“Sometimes it clicks: in front of you is still a person.” Interview with forensic expert Olga Fateeva

A medical examiner is a specialist who opens up people's bodies and draws conclusions about the causes of their death. He cooperates with investigators and helps them solve crimes. And if now you remember the scenes from the TV series "Next", then you should definitely read this interview: in real life, everything is completely different.

“Many countries don’t have forensic experts”

- Let's immediately explain how a forensic scientist differs from a pathologist.

— Forensic experts examine the bodies of those who died a violent death. We receive people who died in traffic accidents, mass disasters, after falling from a height or killed.

We are also studying the causes of sudden death. For example, when a person was just walking down the street, and then fell and died under unclear circumstances.

Pathologists, on the other hand, open up the dead only from diseases - for example, from cardiovascular. And, unlike forensic experts, they do not study bodies in a state of late cadaveric changes - at the stages of decay, mummification, and so on. This is our job.

In many countries there are no forensic pathologists, only pathologists who perform these two roles. But in Russia, forensic medical examination and pathological anatomy are separated.

Although I would be glad if these specialties were combined. Because with any suspicion of the violent nature of death - jokingly speaking, with fracture little finger - pathologists send corpses to us.

- Please explain again what you mean by violent and non-violent death?

- Death from natural causes - old age and disease - is considered non-violent. Everything else is violent death.

Another thing is criminal and non-criminal death. These concepts are operated by the police. Roughly speaking, alcohol poisoning - this is most often not a criminal, but at the same time a violent death.

- And what is the leading cause of violent deaths?

- Poisoning. It is often about an overdose, but not with traditional heroin, but with other substances that are now rapidly synthesized. By statistics, about once a week, one drug appears in the world.

A few years ago there was a period when quite a few deaths were caused by poisoning with a substance that is used in ophthalmology. It causes hallucinations when injected into the bloodstream, an effect that drug users have been trying to achieve.

“You understand that this is not death from acute heart failure, but murder”

- What is your work routine?

— I work in the morgue. Every day we open the bodies that came to us over the past day. Their number is impossible to predict, so I do not know how much work will be waiting for me tomorrow.

We live in a state of unpredictable stress all the time. Today I can open one corpse, and tomorrow - four.

In addition, I have other responsibilities. For example, together with clinicians, I participate in clinical and anatomical conferences, where various cases of death in hospitals are discussed, I go to courts, consult doctors and police officers.

How is an autopsy performed?

- Here are the main steps.

1. Familiarize yourself with referral documents from the investigative and inquiry authorities. They may contain specific questions and tasks from the investigator. For example, remove certain tissue fragments with damage or take samples blood and hair. There may also be questions about the number of impacts and the position of the victim and attacker in relation to each other.

Along with this, I receive a protocol of examination of the corpse and the scene. And if this is the body of a person who died in a hospital, then also his medical record. I make sure to study it before going to the autopsy.

2. I photograph the body from several angles. Aiming - some features and damage. If this is the body of an unknown person, a little more photographs are needed: they are shown to the identifying persons.

3. I'm doing an outdoor study. I describe pollution and excretions. Be sure to pay attention to traces of blood and their number. The condition of the clothes is also important. Before the forensic medical examination, things are not removed and, if possible, their position on the body is kept.

The body is described from top to bottom and from outside to inside. If we are talking about an unidentified person, I make a verbal portrait using a special technique. Be sure to pay attention to all the features - for example, tattoos, scars, the condition of the teeth, the color of the irises, traces of operations and so on.

I describe the cadaveric phenomena in order to be able to establish how long ago he died.

4. I perform an autopsy - internal research. An autopsy of the skull is performed with the extraction of the brain, as well as an autopsy of the torso. At the same time, the organocomplex is released from the tongue to the rectum and internal genital organs.

When it comes to trauma, I make incisions in the soft tissues of the limbs, examine the bones, spine, spinal cord, if there is an indication for this.

5. I am writing a diagnosis. And I draw conclusions.

- Has it ever happened that one cause of death was assumed, and after the autopsy it turned out to be different?

- Yes. It happens that you open up someone who seems to have died suddenly, and then you find signs asphyxia and you understand that this is not death from acute heart failure, but murder.

After all, firstly, during the examination, you may not notice small crescent-shaped abrasions on the neck. Secondly, they may not remain at all if the killer, for example, used a scarf.

Gunshot damage can also be skipped. If we are faced with the so-called small thing - small caliber - on the scalp, the entrance wound can simply not be noticed.

Sometimes it happens that you examine the body of a person who died in a hospital. And it would seem that according to the medical record you observe complications after the primary injury. And at the autopsy, you find signs of iatrogenic - a medical intervention that led to the onset of death.

Now, for example, for chest compressions autopulse is used. This is a device that rhythmically presses on the chest. The first cases of using this device were accompanied by multiple injuries of the ribs, which were formed more than with the traditional method of resuscitation. It comes not only to ruptures of the liver, which also occur during indirect massage with the hands, but also to ruptures of the heart.

- You not only worked in the morgue, but at the same time you were the on-duty medical examiner and went directly to crime scenes. What was the most embarrassing location you had to perform a body exam?

— Yes, I went to the scene at the beginning of my work. I remember the "beautiful" apartments, the floor of which is strewn with cockroaches, crunching underfoot.

