The “Only Forensic Pathologist in the Prefecture,” Who Performs Autopsies on 300 Bodies a Year, Reveals the “Surprisingly Unexpected Reason” He Chose This Career Path

What Does a Forensic Pathologist Do?

“There was even a student who got hooked on the TV drama *Unnatural* (TBS, 2018), enrolled in our medical school, and actually went on to work for the production company behind the show. Even now, many students come to us after watching that series, so from the perspective of the forensic medicine field, we’re very grateful for that,”

These are the words of Professor Morio Iino (54) of Tottori University’s School of Medicine, a forensic pathologist who, as the only forensic pathologist in Tottori Prefecture, performs autopsies on approximately 150 bodies per year, and as a part-time medical examiner in Osaka, on approximately 150 more—a total of about 300 bodies—to determine the cause of death.

Although forensic medicine often appears in mystery novels and TV dramas, unlike the general practitioners we encounter in our daily lives, we likely know very little about forensic medicine or forensic pathologists.

Professor Iino’s book, *A Forensic Medicine Professor’s Lessons on Corpses* (Asuka Shinsha), which covers various aspects of forensic medicine, is a bestseller. Since its release on May 26, it has gone into reprint in no time and is already in its sixth printing. It also ranks No. 1 in two categories on Amazon’s category rankings (as of July 17).

We spoke with Dr. Iino once again to ask about the differences between general medicine and forensic medicine, as well as the current situation facing forensic pathologists who work with cadavers.

“Forensic medicine is the discipline that provides medical advice regarding cases where legal disputes or issues arise. For example, in cases such as assault, murder, or attempted murder—where various legal issues come into play—we offer advice from a medical perspective to help resolve these matters.”

Specifically, forensic pathologists perform autopsies on “unusual corpses”—that is, bodies of individuals who died in crimes or accidents, or whose cause of death is unknown—to determine the cause of death and confirm their identities.

They deal not with living people, but with corpses.

He could have chosen a more conventional path, such as becoming a surgeon or internist who treats living patients. What motivated him to pursue the specialized field of forensic medicine?

I Longed to Be “One of a Kind”

“My father was an anatomist, and he used to say this to us young children—including my two older brothers—as if it were a catchphrase:

‘I’m a doctor, but I can’t treat you guys. I’m not an ordinary doctor who works at a hospital. But I do all kinds of research at the university, and if that research bears fruit, even if I can’t save the patient right in front of me, I might be able to save thousands or even tens of thousands of people in the world instead—that’s the kind of research I’m doing.’

’ That’s what he used to say. From a young age, I vaguely realized that there were doctors who didn’t actually treat patients.”

It was during his second year of junior high school that Mr. Iino happened to come across a textbook on “Forensic Medicine” in the medical section of a bookstore. It contained detailed explanations accompanied by gruesome photographs of bodies run over by cars, drowned bodies, and decomposed corpses.The content was so shocking that young Iino looked at a few pages and immediately closed the book, but after returning home, he reportedly thought , “Since a textbook like that exists, someone must be studying it and facing these issues head-on,” and “But surely no one would want to do that kind of work.”

“I’m a bit of a contrarian who hates doing what everyone else does. When I told my father I wanted to study forensic medicine, he didn’t object—in fact, he told me, ‘There’s only one person doing that in Tottori Prefecture.’ I’d be the only one. It wasn’t forensic medicine itself that drew me in—it was, first and foremost, that rarity.”

Now that she’s actually become a forensic pathologist and performs as many as 300 autopsies a year, is she completely unfazed by any corpse she encounters? Does she ever feel empathy for the deceased, or does it ever get too painful for her?

“It’s not that I lack humanity. In fact, when I first observed an autopsy as a student, I fainted. It was the charred remains of a parent and child—the child was completely blackened—and I found myself thinking, ‘It must have been so hot and painful…’ I ended up putting myself in that child’s shoes.

