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Slain Soldiers Offer Clues To Protect The Living

In 2001, the Armed Forces Institute of Pathology began conducting autopsies on all slain service men and women. Captain Craig T. Mallak describes how the physical (and sometimes virtual) autopsies of soldiers have assisted in the design of body armor, helmets and vehicle shields.

27:25

Other segments from the episode on June 24, 2009

Fresh Air with Terry Gross, June 24, 2009: Interview with Kathryn Bigelow and Mark Boal; Interview with Capt. Craig T. Mallak.

Transcript

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'Hurt Locker' Creators On Explosive New Thriller

TERRY GROSS, host:

This is FRESH AIR. I’m Terry Gross.

What’s the most dangerous Army job in Iraq? Maybe it’s defusing IEDs, car bombs
and other insidiously hidden explosives, knowing that your 90-pound Kevlar body
suit with protective ceramic panels will offer only limited protection if the
bomb explosives.

The new film, “The Hurt Locker,” is about an Army bomb squad in Iraq made up of
three men, one who disarms the bombs and two sharpshooters who protect him
while he works. My guests are the screenwriter, Mark Boal, and the director,
Kathryn Bigelow.

Boal based the story on reporting he did in 2004, embedded with an Army bomb
squad in Baghdad. The movie “In the Valley of Elah” was based on one of his
articles.

Katherine Bigelow’s other films include “Strange Days,” “Near Dark,” “Point
Break,” and “Blue Steel.” “The Hurt Locker” is about the work of the bomb
squad, but it’s also about what leads men to choose this work and what the work
does to them. Jeremy Renner stars as the sergeant who’s just taken over the
team. He’s fearless and brilliant at diffusing bombs but often recklessly risks
his life and the lives of his men.

In this scene, Renner and one his sharpshooters, played by Anthony Mackie, are
in Renner’s room. Mackie pulls out a box from under Renner’s bed filled with
fuses, wires and other remnants of bombs Renner has diffused.

(Soundbite of film, “The Hurt Locker”)

Mr. ANTHONY MACKIE (Actor): (As Sergeant JT Sanborn) What do we have here?

Mr. JEREMY RENNER (Actor): (As Staff Sergeant William James) They’re, you know,
bomb parts, signatures.

Mr. MACKIE: (As Sanborn) I see that, but what they doing under your bed?

Mr. RENNER: (As James) Well this one is from the U.N. building, flaming car,
dead-man switch, boom. This guy was good. I like him. This one, you know, is
from our first call together. This box is full of stuff that almost killed me.

Mr. MACKIE: (As Sanborn) What about this one? Where is this one from, Will?

Mr. RENNER: (As James) It’s my wedding ring. Like I said, stuff that almost
killed me.

(Soundbite of laughter)

GROSS: Katherine Bigelow, Mark Boal, welcome to FRESH AIR. In “The Hurt
Locker,” we see bombs placed in all kinds of improbable places, including in a
human body, in a corpse. And Mark, I’m wondering what are some of the bomb
situations you witnessed or were told about by the men you embedded with?

Mr. MARK BOAL (Screenwriter, “The Hurt Locker”): Well, I remember being in Iraq
for probably less than 24 hours, and somebody explained to me quite casually
that he could have very easily put a bomb under the chair I was sitting on as
we were having that conversation, and I would never know it, and just the
realization that you can make a bomb that’s small enough that, you know, it’s
no bigger than a bottle of water, really, and pretty much anywhere you could
put a bottle of water, you could put a lethal device, and the insurgents in
Iraq have been very clever and ingenious about finding places to put IEDs, and
the whole sort of name of the game of the war over there is the American
military is looking for the IEDs - it’s almost like a giant – treasure hunt is
sort of sort of the wrong word, but it’s a giant game of hide and seek, and the
insurgency or the resisting force, whatever you want to call it, is trying
their hardest to find hiding places. So they end up putting them everywhere is
the short answer to your question, anywhere you could imagine one being, they
try.

GROSS: Anywhere you can imagine, but what were some of the more unimaginable
places?

Mr. BOAL: Well, telephone poles, for example, was a sort of strange one. They
started out very simply putting them in roads, in dirt roads, because it’s easy
to dig up a dirt road, put a bomb in it, cover up the dirt and walk away, and
as a result of that, the Americans got very careful about the dirt roads they
would drive on, and they would select their routes to stay on hard-top, tar
roads, black-top roads.

