12 minute read
Dealing with Death, Healing with Hope
St. Tammany Parish Coroner’s Office
by Karen B. Gibbs
IF YOU THINK the Coroner’s Office is only about investigating deaths and performing autopsies, you’re in for a pleasant surprise—especially if you’re from St. Tammany Parish. Here their work is also about saving and improving lives. This people-centric approach starts at the top with the coroner himself, Dr. Charles Preston. A dynamic, energetic visionary, he has expanded the coroner’s role since taking office in 2014. With inspiration from God (“He’s the one I listen to.”) and encouragement from wife Dr. Lisa Leonard (“I think she got me elected.“), Dr. Preston and his staff focus on healing those who grieve, eradicating preventable deaths, fostering mental health and pursuing truth through science—and doing it all with skill and compassion.
Considering his varied experience, Dr. Preston has what it takes to lead the way. That resume includes being an ER physician, instructor at LSU School of Medicine and co-owner of Doctor’s Urgent Care in Slidell. He is surrounded by a staff as qualified and passionate as he is, and together they make outstanding contributions to our quality of life, such as those described here.
Cribs for Kids
When investigator Chris Knoblauch presented the idea for Cribs for Kids to Dr. Preston, he got a resounding yes. The national safe-sleep project consists of a two-hour presentation that educates parents and caregivers on the ABCs of safe sleep: babies should be Alone, on their Back and in a Crib. Parents who participate receive a voucher for a Pack ’n Play™ crib, which is purchased from Graco with outside contributions.
“There are about 3,500 sudden, unexplained infant deaths (SUIDS) per year in the country,” says Chris. “Sadly, the majority are preventable.” The worst culprit is co-sleeping and accidentally rolling on the baby. This can be as innocent as a mother breastfeeding in bed who falls asleep and rolls on her baby. Other dangerous practices include placing an infant on its belly to sleep and propping up a baby bottle in the child’s crib.
“The CDC requires we do a reenactment with parents who have lost a baby,” says Chris. “We give them a cloth doll and ask them to show us how they put the child to sleep and how the baby was found. All of a sudden, they realize the death was preventable. It breaks our hearts.”
Since Calcasieu Parish began Cribs for Kids ten years ago, there has been a 66 percent decrease in infant mortality from sleeping deaths. These classes save lives and we need to spread the word.
To sign up for a Cribs for Kids class or to request a presentation for your group, contact Chris Knoblauch at 985-781-1150. Donations to Cribs for Kids can be made by visiting the Northshore Foundation Cribs for Kids Page at: northshorefoundation.org/st-tammany-cribs-for-kids
SANE
“One of my highest priorities when I was elected was to establish a sexual assault nurse examiner program (SANE),” says Dr. Preston. As a former ER physician, he knows firsthand that victims of sexual assault require more time and attention than an ER doctor can provide. They need nurses specially trained in forensic exams to provide one-on-one compassionate care over the course of the 3-6 hour exam.
“I love that our program sends a SANE nurse to the hospital where the victim is rather than having the victim transported to a central hospital to be evaluated,” says Ginesse Barrett, SANE coordinator for the St. Tammany Parish Coroner’s Office and former coordinator of the program for University Medical Center in New Orleans. Such a policy is much less traumatic and quickly moves the process along.
The northshore SANE team has two full-time and two parttime nurses who work 24/7 and cover a five-parish region—St. Tammany, Washington, St. Helena, Tangipahoa and Livingston. Last year, they handled 132 cases. When and if these cases go to court, this team provides expert testimony to the judge and jury. (Learn more about this challenging mission on page 38)
Mental Health
“Most calls that the Coroner’s Office receives are about behavioral health—a family member not acting right,” says Adele Smith, mental health outreach coordinator and project coordinator for Safe Haven.
And the numbers bear that out. Each year, the office issues about 350 orders for protective custody plus 4,500 coroner emergency certificates and handles 4,000 physician emergency certificates. “That says something about the need in this parish,” says Dr. Preston.
