Inside the Jefferson Parish Coroner's Office
By HANNA KRUEGER
Sep. 02, 2018
Not one case that rolls into the autopsy room of the Jefferson Parish Coroner's Office is the same. But on any given weekday morning, there are three constants: the smell of peppermint, Top 40 hits trickling from a tiny speaker and Dr. Dana Troxclair singing Mr. Rogers' iconic theme song, "It's a Beautiful Day in the Neighborhood," as she walks in the door.
"Everyone looks at me like, 'What neighborhood are you in?'" says Troxclair, the chief forensic pathologist at the office.
And then come the body bags.
Troxclair has lived in Louisiana all her life. She grew up in Gramercy, a tiny riverside town between New Orleans and Baton Rouge, watching episodes of "Quincy, M.E.," NBC's medical examiner drama that aired from 1976 to 1983. After graduating from Lutcher High School, she completed the pre-med track at Louisiana State University before working as a coroner's assistant with the school's hospital. Her dream of becoming a doctor started to slip away with time, but her boss at LSU encouraged her to pursue it. Today, she sips on the last drops of a Sonic soft drink and sits behind her desk at the Jefferson Parish Coroner's Office with a five-year pathology residency, one-year forensic fellowship and over two decades of autopsies under her belt.
She is a seasoned professional, unruffled by the grisly nature of her work, but it wasn't always that way. When she was 25, working with the Orleans Parish Coroner's Office in a small wing of a funeral home while their office was under construction, her boss asked mid-exam if she would grab McDonald's for the crew. When she returned and he dove into his meal only feet from a corpse, the smell of grease mingled with formaldehyde nearly took her down on the spot. Now, 29 years later, she will discuss what to order for lunch with a scalpel in one hand and human tissue in the other.
Dr. Gerry Cvitanovich, JPSO's head coroner, strides into Troxclair's office.
"It just makes me sick to my stomach," he announces as if in tune with the lunch discussion. "We had four quarterbacks yesterday and now we have two."
Cvitanovich also attended LSU medical school. He and Troxclair dive into a discussion on the Tigers' depth at quarterback. The walls of Troxclair's corner office are dotted with medical degrees, Tiger merchandise and a portrait of her elderly Australian Shepherd. An Anthony Davis bobblehead wobbles on her desk.
"I don't know what the hell is going on," Cvitanovich declares of the quarterback situation before leaving. Troxclair releases a deep-throated laugh and shakes her head.
"We're always cutting up around here," she explains with another slightly too on-the-nose expression. "If we didn't, my God, this would be so depressing."
The Jefferson Parish Coroner's Office boasts a rare National Association of Medical Examiners (NAME) accreditation, a distinction held by only six of the country's 1,600 coroner's offices. In addition to death investigations, the office offers mental health and sexual assault services. Troxlciar is one of three forensic pathologists who work with six death investigators to determine the cause of any suspicious or sudden death, such as homicide, suicide, traffic fatalities and occupational deaths. The office mainly serves Jefferson Parish, but will also accept cases from smaller surrounding parishes who lack the resources to investigate certain deaths.
On a recent Wednesday, the pathology team tackles two cases: a self-inflicted gunshot wound to the head and an unclassified death, meaning investigators have yet to determine whether he died of natural, accidental, suicidal or suspicious causes. First, the pathologist inspects the body and fills out a "cheat sheet," which sketches out where each wound is located on the deceased's body. These two autopsies call for the outline of a man's body, teeth and a skull, but sheets also exist for hand wounds and the bodies of women and infants.
Next, the Y-incision. Two slits start at the shoulders, converge at the sternum and travel across abdomen. "Man in the Mirror" builds in the background.
In the suicide case, the cause of death is quite clear. The X-ray displays bullet fragments scattered throughout the man's skull. The unclassified death, however, requires a systematic search of the organs to determine what killed the man. Ultimately, the on-duty pathologist locates a ping-pong ball sized blood clot in the man's lung. Pulmonary embolism. She places the clot on a metal tray for the medical photographer to document and carries on.
Regardless of whether the cause of death is readily visible or quickly discovered, the pathologist completes a full exam from head-to-toe. At JPCO everyone is examined thoroughly, according to Troxclair, whether it's an octogenarian with a blood clot, a high-profile case like that of Keeven Robinson, who died following a chase with sheriff's deputies, or Joe McKnight, the former NFL player gunned down in a road rage incident.
On this day, the two autopsies are each done in roughly an hour, but cases involving extensive injuries can take up to three or four hours. Some detectives will sit in the room during the autopsy. Others opt to linger in a nearby lounge to avoid the smell and sight of the procedure.
"That's always the big, burly men," a medical student pipes in.
Once the exam is complete, the body is zipped back into a black bag and slid into a freezer maintained at a steady 41-degrees Fahrenheit until transport to the funeral home arrives. As part of their National Association of Medical Examiner accreditation, the office is required to have a device that digitally monitors and records the temperatures of all coolers. Staffers keep a record of all temperatures going back five years.
When the freezer door opens, a wave of peppermint floods out into the hallway.
"Oh that smell? I just put in two new peppermint blocks. They eliminate the smell of death," says coroner's assistant Kevin Mitchell as he secures the gurney in the freezer. The minty deodorizing gel blocks can last for months and are much more effective than the fruity air fresheners Mitchell has also placed in the wing's air ducts.
After the freezer is closed, the peppermint lingers through the entire wing as an incongruously fresh reminder of the body's natural decomposition process.
The coroner's office is one of the few places that no one wants to keep in business, but thrives regardless. When asked how he approaches death, Cvitanovich said, "I don't want to be a coroner's case. I want to be the case where they call in and say, 'Hey, we have a hospice death.'"
Just about everyone in the office can agree they don't want to end up there after their final day. While some cases can play out like a real-life game of Clue, the work exposes dark truths about the way we treat others and ourselves.
Troxclair describes seeing people with lung tissue destroyed by chronic smoking and livers riddled with cirrhosis, a side-effect of heavy drinking that turns the normally smooth tissue slab into a bumpy mess of scar tissue. Lately, she says drug overdoses have kept the office busy. And then there's the trauma inflicted by others.
"When you see what people can do to other people, what kind of things they can cause, it's remarkable," says Dr. Charles Eckert, the Chief Deputy Coroner who has seen thousands of cases in his thirty years at the office.
Troxclair, normally cheerful and wisecracking, drops into a softer register when she recalls a 7-year-old disabled boy from Thibodaux who was decapitated and dismembered by his own father. Or a man stabbed 75 times, who had so many marks on his "cheat sheet" that the body sketch was practically colored solid.
For Eckert, it is the neglect of the elderly that unnerves him despite his many years on the job. Family members will forget to check in on their single grandparents or parents, request a wellness check and the police will find him or her decomposing inside the house.
"I get it. Newspapers don't add up like they used to, but all it takes is a call or a check-in," he says in an office filled with at least as many medical plaques as years he's spent as a coroner.
And yet, something about the line of work keeps the 78-year-old Eckert signing death certificates and Troxclair reaching for the scalpel.
"We are the last voice for so many people," explains Troxclair. "You're speaking for them, especially when you go to court on these cases. Their bodies are actually telling you what happened and how they left this world."