:46,680 --> 00:06:50,400 Speaker 2: started as a front office staff and you know, we 109 00:06:50,400 --> 00:06:52,039 Speaker 2: would listen to him and I'm like, you should have 110 00:06:52,080 --> 00:06:56,200 Speaker 2: become a therapist. You know how patient he was, how understanding. 111 00:06:56,240 --> 00:06:59,560 Speaker 2: We said, Jason, this is like a hidden talent you have, 112 00:07:00,680 --> 00:07:03,839 Speaker 2: you know, and so it is you know, really important. 113 00:07:03,880 --> 00:07:06,000 Speaker 2: And this may be my soapbox in a way of 114 00:07:06,160 --> 00:07:09,479 Speaker 2: how I operate, but you know, I often that my 115 00:07:09,520 --> 00:07:11,280 Speaker 2: secretary would say do you want me to call the family, 116 00:07:11,320 --> 00:07:13,040 Speaker 2: and I say no, I want to do it. You know. 117 00:07:13,720 --> 00:07:16,640 Speaker 2: It's not that she couldn't do it, but I think 118 00:07:16,880 --> 00:07:19,600 Speaker 2: for me, it was very important to show that I cared. 119 00:07:20,840 --> 00:07:23,679 Speaker 2: You know, I did the exam. There's no nothing lost 120 00:07:23,880 --> 00:07:26,200 Speaker 2: like the game and operator, you know where he goes 121 00:07:26,240 --> 00:07:31,080 Speaker 2: around and then things change because lost in translation. I 122 00:07:31,200 --> 00:07:33,480 Speaker 2: really wanted to say I saw these you know, saw 123 00:07:33,560 --> 00:07:35,680 Speaker 2: this with my own eyes. This is what it means. 124 00:07:36,360 --> 00:07:38,920 Speaker 2: And you know we might say, oh, he died of 125 00:07:38,960 --> 00:07:41,360 Speaker 2: a heart attack. No, I don't want to say, no 126 00:07:41,360 --> 00:07:43,040 Speaker 2: big deal, because that's what my dad died. Of you know, 127 00:07:43,440 --> 00:07:45,680 Speaker 2: but we know that it's not a homicide. We know 128 00:07:45,760 --> 00:07:47,840 Speaker 2: it's not an accident, right, it's not a drug overdose 129 00:07:47,880 --> 00:07:50,720 Speaker 2: like we you know, you know, case closed for us, 130 00:07:50,920 --> 00:07:54,600 Speaker 2: right from an investigative standpoint or for a complexity. But 131 00:07:54,760 --> 00:07:59,160 Speaker 2: to that family, that's devastating, you know, and I think 132 00:07:59,560 --> 00:08:02,440 Speaker 2: having in there, both of my parents died of natural diseases. 133 00:08:02,480 --> 00:08:05,440 Speaker 2: It wasn't anything harmful, even though my dad was abroad, 134 00:08:05,960 --> 00:08:13,480 Speaker 2: you know, so obviously they were life altering events for me. 135 00:08:14,360 --> 00:08:17,280 Speaker 2: But again, you know, from a police standpoint, they're like, yeah, 136 00:08:17,320 --> 00:08:19,600 Speaker 2: her parents died, Okay, cool, you know, like it wasn't 137 00:08:19,800 --> 00:08:25,440 Speaker 2: this huge ditch to do. So what I believe is 138 00:08:25,480 --> 00:08:28,120 Speaker 2: first and foremost is the communication. Now I have a 139 00:08:28,200 --> 00:08:31,760 Speaker 2: unique perspective where I'm now working for myself, so I 140 00:08:31,920 --> 00:08:36,760 Speaker 2: run a private autopsy service, and so I'm no longer 141 00:08:36,960 --> 00:08:39,080 Speaker 2: the road, you know, working for the State of Rhode Island, 142 00:08:39,559 --> 00:08:42,240 Speaker 2: and I'm in transition. I might be working elsewhere well 143 00:08:42,320 --> 00:08:45,520 Speaker 2: you know, I don't know where that's going, but part time, 144 00:08:45,559 --> 00:08:52,360 Speaker 2: of course. But regardless, you know, when my primary role 145 00:08:52,520 --> 00:08:56,400 Speaker 2: in this private pathology sector is that families call me. 146 00:08:57,000 --> 00:08:59,760 Speaker 2: And the whole reason this even started as part of 147 00:08:59,800 --> 00:09:04,559 Speaker 2: my practice was that during COVID I had families. I 148 00:09:04,559 --> 00:09:08,360 Speaker 2: had three different calls, three different families crying to me 149 00:09:08,400 --> 00:09:11,679 Speaker 2: on the phone that during COVID their loved ones could 150 00:09:11,679 --> 00:09:15,120 Speaker 2: not get autopsies and that no one would touch them. 151 00:09:15,320 --> 00:09:17,760 Speaker 2: And one of them was a thirty one year old 152 00:09:17,760 --> 00:09:20,880 Speaker 2: guy found on the hospital floor, you know, and I'm 153 00:09:20,960 --> 00:09:23,319 Speaker 2: just like shocked that these people aren't going to be autopsy. 154 00:09:23,440 --> 00:09:27,240 Speaker 2: They had examinations, but they didn't have the full work up, 155 00:09:27,320 --> 00:09:30,120 Speaker 2: if you will. And you know, as a parent, as 156 00:09:30,120 --> 00:09:32,920 Speaker 2: a loved one, it's you know, whether your wife is 157 00:09:32,960 --> 00:09:37,439 Speaker 2: seventy four, eighty four or your son's thirty one. Everybody 158 00:09:37,480 --> 00:09:40,320 Speaker 2: wants to know, right. So it was like, after three 159 00:09:40,360 --> 00:09:42,640 Speaker 2: separate calls of saying, no, I don't do this, I 160 00:09:42,679 --> 00:09:46,640 Speaker 2: realized these people like I'm their last hope, really, you know, 161 00:09:47,120 --> 00:09:51,280 Speaker 2: last outlet, because there's not even that many pathologists. I mean, 162 00:09:51,280 --> 00:09:53,839 Speaker 2: there's not that many forensic pathologists, but on top of that, 163 00:09:54,040 --> 00:09:57,080 Speaker 2: there's not that many forensic pathologists that do private autopsies, 164 00:09:57,600 --> 00:10:01,160 Speaker 2: and so it's really hard to find someone. And this 165 00:10:01,240 --> 00:10:04,600 Speaker 2: is in the backdrop of both you know, emmy offices 166 00:10:04,679 --> 00:10:09,240 Speaker 2: being overburdened and hospitals now really cutting back on their 167 00:10:09,320 --> 00:10:12,920 Speaker 2: autopsy service. You know, my two cents are because it's 168 00:10:13,000 --> 00:10:16,600 Speaker 2: not a financial gain, like insurances don't pay for an autopsy. 169 00:10:17,400 --> 00:10:21,320 Speaker 2: And you know, most hospital pathologists are sort of a divide, 170 00:10:21,360 --> 00:10:23,680 Speaker 2: if you will. The ones that like doing autopsies become 171 00:10:23,720 --> 00:10:27,520 Speaker 2: forensic pathologists and the ones that don't like doing autopsies 172 00:10:27,559 --> 00:10:30,200 Speaker 2: are usually hospital or laboratory based pathologists. 