Just Internships for Death Investigation

Introduction [00:00:01] RTI International's Justice Practice Area presents Justice Science.

Voiceover [00:00:09] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research and actionable strategies to improve the criminal justice system. In episode one of our Supporting Medicolegal Death Investigators mini season, Just Science sat down with Cory Russo, Medical Examiner Investigator at the Utah State Office of the Medical Examiner, and Chelsea Brown, Senior Deputy Coroner at the Orange County Coroner's Office, to discuss how internship programs at medical examiner and coroner's offices can be a great way to pursue a career in the field. While medicolegal death investigators are often heard about in the media, the path to join this profession is often unclear. A great way to get exposure to a career in medicolegal death investigation is through internship programs which are available in some offices. Listen along as Cory and Chelsea discuss the requirements of applying to these internship programs, what an average day looks like for an intern and how an internship can prepare you for a career in the medicolegal death investigation field. This episode is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive, and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Kelly Keyes.

Kelly Keyes [00:01:21] Hello and welcome to Just Science. I'm your host, Kelly Keyes, with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. I'm currently a Research Forensic Scientist at RTI in the Center of Forensic Science Advancement and Application. Prior to transitioning to RTI about a year and a half ago, I worked for nearly 25 years at a large coroner's office, primarily as a medicolegal death investigator and supervising investigator. One question I was always asked was, how did you get into the field? And the answer to that is what we are going to talk about today. Joining me today are two guests who are familiar with internship programs in the medicolegal death investigation, or MDI field. We welcome Cory Russo and Chelsea Brown. Welcome.

Chelsea Brown [00:02:03] Thank you for having us.

Cory Russo [00:02:04] Thank you, Kelly.

Kelly Keyes [00:02:05] Cory, what interested you in exploring the MDI professions and what was your path to get where you are?

Cory Russo [00:02:11] It's a little funny, but actually the first time I was introduced to the forensic science field, I was about seven or eight years old and my mom used to always watch that old show, Quincy M.E. with Jack Klugman, and so from that point on, middle school, high school, I was very interested in forensic science related to examining the body, in a forensic science sense. Not so much crime scene investigation. I didn't even know about the medicolegal death investigation field until I did my internship in undergrad. So I was on the path of forensic pathology because that's what I knew about. So I did my undergrad studies at UNLV. They have a forensic science program. It's an excellent program, very hands on. Earned my degree in criminal justice with a concentration in forensic science and then another bachelors in psychology, and that's when I completed my internship for credit at the Clark County Coroner's Office in Las Vegas, Nevada. It was there that I rotated through every section of the coroner's office. I gravitated towards responding to scenes, but being medically proficient and focusing on the body. And then I went on to get my master's degree from Touro Medical School. I'm currently doing a doctorate in epidemiology and health sciences. So that's kind of my career path. Up till now, I've worked for this is my third office as a medical examiner, investigator.

Kelly Keyes [00:03:43] Chelsea, what about you? What was your career path.

Chelsea Brown [00:03:45] As a kid kind of similarly, I've always been interested in science, biology. I've always kind of done well in my science classes, being curious about how something works and then kind of, as you get older as a teenager, when the world is kind of asking you the daunting question of what's next, what do you want to study? I was drawn into forensics and pathology because I like the problem solving angle of forensics, and I've always liked anatomy and physiology. So naturally, when you put them together, I thought I was going to be a forensic pathologist. And that was the plan for the first year of college. However, I realized, like the schooling and the money that it required was kind of discouraging for a 19 year old at the time. I then took a forensic anthropology class and I kind of fell in love with it because I like the practical nature of it. Along the way, I did my bachelor's and master's in biological anthropology. So after all of that was completed, I moved to California to get my master's degree. So then I did an internship with the Orange County Coroner's in California. I was there for almost a year. I was doing in forensics and investigations. So in 2018, I was hired in the forensics department where I assisted our forensic pathologists with autopsy and that really helped me. And I did that for just under two years. And then there was an opening in investigations. So I was hired as a death investigator or a deputy coroner, in 2020.

Kelly Keyes [00:05:22] Can we talk a little bit more, Chelsea, about the internship from your perspective? I know I was the supervisor at the time overseeing the program, but I wasn't hands on supervising. What exactly was it that you did as a day to day during your internship?