And then so the insurgency switched and developed a method of ripping up the
blacktop, putting a bomb underneath and putting fresh blacktop over and then
aging the blacktop so it was indistinguishable from the rest of the road.

So then the Americans developed techniques to trigger the bomb before it hit
the blacktop, and then the insurgents started putting them farther off the road
into, into in some cases telephone poles, in some cases garbage cans, in
vehicles of every kind, in donkey carts.

It really is one of those things where the threat is so ubiquitous that it’s
impossible to say with any certainty where it’s coming from, and that’s part of
what makes the experience in Iraq so anxiety-producing for people that are over
there.

GROSS: Katherine, the first IED that we see go off is in, it’s close to the
beginning of the film, and it’s a really horrifying moment. I mean, you
basically see, and I think you shot this, part of this in slow motion. You
basically see the pavement lift up and fragment and fly into the air and then
everything else just kind of explode around it into this, you know, ball of
debris.

Can you talk a little bit about shooting that scene and making it have real
impact, and by that I mean it’s not special-effects impact. There’s so many
movies where things are always blowing up, and it’s visually dazzling, but you
don’t necessarily feel anything. You’re just thinking, like, wow pretty cool,
stuff blowing up, big special effects, but this you really feel the threat and
the impact and the danger and the horror.

Ms. BIGELOW (Director, “The Hurt Locker”): Well, I wanted to really put the
viewer at the epicenter of the event and you know, really feel that horror, and
we shot the movie in the Middle East. We shot it in Amman, Jordan. That
particular location happened to have been in a very densely populated area.

In fact, it was near a customs house, and there was something like 200,000 cars
that traveled through that area on a daily business, although we did shut that
part of the city down temporarily. But it was a very densely populated area,
and we knew that had to be a form and type of detonation that was very
palpable.

When Mark spoke to the EOD(ph) techs in Baghdad, they spoke a lot about the
fact that sometimes Hollywood movies, or in fact virtually in every case, the
explosions in a Hollywood movies doesn’t necessarily look like the real thing.

A lot of it has to do with what the matter is that’s being detonated, but we
were very interested in trying to replicate it as realistically as possible. In
the case of a 155, which was the particular ordinance in the middle of the
road, it was meant to have a very dark, dense, thick look that was very
different than those kind of gaseous orange plumes or kind of fuel that perhaps
maybe is more conventional in films.

Anyway, so we performed this detonation, and the effects man, Richard Stutsman,
did an extraordinary job, but it was a very, very large – I think you could you
see it for – it was like a four-story-high explosion that you could see for,
you know, miles and miles, and he used something called a phantom camera, which
shoots 10,000 frames per second, you know, to kind of look at the granular
nature of a detonation of that size.

GROSS: Since you were setting off explosions that you could see four-stories
high, for anyone in the area in Jordan who was hearing or seeing the blast, how
would they know that there wasn’t, like, war breaking down the street? How
would they know for sure that this was a movie? How did you get the word out?

Ms. BIGELOW: Well, there’s actually a fairly evolved filmic infrastructure in
Amman, Jordan. There’s a film school, as well, and many people in the area were
actually aware that we were filming. We actually had been filming in the area
for several days prior to the explosion. We were able to communicate with all
of the individuals, all of the owners of shops and get the word out that this
explosion was coming. So it was not something that was of any kind of surprise.

GROSS: Mark, when you were embedded with a bomb squad in Iraq, how close did
you get to any of the explosions?

Mr. BOAL: Well, I got – you know, when you’re embedded, unfortunately or
fortunately, you’re just sort of right there with the soldiers. So I was as
close as the soldiers would be, and it depended. If they were a mile away, I
was mile away. If they were 100 yards away, I was 100 yards away, and close
enough that you can feel the heat of the explosion, which is really quite
impressive and intense. It’s almost like someone’s taking a hair dryer and
spraying your face and obviously close enough that the shrapnel is whizzing by
around you, and it’s very loud and percussive. It’s like being at a rock
concert.

GROSS: And does the bomb squad team have a pretty decent idea of what the range
of the blast will be if the blast goes off so that they know what the safety
zone is?

Mr. BOAL: They do. They’re kind of – have a very keen sense about it, actually,
and their whole expertise in terms of the physics is quite extraordinary and
impressive. (Unintelligible) bunch of guys that are actually trained to diffuse
nuclear bombs. So for them to calculate the physical blast radius of an IED is
something they can do. It’s the kind of math they can do in their head very
quickly, and so they can tell you with a pretty high degree of certainty where
the blast is going to go and what the impact will be on a given structure,
whether it’ll take down a house or put a hole in a house or whatever.

