Behind the scenes at Utah's medical examiner’s office

When people picture a medical examiner’s office, they often imagine scenes straight out of a CSI show—investigations, crime and death. Dr. Dierdre Amaro understands how her office might be perceived by those unfamiliar with death investigations.

Full-scale X-ray machine at the Office of the Medical Examiner. (Bailey Chism/City Journals)

Her workplace features the expected fluorescent lighting, long hallways that connect coolers with the capacity to hold up to 12 to 70 bodies, and a noticeably strong odor. But beyond the clinical atmosphere, there are also some quirky touches: a full-scale X-ray machine affectionately named Larry, adorned with large googly eyes; a model skeleton with its own employee ID; and a spreadsheet to divide the responsibility of watering the office’s many plants placed on high window sills.

As the leader of the Utah Office of the Medical Examiner (OME), a position she’s held since this summer, Amaro oversees the investigation of all sudden, unexpected, violent, suspicious or unattended deaths in the state. The office conducts postmortem exams and autopsies to determine the causes and injuries behind these deaths. Recently, the OME opened its doors to news organizations to help the public understand the important role it plays in Utah.

“In some places, working as a medical examiner means you deal with death investigations, and everything else is secondary,” Amaro said. “In Utah, however, the work we do is for the benefit of the living. We still face death every single day, which some people think desensitizes us to it. In reality, the exact opposite is true; because death is a part of our jobs, we find meaning and purpose in the unique opportunities we get to serve, protect and support the living.” 

More than 90% of the office’s work involves collecting data that’s then reported to the U.S. Centers for Disease Control and Prevention (CDC). This data helps improve the health and safety of living Utahns.

“Death certificate data becomes a reflection of the health of a community,” Amaro said. “We are literally seeing the terminal results of public health problems here. Drugs? That’s a problem that’s killing people. We see that here. And if we can understand what is killing people in our community and why, then maybe we can figure out how to prevent that. And that is what we are about, not just little goblins under the bridge.”

While TV shows like CSI may glamorize the field, Amaro points out they often miss the mark. Most people assume the office’s work is focused mainly on homicides, but in reality, the majority of cases handled by the OME involve natural deaths and accidents.

Natural deaths might include older individuals who haven’t seen a physician in a long time and suddenly pass away, or young athletes who unexpectedly collapse on the field due to undiagnosed heart conditions. Accidents, such as car crashes and drug overdoses, are also frequent.

So how do investigations work? Utah’s system is distinct in comparison to states with elected coroners, who may not be required to have medical or forensic pathology training. In contrast, Utah’s centralized OME is staffed by highly-trained, licensed physicians.

According to the CDC, the leading causes of death in Utah are heart disease, cancer, accidents, Alzheimer’s disease, COVID-19, stroke, chronic lower respiratory diseases, diabetes, suicide and nutritional deficiencies. Amaro said the office’s cases generally follow a similar pattern to national statistics, with natural causes of death being the most common, followed by accidents, suicides and then homicides.

Life at the Office

A job at the OME is heavy, both physically and emotionally. Staff are alerted about 15 to 20 times a day via a doorbell that signals the arrival of a new decedent. Despite the regularity, the staff never takes their responsibilities lightly.

“Going to someone’s house on the worst day of their lives, being able to really handle their emotions with care and really have empathy for those people on that worst moment, is really important to me,” said Chief Medical Examiner Investigator Cory Russo. “And then to be able to come back and do the follow-up work, whether that’s positive identification after someone has been missing for years, that is so rewarding, to be able to bring closure to families.”

In addition to 12 forensic pathologists, some with specialties in pediatrics and neuropathology, the OME team includes forensic epidemiologists who focus on suicide, drug overdose and prevention efforts.

Suicide is a particularly prevalent cause of death the office encounters. In 2022, Utah ranked seventh in the country for suicide mortality rates. The team of epidemiologists helps make sense of this data.

“We can tell you this person died by suicide with a gun, but (epidemiologists) can tell you what were the circumstances around that death,” Amaro said. “So if we figure out the why, why are so many people in Utah killing themselves, then maybe we can fix that, and that’s what motivates me, and that’s what motivates most of us in this office.”

The facility also houses a space dedicated to DonorConnect, a nonprofit that connects tissue donors with recipients—such as those needing veins, long bones, skin, or corneas—through family authorization. According to Morgue Operations Manager Brandon Callor, this system ensures that viable tissue is recovered efficiently, without the need for lengthy travel that could diminish donation potential.

“There's a window of time in which they can still recover those tissues,” Callor explained. “Whereas in other states, those tissues may have to travel hours, losing a lot of potential donors.”

Though the work can be emotionally taxing, Callor finds purpose in his role. In addition to his duties as a morgue manager, he’s also a social worker. He interviews families who’ve lost loved ones to suicide or drug overdose, looking for ways to help beyond the autopsy suite, including advocating for policies that address public health risks and supporting grieving families.

“I think I can’t feel sorry for myself for very long when I realize there’s so much suffering out there,” Callor said. “And so, being able to be involved in the aid of someone else’s suffering just helps me to gain that perspective and think outwardly.”