One of the most important roles we play in this community is our role as the Coroner. In San Benito County, I not only have the role as your Sheriff, but I am also the Coroner and the Marshall. Each sworn employee of my office serves as a Deputy Sheriff and a Deputy Coroner. Many people do not fully understand this role and why we “do what we do” in death cases. I expect my staff to be assertive, yet compassionate whenever there is loss of life in our community. I hope this column brings some clarity.
One of the things that makes our society great is the reverence we show those who have died. This tradition of delicate care and respect for our deceased is found throughout our great country. When a person dies here in San Benito County, our staff determines as to how the decedent will be “handled.” Over half of our deaths each year are of “natural causes,” or they have some type of medical explanation. In these cases, we work with medical professionals to perform what is best referred to as a “medical statement.” That means either the doctor, or the Deputy Coroner, attests to the death on a death certificate without an autopsy. An easy example of this is a person with a terminal illness. When somebody is in hospice, or under a doctor’s care for something terminal, and they die, we make the determination the death was natural. So, the death certificate would read the cause of death was lung cancer, for example. These decedents are transported directly to the mortuary of the family’s choice.
If that same terminal patient was killed in a car accident, we would not determine the death was natural or related to cancer. It should go without saying that dying in a car accident is not a “natural” way to die. In those cases, we would have an autopsy performed by a licensed medical examiner. More than likely, the cause of death would be blunt force trauma in that case. But that determination would be backed up with medical/forensic evidence in a pathology report.
Our county has a contract with the Santa Clara County Medical Examiner’s Office for Forensic Pathology Services. Our county does not employ our own pathologist. This community can rest-assure that our Chief Medical Examiner Doctor Jordan, and her team in San Jose, are incredibly talented and great to work with. The only unfortunate part of this partnership is explaining to those who have lost someone that their loved-one has been transported out of the county for autopsy. The Medical Examiner’s Office in San Jose is housed at San Jose Valley Medical Center. It is a secure facility and they do not allow visitation or viewing.
Often, we can only provide an estimate as to when an autopsy may occur. It all depends on the workload the pathologist has at the time. Normally autopsies are performed within a few days. Toxicology results take months to get back. This may delay a final determination as to the cause and manner of death in some cases.
An autopsy is performed when there is not a medical explanation for the death. These situations arise in cases of accidents, homicides, suicides, overdose and when someone dies unexpectedly that cannot be medically explained. This is sometimes difficult for our community members to understand. A scenario would be that of a loved one in their late 80s with high blood pressure and diabetes. If this person died in their sleep, a family may want an autopsy done for an answer as to why their loved-one died. In these cases, we reach out to the doctor who had this person in their care. The doctor will often say the death may not have been expected at that moment, but it can be medically explained by age and ailment. You would expect to see the determination of death due to myocardial infarction (heart stopped) due to age, high blood pressure and diabetes. If that person was not under a doctor’s care, they would be sent for an external autopsy where the pathologist would do an external examination of the body for trauma and read all available medical records to make a determination of manner and cause of death. The end-result is usually the equivalent of a “medical statement.”
The era of COVID-19 has created an entirely new set of challenges for the coroner and Public Health Officials. In the normal course of our duties, when people die for medical reasons, the coroner does not take jurisdiction. The medically-related death is handled by the attending physician and the family makes their arrangements. However, in a pandemic, the coroner is notified of any death related to said pandemic. In the case of COVID-19 (SARS-CoV-2), the Public Health Department tracks the decedent statistics. The Public Health Department and Public Health Officials track all deaths and may do post-mortem testing to see if a decedent had COVID-19 at the time of death. These determinations and statistics are held by Public Health, not the coroner. We do work hand-in-hand in tracking statistics for the pandemic, but it does not fall in the jurisdiction of the coroner.
Being a Deputy Sheriff is a great job and calling, but it is in no way easy. This job can be very traumatizing to our staff. In public safety, we see death and trauma often. Some in our community go their entire life without being exposed to death. Deputy Sheriffs deal with it sometimes daily or weekly. Our staff are the ones who are required to collect the remains of those who lost their lives. It does not matter the condition of the remains; they must collect all of the remains. We do this out of respect and dignity of the decedent and their loved ones. This is a very hard part of the job, but it is also one of the most important things we do. We are with you at the worst moments of your lives, and even in death. Some of the most incredible letters and heart-felt calls of thanks for our service are directly related to how we treated our community members during death cases.
We are human. We get emotional when you get emotional. We struggle when children die. We get sad to see your pain. But we do our best to always conduct ourselves professionally. Sometimes that may seem “cold” or “indifferent.” We never intend to be that way. There are certain rules we need to follow, and we always do our best work for the deceased. But please know we mourn with you. We go back to the office and talk about it. We struggle in processing the things we see. We are affected by every loss of life. At times that is why we show frustration with drunk drivers, speeders, parents not paying attention, and other unsafe things. We are the ones who get called to those preventable “accidents.” And we are not alone. Our allies in the police department, fire department and AMR go through it all too. And often overlooked are the medical staff in our hospital and our dispatchers.
It is a humbling experience to be in your homes and by your side during these emotional moments. I promise we will always strive to be empathetic, calm, and sensitive. If you ever have any questions regarding end-of-life issues, do not hesitate to call our office for guidance. Hospice is an incredible resource with some of the most dedicated and caring people I have ever interacted with. You are not supposed to be well-versed in what to do in times of tragedy or end-of-life scenarios with a loved one. There truly are no bad questions. We will do all we can to guide you, be there for you, and treat your loved ones with the dignity they deserve.