But again, that’s assuming that they know exactly what the content of the bomb
is, and some of the time they don’t really know.

GROSS: We’re talking about the new film, “The Hurt Locker,” with screenwriter
Mark Boal and director Katherine Bigelow. We’ll talk more after a break. This
is FRESH AIR.

(Soundbite of music)

GROSS: We’re talking about the new film, “The Hurt Locker,” with screenwriter
Mark Boal and director Katherine Bigelow. The film stars Jeremy Renner as the
leader of a bomb squad in Iraq whose job is to diffuse IEDs and other
explosives.

Part of the drama in “The Hurt Locker” comes from those moments when the person
on the bomb squad whose job it is to diffuse the bomb puts on the suit and does
the walk, alone, to the bomb, and it seems like it would be one of the most
lonely moments imaginable because you’re cut off from the world by virtue of
wearing this 90-pound suit, protective suit, and then also it’s just like you,
there, basically right next to the bomb trying to diffuse it.

Mark, would you talk a little bit about the reality of that situation, like
what you witnessed when it was time for one of the men to take that walk alone?

Mr. BOAL: It’s an everyday occurrence, so I don’t want to over dramatize it,
but there is something extremely iconic about that, and the bomb techs always
talk about that walk, and it’s really a mark of honor if you’ve done it, and
it’s really hard to quantify or explain if you haven’t. But basically once you
put on that suit, and you start walking towards the bomb, you’re in a world at
a certain point in which there is no turning back, and if the bomb goes back,
you’re dead. If you turn around and run, and the bomb goes off, you’re dead. So
the only option is to really go right into the teeth of the matter and diffuse
it.

And they talk about how profoundly transfixing that moment can be and how at a
certain point, say it’s 50 meters out, you tend to have thoughts about your
family or your friends or whatever, and then at 25 meters out, maybe your
thought process changes, and your heart is now beating so fast that it’s really
just a kind of instinctual adrenaline moment, and all the way to the moment
when you’re actually standing over the bomb, and it’s literally impossible to
think about anything other than the simple mechanics of diffusing the bomb.

GROSS: Since some of the IEDs could be detonated remotely by, for instance, a
cell phone, for the sharpshooters, if they saw anybody with a cell phone, like
in the movie, they wouldn’t know whether that cell phone was a detonator or
just a phone, and so you’re confronted with the decision: shoot or not. Is that
something that the men you embedded with talked to you about or what you
witnessed?

Mr. BOAL: Yeah, and you know, what was just so hair-raising about the whole
thing is that all these little kind of moments of everyday life that we never
think about as being particularly threatening or not take on this whole new
aspect when you’re in a war zone. And somebody taking out a cell phone and
looking at you as he’s talking on the phone, you wonder if he’s, you know, is
he calling his wife and saying I’ll take the roast beef for dinner tonight,
honey, or is he calling his friend who is an insurgent and saying hey, if you
come across town, you can get an easy potshot on a bunch of American right now.

And it’s just really – it’s the culmination of the lethality of the IEDs and
the unknowability for somebody that doesn’t speak Arabic or that isn’t really
versed in the culture of, you know, of the motives of the people around you
that makes it so hair-raising.

And in particular, the thing that they would talk about is the cell phones and
also people signaling with flags and kites and that kind of thing, and there
was a whole sort of semiotics about it, trying to figure out whether somebody
putting a carpet, shaking a carpet out on their doorstep, was that because they
were trying to clean their carpet, or was that because they were trying to
signal the neighbor across the street that there were Americans coming.

GROSS: Let’s talk a little bit about the casting. I mean, I think everybody who
sees the film feels this way. One of the things that really throws you is that
there are several pretty famous actors in the movie, including Ralph Fiennes
and Guy Pierce, and you know, you see them, you think oh, you know, at first
you think they’re going to be the hero of the film, but I mean they’re not
necessarily. They don’t even necessarily survive, and the people who are the
real leads in the film, you’ve probably never seen before or seen only in small
roles, and you think that’s a familiar face. Where did I see them?

It’s like reverse casting with lesser-known people in the big roles and the
well-known people in the small roles. Why did you do that?

