A new medical examiner will explain death to the living

EVERETT — One day your heart will stop beating, and your life will end.

If your death is sudden or unexplained in Snohomish County, your body falls under the jurisdiction of an office run for the past 4½ years by Dr. Daniel Selove.

The chief medical examiner performs and oversees the autopsies that determine how people have died.

Was it natural, or homicide, or suicide, or accidental or too unclear to say for sure? Was there trauma? Were drugs a factor? And sometimes most urgently, what is the name of this person on the autopsy table?

Next month, the office will have a new leader in Dr. J. Matthew Lacy, who has been the associate medical examiner since 2017. The county council approved his promotion last month. Selove plans to retire.

Lacy, 47, earned his medical degree at Loyola in the 1990s.

“About that time,” Lacy recalled, “the Patricia Cornwell novels were coming out — ”

“Mmhmm,” Selove said with a nod, across a table.

The books had bold all-caps titles like “Postmortem,” “Body of Evidence,” and “All that Remains.” Her grim plots unfolded in the familiar scenery of Virginia, where both Selove and Lacy grew up.

“Maybe that planted a seed? I don’t know. But I did a rotation in med school, and I guess I caught the bug,” Lacy said.

Lacy spent over a decade in Seattle, at the University of Washington and Harborview. He fell for the strange intimacy of working with the dead, trying to deduce what happened to the voiceless and making the findings clear to others. Death investigators walk into private homes. They see how people lived. They talk to family members, and hear personal stories.

“I do way more communicating with the living, if you will, as a forensic pathologist, than I ever did doing hospital pathology, where you could potentially live in a basement,” Lacy said. “This is a very people-centric field.”

After leaving his previous job as associate medical examiner in Pierce County, he joined other public critics of his former boss, Dr. Thomas Clark, who was accused of misconduct in child death investigations, unethical coziness with organ harvesters and personal issues.

“The medical examiner must be objective, must be honest and must be professional at all times,” Lacy told KIRO 7 in an interview earlier this year. “And that office (in Pierce County) is no longer fulfilling any of those categories.”

After five frustrating years in Tacoma, Lacy got an out-of-the-blue phone call from Heather Oie, the Snohomish County office’s operations manager.

“I was rescued,” Lacy said. “I was plucked out of the fire. I was actually thinking of maybe even leaving the field, it was that bad down here. So I came up here and met Dr. Selove, and they offered me a job, and it’s been off to the races since then. It’s been the best turnaround of my life, really.”

He has thought a lot about how his past job will inform his approach going forward, he said.

“I learned a great deal in Pierce County about how not to treat people,” Lacy said. “I learned some lessons about what doesn’t work in management.”

Selove, 71, a former elementary school teacher who speaks at a pace and volume akin to Mister Rogers, was hired to lead an office reeling from controversies related to former head Dr. Norman Thiersch, who saw high employee turnover amid staff complaints about tantrums during autopsies, harassment and gender discrimination. Selove was the target of a lawsuit, too, that ended in a $150,000 settlement, after he fired Dr. Stanley Adams in an apparent disagreement over how to prepare reports.

Overall it appears when Selove retires, he will leave the staff of 16 in calmer waters than he inherited.

“I’d like to think I’ve contributed to turning around the tone and culture here, so there’s good staff morale, there’s job satisfaction, there’s cohesiveness and teamwork, there’s respect for each person’s contribution and training and ideas and experience,” Selove said. “ … Without key people here on the staff, and the staff as a whole, I would’ve been whistling in the wind.”

He largely credited Lacy and Oie — who has been “an ongoing lighthouse and wealth of knowledge” — for an improved atmosphere.

Old episodes of “Quincy, M.E.” were Selove’s first introduction to death investigations, but it wasn’t a career path until after he’d started medical school in his 30s.

“Once in medicine, it was serendipity that brought me to forensic pathology,” Selove said. “I hadn’t even heard of it.”

For two decades, Selove and his wife traveled around the Pacific Northwest for thousands of investigations, in places without a full-time forensic pathologist.

In Snohomish County, both the chief and associate medical examiner perform 230 to 250 examinations per year. Anything over 250 would exceed standards set by NAME, the National Association of Medical Examiners.

Roughly 5,300 people died in Snohomish County in 2018, according to the medical examiner’s office. Most of their death certificates were signed without an autopsy, because the passing was natural and not at all suspicious. About one-eighth of the deceased underwent a postmortem examination at the office. Fewer still were subjected to a full autopsy.

“We try to do the least invasive examination to give us an answer,” Lacy said.

This month, the office will begin to use a new tool from Randox Laboratories that can give investigators a better idea of whether a person died of an opioid overdose — on the day of autopsy, rather than weeks later. That could make investigations more focused and efficient.

In the near future, Lacy also hopes to build stronger partnerships in neighboring counties with coroners, for example, San Juan, Skagit and Island counties.

“Coroners would love that,” Selove said, “to not be marginalized and be more respected, and thought of as part of the team with medical examiners, rather than apart.”

Selove planned to retire at the end of the year, until he learned of a hangup. If the newly hired associate medical examiner comes from out of state, it could take months to get licensed in Washington. He will essentially swap places with Lacy until the new hire is ready.

Lacy will become the county’s highest-paid employee, at $240,928 a year. It’s a job few people are qualified to do, and it takes a unique breed of person to live each day surrounded by death.

Sometimes the senseless death of a child, or someone who shares some physical features of a loved one, will catch Selove off-guard, he said. But speaking with the bereaved can be rewarding, if it helps the healing.

“You can contribute something,” he said. “ … I’m full of sympathy for those families in the grieving process, but I don’t go home at night grieving.”

“Every day is a reminder that life is short,” Lacy said.

“It so does make one appreciate the miracle of life, that we have every day,” Selove replied. “It often goes unnoticed, what a gift it is every day to be here.”

Caleb Hutton: 425-339-3454; chutton@heraldnet.com. Twitter: @snocaleb.