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Q&A with Forensic Pathologist, Thomas Young, MD spoke with Dr. Thomas Young, forensic pathologist and owner of Heartland Forensic Pathology, LLC. He is the former Jackson County Medical Examiner and was the chief death investigator for metropolitan Kansas City, Missouri. He has testified in court more than 385 times.

Below Dr. Young talks about the realities of a career in forensic pathology and some of the issues future forensic scientists should be aware of.

Q: What is your current position and what kind of training did it require?

I'm a board-certified, forensic pathologist, which basically means that I'm a medical doctor. I went through medical school, which is four years long, and I also did a four-year residency in anatomical and clinical pathology. On top of that, I did another year of training in forensic pathology.

Q: What is forensic pathology? How does it differ from other forensic science specialties?

Most of the other forensic science specialties do not necessarily involve medical doctors. When I say "forensic," I'm talking about [involvement] in courtroom procedures or in presenting evidence in a courtroom. A lot of the forensic science areas are predominantly involved in doing analyses. They're looking at firearms, fingerprints, or hairs and fibers among other things. It's more of a laboratory analysis, whereas [forensic pathologists] are trying to provide testimony to a reasonable degree of medical certainty regarding certain aspects of injury and death.

Q: How did you get started in this field?

I was doing a pathology residency, and I was reading a book written by a forensic pathologist named Thomas Noguchi, who used to be the Chief Medical Examiner for Los Angeles County in California. He wrote a book called Coroner. I hadn't even realized that such a field existed. I went to my residency program director, and I asked to do some elective time in forensic pathology. At the time, I was in San Bernardino County, just east of Los Angeles. I did a couple of months of elective there, and I enjoyed it thoroughly. After I did a few years of hospital pathology, I did some fellowship training in forensic pathology, and I've been doing that full-time ever since.

Q: In your work in forensic science, what is an average day like? What type of issues do you typically encounter?

If you're starting out as a forensic pathologist, you're probably associated with a coroner or a medical examiner office; you're doing autopsies in the autopsy room, looking at slides under a microscope, reviewing medical records, and/or checking laboratory results. Also, you're dictating and editing reports. Sometimes, you're called into court to testify on the reports that you've dictated. Sometimes, you're sitting in interviews with attorneys, family members or even the media.

Q: What do you think are the common misconceptions about the career and what is the reality?

There are many misconceptions about the field. It's hard to even know where to begin. A lot of what is depicted on television as far as what medical examiners or forensic pathologists do is just plain wrong.

When you're doing the job, there are a lot of fascinating aspects about it: trying to figure out and come to an understanding of what happened. Sometimes you come up with good answers; sometimes you don't know. Sometimes in doing [your job], you're involved in some very disagreeable things. Often, the odors are bad. Sometimes you end up going to certain kinds of death scenes that are horrific. Sometimes, the politics are very disagreeable. This is not a field for somebody with thin skin. Dealing with family members and angry people can be very difficult. Dealing with the media can be as well. So, [forensic pathology] is a stressful area. It comes with a lot of rewards, but, then again, it's got a lot of problems too.

Q: What do you think are some of the biggest benefits of working in forensic pathology?

I enjoy the challenge of trying to figure out what happened and coming up with good answers. That's always exciting. Those are the good challenges.

Q: Was there something that really surprised you about forensic pathology?

Well, I was pretty much warned before I started out. When I developed an interest in forensic pathology, the guy who was instructing me said, "Do not go into this field."

He said it's a no-win situation because you're supposed to basically get the right answers all the time, but you're working in a situation in which there are a lot of politics. You've got people who are cutting your budget all the time, and nobody wants to spend taxpayer money on death investigations. Even so, when you make a mistake, everybody is pointing a finger at you and blaming you. Nobody blames the politicians.

Q: In general, are there any specific traits that work well in this career?

If you want to do well at [forensic pathology,] you first have to be honest. You also have to be smart. You have to deal with people very well. You have to understand people and know how to talk to them. You have to be able to write and speak well. Also, you have to have thick skin and be somewhat tough.