Ms. BIGELOW: Well, part of it was to intensify and increase element of suspense
and tension and that you are looking at a face, you’re looking at an individual
for whom you have kind of an awareness of but not necessarily a specific – you
know, he or she, or he in this case, doesn’t come with a kind of provenance
that therefore will protect him.

In other words, this is a major movie star. He can’t – nothing can happen to
him. His life won’t be in peril until the end of the film, but if you take that
out of the equation, then you’re looking at these particular cases and looking
at these characters, and anything is possible, and so I think it sort of
amplifies the tension, and then taking a more familiar face and putting them in
harm’s way just kind of takes the balance and makes it more surprising, I
think.

GROSS: You cast Jeremy Renner as the person who’s the lead person in the bomb
squad team. He’s the person who actually diffuses the bomb, and he’s a real hot
dog. I mean, he is totally into risk, and he’s willing to not only risk his
life but to risk the lives of the other men on the squad in ways that are
unnecessary and that violate protocol. How did you cast Jeremy Renner in that
role and tell us who he is because most people will not have seen him before.

Ms. BIGELOW: Well, Jeremy Renner, in my opinion, is probably one of the most
talented actors of his generation, and he’s been in actually quite a few
independent films and some semi-larger films but in smaller roles, and I became
aware of him in a movie called “Dahmer,” where he played Jeffrey Dahmer, the
serial killer, and he elicited so much honesty and truth and actual empathy for

a character of whom I couldn’t even imagine having empathy for, and so I
thought that it was a pretty profoundly evocative performance, and I was
determined to work with him.

And then as Mark was developing the script, I began to see Jeremy Renner in
that character of Sergeant James, who has a kind of bravado and a swagger and
an almost reckless quality but combined with a profoundly able and capable
skill set, and so, you know, I needed to create in that character and have an
actor that can provide the authority to pull that paradox off.

GROSS: Katherine, one of the things that made an impression on me in the movie
is that occasionally, there’d be, like, a stray feral cat walking across the
street or down the street, and one of the cats has only three functioning legs,
and one of the cats just looks half, like, starved to death and unhealthy and
kind of afraid. And I was wondering, like, whether you cast these cats, whether
these were, like stray cats that you found or that were actually – happened to
be walking down the street.

Ms. BIGELOW: In all honesty, they happened to be walking down the street. Kind
of the bonus of shooting in situ, in an environment that was in an area that
was sort of, I suppose, down-marketed, shall we say. And so it’s a matter of
always keeping your camera department alive and looking in all directions just
in case there might be some surprise, a beautiful woman up on a balcony, head
shrouded in cloth, looking down, gazing down on you, and just trying to be very
sensitive to the environment in which you’re in and open and spontaneous and
take that into consideration where you’re shooting.

GROSS: You know, one of the things I got the impression of from your movie is
that your movie is, in part, about men who have no talent for ordinary life,
for life on the home front, for ordinary family life, that something is stirred
in them being on the front lines, being in danger, being in a bomb squad. You
know, that kind of work, but at the same time, you reach a point where you
can’t take that anymore, either, and then what are you left with?

And I guess I’d just be interested in some of the thoughts you had during the
making of the movie about people for whom ordinary life isn’t enough, isn’t
pleasurable or fulfilling in any way.

Ms. BIGELOW: Well, I don’t know if you’re familiar with Chris Hedges’ book,
“War is a Force that Gives us Meaning.”

GROSS: Yes.

Ms. BIGELOW: It’s a pretty extraordinary piece of writing, and he discusses
that very fact, that sense of purpose and meaning that moments of peak
experience can provide. In this case, we’re obviously in combat, and as Mark
mentioned earlier, it could come with, you know, race-car driving, or again,
moments of peak experience - that once, you know, once that captures your
imagination, it’s a very difficult feeling, sensation, emotional peak to
replicate other than in that context.

GROSS: Well Mark Boal, Katherine Bigelow, congratulations on the film. Thank
you very much for talking with us.

Ms. BIGELOW: Thank you very much.

Mr. BOAL: Thank you, thank you, it’s been a pleasure.

