By Amy DiCresce
Werner Spitz, MD, has seen things you can’t even imagine: people shredded in plane crashes, bodies mutilated by murderers, and babies who’ve been battered to death. But when Dr. Spitz lies awake at night, it’s not the faces of the dead he sees; it’s the grieving faces of the living.
Somewhere between your worst nightmare and your wildest curiosity lies the work of a medical examiner. His job, his interest, his expertise is the phenomenon of death: what causes it, who does it, and what happens to the body following it.
One might think such a job requires somebody heartless and cold, but one meeting with Werner Spitz, MD, proves otherwise. "The fact that people are dead--it doesn’t bother me. I can do an autopsy on any kind of mutilated body and that doesn’t upset me one little bit," Dr. Spitz says. "In fact, it challenges me to find out more. How did it happen? Did they use a chainsaw? A knife? An ax? That intrigues the hell out of me. But what does upset me tremendously is talking to the family of a victim. That’s too hard for me."
Since coming to America from his homeland of Israel in 1959, Dr. Spitz has built a successful career as a forensic pathologist, toxicology consultant, and professor of pathology at the Wayne State University School of Medicine. He was the Wayne County Medical Examiner for 16 years and now serves in that role for Macomb County. He has served on committees investigating the deaths of President John F. Kennedy, Jr., Martin Luther King, Jr., and Mary Jo Kopechne, who drowned after the car driven by Senator Edward Kennedy plunged off the Chappaquiddick Bridge. He has also served as an expert witness in numerous high-profile cases including the California Night Stalker, the Preppy Murder Trial in New York, and the wrongful death suit against O.J. Simpson. Presently, he is advising the Boulder, Colo., police in their investigation of the Jon Benet Ramsey case. He is the author and editor of the textbook, Medicolegal Investigation of Death, now in its third edition and considered to be the authoritative textbook in this specialty, worldwide.
Dr. Spitz has been investigating death for 45 years; but he’s been enjoying life much longer than that.
In the seven years that Werner Spitz worked in the coroner’s office in Jerusalem, he saw only one homicide. During his first year in America, he saw 400.
"I began medical school at the Geneva University in Switzerland. My parents lived in Israel. After four years in Geneva, the Hebrew University in Jerusalem established Hadassa Medical School and I transferred, receiving my medical doctorate after an additional three years," recalls Dr. Spitz. He graduated at the age of 27.
When asked why he got into pathology, Dr. Spitz responded, "Because as the son of two physicians, my parents wouldn’t let me sit at home for the three months of summer-break during high school. They sent me to work at the hospital. No department could use a high school student, except pathology, so I went there and functioned like an orderly. I cleaned the place, put a body on the table for an autopsy, removed it from the table, fetched this, got that. After I’d been working there awhile, they realized it was a waste to send me for sandwiches. So when employees couldn’t come in, I would do their jobs. I would cut a frozen section or help with autopsies--something that required a little more brains. They began to realize I was capable of more than your average orderly."
When the time came for Spitz to choose a specialty, he felt most confident in the field in which he had acquired some experience. He chose a pathology residency at a busy government hospital, where all medicolegal investigations and autopsies were performed in my department, in addition to the usual hospital service. After a few years, a group of forensic pathologists moved from the hospital pathology department into a separate medical examiner’s office, and they took Dr. Spitz with them.
"From 1953 to 1959, I worked at the medical examiner’s office in Jerusalem," he said. "I saw lots of gunshots, because of shootings at the borders. The Israeli government ordered all these bodies autopsied because they wanted to know what kind of bullets were being used. These were not the kind of murders requiring investigation, as the cause of death was not in dispute. The one and only real murder I saw was a stabbing. There were all kinds of suicides back then, but there were few deaths from traffic accidents or alcohol, and none from drugs."
When it came time to do a fellowship, Dr. Spitz learned that a forensic pathology resident was needed in Baltimore, where the State of Maryland had a renowned medical examiner’s office. He applied for a visa at the American embassy in Tel Aviv and said he wanted visitor status, since he planned to return after a year in America. The immigration officer, who was also a friend, shook his head and issued Spitz an immigrant visa. "Once you get a taste of it, you won’t be back," he said.
His first day in Baltimore, he took a cab to the medical examiner’s office, which was simply referred to by the locals as "the morgue." He recalls driving up to the most dilapidated, terrible-looking section of Baltimore in the harbor area. "I walked up the stairs to the building, went inside, and saw a door with a little window in it," he said. "So I look through the window and I see a bunch of open bodies--at least 15 of them. I had never seen anything like it. And the next day, there were lots more. And the day after, there were again lots more. I saw 400 homicides that year. Prior to that, I had only seen one."