173 00:10:30,240 --> 00:10:33,120 Speaker 1: So but you know, that leads me to a question 174 00:10:33,200 --> 00:10:36,600 Speaker 1: because as you're talking, I have heard that there are 175 00:10:36,640 --> 00:10:41,120 Speaker 1: some insurances that won't pay if it's a suicide. That's right, 176 00:10:41,360 --> 00:10:44,600 Speaker 1: So the family's gonna need you to say it was 177 00:10:45,080 --> 00:10:47,160 Speaker 1: medical or natural or right. 178 00:10:47,320 --> 00:10:49,960 Speaker 2: Right. So it's a huge deal. Oh. I mean I 179 00:10:50,000 --> 00:10:52,719 Speaker 2: can talk hours about this because in my career I've 180 00:10:52,760 --> 00:10:55,720 Speaker 2: dealt with so much of this. You know. Part of 181 00:10:55,760 --> 00:10:57,800 Speaker 2: it is I think I look at it as what's 182 00:10:57,840 --> 00:11:00,280 Speaker 2: the first step. The first step is to just, you know, 183 00:11:00,520 --> 00:11:04,319 Speaker 2: understand where the family's coming from and this autopsy. I mean, 184 00:11:04,600 --> 00:11:07,360 Speaker 2: ninety nine point nine percent of the people have never 185 00:11:07,440 --> 00:11:10,080 Speaker 2: even I would say doctors that are my colleagues, who 186 00:11:10,120 --> 00:11:14,080 Speaker 2: are non pathologists don't know what a true autopsy is. 187 00:11:14,120 --> 00:11:16,680 Speaker 2: They may have never seen one. You know, they know 188 00:11:16,880 --> 00:11:19,439 Speaker 2: of it, that it exists, but what does it entail? 189 00:11:19,520 --> 00:11:21,440 Speaker 2: What can you know we tell from it? They have 190 00:11:21,480 --> 00:11:25,800 Speaker 2: no idea. So like you know, with that being said, 191 00:11:26,520 --> 00:11:29,559 Speaker 2: they you know, are in a state of shock. As 192 00:11:29,600 --> 00:11:31,600 Speaker 2: you said, they come to me, doctor, I need you 193 00:11:31,679 --> 00:11:34,280 Speaker 2: to do this. You know. Obviously I have to charge 194 00:11:34,320 --> 00:11:37,840 Speaker 2: them because of you know, the cost of doing it. 195 00:11:37,840 --> 00:11:39,800 Speaker 2: I don't have a I usually do it out of 196 00:11:39,800 --> 00:11:41,760 Speaker 2: a funeral home. I don't have a set up myself, 197 00:11:42,400 --> 00:11:44,079 Speaker 2: and I have to have help, so you know, there's 198 00:11:44,120 --> 00:11:47,080 Speaker 2: an overhead cost and what an uncomfortable time to talk 199 00:11:47,080 --> 00:11:51,000 Speaker 2: about money, right, But you know, after that sorted out, 200 00:11:51,080 --> 00:11:54,160 Speaker 2: one of the basic questions is can I have a 201 00:11:54,200 --> 00:11:58,480 Speaker 2: funeral for my loved one? You know? And I go 202 00:11:58,600 --> 00:12:01,240 Speaker 2: through this and say, you know, we the utmost care 203 00:12:02,000 --> 00:12:06,280 Speaker 2: that whether it's going to be an open casket or 204 00:12:07,800 --> 00:12:10,680 Speaker 2: you know, cremation, I still treat the body the same way. 205 00:12:10,720 --> 00:12:15,359 Speaker 2: And an autopsy and an you know, intact non decomposed 206 00:12:15,400 --> 00:12:20,240 Speaker 2: body does not prevent an open casket funeral. You know. 207 00:12:20,760 --> 00:12:22,880 Speaker 2: The you know, they we do it in a way 208 00:12:22,920 --> 00:12:25,880 Speaker 2: that the funeral directors can embomb the body, they can 209 00:12:25,960 --> 00:12:29,160 Speaker 2: dress it up. They have you know, full suits under 210 00:12:29,280 --> 00:12:32,160 Speaker 2: the like sort of plastic I don't know, like almost 211 00:12:32,160 --> 00:12:36,160 Speaker 2: like a partial partial like TIEVEK type suit where they 212 00:12:36,280 --> 00:12:39,520 Speaker 2: you know, zip up the body, everything's contained and then 213 00:12:39,559 --> 00:12:42,679 Speaker 2: they're you know, beautifully dressed in their final clothes. And 214 00:12:42,720 --> 00:12:47,480 Speaker 2: there's nothing that interferes with that because I want to 215 00:12:47,640 --> 00:12:50,439 Speaker 2: gather this information and give them closure. But obviously I 216 00:12:50,480 --> 00:12:56,080 Speaker 2: would never want to hinder the final you know, respects 217 00:12:56,120 --> 00:12:59,600 Speaker 2: of that person, right, I would never want to alter 218 00:12:59,800 --> 00:13:03,120 Speaker 2: their funeral, you know, So in any case, like that's 219 00:13:03,120 --> 00:13:06,400 Speaker 2: probably probably one of the biggest questions that I get, 220 00:13:06,920 --> 00:13:09,040 Speaker 2: you know, and then there's like what can you tell me? 221 00:13:09,080 --> 00:13:13,560 Speaker 2: And and really, you know, unfortunately what is oftentimes what 222 00:13:13,679 --> 00:13:16,480 Speaker 2: they want is not possible. I mean I spend a 223 00:13:16,480 --> 00:13:19,640 Speaker 2: lot of time, what I would say, counseling families that 224 00:13:19,960 --> 00:13:21,800 Speaker 2: I'm not here to take your money. I'm here for 225 00:13:21,880 --> 00:13:24,960 Speaker 2: to ride a service if it's useful. So I spend 226 00:13:24,960 --> 00:13:27,200 Speaker 2: a lot of time counseling them about like what's the 227 00:13:27,360 --> 00:13:30,439 Speaker 2: question you want to answer? What are you looking for 228 00:13:30,480 --> 00:13:32,720 Speaker 2: me to help you with? Because I am doing a 229 00:13:32,800 --> 00:13:36,559 Speaker 2: medical procedure, you know, and we can get into that, 230 00:13:36,640 --> 00:13:38,679 Speaker 2: we will get into the difference. But you know, they 231 00:13:38,760 --> 00:13:42,080 Speaker 2: grant me permission, but they don't really know exactly what 232 00:13:42,160 --> 00:13:45,800 Speaker 2: I'm doing, you know, and so you need to understand 233 00:13:45,800 --> 00:13:49,360 Speaker 2: the limitations of that as well. Sometimes it's a very 234 00:13:49,440 --> 00:13:52,160 Speaker 2: valid question and I'm like, yes, let's do this, And 235 00:13:52,240 --> 00:13:56,240 Speaker 2: those are the most satisfying autopsies. Like I'm a pretty 236 00:13:56,280 --> 00:14:00,440 Speaker 2: strict like screener, if you will, and believe or not, 237 00:14:00,720 --> 00:14:03,640 Speaker 2: I'm the one that talks to families. I don't have 238 00:14:03,679 --> 00:14:07,760 Speaker 2: a secretary, I don't have anybody doing the filtering, you know, 239 00:14:07,960 --> 00:14:10,599 Speaker 2: I'm the one that has because I think, you know, 240 00:14:10,760 --> 00:14:13,240 Speaker 2: even if someone takes the initial call, these kind of 241 00:14:13,280 --> 00:14:17,720 Speaker 2: difficult medical conversations, the nuances are really something that I 242 00:14:17,880 --> 00:14:20,800 Speaker 2: need to explain to the family and have that difficult 243 00:14:20,840 --> 00:14:25,040 Speaker 2: conversation because is this even the right way to proceed, 244 00:14:25,600 --> 00:14:28,600 Speaker 2: you know. And I've told families, hey, it's better for 245 00:14:28,680 --> 00:14:31,560 Speaker 2: you to wait on the initial autopsy and then have 246 00:14:31,760 --> 00:14:35,560 Speaker 2: me look at the report as an expert pathologist later. 