GROSS: Katherine Bigelow directed the new film “The Hurt Locker.” Mark Boal
write the screenplay. You can watch clips from the film on our Web site,
freshair.npr.org. I’m Terry Gross, and this is FRESH AIR.
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Slain Soldiers Offer Clues To Protect The Living

TERRY GROSS, host:

This is FRESH AIR. I’m Terry Gross. Soldiers who have died in Iraq and
Afghanistan can still tell stories about how they died through their autopsies.
It was the decision of my guest, Captain Craig Mallak, to perform autopsies and
CT scans on all of the fallen in Iraq and Afghanistan. Mallak is a Navy
pathologist who is the chief of the Armed Forces Medical Examiner System, which
is part of the Armed Forces Institute of Pathology. Captain Mallak performed
some of the autopsies himself. The results are made available to families of
the dead and to researchers who are trying to learn how to better protect
American soldiers.

Consider this famous quote from the Annals of Pathology: Let conversation
cease. Let laughter flee. This is the place where the dead come to the aid of
the living.

Captain Mallak, welcome to FRESH AIR. Since your office has done so many
autopsies and CT scans of the fallen in Iraq and Afghanistan, what are some of
the fatal injuries that you've seen that have helped you understand where our
men and women are most vulnerable and how we can overcome those
vulnerabilities, through either better medical equipment, better medical
technology, better armor?

Captain CRAIG MALLAK (Pathologist, Armed Forces Medical Examiner System): Well
our service members die in a variety of ways as you can imagine in the time of
war and some of them are similar to what is seen in the United States with
gunshot wounds or drownings. But we also see a number of blast injuries and
that has been one of our major focuses is on how to protect our members when
they encounter a blast device such as an IED or another munition that is
designed to hurt or kill them. And that information and those wounding patterns
are provided to those who designed this material - and in an effort to provide
better coverage, provide better vehicle design.

GROSS: So can you give us an example of how a vehicle, or how armor or medical
technology, has been redesigned as a result of what you’ve been seeing in
autopsies and CT scans of the dead?

Capt. MALLAK: We don’t talk too much about it because those changes then would
be known to those that are trying to hurt our young men and women out there so
- but in the medical field, we did help redesign a way to treat collapsed lung
or - it's called a pneumothorax, is the medical term. And we found that the
catheters being used by the emergency responders were not long enough to get
into the chest cavity to release the air that's trapped there. And over the
course of about a month, we looked at a hundred different chest wall
thicknesses and we found that our soldiers and Marines have thicker chest walls
than those of the average American and the needles were not penetrating the
chest cavity. So the Army Surgeon General sent out a memo and changed the
methodology to treat these injuries and hopefully save lives.

GROSS: So is this because men in the military are more bulked up, that they
work out more so they have bigger chest muscles, and therefore the tubing isn't
long enough to get to the collapsed lung?

Capt. MALLAK: It wasn't long enough to get into the chest cavity and that's
probably true. Well they're also a younger population in general where you
don't want to use a too long needle where you could actually go in and damage
something. We found that that wasn't the case, where American military that are
young and in very good physical shape, that by using this longer needle, it
wasn't placing them at any additional risk, but it was needed to provide the
appropriate medical treatment.

GROSS: Now the process of autopsying and providing CT scans for all the fallen
in Iraq and Afghanistan, this is like a relatively new policy that I believe
was started under your tenure with the Medical Examiner System. Is that right?

Capt. MALLAK: Yes ma’am. In previous conflicts, they did some autopsies in
Korea and in Vietnam and very few in the first Gulf War, but at the beginning
of this conflict, our office decided as a group that we were going to fully
account for each of the fallen, and that included a complete examination and
then providing information to the families so they had a better understanding
of what happened to their loved one.

GROSS: So how does this work? Do the loved ones automatically get sent a copy
of the autopsy and the CT scan or do they need to ask for it in order to get
it?

Capt. MALLAK: When families are notified that they're loved one is deceased
they are provided with a fact sheet about our involvement. And in that fact
sheet is all the information they need to get a autopsy report. And they send
that into our office and we provide them with the autopsy report. If they ask
for the pictures or the CT scans, we provide them, but only upon request.

GROSS: So what information could, you know, a person who’s not a medical expert
get from the autopsy or the CT scan?

Capt. MALLAK: Many times the families are not able to view the remains at the
funeral due to the severity of the injury. And weeks and months later they have
questions about exactly what happened to my loved one and was that really them.
And we provide that information in the autopsy report, not only a description
of the wounds, but also how we identify them. We don’t accept visual
identifications - that another soldier says, yes, that's my buddy. We require
fingerprint, dental, or DNA identification. And sometimes even families want
beyond that. They'll want a picture of a tattoo or a picture of some part - a
scar on the body - and we'll provide that to them to help them accept that yes,
this was their loved one and they did die.

