The Working Stiff

What drew you to pathology – and to forensics?
In my second year of medical school, when pathology was on the curriculum, the teachers were all part of the pathology department – and they were the best teachers we had. They understood medicine in a way I had never seen until that point. I was immediately impressed with the way pathologists seemed to know everything. At the end of the year, we were offered a post-sophomore fellowship in pathology. I jumped at the chance – and it was a wonderful experience with amazing mentors.

So much of medical school culture involves telling students they know nothing and damaging their self-esteem. This fellowship was the opposite – all about building people up and teaching us without making us feel like idiots. During the fellowship, I did research in the surgery department – and, having fallen in love with surgery, chose to pursue it after medical school. That was a big mistake – I lasted about six months before calling the pathology department and asking them to take me back. They did, and I think that saved my medical career!

My rotation at the New York City medical examiner’s office opened my eyes to forensic pathology. I was called to a death scene on a construction site where a crane had collapsed – and, when I crossed the police line, everyone was waiting on me. “Doc, Doc, what happened? Tell us what you can see.” It was exciting and overwhelming – and so real.

In some cases (like a collapsed crane), the natural tendency may be to think, “Why do we need an autopsy? The cause of death is obvious.” But there’s a lot at stake in these kinds of decisions. Was the crane operator under the influence of drugs or alcohol at work? Was he wearing appropriate safety gear? Was the accident due to malfeasance or negligence? Was the crane built properly? Forensics is much more than just cause of death.

How did you become an expert witness?
First, you have to be an expert. An expert, according to the legal system, is someone who knows more than the average population and can inform the court about their specialty. There are tire-tread experts, dog-handling experts, tree-trimming experts…

In my forensic fellowship, we were taught how to testify in court. We were given transcripts of depositions and prior testimony from the other staff members; we had to study the questions we might be asked. Expert testimony – interacting with prosecutors, answering questions, dealing with defense attorneys – it’s all part of the job.

What inspired you to begin writing books?

When I was in medical school, a professor suggested we keep a diary to track our transition from being laypeople to being doctors. I thought, “This guy has no clue. Who has time for that? I’m in medical school! I’m busy studying!” But his words stayed in the back of my head and, when I started at the New York City medical examiner's office, I thought, “Maybe I should keep a diary.” The transition from layperson to doctor had been done before – but this was the transition from doctor to detective.

I kept the diary for two years – and, at the end of the fellowship, I handed it to my husband, TJ Mitchell, who is also a writer. I said, “Honey, I don’t have time to write this, but you’re the English major – see if you can do something with it.” And our first book, Working Stiff, was born.

You write fiction now – what’s your creative process?
Usually, the seed idea comes from actual cases. I usually combine two real cases into one fictional one for our main character, Jessie Teska, to solve. TJ takes that seed idea and works it into a detective-novel narrative. He does the writing; my contributions are ideas: the scientific elements of the plot, many of the characters, and the dialogue among our fictional medical and crime-solving professionals – because I’m the one interacting with the police and the courts on a daily basis, which gives me a good sense of how people really talk in my field.

Give us the elevator pitch for your most recent book, Aftershock.
Jessie Teska is a young, inexperienced forensic pathologist who has just been elevated to the position of deputy chief in San Francisco. She has to investigate the death of a famous architect at a construction site and realizes that the death is no accident; it’s something a lot more sinister.

What advice do you have for pathologists just starting out in the field?
One of the things I’ve realized since my recent move to New Zealand is that I used to have a terrible work-life balance. It’s much better now. Electronic devices make us constantly available – and, eventually, the texts and emails will erode away our personal lives and our most important relationships. It’s important for everyone – but especially young people – to know when to put on the brakes.

Don’t just pursue the most ambitious job you can find – be mindful of your work-life balance. Professional success should never come at the expense of your personal life. No amount of money is worth sacrificing your family or your health.