COMMENTARY

What Did the Autopsy of Mary Jo Kopechne Reveal?

Hello and welcome. I am Dr George Lundberg and this is At Large at Medscape.

What did the autopsy of Mary Jo Kopechne reveal? If you are an American above the age of 65, you will immediately recognize that name. If you are a buff of American political history or even a current moviegoer, the name may also ring a bell.

In July 1969, two days before man took his first steps on the moon on July 20, this 27-year-old white, single, female political worker was found dead, alone, under water, in an overturned Oldsmobile sedan, just off a bridge on Chappaquiddick Island near Cape Cod, Massachusetts, under—still, now 49 years later—mysterious circumstances.

Many questions surrounding the tragic end of her life remain unanswered. A major political dynasty was diverted by the event and its aftermath.

She was last definitively seen alive by friends at a nighttime beach cottage party during a multiday yachting event attended by six single women under 30 and five married men (plus one single older male chauffeur).[1] She is said to have left the party, ostensibly to be driven back to her motel in Edgartown, Massachusetts, by Senator Edward Kennedy.

What happened from their seemingly unobserved departure from the party—sometime between 11:15 PM and 12:45 AM—until the next morning, when fishermen accidentally discovered an overturned, sunken car containing her body in the area of the back seat, remains murky and under dispute. Local witnesses and law enforcement, friends, family, state authorities, an inquest, a grand jury, judges, lawyers, political operatives, numerous investigative reporters, filmmakers, and even Roman Catholic priests have engaged in the still-questioning effort to learn, or to obscure, "truth," depending on their personal motivations.

So, what did the autopsy reveal? Nothing. There was no autopsy. Donald Mills, MD, the local associate medical examiner (not a pathologist) called it accidental drowning.[2] The body was quickly shipped to another state for burial. Later efforts to exhume her remains for postmortem examination were denied.

What could have been the value of a properly performed autopsy in preventing some of the subsequent confusion? These pertinent questions probably could have been answered:

  • Was she dead of foul play before the car went into the water?

  • Did she suffer brain damage from the collision of car with water?

  • Was her neck broken when the car landed upside down on the pond bottom? The top was dented and the windshield shattered.

  • Did she die of suffocation in a diminishing air bubble before her head became immersed in water, and how long did she survive in the overturned car?

  • Did she drown?

  • What was the source of the blood described by witnesses on her clothing?

  • Had she recently had sexual intercourse? And if so, with whom?

  • Was she pregnant?

  • What was the alcohol level of her blood, urine, gastric contents, and vitreous?

My pathology colleagues and I discussed this actively at that time, and Harry Nelson wrote an article published in the Los Angeles Times on July 31, 1969, about why autopsy should (still) be done.[3] Without autopsy, these questions, and perhaps many others, are left unanswered and add to the intrigue and the suspicion of a long-term cover-up. Who was really trying to hide what, and why?

Eleven Reasons Why Autopsies Are Performed

In 2015, after Justice Scalia's sudden unexplained death, I described the 11 reasons for autopsy:

  1. To establish cause of death

  2. To assist in determining the manner of death (homicide, suicide, accident, misadventure, natural, or undetermined)

  3. To compare premortem and postmortem findings

  4. To produce accurate vital statistics

  5. To monitor the public health

  6. To assess the quality of medical practice

  7. To instruct medical students and physicians

  8. To identify new and changing diseases

  9. To evaluate the effectiveness of therapies such as drugs, surgical techniques, and prostheses

  10. To reassure family members

  11. To protect against false liability claims and settle valid claims quickly and fairly

Was the decision not to perform an autopsy on the body of Mary Jo Kopechne a result of ignorance on the part of an authority, primarily Dr Donald Mills? Or was it due to influence by a very powerful political family concerned about what [the details] might disclose? Remember these lessons the next time you are confronted with a death, especially if it's sudden, unexpected, and unwitnessed.

That's my opinion. I am Dr George Lundberg, at large at Medscape.

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