GROSS: I know that when you send out the reports to loved ones it includes a
note saying don't look at this alone. Why do you give that advice?

Capt. MALLAK: Well, we care very deeply for these families and a lot of the
information in these reports is very, very graphic, and reading them alone
we’ve learned over the years is a very difficult thing for families. We receive
feedback from families. They'll call us on regular basis and they'll say, yes,
I really needed to do that with someone else, or I read it alone and I
shouldn't have. That going through that and reading about exactly what happened
can be very traumatic on a family and we’re trying to help them.

The last thing we want to do is make it worse for them. So for them to have
somebody willing to support them often provides that bridge and helps them get
through that, so that they can understand the injuries and what happened, but
still have that support system right there with them. It’s worked over the
years and the families have said that this is the right thing to do, so we
continue to encourage them to have support around when they read our reports.

GROSS: What kind of information have you found that families find most
reassuring as opposed to just upsetting when they read the autopsies?

Capt. MALLAK: Well, from the feedback that we’ve receive from families, the
information about the identification is very important to them. They believe...

GROSS: To know for sure this is really my loved one. It's just like, you know,
because isn't it, like you said, it's not like they're going to view the
remains.

Capt. MALLAK: Not in all cases. In some cases the can and...

GROSS: Some cases they do? Mm-hmm.

Capt. MALLAK: ...and that's a mortuary decision. It’s not our decision. That is
made by the morticians and they make recommendations to the family. And the
family can actually, if they want, view a set of remains even after being
warned not to. They're entitled to do so. But when our mortuary colleagues
recommend that you don't view the remains, it's for a reason.

GROSS: How much direct contact do you have with families?

Capt. MALLAK: Between 85 and 90 percent of the families have requested reports
and probably 10 percent of that number call us back.

GROSS: What kind of questions do they usually ask?

Capt. MALLAK: They ask about the medical terminology. They ask about the
wounds. They ask about the suffering, of course - is always a major topic. They
also want to know about any natural diseases that we may have identified and
whether that's something that their family should be monitoring. If the soldier
had children or brothers or sisters, if we found something that's potentially a
life-threatening condition that we didn't know about before they went off to
Iraq or Afghanistan, that is also discussed with them at length, and how to
approach their family physician with this information.

GROSS: Do you end up getting close to families who you talk to?

Capt. MALLAK: We provide them support as much as they need and they can call as
often as they want. Do we get close to them? Do we get personal with them? No.
We are there to support them, but like any physician, it's more of a physician-
patient relationship than a personal relationship.

GROSS: Do families often feel this, like, bond with you, or the other people in
your office who perform the autopsies, because you were the last people to see
the remains, handle the remains or really, like, analyze the remains of their
loved ones - and that makes you an important witness to what happened to their
loved ones, so does that mean that the families feel a certain connection to
you?

Capt. MALLAK: Not a large number, but there are a few that will call us
repeatedly and even years later will just want to call and talk to us and -
exactly what you said, that we were the last ones that had this chance to be
with them. Other than the funeral directors, we’re the ones that - we’re
they're final doctor. We’re the ones that gave them their final - in some ways,
it's a physical. And they will come back to us repeatedly just to talk about
their family and - or talk about their loved one, or if there's something
that's happened with the family, that they would come back and ask us if
there's anything we could contribute to that. Say there's another death in the
family, is there something that we can help them with? And we’re available 24-7
for them anytime anywhere.

GROSS: When you say we, does that include you?

Capt. MALLAK: That includes me.

GROSS: So do you have a cell phone on 24-7 to deal with families?

Capt. MALLAK: Yes, I do.

GROSS: Can you tell us more about what those conversations are like?

Capt. MALLAK: We’ve learned that the death really for families has - their
reaction has really no boundaries. And we - when we talk to them, we see every
emotion that you can think of from being very upset to them being very thankful
for us making sure their loved one did come home and is fully accounted for, to
sometimes being very upset with the system, being upset with the way things are
handled. But we’re there and everybody in the casualty system and the Medical
Examiner's Office, we just do our best to meet their needs.

GROSS: My guest is Captain Craig Mallak, chief of the Armed Forces Medical
Examiner System. We'll talk more about autopsies of fallen soldiers after a
break. This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Captain Craig Mallak, chief of the Armed Forces Medical
Examiner System. He instituted the policy of performing autopsies and CT scans
on all soldiers who have died in Iraq and Afghanistan.