247 00:14:35,720 --> 00:14:38,760 Speaker 2: You know, maybe I can't do a second autopsy because 248 00:14:38,760 --> 00:14:40,640 Speaker 2: it's not going to add anything, but you need to 249 00:14:40,680 --> 00:14:42,840 Speaker 2: wait for the results for the medical examiner and then 250 00:14:42,880 --> 00:14:46,440 Speaker 2: we can look at it. Because oftentimes litigation, you know, 251 00:14:46,600 --> 00:14:49,360 Speaker 2: or other questions. I mean a lady had hired me 252 00:14:49,520 --> 00:14:51,920 Speaker 2: just to even sit down with her on another you know, 253 00:14:52,040 --> 00:14:54,560 Speaker 2: offices autopsy, to go through it with her husband and 254 00:14:54,600 --> 00:14:58,880 Speaker 2: her you know, mentally challenged son because he was very 255 00:14:58,920 --> 00:15:02,520 Speaker 2: distraught by not understanding what the autops he meant. And 256 00:15:02,520 --> 00:15:05,480 Speaker 2: I could provide just interpretation closure to them. So I 257 00:15:05,520 --> 00:15:08,600 Speaker 2: sat at their dining room, you know, going over it 258 00:15:08,640 --> 00:15:10,640 Speaker 2: with them, just because I was like, why didn't the 259 00:15:10,680 --> 00:15:14,240 Speaker 2: doctor talk to you? They should have done this for you. 260 00:15:14,240 --> 00:15:18,080 Speaker 2: You know that that's how you get closure. Handing them 261 00:15:18,120 --> 00:15:22,200 Speaker 2: a medical report doesn't tell the layperson what happened? What 262 00:15:22,320 --> 00:15:26,560 Speaker 2: is all this jargon? Meat? 263 00:15:28,440 --> 00:15:30,200 Speaker 1: Well, you know, you and I have talked about that. 264 00:15:30,400 --> 00:15:34,880 Speaker 1: I've got two sisters that are trauma nurses. They know terminology. 265 00:15:35,040 --> 00:15:39,960 Speaker 1: I don't know. And usually if there's a medical issue 266 00:15:39,960 --> 00:15:43,960 Speaker 1: within the family or friendship circle, they are ahead of 267 00:15:44,000 --> 00:15:48,920 Speaker 1: me like six or seven steps, where I'm like, Okay, 268 00:15:49,320 --> 00:15:50,920 Speaker 1: what are we going to do? How can we help 269 00:15:50,960 --> 00:15:53,880 Speaker 1: them get better? They may already know they're not going 270 00:15:53,960 --> 00:15:56,120 Speaker 1: to get better. I'm not there yet. 271 00:15:56,360 --> 00:15:59,280 Speaker 2: Right, they're fund of knowledge or they're bad and experience 272 00:15:59,360 --> 00:15:59,880 Speaker 2: is different. 273 00:16:00,120 --> 00:16:02,880 Speaker 1: Right, So when you took the time to sit down 274 00:16:02,920 --> 00:16:07,080 Speaker 1: with that family. That's that's more than communication. That to 275 00:16:07,120 --> 00:16:11,400 Speaker 1: me is so critical just as a human you're giving 276 00:16:11,400 --> 00:16:14,840 Speaker 1: them a gift to so that they can't accept it. 277 00:16:15,720 --> 00:16:18,760 Speaker 2: Yes, and you know, it was very I don't want 278 00:16:18,760 --> 00:16:22,000 Speaker 2: to say strange, but it is very personal to be 279 00:16:22,080 --> 00:16:24,840 Speaker 2: in someone's home, right, Like if you think about it, 280 00:16:24,880 --> 00:16:27,880 Speaker 2: and I actually say that as someone who did crime 281 00:16:27,920 --> 00:16:30,320 Speaker 2: scene work, like you know, as any I used to 282 00:16:30,360 --> 00:16:32,480 Speaker 2: go to scenes when it was suspicious and I was 283 00:16:32,480 --> 00:16:37,920 Speaker 2: on call, and I found those personal effects personal you know, 284 00:16:38,040 --> 00:16:41,240 Speaker 2: scenarios where it was in their house to be the 285 00:16:41,240 --> 00:16:47,280 Speaker 2: most different, emotionally challenging, difficult to handle scenes because you're 286 00:16:47,280 --> 00:16:51,720 Speaker 2: in their lives right and you know, being in this 287 00:16:51,840 --> 00:16:55,320 Speaker 2: family's dining room where they used to have dinner every night, 288 00:16:56,360 --> 00:17:01,080 Speaker 2: you know, family photos, et cetera. That really like I 289 00:17:01,120 --> 00:17:02,640 Speaker 2: you know, I guess I was like, oh, it's an 290 00:17:02,680 --> 00:17:04,720 Speaker 2: hour on my life, you know day. Why didn't the 291 00:17:04,720 --> 00:17:06,480 Speaker 2: other emmy sit with them? But I was like, you 292 00:17:06,520 --> 00:17:08,879 Speaker 2: know what, at least I can do this for them. 293 00:17:09,160 --> 00:17:11,800 Speaker 2: And I felt so much better after leaving because I 294 00:17:11,840 --> 00:17:16,159 Speaker 2: felt like the sun really you know, was able to 295 00:17:16,320 --> 00:17:19,320 Speaker 2: grasp it. You know, obviously the dad's not there anymore. 296 00:17:19,840 --> 00:17:21,800 Speaker 2: But I think the why he had a lot of 297 00:17:21,840 --> 00:17:25,520 Speaker 2: basic questions and you know, no he didn't suffer, No, 298 00:17:25,760 --> 00:17:29,040 Speaker 2: he didn't, you know, those kinds of things he did receive. 299 00:17:29,200 --> 00:17:33,240 Speaker 2: You know, they tried to save him, just basic things, 300 00:17:33,280 --> 00:17:35,760 Speaker 2: you know, or the fact that they tried to save him, 301 00:17:36,080 --> 00:17:39,720 Speaker 2: but that it wouldn't have worked, you know, that they 302 00:17:39,760 --> 00:17:42,200 Speaker 2: didn't feel like they were missing something. Does that make 303 00:17:42,240 --> 00:17:44,840 Speaker 2: sense that their loved one they did enough or they 304 00:17:44,840 --> 00:17:47,200 Speaker 2: couldn't have done anything else that, because I think there's 305 00:17:47,240 --> 00:17:50,399 Speaker 2: a lot of regret or what if you know, that 306 00:17:50,520 --> 00:17:52,639 Speaker 2: kind of thing. And I actually played that out with 307 00:17:52,720 --> 00:17:55,760 Speaker 2: my dad too, Like he died of a heart attack, 308 00:17:55,840 --> 00:17:58,760 Speaker 2: Well what if like I had sent him to a 309 00:17:58,800 --> 00:18:02,000 Speaker 2: cardiologist months before? What if I had done this? You 310 00:18:02,000 --> 00:18:05,080 Speaker 2: know it just even that what if plays out in 311 00:18:05,200 --> 00:18:08,359 Speaker 2: my mind because now I'm the daughter with you know, 312 00:18:08,440 --> 00:18:10,960 Speaker 2: a doctorate, right, like an MD who does this for 313 00:18:11,000 --> 00:18:13,399 Speaker 2: a living. How did I miss it? Like? And I 314 00:18:13,440 --> 00:18:15,560 Speaker 2: don't think I missed anything, honestly. I think it was 315 00:18:16,200 --> 00:18:21,800 Speaker 2: you know, bad luck. But you know, it just happened, 316 00:18:21,800 --> 00:18:23,520 Speaker 2: you know, it's like it does. But I think when 317 00:18:23,560 --> 00:18:27,000 Speaker 2: it's so shocking, you know, and the family doesn't know, 318 00:18:27,040 --> 00:18:29,240 Speaker 2: they've read the report twenty times, but they don't know 319 00:18:29,280 --> 00:18:32,000 Speaker 2: what it means. That doesn't help anybody. 