Autopsy video

Filming the taboo: Documentary about autopsies was difficult to make and is more difficult to sell

By Lorna Collier
Published September 14, 2000 (Chicago Tribune, Tempo section)

When California filmmaker Michael Kriegsman set out to make a documentary about autopsies and the pathologists who perform them, he expected the project to be somewhat controversial and difficult.

He did not, however, anticipate the number of obstacles he would encounter in trying to produce a film about such a taboo topic, the sometimes-disturbing public reaction to the movie, or the personal reward he would find in facing death at its most elemental level.

Kriegsman's film, "Autopsy: Through the Eyes of Death's Detectives," released as a home video earlier this year, is both an unflinching look at what happens to bodies during autopsy and a sympathetic portrayal of the pathologists behind the gowns and scalpels. The film, which was produced with cooperation from the Los Angeles County Coroner's Office and UCLA Medical Center, also emphasizes the need for autopsies, which, to the alarm of many pathologists, are being performed much less often today than in years past.

"I had been thinking about doing this film for 10 years," says Kriegsman, 41, who won a student Academy Award in 1982 for a documentary about children with facial disfigurements ("Face Value"). "I felt that autopsy was a subject that has never been properly presented to the public. Even the reality-based TV shows that tease the procedure in their titles and in their promos never actually show it."

Kriegsman's film and a companion piece -- a complete, uncensored autopsy conducted by Dr. Thomas Noguchi, former Los Angeles County coroner, called "Voices of Death" -- sold 50,000 units in their first six months of release, at $19.95 each, says Kriegsman.

They can only be ordered by phone or via the Internet and have had limited advertising, primarily on cable outlets such as the Discovery Channel.

Indeed, advertising and mass distribution remain hurdles for Kriegsman, who spent a frustrating year before the film was made trying to gain the cooperation and trust of autopsy pathologists, many of whom feared he planned to make a lurid piece of sensationalism a la "Faces of Death," a notorious pseudo-documentary produced about 20 years ago.

"A lot of TV stations refused to air our spots," says Kriegsman. "We're continually having to prove to the Discovery Channel that it's a quality product, not an exploitation film. Every time there's a change in their management, they say, `We're running an autopsy commercial? Get it off the air.' We have to prove it's a credible project, and ultimately we do get back on the air, but that's been a fight."

Kriegsman plans to cut another version of the film with less stomach-churning footage. He hopes this will allow the film to be broadcast on a channel such as HBO. Kriegsman's wife and partner, Judith Heiman Kriegsman, is attempting to secure distribution for the video in video stores this fall. A DVD version of the film also is being prepared, with further commentary and footage.

The reaction of the public to the film has both elated and disturbed Kriegsman.

"We've gotten e-mail from people saying it changed their life, that now they're going to specialize in this in medical school," he says.

On the other hand, he adds, "a lot of people who buy the tape feel it's not bloody enough. . . . People want to return it because they didn't see enough blood."

The potential for misuse of the film by those who derive pleasure from graphic depictions of death is a concern for some pathologists.

"I'm a bit anxious about some of these images being in the public domain," says Dr. Gregory Davis, associate chief medical examiner for Kentucky and associate professor of pathology at the University of Kentucky College of Medicine. "Unfortunately, there are some people who enjoy them too much," adds Davis, a member of the College of American Pathologists who serves on its Forensic Pathology Committee.

Despite initial fears about its potential for exploitation, Dr. Michael Fishbein, head of pathology at UCLA Medical Center, participated in the making of the film.

"When the film was proposed, I was concerned that it was for sensationalism, but I think it was done very well," he says. "I think it could benefit people considering a career in [autopsy pathology]. Even a lot of doctors don't really know what pathologists do or what's involved -- there are people who have gone through medical school in the U.S. who have never seen an autopsy."

Fishbein also notes that the movie helps shred popular prejudices about autopsy pathologists. "It bothers me the way pathologists are portrayed" in other films, Fishbein says. "We are just human beings -- a little different, maybe. But in movies we have blood over our gowns, eating pizza."

The film includes interviews with Fishbein and several other pathologists, who discuss the pain of performing autopsies on children (one doctor is moved to tears recollecting the experience); the toll their job and its stress takes on them and their families; the hobbies they use to seek relief (one pathologist is a roller-coaster fan, while Noguchi paints watercolors); and the genuine scientific pleasure they take in their work.

"They are really passionate people who love life, which is so different from what Hollywood would have you believe," Kriegsman says.

Another benefit Fishbein and Davis see is the film's potential to educate the public about the importance of autopsies. Today, about 10 percent of deaths result in autopsy, compared to about 50 percent in the 1950s; some hospitals are being built today without autopsy facilities. Yet, says Fishbein, autopsies in up to 30 percent of cases reveal unexpected causes of death; the procedure also helps doctors better understand many conditions, such as AIDS and Alzheimer's disease. To have autopsy rates drop so low "is a real crisis," he says.

Reasons for the decline, say Davis and Fishbein, include cost containment (an average autopsy costs $2,000 to $3,000), busy doctors who don't have time for the two- to four-hour procedure, and a fear of litigation by hospitals who worry that an autopsy will prove doctors' mistakes.

Kriegsman learned about the decline in autopsies only after he began working on the film. His initial motivation was to shed light on the procedure for the public and to discover what pathologists were really like. Kriegsman's crew filmed about five or six autopsies in all.

"I could never detach myself from the human aspect of the decedent," Kriegsman says. "I was able to get through the dismantling of the body. But I could never forget that that was a human being that four hours earlier was alive, and that somewhere close by were people mourning for that person. Especially when we filmed the autopsy of a young mother, which was devastating for our whole crew."

Kriegsman digitally blurred faces and identifying marks, such as tattoos or birthmarks. He also tried to use delicate, floating camera angles and a softly spiritual musical score composed by Ira Newborn to convey some of the gravity and significance of the procedure.

Shortly after finishing the film, Kriegsman's mother died. "That was almost too much too take," he says. "Doing this film was getting very close to death. When my mother died, I felt like I had embraced it too closely."
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For more information about the film, go to www.autopsyvideo.com or call 1-888-557-0109.