Lesson 10: Go slow at first.

Before I left Atlanta to begin my new job as chief medical examiner in Kansas City, Dennis McGowan, formerly the chief investigator for the medical examiner office in Fulton County and a man with much experience in death investigation, gave me some sage advice.

He said to make no changes in the office for one year.

Stephen Covey’s book, “The Seven Habits of Highly Effective People,” contains many useful ideas for the new chief medical examiner. One of those habits—to seek first to understand before being understood—is particularly important1. Robert Frost also helped the erstwhile chief medical examiner when he said, “Never tear down a fence until you know why it was raised2.”

It is very tempting to walk into a new situation—particularly if the new situation is a troubled situation—and institute immediate changes. This temptation is one you should resist with all your might. You may not realize until much later how much you damaged yourself at the outset.

The medical examiner system you have chosen to lead did not begin on the day you walked through the door of your new office. Frequently, it evolved over a long period of time. Personnel in the office frequently have been using the same policies and procedures for years. Additionally, law enforcement officers, prosecutors, child protective services, and a host of other agencies have become accustomed to performing in certain ways. Just as you may feel that the office you left performed the job in the best possible way, members of these agencies feel the same way about the jobs they do.

Also, first impressions are indeed lasting.

Over the years, I have taught medical students and pathology residents how to testify in court. I have told them that the most important part of the testimony is what they do at the outset—how they walk into the courtroom, how they look and dress, how they stand to take their oath to tell the truth, how they make their initial eye contact with the jury. If they do well with this, they will develop immediate rapport with the jury. They will take advantage of the “halo effect” where they are perceived as being better than they actually are. On the other hand, a poor initial performance will make the job tougher and they will less likely succeed.

The initial showing of the chief is even more critical. At the outset, the office staff views you with trepidation. Nobody likes to change; yet your arrival signals that major changes are ahead. They wonder what you are like, how easy it will be to work for you, and how much additional work they will have to do. When I began in Kansas City, some in the office even worried that I would replace them with someone I would bring with me from Atlanta!

At the outset, the new chief is intensely scrutinized, not only by the office staff but also by law enforcement officers, crime scene technicians, and assistant prosecutors. The question foremost in their minds is, “Are you a good guy or gal or are you a jerk?”

At the outset, you as the new chief should plan on spending long hours at the office. The purpose of the long hours is to learn as much as possible about the office. In order to do this, you need to “hang out” at the various times when people are on duty. You need to watch and listen to everything that is going on. And you need to do this long before you make any changes.

When I began my new job as chief, I set up appointments to meet with every member of the staff. I asked each of them questions—questions about themselves, questions about the history of the office, questions about how the office functioned. I also gave them the opportunity to ask me questions, and I recall that they asked me many questions—what was I going to change, what was going to happen, what was I going to do about particular issues. This time was about building trust and relationships. It was also an invaluable time to learn about the office.

I also asked the investigators to take Polaroid photographs of every new person I met in the office. There were many—homicide investigators, crime scene technicians, hospital personnel, etc. I pinned these photographs with the names of each person on my bulletin board so that I could learn their names or at least be reminded who they were.

I also spent much time looking through the office files. It turned out to be a very good thing. While looking through the files one day, I discovered several with blue round labels. I asked the secretary what these labels meant. She told me that those were files where the previous acting chief medical examiner had not dictated and signed an autopsy report. To my amazement, about one third of the cases ranging over a year and a half did not have dictated autopsy reports. I asked her when she was going to tell me about this. She said she was afraid to say anything.

Needless to say, certain emergency situations require changes to be made quickly, and the state of these dictations constituted such an emergency. When this happens, it is better that too many changes were not occuring at the same time. I was glad to go slow at first.

1 Covey SR. The Seven Habits of Highly Effective People. New York: Simon & Schuster, 1990.

2 http://www.jcookseybono.com/more_quotes_1.htm