Join us for an enlightening DocScopy session with Dr. Harish Pathak, brought to you by The MedBound Times, a health journalism platform by MedBound. MedBound is a networking, educational, and career-enhancing platform designed for healthcare professionals and students.
In an exclusive interview conducted by Dr. Darshit Patel from MedBound Times, Dr. Pathak, a renowned forensic expert, shares valuable insights into his life and remarkable professional journey. Dr. Pathak delves into the reasons that led him to choose a career in forensic medicine and highlights the passion that drives his work in criminal investigation and evidence collection. He also discusses the challenges faced in his field, and the significance of forensic medicine in the pursuit of justice, and addresses the skepticism surrounding autopsies. Dr. Pathak's extensive experience and expertise shed light on the diverse nature of forensic medicine and its critical role in unraveling the truth behind crimes.
Dr. Darshit Patel: Welcome to this Docscopy session, Dr. Pathak. We are truly honored to have the opportunity to interview you today. It would be greatly appreciated if you could provide us with some valuable insights into your life and professional journey, sir.
Dr. Harish Pathak: I graduated from Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram and then I did my post-graduation from the same institution. In 1995 July, I joined the GS Medical College as a lecturer. Subsequently, after three and a half years, I was transferred to another municipal Medical college which is known as Lokmanya Tilak Municipal Medical College in Vasai Mumbai. I was there for almost ten years and wherein I was promoted to associate professor in 2001. In 2008, I became a professor and I also went on deputation to AIDS composed society, Mumbai District Society where I worked in public health for four years. I was an Addition Director. Then I came to GS Medical College as a professor and head in 2012. So I've been here for the last five months. I am a Dean academic also apart from the professor and in between, during COVID times, for about one and a half years, I was Dean of a Jumbo COVID center at Kanju Munar just 2000 and it was a preparation for the third wave. Ah, but it was very wide and fortunately, we didn't get medications.
Dr. Darshit: So talking about forensic medicine, so why did you or what made you choose this career path?
Dr. Pathak: During my school days, people used to say that I am good at arguing. People would often suggest that I should consider becoming an advocate. At that time, my elder brother, who was three years older than me, enrolled as a medical student in the same institution. I noticed a significant increase in the level of respect he received from our family and family friends.
However, it was during my second year, specifically when we were introduced to forensic medicine, that I realized my true passion lay in this field. After completing my MBBS degree and internship, which included two six-month house jobs, I had the opportunity to apply for a postgraduate program in a subject of my choice. Instead of immediately pursuing a postgraduate degree, I took a different path. I dedicated three years to specializing in MD Forensic Medicine, a subject that had seen no recruits for the previous three years. Alongside me, my batchmate Dr. Rajendra Bhamar shared the same enthusiasm, and both of us listed forensic medicine as our first, second, and third choices in our application forms, much to the amusement of others. Following the successful completion of my postgraduate studies, I embarked on my professional journey.
Dr. Darshit: What drives your passion or ignites your interest within your field of work?
Dr. Pathak: When l arrived in Mumbai in July 1995, the prevailing topic among forensic professionals was medical negligence, fueled by a significant decision made by the Supreme Court. The court ruled that the Consumer Protection Act extended to the medical profession. This decision brought clarity to previous judgments, particularly in Madras and Chennai, where the applicability of the act was in question. With the Supreme Court's confirmation, medical negligence and the best practices for doctors became the primary focus for many professionals. However, my concentration remained focused on exploring how forensic medicine could contribute to crime investigation.
Because today the biggest challenge in India as far as the conviction rate is concerned, is the eyewitnesses becoming hostile and human eyewitnesses can lie but scientific evidence will never become hostile and dead bodies will never lie. So if you know forensic medicine, forensic pathology, and the art of communicating with the dead and knowing how he or she has died, under what circumstances, and how long, so all those became my passion, and yes, so in a way my interest was unique among my colleagues in forensic medicine, wherein everyone wanted to work towards medical negligence. Right from the beginning I had an immense passion for crime scenes, and collecting evidence, working with the police. I remember after 04:30 p.m. when my work hours were over, I used to go to the Crime Branch, I used to sit with the police and eventually, many leading cases were referred to me even if they were not within our jurisdiction.
