A dozen autopsy technicians who work at the Office of Chief State Medical Examiner have hired a private lawyer to advocate for better pay and fairer treatment.
"The people who pick up our trash make more money than we do," Amanda McGinnis, a five-year contract employee, says. "And we bag it up for them."
The technicians undress, clean, X-ray, and eviscerate up to 13 bodies each day, assisting the assistant medical examiners who perform the autopsies. The work can be physically demanding, with 100-pound autopsy techs flipping over 300-pound cadavers. And it can be emotionally challenging, as when infants killed by abusive caretakers arrive. Sometimes the work is gruesome.
"Every case you approach is a different story," says McGinnis. "I could have a motor vehicle [accident victim] intact or a motor vehicle [victim] with pieces everywhere."
The group's effort began more than a year ago, and culminated more recently with J. Wyndal Gordon, a prominent lawyer specializing in criminal defense, taking the workers' cause on a pro bono basis and publicizing a Change.org petition on his Facebook page. The Afro-American featured the autopsy techs on Aug. 6. The story said the workers had not gotten a raise for 20 years. The best-paid one makes $33,608 per year after 38 years on the job.
Robert Mills, an autopsy tech who has worked for six years in the Baltimore office and spent 13 years doing the same job in Atlanta, says the base pay in Georgia was "much higher than this," with regular raises. When he came to Baltimore, Mills says, he was hired as a contract employee and paid as if he had no relevant experience.
State workers are mostly represented by unions affiliated with the American Federation of State, County and Municipal Employees (AFSCME). Of the 12 technicians who have hired Gordon, seven are state employees represented by AFSCME and five are contract workers.
"These folks are ours," says AFSCME Council 3 spokesman Jeff Pittman. "What we have in the database is seven permanent members in that job classification. The position is autopsy assistants."
Pittman says the full-time state employees got a new contract this year that includes four raises—a 3-percent cost-of-living adjustment (COLA) that came on Jan. 1, another 2-percent COLA that will come in January 2015, and two step increases that will range between 1.8 percent and 3.4 percent—one that came in April of this year and the other July of this year, or January of next year, depending on the employee's date of hire.
The salaries are still pretty modest, ranging from $29,600 to $31,300, Pittman says.
"I think the legitimate argument is, the folks who are contractual employees, if they are not making what the permanent people are, then they are being taken advantage of by the state," he says.
The different term for the job—autopsy assistants instead of autopsy technicians—is not without consequence, Pittman says. The union salary studies have found it hard to compare the Baltimore job title and description with those in other states.
"If you look at autopsy techs in other states, the average [salary] was closer to $40,000," Pittman says. "But they have a four-year degree." Maryland's autopsy assistants are required to have only a high school diploma, he says—although some do have more advanced degrees.
"It takes a special person to do this kind of work," Pittman says. "So we need to look at what their duties are."
A spokesman for the Medical Examiner's Office, Bruce Goldfarb, says the office doesn't talk about personnel issues. He says Dr. David Fowler, the chief medical examiner, is sympathetic to the technicians and that everyone in the office is underpaid relative to those in medical examiners offices in other states. "I know medical examiners in other states can be paid better," he says, adding that Maryland's per-capita cost for each autopsy is "about one-third below the national average. We're very lean and efficient."
State budget documents show the office's budget for salaries has increased from about $7.4 million in 2013 to $7.9 million in 2014. At the same time, the office's fuel and utilities budget was cut by $60,000, supplies were cut by $15,000, and the budget for equipment replacement shrank from $42,702 in 2013 to $22,460 in 2014.
Each medical examiner's workload increased from 247 autopsies a year in 2012, which is just under the National Association of Medical Examiners' maximum recommended guideline of 250 per year per medical examiner, to 280 in 2013. The figure this year is estimated at 293. This is well above the accreditation guideline, though the national association sets an absolute maximum of 325. "If we lost a doctor or if caseloads increased dramatically . . . that could threaten accreditation," Goldfarb says.
"Baltimore is one of the best. A lot of offices go by their standards," says Denise McNally, Executive Director of the National Association of Medical Examiners. "I do know that Baltimore just had an inspection."
The autopsy techs say the increased workload for medical examiners means more skilled work falls to them. In an interview in Gordon's office, five techs explain in detail how a typical day goes. They arrive for work starting at 6 a.m. to find 8-13 new cases. They read the case narratives and get to work accordingly, X-raying some, CT-scanning others (although they are not radiologists), and then wheeling them into the autopsy room so the medical examiners can divvy up the work and the staff.
The work continues according to what is needed in each case, McGinnis says. A homicide might require a nail clipping first so the detective can send it to a lab to look for an assailant's DNA. "They might ask for a Luminol swab to search for other body fluids."
After cleaning the bodies—readying them for photography—the next step is to remove the organs. The techs cut the skull open to remove the brain, they say. They cut open the abdomen and chest and remove those organs too.
"Then sometimes you have to take the spinal cord out," says Jessika Logan, who has worked in the office on contract for about a year. And there are other surprises as well: "OK, once I had a snake. A live snake almost bit me."
Logan says it was in the leg of a body that had been found in the water. "I ran," she says.
"Just the other day I opened a [body] bag and it was full of maggots," McGinnis says.
A tech, on a given day, may be dealing with five cases at once.
McGinnis says she has not been offered a full-time state position in her five years because she has been the most vocal about pay. Mills backs her up, saying he was offered full-time status three times before he took it. "I told them to give it to her," he says. He finally relented when, he says, he was told the promotion would no longer be available if he didn't. He feels bad about it.
The full-time status comes with union representation, plus a pension, paid vacation, and medical insurance. "They did it to me because they didn't like me," McGinnis says. "All I wanted was insurance.
She says she adopted her daughter last year on a Friday and was back at work on Monday.
The 6 a.m. shift goes until 2:30 p.m. The 7 a.m. shift goes until 3:30 p.m. Bodies that come in after noon usually have to wait for the next day. "We really want people to understand what we really do," says Mills.
"People just want to try to make a living and take care of their families," says Leroy Jones, who has worked in the office since 1988. "I can't take care of my family on $775 every two weeks."
The autopsy technicians would like health hazard pay. They would like counseling. Others who work with the dead all the time receive counseling—or the option to get it. Techs do not, they say.
Last year, the group wrote U.S. Rep. Elijah Cummings about their problems. Cummings toured the office a few months later but, the workers say, he did not get the full picture.
"I think they knew; they made it more of a show," says Mills. "They were prepared for him. I remember that day I had a homicide. They did not want me to do the things I normally do. We were just eviscerators."
Asked what he plans to do, Gordon says he's been talking to politicians. "This issue is going to have to resolve itself most likely in the general assembly," he says, "rather than in a court house."
Pittman, the union spokesman, says the union is "kind of mystified" that the techs have hired a private lawyer to try to get the state to hire its contract workers. The general assembly can only cut the budget, he says; they can't insert money to pay these people more. "The governor would have to put into his budget to convert those folks."
Gordon also says he intends to raise the profile of his new clients. "I would love to see the name [title] changed to technologist," he says. "They use the same surgical instruments as physicians. They use them with the same precision, which is absolutely necessary to do the job correctly. If you don't eviscerate properly, when the body is sent to the funeral home, they can't provide a decent presentation for burial.