‘We speak for the dead to protect the living’: Karissa French is a G. Raymond Chang Forensic Pathology Fellow

Oct 3, 2022

Karissa French is a G. Raymond Chang Forensic Pathology Fellow at the University of Toronto’s Temerty Faculty of Medicine. Born in Calgary to parents from the Nazko First Nations and Neskonlith First Nations, she moved to Toronto for her education, earning an undergraduate degree in forensics and biochemistry from the University of Windsor and a master’s degree in research biology from Cardiff University.

What inspired you to pursue a career in medicine?

Originally, I wanted to study chemistry. As an undergraduate, I did a work placement at the Oakland County Medical Examiner’s Office in Detroit where I observed an autopsy for the first time. One of the forensic pathologists there was able to take all the information and determine the cause of death. I thought it was amazing. It was the same forensic pathologist who asked me if I had ever considered medicine — up to that point it had never crossed my mind as an option. In many ways, they were the reason I decided to apply to medical school.

And why did you choose forensic pathology at Temerty Medicine?

I entered medical school knowing I enjoyed forensic pathology and found it to be my niche. It’s a very integrative field. You take in a little bit of everything, and you put it all together — I really liked that kind of true diagnostic specialty.

There are only four Forensic Pathology Fellowship programs in Canada — I think Toronto is the best one.

There are only four Forensic Pathology Fellowship programs in Canada — I think Toronto is the best one. In Toronto, the amount of teaching, the complexity of cases and the facilities here all come together. Despite it being very busy, you’re not here to get through as many things as you can, you’re here to learn to be the best forensic pathologist you can be. And the program at U of T does that really well.

What I love most is getting to perform autopsies and to pull together all the information for a final diagnosis. Now, that’s what I do every day!

There are only four Forensic Pathology Fellowship programs in Canada — I think Toronto is the best one.

What particular forensic issues are you working on right now?

There’s been recent research into a more molecular genetics approach to forensic pathology. In a lot of cases, the cause of death can be very sudden — especially for young people. Sometimes, unfortunately, you’re left without answers. Growing up, especially with my background, persons of Indigenous descent have a very high mortality rate compared to other groups in Canada. Again, you’re left with more questions than answers.

Persons of Indigenous descent have a very high mortality rate compared to other groups in Canada. You’re left with more questions than answers.

Where I, as a forensic pathologist, can be helpful is with families. I can look at the genetics side because a lot of these things are inheritable. I can refer families to physicians or genetic counsellors who would be able to screen them for similar mutations — like conductivity issues in the heart — that they don’t know about. And that way you can help the surviving family members in the primary prevention of certain diseases and you’re protecting other people.

Persons of Indigenous descent have a very high mortality rate compared to other groups in Canada. You’re left with more questions than answers.

What are you most excited to learn more about?

Everything, right? For example, I find accident reconstruction absolutely fascinating. This is where you take injury patterns and reconstruct what happened so you can work to prevent accidents from happening again. There’s research about how patterns of pedestrian injuries are changing as car shapes change — meaning injury patterns from cars in the ’90s are completely different than our SUVs today.

The G. Raymond Chang Forensic Pathology Fellowship is an endowment that was generously established by The Raymond Chang Foundation. What impact did it have on your experience?

It allowed me to stay in Canada for my training. The G. Raymond Chang Forensic Pathology Fellowship is building talent from all over the world, so we can then provide a vital service to our local communities that are often understaffed. Because of the pandemic and international travel restrictions, they generously allowed Canadian fellows to apply for these positions.

As I think about my own community, I know it is difficult to keep up with the needs of the death investigation system. In some jurisdictions, especially due to the opioid crisis, deaths are not investigated as well as they could be because pathologists are just so busy. But that’s a vulnerable population that deserves every bit of our investigative abilities. Being able to cultivate strong forensic pathologists who are trained in Canada can only help with this.

The motto for coroners is “We speak for the dead to protect the living” and I really appreciate that the donors understand that.

If you could speak directly to the donors of this fellowship, what would you say?

First off, thank you so much. I really appreciate the experience and the possibilities that I’ve been given. Thank you for valuing this work. Death investigation is not something that people often think about donating to. Our patients obviously can’t advocate for themselves. The motto for coroners is “We speak for the dead to protect the living” and I really appreciate that they understand that.

The motto for coroners is “We speak for the dead to protect the living” and I really appreciate that the donors understand that.

You’ve received a lot of support from your First Nations community. What does this mean to you?

I’ve lost family members suddenly and unexpectedly and that helped initially drive that motivation to figure these things out — because I was left with a lot of questions myself. Now, I can help other people know why and that is often not really appreciated until you’re in that situation.

Every one of those deaths impacted the whole community. Having a sensitive death investigation system that understands really helps the healing process.

With the high mortality rate in my community, growing up, every one of those deaths impacted the whole community. Having a sensitive death investigation system that understands really helps the healing process. I think it is a service, we unfortunately as a group, interact with more than we should. The missing and murdered Indigenous women are always on my mind so helping to identify unidentified remains and working to solve these crimes is something that is very important to me.

If you go back even 10 years, there were no Indigenous forensic pathologists and now I know several who are helping with some of the more culturally sensitive issues. Being able to have representation and advocacy shows that the system is changing.

Every one of those deaths impacted the whole community. Having a sensitive death investigation system that understands really helps the healing process.

By Deanna Cheng. Read a longer version of this Q&A at the Temerty Faculty of Medicine