320 00:18:32,000 --> 00:18:35,560 Speaker 1: Right, But like your dad, there was a whole process. 321 00:18:35,680 --> 00:18:38,320 Speaker 1: You didn't know about it. You didn't know who to call, 322 00:18:38,440 --> 00:18:40,520 Speaker 1: or where to go or how to get things done. 323 00:18:41,080 --> 00:18:46,160 Speaker 2: I was in Calcutta with my mom, like, we schlept 324 00:18:46,240 --> 00:18:49,360 Speaker 2: all over. I've never been to a US embassy abroad. 325 00:18:49,800 --> 00:18:51,720 Speaker 2: I had to go to the police state. I mean, 326 00:18:52,840 --> 00:18:56,199 Speaker 2: you know, we almost felt like criminals, you know, and 327 00:18:56,240 --> 00:18:58,520 Speaker 2: I hate to say it that way, but they were like, well, 328 00:18:58,560 --> 00:19:01,479 Speaker 2: who are you. You have to prove this is your dad. 329 00:19:01,920 --> 00:19:04,440 Speaker 2: You have to. My mom had to take her wedding 330 00:19:05,080 --> 00:19:10,000 Speaker 2: marriage certificate from nineteen seventy from her lock box, Like 331 00:19:10,280 --> 00:19:12,280 Speaker 2: she had to dig that out before we were going 332 00:19:12,280 --> 00:19:14,600 Speaker 2: on an emergency flight to India. She was like, I 333 00:19:14,640 --> 00:19:19,320 Speaker 2: don't even know if I have something you know that's 334 00:19:19,359 --> 00:19:22,720 Speaker 2: fifty sixty years old. You know, just think about it, right, Yeah, 335 00:19:22,720 --> 00:19:25,880 Speaker 2: She's like, who keeps this stuff where? You know, we're 336 00:19:25,920 --> 00:19:29,440 Speaker 2: in our sixties. You know, my dad was sixty nine, 337 00:19:29,560 --> 00:19:32,359 Speaker 2: my mom was sixty eighth. It's not like, you know, 338 00:19:32,400 --> 00:19:36,240 Speaker 2: they were together forty years. It's not like they questioned it. 339 00:19:36,320 --> 00:19:39,320 Speaker 2: So she was like, and they wanted all this paperwork. 340 00:19:39,600 --> 00:19:42,639 Speaker 2: It's so overwhelming. I mean, that was one of the 341 00:19:42,640 --> 00:19:46,240 Speaker 2: most humbling experiences of my life. And I could talk, 342 00:19:46,400 --> 00:19:48,960 Speaker 2: you know, out of my teeth. Okay, I know the process. 343 00:19:48,960 --> 00:19:51,680 Speaker 2: He had an autopsy, but that doesn't prove in their 344 00:19:51,840 --> 00:19:54,600 Speaker 2: eyes that I'm legit right, that this is the wife, 345 00:19:54,640 --> 00:19:58,520 Speaker 2: this is the daughter, like to claim the body, you know. Yeah, 346 00:19:58,560 --> 00:20:00,920 Speaker 2: And that was and they had him because he was 347 00:20:01,000 --> 00:20:03,959 Speaker 2: a US citizen and died like an act and working 348 00:20:04,000 --> 00:20:06,960 Speaker 2: for the government. This was like even more rig up, 349 00:20:07,080 --> 00:20:11,159 Speaker 2: like more coops to jump through. It was hard, you know. 350 00:20:11,720 --> 00:20:14,480 Speaker 2: And I can only imagine if someone's in a different state, 351 00:20:14,640 --> 00:20:18,160 Speaker 2: doesn't speak the language. I mean, there's so many potential 352 00:20:19,080 --> 00:20:22,960 Speaker 2: difficulties that just you know. That's why any any communication 353 00:20:23,200 --> 00:20:26,760 Speaker 2: is so good. And I remember once in my career 354 00:20:27,640 --> 00:20:29,439 Speaker 2: there was a there was a running it became a 355 00:20:29,520 --> 00:20:34,560 Speaker 2: running joke in a way because I had a terribly 356 00:20:34,640 --> 00:20:38,720 Speaker 2: unfortunate case where a young girl from Guatemala died while 357 00:20:38,880 --> 00:20:41,520 Speaker 2: coming to camp in America. It was just a terrible accident. 358 00:20:42,240 --> 00:20:45,080 Speaker 2: Her parents flew over the next day. I met with 359 00:20:45,320 --> 00:20:51,359 Speaker 2: the parents and the consulate, like the Chief of the 360 00:20:51,400 --> 00:20:54,280 Speaker 2: Consulate of Guatemala in Providence, Rhode Island, Like they came 361 00:20:54,320 --> 00:20:58,120 Speaker 2: to the office, and since that day, I got invited 362 00:20:58,160 --> 00:21:04,119 Speaker 2: to every Guatemala Day festival, every every celebration in the 363 00:21:04,119 --> 00:21:09,200 Speaker 2: Guatemalan embassy. I got called single handedly from the embassy 364 00:21:09,880 --> 00:21:12,639 Speaker 2: that you know, they want to invite me. And I 365 00:21:12,800 --> 00:21:15,080 Speaker 2: was pregnant. I remember that I was, you know, first 366 00:21:15,160 --> 00:21:17,639 Speaker 2: I was not pregnant, and I was pregnant. She you know, 367 00:21:17,680 --> 00:21:19,480 Speaker 2: they were so thrilled that I was going to have 368 00:21:19,520 --> 00:21:21,840 Speaker 2: a baby. But it was funny how they accepted me, 369 00:21:22,520 --> 00:21:24,560 Speaker 2: you know, just because how I treated the family and 370 00:21:24,600 --> 00:21:28,600 Speaker 2: I can't even imagine losing a kid. You know. They 371 00:21:28,600 --> 00:21:30,960 Speaker 2: wanted to see pictures, and I actually took her aside 372 00:21:31,000 --> 00:21:34,240 Speaker 2: and said, I'm not comfortable showing. You know, this is 373 00:21:34,280 --> 00:21:38,760 Speaker 2: not how parents want to remember their child autopsy. You know, 374 00:21:38,800 --> 00:21:43,200 Speaker 2: I'm very hesitant to show autopsy pictures of any relative, 375 00:21:43,240 --> 00:21:46,879 Speaker 2: but especially a child. And then they were forcing me, 376 00:21:46,960 --> 00:21:50,960 Speaker 2: and I finally told, you know, the ambassador, I was like, 377 00:21:51,080 --> 00:21:53,640 Speaker 2: I don't feel like this is okay. You know, I'm 378 00:21:53,640 --> 00:21:57,240 Speaker 2: not personally comfortable. And I took her aside and I 379 00:21:57,320 --> 00:21:59,720 Speaker 2: shoulder and then she said yeah, this is not good, 380 00:21:59,760 --> 00:22:02,200 Speaker 2: you know, like they can't have this image in their head, 381 00:22:02,760 --> 00:22:06,879 Speaker 2: and so like, you know, it was so interesting how 382 00:22:07,880 --> 00:22:12,000 Speaker 2: you know, I sort of got connected with a different community. 