I am thirteen years old and read that you said that you cannot determine if someone died peacefully in their sleep because "all of the muscles relax when one dies." However when I asked my science teacher if you could tell, she said that you can because of the dilation of the eyes. Does dilation of the eyes mean a person was relaxed when they died? I just want to be sure?

Your teacher is correct. We can see dilated eyes after death but that doesn't tell us if the decedent died peacefully or in pain. The irides (or irises) dilate when in the relaxed position. Narcotic drugs, such as heroin, cause the irides to contract and produce a pinpoint appearance which can be present after death.

Loved your book. Will you be publishing another?

Thank you. Unnatural Death: Confessions of a Medical Examiner stimulated the HBO Autopsy series. It's still available in paperback. My next book, Dead Reckoning, written with an outstanding science writer, Marion Roach, is scheduled for publication in September.

Is the hyoid bone always broken in a case of manual strangulation?

No. The hyoid bone is a thin, u-shaped bone in the neck just above the Adam's Apple which is very supple, pliable and bendable when we are young and, thus, hard to fracture. It becomes calcified and more brittle, as we get older, so that it is more likely to fracture when the neck is squeezed by the hands of another.

Would you explain what happens when someone in an automobile strikes a wall at a high speed. Are head injuries the most common cause of fatality in that situation?

Yes. Head and brain injuries are the most common cause of death in drivers and passengers in frontal auto impacts; the body keeps moving forward after the vehicle is suddenly stopped and the head may impact the windshield, dashboard or steering wheel, or the back of the seats in front. The three point seatbelt restraints were designed to prevent these secondary body impacts. Head rests have diminished whiplash neck injuries. Air bags prevent head, chest and abdominal injuries.

Have you ever seen a case of paradoxical hypothermia?

Yes. This refers to an unusual phenomenon, usually occurring in intoxicated persons, who, when freezing to death in the snow, begin to feel very warm as the blood vessels near the skin dilate, releasing needed body heat. The individual may take off his or her clothing and make swimming type movements of arms or legs while lying nude in the snow. Initial police investigators may misinterpret these findings as indicating that a sexual altercation had occurred.


Have technological advances in recent years made your job easier? Or does it still come down to good old-fashioned medical knowledge and experience?

Yes and yes. New technologies, like DNA, have made the identification of blood and semen much easier. But proper protection of the crime scene, documentation of all significant findings on the body by old-fashioned technology such as by verbal description, photographs and X-rays, doing a complete and careful autopsy and experience are still the most important tools of the forensic pathologist.

How long are autopsy records kept? Is there any way a family member can request them several years after the fact?

Autopsy records in hospitals, medical examiner and coroner's offices are usually kept for decades or longer. Family members can request and expect to obtain a copy of the autopsy report many years later. Some states require that the next-of-kin family member make the request.

Can it be determined whether bruises on an individual were caused by another individual's knuckles? And, if so, can they be measured to determined whose knuckles caused the injuries?

No. The knuckles do not contain sufficiently specific and unique characteristics - as does a ring worn on a finger, or a bite mark may - to leave an identifiable imprint in soft, pliable skin. They leave non-specific bruises.

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