What does the CT scan show that a regular autopsy would not?

Capt. MALLAK: The CT scan is - takes approximately 3,000 cross-sectional X-rays
in about five minutes. And our radiologists and our program manager are able to
reconstruct the entire body then - and in three dimension, which can be
examined in any angle. It can be looked at and turned. You can look at just
soft tissue. You can look at just bone injuries. You can look at where the
armor is because it shows up on the CT scans. So, it gives you a complete three
dimensional reconstruction record that we will have forever for researchers,
and designers, and developers for years and decades to come.

GROSS: So when you do the CT scan, it’s of the soldier as they fell? In other
words, they're wearing their clothing, they're wearing their armor, so that you
could better understand what happened?

Capt. MALLAK: Yes. If there's no resuscitation we asked back in 2004 - much
like our civilian colleagues in the medical examiner world do - that the body
be left alone. That it be made safe, but after that, that it just be left alone
and sent to Dover so that we can collect the same types of information in a
forensic fashion that we were taught to do with – along with our civilian
colleagues. And we couldn't do that if they took the bodies, took the clothes
of, washed them down. Much of the evidence is lost then.

GROSS: Is the CT scanner you use different than the ones we would find if we
were getting a CT scan for health problems in the states as civilians?

Capt. MALLAK: It's a little different. When we started this program back in
2004, we received a clinical CT scanner, which you would recognize. And if you
saw our CT scanner right now, you wouldn't – looking at it you wouldn't notice
any difference. But what we found is that a clinical CT scanner is not designed
to do a full body CT scan at the highest resolution, repeatedly and in the
course of a morning if we have four, five, six cases. And there were problems
with components burning out. And we also found that the table was only - only
moved five feet two inches and most of our military members are far taller than
that.

And the opening through which the body passes through was also too small for
the bodies to pass through, with the body armor on. And also some of our
Marines and soldiers are very large and they didn't fit through the opening in
the CT scanner. So our partner redesigned the CT scanner just for our needs and
it was replaced a year and a half ago with one that’s designed for forensic
use.

GROSS: How is the body preserved until the autopsy can be done?

Capt. MALLAK: Working very closely again with our mortuary affairs colleagues,
the bodies are collected as quickly as possible and then they're placed on ice
and the temperature is monitored throughout the process. And it usually takes
less than 48 hours for them to arrive back in Dover. Of course there'll be
cases where bodies have recovered right away for a number of reasons. And there
is some decomposition in those cases. But we try to minimize that and we work
very hard to make sure that the decomposition is as minimal as possible so the
family can have a viewing if they so desire.

GROSS: What happens when a soldier has been killed by an explosion and you get,
say, body parts? And then later on you get another body part. Do you have a
system so that you can analyze if a body part comes in after the rest of the
body that is part of the same remains?

Capt. MALLAK: Yes, often the bodies are fragmented. And again, it's a family-
driven process. If the medical examiner decides that the body is not complete,
a letter is given to the family informing them of that and they are given the
opportunity to decide whether they would like to be notified, if we're able to
identify any additional portions that – we may have already, we have to run the
DNA on or may come in later. And if we do make identification, the family is
notified.

And when they're notified, they're asked again. If we find something else, do
you want it to be notified? And that goes on as long as the family keeps saying
yes, every time something is identified. And we've had portions identified
weeks to months later. And some families say, no, that’s enough, I don't want -
we had closure, we're done. Other families say, no, I want to know every time
you make an identification. And we do what the families ask us to do.

GROSS: My guest is Captain Craig Mallak, chief of the Armed Forces Medical
Examiner System. We’ll talk more after a break. This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Captain Craig Mallak, chief of the Armed Forces Medical
Examiner System. He instituted the policy of performing autopsies and CT scans
on all soldiers who have died in Iraq and Afghanistan. In addition to the
autopsies and CT scans that your office conducts on the men and women who have
died in Iraq and Afghanistan, you've also consulted on cases of alleged torture
and assault on detainees. Can you tell us a little bit about those cases?

Capt. MALLAK: Yes, again, using our civilian model we saw detainees the same as
prisoners that would be in jail in any state in the union. And in most states
they require anyone that’s in the custody of the state to have an autopsy if
they die while in the custody of that state. Using that model, anytime we had
death of a detainee we use the same methods and do a complete forensic
examination to either rule in or rule out any allegations of torture or
mistreatment.

