Blazing a path less traveled

Black Enterprise, Feb, 1998 by Caroline V. Clarke

"I believe that when a person dies, [the] soul separates from [the] body," Carter says, going on to explain how much one can tell about a person's life and health from fingernails and feet. "I give a body its last opportunity to speak for itself." And, when necessary, she serves as its voice, even at the risk of upsetting the living.

As chief medical examiner in Washington, D.C., back in 1996, Carter, who generally supports and encourages organ donorship, caused a stir when she informed government officials that she and her staff would not comply with a law empowering them to harvest people's corneas and heart valves without family consent. "I asked them, would you expect me to take a congressman's loved one's corneas without asking? Never. But it's okay for me to take those of a poor black male without asking or educating his loved ones, right? No, not on my watch." The law was changed.

Carter's career path has included stints as chief resident in pathology at Howard University, a fellow in forensic pathology in Dade County, Florida, and chief physician and forensic pathologist in the U.S. Air Force Medical Corps.

She admits that her comfort with and boundless curiosity about death are a bit odd. "This is not the job my mother would've wanted for me," she says, laughing. But she finds America's cultural attitude about death even stranger than her own. "There's such a taboo in this country about the one thing that everybody, regardless of their race, creed or socioeconomic standing, has to do," she says. "Death is the great equalizer."

Carter, who is 40 and single, got hooked on forensics back in high school when she witnessed her first autopsy. Later, when she studied medicine at Howard University, she never wavered. In fact, she is more uncomfortable with the idea of treating the living because, she says, "I don't like to see people suffer."

As chief medical examiner for Harris County, Texas, Carter oversees about 80 physicians, chemists, lab technicians, investigators and secretaries. With a population of 4 million-plus, hers is the fourth-largest county in the nation, generating about 10,000 cases a year for Carter's office. As the first woman to hold the position (and one of only a handful of African Americans in her field nationwide), she endures more than her share of "Can you handle it?" queries and Quincy (as in the old television series) jokes.

By law, medical examiners investigate unnatural deaths (those stemming from mass disasters, car accidents, violence, etc.) or natural deaths where there was no doctor present (often involving the homeless, or people who expire at work, in transit or at home). Most Harris County cases are resolved rather simply, but about 3,500 a year require an autopsy.

Although Carter still occasionally does that type of hands-on work herself, her time is spent mostly on administrative duties, testifying in criminal cases (as to the official cause of a victim's death), writing and lobbying for changes that grow out of her work. She also teaches at both Howard University and Houston s Baylor College of Medicine. Carter, a vigilant anti-gun lobbyist, is emphatic about her responsibility to use her work to enact positive change for the living. She is quick to note that the information that led to air bags in automobiles grew out of medical examiner's work, as did the child safety warnings that now come on venetian blind cords. "Eventually everyone dies," she says. "We can't prevent that, but we can prevent certain types of death."