Forensic pathologist insists there are no two gunshot wounds that tell the same story.

Karen Gunsun, Oregon's medical examiner, shows photos of the bodies she's examined as a forensic pathologist. (Photo by Michael Freeman.)

PORTLAND, OREGON – When Karen Gunson arrives at a crime scene after a body has been found, the first thing she’s asked is when the victim died. It’s not an easy question to answer, she said.
“Time of death is always a problem,” Gunson said. “I can tell you even from what we know, we’re plus or minus six hours.”
Law enforcement officers, naturally, are looking for something more specific, she said.
“We’re asked when were they found and when did they die, and I say ‘Oh, it was somewhere in-between there,’ “ she said.
Gunson is a physician and the medical examiner for the state of Oregon. During a presentation at the Hilton Hotel in downtown Portland, Gunson said television shows about forensic science sometimes offer up a misleading picture of how her office operates. There is detective work to be done, she insisted, but it mainly involves the slicing and dicing of those bodies, usually well into the postmortem stiffening known as rigor mortis.
“There is sometimes confusion about forensic pathology,” she said. “A forensic pathologist is someone who specializes in autopsy medicine. I don’t see live people anymore. I don’t know what to do about your cough.”
There are, she added, between 350 and 400 forensic pathologists in the United States.
“We could use one-thousand more,” she said.
A medical examiner is also not to be confused with a coroner, she added.
“Most people don’t understand the difference between a coroner and a meidcal examiner,” she said. “A coroner is an elected official. There is no requirement for them to be a physician.”
A medical examiner, on the other hand, investigates a variety of cases, including deaths due to homicide, suicide and accidents, deaths due to drug overdoses – and Gunson said methodone and heroin are the leading causes of overdoses that she sees – and deaths that occur on the job.
She also looks into deaths of people in state custody, such as inmates in prison, jail or in mental institutions.
“We are not affiliated with the penitentiary, and we want separate eyes to look at these (deaths) to make sure there is no hanky panky going on,” she said.
She also tracks cases involving “people who die at home and have no reason to die. Say someone has heart disease and has a physician, but has not seen them in months, and is out mowing their lawn and drops dead.”
A lot of her cases, she said, involve gunshot wounds. Some turn out to be murders, others are suicides, a few are accidental.
“The majority of the cases we do are gunshot wounds, because guns are so prevalent,” she said.
Examining a gunshot wound is more complex than people might think, she added. The look of the wound tells a lot about how the victim died, and under what circumstances.
“When a bullet goes through the body, it is propelled by the gas formation and there’s the lubricant on the gun,” she said – all factors that need to be examined.
“It has a round, punched out appearance,” she said of the bullet wound. “Sometimes it’s oval, with a rim of abrasion. A rim of abrasion will help you distinguish between a gunshot wound of entrance and a gunshot wound of exit. Most of the time, bullets do not exit the body. Usually we are going to find the bullet in the body.”
It becomes harder, she said, when the victim dies from a 22 caliber bullet, one she called “small and disgusting” and fairly easy to hide in the body.
“I think they (the assailant) should get more time if they use a 22,” she said.
Not all gun victims are killed by others.

Oregon State Medical Examiner Karen Gunson brought along plenty of explicit photos of the bodies she's dissected in her forensic pathology lab. (Photo by Michael Freeman).


“The most common gunshot wound is a contact gunshot wound to the head,” Gunson said. “Many people use guns to commit suicide.”
She recalled one case of an elderly man who was believed to have taken his own life because he left a suicide note. But her office got suspicious when they discovered he had three gunshot wounds to his head.
But after a careful examination, they discovered it was a suicide after all.
“Just because you have more than one gunshot wound to the head doesn’t mean it wasn’t a suicide,” Gunsun said. “Two of those bullets just flattened up against the skull and didn’t hit the brain. Why does that happen? Old ammunition. He had a hell of a headache, but he didn’t kill himself until the third shot.”
Another case left them baffled at first – the victim had a gunshot wound to his head, but also multiple other smaller wounds all around it.
“This is what we in the forensic pathology industry call an atypical gunshot wound, basically because it’s not round and punched out,” she said.
That case turned out to be a road rage incident. Someone had shot the victim through the back of his pickup truck. The smaller cuts to his head were caused by shattered glass.
“You have to think like a bullet sometimes,” Gunson said. “We can’t pinpoint the time of death, and gunshot wounds are what we see a lot of.”
There are other factors to be considered when examining a body, she added.
“The environmental conditions count – are you inside your house, are you sheltered from the wind, are you in the rain,” she said. Determining when rigor mortis set in is also a critical first step.
“If you watch my investigators, the first thing they do is touch (the body) and find out how stiff are the fingers, how stiff is the face,” she said. “The first sign of decomposition is when the body starts to go flaccid. Sometimes rigor can tell us the cause of death.”
Her office is helped immensely, she said, by the fact that so few murderers understand forensic science, or know much about the myriad of clues they leave behind.
“I don’t know why people think they should get rid of a body by burying it,” Gunson said. “They should just leave it in the forrest and let the animals get at it.
“Of course,” she added, “don’t let anyone know I told you that.”

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