383 00:22:12,040 --> 00:22:14,760 Speaker 2: And can you imagine internationally going and getting like the 384 00:22:14,800 --> 00:22:18,560 Speaker 2: worst news of your life basically, So you don't know 385 00:22:18,600 --> 00:22:20,520 Speaker 2: where people are coming from. They could be local, they 386 00:22:20,560 --> 00:22:25,240 Speaker 2: could be international, but it's always an unfortunate time. You know. 387 00:22:25,480 --> 00:22:28,280 Speaker 2: The other thing I sort of say is you know, 388 00:22:28,359 --> 00:22:31,240 Speaker 2: walking them through the process, you know, getting a funeral home. 389 00:22:33,000 --> 00:22:37,520 Speaker 2: We often because there's a lot of international families here. 390 00:22:37,520 --> 00:22:40,440 Speaker 2: We have a lot of Guatemalan, we have Cambodian families. 391 00:22:40,720 --> 00:22:43,160 Speaker 2: I'm just talking about Rhode Island, you know, the populations 392 00:22:43,200 --> 00:22:46,520 Speaker 2: and that varies throughout I mean Atlanta talk about like 393 00:22:46,760 --> 00:22:49,880 Speaker 2: a mixing bowl, right, I mean I grew up in DC. 394 00:22:50,040 --> 00:22:52,480 Speaker 2: That was the same thing in Maryland, DC area. So 395 00:22:53,040 --> 00:22:57,359 Speaker 2: you know, people are often cremated and sent abroad or 396 00:22:57,840 --> 00:23:01,560 Speaker 2: embombed and then sent you know, broad for burial whatnot. 397 00:23:01,840 --> 00:23:06,119 Speaker 2: So we're working with all avenues of people, you know, 398 00:23:06,200 --> 00:23:08,840 Speaker 2: and so I think the cultural awareness, even if you 399 00:23:08,880 --> 00:23:12,040 Speaker 2: don't know what to do, just the empathy can really help. 400 00:23:12,080 --> 00:23:13,639 Speaker 2: They know that you're trying to help them. You know, 401 00:23:13,640 --> 00:23:16,000 Speaker 2: you're not a man them. Ye you know, it's like 402 00:23:16,040 --> 00:23:18,640 Speaker 2: I don't speak your language, you know, but at least 403 00:23:18,680 --> 00:23:21,800 Speaker 2: I can try to help you. And you know, I 404 00:23:21,880 --> 00:23:24,760 Speaker 2: have to say that, like that was the best part 405 00:23:24,800 --> 00:23:26,879 Speaker 2: probably of the staff I worked with, as I was 406 00:23:26,880 --> 00:23:30,280 Speaker 2: always impressed and in various offices, I've always been impressed 407 00:23:30,800 --> 00:23:36,240 Speaker 2: how collegial it is and how you know we've gotten 408 00:23:36,280 --> 00:23:40,360 Speaker 2: people from. You know, they'll call the Department of Health 409 00:23:40,400 --> 00:23:43,719 Speaker 2: and say, does anybody speak Filipino because you know the 410 00:23:43,760 --> 00:23:46,800 Speaker 2: families here and no one in our office did you 411 00:23:46,840 --> 00:23:49,480 Speaker 2: know that kind of thing? Or Indian or you know, 412 00:23:49,520 --> 00:23:51,439 Speaker 2: there was a family that lost a baby and they 413 00:23:51,440 --> 00:23:52,879 Speaker 2: were Indian. I was like, let me tell you, and 414 00:23:52,920 --> 00:23:55,159 Speaker 2: they did not want to have an autopsy, so I 415 00:23:55,960 --> 00:24:00,600 Speaker 2: know that, you know, Hindu religious duties. I called them 416 00:24:00,640 --> 00:24:02,960 Speaker 2: and I said, look, you know, I'm of the same background. 417 00:24:03,240 --> 00:24:06,000 Speaker 2: I know how devastating this is. You know, those kinds 418 00:24:06,040 --> 00:24:08,600 Speaker 2: of things. So when you can reach beyond the cultural 419 00:24:08,680 --> 00:24:13,600 Speaker 2: sort of differences, it helps you understand, like it's not 420 00:24:13,640 --> 00:24:17,639 Speaker 2: that they were trying to be difficult. They religiously didn't 421 00:24:17,680 --> 00:24:20,200 Speaker 2: want an autopsy, you know, on this. 422 00:24:20,240 --> 00:24:23,920 Speaker 1: Baby and all of that is communication, right. 423 00:24:24,119 --> 00:24:25,679 Speaker 2: And I do want to say and we could this 424 00:24:25,680 --> 00:24:30,439 Speaker 2: will probably go into many other like episodes. But the 425 00:24:30,600 --> 00:24:33,159 Speaker 2: other thing that I take away from autopsy and the 426 00:24:33,200 --> 00:24:36,840 Speaker 2: communication part is like, you know, why do you have 427 00:24:36,880 --> 00:24:39,919 Speaker 2: to cut into my loved one? Well, God, for you know, 428 00:24:40,000 --> 00:24:42,600 Speaker 2: how will I know why they died? I need to 429 00:24:42,640 --> 00:24:44,760 Speaker 2: be able to stand up in quarter or to the police, 430 00:24:44,880 --> 00:24:46,720 Speaker 2: or even to look you in the face and say, 431 00:24:46,760 --> 00:24:49,359 Speaker 2: this is what proves how they died, right, And it 432 00:24:49,400 --> 00:24:52,280 Speaker 2: may not just be a toxicology issue that I can 433 00:24:52,320 --> 00:24:56,760 Speaker 2: do externally, right, And so that's a reason. And I 434 00:24:56,800 --> 00:24:58,960 Speaker 2: know it's invading the body, but this is the only 435 00:24:59,080 --> 00:25:02,399 Speaker 2: chance I'm going to get, you know. And then I 436 00:25:02,560 --> 00:25:07,080 Speaker 2: have had cases myself, but also I've handled as an 437 00:25:07,119 --> 00:25:08,920 Speaker 2: expert witness. You know, I do a lot of court 438 00:25:08,920 --> 00:25:13,120 Speaker 2: work where they didn't want an autopsy, and two years 439 00:25:13,200 --> 00:25:15,600 Speaker 2: later they want to file a lawsuit and then they're like, 440 00:25:15,680 --> 00:25:18,479 Speaker 2: oh man, we should have had an autopsy. You know, 441 00:25:18,560 --> 00:25:20,359 Speaker 2: we're sort of doing a work around what do you 442 00:25:20,440 --> 00:25:22,280 Speaker 2: think they died of? And I'm like, well, you know, 443 00:25:22,359 --> 00:25:24,960 Speaker 2: I can look at medical records and look at injury 444 00:25:25,000 --> 00:25:28,400 Speaker 2: patterns or whatnot. But obviously an autopsy speaks for itself, 445 00:25:29,480 --> 00:25:32,200 Speaker 2: you know, and to really communicate with that, and that 446 00:25:32,280 --> 00:25:36,040 Speaker 2: finally brings me to very interesting medical cases I've had. 447 00:25:36,080 --> 00:25:39,199 Speaker 2: You know, we know when it's like, you know, you 448 00:25:39,240 --> 00:25:42,000 Speaker 2: get that gut feeling