Baltimore provided many learning and teaching experiences for Dr. Spitz. "I was really in a very good position," he said. "I, as a fellow, was teaching the assistant medical examiners things thye didn’t know." Although he hadn’t seen too many violent crimes in his early career, Dr. Spitz was very experienced in the pathological elements of autopsies. He published, gave presentations, lectured at the National Institutes of Health, and received funding for pathology experiments. He had faculty affiliations with the University of Maryland, and Johns Hopkins. Even in the middle of a then-crumbling city, he knew this was the ideal job and the ideal place for him.
"My boss back in Israel used to tell me, you don’t need gold door knobs in order to have a first-rate office. If you have teaching, and you have good people, it doesn’t matter whether the walls are painted. He knew I’d be fine here," Dr. Spitz said.
After making a name for himself in Baltimore, Spitz came to Detroit in 1972 to work as chief medical examiner in Wayne County. It was a tough place to be at that time: the coroner’s office was a mess; Detroit was on the heels of the riots; and in 1974, there were a record 908 murders. He must have found it intriguing, however, because this is where he stayed to build his career. Since that time, he has investigated complicated drug-ring murders, domestic violence cases, suicides, plane crashes, and everything in between.
"When I got there, the fire was still burning," said Dr. Spitz. As the Wayne County medical examiner, he was on the scene when Northwest flight 255 crashed just outside of the Metro Detroit airport in 1987. Less than 45 minutes after the plane came down, the place was already teaming with relatives who wanted to know if he could identify their loved ones. "And I was the one who had to tell them," he said. "There’s just nothing worse than that."
"I was driving back from Chicago when 255 came down," Dr. Spitz said. "I had just done an autopsy there, and my secretary called to tell me I better get over to the airport. I told my wife and kids, ‘I’ll see you in a week,’ and I headed out."
Dr. Spitz was shocked upon arrival. He expected the bodies to be in much better shape than they were. He had heard the plane came down from about 150 feet, however, it actually got lodged beneath the freeway overpass, lost its wings and spewed gasoline everywhere. "The whole ground was scorched," Dr. Spitz said. "The plane was full of flames and the bodies were all burned and broken up. Very few bodies were in one piece and because they were so mutilated, it was very difficult to identify anybody."
He went to work in an empty airplane hangar, which functioned as a makeshift autopsy room. They set up trashcans, buckets of water, and 20 sawhorses with plywood covered in plastic. There were at least 20 bodies in the room at any given time. Because of their miserable condition, however, traditional identification tools were unreliable. Fingerprints didn’t work because the burns were too bad; DNA testing was unavailable at that time; and dental records helped, but the bodies were in so many parts, they were difficult to reconstruct.
So, Dr. Spitz did that which is most difficult for him. He spoke with the victims’ family members, searching for tiny clues to help describe hair fibers, scars, jewelry, watches, tattoos, birthmarks--anything that would help identify them. He speaks with difficulty when he recalls a conversation he had with a victim’s wife.
One woman was devastated, because her husband was on the plane, but we hadn’t found any identifiable remains, Dr. Spitz recounts. Then she remembered something. While her husband was packing and getting ready to leave on this trip, she was at the end of the bed painting her toenails with polish. He playfully messed up her hair. And out of fun, when he walked by, she swiped the nailpolish brush across his toe.
"I found it," Dr. Spitz said, still visibly upset more than a decade later. "In all this mess, I found it."
He worked 18 hours a day, exhausting himself both physically and mentally, but he knew every detail was extremely important and he counted on each one to help tell stories about who these people were. There were 156 bodies in all, and each one was finally identified. We finished in exactly six days--nearly to the hour, Dr. Spitz said. So he walked off that case, and straight into another.
"Conspiracy? No way. Much of the controversy surrounding the assassination of President John F. Kennedy could have been avoided had the wound in the front of the president’s neck been correctly identified as an exit wound and the back of the head been shaven," said Dr. Spitz.
After serving on two panels to investigate the death of President John F. Kennedy, Dr. Spitz issued a decisive conclusion that the facts are obvious and based on the autopsy, a conspiracy theory is "nonsense."
The first committee was set up in 1974 by Vice President Nelson Rockefeller. It consisted of five experts in different specialties, with Spitz serving as the forensic pathologist. They reviewed the evidence, autopsy reports and photographs. The panel agreed on a simple, straightforward explanation of the murder: that Lee Harvey Oswald was the lone gunman, striking Kennedy with two bullets.
The second panel was the 1976 House Assassination Committee which included nine expert pathologists. Dr. Spitz agreed to participate.
