Most unnatural deaths poor, alone

For two days, Mr. Hahm lay dead in a tiny motel room in Hwagok-dong, western Seoul. By the time police arrived, his corpse had already oozed enough fluid to soak the mattress. The 39-year-old’s family could not be reached.

For many medical examiners in Korea, dreadful cases like Hahm’s are all too typical; a single, low-income individual whose corpse goes undiscovered for days and whose refrigerator is filled with empty soju bottles.

Last March, the National Forensic Service (NFS) began a yearlong project in the Gangseo, Guro and Yangcheon districts of western Seoul, conducting 990 postmortem tests and autopsies of unnatural deaths.

When the JoongAng Ilbo analyzed the resultant data, the results were staggering; the average age was 62, and 943 died poor and alone. They were either unemployed or working as day laborers.

The causes of these unnatural deaths varied. Murder, suicide and accidents accounted for 351 deaths and illness accounted for another 325, while the cause of death for the remaining 314 remained unidentified.

The data also revealed that roughly one in four people, or 242, took their own lives, and men were far more likely than women to die of unnatural causes; 652 of the 990 unnatural deaths were men.

Many of the deaths occurred in one-room basements and small apartments, with 120 taking place in Gayang-dong and Deungchon-dong of Gangseo District, areas known to be populated by recipients of basic living pensions.

Only about 20 deaths occurred in Mok-dong of Yangcheon District, which is known for its high-end apartments.

Members of Korea’s middle and upper class are more likely to meet their end while in hospices or hospitals, thus meeting the requirement for “natural death” in the eyes of the medical examiners who conducted the project.

“I’ve only been to the house of the wealthy once or twice in my one year of 24-hour medical examinations,” said Lee Han-young, an NFS medical examiner.

The postmortem visit to Hahm’s hotel room on Feb 16 found half-empty soju bottles, a grungy construction uniform and a stack of health insurance bills 10 years overdue totaling 2.4 million won ($2,052).

“His stomach was expanded, which may mean he was suffering from liver damage,” the medical examiner said. An autopsy two days later revealed Hahm to have been suffering from liver cirrhosis and a cardiac disorder. His heart had expanded to twice the normal size, weighing 600 grams (21 ounces). A normal person’s heart weighs about 350 grams.

“It’s important to conduct on-site postmortem examinations because the body may be damaged while being taken to the hospital, and if a lot of time has passed, it becomes difficult to determine the time and cause of death,” said Yang Gyeong-moo, an NFS medical examiner.

However, until last year, Korea did not stipulate on-site autopsy and postmortem examinations by medical examiners in the cases of unnatural deaths; police and crime-scene investigative teams would get to the scene first, and medical examiners would often see the bodies after they arrived at the hospital, or not at all, if police or prosecutors did not consider their service necessary.

This has resulted in instances of serious misjudgment and humiliation. For instance, in June 2014, a body was found in a field in Suncheon, South Jeolla, following a nationwide manhunt for Yoo Byung-eun, owner of the sunken Sewol ferry.

A doctor for general health, not a medical examiner, was committed to the scene. What’s more, the body was not examined on spot but first moved to Suncheon Medical Center.

It was only in July that authorities announced the body as that of Yoo. Police admitted no one had taken notice of his personal belongings, which ultimately provided clues to his identity.

When the Sewol ferry sunk in April 2014 and the bodies of students were being hauled out, a limited number of medical examiners led many local doctors and Navy coroners to take part in the postmortem tests. To the parents’ horror, some bodies were found to be misidentified by untrained doctors.

Thus the NFS decided last year to carry out the yearlong investigation project, with a plan to increase the number of experts, including medical examiners, who can conduct postmortem tests to 113 by 2020. Korea currently has only 28 NFS medical examiners in action.

With such a limited number of medical examiners, experts say it is quite easy in Korea for criminals to make their murders look like accidental deaths.

“Postmortem testing and autopsies are not systemized in Korea, making it easy for murderers to fabricate causes of death,” said Lee Soong-deok, professor of Seoul National University College of Medicine.

Lee Han-young, a medical examiner who works at NFS, said he uncovered a murder by a family member of the victim in a case last September. The family had insisted that the 79-year-old man had fallen down in the kitchen and died.

But when Lee examined the body he found the bleeding in the face and neck to be too extensive to have resulted from a fall. From a police probe initiated by the medical examiner, the grandson of the dead man was discovered to be the murderer.

Medical examiners cannot always pinpoint the cause of death, however, adding to the grief of families who must live with the unresolved death of a family member.

Yang Gyeong-moo, an NFS medical examiner, recalled an examination in February in which a 44-year-old man surnamed Kang was found dead in the stairway of an old health clinic in his neighborhood. He was found without his wallet and cellphone, but had no external signs of injury. Yang found in Kang’s home a month’s supply of medicine. Kang had been living with his mother after his divorce seven years ago, and often complained of rheumatism and difficulty breathing.

“How can you tell me that my son has just died without a clear reason?” the mother asked Yang. Kang was the last of her children to have died, and in her grief, she sought the consolation of clarity. But Yang had no choice, and recorded the death as “cause unidentified.”

Regardless of whether their service is wanted or not, the medical examiners the JoongAng Ilbo met with have their own philosophy about their work.

“We should not permit even 1 percent of error in identifying causes of death, and on-site and immediate postmortem examination exists for that reason,” said Lee Han-young, who had been working at NFS as a medical examiner from 1990, when he said there were only four other examiners.

“I recall most clearly the time I examined the late actress Choi Jin-sil,” Yang said. “I was quite depressed during that time. It hurt that someone of my age and an actress that I liked made a choice to end her life like that.” Yang also performed autopsies in the car accident of Big Bang’s Daesung.

Though they deal with the dead, medical examiners generally agree that their job is for the living. “If the family of the deceased doesn’t know why their beloved passed, what can be worse than that?” said Lee Soo-kyeong, a medical examiner for three years.

“I approach the bodies not as the dead but as people. I focus on the lives they led and what kind of people they were.”

BY CHAE SEUNG-GI, YUN JUNG-MIN, SOHN GUK-HEE, ESTHER CHUNG [chung.juhee@joongang.co.kr]