KUALA LUMPUR, Sept 8 — In any US criminal procedural drama, a central character will be a pathologist (or a coroner in the UK), working to decipher clues left behind on a body in order to catch a killer.
What takes place on the television screen, however, offers only a small window into the real-life work of a pathologist.
“Tears, sleepless nights, emotions, blood and sheer focus,” said Hospital Kuala Lumpur’s National Institute of Forensic Medicine director Datuk Dr Mohd Shah Mahmood, 58.
Malay Mail was recently given the chance to get a glimpse of what happens at the institute.
The hour-long interview allowed us the chance to dissect what a forensic pathologist does, from the moment he is tasked with conducting a post-mortem examination until the body is returned to the next-of-kin.
He described a forensic pathologist as someone who deals with the dead and the living.
Dr Mohd Shah, who will be retiring in two years, said he has no regrets pursuing this career that has been filled with ups and downs since he started in 1992.
It has left him with some painful memories too.
“At times, when I receive a body, I cringe at the thought of how someone could hurt another so badly.
“There are days when a body arrives and it is of a kid. They did not deserve such a death,” he added.
Justice for the dead
Dr Mohd Shah said the most important duty of a forensic pathologist is to conduct a thorough post-mortem examination.
Autopsy results can be put into four categories: Natural death, sudden death, accident or homicide.
“The public always has this perception that we perform an autopsy on anyone who is dead but that is incorrect,” he said.
“We only have the right to do so after the police demands that a post-mortem examination be conducted if they cannot confirm the cause of death.
“Only government doctors specialising in this field are allowed to do it and the authority must come from the police first.”
He added that it is important to conduct an in-depth examination because it can help secure justice for the dead.
“At the end of the day, we produce a report that can be used in court,” he said.
“We are acting on behalf of the dead to ensure justice is served.
“When we present this report in court, we are also a witness giving statements.”
Day or night, these doctors are on standby duty to ensure autopsies are dealt with in the quickest way possible.
In Malaysia, there are 33 specialists and when one person from another state goes on leave, someone else has to stand in.
Dr Mohd Shah said each autopsy takes about three hours, except in homicide cases.
“This includes stitching, washing and the examination.
“For homicide cases, each one takes about six hours at times, depending on how complex the stab wounds or shot wounds are.”
Dr Mohd Shah said the biggest challenge for any pathologist is the ability to hold their mental concentration and not allow emotions to take over.
“It affected me in the early stages of my career, especially when I had to examine dead babies,” he recalled.
“I try to calm myself down and do the best that I can, so the culprit or suspect will be brought to justice.
“Dealing with the dead doesn’t sound like such a good prospect but in the long run, I see that I can contribute something to the nation.”
Highland Towers, MH17, tahfiz school fire
Among the major cases that he was involved in were the Highland Towers collapse, the Malaysia Airlines Flight MH17 tragedy and the tahfiz school fire last year.
He was 33 and had only been practising for one year when the Highland Towers incident took place on a Saturday afternoon on December 11, 1993.
“I was attending to a homicide case in Bangsar when I received the call,” he said.
“I had to forego it and prepare myself for what I was about to witness.
“Based on the phone call, it sounded bad. I did not have much experience then, but I was ready.”
The collapsed Block 1 of Highland Towers killed 48 people, and the body identification and examination that took nearly two weeks tested Dr Mohd Shah.
“There were only three or four pathologists then. We had some backup from Singapore, Japan and France that helped us tremendously,” he said.
“Seeing the victims, the way they died is something I’d like to forget. Thankfully, the incident happened in the afternoon, and not at 1am, because the number of victims could have been triple if it had.”
He was also involved in the high-profile murder case of eight-year-old Nurin Jazlin Jazimin in 2007.
“Every time I think about it, it leaves me with a sense of loss and regret. She did not deserve death in that manner,” he shared.
The case remains unsolved.
When it came to the MH17 tragedy, he spent close to a month in Ukraine and the Netherlands in 2014 as part of the Disaster Victim Identification team to retrieve the remains of the 283 passengers and 15 crew members.
Dr Mohd Shah said it was his first experience outside Malaysia, adding that the team, which included specialists from Belgium, Germany, Indonesia and United Kingdom, did a brilliant job.
More recently was the Darul Quran Ittifaqiyah tahfiz fire that killed 22 students and two school wardens, with victims as young as six years old.
“It was one of the days in my career I think I can never forget,” he said.
“The incident shook the nation, even us, but we had to put emotions aside and carry out our duties the best way possible.
“It was not easy,” he said when asked how his team carried out the post-mortem examination on the 23 charred remains of the victims.
Forensic pathology in Malaysia
“Not many are interested,” Dr Mohd Shah replied when asked about the field of forensic pathology.
“We need more. We can still manage for now, but that is the reality of this field.”
Dr Mohd Shah cited a few reasons to why he feels it is unpopular among medical graduates.
“Maybe, it is because you can only work for the government by law, and you cannot make any extra money on the side,” he said.
“We also have to give evidence in court. It is a very challenging because you are going to get ‘grilled’ by the lawyers.
“There will be lots of questions asked, especially during a murder case.”
Under the Health Ministry and National Institute of Forensic Medicine, there are two specialists in Kedah, three in Penang, two in Perak and Pahang and one each in Kelantan, Terengganu, Sabah and Sarawak.
The rest are based throughout the Klang Valley.
Dr Mohd Shah said the team conducts at least 800 post-mortem examinations a year.
He also lamented that some people have the wrong perception about the job of a forensic doctor.
Some think they secretly remove organs.
Dr Mohd Shah added that the only thing useful in a dead body are the corneas, skin and bones.
“No, we do not remove any organs or whatsoever without written consent,” he stressed.
“We cannot do any unlawful things.
“We handle every corpse with respect and the best knowledge that we have.”