"I looked upon this as setting the record straight," he said. The panel concluded that Kennedy was struck by two and only two bullets, each entering from the rear.
"The bottom line is that he [Kennedy] was never shot from the front and never shot from the side. The bullet wound in the neck is not an entrance wound, it is an exit wound. And both shots--the one in the back of the right shoulder and the one to the head--both are consistent with having been fired from the sixth floor of the Texas Book Depository. This was not a difficult case to solve; in fact, it’s a very simplistic one," said Dr. Spitz.
Part of the confusion and chaos over Kennedy’s death was the inaccurate original autopsy report, but Dr. Spitz says there’s a simple explanation for that. Kennedy was autopsied by a pathologist who had never done a gunshot autopsy before.
Furthermore, he points to his head saying, "To this day, we don’t know if the bullet entered exactly here or here. The wound was never shaven. You should never make a determination on a bullet wound without cleaning it and photographing it properly. It’s the only way you can see the details." Dr. Spitz says, today, a drug dealer shot in any major city in the United States would have a better autopsy than Kennedy had, because there are better standards to aid evaluation.
Some would say the medical examiner is a very political position, but Dr. Spitz disagrees. Sure, people called him asking how much he got paid for his opinion in the Kennedy assassination, and some politicians thought panelists might have accepted bribes. Dr. Spitz laughs. "You know how much I got for that opinion? I got $121, which paid for the airplane ticket to Washington and back. Otherwise, they didn’t give me anything."
He says there have only been rare incidents, maybe one or two, when someone of political influence tried, but failed, to get Spitz’s ear. "One time, I signed out a death certificate saying suicide," he said. "And I got a call from a politician who wanted to know if I was sure it was a suicide. So I told him that based on the information I had, I thought it was and if he had new evidence that said otherwise, he better get busy. Of course he never called back."
Medical examiners do have an important assignment. State law requires that unnatural, sudden, unusual and suspicious deaths be investigated. It is the medical examiner or coroner who then determines the course and scope of the investigation. According to a paper by the American Bar Association, in about 95 percent of autopsies, the cause and manner of death are readily apparent, but the remaining five percent are those that require more intense questioning, scrutiny and expertise.
Dr. Spitz seems to avoid politics altogether, even in the Kennedy investigation which was highly charged. "All I’m saying is, medically and pathologically, the conspiracy theory doesn’t fit," he says. "If you tell me that Castro paid for this, fine. But I certainly can’t determine whether he did or not. And I don’t care. All I know is that medically, nothing else is possible. In all the time we investigated the assassination, I’ve never once had any political feedback or political intervention. That’s just a bunch of nonsense."
"My assistant, Diane, tells me all the time, ‘You know, if you wait long enough, all the big cases from around the country will eventually end up right here in your office.’"
Very early on, Dr. Spitz was contacted by Robert Shapiro, the defense attorney for the murder trial in which football legend O.J. Simpson was suspected of killing his ex-wife Nicole and her friend Ronald Goldman. After reviewing the evidence, Dr. Spitz refused to testify on Simpson’s behalf, but would have jumped at the chance to be a prosecution witness, he says. After Simpson was found not guilty in the criminal trial, a civil trial was brought against him. At the civil trial, Dr. Spitz delivered testimony and conclusions which, according to a recent newspaper article, "were more absolute than any heard before from those who have analyzed autopsy records." Spitz’s conclusions were in direct opposition to those of Michael Baden, former chief medical examiner of New York City, plaintiff expert, and long-time friend of Dr. Spitz.
For instance, Baden said that murder victim Ronald Goldman bled profusely and struggled for as long as 15 minutes before he died, thereby making it impossible for Simpson to complete the murders, return home and catch his plane on time.
The testimony by Spitz was in sharp contrast. "Goldman died within seconds. The abdominal aorta was nearly severed and instantaneously, there would have been little or no bleeding from any of the other wounds. All the bleeding was internal into the space called the retropreitoneum, whem the abdominal aorta is contained. There was no bleeding into the abdominal cavity." This fact, according to Dr. Spitz, is the reason the victim died quickly. The killer would not necessarily be covered in blood because the killings occurred from behind.
Other conflicts between Baden and Spitz involved the cuts on O.J. Simpson’s hands, contamination of evidence, reliability of DNA testing, and more. Baden said, for instance, that cuts on Simpson’s hands were caused by some jagged piece of glass or a knife. Dr. Spitz, however, said the cuts were unmistakably fingernail gouges from the victims.