GROSS: So did you find torture or mistreatment?

Capt. MALLAK: We found injury patterns and whether it’s actually torture or not
is for the courts to decide. But we’ll find injury patterns that concern us and
we will give that feedback to the law enforcement agencies, such as the Army
Criminal Investigation Division or the Navy Criminal Investigative Service. And
then that information goes forward as they prepare for a prosecution of a
possible assailant.

GROSS: So what kind of patterns have you seen?

Capt. MALLAK: You can see, you know, a variety of patterns from blunt force
injury to gunshot wounds. And it doesn’t always mean that it’s torture. It just
means that those patterns are there and those injuries are there, and at times
those patterns had nothing to do with the American service members. It may have
happened before they actually came into our custody. And that is how all to be
sorted out by the investigative agencies, and it also includes the FBI’s
involvement in some of these cases.

GROSS: I think your office had to I.D. the bodies of Saddam Hussain and his two
sons, is that right?

Capt. MALLAK: Yes, ma’am.

GROSS: Can you talk a little bit about how that was done?

Capt. MALLAK: Well, when the two sons were killed we were called to Iraq and we
did our examinations and we took a forensic dentist with us. And they actually
had dental records and we are able to through the dental records make
identification on them. And then we collected, of course, DNA samples, like we
do on every case, and we had those profiles. And when Saddam Hussain was
captured we had his son’s DNA profiles, which we were able to compare with that
of Saddam Hussein and able to match that up.

GROSS: And I guess it was actually really important with Saddam Hussein because
he had body doubles. So it was always possible that the person who was
discovered was really a body double who was hiding out as a decoy.

Capt. MALLAK: That was a possibility and that’s why we, our DNA ladder is the
gold standard in the world, and we were able to turn that case round very
quickly so that the leadership in the government and the military had a
positive identification.

GROSS: So do you do the hands-on autopsies or do you just oversee other people
doing them?

Capt. MALLAK: I don’t do as many as the rest of the staff do. But I still do
autopsies on a regular basis to maintain my skills and to maintain that sense
of the importance of the mission.

GROSS: Are there families who ever ask that you don’t perform an autopsy
because they think that the autopsy will somehow desecrate the body or violate
their religious views about death and the body?

Capt. MALLAK: We have very few – it’s surprisingly few that request that we
don’t do our examination, and we talk with them at length and explain to them
exactly why we’re doing what we're doing. Usually that works out just fine.
Sometimes, once in a great, great while - I’m talking less than handful cases
since 2002 – it’s had to go beyond that, where we’ve had to do extensive
counseling with the family and had other types of professionals involved. If
they have a religious objection, we provide religious support at Dover. If they
would like a certain type of clergy there while we’re doing our examination or
there are certain limitations that some religions have on autopsies, we’ll
observe all of those and we’ve done our best to meet all those concerns of the
family, and to date it has not been a problem.

GROSS: Is it hard for you to not only be around so much death, but this is a
death caused by war, which is some ways the worst of humanity? So is that hard,
and if so, what you do to counteract that, to keep yourself sane?

Capt. MALLAK: We view these young men and women as the very best that the
United States has. They have volunteered their service in the defense all of us
and they deserve to be treated, whether alive or dead, with the best care
possible, and their families deserve our best to bring them the answers that
they deserve, and that’s what drives us every day, just keeping that focus. If
we lose that focus, that’s when it’s time to leave.

GROSS: Do you feel like you’ve been changed in any fundamental way or that your
view of death has been changed in any fundamental way from doing the work that
you do?

Capt. MALLAK: I think doing this work for anybody, it does change you over the
years. There’s no way for not to. I don’t think it’s necessarily a bad or good
way, just that as this becomes part of your life there are things that you look
at differently, there’s things that you appreciate more. When I leave in the
morning from home I always make sure I’m on - my wife and I, we never leave on
sour terms, where everything is fine when I go off to work or she goes off to
work because we understand how fragile life is and that we may never see each
other again. We know the chances are small but we’d never want to take that
chance.

GROSS: Captain Mallak, thank you so much for talking about your work with us. I
really appreciate it.

Capt. MALLAK: You’re welcome ma’am.

GROSS: Captain Craig Mallak is chief of the Armed Forces Medical Examiner
System.
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Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.

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