A Forensic Pathologist on the Most Grisly Murders She’s Worked

For someone who deals with death on a constant basis, Dr. Rebecca Hsu is shockingly bubbly and vivacious. A seasoned forensic pathologist, Hsu has dedicated over twenty years to examining the post-mortem, offering insight and analysis into the many ways the body dies while debunking myths perpetuated by her Hollywood counterparts on Law & Order and CSI.

As dedicated as she is to her work, Hsu’s life isn’t totally consumed by the dead. In the most recent episode of Balls Deep, we get a glimpse into her everyday life as she juggles raising two children and caring for her aging father while managing her freelance forensic pathology business. Dealing with the departed is a daunting feat, but it’s taught Hsu the importance of remaining optimistic.

VICE: How did you get interested in forensic pathology?
Dr. Rebecca Hsu: I actually wasn’t for a very long time. I was going to be a psychiatrist until I realized just how boring the day-to-day was. You’re not working on the Hannibal Lecters of the world—most of the time you’re just evaluating a criminal to see if they’re fit to stand trial, or if they know the difference between right and wrong. I knew I couldn’t do that every single day.

Do you have any fascination with serial killers?
I find the psychological dynamics of serial killers to be interesting, but far from interesting enough to find them fascinating. I’d say they are disturbing. I find it even more disturbing that our society plays a large role in their formation, and that our failures in the justice system allow them to carry out their fantasies for longer than should be allowed. I find it even more disturbing that so many people find them fascinating. They are mentally ill persons who need treatment, not publicity.

What type of people seek out a freelance forensic pathologist?
I am hired by anyone who needs the skills of a forensic pathologist but do not qualify for whatever reason to be a medical examiner’s case. Generally speaking, coroners and medical examiners who examine the deceased victim will testify for the prosecution in court. The investigative information is provided by police and other agencies, and there are multiple laws in every state that allow the medical examiner or coroner to refuse cases that families may want autopsied. Not everyone gets an autopsy, since offices are very busy and can’t afford the time or money to fully work up each case. That’s where private practice physicians come in.

As a private practice forensic pathologist, I also harvest tissues for research departments who need tissues for crucial research, as well as offering “second look” autopsies and exhumations. I often assist lawyers with their evaluation of cases by reviewing medical records and work with defense attorneys to testify as an expert witness to evaluate their client’s story and case.

What are some of the frustrations you have in your line of work?
Do you have all night? I could go on forever. Our field pays very poorly compared to equivalent physician jobs that also take many years of extra training—it pays roughly a third of what surgical pathologists can make with less training. Most people don’t want to spend an extra year or two to subspecialize in forensics and make well under $200K when they can do just a few years of surgical pathology and have a starting salary of over $300K with set hours, little to no court time and no smelly crime scenes to go to.

The discrepancy in salary is generally due to the fact that tax dollars pay for forensic salaries—they’re overworked, underpaid government workers. In the private sector, it’s frustrating because you’re called a “WHORE” (Witness Having Other Reasonable Explanations) regardless of the fact that you might be helping people avoid a medical malpractice case. The private sector is also difficult because the work is sporadic, you may have to travel on short notice, and running the business in addition to being a physician takes a great deal of effort.

How do you keep the suffering of your clients from permeating your own life?
I have a very good off switch. Working with grieving families can be hard because they want to share the person with you. They want to talk about their interests or their latest ski trip, and to tell stories about them. It makes it hard for me because I don’t just examine the body and throw a report at them.

What’s one of the most interesting cases you’ve worked on?
When you’re working in this field, you realize how there are some truly smart people in the world. I’ve examined the bodies of people who committed suicide in the most creative ways that would have never crossed my mind. There was an engineer who killed himself by crawling into the liner of a waterbed, attaching a vacuum to the nozzle, and sucking out all the air. Unfortunately he was dealing with severe depression that led him to that, but the man was a genius.

You work with Nancy Marlow, a forensic medium.
She’s great for when people have questions that I can’t answer. Family members will ask me what the person felt or thought as they were dying and there’s no part of the body I can examine to find the answers. That’s where Nancy comes in.

Next of kin have the option of burying, cremating or even turning their loved ones into diamonds when they die. What do you want to be turned into when your time comes?
I want people to do as little as possible with me. Why waste the money?

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You can catch Balls Deep on VICELAND. Find out how to watch here.