While most medical examiners deal with numerous undistinguished deaths, a professional of Baden's stature often attends to cases that inspire international interest. In Dead Reckoning, after indicating just how many body bags are required in New York City each year---around 8,000---he provides the details of an autopsy.  In forensics, this generally means handling the body with an awareness of significant evidential findings.  If the victim was shot, then care must be taken not to damage the bullet trajectory path or to mess up entrance and exit wounds.  If poisoning is suspected, then tissues from the organs will be sent to the toxicology section of the lab for thorough analysis.  Even just paying attention to the odors around the body can help.  Cyanide, for example, smells like bitter almonds.

An autopsy is done to examine the internal organs of a dead body.  First there's a search for trace evidence on the body, and an identification is made (if possible). On an official form, when the death is not natural, the coroner/ME records the circumstances surrounding the death, along with all available information about the deceased person.  He also records the results of the external examination and lists all physical characteristics, including height and weight.  When the examination is complete, he will include the cause of death and sign the form.  This is presented as the official statement to families and to the court     

Before anything is done to it, the body gets tagged and photographed, both clothed (if it was clothed when found) and unclothed.  Then it is x-rayed, weighed, and measured, and any identifying marks are recorded.  Old and new injuries are noted, along with tattoos and scars.  Trace evidence, such as hair and fibers, is collected off the body and from under the fingernails before it is cleaned.  Even the nails are clipped.  The wrapping sheet, along with clothing and trace evidence, is sent for analysis.  Fingerprints are taken, and if rape is suspected, a rape kit is used for evidence collection.  In cases of suspected suicide by gunshot, hands are swabbed for gunpowder residue.

Once the body is clean, it is laid out on its back on a steel table, with a stabilizing block placed under the head.  The surgeon then makes what is known as a 'Y' incision, which is a cut into the body from shoulder to shoulder, meeting at the sternum and then going straight down the abdomen into the pelvis.  (Baden says that his Y-incision is more like a U with a tail.)  That exposes the internal organs and provides easy access.  The pathologist cuts through the ribs and collarbone and lifts the rib cage apiece away from the internal organs.

He then uses X-rays of injuries or a lodged bullet as a guide, because he might have to trace a trajectory path or avoid a knife wound.  He takes a blood sample to determine blood type and removes the individual organs to weigh them.  Samples are taken of fluid in the organs, and the stomach and intestines are opened to examine the contents. 

The last step is to examine the head. The eyes are probed for hemorrhages that reveal strangulation.  After that, an incision is made in the scalp behind the head and the skin is carefully peeled forward over the face to expose the skull.  Using a high-speed oscillating power saw, the skull is opened and a chisel is used to pry off the skullcap.  Then the brain can be lifted out, examined, and weighed.  All tissues and samples are sent to the lab for further analysis.  Organs that need to be kept for the investigation are preserved and the rest are returned to the body cavity.

Human bones on morgue table  (AP)

It may surprise those who watch crime shows on television that the medical examiner also spends a considerable amount of time looking at bones.  Since there are few consulting forensic anthropologists in the country—and the NYPD calls on an expert in Florida---the ME must be able to distinguish animal from human bones, and old bones from recent.  If they're old, a forensic anthropologist may be asked for an opinion.

"When we exhume bodies," says Baden, "we often find skeletal remains.  In some cases where we expect that, we're surprised, such as the case of Medgar Evers [a civil rights leader murdered in 1963].  After thirty years, his body was still intact."  More than intact, when the coffin was opened, the corpse looked as fresh as the day it was buried.   Yet that's an exception.  More often, the bodies have decomposed, and one of these exhumations in which Baden was involved stirred interest around the world.

Czar Nicholas II of Russia (AP)

He was on the team with anthropologist William Maples, hair expert Cathryn Oakes, and forensic dentist Lowell Levine that was invited in 1992 to fly to Russia to help determine whether a large cache of charred bones might be the remains of Tsar Nicholas II and the royal Romanov family.  The tsar had been forced to abdicate leadership during World War I, after three hundred years of unbroken Romanov rule.  He, his family, his doctor, and their servants were kept in a house in Siberia while Lenin pondered their fate.  On July 16, 1918, Bolsheviks took the family and servants into the basement.  There they shot, bayoneted, and beat them until all eleven were dead: the tasr, tsarina, five children, the physician, and the three servants. The bodies were dumped in a mineshaft, where a futile attempt was made to burn them.  Then acid was thrown onto them to make them decompose quickly.  Then most of the bodies were taken to another location and buried, leaving two behind.  Yet when the bones were found and pieced together, only nine were accounted for.

While the others on the forensic team worked on the bones and teeth, Baden examined one set of remains that still had some tissue.  "The family doctor had some adipocere tissue [a hardening of body fat]," Baden recalls, "and when we dissected that, we found two bullets.  They were important because part of the issue was whether these remains actually were from the Romanovs or from some family caught in the Stalinist purges on a later date.  The bullets dated back to World War I, which gave credibility to the fact that it was the Romanovs." 

For Baden, going over to Russia had a personal note.  "My mother had told terrible stories about Tsar Nicolas II," he says.  "She'd been in Russian Poland in the early 1900s when he was in charge.  She'd tell me stories about how if he woke up on the wrong side of the bed, he'd order the Cossacks to go out and kill Jews in a village.  When they came galloping through, she'd have to hide in the outhouse.  It seemed ironic that Lowell Levine and I, who were both Jewish, were going over to identify the remains of a man who was so anti-Semitic.  Yet Lowell pointed out that, if it weren't for Nicholas, his folks and my folks wouldn't have come to the U. S. to avoid the pogroms, and thereby wouldn't have avoided Hitler.  So we owed something to him that we got born in the first place." 

As skillful as Baden is in the field of forensic pathology, it wasn't his original goal.  Even so, the seeds were planted early.