These emergency certificates give legal authority to transport a patient who is mentally ill or suffering from substance abuse and is a danger to self or others to a treatment facility for diagnosis and treatment for up to 15 days. Once law enforcement receives the emergency certificate, they pick up the person and typically take them to the ER for an examination. Because ERs do not have psychiatrists on staff, the person remains in a room under supervision until a bed is found in a treatment facility. This could take up to three days.
“Having a loved one going through a mental health crisis is a roller coaster for the family,” says Adele, who helps families navigate the complicated maze before them. “Guilty, scared and exhausted, they breathe a sigh of relief when I tell them they’re not alone—we’re going to walk through this with them.”
Dr. Preston, a staunch advocate for mental health, recognized the need for another option for persons with mental illness. He found it in Safe Haven. The vision of Jan Robert and the late Pat Brister, Safe Haven is a 24-bed crisis receiving center, open 24/7, for people going through a mental health crisis. Included on site is a federally qualified health center to meet physical medicine needs, too. Patients can enter voluntarily or be committed involuntarily for up to three days. This allows them time to get stabilized, be placed on a continuum care program and work with a case manager to connect with appropriate agencies for assistance. The Safe Haven model is a growing collaboration of services, organizations and resources aimed at creating a sustainable and healing center for behavioral health in St. Tammany.
Safe Haven is located on the grounds of the former Southeast Hospital in Mandeville. For information go to safehavenstp.org.
Amanda Pennington, DNA Analyst.
DNA Lab
Impressively, St. Tammany Parish has the only Coroner’s Office in Louisiana with its own DNA lab. Under the leadership of DNA Technical Leader Natasha Poe, the lab opened in 2007, thanks to a 2004 voter-approved property tax. Ninety-six per cent of its work is for law enforcement. The remaining 4 percent helps identify human remains.
“The advantage of having our own DNA lab,” says Natasha, “is we can work anything from homicides, to sexual assault, to home invasions and burglaries—as long as it occurred in St. Tammany and is a felony offense that will be going to court.”
Interestingly, most of the DNA cases are burglaries. This is important because, according to Federal statistics, individuals who commit burglaries generally escalate into more violent crimes in the future. “We’ve seen individuals suspected in burglaries advance into more violent cases, such as sexual assaults and homicides,” says Natasha. Burglaries are also costly in terms of materials lost and damage done.
Crimes fluctuate and cases fluctuate, so Natasha appreciates the support Dr. Preston offers if she needs to increase staff. “Thanks to Dr. Preston, we’ve done a pretty good job of having the staff we need to get the work done efficiently. Currently, we assign cases when they walk in the door. No delay. The average time to work the evidence, review the case file and reports and get it ready to present in court is a couple of months as opposed to a year or more throughout the country.”
Forensic Pathology
When Dr. Preston was elected in 2014, the Coroner’s Office had one pathologist, Dr. Michael DeFatta, who conducted 297 autopsies. Today, the department conducts over 450 autopsies per year for St. Tammany and several other parishes—a fiscally smart move since other parishes pay for the service. It also has a second forensic pathologist, Dr. Christy Cunningham. Considering there are fewer than 500 full-time forensic pathologists in the United States, that’s quite impressive.
Also on staff are autopsy technicians and highly trained physicians, including Dr. Charles Foy, a forensic odontologist. For years, Dr. Foy has volunteered his services for the dental part of autopsies, which is crucial to identifying bodies that are burned, decomposed or traumatized. “What an incredible servant he is,” says Dr. Preston. “He works full time in his practice and then comes here in the evening as a volunteer—often bringing his own help.”
Mark Ford, Deputy Director of Investigations.
Death Investigations
Forensic death investigators go to the death scene, investigate the death, examine the body, photograph the scene and report findings to forensic pathologists if the death is not from natural causes. “We are the eyes and ears—and nose— of the pathologist and need to be able to sense when something’s not right,” says Death Investigator Chris Knoblauch. “We’re also there for the family, offering them closure and answers.”
