”My Job Is to ‘Make the Dead Better,’” Says Forensic Pathologist
Forensic pathologist, unlike other doctors, cannot cure their patients, as they are already dead. But they can speak for them – say what happened to them, help find justice for the victims, be able to help society with prevention. “Our patient is the public,” says professor Christopher Milroy, a leading forensic pathologist. He is among the 30 most cited authors in the field of forensic medicine worldwide. He has served as Chief Medical Examiner for the City of Ottawa and, since 2008, has been a professor at the University of Ottawa Faculty of Medicine, having relocated from his native England. During his career, he has participated in war crimes investigations in the former Yugoslavia and testified in hundreds of cases of violent deaths across the world—from Europe to the Caribbean, Africa, and Australia. He has also worked with archaeologists in examining ancient human remains. Prof. Milroy visited the Jessenius Faculty of Medicine in Martin on 30 June 2025 and delivered two lectures: one on forensic neuropathology and vascular trauma, and another on forensic pathology and the opioid crisis in North America. For our magazine, he spoke about the various roles forensic pathologists play, not only in assisting justice through the investigation of crimes but also in preventing deaths and protecting human rights.
What types of cases do you usually handle as a forensic pathologist who often testifies in courts?
I typically deal with murder or manslaughter, different degrees of unlawful killing. It's mostly shootings, stabbings and beatings. Some cases are very straightforward, others may be more complex. But we also examine whether the death could have been prevented. For example, we might uncover an error in how a hospital prescribed medication, our findings can lead to changes in medical practices.
Is Ottawa, or Canada in general, a safe place to live? Do you handle many cases?
Canada is a very safe country. We have a homicide rate that is very similar to England and Europe. We had 25 homicides last year in Ottawa, a city of a million people, and it was a busy year. It's very different from the United States of America, as our gun ownership laws are different. I have been to trials beyond the Arctic Circle, and up there, it can be more violent. There are more guns there, because everyone has a hunting rifle - hunting is part of their culture.
Who is, in your experience, the typical perpetrator of a murder?
Violence across the world is principally a male thing. It's rare to have a female killing.
In Martin, you gave a lecture on opioid abuse in Canada and the challenges it presents to forensic pathologists. Would you describe this situation as an epidemic?
In a public health sense, it is an epidemic. It's not an infection spreading but there has been a huge increase. Every year, 100,000 people are losing their lives to drug abuse in the U.S. while in Canada, it's 8,000. It is a big issue. I encounter opioid- related death very frequently in my work.
Who is responsible for this crisis?
The medical profession must bear responsibility. In the U.S. they started by overprescribing opioid painkillers. Then people got addicted. And then the drug cartels started to feed the addiction by making fentanyl, a very powerful drug that is relatively easy to make.
What is the typical age of someone who dies from fentanyl abuse?
It is not teenagers, the victims are typically older. People often use it with other drugs, mostly cocaine. When you're younger, it doesn't have fatal effects, but you accumulate ill health from it. It affects your heart, your blood pressure. And there comes a time when you've become much more vulnerable, which is why we are seeing deaths in the 40s and 50s and 60s. Because then you've got an interplay of the drug and a natural disease and people are dying prematurely.
Why do people use drugs?
There is a saying in England: 'Why do people climb mountains? Because they are there.' It is the same with drug use. People use them because they're there. It is very difficult to get people to stop using drugs.
Besides being an expert in drug-related deaths, you have also worked internationally on war crimes cases during your long career as forensic pathologist.
Forensic medicine plays a major role in protecting human rights. I used to prepare reports on the victims and their families for the European Court of Human Rights. I was asked to help with the war crimes in the former Yugoslavia. I worked on the Srebrenica mass graves. We had a mortuary in Bosnia and would perform post-mortem examinations.
