A Coroner’s Guide to Writing about Autopsies
To get right to it, here are a few misconceptions about medicolegal death investigation I’d like to address before moving on to suggestions and resources to help mystery writers get it right.
PET PEEVES ABOUT AUTOPSIES in FICTION
- Mixing up the roles of coroners, medical examiners, and forensic pathologists
- Doctors who aren’t pathologists performing complex forensic autopsies
- Coroners, medical examiners, or forensic pathologists going after criminals — in real life, that’s a law enforcement responsibility
- Fictional coroners/medical examiners who spend all their time on one case
- Family members identifying a body at the morgue: not a scientific method of identification
WRITING THE AUTOPSY SCENE
Even if you have no medical background, you can write an autopsy scene by focusing on one or more of the following journalism W’s:
Who
Tell the reader about the pathologist, the coroner, the autopsy technician, the police officer or the prosecutor in the room.
Who’s your protagonist? If she’s a forensic pathologist as in After Shock (J. Melinek and T. J. Mitchell), readers may expect more detailed autopsy scenes. Author Melinek is a well-known forensic pathologist and writer, so it’s not surprising to find anatomical details galore in this novel.
What
What kind of autopsy? Autopsies done by or for coroners are forensic (not medical) autopsies. Sometimes families choose to have a private autopsy performed afterwards, a very costly undertaking. This can lead to conflict if findings don’t agree!
The autopsy scene should be essential to the plot, not gratuitous gore. No need to dwell on every detail of the autopsy if there’s only one that matters.
There’s a masterful example of this in chapter 33 of P.D. James’s classic Original Sin. The autopsy description is limited to one concrete observation: a scratch on the upper palate. The rest of the chapter describes the building, the people, the appearance of the body, and the discussion about the meaning of that scratch in the victim’s mouth.
Where
Not long ago a mystery writer working on a new novel called to ask me about coroners in Pennsylvania. In which county will the body in your novel be found? I asked. The USA has such a patchwork death investigation system, you have to get that specific.
Irene Hannon got location specifics right in her romantic suspense novel Body of Evidence. The protagonist is a forensic pathologist who performs autopsies for coroners in rural Missouri. Hannon lives in Missouri, but you can find information on every state’s medicolegal death investigation system on this CDC website.
Local death investigation practices also apply to international mystery settings. For example, the qualifications and duties of a coroner in the United States are very different than those in Great Britain, a topic worth a blog of its own. Speaking of Great Britain, I love the television program Silent Witness, particularly the early episodes where Amanda Burden played forensic pathologist Sam Ryan.
When
Is your novel historical, contemporary, or future time? Research may be required!
I’m listening to the audiobook of Murder by Degrees (Ritu Mukerji), a debut mystery featuring a pioneering woman doctor and anatomist in late 19th century Philadelphia. Mukerji, like me, went to medical school in the city, but she would have done historical research to write this novel.
A few years can make a difference in the tools and techniques available for forensic autopsies. Just last year, for example, I wrote about RapidDNA and investigative genetic genealogy, technologies just now coming into common use, especially in cold cases.
Why
Why write an autopsy scene at all? Do your readers need to “see” the autopsy for themselves? Might it suffice to have someone mention the results? Could a coroner, medical examiner, or forensic pathologist give evidence from the autopsy at a courtroom trial or coroner’s inquest?
RECOMMENDED TECHNICAL RESOURCES
- The Autopsy Book — detailed tutorials on medical (not forensic) autopsies.
- The National Association of Medical Examiners website
- COMEC — CDC’s website for coroners and medical examiners
Finally, the bottom line is that you’re writing a story, not a lab report. So take my comments with a grain of salt and, if you must, bend reality to your own purposes!

Thanks for joining us and imparting this useful information, Christina~
You’re so welcome! I love this website and am thrilled to be able to contribute.
This is so helpful. Thank you. Think I will go back and read PD James.
Thank you, Susan, glad you find it helpful. Yes, when I re-read Original Sin, it was twice as good as the first time.
Wow, this was an extremely helpful article, thank you! I love the inclusion of both the resources and the books that show the examples.
I appreciate that, Dawn! Hope you can make use of the sources and I can always provide more if needed.
So much good info here. Thank you.
You’re welcome, Lana! I hope you can put it to good (?evil) use.
Thanks for this informative post and for the links to additional resources. Between new technologies and that patchwork investigative system, it’s a daunting topic!
Yes, I learned so much I never knew or thought about after I was elected coroner!
Thanks for this information, Christina. Two beta readers of my up coming NYPD Detective Chiara Corelli Mystery, called me out for having a relative identify a victim.
I wonder if it’s more common to do that in (for example) the U.K.? It seems to happen all the time when I watch BBC mysteries. But no, here most coroners and MEs may not even have an appropriate place for families to view let alone identify someone.
Great information here! Thank you Marnie and Christine!
Hi, Jim, and thanks for reading!
Wow, this is great! On a weird side note about getting the details right–I once was a reader for a short story anthology, and one of the submitted stories included an autopsy scene in NYC. One of my friends worked as a photographer for the medical examiner, and I recognized her from the description in the scene of the short story! That was such a strange coincidence, it made me push the story to the front of the line because it felt so authentic. The story made it into the anthology, for the same reason. After I found out the name of the author, it turned out he had been an NYC detective, witnessed many autopsies, and knew my friend. So… details matter!
Hi, Emilya, yes, there are so many more people involved with autopsies than just the forensic pathologist and (usually) one assistant. For example, in the region where I worked it seemed some rookie law enforcement officers were required to attend at least one autopsy. I always kept a close eye on them to make sure they weren’t going to crash to the floor!
I finally, hopefully, found a site that will answer a few questions to make my novel accurate. It’s not about an autopsy, but there is a coroner testifying about one. It’s not intended to be a long scene with difficult cross-examination and medical stuff I don’t know. Here are the facts, and I do apologize – if there is a better way to do this please let me know.
1. Deceased hit in the back of his head with a rock and dies.
2. Body found 3 in country weeks after death. Snow and rain kept animal activity at minimum. Murder is suspected.
Question – Would an autopsy this long after the murder be able to detect a traumatic brain injury? Or would the best they could do after this time be to just rule blunt force trauma?
Thank you so much!
Hi, Shell, and interesting you mention testifying, which I’ve done; just a few times but fascinating. Earlier this year I posted two blogs on my website about coroners in court which you may want to look at, assuming your novel is set in the U.S.
To answer your specific question, it is unlikely the brain tissue itself would be able to be examined because it decomposes rapidly into a semi-liquid state. Most likely the damage to the skull bone(s) would be the only remaining evidence as far as the body itself. The question forensically might be whether this could have been an accident (hiking and falling onto a rock) vs. a homicide. Then the surroundings become relevant: was the person found near a rock? Did it have blood or hair on it? Of course the weather might have removed some of that.
Hope this answers your question! Best of luck with your novel.
Thank you very much. After reading your well-explained answer, I know exactly how I will proceed.
Shell
Glad I was able to help!