Saturday, Dec. 13, 2008 | Countless bodies have been reunited with their identities thanks to Dr. Glenn Wagner, the chief medical examiner of San Diego County.
A cop-turned-coroner, the 62-year-old has worked on a long list of high-profile cases including the 9/11 attack on the Pentagon, the two space shuttle explosions, the Jonestown massacre in Guyana, the aftermath of atrocities in Rwanda and Bosnia and many others.
Wagner returned to San Diego to become medical examiner in 2003, three decades after serving here in the U.S. Navy. He took on his new job after retiring as commanding officer of the Armed Forces Institute of Pathology.
Wagner oversees an office with 60 employees, an $8.4 million budget and an annual caseload of about 11,000 deaths, roughly half of those in the county. Pathologists perform some 2,700 autopsies each year; Wagner himself performs hundreds of them.
A genial man who works out of a Kearny Mesa office overflowing with hundreds of books, Wagner sat down with us to talk about the business of autopsies and a new $85 million medical examiner’s building that is scheduled to open in December 2009.
What makes cases in San Diego unique compared to where you’ve worked on the East Coast?
I don’t think I have seen anywhere the variety, and sometimes the complexity, of cases that you see here — tattoos, implants, body piercings and “better life through chemistry.”
What else is unusual about cases here?
Probably 97 percent of our cases are positive for something in terms of toxicology: alcohol, drugs of abuse — including amphetamines and opiates of one sort of another — as well as a large number of antidepressants. They are either prescribed to the person or they have access to it.
Drug interactions as well as lethal concentrations are a big issue. In some cases, they mix (antidepressants) with over-the-counter drugs or even herbal and natural (medications).
Forensic science has gained a higher profile over the last decade thanks to TV shows like “CSI: Crime Scene Investigation.” Has that changed expectations?
It comes up in court, certainly with the jury, the public and the press.
I end up doing a lot of public presentations, and the “CSI” issue is there. What I tell them is that what they see is largely representing technology that’s available, but none of us have the ability to solve crimes in 24 hours, and none of us have access, as far as I know, to holograms and some of the fancy stuff.
There’s also what’s described as the “CSI effect.” It refers to perceptions by the public sometimes, and juries in particular, about the level of evidence that needs to be presented in order to get a conviction.
The medical examiner’s office sees more suicides than homicides. In 2007, for example, you had 358 suicides in the county, compared to 135 homicides. What do you make of those numbers?
When you compare our numbers with the other 57 counties in California, we’re in the top third just as we are in population, so it’s not excessive.
But for some reason or another, the suicide rate is substantially higher west of the Rockies. That’s been extensively studied.
There’s three waves (of suicide): Young people, the youngest being 8, a couple 10 and 11 year olds and quite a few teens. That’s been a focus of concern and subsequent health outreach efforts.
It slows down and picks up again in that 35-40 age group. Typically, lost loves, bad finances, and Viagra not working all conspire. It goes down again until roughly 65 and picks up again, when there’s consistently more bad health and loss of spouses and significant others.
There’s a significant cultural bias, even in a diverse population, against suicide. But once that door is open, it tends to stay ajar. It’s not uncommon to see a second suicide in a nuclear family.
Do you see the bias against suicide reflected in the number of families who don’t accept a verdict that a person committed suicide?
Of all the manners of death — and there are only five that we have available (homicide, accident, suicide, natural and undetermined) — families and estates are likely to contest suicides over any other.
Are you seeing more of any particular type of case?
We’re seeing more family-requested autopsies, believe it or not. It’s on the increase and has been on the increase over the last three years. (These autopsies aren’t required by law and cost families about $2,200. The number performed by the medical examiner’s office has grown from 10 in 2003 to 33 in 2006, 26 in 2007 and 22 so far this year.)
It may represent a more litigating community. It may represent that our population is somewhat older and in periods of hospitalization, and families are not satisfied with the level of care that they get.
How many unidentified John and Jane Doe cases do you get?
We run about 300 a year. They not only represent undocumented folks but a lot of homeless people, oftentimes living under an alias, as well as other folks.
Over 97 percent are identified. That represents a very consistent and very strong effort on the part of this office.
Because of active involvement with multiple databases, we were (recently) able to identify a person who came through in 1980 and finally give him a name and final disposition. That’s pretty exciting.
How will the new building affect operations?
The earlier (San Diego) coroners, oftentimes physicians, military surgeons, would do their inquiries in funeral homes. After the turn of the century, the coroner’s office was a real place, and for many years they were downtown. And then they went to the outskirts of Old Town until the late 1950s, when we were displaced when (interstates) 5 and 8 were built and the two intersected.
We’ve been in this building (in Kearny Mesa) since 1962. It’s 16,000 square feet, and it holds the whole operation. When fully complemented, I have a staff of 60 and a budget of about $8.4 million.
The new building will give us access to 84,000 square feet. Not all of it is mine, some will be shared with county veterinary diagnostic lab. But most of it is medical examiner space with the capacity to handle a significantly larger number of decedents at one time and an expanded toxicology capability.
You’ve had quite a colorful past. You were part of a team assigned to perform an autopsy on the president if he was ever assassinated.
We worked with the Secret Service and the FBI to track the president when he traveled and make sure there were appropriate mortuary facilities should [an assassination] occur.
The closest I came to that was when John Hinckley shot Ronald Reagan. Hinckley used a new type of ammunition called the exploding bullet, a hollow-point that had been modified. I was part of the investigation of that ammunition.
When the president was taken to George Washington Hospital, they recovered an exploding bullet. They had real concern that one of these would go off and be an additional concern to trauma surgeons.
That concern led to a pretty aggressive evaluation of the ammunition and eventually it was outlawed.
What was your most unusual case?
One of my more interesting ones was in Cameroon, Africa, when Lake Nyos belched [in 1986]. The lake erupted in some way and killed some 3,000 inhabitants and probably four times as many livestock.
It was a significant multinational investigation. We had hoped to have access to the dead, but they had buried all the dead in mass graves and covered them with lime. When we wanted access to them, the Cameroonian army basically gave us shovels and said, go to it.
We did unearth or exhume a number of people, and we collected toxicological specimens. It was clear that it was an asphyxial (suffocation) death.
A quarter-mile cube of carbon monoxide was released from the lake. And because carbon monoxide is heavier than air and the lake was above all these villages, the gas basically came down the mountain and asphyxiated everything but plants.
I understand that you’re a religious man. Has your faith affected your job?
I grew up in Philadelphia to a Protestant family. Being primarily a fundamentalist American Baptist is my background.
I actually went to Eastern Baptist Seminary (now Palmer Theological Seminary) for a short period of time. That was as a cop. A lot of my fellow students thought a cop in divinity school didn’t fit, especially because Philadelphia cops had a reputation for thumping, and [the city was described by some] as a police state.
I had an opportunity to be an assistant pastor at the church I grew up in and to work with young people. I didn’t find any conflict, and actually found a certain amount of stability in addressing not only the physical and mental but the spiritual aspects of life.
Coming to grips with that and your mortality is a big deal. I’m reminded of that more and more as I get older. A lot of my clients are younger than me.
I do believe in the afterlife, and I think most people aren’t too concerned about being dead, but rather with dying. We all have that appointment.