Chris is a Fellow with the American Board of Medicolegal Death Investigators—a national certification board which is regarded as the gold standard throughout the country. He is one of ten investigators in the Coroner’s Office who are ABMDI-certified. The eleventh investigator is currently going through the ABMDI process, which includes 640 hours of training.
In a brilliant move for the parish, Chris, who is board certified for ABMDI and has advanced training and experience with course development and curriculum, is developing a 40-hour basic forensic death investigator course for the office. Due to be completed by the end of 2021, the course will save taxpayers $5,000 per course per investigator and generate income by offering the course to investigators throughout the country.
During his first term, Dr. Preston saw the need for trained people to offer support and spiritual comfort to those suffering the loss of a loved one. “At the time, we were handling 300400 deaths per year.” With the help of dedicated clergy in St. Tammany Parish, he set up the Chaplain Corps, a group of about 40 clergy who voluntarily rotate being on call throughout the month.
The response has been nothing short of divine. For example, one day an AfricanAmerican Baptist minister responded to the suicide of a young, white Jewish man. “I was a bit apprehensive,” says Dr. Preston, “but within two minutes, they were holding hands, praying and hugging. I knew at that moment that denomination doesn’t matter. People need a compassionate heart.”
Such compassion is at the heart of every person, every outreach in the Coroner’s Office. Tammy Switzer, the receptionist and secretary, is a prime example. She interacts daily with grieving families. “We don’t deal only with bodies. We reach out to those grieving and offer help or simply listen,” she says. “We’re very proud of Dr. Preston for letting us help the survivors with grief and other problems associated with death.”
Seeing the need for something tangible to give people on grief and bereavement, Tammy and other co-workers composed a brochure. Packed with information, it explains grief, mourning and bereavement, and provides a list of counseling and support services for adults and children, as well as information on organ donation and more. To receive a brochure, call Tammy at 985-781-1150. >>
Ten-year veteran Ana Welch is another caring part of the team. As case coordinator, she is the liaison between the coroner’s office and the family—the only person they need to call. “I’ll stay on the phone with the family as long as they need to talk. I tell them, ‘let me help you through this,’” says Ana. She also works with life insurance companies so families have no delay in getting benefits. “They shouldn’t have to worry about the financial part while they are grieving.”
Such compassion starts with Dr. Preston, himself, whose email tagline sets the tone for the entire Coroner’s Office: “Be kind, for everyone you meet is fighting a battle you know nothing about.”
Brochures on death investigation, Cribs for Kids, mental health, and sexual assault forensic exams, as well as information on pool safety, burn prevention, carbon monoxide poisoning, teen drug awareness and suicide awareness are free and available at the Coroner’s Office, 65278 Hwy. 434, Lacombe, LA 70445, 985-7811150. stpcoroner.org.
Important Information about Sexual Assault and SANE
• It is mandatory to report sexual assault against children under 18 years of age or elderly or disabled adults who cannot make decisions for themselves.
• People older than 18 and of sound mind do not have to report the assault right away. However, they can go to the hospital and request an unreported kit. This provides the same exam but there is no identifying information on the case. By law, police must hold that evidence for at least a year to give the person time to make a decision about reporting the crime or not.
• Victims have the right to opt out of any parts of the exam.
• SANE nurses respond up to 96 hours after someone’s been sexually assaulted. After that, science does not support that there’s DNA there.
• SANE works closely with support groups like Metro Centers for Community Advocacy, which provides counseling and advocacy after the fact, and STAR (Sexual Trauma Awareness and Response), which supports the patient during the exam and offers free counseling for survivors and loved ones of survivors. • Thanks to Act 229 legislation, victims are never billed for SANE exams. Instead, hospitals and the coroner’s office receive reimbursement for the exams with funding from the Crime Victims Reparation program.