at scene or as you're doing 449 00:25:42,040 --> 00:25:44,520 Speaker 2: the case, like, oh, this is not adding up. This 450 00:25:44,560 --> 00:25:47,879 Speaker 2: is not kosher, right, this is something bad happened. But 451 00:25:48,840 --> 00:25:54,280 Speaker 2: I think the stuff that people miss or don't communicate 452 00:25:54,280 --> 00:25:57,320 Speaker 2: to families as much, or I hope they do, are 453 00:25:57,480 --> 00:26:01,760 Speaker 2: like genetic conditions, you know. Now I have seen very 454 00:26:01,800 --> 00:26:06,359 Speaker 2: interesting things happen. I remember all the way back to 455 00:26:06,359 --> 00:26:09,160 Speaker 2: when I was training in Baltimore, this African American man 456 00:26:09,280 --> 00:26:11,480 Speaker 2: had blood in his urine and they never knew why. 457 00:26:12,359 --> 00:26:14,439 Speaker 2: And I did his autopsy and said, he has this 458 00:26:14,560 --> 00:26:19,160 Speaker 2: genetic kidney condition. No one detected. It was called polycystic 459 00:26:19,240 --> 00:26:24,040 Speaker 2: kidney disease. So I don't know why the other doctors didn't. 460 00:26:24,560 --> 00:26:26,640 Speaker 2: If they did a CT scan or you know, even 461 00:26:26,640 --> 00:26:28,760 Speaker 2: an ultrasound of his kidneys, they should have seen it. 462 00:26:29,200 --> 00:26:31,800 Speaker 2: And that means it's important because that can be a 463 00:26:31,840 --> 00:26:34,920 Speaker 2: reason someone goes to kidney failure and on dialysis because 464 00:26:34,920 --> 00:26:38,240 Speaker 2: it's genetic. So I called the family and I said, look, 465 00:26:38,400 --> 00:26:39,960 Speaker 2: you know you were you told me he had this 466 00:26:40,520 --> 00:26:42,399 Speaker 2: blood in his urine. You thought he may have had 467 00:26:42,440 --> 00:26:45,320 Speaker 2: a kidney infection. But indeed, now everybody should go to 468 00:26:45,359 --> 00:26:48,359 Speaker 2: their doctor and get screened for this. You know. And 469 00:26:48,520 --> 00:26:52,399 Speaker 2: probably the most telling things I've had really are centered 470 00:26:52,400 --> 00:26:55,320 Speaker 2: in the heart, you know, where the more genetic DNA 471 00:26:55,440 --> 00:26:59,359 Speaker 2: studies are done, the more we know about diseases of 472 00:26:59,400 --> 00:27:03,880 Speaker 2: the heart that's inherited. I have seen so many things, 473 00:27:04,240 --> 00:27:10,439 Speaker 2: you know, that are just crazy. I had a kid 474 00:27:10,880 --> 00:27:14,120 Speaker 2: who died and it was a very high profile case here, 475 00:27:14,160 --> 00:27:17,080 Speaker 2: and it turns out he probably had an arrhythmia. And 476 00:27:17,119 --> 00:27:19,080 Speaker 2: I called the mom and I said, look, you know, 477 00:27:19,640 --> 00:27:22,719 Speaker 2: there's all this other stuff, but I really am very suspicious. 478 00:27:23,080 --> 00:27:26,240 Speaker 2: Please get any surviving children worked up. And the sister 479 00:27:26,320 --> 00:27:29,960 Speaker 2: went to another hospital in the region, another academic center, 480 00:27:30,000 --> 00:27:32,760 Speaker 2: you know, where they're very specialized, and she got put 481 00:27:32,800 --> 00:27:35,800 Speaker 2: I think a pacemaker in because she had the same 482 00:27:35,960 --> 00:27:40,400 Speaker 2: arrhythmia that no one would have ever discovered otherwise. 483 00:27:44,280 --> 00:27:46,959 Speaker 1: Doctor, this is blowing my mind. I'm going to tell 484 00:27:47,000 --> 00:27:52,920 Speaker 1: you something I have often told young detectives and rookies 485 00:27:53,520 --> 00:27:56,720 Speaker 1: that medical examiners are the reason we had things in 486 00:27:56,800 --> 00:27:57,400 Speaker 1: place like. 487 00:27:57,600 --> 00:28:00,600 Speaker 2: Seat belts, yep, yep, ye very much. 488 00:28:00,640 --> 00:28:06,399 Speaker 1: So I have never thought about you discovering something and 489 00:28:06,440 --> 00:28:08,520 Speaker 1: then been able to call the family to say, hey, 490 00:28:08,920 --> 00:28:11,080 Speaker 1: some more y'all probably have it well. 491 00:28:11,080 --> 00:28:16,000 Speaker 2: Probably the most heartbreaking case that stands out was a 492 00:28:16,040 --> 00:28:18,439 Speaker 2: thirty eight year old African American man and he was 493 00:28:18,560 --> 00:28:20,600 Speaker 2: a big dude. But I mean, everybody's bigger than me 494 00:28:20,600 --> 00:28:23,280 Speaker 2: because I'm only five to one, you know, But like, 495 00:28:23,920 --> 00:28:25,199 Speaker 2: you know, but when I look at him, like, oh, 496 00:28:25,240 --> 00:28:27,760 Speaker 2: he's a strapping young man, but for thirty eight, you know, 497 00:28:27,880 --> 00:28:31,320 Speaker 2: six ft something, he wasn't that heavy, do you know 498 00:28:31,359 --> 00:28:33,879 Speaker 2: what I mean? Like he's a strapping young man. He 499 00:28:33,960 --> 00:28:36,160 Speaker 2: may have been okay, ten twenty pounds over a week, 500 00:28:36,200 --> 00:28:40,480 Speaker 2: but he's by no means unhealthy, right, And he's totally active. 501 00:28:40,520 --> 00:28:43,840 Speaker 2: And he drops dead and I get his heart and 502 00:28:43,880 --> 00:28:46,720 Speaker 2: his heart is humongous, like I can't hold it in 503 00:28:46,760 --> 00:28:49,400 Speaker 2: my hands, it is so big. And I was like, 504 00:28:49,560 --> 00:28:53,080 Speaker 2: this is really weird, Like this doesn't make sense to me. 505 00:28:53,160 --> 00:28:55,520 Speaker 2: And I sent it to a heart pathologist because I 506 00:28:55,560 --> 00:28:59,240 Speaker 2: had to basically advocate this needs a special study. I'm 507 00:28:59,240 --> 00:29:03,240 Speaker 2: not comfortable with this. This is unexplained and it turns 508 00:29:03,280 --> 00:29:08,320 Speaker 2: out that he had a genetic condition called dilated cardiomopathy, 509 00:29:08,880 --> 00:29:12,840 Speaker 2: where his heart got so big and so it became 510 00:29:12,920 --> 00:29:15,520 Speaker 2: sort of like this loose balloon, if you will. It 511 00:29:15,560 --> 00:29:22,160 Speaker 2: wasn't an effective pumping mechanism. Then I called his relative, 512 00:29:22,240 --> 00:29:25,120 Speaker 2: I think it was his aunt or sister, a female, 513 00:29:25,240 --> 00:29:27,880 Speaker 2: and they were driving to his funeral, and I said, look, 514 00:29:28,280 --> 00:29:31,760 Speaker 2: I'm really concerned that this is, you know, something that 515 00:29:31,840 --> 00:29:33,960 Speaker 2: running in the family. Does this guy have any children? 