Like with every institution, a few police stations are attached, so we used to get only cases from those police stations that came under our institution’s jurisdiction. Subsequently, now for the last two years, even CBI started collecting cases from us.
Dr. Darshit: What are some of the most challenging situations in your field of work?
Dr. Pathak: If we are strictly focusing on crime investigation, and on the investigation agencies, I see that most of the time there is a lack of technical support that these investigating agencies can get. I had been to Canada and the US. So, I remember about 15 years ago in Canada, at a Crime scene there used to be around half a dozen to one dozen types of experts. The crime scene used to be secured in the next 24 to 48 hours. There will be blood spatter experts, fingerprint experts, psychologists, and photographers. So there are six to twelve different types of experts who visit the crime scene there.
When we accompanied the police, we used to do everything. Even once upon a time, not even simple photography cameras were available. Nowadays, everyone is taking photographs by cell phone, which is also not a good trend because it becomes difficult to produce it in court and make it an admissible evidence. I remember whenever I used to request a vehicle to visit the crime scene, the police stations used to have only two vehicles. Now they have at least three vehicles or even half a dozen or more than that, so things have improved a lot a. You have crime scene vans but there is a lack of experts. So there are many challenges. The government is spending a lot of money on forensic science but not on the kind of expertise that is required. They have invested in a lot of machines and buildings perhaps the kind of investment required in human resources, and competency management among forensic scientist lags. Second, we require updates on Criminal law with reformed justice. The human resources system and the law require much improvisation and improvement but that was never implemented.
Still, we are waiting for major improvements or improvisation of Criminal laws. Although if we look at our laws, most of them are taken from the United Kingdom. But, they have changed and we are still lagging. So we need to improve on that. There is a huge dependency on Panchanama. Many times, Panch becomes hostile, and that becomes better for the case. Too much reliance on eyewitnesses. So as I said, we should concentrate more on scientific evidence.
Fortunately, due to technological advances, nowadays most cases are detected in two, or three ways. Number one, whether you know the cell phone, you can take the location and how many times they communicated with each other or with the perpetrators. The second thing is if there was CCTV then you can track them. And then it's possible, for instance, through computers. So the way we used to investigate earlier, things have changed but still a lot of awareness and training are required for making very good use of this technology.
I see improvement but I think it is far from the requirement. In 2019, at the beginning of March, I was in Washington DC where there was a workshop on strengthening the medical-legal system, and in Washington DC, the burners of this autopsy center are next to Merriott. That is the kind of hygiene and order control mechanism there is. So today, whenever you try to plan a mortuary in an area, autopsy center, or surrounding areas the people go to the local leaders and say they don't want this center to be in their vicinity. So, huge improvement is required. The way we used to conduct autopsy has not changed in the last 50 years. One of the major reasons is that we don't have a discipline which is called mortuary technicians. So either you have a doctor or class four employees. Class four employees who are conducting autopsies are not at all comfortable using better technologies like autopsy sources and other technical techniques. The doctor is hardly present except for observation and for, you know, cutting off the organs and all that. This is one lacuna that we have realized and we need to have qualified technicians also who will be able to maintain the machines which are used in modern autopsy centers as well as use them. So these are the things that are lacking.
Dr. Darshit: Sir, could you share a specific case or incident from your professional experience that has left a lasting impression on you?
Dr. Pathak: There have been many cases and incidents throughout my career, and one that stands out is the recent incident during the Dhanbad Hearing session. During a morning walk, the judge was hit by an auto-rickshaw, resulting in severe head injuries and he succumbed to these injuries. This incident garnered significant attention nationwide, as it appeared that the auto-rickshaw had intentionally taken a sudden turn and struck him before swiftly fleeing the scene, all of which was captured on CCTV footage. So CBI was handed over the case. We were requested by the CBI unit to visit the crime scene and when you work with the investigating agency and when you give the pieces of evidence, there needs to be credible evidence that is acceptable to the court. So it was not easy to prove that it was a homicide because unless and until proven otherwise it is presumed that it was an accident. But after going to the crime scene and exactly looking at what angle the auto took a turn and after hitting the victim how immediately it took the right turn and in this whole process he was properly under his control was perfect. So it could not have been an accident. So, number one; then whether this was a hit-and-run case, and number two; whether the auto was responsible for the death or was it fall on the floor. So there were two heading units on both sides and both of them singularly and together were responsible for the death. So that had helped the courts. Our job is that we are neither the witness for the prosecution nor the defense. We are the witness for the court and we are really happy to say that that case ended up with conviction.