Forensic medicine plays two roles in international law: the first is to conduct war crimes investigations and assist in prosecutions, to provide identities for the victims so that the families have a name, a body, and a place to bury them. Another is the humanitarian side, which is to look after the prisoners. I've also worked on human rights tribunals aiming to pressure governments to treat detainees better. I've also investigated the deaths of migrants - people who died crossing the borders or drowned in Mediterranean or the English Channel. One of our roles is to provide names and identities to these people. Those are all roles I've had over my career, and I'm quite proud of that.
Have you worked on very old cases, such as archaeological investigations involving human remains?
I have. I did a film for the BBC; it was about a body that turned up in Pakistan, purported to be the body of the daughter of Xerxes, the emperor of Persia. It was a real mummified human body, the organs out and wrapped in linen bandages, and it had Persian writing on a gold plate. They were trying to sell it. Well, we were able to show that the body was about 25 years old!
I was also reviewing peat bodies. Peat is a type of acidic soil on moorland; it can preserve bodies. A famous group of bodies was discovered in Denmark—they were called bog people. In 1983, when I had just qualified as a doctor, a man's body was discovered in a peat bog in England. It was buried around the time of the Roman conquest, roughly 2,000 years ago. He had a ligature around his neck and a stab wound. We debated whether this was a ritual sacrifice, an execution, or even an Iron Age mugging. It is now on display in the British Museum.
As a university professor and researcher, do you still attend crime scenes? Like we see in movies—with the white overalls and the suitcase?
Yes, occasionally I do scene work. I give advice and help gather evidence before the body is moved. We might take swabs or recommend specific examinations. It’s part of the job.
What is the biggest change you have seen in forensic pathology over your career?
Little has changed in the way we conduct the examination of post-mortem. But what has improved are the tools we use—better drug analysis, access to genetic testing, and now post-mortem imaging like CT scans, which are becoming much more common. Drug-related deaths have changed. When I first started, we didn't see much cocaine in England; we saw ecstasy, heroin. Now it’s fentanyl deaths in the U.S. and Canada. But most of the patterns of violence and suicide haven't changed.
Your wife is also a forensic pathologist. How does the household of two pathologists function?
We have quite young children (9 and 11), so with them around, we must be careful, and we speak in code. And we try to hide our textbooks away from them! But it’s also useful to have support in a partner.
Do you have any techniques for getting your job out of your mind? How do you relax?
There was a British politician, Denis Healey, who once said: “The secret of a good life is to have a hinterland”—something outside your profession. We all need a hinterland, whatever our career. We need a family life, hobbies, need to be able to switch off, to do things that are different. I like reading history books, listening to classical music, I like to travel. I like going out for dinner with my wife, and yes, we may talk shop, but we'll try to do other things as well. Some people in my profession have bad dreams; I do not.
Why should a medical student choose a career in forensic pathology? It is not medicine in the traditional sense, curing patients and helping them. What would you say to them?
It is true, we cannot cure the dead. As a forensic pathologist, you can't do anything for the victim but speak for them: say what happened to them and be able to help society with prevention. Our patient is the public. We can help society - both the justice system and public health. There are two main types of autopsies we perform. One is documentation—for instance, when someone is shot in a drug-related incident. The police know what happened, and our job is to document it properly for court. The other type is discovery. For example, if a 35-year-old is found dead at home with no obvious cause, we investigate to find out what happened. Could it be meningitis? A genetic condition that affects the family? That’s part of the public health side of our work—looking for disease patterns or trends in drug abuse, which is an area I’m very interested in.
To students, I’d say: you will use all of your medical training in this field. You need to know a little about a lot—and a lot about your specialty. It’s endlessly interesting. You never know what’s coming next. You’ll interact with police, courts, and families, so your communication skills are essential too. As a forensic pathologist, you have a career where you really stay interested for the whole of it. My colleagues are not the people who are moving into administration or want to do something else because they got bored. There's really no routine in what we do. The other great privilege I've had in my career is coming to places like Martin to lecture, to go around the world. Once, when my little son was asked at school what his father did, he said: He makes dead better. I liked that.
Barbora Tancerová
Photo: Zuzana Marčeková, Barbora Tancerová