516 00:29:34,000 --> 00:29:36,440 Speaker 2: He goes, yeah, he has a two year old. And 517 00:29:36,480 --> 00:29:41,280 Speaker 2: I said, okay, and has anybody you know and your family, 518 00:29:41,360 --> 00:29:45,200 Speaker 2: extended family, you know, died at the same age. And 519 00:29:45,200 --> 00:29:47,400 Speaker 2: he's like, oh yeah, we had an uncle, a cousin. 520 00:29:47,480 --> 00:29:50,600 Speaker 2: They both dropped dead. And I was like, oh my god, Like, 521 00:29:51,720 --> 00:29:54,800 Speaker 2: you know, it was like bone chilling to me that like, 522 00:29:55,080 --> 00:29:58,080 Speaker 2: can we prevent any more debts? You know, there's obviously 523 00:29:58,080 --> 00:30:02,240 Speaker 2: something going on that it didn't strike them. They just said, okay, 524 00:30:02,280 --> 00:30:05,760 Speaker 2: the men, some men in our family die young, you know. 525 00:30:06,000 --> 00:30:09,080 Speaker 2: And that's what shocks me, you know, that, Oh my god. 526 00:30:09,680 --> 00:30:14,200 Speaker 2: And so and I'll have to throw in like a 527 00:30:14,320 --> 00:30:18,000 Speaker 2: pet story this week because it's like totally affected me, right, 528 00:30:18,560 --> 00:30:22,960 Speaker 2: But you know, I love my pets. Right, that's oh everybody, 529 00:30:23,000 --> 00:30:27,040 Speaker 2: anybody that knows me or follows me and like online 530 00:30:27,080 --> 00:30:29,960 Speaker 2: it's basically pictures of my kid and my pets. Okay, 531 00:30:30,600 --> 00:30:34,720 Speaker 2: Well I have Sphinx cats, right, So like think about 532 00:30:34,760 --> 00:30:38,320 Speaker 2: this in a way where I am now the consumer, right, 533 00:30:38,400 --> 00:30:41,800 Speaker 2: I'm now on the patient side. So Monday I took 534 00:30:41,840 --> 00:30:45,040 Speaker 2: two of my special cat Sphinx cats. So if anybody 535 00:30:45,080 --> 00:30:48,680 Speaker 2: listening to this ever saw Austin Powers, mister Bigglesworth was 536 00:30:48,840 --> 00:30:52,400 Speaker 2: one of those cats. No hair, okay, and that is 537 00:30:52,440 --> 00:30:55,160 Speaker 2: a genetic condition. That's why they have no hair. But 538 00:30:57,800 --> 00:31:00,920 Speaker 2: close to that, these cats off and inherit a gene 539 00:31:01,000 --> 00:31:04,520 Speaker 2: that affects their heart. It's a genetic heart condition. And 540 00:31:04,800 --> 00:31:07,960 Speaker 2: I mean, if anybody knows me, they know how much 541 00:31:08,000 --> 00:31:10,360 Speaker 2: I love my cats and how spoiled they are. Okay, 542 00:31:11,240 --> 00:31:14,520 Speaker 2: they don't want for anything. But Monday I had to 543 00:31:14,560 --> 00:31:17,240 Speaker 2: take them for what I thought was just screening. They're 544 00:31:17,280 --> 00:31:20,680 Speaker 2: not sick, they're not anything. And believe it or not, 545 00:31:20,960 --> 00:31:25,160 Speaker 2: my younger cat has some mild heart changes due to 546 00:31:25,160 --> 00:31:29,280 Speaker 2: her genetics. So now I am. I cried in the 547 00:31:29,360 --> 00:31:32,520 Speaker 2: doctor's office and now I'm like, there's a medicine that 548 00:31:32,640 --> 00:31:36,200 Speaker 2: just came out like a month or two ago, that 549 00:31:36,280 --> 00:31:39,400 Speaker 2: she's going to start on that hopefully makes some changes 550 00:31:39,400 --> 00:31:41,239 Speaker 2: to her heart to protect it, you know, from her 551 00:31:41,280 --> 00:31:44,320 Speaker 2: passing away. So like, think about it. Not only am 552 00:31:44,360 --> 00:31:46,760 Speaker 2: I you know, obviously it's my cat, and a lot 553 00:31:46,760 --> 00:31:48,640 Speaker 2: of people are like, oh, it's just a cat. But 554 00:31:49,560 --> 00:31:52,600 Speaker 2: you know it's the same sort of parallel, right, it's 555 00:31:52,760 --> 00:31:57,520 Speaker 2: recognizing it and communicating it, screening for it, and then 556 00:31:57,720 --> 00:32:03,040 Speaker 2: allowing families to maybe prevent whether it be future cancers. Right, 557 00:32:03,120 --> 00:32:06,000 Speaker 2: Like if we have like the breast cancer, sure, early 558 00:32:06,040 --> 00:32:09,920 Speaker 2: heart attacks, some people have like cholesterol problems. We can 559 00:32:09,960 --> 00:32:14,480 Speaker 2: see changes in their skin, you know. And and sometimes 560 00:32:14,520 --> 00:32:16,720 Speaker 2: I've seen people die in like a car crash, even 561 00:32:16,760 --> 00:32:18,800 Speaker 2: a twenty year old. But if they have something, I 562 00:32:18,840 --> 00:32:22,440 Speaker 2: know it's scary because I've seen you know, heart disease, 563 00:32:23,200 --> 00:32:26,080 Speaker 2: narrowing of the arteries in someone who's twenty or thirty, 564 00:32:26,120 --> 00:32:31,360 Speaker 2: and I'm like, that's really strange. Like if it's so prominent, 565 00:32:31,440 --> 00:32:33,280 Speaker 2: I might give the family a call and say, hey, 566 00:32:34,120 --> 00:32:36,320 Speaker 2: you know, I know this was hard, and he died 567 00:32:36,560 --> 00:32:39,200 Speaker 2: unrelay he or she died of unrelated issues. But we 568 00:32:39,280 --> 00:32:41,760 Speaker 2: always document everything, right, I say that in court all 569 00:32:41,800 --> 00:32:45,640 Speaker 2: the time. I document every little scratch, every finding on 570 00:32:45,680 --> 00:32:48,240 Speaker 2: the body, not just the trauma or not just the 571 00:32:48,320 --> 00:32:53,000 Speaker 2: drug overdose, every single thing. And so it's like, huh, 572 00:32:53,160 --> 00:32:56,280 Speaker 2: look at this this person has you know why at 573 00:32:56,320 --> 00:32:59,960 Speaker 2: at twenty five is this person having heart disease? Maybe 574 00:33:00,120 --> 00:33:03,920 Speaker 2: there's something genetic that's unknown and that they should get screened. 