Chelsea Brown [00:05:35] Like I mentioned, I was in both forensics and investigations. So part of the week I was teamed up with one of the, what you call, autopsy technicians. So she had a project called the Doe Project. So that was a particular interest of mine coming from anthropology, being as though a lot of the, you know, Doe's we have our skeletal. So I got to assist her with that project, you know, organizing it, understanding how it all works. And then in the other half of the week, I would be in investigations with a death investigator. So I would be assisting them with anything that they were doing throughout the day, rolling out with them in the field, getting a lot of context of the operations of a corner medical examiner office, you know, understanding jurisdiction, what we can't do versus what we can do, what is a reportable case to the coroner, because all of that stuff can be very daunting to someone who doesn't know about getting into that. So I was there for a little under a year doing both departments.

Kelly Keyes [00:06:41] Was there a particular or specific highlight of your internship that stands out that you can share?
Chelsea Brown [00:06:47] Kind of getting to know everybody, putting into context like what you think you know the coroner does, and then actually doing it. And then probably just going out into the field with the death investigator and understanding the importance of the job. Understanding like we are, you know, an important component of the death investigation.

Kelly Keyes [00:07:08] Cory, what's your involvement with the interns in your office these days?

Cory Russo [00:07:12] Yeah, so I'm the internship supervisor here at the Utah Medical Examiner's Office, so I receive applications throughout the year. I run three internship cycles by semester; fall, spring and summer. So I receive those applications. I review them. I then interview the candidates and then offer 1 to 2 spots per semester. So I oversee and I've created a new internship program structure than what they used to have.

Kelly Keyes [00:07:43] Do you offer your internships for credits and or are they paid internships?

Cory Russo [00:07:48] They are not paid and we do provide credit and we actually give preference to students who are in a related program that need credit.

Kelly Keyes [00:07:58] I love that you're building the future of medicolegal death investigation. What are your interns allowed to do in your office and are there things that they're not allowed to do? I know in our office we didn't allow our interns to go on cases that we believed to be homicides. What about in Utah?

Cory Russo [00:08:13] How I structure the program, they start by getting a tour of the office, meeting everyone, and then I actually have them rotate through every department in the medical examiner's office. So that includes admin, epidemiology, we have an epidemiology team here for suicide and drug overdose prevention efforts. So I will have them shadow on phone calls for families of people that have died by suicide or drug overdose. I also have them rotate in the morgue to view autopsies, receive bodies, released bodies, and then a large component is shadowing the investigators and going on scenes. So they are allowed to go to scenes. If it was a high profile homicide, probably not. But they definitely do go to homicides and they're allowed to just shadow on scene.

Towards the end of their internship they can take photographs on a separate camera. It doesn't become the photographs of the scene case file, but they are allowed to be a little more hands on in practice and they do a lot of narratives after every case they go to that just get turned into me so that they can have feedback from those narratives. So they can't lead a case at any point, but they can get pretty hands on by the end. And then I do have projects throughout that they do and then a final project at the end where they actually do a presentation and work the case backwards and try to conclude cause and manner of death and all of that. So that's a summary of how we work the internship program here.

Kelly Keyes [00:09:56] I love that you have the access to the epidemiologists and can really focus on that public health responsibility of MDI. I think that's really something that sometimes is lacking in the community.

Cory Russo [00:10:06] Yeah, it's rare to have that at a medical examiner or coroner's office.

Kelly Keyes [00:10:11] Can you give an example? Is there a recent presentation or one of their final presentations that really stands out to you? Do they pick the case themselves?
Cory Russo [00:10:20] No, so what I'll do is I'll actually pick one of our cases. Closed case, and they don't have any identifying information on the decedent. And what I do is I will show them pictures in office of the scene. They can't take the pictures out of the office.

And when they look at those photographs, they have to write a narrative based off of those photographs, which is similar to the fellow American Board of Medicolegal Death investigator examination, where you see photographs and work backwards, write a narrative. So they'll write the narrative, and then they will also create a PowerPoint presentation and they'll discuss what they're seeing on scene and then talk about anything related to the cause and manner of death that they come up with. So if they come up with suicide, then they can also add in anything else about suicide that they've learned throughout the internship, and then they present that.

Kelly Keyes [00:11:21] So it really is a nice accumulation of everything that they've learned. That's great. Now, Chelsea, you obviously, you know, are seeing interns around the office and I imagine you're probably interacting with them on a regular basis. I'm wondering, what do you think is the biggest challenge for the interns that come through the office?

Chelsea Brown [00:11:39] I think possibly kind of everyone at the office to be on the same page and understanding the functions of an intern like you mentioned. Like what they can't do versus what they can. And it can be a challenge because an investigator may be possibly hesitant to ask them for help with something because they're unaware of their limitations. But I think the ultimate challenge on the intern themselves to kind of put themselves out there be uncomfortable because that's when you learn the most and you're the most memorable if and when you get hired. It kind of just depends on what they're doing I would say.

