Dr. Christopher Happy has been on the job as Honolulu’s chief medical examiner since late November and already he can tell you that some changes at the city morgue in Iwilei are going to have to be made soon.
"What we need to do," said Happy, whose appointment was confirmed by the City Council in late January, "is start to expand the refrigeration space downstairs. Basically we’ve got two coolers and a crypt system that can hold about 10 more bodies. Our upper limit of capacity, if we really got crowded, would be around 60 to 70, and we get close to that on occasion. … So obviously we want to be prepared if anything happens."
Happy said that in recent years, his staff has been doing about 600 to 650 autopsies a year.
"I imagine that maybe even this year we may go up to about 700," he said, "and in years to come, if our population continues to grow, we’re going to hit a thousand in 10 years. So, you know, your services have to grow with your population. That’s what we’ll be looking at."
Before Happy, Dr. Kanthi De Alwis had been the chief medical examiner, but she retired from the post in late 2009. Overseeing operations and the staff of 22 in the long interim was Dr. William Goodhue, a U.S. Army pathologist for 26 years who joined the Department of the Medical Examiner in 2001.
Happy came to the position fully qualified in both credentials and experience. Most recently he was assistant medical examiner for the San Francisco Medical Examiner’s Office. Before that he was chief medical examiner in Milwaukee,
assistant medical examiner in Santa Clara, Calif., and city medical examiner in New York.
He earned his doctor of medicine degree from St. Louis University School of Medicine, then did one year of residency at University of Massachusetts Medical Center and four years of residency at the University of New Mexico Medical Sciences Center, in Albuquerque. He also did two fellowships in New York. He’s been an assistant professor and produced academic research. Perhaps most important, he is certified by the American Board of Pathology in anatomic and forensic pathology, which was necessary for the department to regain its accreditation after years of being unaccredited.
As for high school, Happy started at Culver City High School in California, and finished at Shea High School in Pawtucket, R.I.
Happy, 43, is divorced. He lives in Kakaako with his 6-year-old son.
QUESTION: Why did you decide to accept this position?
ANSWER: Well, I was called by Dr. Kanthi De Alwis last year when I was an assistant ME at the San Francisco Medical Examiner’s Office. As you know, they were doing a prolonged search for a qualified person to take her place as the chief, which had gone on for several years, a lot of that being due, basically, to not having the correct salary in place for a chief medical examiner.
I think part of why they were able to get me, obviously, is that they brought it up to national levels. Quite frankly, for an expensive place to live like Honolulu, anywhere between what I’m getting at $250,000 to $300,000 is about right. …
I actually wasn’t too happy in San Francisco. The office there has a few problems, one of it being they just don’t have enough staff; they lost three people before me in the span of like a year. Things move slowly, I understand that, but it just looked like it was going to be a long slog before those people got replaced, and this (Honolulu position) was both a financial and professional promotion, so it was kind of a no-brainer. …
Now we are poised to get reaccredited. The accreditation, which is given by the National Association of Medical Examiners, was something that the
Honolulu office had had for many years, while De Alwis was chief, and then when she retired, they lost it because they could not replace her with a board-certified pathologist.
Q: So your hiring was about an adequate salary coinciding with the need for a board-certified pathologist?
A: Right. They were not going to hire anybody who’s not board-certified.
Q: Why is accreditation needed?
A: Accreditation is not required, but it does ensure that we are meeting the standards set by the National Association of Medical Examiners … and perform good death investigations.
In addition, having been previously accredited and then losing it makes the citizens of Honolulu think that the office has gone downhill. Getting reaccredited will assure them that this is not the case.
Q: Are there any changes you intend to make? What about the building and its facilities?
A: Well, I’ll tell you what we need. This building here — which is actually quite new compared to some offices in some places — was built in ’88 or ’89. … So we’re not bleeding edge, but we’re also not too antiquated.
Q: Bleeding edge?
A: Bleeding edge, right. No pun intended.
Q: I hear there are a lot of inside jokes about working at such a place.
A: Yeah, well, it’s one of the coping mechanisms, right? We see so much bad stuff, every single day, that you can either try to have — what do they call it — graveyard humor, or you could just cry at your desk all day. You gotta cope somehow. I mean, we’re very respectful, obviously. Everybody realizes that these are loved ones of some individual that’s still out there, and, really, you know, that’s one of the reasons why I went into this field, because I help families a lot, and I get a lot of satisfaction out of that.
But anyway, we were talking about the building. The building is fine, (but) it will need some renovation going forward. … Obviously we’ve been gaining population every year on Oahu, and we expect that to continue.
Q: Do you serve just Oahu?
A: Yes. It’s just under a million people on the island. So we’re a big office. It’s not L.A., it’s not Chicago and it’s not New York, but we’re a big office. We do the same number of autopsies each year as San Francisco.
Q: Are you going to be pleading for a capital outlay of some sort?