575 00:33:04,080 --> 00:33:07,280 Speaker 2: You know, I just think, am I doing the screening? No? 576 00:33:07,520 --> 00:33:10,600 Speaker 2: All I'm doing is sort of referring them. And the 577 00:33:10,760 --> 00:33:16,640 Speaker 2: other sort of thing is I can only do so 578 00:33:16,840 --> 00:33:20,240 Speaker 2: much lab work on a deceased person. Right, most of 579 00:33:20,320 --> 00:33:24,440 Speaker 2: genetic screening is only covered by insurance and living individuals, right, 580 00:33:24,480 --> 00:33:27,320 Speaker 2: because it's prevention treatment. Right, They're not going to cover 581 00:33:27,440 --> 00:33:30,560 Speaker 2: someone who's dead, and they don't treat anymore. But so 582 00:33:30,720 --> 00:33:33,320 Speaker 2: I'm not even really doing the treatment for me. It's 583 00:33:33,360 --> 00:33:36,600 Speaker 2: more like, hey, and I don't even know the result, 584 00:33:36,680 --> 00:33:38,200 Speaker 2: you know what I mean. Like, and some people may 585 00:33:38,200 --> 00:33:40,120 Speaker 2: blow me off saying, oh, she's crazy. I'm not going 586 00:33:40,200 --> 00:33:41,840 Speaker 2: to go to the doctor. Well that's up to you. 587 00:33:41,840 --> 00:33:44,440 Speaker 2: You know, I can't make you do anything. But if 588 00:33:44,440 --> 00:33:46,880 Speaker 2: there's someone who listens to me and maybe they can 589 00:33:46,920 --> 00:33:50,040 Speaker 2: get an intervention, you know, it may help them or 590 00:33:50,080 --> 00:33:53,520 Speaker 2: their loved one. You know, when you go to the doctor, 591 00:33:53,560 --> 00:33:56,760 Speaker 2: they always ask you, hey, what problems run in the family. Right, 592 00:33:57,200 --> 00:33:59,640 Speaker 2: That's what I'm getting at. Right if you have if 593 00:33:59,680 --> 00:34:02,120 Speaker 2: you're mind had a stroke, your dad had a heart attack. 594 00:34:02,200 --> 00:34:05,000 Speaker 2: That's why they doctors write these things down because they know, 595 00:34:05,640 --> 00:34:08,080 Speaker 2: oh it runs in the family. So I'm seeing it 596 00:34:08,600 --> 00:34:12,040 Speaker 2: unfortunately at you know, at the other end. But maybe 597 00:34:12,080 --> 00:34:16,160 Speaker 2: we can backtrack by communicating with the families to then say, hey, 598 00:34:17,480 --> 00:34:19,920 Speaker 2: you know the insurance will cover you guys. Right if 599 00:34:19,960 --> 00:34:22,760 Speaker 2: you say my brother died of you know, this really 600 00:34:23,080 --> 00:34:26,640 Speaker 2: rare heart condition. Can you send me to a cardiologist 601 00:34:26,640 --> 00:34:29,360 Speaker 2: and get an ultrasound of the heart or imaging of 602 00:34:29,360 --> 00:34:32,279 Speaker 2: the heart. Yeah, that's that should be covered, right, because 603 00:34:32,280 --> 00:34:35,520 Speaker 2: they want to prevent death. And so sure, I think 604 00:34:35,560 --> 00:34:37,680 Speaker 2: where I feel like I'm making a difference. You know, 605 00:34:38,040 --> 00:34:41,840 Speaker 2: it's not just giving closure, but I think there's actually 606 00:34:41,920 --> 00:34:43,879 Speaker 2: clinical benefit to. 607 00:34:43,880 --> 00:34:49,200 Speaker 1: It, doctor Pria. I have never in my life thought, hey, 608 00:34:49,880 --> 00:34:52,280 Speaker 1: the medical examiner could save your life. 609 00:34:52,880 --> 00:34:55,359 Speaker 2: Yeah you know, but that's what you did for the thing. 610 00:34:55,880 --> 00:34:59,799 Speaker 1: But that's what you're doing with the unusual kidney is 611 00:34:59,840 --> 00:35:02,560 Speaker 1: she and the heart issue? Wow? 612 00:35:02,960 --> 00:35:05,200 Speaker 2: And I mean I will document it too and say, 613 00:35:05,239 --> 00:35:08,359 Speaker 2: you know, this result was communicated with the family and 614 00:35:08,800 --> 00:35:12,320 Speaker 2: you know needs cardiology work, you know, or is suggested. 615 00:35:12,400 --> 00:35:15,439 Speaker 2: I can't say you must get it right because that's 616 00:35:15,480 --> 00:35:18,399 Speaker 2: not my place, but I really do think it's it's 617 00:35:18,520 --> 00:35:22,400 Speaker 2: part of our follow through. Right. If a doctor orders 618 00:35:22,400 --> 00:35:26,319 Speaker 2: a lab test and the result is abnormal, they call you, right, 619 00:35:26,560 --> 00:35:29,160 Speaker 2: you have an abnormal lab test. You need to get 620 00:35:29,360 --> 00:35:32,080 Speaker 2: XYZ done. And so to me, that's what it is. Yes, 621 00:35:32,160 --> 00:35:35,040 Speaker 2: I'm there to figure out why John Smith died, and 622 00:35:35,080 --> 00:35:37,440 Speaker 2: he died of a car accident, but if there's still 623 00:35:37,520 --> 00:35:41,799 Speaker 2: something you know, out and left field, it may not 624 00:35:41,920 --> 00:35:44,200 Speaker 2: have had anything to do with the death, but I'm 625 00:35:44,200 --> 00:35:46,759 Speaker 2: the only one that's going to look inside of him, 626 00:35:47,200 --> 00:35:50,000 Speaker 2: and you know, God forbid it could cause death in 627 00:35:50,120 --> 00:35:53,520 Speaker 2: someone else, right, or they didn't know that this you know, 628 00:35:53,640 --> 00:35:56,799 Speaker 2: weird thing could happen, like oh my god, what if 629 00:35:57,000 --> 00:35:59,200 Speaker 2: you know even think about like an aneurysm in the 630 00:35:59,239 --> 00:36:02,880 Speaker 2: brain or something that is silent until it's not. And 631 00:36:02,920 --> 00:36:05,279 Speaker 2: those are the big things that you want to you know. 632 00:36:05,360 --> 00:36:10,400 Speaker 2: I really do make it a point to call the families, 633 00:36:10,400 --> 00:36:12,839 Speaker 2: and sometimes they're like, why are you calling me? They 634 00:36:12,880 --> 00:36:16,480 Speaker 2: do get almost weirded out, you know, in a way. 635 00:36:17,360 --> 00:36:20,600 Speaker 1: I think if the medical examiner calls you to say 636 00:36:20,760 --> 00:36:26,319 Speaker 1: I found I located. I noticed something really unusual that 637 00:36:26,400 --> 00:36:29,239 Speaker 1: genetically you may not be aware of, that you may 638 00:36:29,280 --> 00:36:36,000 Speaker 1: also carry. That is vital communication. So again, you know, 639 00:36:36,880 --> 00:36:41,480 Speaker 1: everybody listening, that's just one more level that I did 640 00:36:41,520 --> 00:36:44,480 Speaker 1: not even know was part of the service. I didn't 641 00:36:44,880 --> 00:36:49,040 Speaker 1: never cross my mind, Doctor Pria. I cannot thank you 642 00:36:49,200 --> 00:36:52,600 Speaker 1: enough because again, I mean, I've witnessed how you operate, 643 00:36:52,760 --> 00:36:58,240 Speaker 1: and it is from your heart. You just naturally have empathy, 644 00:36:58,360 --> 00:37:02,440 Speaker 1: and I just appreciate what you're doing here on Mondays. 645 00:37:03,080 --> 00:37:05,560 Speaker 2: Well, thank you for the avenue you know to really 646 00:37:06,280 --> 00:37:09,000 Speaker 2: you know, these are my soapboxes or I mean, you 647 00:37:09,080 --> 00:37:11,680 Speaker 2: have to realize this is my view, right. Not everybody's 648 00:37:11,760 --> 00:37:14,920 Speaker 2: like me, but definitely you know, this is how I 649 00:37:15,160 --> 00:37:18,640 Speaker 2: practiced before and I continue to practice. 650 00:37:18,880 --> 00:37:23,880 Speaker 1: Y'all. I'm Cheryl McCollum and I'm joined with doctor Priab Energy. 651 00:37:24,440 --> 00:37:29,600 Speaker 1: Do not miss Pathology with Doctor Pria Monday's on Zone 652 00:37:29,640 --> 00:37:29,960 Speaker 1: seven