Kelly Keyes [00:12:16] In investigations, do you generally see the interns doing sort of approximately the same things that Cory described that they do in the Utah office?

Chelsea Brown [00:12:23] Yeah, for the most part, they are going out to calls. They are, you know, practicing writing reports. They're practicing, you know, taking photos. And I do like the idea of the PowerPoint at the end. I think that would be a cool thing to add. But it's similar in the capacity that they're doing everything, but they're not like obviously a handling investigator, but they are assisting along the way.

Kelly Keyes [00:12:49] What about in forensics? You mentioned you worked on an unidentified decedent component of things, but you also assisted with autopsies.

Chelsea Brown [00:12:58] Correct. So I started out assigned to an autopsy technician to assist her with the Doe Project that we have. You know, we do have quite a few I think about 101 unidentified cases right now. So that can be a daunting task. And it's an ongoing task that keeps, you know, updating and you have to be on it, otherwise you can kind of get buried in it. So understanding how all of that works and helping document that, that's what I assisted with. And then during the day I would assist with the autopsies. So I really understood the operations in forensics, how to work with the pathologists, because they're all their own individual persons and they all have their preferences. So I really got a kind of all encompassing thing.

Kelly Keyes [00:13:49] Cory, you mentioned that you gave preference to students that were needing college credit in a related program. Are there other requirements to be an intern in Utah?

Cory Russo [00:13:59] They have to be 18 years old and enrolled or graduated from a related program.

Kelly Keyes [00:14:07] Chelsea, you mentioned that you had done field work for forensic anthropology or for anthropology prior to your internship. Is there anything that you would suggest to Cory or to another office with an internship program or someone thinking of creating one that they could do to enhance their program?
Chelsea Brown [00:14:24] I'm not sure about the field work component because that can get kind of tricky, but I like the idea of having them work on a project. Like a long-term project and feeling like they're contributing in some way to the overall goal of the office. So I really enjoyed, you know, working on the unidentified individuals and kind of gathering data for that to assist. So I think if you have this continuous flow of interns to have them all lift that burden for something. So like I mentioned, daunting, that can really help alongside you know, doing their daily things where they're going out into the field with you.

Kelly Keyes [00:15:07] What did you find are the biggest surprises about medicolegal death investigation that the interns take away from the internship?

Cory Russo [00:15:15] I've noticed a lot of interns come into it not really understanding that it's not crime scene investigation. It's very body medical focused. That's the most common factor that people are surprised by. And it's understandable because a lot of people don't even know about the field. They think that we're either pathologists or we're CSI based off of the media and what they've learned. So I think it's just they don't realize how focused we are on the body because that's what we have jurisdiction over. Most of them handle it very well. There's been a few that would rather not be so much involved in decomposing bodies and more so just evidence. But that's how they learn where their preference is.

Kelly Keyes [00:16:08] I know one thing that I felt the interns were often surprised by was how long things take. You know, in television death investigation is wrapped up in a single episode. I found interns were really surprised that they might start their internship and they've gone on a case day one, and if it's convoluted, we might not even have toxicology back by the end of their term. Are there any other surprises, Chelsea, that you've encountered or that you had?

Chelsea Brown [00:16:36] Just to echo a little bit of what Cory said, like not many people know that we're our own individual kind of department of learning, you know, separate from CSI or the forensic pathologist. And then I think a big surprise which came to me and pretty much anybody who's an intern or even a ride along has realized is we do a lot of office work. We're not always, you know, bumping around from call to call or answering the phone. We're doing follow ups with families. We're taking those death certificates, All of that little nitty gritty, tedious office stuff I would say is like 70% of what I do.

Kelly Keyes [00:17:18] That's true. Most of the investigation really is in the office.

Cory Russo [00:17:21] That's another thing I was going to say is people are surprised by how much we do. How many different types of things we do and how every office is so different. You know, I worked at three offices now, and every office has so many different responsibilities. In Des Moines, Iowa, it was the MDI's responsibility to do legal blood draws on living people. So we all had to have, you know, be phlebotomy, certified and respond to jails, ERs, wherever we needed to go to draw blood on someone that was suspected of DUI. And sometimes they would be in the ICU and they would become our case as well. So we were able to follow them through a longer process. And then in Las

Vegas, we also are responsible for property and acting as public administrator. And yeah, it's just so different from office to office.
Kelly Keyes [00:18:20] That's great that you have that experience in the different offices to bring to the program and explain that to the interns. Because, yeah, certainly blood draws on live people was not something that we had to deal with. You both started as interns, just like I did. Do you find that a number of interns apply for jobs and even get hired either at your office or at other offices?

