A couple is sitting at the breakfast table, when the wife suddenly
complains about a severe headache. She jumps up, screams and collapses.
But only when she stops breathing at around noon does her husband call
an ambulance.
For the investigating criminologists, this case of unbelievable
heartlessness raised one question above all: What could the man have
done to his wife? Their surprising conclusion was that he did nothing,
and that he was only guilty of a shocking lack of interest in his
partner.
Forensic scientists with the Institute of Forensic Medicine at the
University of Zurich in Switzerland diagnosed blood in the cerebrospinal
fluid as well as a small aneurysm that had burst in the woman's head,
which indicated that she had died of natural causes.
In another case, the Zurich police searched for the weapon with which
a woman had been murdered. The forensic pathologists discovered tiny
metal particles in the chin region. That find eventually led the police
to the corpus delicti: a kitchen knife.
To solve both cases, it wasn't enough for the forensic scientists to
simply cut open the sternum of the dead woman, in accordance with the
standard procedure used when conducting a classic internal autopsy. To
examine the circumstance of death, they didn't perform an autopsy on the
body. Rather, they reviewed three-dimensional images of the dead women
they had stored on their computer.
The method, in which forensic scientists combine images from powerful
computed tomography (CT) and magnetic resonance imaging (MRI) together
with surface scans of corpses is called "virtual autopsy."
More Efficient Autopsies
With the help of these combined imaging techniques, experts are now
capable of gaining revealing and fascinating insights into the interiors
of dead bodies. Most of all, they are finding fractures and hemorrhages
that were not discovered during conventional autopsies.
Experts rave about the new method which is, at the very least,
expected to complement classic autopsy. The idea is that after imaging a
body, radiologists can draw abnormalities they encounter on the screen
to the attention of forensic scientists.
"This enables forensic scientists to plan their autopsies much more
efficiently," says Dominic Wichmann, a specialist in internal medicine
at the University Hospital in Hamburg's Eppendorf district. In a study
recently published in the journal
Annals of Internal Medicine,
Wichmann praises the benefits of virtual autopsies. Likewise,
specialists with the United States Federal Bureau of Investigation (FBI)
have been traveling to Switzerland lately to marvel at the
computer-aided autopsies being performed at the University of Zurich.
Forensic scientist Michael Thali refers to the suite of devices he
developed as "Virtobot." The idea for virtual autopsy began with the
murder of a woman and the question of whether the killer had beaten her
to death with a hammer or a bicycle wrench.
When he first tried to solve the mystery with the help of a computer,
Thali and his staff were still housed in a cold barrack-like building
on the campus of the University of Bern. "We were freezing in the
winter, with only the computers putting off heat," says radiologist
Steffen Ross, a member of the team for many years now.
A 'Revolution'
It was only the move to the University of Zurich and a bequest from a
wealthy ophthalmologist that led to the project's breakthrough. But it
was poorly received in the professional world at first. "Initially we
were decried as the enfant terrible of forensics," says Thali. Older
champions of the autopsy room would often tersely refer to the idea of
virtual autopsy as "crap," Thali recalls.
But a younger generation of forensic scientists, who have since taken
over at most institutions, are much more open to the new technology.
Michael Tsokos, the chief forensic scientist at Berlin's Charité
Hospital, recently ordered a pared-down version of the Virtobot. "We use
a version that a poor city-state like Berlin can afford," says Tsokos.
He characterizes the new possibilities of post mortem imaging a
"revolution for forensic medicine," on a par with the discovery of the
genetic fingerprint and hair analysis. "If (former German politician)
Uwe Barschel or (singer) Kurt Cobain had been pushed into CT scan
machines, their deaths wouldn't raise so many questions today," says
Tsokos.
In addition to Charité, three out of a total of 35 forensic medicine
institutes at German universities can now conduct virtual autopsies. But
even in Berlin, scans are made of only a fraction of dead bodies due to
a lack of technicians trained to use the equipment. Tsokos and his
colleagues likewise felt clueless at first. The manufacturer hadn't
provided anything resembling a manual on how to store, archive and
interpret the data that had been obtained.
The complexity of the new procedure means that the once prominent
role of the forensic scientist as the maestro of the autopsy table could
fade. In Thali's laboratory in Zurich, he wouldn't even be able to
operate his suite of machines without radiologists and engineers as
equal partners at his side.
Dwindling Number of Autopsies
Furthermore, virtual autopsies could also lead to changes in ordinary
autopsies. Nowadays most family doctors decide whether or not a person
died of natural causes. But this practice has fallen into disrepute in
Germany. Forensic scientist Tsokos suspects that about half of all
homicides are currently being overlooked. He attributes this to doctors
who simply have not mastered this part of their profession, or who do
not treat it with sufficient seriousness.
Employees at the Institute of Forensic Medicine of the Hannover
Medical School (MHH) in northern Germany agree with Tsokos's critical
assessment. In an essay recently published in the German criminology
journal
Archiv für Kriminologie, the MHH experts write "that the
post-mortem in more than 10 percent of cases is performed incompletely
or not in accordance with legal requirements." They conclude: "The
inspection of corpses currently does not satisfy the intended quality
standards, especially not with regard to legal certainty."
In contrast to forensic medicine institutes, autopsies are hardly
performed at all in hospitals anymore. Whereas a forensic autopsy is
ordered by the public prosecutor's office in suspected murder cases, a
pathologist can only perform a clinical autopsy with the permission of
the family of the deceased.
There has been a drastic decline in this clinical form of autopsy in
Germany in the last few decades. Only about 3 percent of all corpses of
the recently deceased are opened up to inspect the internal organs. By
comparison, 10 times as many cases end up in a pathology department in
Austria.
The main reason is that relatives are often determined not to allow the
body of their deceased family member be cut open, says specialist
Wichmann of the Hamburg university hospital. The bereaved are far less
queasy about virtual autopsy.
To their delight, the Swiss pioneers have also discovered that the
new autopsy method makes it less likely that they will be confronted
with excessively bloody experiences, such as in the case of a mountain
climber who had fallen to his death in the Swiss Alps. The diagnosis
reached by Thali's team included a shattered neurocranium, a fractured
lumbar spine and a broken lower leg -- all done on a computer screen.
Other examinations, even those performed virtually, can still be
messy. A dead body that remained undetected in an apartment for weeks
and has begun to decompose still isn't easy to look at, even in the form
of a 3-D image on a computer screen.