But perhaps the most shocking case was this. We came to a call to a dysfunctional family. Mother, father and son lived in a small room. father suffered alcoholism. When he once again came home drunk, his wife hit him on the head during a fight. He fell, but, apparently, continued to cause concern to everyone. Then she tied him to the leg of the bed, and then strangled him with a pillow. The boy at that moment was sitting in the room and doing his homework.

After the inspection, I decided to walk around the apartment - I was interested, since it was one of my first trips. Operatives and forensics allowed.

I started leafing through the boy's school notebook. It alternated homework and classwork, written in a smooth, neat handwriting. Among them, the last one stood out, which occupied only one line.

It was the only sentence from the red line: "Mom strangled dad."

A testimony written by a child, so directly and openly... It was the worst thing.

Have you received complaints about your work? What did they look like?

- Yes. The most common and most common problem is distrust. Relatives of the deceased may file a complaint against my determination that the death resulted from non-violent causes. They think: “No, he was killed! And the expert, of course, colluded, took the money and covered up the crime!” This is a classic pattern from films.

It often happens that an accidental fall from a height or suicide occurs. But relatives do not believe in this, especially if the death occurred in front of witnesses. Additional examinations are starting, we are getting on our nerves.

There is a common myth that it is easy to calculate whether a person fell with the acceleration initially given to him or not. But this is not true. There are no clear and reliable morphological criteria for this. One can assume, speak out, think, but it is impossible to establish 100%.

For example, I had such a case. The young girl fell out of the window. Before that, she was in the apartment with a friend. The mother of the deceased decided that it was she who dumped her daughter. And I wrote in conclusion that the girl just fell, without specifying whether she herself or with someone's help. The police have to fix it. Because of this, my mother filed a complaint, and I was eventually called in for questioning. To be honest, I don't know how the story ended.

Forensic experts often find themselves in situations where they cannot defend themselves. If the accused has good lawyers, it will be easy for him to undermine the court's confidence in the conclusions.

For example, by order, I must indicate the price of division thermometer, which measured the temperature, the division value of the ruler, which was used during the autopsy, the brand of the camera, which captured the body of the deceased. If all this is not written, the court may doubt the rest of the information written in the conclusion. Including - in the diagnosis, cause of death, conclusions. Although I am not very interested in the division price of a thermometer.

"More courage is needed to work with the living"

- What is your professional deformation expressed in?

- In increased cynicism - completely sharp and uncompromising. When I began to notice this in myself, I tried to work with it. Now I feel more emotions, and it bothers me. However, at the same time, I feel that I am becoming more human.

I also noticed that I treat the opened body as research material. I come across interesting, uninteresting, funny cases. Somewhere slips a specific medical black humor. But sometimes it clicks: in front of you is still a person.

- Has it ever happened that the profession disgusted you?

- I felt disgust, probably, a couple of times when I went out after the decree. During pregnancy, my perception of smells changed. Therefore, when I began to conduct research on putrefactive corpses, I had bouts of physical nausea. This usually never happens to me!

And some of the nightmares that I encounter, cause me more fear and a sense of powerlessness. But in "fast pacedI described two incidents that horrified me.

In 2016 in Sochi plane crashed with the Alexandrov Ensemble. And in 2018 there was plane crash in Ramenskoye (a district in the Moscow region. — Approx. ed.).

Instead of bodies, their fragments were brought. I could not imagine that there is such a force that turns living people into tens of thousands of pieces.

If in Sochi airplane fell into the sea and from there it was not possible to catch so much, then in Ramenskoye there was an opportunity to collect the remains from the ground. There were 71 passengers on board. They brought more than 10,000 fragments of human bodies.

“It definitely takes courage to work with something like this!”

- I think in this case one should be able to suppress the physiological natural reaction. More courage is needed to work with the living.

- In your autobiographical "Skoropostizhka" you write that you came into this sphere to help people. How exactly do you think you do it?

- I thought that this specialty, on the one hand, helps justice. On the other hand, it improves the quality of medical care. After all, it is thanks to mortality statistics that the healthcare budget for the next years is planned.

If, for example, a lot of people died from cardiovascular diseases, then the industry cardiology should allocate more funds: to train new doctors, to provide hospitals with modern medicines and high-tech equipment...

However, in practice it doesn't work that way. Medical statistics are a tricky thing. We have seen this on the example of COVID‑19. And the budget money between sectors is not always distributed fairly.

Speaking of helping justice, forensic science has a narrow scope.

Detective films have created a myth that the medical examiner is a king and a god who will tell you everything about a crime.

The power of cinema is so great that even employees of the investigation and inquiry agencies often believe in it. They come to me with the words: "Tell me, under what circumstances did the murder take place."

But a forensic medical examination can answer this question in a very limited number of cases. After all, this is a science based on morphology, that is, on what you see: with the eye, with a magnifying glass or microscope.

If in front of you is a stab-cut wound, so there is a wound channel. It can be measured, set the length and width of the blade of the blade, the direction of this channel. But if you are asked where the attacker was, you understand that he could be in front, and behind, and on the side. It is impossible to restore this only on the basis of the data that the forensic expert has.

Therefore, the real percentage of work that is worth something for the investigation is very small.

Having devoted so many years to this profession, I understand that I am built into a system without which a person in our country cannot be buried. This is the only help I bring to people. Such thoughts cannot serve as a consolation - this is an offensive minimum. That's why I'm planning to quit my job. I've had a big reassessment of what I'm doing.