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“When I was a teenager I became very interested in crime programmes that were always on in our house like Cracker, Taggart, Inspector Morse. I was interested in the investigations around those and the psychology around it all.”
Chief State pathologist Dr Linda Mulligan spoke with The Irish Times recently and told us about the path that led her to a career in forensic pathology.
“When I was 15 or 16 a programme called The X-Files came out. I remember watching an episode one day when Dr Scully was doing an autopsy and I thought wow, that is an actual job that you can do. I was always interested in biology and science classes.”
Dr Mulligan attended a UCD open day where she spoke with one of the medical students and that helped her decide on her future career.
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“So I worked really hard from transition year until my Leaving Cert and managed to get the points to do medicine in UCD.”
After training to be a doctor for six years, she did her internship in Ireland before developing an interest in oncology and histology, which is the study of tissues and their structure.
“I decided to go to Australia for two years and I worked in clinical medicine there, but again my interest went back to radiation oncology and working in the bone marrow transplant unit. They’re very much focused on the microscopic examination of tissues and the cellular level of stuff.”
An opportunity arose for her to train as a histopathologist in Ireland. Histopathologists are doctors who diagnose and study disease through the examination of cells and tissue samples.
“When I was a medical student I did a research graduate [course] with Professor Marie Cassidy, or Dr Cassidy as she was then.”
Professor Cassidy was the first woman to hold the position of State Pathologist of Ireland, a role she held from 2004 to 2018.
“Professor Cassidy had given us a lecture at the Pathology Society and of course I was a member of the society. I approached her afterwards and just said, ‘Look, I’m quite interested in this area’ and ‘Is there a possibility for research?’
“She was really supportive. I spent about two months with her one summer and got to see her day-to-day work and to follow her around. I found it fascinating that she was able to examine somebody from head to toe and then come up with answers to questions the family had and answers to questions the guards had.
“She was able to help so many people just by this examination and I just thought that was brilliant.
“That sparked my interest in forensics. I always returned to that area all through my training. Even in histopathology I was always interested in autopsy practice. I loved the way it was able to answer a lot of questions and looked at the bigger picture of the whole body as an organism.”
Once her histopathology training ended an opportunity arose for her to work with Professor Cassidy and Dr Michael Curtis in the office of the state pathologist.
“I was very lucky when my histopathology training ended that an opportunity came up for me to work with Professor Cassidy and Dr Curtis.”
Dr Mulligan is committed to developing a focused strategic plan for her office, including participating in the establishment of a sustainable national autopsy service.
She explained that there is currently no established path for doctors wishing to train as forensic pathologists but that this is an area that is being addressed.
“When you become a doctor there is no option to get onto a training scheme for forensic pathologists in Ireland,” explains Dr Mulligan.
“There might be an option to train as a radiologist or in histopathology but there is no option to get onto a training scheme for forensic pathology.
“It makes it difficult recruit and train forensic pathologists. We’re working very closely to progress that with the Royal College of Physicians and the Medical Council.”
As with so many other parts of the health service, Covid-19 had a big impact on the work of the state pathologist.
“Covid-19 brought a focus back onto how useful the autopsy is as a tool for medical knowledge and development; for knowing how a disease works in the body, particularly of those who unfortunately it led to their demise. A focus has come onto autopsy because of the pandemic.
“There was nothing positive about the death toll from this pandemic but, as medical professionals, we need to look at what we have learned from it and how we can fight the disease and focus learning in order to save lives in the future. That is what the practice of medicine is about at the end of the day.”
When some people think of forensic pathology they think of the process involved with determining the cause of death of an individual. But there is more to the science of forensics than that.
“Forensic pathology is a very specialised and niche area of medicine but there is a far wider world of forensics out there. We’re a very small part of a death investigation process.
“Forensic Science Ireland is the lab-based practice where they do all the DNA analysis, the cold case reviews, blood pattern analysis, toxicology and that kind of work. There are plenty of forensic science opportunities for those interested.
“An Garda Siochána have the technical bureau with forensic photographers who specialise in photographing scenes of crime and fingerprint and ballistic experts. “There are whole range of science-based jobs you can go into and specialise in with plenty of courses. A general science degree is a very good place to start as well as the specific forensic science courses.
“When you see forensic pathologists on a TV show they are sort of distant and away from the investigation and that can be true in real life but we do have the opportunity to attend inquests where there are questions that the family have.
“That is probably the interface where I always feel we provide the most help because families can talk to us directly while we’re giving our evidence and they can ask questions that are on their minds, if they haven’t been answered in the report we give to the coroner.”
And that is one aspect of the job that might not always be in the public eye but that can be very valuable for families seeking answers at a very difficult, stressful and emotional time.
“That is the opportunity to explain to them, hopefully in a way that is not too complicated or technical, about what happened and what the last events of their loved ones’ lives were.
“I would hope they get comfort from that. We spend a lot of time and effort making sure our reports answer all their questions. I think that is so important for the grieving process.
“Being a forensic pathologist is not for everybody. There is a lot to take on board but if you’re able for that we’re always happy to answer questions and help you on your path.”
Dr Mulligan will speak about careers in bio and medical science at Higher Options 2021
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