Helping Dead Men Tell Tales

By Lisa Asato
Interviewed by Lisa Asato
Wednesday - September 26, 2007
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Dr. Kanthi De Alwis and Dr. Gayle Suzuki examine a skull with a gunshot wound
Dr. Kanthi De Alwis and Dr. Gayle Suzuki examine a skull with a gunshot wound

How many deaths does the medical examiner’s office investigate in a year?

Our department investigates about one-third of all the deaths on Oahu, and approximately 1,800 deaths get reported to our department every year. For the last few years, of course, it has increased to 1,800.

How many of those are criminal investigations? The majority?

Out of the total number of deaths investigated, 1,813, we assumed jurisdiction on 748 cases for last fiscal year - 421 fell into violent deaths and only 278 were nonviolent, which are natural deaths.

Who notifies you about cases?

Our department is a 24-7 operation. Deaths are reported to us by either the police, the hospital where a person dies ... sometimes we even get notified of cases from mortuaries, even the health department.

What kinds of cases do you investigate?

The deaths that fall under our jurisdiction include all the violent deaths, which are suicides, accidents, homicides and “undetermined” deaths, which are violent deaths which cannot be categorized into suicides, accidents or homicides. Also all suspicious deaths, all deaths in police custody, all prison deaths and anytime when someone dies suddenly with no doctor in attendance to certify the cause of death.

As medical examiner sometimes you disprove what’s initially described as an accident.

It doesn’t have to come as a homicide all the time. I’ve had cases that have come as accidental drowning/fall/injuries, however, from my autopsy examination I have determined that the injuries were not consistent to be accidental and were then classified as homicides. Oftentimes deaths involving infants, children and elderly have been reclassified.

In that sense, I am the first person who can say, “This is a person who has been killed.” That’s how we help law enforcement. Another way we help law enforcement is by contradicting a witness account that does not corroborate with the autopsy findings. An autopsy really is an incredible tool that speaks volumes of the dead, which helps the living. Dead men do tell tales.

What else do autopsies reveal?

An autopsy tells us how we can prevent deaths. We may be the ones to first recognize an emerging infection. Or let’s say I do a baby case and I find an abnormality that is congenital, or inherited. I will then call the parents, call the pediatrician and let them know that the family should get genetic counseling to prevent any more children from having the same condition.

You also say that you use a “suspect everything” approach.

It’s easier to go forward than backward. As we usually say in courts, somebody is innocent until proven otherwise. However, in the autopsy room it’s a suspicious case until we do a thorough examination and further studies to exclude homicide. And it’s great if it doesn’t turn out that way. I only have one chance.

There’s also a court aspect to your profession.

The most gratifying and the most interesting part of this job for me is to really give the voice to the deceased, particularly in court because that’s where we can tell the jurors what happened and how it happened. And it’s up to the jurors to then determine who did it.

You’ve worked on many high-profile cases such as Ehime Maru and the Xerox shootings. Is there a case that stands out for you?

It’s true, every case is unique, every death is unique, but there are some that have been very challenging and that have remained and will remain forever (with me), where I can close my eyes and remember every injury, particularly the ones that involved little girls who have been murdered.

Is there one case in particular?

Maile Gilbert stands out as one one of my earliest, in 1985. This little girl who was only 6 was sexually assaulted and murdered. I can remember all the injuries to this day, and I still think of her.

What was the outcome of that case? (The state’s MAILE AMBER Alert system bears her name.)

(The assailant) is in prison. ... I told Phil Camero once, from the police department missing persons, that I would like to meet (Maile’s) parents. Not that I can put closure, but I really needed to meet her parents. So last year he had a dinner at his house, where I met the parents and that was very healing for me. ... She was the same age as my son Ravi, so along the way and on Ravi’s 21st birthday I would think of Maile. So meeting the parents, talking to them ... I found solace in meeting them.

You’ve been chief since 2001, six years, but you’ve been with the Medical Examiner’s office for 22 years. After that amount of time, how do you keep that sense of compassion?

In the autopsy room if I am emotional then I lose my objectivity. But I connect with the deceased at a human level if and when I talk to the family, see them on the evening news or read a suicide note. In the courtroom I consider myself as the doctor and a teacher and a storyteller because if I haven’t done that, then no matter how good a doctor I am - what’s the point?

I never wanted to be desensitized. Even after having done 7,000 examinations I am glad that I am still in touch with my emotions.

You were also influenced by a medicine man while you were growing up in Sri Lanka?

I went to an all-girls school, so my parents didn’t believe in letting me go out and play so, they had this older wise man who was the medicine man of the village who was also our gardener, whom I followed around. He was my only friend at home. He would take me to his little house where he would be making herbal medicines while telling me stories whose message was compassion, compassion compassion. He always told me you can conquer the world with kindness and compassion. So I think that influenced me a lot to be a doctor.

Your office is accredited nationally. That’s significant.

Yes, we are. Our department, even before I came in, we were accredited, but we kept it continuous. Out of 960 death-investigative systems nationwide, there are only 55 medical examiner offices that are accredited by the National Association of Medical Examiners, and we are one of them.

You also have morgue tours? Who comes for the morgue tour, kids?

I established the morgue tours as an educational program in 2001. It was my original idea. I thought I can prevent deaths through education, and amazingly we have had so much success and feedback from the kids who have come through our department about how much they have learned of the deaths related to speeding, alcohol and drug use. We have high school kids, drivers’ ed students, students from science classes and clubs, forensic clubs and troubled-youth programs. They don’t get to see an autopsy ... but they get to be in the morgue, surrounded by the big refrigerators where they know the bodies are stored, although they cannot see the bodies. However just being in that environment while listening to what can happen has a big impact. I would say we have about 200 to 300 students and adults come through a year, mostly students.

Anything else you’d like to mention?

I want the public to know as their medical examiner that I have not lost the human aspect with the strong belief that the cases come to us are not just another dead body. It’s an individual who is deeply missed and an individual who comes in contact with us believing that we will be able to tell their story by giving them a voice. And we really do become that voice to the best of our ability. We have a great team here who take pride in their work, who are very sensitive, compassionate and competent.

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