What Does a Forensic Pathologist Discover?

TL;DR

Heart disease is the most common cause of death encountered by forensic pathologist Dr Richard Shepherd, followed by respiratory disease. Forensic pathology determines how and why unexpected deaths occurred by combining external and internal examinations, tissue and fluid testing, scene evidence, and accident analysis. Shepherd also concludes that wearing a seatbelt would probably have prevented Princess Diana’s fatal injury.

Transcript

It's stabbings. Stabbings, stabbings, stabbings. They are the commonest cause of death, and the person most likely to stab you is a friend or a relative. There is a very simple step that occurred that took me from nowhere to forensic pathology in the space of about two hours. A friend of mine's father was a general practitioner, and in his office h... Read More

Key Insights

• Forensic pathology is the investigation of sudden and unexplained deaths for police, coroners, families, and society. The pathologist builds a complete account of how and why someone died by combining findings from the body, laboratory samples, the scene, and other physical evidence.
• A post-mortem examination is both external and internal. A forensic pathologist inspects the body’s surface and organs, may examine tissue under a microscope, and can test blood, urine, liver, and other tissues to determine whether drugs were present.
• Scene examination is an important part of death investigation. A forensic pathologist may visit the place where a body was found or inspect a vehicle after a road traffic accident, looking for damage patterns inside, outside, and around it that help reconstruct events.
• Heart disease is by far the most common cause of death Shepherd encounters, with respiratory disease following it. He says diseases associated with cigarette smoking are beginning to decline as fewer people smoke, while the possible long-term diseases associated with vaping remain unknown.
• Drugs and road traffic accidents are prominent causes of accidental death in Shepherd’s work. For murders, stabbings are the most common cause he encounters, and he says the person most likely to carry out a stabbing is a friend or relative of the victim.
• Repeated autopsy experience can make odor an insignificant distraction. After performing 23,000 autopsies, Shepherd focuses instead on appearance, texture, cutting characteristics, and what the body reveals about a person’s life and death, while choosing to work in silence so he can concentrate.
• Princess Diana’s fatal injury was initially hidden despite her being alive and talking after the crash. Shepherd describes a tear in a relatively small blood vessel in her left lung, followed by increasing instability, cardiac arrest during the journey, and unsuccessful major thoracic surgery at the hospital.
• Seatbelt use was the decisive protective difference in the Princess Diana crash analysis. Security officer Trevor Rees-Jones had fastened his seatbelt and survived despite severe injuries, while Diana, Dodi Al Fayed, and driver Henri Paul were not wearing seatbelts, and the latter three died.

Questions & Answers

Q: What does a forensic pathologist do?

A forensic pathologist helps police and the coroner investigate sudden and unexplained deaths. The work includes examining the body’s external surface and internal organs, studying selected tissue under a microscope, and testing blood, urine, liver, or other tissues for drugs. The pathologist combines these findings with scene and accident evidence to establish how and why the person died.

Q: How does a forensic pathologist determine the cause of death?

A forensic pathologist builds the explanation from several kinds of evidence rather than relying on one observation. The process can include external and internal examination, microscopic analysis of organ samples, and testing of bodily fluids and tissues for drugs. The pathologist may also examine where the body was found or inspect damage to a vehicle involved in a road traffic accident.

Q: What are the most common causes of death encountered in forensic pathology?

Shepherd says heart disease is by far the most common cause of death in his work, followed by respiratory disease. Among accidental deaths, drugs are prominent, either alone or alongside road traffic accidents. In murder cases, stabbings are the most common cause he encounters, and the attacker is most likely to be a friend or relative of the victim.

Q: How do forensic pathologists cope with the smell during an autopsy?

Shepherd says that after performing 23,000 autopsies, he no longer notices the smell or gives it significant attention. He considers it transient and unimportant in 99.99% of post-mortems. His attention remains on what the body looks and feels like, how tissues respond during cutting, and what those physical details reveal about the person’s life and death.

Q: Why does Dr Richard Shepherd work in silence during autopsies?

Shepherd works in silence because he wants to maintain complete focus on the examination. Although some colleagues play heavy rock, light rock, or classical music, he believes the work is too important to the family and society to permit distractions. His preference differs from some surgeons and pathologists who use music to lighten the atmosphere while they work.

Q: Why does Dr Richard Shepherd believe Princess Diana died?

Shepherd believes Princess Diana died from a concealed injury involving a tear in a relatively small blood vessel in her left lung after the car crash. She was initially alive and talking, but her condition became increasingly unstable during the journey to the hospital. She then had a cardiac arrest, and major thoracic surgery at the hospital could not save her.

Q: Would a seatbelt have changed the outcome for Princess Diana?

Shepherd is confident that Princess Diana would probably still be alive if she had worn a seatbelt. He explains that the Mercedes passenger compartment was designed to withstand major impacts when occupants were restrained. Trevor Rees-Jones managed to fasten his seatbelt and survived, although severely injured, while Diana, Dodi Al Fayed, and Henri Paul were unrestrained and died.

Q: Was there evidence of a conspiracy in Princess Diana’s death?

Shepherd says he saw nothing indicating a deliberate attempt to cause Princess Diana’s death. He participated in an expert review assembled after conspiracy theories continued to spread. Based on his experience examining hundreds of road traffic accidents, he regarded the event as a tragic crash whose fatal consequences were significantly affected by the occupants not wearing their seatbelts.

Summary & Key Takeaways

• Forensic pathologists help police and coroners investigate sudden or unexplained deaths. They examine the body externally and internally, study organs under a microscope, test blood, urine, liver, and other tissues for drugs, and sometimes inspect the location or vehicle involved. These findings are combined to determine how and why someone died.

• Shepherd says heart disease is by far the most common cause of death he encounters, followed by respiratory disease. Drugs and road traffic accidents feature prominently among accidental deaths, while stabbings are the most common form of murder he sees. In such cases, the attacker is often a friend or relative.

• Shepherd’s review of Princess Diana’s case found no evidence of a deliberate attempt to cause the crash. Diana suffered a concealed injury involving a torn blood vessel in her left lung and was not wearing a seatbelt. He believes a seatbelt would have left her relatively uninjured and probably alive today.