That never happens to me anymore. That’s because the pressure of the work required of me is much stronger than that. The forensic examination request form provided by the police bears my name, so the responsibility is immense. I can’t afford to feel sick to my stomach. I’m completely focused on approaching the bodies professionally.”

There is no data that can serve as a benchmark

According to Mr. Iino and his colleagues, the forensic examination requests they receive from the police always require a set of three items: “cause of death,” “type of cause of death,” and “time of death.”“Time of death” is a standard term often referred to as the “estimated time of death” in TV dramas and the like. However, even regarding this “time of death,” there is actually no benchmark data; instead, each forensic pathologist makes a judgment based on their own experience.

“‘Time of death’ is a major required element and is very important because it affects subsequent legal proceedings. However, it varies depending on a wide range of environmental factors—such as a person’s physique, the season, whether the body is indoors or outdoors, in water or on land, or buried in sand—yet there is no data. This has been a long-standing issue.

At the University of Tennessee in the United States, there is a facility called the ‘Body Farm’ where corpses are exposed to various natural environments to observe the changes that occur over time. While this cannot be done in Japan, it provides data that is extremely important for estimating the ‘time of death.’”

Forensic medicine requires mobilizing a wide range of medical knowledge to reach a conclusion. While it is necessary to learn about new reagents and new forensic techniques, there are circumstances that make this difficult.

Mr. Iino’s forensic medicine department is highly sought after by medical students for its practical training programs, but few students actually choose to pursue a career in forensic medicine after graduation.Nationwide, there are currently only about 150 forensic pathologists. Due to this chronic shortage of personnel, the reality is that many forensic pathologists diligently attend academic conferences and read literature on their own to gather information.

Since it deals with “death,” there are insights that can be gained from it

One reason for the shortage of candidates is undoubtedly the financial mindset of the individuals and their families : “Since we went through all that hardship and spent so much money to get into medical school, we want to become doctors with a guaranteed stable income.” However, isn’t a more fundamental mindset—such as “Since I’ve become a doctor, I’ll treat people as usual” —also a major factor?

It’s true that determining the cause of death is not a medical procedure. It’s the process of making a judgment about something that has already occurred. However, precisely because it’s a field dealt with exclusively by forensic medicine, there are aspects where insights can be fed back.Take, for example, deaths that occur while bathing. There are reportedly about 19,000 accidental deaths related to bathing each year—a figure that is actually about seven times higher than the number of people who die in traffic accidents. That fact alone is surprising enough, but…

“The leading cause of death during bathing is actually heatstroke, rather than heat shock. We’ve had the data compiled in Tottori Prefecture and, in collaboration with local government, are running a campaign to raise awareness about measures to prevent winter heatstroke and other related issues.

Additionally, there used to be an initiative where forensic medicine and emergency medicine held joint conferences. In cases where emergency responders were unable to save a patient, the attending physician would perform an autopsy, and based on the cause of death, that information would be fed back to the emergency medicine team to inform future care. While this kind of feedback to the medical field is rare in reality, I believe it should naturally be a standard practice.”

Although forensic medicine is not a direct medical practice, using the facts revealed by a corpse to aid in the future treatment of living people and in preventive medicine resonates with the words Dr. Iino heard from his father : “I may not be able to treat the person right in front of me, but I’m doing research that might save many people.”

Given the reality that few students aspire to pursue forensic medicine, Mr. Iino is turning his attention to the younger generation.

“When it comes to forensic medicine, I’d rather have middle and high school students learn about it—just as I did when I was in my second year of junior high—than wait until they enter medical school aiming to become doctors. If that happens, perhaps some of them will enter medical school with the goal of becoming forensic scientists rather than doctors. My greatest hope is that such young people will emerge, which is why I wrote this book in very simple, easy-to-understand language.I hope this book will help young people discover forensic medicine and aspire to it, just as I did.”

This book, which many readers are picking up, will surely inspire a second “young Iino” to take an interest in forensic medicine.

*Lessons on Corpses Taught by a Professor of Forensic Medicine* (by Morio Iino / Asuka Shinsha)