Dr. Darshit: That was an interesting case, thank you for sharing it with us. So, can you tell us what is the difference between forensic medicine, and other fields of medicine like cardiology or anything? Some distinctive things.
Dr. Pathak: So there are two things. Number one, you rarely in your professional life, get live cases. So most of your subjects are dead. Almost all. We have one of the best and very well-equipped one-point centers for survivors of sexual assault. We get many cases for examonation of accused of sexual assault. But our major case is crime investigation assistance in the dead body. So when you are interacting every day to day in medical college with students while teaching them or when you go to the Mortuary, there will be half a dozen dead bodies.
With every dead body, there will be around half a dozen or a dozen relatives and you have exhausted police constable with every dead body who must have done either night duty or been on duty since morning. Nowadays we have been able to tackle that to a great extent under the influence of our program. So with this atmosphere, where there is so much negativity around, to remain positive and to still love your profession is challenging for many people. I always joke that on doctor's day, all my friends from cardiology and neurology and medicine and surgery get maybe a dozen, and dozens of card wishes. I always say that I'll get hundreds of them when I reach heaven and that they all will meet me at once. Generally, if you ask your grandfathers, grandmothers, or your parents, they will say there is always a saying that you should never get an opportunity or an occasion to either visit a police station or court or a hospital. So our main job is in the hospital and that too in a mortuary where even if you go to a hospital, you shouldn't have had to go to a mortuary. So we work in a mortuary. We work for the police. So often for professional interaction, we go to the police station and ultimately whatever we prepare the report, they are to be submitted in the court and you have to bring the evidence. So the three negative factors which we think about in the ordinary course of life, in social setup, all are our ornaments. So it's different than all other professionals.
Dr. Darshit: Next question would be from some of my personal experience. So I got an opportunity to work with the mortuary as an assistant for assisting in autopsies. So I worked there for three months. It was back in Russia. I got to work with the system and with the police and everything was great. So, I made up my mind, yes, I'll go into forensic medicine now. Then I had a word with my friends and family. They had one question and they were like what is the significance of justice once a person is dead? So I would like to ask you.
Dr. Pathak: That is a very interesting question! Remember one thing, the person is gone. Surgery on a live patient is with pain and should require anesthesia and it is for the benefit of an individual. Surgery after death is without pain and it is for the benefit of society if murder happens. Somebody has been killed, they say that is what is left. But to keep other people in society safe, the culprit must be punished.
If a girl is raped and murdered, the girl is gone. But we have to make sure that these things do not happen. Sometimes, if you go to any big jail or the road jail, 70% of the detainees are those who are repeating, coming again and again and again. So if they are not punished, they will repeat their deeds. So it is a necessity that they are identified and punished. So this autopsy is for the benefit of society, not for just an individual. A murder, it's not a crime against an individual. It is tried as a crime against the state and the state fights against the communities, not the individual. So in our country, if somebody has been killed you cannot compensate the relatives and give them blood money and they will say, okay, it's fine. They may or may not complain. A state will help because it's a crime within society, which means against the state. So the state has to fight. So I think surgery after death is much more important than the usual surgery.
Dr. Darshit: In India, we often see that people are very skeptical about autopsies. It may be due to various reasons like religious or cultural or even emotional. So what is your take on this?
Dr. Pathak: Beginning, I will say that what is our purpose on this land? On this land, does Hinduism work? We will go religion by religion. Then emotion, do we support it? Are we against it? So our principle is that the body came into existence from Panchtatva. It will go back to that. You incinerate, you burn, and it goes back. Now, in this process, if you can educate a few people if you can find the truth, nothing will happen and the biggest example of a donation-owned body for the benefit of society is of a rishi called Dadhichi. There was a demon who was independent. He and the gods realized that if you make weapons with the bones of Rishi Dadhichi you can kill it. So they came and requested and told him that they need his bones and he agreed and with whatever yoga or power he left the body then the muscles were ripped apart and with his bones, the weapons were made. So if a Rishi can donate his body for the benefit of society then who are you and me? So we don't believe that somebody will come back after death. So I don't think the local religions are against it. Things have changed.
