“My kids say their dad makes people smile and I take care of dead people,” Dr. Ponni Arunkumar, Cook County’s Chief Medical Examiner, jokes in her office in late June. Her husband, an internist, chose to care for the living, while she chose pathology after a rotation in the medical examiner’s office on Chicago’s near West Side.
The job is notoriously difficult. There is a nationwide shortage of pathologists. “You see sometimes the worst of society, you’re dealing with people who are in their worst day, they’re grieving,” Arunkumar said on The Daily Line’s Aldercast, but “I really like the field because you’re involved with every aspect of pathology. You’re also explaining to a jury what happened to a person, so you’re teaching, as well. I did my fellowship training program in forensic pathology in the Cook County Medical Examiner’s Office and have stayed here ever since.”
Arunkumar was promoted to medical examiner three years ago, after her predecessor, Dr. Stephen Cina, won the office a seal of approval from the National Association of Medical Examiners and promptly resigned, citing the stress of the job. The accreditation was especially monumental because of a 2012 crisis at the office that saw dead bodies piled on top of each other and coolers “overflowing with corpses.”
While past eras for the office have been characterized by mass disasters like the 1995 heatwave, the crash of American Airlines Flight 191, the Tylenol poisonings, and John Wayne Gacy’s murders, Arunkumar said 2012 was the most significant hurdle she’d faced in her time at the office.
The county’s morgue cooler is now the largest in the country, able to house 250 bodies. The day of the interview, the morgue’s census was 160, which can include storage from nursing homes, hospitals and funeral homes. Adding storage capacity was just part of the turnaround.
“We’ve built a new cooler where we house our bodies,” Arunkumar said. “We have an indigent coordinator, we have increased staff in the office, we’ve introduced an electronic case management system whereby any case or any body that enters the office is tracked wherever it goes. All the samples that are taken are also barcoded and tracked, our case reports are also in this case management system. We have the support and the funding that is needed… we meet not only national standards but international standards as well.”
Arunkumar’s office has also been in the spotlight for its review of fired pathologist Dr. John Cavanaugh’s determinations. Cavanaugh was fired after an internal review found he botched autopsies, the Sun-Times reported, including a missed homicide. Of the 219 cases he handled, 92 have been reviewed, and 18 have had their cause or manner of death changed, ME spokesperson Natalia Derevyanny says. That’s an uptick since December 2018. Three of the latest cases changed were natural deaths, but with the cause of each adjusted.
“We’re still going through the review process,” Arunkumar said, estimating the office is roughly halfway through its review and plans to finish it by the end of 2019. “We trying to triage such that the more child deaths and homicide deaths are looked at, then all the other case types… taking care of more difficult cases first.”
The office’s own quality assurance was “the reason these errors were first noticed. We’ve also started reviewing cases for a pathologists who come to the office, such that for the first three months, their cases are randomly reviewed by the deputy chief and the chief medical examiner to improve the quality assurance process that’s already in place,” Arunkumar said.
Her face also became nationally known when she testified during Chicago Police Officer Jason Van Dyke’s trial on the 16 gunshots that killed Laquan McDonald, one of Arunkumar’s highest profile cases. She did not perform the autopsy, but said it was one of roughly 10 cases where she’d explained that many bullet wounds in a single victim.
“It was stressful, but as long as I remembered that my job is to explain to the jury what happened to Laquan… I agree in the beginning there was the stress of all the cameras pointing at you,” Arunkumar said. “After a little bit, I was just looking at the jury and explaining to them what happened to Laquan and it was no longer stressful.”
Other takeaways from the interview:
- What the office does for the living – The public health aspect of the job gives Arunkumar hope, she says. Its organ and tissue donation program helps hundreds – one body can produce seven organ and 30 tissue donations. The office is also working to hire an epidemiologist to spot trends in deaths earlier. The ME likely saved lives when it found deaths due to synthetic marijuana being mixed with rat poisoning and advises the county’s health and hospital system on how opioid deaths are changing, Arunkumar said.
- How death has changed here during her career — “We’ve seen the opioid epidemic affect Chicago and all the neighboring suburbs. In 2016, we saw a 70 percent increase in deaths due to opioids, this number has continually increased,” Arunkumar said. “We’ve also seen an increase in our number of gun homicides. There was a 50 percent increase in gun homicide deaths in 2016, this number has reduced in 2017 and ‘18, but the number of gun homicides our office deals with is more than what New York and LA office see put together… We’re seeing people getting shot multiple times and also we’re seeing them more often in automobiles, whereby the gunshot wounds have some– we have to deal with bullets going through glass or through the car door, changing the characteristics of the wounds.”
- On why Cook County’s stands alone — Cook County is the only county in Illinois with a medical examiner, which is an appointed position requiring pathology experience. Other counties elect coroners. Cook County owes this distinction in part to the long controversy surrounding Black Panther Fred Hampton’s death in 1969 at the hands of Chicago police. “There was a scandal where when Fred Hampton was killed, the coroner at the time determined a number of gunshot wounds that was different from an independent pathologist who was hired by Fred Hampton’s family,” Arunkumar said. Four autopsies took place on Hampton’s body, and also examined whether he was under the influence of barbuates. By referendum, county voters established a Medical Examiner’s office in 1972, and the Coroner’s office was abolished in 1976.
- Advice for the living from someone surrounded by death — “I think appreciating everything that you have, even the simple fact that you’re alive, your family is healthy is what I would say. Sometimes you forget to appreciate the simple things one has. Dealing with this field for a long time makes you appreciate the simple things.”