The 911 call came in at 6:09 a.m.
“Can you please send a police car to the InTown Suites at 1990 Willow Trail?” a woman asked the Gwinnett County E911 call-taker. “There’s a body — a dead body — in the lake right next to the Krystal’s. The bridge, right next to the Krystal’s, there’s a dead body floating in the water.”
Within minutes, Gwinnett police, and shortly thereafter, Gwinnett fire personnel, arrived on scene. By 8:25 a.m., the Gwinnett County Medical Examiner’s Office Investigator was there too, and ready to preliminarily examine the body.
“I think the creek was about knee-deep,” said Gwinnett County Medical Examiner Dr. Carol Terry. “The man’s wallet was nearby and there was a driver’s license in there, so we had a start to his name, but many people look similar, so we wanted to confirm it scientifically.”
Police, and Terry, also wanted — and needed — to determine the man’s cause and manner of death.
“In looking at him, near his lip, he had a very superficial cut, but they said they saw a turtle swimming away, and it looked like a cut from a turtle claw,” Terry said. “He had not been dead all that long, he had not been in the water all that long and he had no obvious external trauma, based on my investigator looking at him.”
Ultimately, Terry ruled the man, whose next-of-kin has not yet been notified and thus his name has not been released publicly, died from an accidental drowning. But just how did she come to that conclusion?
‘Felt like home’Terry, who became the county’s sole full-time medical examiner in 2006 — a part-time medical examiner aids her on certain weekends or when she’s otherwise unavailable — was born and raised in Gwinnett, graduating from North Gwinnett High School in 1983.
After high school, she attended Emory University, where she received her undergraduate degree and then, in 1990, her M.D.
“When I went into medical school, I thought I was going to be a surgeon,” Terry said. “I was naive and even thought I could do anything in the field of medicine and I’d be happy. But there were certain things I enjoyed in certain areas — I enjoyed the trauma surgery and, technically, I’ve always been good with my hands — and as I was rotating through different things, I did a rotation in pathology. Pathology just felt like home.”
Terry, who comes from a family of teachers, said pathologists — doctors who study the causes and effects of diseases by examining body tissue — are similar to educators in a way, given they’re consultants for other doctors.
“Few people want to go to medical school to be a pathologist; they want to treat patients and all that sort of stuff,” she said. “But pathologists do too, we’re just one of those doctors you get a bill from and you never see. As weirdly as we get portrayed on TV, you know, the pathologists are down in the basement and have terrible people skills and whatnot, they were the most normal people (in my) rotations.”
While she’d already gravitated toward pathology, after rotating through various specialties, Terry was, one day, pulled aside by a surgeon.
“I was young and starting out so I was (encouraged) by everyone to go for the glory,” she said. “But (the surgeon) said, ‘I’ve got a wife and three children I never see because I’m always at the hospital. You seem to like your intramurals, you seem to like your sports, think about what you want your life to look like. Do you always want to be in the hospital?’”
Terry was sold, and settled on forensic pathology — a subspecialty that focuses on determining a person’s cause of death.
While there are certain things that can be pressing and require her immediate attention as medical examiner, she said the job “affords one an opportunity to have a more normal life.”
“If I get a call about a critical lab result, it’s like, ‘Really? What is critical coming from the laboratory at the medical examiner’s office?’” she said, laughing. “It’s just like, ‘You know the patient’s dead, right?’”
After graduating from Emory, Terry worked for the Fulton County Medical Examiner’s Office for 10 years, then was at DeKalb’s office for two years. Then, when Gwinnett’s contract was up with the former medical examiner, Terry saw the opportunity to form her own company and place a bid for the new contract.
She won it, and has been the county’s medical examiner since.
(Though her firm, Forensic Pathology Services, P.C., does business as the Gwinnett County Medical Examiner’s Office, Terry and her employees are completely independent of the county.)
“(Forensic pathology) is one of these fields where people don’t think about us being physicians; I’ve had people ask me at social gatherings, ‘Well, why didn’t you become a real doctor? Why did you choose not to see patients?’” Terry said. “I am a real doctor, and I do see patients, they just don’t see me.”
‘Tell the truth’
The main difference between Terry and a “real” doctor, of course, is that Terry’s patients are not alive. But that can have its benefits, she said.
“I can’t cut (live) patients open to get a look,” she said. “So with (the drowning victim), we open him up and look for any trauma that may not be apparent externally. While he didn’t have any traumatic injuries, he’s got terrible heart disease — there’s narrowing of his coronary arteries and his heart is big.”
There was also water in his stomach, Terry said.
“Sometimes when people are drowning, they’ll swallow water in before they ultimately inhale it and die,” she said. “We do know his face was in the water, he’s got water in his stomach, and he’s been breathing it in and swallowing it. What happened to him terminally I don’t know, but what I do know is whatever happened to him terminally was aggravated by the fact that he’s collapsed in water, and he’s breathing and swallowing the water in. Now, had he collapsed on the bank, he might still be dead, but he would have had a better chance of living than collapsing in this hostile environment of water.”
When determining the cause and manner of death, Terry said, medical examiners give the majority of the weight to the non-natural event that occurred.
“An epileptic who has a seizure on a roof and falls off and dies from the fall, we’ll call that an accident, even though the underlying disease may have been what kicked it off,” Terry said. “This guy here, maybe he’s acutely drunk, maybe he’d had a cardiac event and he’s collapsed in the water, but that ultimate collapse in the water has aggravated his natural disease, so it’s a drowning. But it’s more complicated than just saying ‘accidental drowning.’”
Sometimes, Terry said, because the factors that go into her rulings are more complicated than the one or two words that end up on a death certificate, grieving families and the public have a hard time understanding a determination, and her rulings are questioned.
But outsiders frequently don’t have the whole picture, Terry said.
“We’re looking at objective evidence here. The autopsy is one small piece of the puzzle that we use to put together and ultimately hope to have a complete picture,” she said. “I’m not affiliated with the police department, I’m not affiliated with the district attorney’s office and unlike a coroner, who is elected and doesn’t have to have any medical knowledge, I am not pandering to the public to get their support. Very few times do I do things that are going to make people happy, because if I were going to make people happy, I’d be resurrecting their loved ones, and I obviously can’t do that. I can’t generate death certificates or rulings to make people happy; I’m doing my job to the best of my ability to tell the truth.”
That truth, in this case, was the man accidentally drowned. While Terry is still waiting for his toxicology report to her his blood alcohol level and whether any other substances were in his blood, the case was relatively open-and-shut, she said.
“It’s kind of like in court, when the judge gives the jurors the charge: ‘You have heard all the evidence, you are the people who are in the best position to make a decision,’” Terry said. “That’s me, in these cases. I have the most knowledge about this; if I need more, I send my investigators out for more, or I tell the homicide (detectives) to get me more information or I’ll subpoena records until I have enough information to make a decision. Then I am the best person to make that decision.”