Q: What kind of changes have there been in forensic pathology in the last few years?

Science, natural and physical science, has led to a great deal of progress. Forensic science; however, has been a major disappointment. In many respects, it's one of the leading causes for the incarceration of innocent people. Science people for the federal government have done a big study of this and back in 2009 released Strengthening Forensic Science in the United States. It has been recognized that forensic science doesn't work well. You can get scientists from all different points of view and come up with all kinds of answers. That's not really reliable science; we wouldn't have been able to put a man on the moon with this kind of chaos.

Arthur Conan Doyle, basically thought of [Sherlock Holmes] as a forensic scientist. The idea that you can go to a crime scene and look for clues and evidence and be able to reason backwards to the events that happened basically came out of the Sherlock Holmes model. For example, you can determine that the number 14 follows next after the number 12 when you list a series of even numbers, but you cannot look at [the number] 14 by itself and tell me [all the numbers that came before it]. When Sherlock Holmes looks at clues, that's what he claims to do. He claims to take the number 14 and tell you the pattern that led up to it, and he claims to do so with great intelligence and certainty. The only problem with the whole thing is that it's a logical fallacy. Even if you might be able to predict what an outcome would be if you heard the past events, you can't look at the evidence and surmise the past events that led to that evidence. There may be numerous scenarios that might have led to the same evidence. The logical fallacy of determining the prior events by looking at the result is called "affirming the consequent."

Even though we might come up with a theory or hypothesis about what happened, that's just basically a guess. All these forensic scientists get up in court and propose guesses and state that they are scientifically certain of their statements. Whenever you're reasoning from an effect to a cause, you're hypothesizing. I write about this quite a bit on my website, including an article that I put up there called, "Attorneys and Judges, You Can Stop the Madness Now."

The same Sherlock Holmes model is being applied to every single detective show that you see on TV, including CSI. It's all the same kind of backward inference, and it doesn't work.

When I'm confronted with a case, I listen to the accounts given by eyewitnesses, people who were actually there to see it. I look at their accounts, and then I look at the physical evidence. Then, I ask the question, "Is the physical evidence explained by their account?" If the physical evidence is consistent with their account, I believe the account because I have no reason not to believe it. The evidence fits what they said. This is reasoning forward.

I'm reviewing cases in which people are being sent to jail for stuff they didn't do, and I'm seeing this a lot. This is very, very discouraging. It is my hope that people who are going into the forensic sciences study logical inference, study exactly the sort of thing that I'm talking about here, and figure out how to do this better than what we have been doing in the past.

Very few people realize how bad [some practices in forensic science are]. They have an idea. They're talking about getting more accredited training and accrediting more crime labs, but they have not really put their finger on the underlying problem. And until they do, we're going to continue to have problems in the field.

Q: What do you see for the future of forensic pathology?

I am always hopeful. I don't know that the answer is going to come from the scientists. I'm hoping that in time, the attorneys, judges and courts figure out the problems with forensic science. I am optimistic, but right now it's pretty discouraging.

Q: As a teacher of forensic pathology, what do you think students need to look for in their education to help them prepare for the field?

I was the director of a training program in forensic pathology. I encourage students to be very skeptical about some of the stuff they're being taught. There is a lot of misinformation. People think that they know how to do this, and the problem is: who's to tell them they're wrong? Somebody gets sent to jail, and everybody thinks that's the end of the matter. I encourage students to be very, very skeptical about things; look at everything very critically because things are not always the way they seem.

Q: Any other particular recommendations for aspiring forensic pathologists? Is this a career path that you would recommend for them?

I have no regrets. I love what I do. It's not going to bring me fame and fortune, but I think I was made to do this. I think I am making a contribution, and I'm very excited about what I do. If somebody is going to go into this field, they have to have their eyes open, and they have to know what they're getting into. They have to realize that not everyone is going to be just patting them on the back for doing a good job. They're going to get a lot of resistance. They have to be kind of tough.

***If you are interested in forensic pathology, you might also be interested in:
Forensic Science Degrees
Forensic Psychology Degrees
Forensic Nursing Degrees

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