Daily confrontations with tragedy Medical examiner focuses on science


Immediately inside the entrance of the plain gray building at Penn and Pratt streets is a large mural bearing Hippocrates' words: "Wherever the art of medicine is practiced, there is also a love of humanity."

But here, at the state medical examiner's office, Dr. John E. Smialek and his team of seven pathologists practice only on dead humanity. Dr. Smialek, 50, has been Maryland's chief medical examiner for eight years. He estimates that since he became a pathologist, he's completed autopsies on between 6,000 and 7,000 corpses.

With so many murders occurring in recent years, Dr. Smialek's work has been consumed by the dark and violent side of life. Police report that 280 people have been slain in the city this year.

Each day Dr. Smialek commutes to Baltimore from his quiet Havre de Grace neighborhood. And virtually each day, another person is murdered, meaning another slain body at the office when Dr. Smialek arrives.

Q: For the second consecutive year, Baltimore is well on the way to setting a record for homicides. You've chosen to deal with death as an everyday part of your job, but is this starting to take a toll on you?

A: The way I look at it, there's a personal involvement, and there's a professional involvement. You can't separate your personal involvement totally, although you try to be objective and scientific.

But whenever I look at a homicide, I can't help but think how this individual was feeling less than 24 hours ago. I think of what he was doing as a member of his family, or what he was doing with his friends, or what he must have been planning or thinking of, just before some violent act took his life.

It's especially true when you look at young people, who had their whole lives in front of them. You can't help but think of how they must have been totally unprepared.

It's just incredible to think of something so sudden as when you look at a bullet wound and see how simply a person dies. That life vanishes.

And then you think of how their families must be feeling. Here is this healthy boy or girl -- the light of somebody's life -- and &L; suddenly they're gone.

It's just a tiny little bullet; it's not very heavy. But it snuffs out life very quickly.

Q: What is the human toll of all this murder? A lot of people discount these victims as nothing more than "young punks." But do you hear from the families and get a chance to understand what effect the murder has on their lives?

A: Sometimes the families will want to understand what happened. They'll contact either me or one of the other pathologists and want to discuss what we found. Sometimes they want to know if their child suffered before dying. Often that can be very important to a parent.

We try to answer as professionally as possible. Was the fatal wound something that would have caused the victim to lose consciousness immediately? Would he have died instantaneously? If we can give them that type of information, we do. Sometimes it just helps them accept it a little more.

Sometimes families come to identify the body. From the account of the shooting, and the events surrounding it, you would think that the victim was the lowest form of life. But it's not always a bad family that produces somebody totally incorrigible.

To get into a life of crime and to end up getting shot doesn't take much these days. To get into a life-threatening situation isn't hard nowadays, either.

So they end up dead, and the family, a very respectable group of people, becomes shattered.

Q: Do certain cases still shock you?

A: In terms of the value of life, the most recent shocking case was that young boy from Towson State University who had gone over to see a friend [in Northeast Baltimore].

It sounds like some of these kids came up to him and said we want your shoes or your jacket or something like that. And they kill him. They shot him at close range; you could see the gunpowder right on his face. They stuck that gun right in his face. To think about somebody pulling a trigger on somebody like that -- that still gets to me.

Q: Local, state and federal law enforcement officers frequently speak of increasing firepower as a major contributor to escalating homicide rates. Are the victims being hit with higher-caliber, more lethal weaponry?

A: What I've seen over the past several years is an increasing number of cases where the person is hit many more times [than in the past]. Semi-automatic ammunition has become more common, and more shots are being fired.

Many cases take place in a very closed environment, such as out on the street where somebody walks up to another person and shoots at very close range -- within a few feet, usually. Or someone will come up to a car and shoot the people inside.

It's not the weaponry that's become more deadly; it's the mentality.

Guns in the hands of people with little or no value for life -- that's producing the large volume of homicides.

Q: After seeing the homicides for so many years, has your perspective on the job has changed? How does one get through the day-to-day grind of death, murder and tragedy?

A: Those are hard questions.

I guess you try to insulate yourself from all the violence. We have a very important job to do, insuring that the investigations and examinations that we perform are done thoroughly and professionally.

You become so absorbed in your work that you manage to reach a level at which you're insulated from the personal tragedies -- to some degree. Sooner or later, though, you have to talk to family members. You don't remain immune for very long.

Although we handle a dozen cases [not necessarily murders] every day, there'll be one case that will be so complex and presents such unique questions that it occupies a large amount of your time.

We don't just sit here saying, "Isn't this a terrible job?" It isn't. It's an interesting job. It's interesting because of the questions we have to answer.

That's how we get from day to day, by maintaining our level of interest from a scientific standpoint.

I don't find myself at a point where I say the work is so depressing that I don't want to do this anymore. At least I haven't found it yet. But there are always those times when you look at a case and just have to shake your head.

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