What tales do dead bodies tell?

Dr Johanssen Oduor, the chief government pathologist.

Being the chief government pathologist, you have examined many bodies. What has been the most common cause of death for most bodies that have ended up on your table?

I perform an average of 25 autopsies per month, translating to an average of 300 per year. Unfortunately, the majority of what ends up on my table is not from natural causes, but largely due to gunshots wounds and assaults.

Can you tell just from observation of the body’s insides of

a.)   Smoker from nonsmoker? 

Many smokers have increased concentration of carbon particles in the lungs. When one inhales smoke, the carbon particles permanently stick in the lungs. However, due to the environments that we live in, (bearing in mind that most of us who grew up in rural areas used firewood to cook and also used lantern lights at night), carbon particles are a common feature in most of our lungs. They look darker in appearance.

 b.)  A drug abuser from a non-drug abuser?

Yes. Depending on drug of abuse, we may find abnormalities in the heart, kidneys, liver or blood vessels

c.) A fitness fanatic from a sedentary person?

In fitness fanatics, you can easily see that there is less fat in the body, they have bulky muscles and their hearts are in prime condition. That a good heart, as opposed to the sedentary persons who mostly have the opposite

d.) An alcoholic from a non-alcoholic? If yes, how?

Alcohol has an effect on almost all organs in the body. Chronic alcoholics have cardiomyopathies, brain atrophy, liver pathologies ranging from fatty liver to cirrhosis; some may have pancreatitis and gastritis. These are variables. Some, however, may have normal organs

Which body organ have you consistently noted, is often ravaged by disease even when the death of the person was due to an unrelated incidence?

This would be the cardiovascular system (the heart and blood vessels) are almost always in a poor state.

Is it possible to get diseases from a dead human?

It is very difficult to contract diseases from human remains. However, there are a few diseases which can be transmitted from the dead persons and these include bacterial ones like cholera, tuberculosis; viral infections, including HIV, hepatitis and the ones causing hemorrhagic fevers like Ebola, Dengue fever, Marburg and Chikungunya among others.

We, therefore, treat all dead bodies, as potentially infectious so precautions must be taken including use of gloves, face masks, gumboots and personal protective equipment.  We are also very cautious when using sharp instruments to prevent pricking ourselves.

What would you describe as the worst moment in your 12-year career?

Anytime I have had to deal with mass killings. There tends to be so many decomposed bodies which makes everything scary and chaotic. It becomes even worse when the killings take place in a remote area and by the time the bodies are ferried to the capital, they are already decomposed which makes identification difficult. One such case is that of the massacre that took place in Garissa.

Knowing what you know now, from poking into dead bodies, what are the main principles the living should be observing?

·         Regular health checkups are a great thing to do. It does not hurt to get yourself checked. Also, the ladies should be going in for cancer screening. This is especially cervical and breast cancer which are the most common. Unfortunately, they are detected too late to do much. I see the cases a lot.

·         Prostate cancer checks for the men should be a given. It is a very common cancer which can be treated if detected early.

·         High blood pressure and diabetes, slowly destroy body organs and cause sudden deaths. Get checked and control them as directed by the doctors.  

·         Live a moderate lifestyle. Avoid drinking and driving. It sounds cliché but it ranks highly in the cause of deaths in the country. A senseless way to have your body lying on a cold slab.

What was the most interesting autopsy you have ever undertaken?

I was once called for an autopsy of a suspected homicide from domestic violence. However, I found no injuries. The most remarkable thing I found was an atrial myxoma (a tumor on the right atrium of the heart) some of it had dislodged and blocked the internal carotid arteries (these are blood vessels supplying the brain with blood) leading to coma and death.

The relatives refused to believe this hence leading to a repeat autopsy by a different set of pathologists whose findings were the same. This was also confirmed by histology (microscopic analysis). This case is memorable due to the fact that were it not for systematic way of performing autopsy, I would have missed the diagnosis. And who knows the effects it would have had on some people’s lives?  We even went ahead and published the case in a scientific journal.

Can you guess the age of a person by a cursory examination of the body?

There are parameters we use in order to estimate the age with a margin of error of 5 years. The length of your bones are a good tell.

Longer bones show youth while the shorter bones show old age.

Dr Johansen Oduor is the chief government pathologist