"I knew this would come up in court," Spitz said, "so that morning, I cut my fingernails short and I shaved my forearm, because I knew I would be asked to demonstrate. So of course, the defense attorney approaches me on the stand and says, ‘show me, show me, go ahead right here on my arm.’ I turned to the judge for permission and he said, ‘We’re not going to have any gouging of flesh out in my courtroom.’ He did agree, however, that it would be OK if I demonstrated on myself. So I made the marks in my skin and compared them to the marks on Nicole and Ron’s bodies. They looked exactly the same."
Dr. Spitz says the O.J. trials have not made him lose faith in the justice system, but he certainly lost faith in that particular case. "How can you deny DNA evidence?" questions Spitz. "This is a typical example of what smart attorneys can do to a jury by way of confusing them. Imagine keeping the medical examiner of Los Angeles on the stand for nine days. Imagine bringing that expert in from the DNA lab--she was on the stand for two weeks. What should a juror make of that kind of information? You and I, sitting 2,000 miles away from the courtroom see DNA as a meaningful tool. In the courtroom, because of this long drawn-out hocus pocus, the DNA became meaningless. Those jurors sitting 50 feet away didn’t get it. They were bored and they did not get it."
Sometimes, says Dr. Spitz, people make the simplest things the most difficult.
"I don’t know that I am cut out for being a clinician. My father was an internist and he would take a huge needle and put it in somebody’s chest, and I always wondered about how he did that."
Dr. Spitz is a coroner. He has no difficulty inspecting stab wounds, cutting open a skull or cracking a rib cage to look inside someone’s chest cavity. But this same man becomes very timid about giving a cortisone shot to a patient with a bad knee. It’s ironic, since he comes from a family of physicians. His parents were both internists, and his two sons recently completed medical school, just as his daughter became an attorney. "You can imagine the arguments we have over dinner," laughs Dr. Spitz.
While on rounds one day, a young Werner Spitz watched his father extract fluid from a man’s lungs. "He took this huge needle, it looked like a horse needle, and brought out a large amount of pus. Oh, I could never do that. I don’t have the ability. One time, when I got older, a friend needed the fluid drained from his knee and he asked me to do it. He was in terrible pain. I was a doctor by then, and my parents were out of town. A colleague showed me the procedure at the hospital. I kept thinking, ‘Me? A pathologist?’ I don’t know how I did it, but I did." That was, however, the last time.
So what else scares Werner Spitz, a man unruffled by crime scenes, blood spatter patterns and decaying bodies? Although he often views brutality administered by other people, Dr. Spitz is genuinely troubled by the brutality of Mother Nature. For example, sudden infant death syndrome (SIDS) is a phenomenon that both intrigues and bothers him. "These kids less than a year old die suddenly, unexpectedly, without cause. I can hypothesize as to what transpired, but sometimes, I just don’t know," he says.
He regularly consults with surgeons, pathologists and researchers when he comes across unusual cases, such as SIDS. Even so, there are some mysteries he is still unable to solve. Personalizing the story, Dr. Spitz proudly refers to his new grandson who was born just a few weeks ago. "It’s my third grandchild," he said, "and with each one, I worry about SIDS. I know what I’ve seen and it’s a very frustrating thing. We need more research. We need to uncover these secrets of medicine."
"Few professions create greater despondency about the goodness of man and the worth of life than the practice of criminal law...The criminal lawyer seeks justice--the forensic pathologist, truth. Noble causes...We must have the courage, indeed the ardent desire, to know the causes of death...A people who will not face death cannot revere life."
So says Ramsey Clark, former attorney general of the United States, who wrote the foreword in the textbook written and edited by Dr. Spitz. This book, which is the largest English textbook in print, contains many graphic pictures, explanations and examples that Spitz has encountered throughout his career. The stories he presents provide training for homicide investigators, criminalists, evidence technicians, attorneys, prosecutors, coroners, insurance adjusters, private investigators and other forensic pathologists. And the stories show the importance medical science plays in determining truth.
Clark’s foreword continues, "We must have the courage...to know the causes of death...We should not faint at the photos here. They are true, and while all truth may not seem beauty, all truth can strengthen humanity."
Do such truths harden Dr. Spitz or make him feel that the world is getting too cruel or too violent? "Oh no," he says. "Crimes have always been terribly violent. In the old days, they’d cut off people’s heads with the guillotine. They’d kill people in the streets and have crowds gathered to witness it. It’s not that people have become better or worse, more civilized or less civilized. It’s just human nature."
Perhaps after all he’s seen and heard, it’s not the violence and horror of the human psyche that intrigue Dr. Spitz. It’s the emotion, the wonder, the motivation, the dynamics--the life.