Cory Russo [00:18:43] Yes, definitely. A good example of that is someone I work with, one of my colleagues now, she started as an intern in her forensic science program here, received credit for it, then she went on to become a vendor investigator here, which is kind of like a contracted investigator, not part time, but similar hours. And then she actually went to part time status and is now a full-time investigator. So she's moved up through every step in the process and is one of our best investigators. And she and I are actually working together right now on creating a better training program for our new hires, because she has that knowledge of moving up through every step. And then I have the experience of working at multiple offices. So I think we work well together and she's a good example of a success story of someone that started as an intern.

Kelly Keyes [00:19:40] I recall one intern that I know she has worked at least two other offices around the country since she was with us.

Chelsea Brown [00:19:48] I can think of like two that were interns at our office, not including me as well, but I think just interns in general in some capacity at a different office. Like we have somebody who is an intern, you know, in New York. You know, we have a couple that interned at L.A. County.

Kelly Keyes [00:20:06] Given that it's such a valuable experience to somebody who's wanting to get involved in the medicolegal death investigation profession, are there any tips that you would give to somebody who's interested in, you know, obtaining an internship? Are there, you know, certain pathways in college they should take or certain courses they can take or certain things they can study?

Cory Russo [00:20:27] My degree was in forensic science, but I did all of my pre-medical prerequisites for my master's degree at Touro Medical School, and I worked at a lot of hospitals in different capacities, and so I was more medically in biology and more science based and I see that that helps a lot in this profession. You know, if there's someone that's just coming straight from law enforcement, they have no medical background at all or no anthropology background, it's a little more challenging for them, I've noticed. At least I believe that it's harder to teach the medical science side. It's easier to teach the investigation side, the scene investigation side. So I would say just, you know, doing a forensic science program that's a well-established program, that is hands on is very helpful. I've noticed that the interns that are coming from forensic science programs often do better than just someone that's in a criminal justice program and that's it. But just having that medical and legal balance, I think, helps people a lot.

Chelsea Brown [00:21:38] Yeah, I agree. I would say kind of learn what the requirements are of the internship, what kind of degrees you would need, and if you're coming from, you know, more of a medical degree, you know, strengthen the other area. But I do agree with Cory in that the medical part is very hard to teach, you know, once they're already in. It's easier to teach the investigative side. So it helps, you know, coming in from that medical side for sure.
Kelly Keyes [00:22:08] So would that be like a medical terminology course or an anatomy course or?

Chelsea Brown [00:22:14] Medical terminology, anatomy, pathology. In high school, I took a medical terminology class that breaks down something so silly that you would think is just the breaking down the prefix and suffix of like a medical word. So something like a medical terminology class can help you understand what a disease is by just breaking down what the word is.

Cory Russo [00:22:36] One thing I would recommend too is I was a scribe in multiple emergency departments in Las Vegas and a lot of pre-medical students scribe for a while. It's so helpful in just learning how to look at medical records, how the ED works, you know, medical terminology, even, you know, disease processes, and it just help strengthen that. And you're kind of in an intense environment in the emergency department and you're exposed to a lot of things, you're having to adapt. So I think a lot of scribe positions are offered to pre-medical students, but I would even recommend people that are interested in medicolegal death investigations to scribe while they're in undergrad or graduate school.

Kelly Keyes [00:23:25] I like that, Cory. One thing I also tended to find made a little bit better intern, was somebody who had some real-world experience in dealing with difficult people. So maybe somebody who had worked at a bank or in food service or something like that. Somebody that had that ability to interact with people and problem solve, which I think helped to prepare them for sort of the customer service part of what a death investigator does. Now, you know, our interns obviously weren't problem solving per say. They were never alone on their own to do so. But do you find something like that helpful or was that limited to just myself?

Cory Russo [00:24:02] I definitely think it's helpful to have just people skills in any capacity is definitely a plus. We have to speak with families all the time and that's a huge part of what we do. So being able to, you know, know how to speak to people and what's appropriate and to also be direct but empathetic is important.

Kelly Keyes [00:24:26] Chelsea, what's the biggest challenge to having interns around the office when you're working as an investigator?