Nowadays, there has been a significant reduction in unknown deaths and unknown causes of death, thanks to the increasing frequency of ECG tests being conducted every 15 minutes. Moreover, there are now specialized centers in the UK, Malaysia, and soon in the US, where non-invasive autopsies are being performed using whole-body CT scans. These centers cater to around 80% of cases where conventional autopsies requiring body opening may otherwise be necessary. There is one in AIIMS New Delhi where they have started researching it, we are proposing one for our hospital too.
But is it brutal on your emotion? Yes. Your loved ones will be, and their body will be dissected. Part of that will be removed for investigation. It's not easy on your psychology, but when you try to correlate it with spirituality and I think there is no religious reason not to allow an autopsy. Because ultimately, as I said, it is for the larger benefit of the society. Because as we discuss Jisko jana tha wo gay.
Dr. Darshit: I have a question regarding forensic errors. Could you provide insights on the topic and suggest strategies to minimize such errors in forensic investigations?
Dr. Pathak: See what has happened? There is a project called The Innocence Project, you can read about it. It's a project that sheds light on a significant issue. In numerous cases, individuals were convicted based on forensic evidence that seemed conclusive at the time. However, with the advent of DNA technology, many of these individuals applied for DNA testing, and even after spending 18 to 20 years in prison, they were proven innocent and exonerated. Many such errors exist, like in postmodern examination. Most of it is subjective, not objective. So subjectivity is to be reduced. It has to be more objective. And we are working. Science has always been working on that. There were techniques like hydrostatic tests that were used to determine whether a newborn baby was born alive or stillborn. Unfortunately, based on this flawed method, many innocent young girls were wrongly accused and imprisoned. This raises the question of whether such a method is reliable. While it may have been considered effective in most cases, it is crucial to continually advance our techniques to minimize instances where innocent individuals are unjustly incarcerated. But remember that the best of the scientists of their time said that the sun revolves around the earth and that the earth is not flat. So there is always a potential for error and also advancement in science.
Dr. Darshit: What is your take on the death penalty? And given the increase in the number of homicides and the crime rates in our country, do you think the death penalty must be encouraged or severe punishments must be given to the offenders?
Dr. Pathak: See, the death penalty is given in our country in the rarest of rare cases, the cases wherein it is presumed or it is considered that the convict is dangerous for society and is to be removed from the society. I think in the rarest of rare cases it should be executed because there is fear of death and people say that if somebody is on the death road for 15 years and nothing has happened or changed in the person, then the fear of death in itself is a big pain and I think whatever law exists, they need to be implemented. They need to be implemented in a better manner and there have to be more convictions and executions also. So I'm a supporter of that.
Dr. Darshit: If you weren't in your current profession, what career path would you have pursued instead?
Dr. Pathak: I would have chosen to be a lawyer.
Dr. Darshit: How would you define your work considering the concept of justice, which is often portrayed as blind and based on the balance between merits and demerits?
Dr. Pathak: The rationale behind the specific timeframes and durations prescribed by the law raises questions regarding their precision and consistency. For instance, why is the law updated every 6 months instead of 5 months? Similarly, the determination of a 12 years sentence for life imprisonment without considering alternative durations like 13 or 11 years lacks a clear justification. Moreover, the lack of precise guidelines for the age of consent in sexual matters, with sudden shifts from 16 years to 18 years, further undermines the consistency and fairness of the legal framework. The absence of clear guidelines regarding the definition of consent in various sexual situations is a significant issue. To address this gap, the legal system often refers to the concept of consent as defined in contract law. However, this approach leads to numerous cases being unnecessarily entangled in disputes over promises of marriage, despite the Supreme Court and high courts repeatedly emphasizing that the failure of a romantic relationship should not carry severe consequences. Unfortunately, many men find themselves unjustly implicated in such cases. Moreover, the lives of many young boys, aged between 16 to 18 years, are adversely affected due to a lack of clarity in the age of consent laws. Even when the girl involved willingly consents, these late teenage boys may be unfairly labeled as sex offenders, thereby jeopardizing their future professional and personal lives. It is essential to engage in continuous introspection, reassessment, and evolution of our laws. However, the process of changing legislation is often challenging and time-consuming, resulting in significant injustices during the transitional period.