Nevadan at Work: In handling death, coroner sees life’s precious value

Mike Murphy will never run out of business.

His workload is immune to recession and inoculated against economic trends.

Murphy is Clark County's coroner. It's a job he's held since 2002, when the County Commission appointed him after evaluating nearly 50 applicants.

Of the 14,500 deaths a year in the county, Murphy's office autopsies and investigates 3,000 to 4,000, or 10 to 12 cases a day, including deaths from unnatural circumstances or violence, as well as unattended deaths and deaths of people younger than 18.

The caseload hasn't ebbed in the downturn. And like any business, Murphy's office has to do with less: Cuts have taken the agency's budget from $5.2 million in 2007 to $4.8 million in 2011, and pared its staff by more than 10 percent. Murphy's gotten creative to help his agency meet unrelenting demand for its services.

Question: Would you explain the difference between the coroner and the doctors who do the autopsies?

Answer: Doctors determine the medical reason someone ceases to live. The coroner determines the method by which someone died. There are five methods: homicide, suicide, natural death, accidents and undetermined. The doctors look at what the body tells them. Our responsibility is to investigate and interact with family, first responders and people who know the decedent and put together the puzzle of their death.

Question: What's a typical day like?

Answer: Our days can start at 6 or 7 and wrap up as late as 7 or 9 in evening. Every morning, the staff meets and we assign cases. Then we review each case that had a determination made. We clear cases so we can issue a death certificate. Then, the medical staff goes into autopsy, and I deal with day-to-day issues. We run a business, so that involves everything from writing notes to employees for great work to overseeing maintenance of our vehicle fleet.

Never a day goes by where I don't interact with families, whether it's notifying them of the outcome, being involved in initial response or talking to them about a decision we've made. Eighty percent of the time I spend with families is dealing with families who have lost a loved one to suicide. We can explain how it occurred, but why people do what they do is always difficult. Telling someone about the death of a loved one is what I was most concerned about when I took the job. It's never easy, but it's an honor. The resiliency of people is phenomenal.

Question: How do you measure performance?

Answer: That's difficult to track sometimes. We have done surveys where we contact families 90 days after a death to talk about how we've done and what we can do better. We take very seriously the feedback we get from families.

Other benchmarks have to do with turnaround. The time it takes us to get a decedent from our office to the mortuary is typically 24 hours, which is one of best time frames in the country. Some offices around the country take two to three days. Some take weeks. We're proud of our turnaround time and try to maintain it. We work seven days a week, 365 days a year. We've obtained federal grants to bring in visiting doctors to assist with caseload. If a case comes in today, we want to get it done today, unless it needs a lot of work. We want to keep the work going because there's no end to (death). It's going to happen, and we're going to have to complete these cases.

We also get input from (attorneys) about our doctors on the stand. We do what we can to raise their level of ability on the stand. We work to have our people certified by the American Board of Medicolegal Death Investigators. And we try very hard to keep undetermined cases in the single-digit percentages.

Question: Who's your customer?

Answer: The citizens. We speak factually about what we know. If we don't know, we say we don't know. We speak for the decedents we serve and their families. We're not here to represent insurance companies or one side of the law. We're here to represent facts about the decedent and to assist the family as they navigate through a very difficult time.

Question: Any unusual cases stick out?

Answer: There are so many. There are cases you carry for the rest of your life. They're emotionally engraved in who you are. It isn't always a case involving a kid or a tragedy. It's the case that catches you off guard just when you think you've got a handle on it every day, and you've got it all sorted out, and you're doing OK with it. There's going to be that case that grabs you, or tilts you, as my wife puts it. I want to embrace that. The point cases don't do that to me anymore, I don't want to do this job anymore, because it would mean I've become too callous. I much prefer to have an emotional side to it. I'm OK with the fact that it affects me.

Question: How has your office dealt with budget cuts?

Answer: We've changed the way we do business. We used to assign an investigator to a case until completion. Now, an investigator can bring in another investigator at the end of a shift to avoid overtime. We've eliminated middle management and 30 percent of our first-line supervisors. Clark County has tried to keep us as whole as possible, but we've faced cuts like everyone else. We've had to work smarter and rethink the way we do things. You accomplish your core function and see if there's anything left.

Question: You were involved in the National Missing and Unidentified Persons Initiative. The office posts photos of unidentified dead online. How do you balance a family's privacy and publishing photos of a loved one?

Answer: I hope a family sees it. That's the goal. It's not to provide macabre pictures for curiosity seekers. When we started, a lot of organizations across the country chastised us. I thought I was going to lose my job. But we asked families how they might feel about it, and overwhelmingly, they told us if it got their loved one identified, they'd be good with it. There's a fair number of armchair detectives looking at these and matching up cases they've heard about. What the person was wearing or another detail can be essential to spurring identification. After we started having success, the agencies that criticized us asked us to help them put together a website. We believe the work we've done has assisted in many parts of the country.

Question: What's the worst part of your job?

Answer: The worst part is when you've done all you can do for a family and there are unanswered questions. People think the worst thing would be knocking on that door. And it is: You're delivering the worst message. But once you get through that, and the family says, "We don't understand why our loved one did this," and there's no way to give an answer - that leaves you empty sometimes.

Question: What's the best part?

Answer: Interacting with families and seeing the resiliency of people. Understanding the pure joy of life and grasping how precious life is.

Question: How has seeing what you see every day changed your outlook?

Answer: It's made me recognize what's important. It has given me what I consider an appropriate thirst for life. In our family, no one is allowed to leave the house without saying that we love each other, because you may never get another chance. This job brings that painfully home to you. Every family struggles with issues, but my job has taught me to value what's important, and it's not things. It's people.

Contact reporter Jennifer Robison at jrobison@reviewjournal.com or 702-380-4512. Follow @J_Robison1 on Twitter.