July 2015 Pathology/Biology

Disclaimer: The views and opinions expressed in the articles contained in the Academy News are those of the identified authors and do not necessarily reflect the official policy or position of the Academy.

Source: Jim Caruso, MD, Section Secretary

As members of the Pathology/Biology Section, the vast majority of us have backgrounds that include, well…biology. It is very difficult to get through a biology course, at least at the basic level, without an exposure to evolutionary theory. President Victor Weedn has declared the theme of the 2016 Annual Scientific Meeting in Las Vegas to be Transformation: Embracing Change, and would you really expect anything different from a pioneer in the DNA field? Change and transformation are the very basis for evolution. Organisms that can adapt or have a selection advantage more compatible with the changing environment thrive. And those that cannot adapt to change reside in display cases at natural history museums.

The multiple disciplines included in the family of forensic sciences are all changing, some more quickly than others. For the Pathology/Biology Section, one only needs to look at examples such as postmortem radiographic imaging, DNA technology, postmortem genetic testing, and even the manner in which our trainees learn their trade. Also affecting our practices are changes occurring in collegial disciplines such as toxicology, anthropology, and trace evidence analysis. Those areas continue to evolve, with some older, tried-and-true methodologies becoming obsolete and cast aside in favor of newer, more precise analytical procedures.

As scientists, we can choose to fight the transformation or, as President Weedn has encouraged, embrace it. That is much easier said than done in many instances. Embracing change requires an open mind and a willingness to accept that some long-held beliefs that may have been very useful approaches in the past may be partially or entirely flawed. It is an uncomfortable feeling to realize that dogmatic statements in our field may have minimal or no scientific basis.

One of the best examples I can recall of an open mind disproving a long-held theory in forensic pathology was passed along to me by a Fellow of our section, Steve Campman. Steve is presently a medical examiner for San Diego County. When I was a fellow in forensic pathology, Dr. Campman was a staff forensic pathologist for the military. There was a long-held belief that if you saw certain injury patterns on the hands and feet of victims of an aircraft mishap, you could not only differentiate between the crew and the passengers, but you could even tell which pilot was in control of the aircraft at the time of impact. This theory, known as the principle of control surface injuries, was deemed somewhat infallible among forensic pathologists, flight surgeons, and aircraft mishap investigators.

Steve, who did not buy entirely into the theory, decided to take a critical look at control surface injuries. Perhaps he was guided by advice offered by Carl Sagan who wrote, “Once you are open to questioning time-honored rituals and practices, you find that one question leads to another.” After a detailed review of the autopsy reports and photographs from scores of military aircraft mishaps, Dr. Campman proved that the presence or absence of control surface injuries has about the same predictive value as a coin toss. I am still asked about control surface injuries every so often and my response is to cite the study that challenged the status quo by taking a critical look at the data with an open mind.

I suspect there are several other beliefs and convictions in our field that may not stand up to the scrutiny of a well-designed research endeavor. Then there are those areas where much more insight and research are sorely needed. Unexplained infant deaths, abusive head trauma in children, sudden deaths associated with seizure disorders, and the phenomenon of excited delirium come to mind to make up a short list.

By the time you are reading this, the August 1 abstract submission deadline for the 2016 Annual Scientific Meeting will be only weeks away. Perhaps you are working on a presentation of your research that will result in a change in the approach to an important area of the forensic disciplines. I hope that is the case and I encourage you to share it with the rest of us in February. And in this situation, we will have to make an exception to one long-held policy. What happens in Las Vegas need not stay in Las Vegas! Section Chair Kathy Haden-Pinneri and I look forward to seeing you in Las Vegas and this year’s program chair, Joyce deJong, is awaiting your abstract submission. Don’t be late!

The way forward is to embrace change and be a part of the transformation or risk becoming a dinosaur.