Chelsea Brown [00:24:33] I would say just understanding what their capabilities in terms of the communication, what they can and can't do, and kind of just remembering that they're there. It sounds silly, but like approaching them and not so much myself, but maybe partners of, okay, I'm going out on this call, I'm going to bring her along or bring him along. And really buckling down and committing that time to basically explain, you know, what you're doing and why you're doing it and. Kind of bringing them, you know, under your wing, so to speak, and having them assist you in that process.

Cory Russo [00:25:14] I agree with Chelsea. I think it's important. I'm a big picture person. So explaining the why and the big picture is very important. And that's why I restructured the program to rotate through every department in the medical examiner's office. Even if it's something as simple as filing our cases, just to understand why we are doing every step that we do and how it all comes together is very important. And that's one of the best things I took away from my internship in Las Vegas was, you know, there were times

where I was like, Oh, this is boring. I'm doing 8 hours of filing today, but I realize how important it is to be able to put your hands on every aspect of the office. And that's why I have them do the same thing. Just to understand and explain the why to them. Keep them engaged, but don't throw too much at them at once. It's a fine balance.

Chelsea Brown [00:26:14] I think that's so important because like, that's truly how you learn is like an individual. And if you're able to like, say, this is what we do and this is why we do it and give them context to an overarching idea, then that's really how you learn as an individual, I think, for a lot of things.
Kelly Keyes [00:26:33] Chelsea, certainly to your point, and Cory even I think a little to your point, obviously medicolegal death investigation, medical examiners, coroner officers have been really challenged the last few years with rising overdose deaths and the COVID crisis. Has that at all impacted the internship programs at all?

Cory Russo [00:26:50] I would say that COVID probably impacted everything the most in our office. It was just so insanely busy on a daily basis that I believe we did take one semester off from having interns at all just because the workload was so high and there - it would have been very difficult to also work with an intern while trying to do all these COVID cases. Plus, it was the matter of we don't want extra people in the office if we don't need to have them right now because of COVID 19. So I would say that impacted the program, the internship program, more than anything thus far.

Kelly Keyes [00:27:33] As we wrap up, if someone is out there thinking, I want to create an intern program for my medical examiner office or I want to bring interns into my coroner's office, is there one or maybe even two lessons that you learned from your internship experiences that can help that medical examiners corner office develop their intern program?

Cory Russo [00:27:53] Yes, I would say just make sure to not get tunnel vision and just only have them focus on the medicolegal death investigator aspect. Like I said, having the big picture, having them rotate through every department of the office is important for them to understand why we do our job the way we do, how everything is interconnected. And that's what I would recommend, is keeping them engaged with projects, wide variety of exposure to autopsy, on scene work, admin even, and just keeping them well-rounded throughout the whole process.

Chelsea Brown [00:28:35] Yeah, I like what Cory said, because not everyone goes to, you know, different departments. So I felt very privileged in that I could go to both and I feel like they really worked well together. So kind of like what Cory said, understanding the big picture, understanding how we work as an organization as opposed to, like you mentioned, the tunnel vision of just this and that sort of thing.

Cory Russo [00:29:01] It's helpful to have them work a case from start to finish. You know, they see every aspect of that case from the time the phone call comes in to responding to the scene to then viewing the autopsy of that decedent. So then seeing the follow up work and then the case closure and filing and speaking with family just working that case start to finish is important for them to grasp.

Kelly Keyes [00:29:29] As we're wrapping up, Chelsea, do you have any last-minute parting thoughts?

Chelsea Brown [00:29:34] All I can think of is that kind of just to the overarching idea of like how important an internship is, I really think it kind of took the nerves away from like when I was actually applying for the job and just really understanding how we function.

Kelly Keyes [00:29:50] And I'll add to that, I think it also is a great opportunity for people to find out that it probably isn't the right career for them. You know, you can do this internship and realize, that is absolutely not what I thought it was going to be. It Is nothing like it is on television and that is not what I want to do some day and I'm going to go become something completely different in the world and make my impact differently.
Thank you, Chelsea and Cory, for sitting down with Just Science to discuss all of the work you are currently doing within the MDI community.

Cory Russo [00:30:20] Thank you.

Chelsea Brown [00:30:21] Thank you, guys.

Kelly Keyes [00:30:22] If you enjoyed today's conversation, be sure to like and follow Just Science on your podcast platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOE.org. I'm Kelly Keyes, and this has been another episode of Just Science.

Voiceover [00:30:39] Next week, Just Science sits down with Lindsey McNaughton to discuss autopsy technicians. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.