Avoiding an Early Toe Tag

As a medical examiner, Dr. Jan Garavaglia-a.k.a. Dr. G-has a unique vantage point for her health advice, the morgue. Her opinions on living a healthier lifestyle come with a CSI twist.

If you have an appointment with Dr. Jan Garavaglia, you won’t have to worry about a lecture for gaining weight or not exercising. High blood pressure or crazy cholesterol numbers? No problem. Early signs of diabetes? Relax! By the time Dr. G sees you, it’s too late—you’re dead. And the sad thing is, according to Dr. G, you probably shouldn’t be.

Based in Orlando, Dr. G is the chief medical examiner for Florida’s District Nine Medical Examiner’s Office, which covers Orange and Osceola counties. She is also the host of the Discovery Health Channel series Dr G: Medical Examiner and the author of the recently released book How Not To Die: Surprising Lessons on Living Longer, Safer, and Healthier from America’s Favorite Medical Examiner.

Dr. G’s career as a medical examiner has taught her a lot about how people die. And the results might surprise you. Under her guidance, the District Nine office performs an average of 1,100 autopsies a year and here are some sobering statistics about the causes of death: 40 percent are from premature, and likely preventable, natural diseases; 40 percent are from accidents; 10 percent are from suicides; and 10 percent are from homicides.

That’s right—80 percent of the time, people die when quite possibly they didn’t have to. Dr. G has learned from the morgue table that more often than not, the dramatic or traumatic isn’t what kills us. No, the majority of the time the combination of bad lifestyle choices and/or lapses of judgment land us sooner, rather than later, in the morgue.

In an exclusive interview with Lake & Sumter Style, Dr. G shared some of what she’s learned about how not to die.

Bad Lifestyle Choices

Medical examiner is an interesting career choice. How did that come about?

I was actually on my way to becoming a doctor, but I became frustrated as an intern in dealing with patients whose problems were caused by bad lifestyle choices. I would counsel them and treat them, but they kept coming back with the same problems because they refused to change how they were living.

I took a course in forensic pathology while in med school, became fascinated with the work, and changed my career path. From my very first cadaver—an elderly woman who had died with chewing gum in her throat—I became fascinated with how people ended up in the morgue. I decided I could do some good in the world through forensic science.

Most people think a medical examiner and a coroner are the same thing. What’s the difference?

Coroners are elected officials and usually aren’t forensic pathologists. Their training can range from absolutely no medical training to full training in forensic pathology. In making death rulings and signing a death certificate, coroners don’t have to consult a physician, but they do have to hire a physician to do autopsies.

However, a coroner doesn’t have to rule in agreement with an autopsy’s findings. I find this very disturbing. In finding the cause of death, the autopsy is the best chance of finding the truth. As a medical examiner, I’m not worried about being re-elected. I’m concerned with finding how someone died.

Every Body Had A Story

How did the Discovery Health series happen?

There started to be a lot of interest in forensic science because of Patricia Cornwell’s novels. A writer from Redbook magazine contacted me for a feature article on being a medical examiner. Someone at Discovery Health read the Redbook article and got in touch with me about a series.

I initially turned them down because they wanted all the cases to be murder cases. I told them that murder cases were only one small part of what my office did and I was only willing to do the series if we covered all the cases. I told them that every body had a story.

To my surprise, they agreed to my terms. We’re into our fourth season now.

Did the idea for the book, How Not To Die, come from doing the TV program?

Yes, we began almost immediately to get cards, letters, and e-mails in response to the show. People told us how we helped them gain closure about how a loved one died. Then there were those who were affected by the visuals—lungs mottled with black streaks from smoking, enlarged toxic organs from heart disease and obesity, yellow livers from alcohol abuse, diseased colons from unhealthy diets.

We began to hear from people who changed their lifestyles because of what they saw on our show. I decided that if we were reaching that many people with the TV program, then we’d reach even more with a book on how not to die. Now my mantra in the morgue is “Here’s another one who should have read my book.”

Control How You Live

And how do people end up in your morgue?

The number-one cause is sudden death from heart and cardiovascular disease, which are primarily preventable lifestyle diseases. These aren’t people who were in the hospital being treated—these are people who just dropped dead. Either they didn’t recognize or ignored the symptoms and warnings. They didn’t seek treatment because they were afraid of doctors or hospitals, or because they didn’t have health insurance.

For 30 percent who die from heart disease, their first symptom is death. And the number-one day for DOAs in the morgue is Christmas Day because even if people aren’t feeling well, they don’t want to disrupt the holiday. So they die—that’s a pretty big disruption.

What are the physical clues that you find in an autopsy that someone died from heart disease?

If it’s from hypertension, high blood pressure, then the heart is enlarged and very thick. If it’s from a heart attack, then the heart’s blood vessels are clogged with yellow plaque caused by high cholesterol with overlying blood clots.

It’s been well-documented that this country is experiencing an obesity epidemic. Do you see evidence of that in your morgue?

Oh, my, yes. We’ve had to order special, large-sized tables. And we have a lot of trouble moving bodies because of their heft, and cutting for an autopsy is very difficult. Being overweight causes visceral fat, deep tissue fat, to accumulate in and around the organs and the extra weight bears down on the joints. People end up with heart disease, diabetes, hypertension, joint disease. Fat particularly accumulates in the liver, which leads to hepatitis and cirrhosis. All of these are preventable diseases that can—and do—lead to premature death.

Is it fair to say that there is much to be learned from the dead?

Yes, there are many lessons that can help us, the living, take better care of ourselves. While death is inevitable, you can control how you live. Life is a series of choices and making right health choices gives you a chance, a very good chance, at a much longer and healthier life.

Want To Know More?

ON TV: Dr. G: Medical Examiner. Discovery Health TV, Mondays at 9pm

 

IN PRINT: How Not To Die: Surprising Lessons on Living Longer, Safer, and Healthier from America’s Favorite Medical Examiner, by Jan Garavaglia, M.D. $24.95, Crown Publishers

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