A: Well, my point was that back when this building was built and the population was what it was, they thought room for 50 bodies was gonna be all they ever needed. But when you’re dealing with a lot of indigent population who does not get anybody to claim their body, sometimes for months, the storage of those remains obviously resides with us. We’re running a census right now of about between 30 and 40 bodies. And obviously, when we’re getting up to 40, sometimes 45, we’ve got room for one big disaster, and not even a big disaster. One big car accident.
Q: How would you deal with a large incident like a natural disaster?
A: Well, we have plans in place that, should we reach and overflow our capacity, we would have backups with local hospitals and with local military bases, and we also have a plan that we could get refrigerated trailers here.
Q: You mentioned the bodies backing up because no one’s claiming them. Is that a reflection of our homelessness?
A: It depends. Some people just don’t have any next of kin — no mother or father, brother or sister, or anybody.
Q: What do you do with them after a while? Is there a pauper’s grave, or do you donate them?
A: No, we don’t donate them. Their bodies are cremated at a funeral home, and the expense is assumed by the state. But before the state will assume that expense, we have to do our diligence in trying to find family. And that can take a long time. Then, of course, like I said, there’s going to be quite a few people who we don’t find their families. And some people, of course, remain unidentified.
Q: Not to hammer on that homeless point, but has there been an uptick of them in past years?
A: I can’t say in past years, … but at this time I have not identified that it’s more than what would be expected for any population. If I knew something like that, I would certainly try to figure out how to address that type of problem. Or at least I could tell you why.
The other thing is, and I think you did sort of hint at this, that the people who come to us are the disenfranchised. They are the ones who are victims of homicide, they are the ones who are dying of drug abuse. We see an underserved, mostly poor population of people. Because if you’re middle class, if you’re upper middle class, if you’re upper class, you have a doctor. Just percentagewise, you’re not a drug addict and you’re at less risk for a homicide than a guy on the street.
Q: And you probably have an
attended, easily explainable death.
A: Exactly. You’ve been to the doctor and they know what your problems are. … Most likely you’re going to die either at the hospital or peacefully at home … (and) some doctor’s going to sign your death certificate.
A perception the public has is that we do mostly homicides and accidents and suicides. But we do mostly naturals — 30 percent, approximately — and these are people who either don’t like doctors, don’t have health insurance … About 20 percent are gonna be accidents, about 10 to 15 percent are gonna be suicides, and maybe another 10 to 15 percent are going to be homicides. …
Q: You get the impression from all the anti-suicide campaigns that it’s mostly kids. But I was looking at the figures for Oahu you have online and it’s actually mostly people in their 40s followed by people in their 60s and up.
A: That’s right. … Teen suicides are not, thankfully, that common.
Q: What are your findings on those older suicides?
A: I think it’s the kind of thing that, "I’m not young anymore, I don’t feel well anymore, and I’ve lived a full life." A lot of suicide, obviously, is associated with mental illness, right? But these people aren’t thinking like that. They’ve just got depression and other problems.
Q: Are you expected to go to court and testify?
A: Oh, yes, that is a big part of our job. If there’s a homicide and a suspect is identified and brought to the justice system, we’ll be there. We have to go. We have to present the information from the autopsy as evidence.
Q: Are your findings ever challenged?
A: Oh, all the time. We have an adversarial system, right? So, as you know, even the most guilty of us are presumed innocent. And even though sometimes it seems pretty cut and dry — here’s the gun, here’s the person, witnesses saw a shooting and so forth — you still have a trial, you still have the presumption of innocence, and you will still have lawyers advocating for their clients.
Q: How long does an autopsy take anyway?
A: It depends. Say somebody just died at home, they’re elderly, they don’t have any medical history, we don’t know why they died — we’ll do the autopsies. If you’re playing the statistics, 85 to 90 percent it’s going to be heart disease for an elderly male. That would take an hour. But if I’ve got an individual whose been stabbed 100 times, that might take me two days. … It just depends.
Q: How about that woman who drove off the cliff in Laie — was that a case that came to you?
A: Oh yeah. Any accidental death. No doctors besides forensic pathologists at the medical examiners or coroners office can sign non-natural death certificates. Anybody who dies non-naturally has to at least be referred here.
Q: We talked a little about how the work you do must take a psychological toll, depending on the case, like maybe it’s a little child.
A: Exactly. The things that really get to me, after I had my child, are children, especially abuse cases, … and teenagers who commit suicide. Because, hey, we were all depressed teenagers at one time, right? … And then what happened? A week later, we were fine, right?… I always just want to say, "Oh, if you just could have gone another week, everything would have been fine."
Q: Has your last name influenced your outlook on life in any way?
A: (Laughs) Well, you know, obviously there’s no avoiding that it’s influenced my outlook on life. … People love to make puns, right? And then they feel bad. … And I always tell them: Look, I survived junior high school. I’ve got pretty thick skin when it comes to my name, so you go ahead, and if you can think of a joke that I haven’t heard, I’ll be the first one to pat you on the back and chuckle about it.
