IOWA CITY -- It takes a certain personality to be a medical examiner because "there's a lot of difficult things we see." But it's a rewarding job to be part of the medical and legal system, aiding public health and providing families with answers about how their loved ones died.
"It's a versatile career," said Dr. Melissa Blessing, 48, who started last month as a Johnson County deputy medical examiner. "Forensic pathology is interesting in the sense that you get to see a broad range of human illness and injury, so scientifically it's interesting. But at the same time you get to interact with the community in a unique way."
As a forensic pathologist and a medical examiner, she is responsible for determining the cause and manner of death in sudden, unexpected, violent or suspicious deaths but also has other duties. One day, she may be doing an autopsy, the next she will be court testifying or talking to the Centers for Disease Control and Prevention. Then a few days later, she may be talking to families who are grieving and want an explanation for why their loved one died.
"Some families just want the preliminary information and others want more details," said Blessing, also a clinical assistant professor of pathology the University of Iowa Carver College of Medicine. "I'm always willing to talk to families. It's an important part of the job because it's the forensic pathologist and autopsy pathologist who look at all the medical records and puts the pieces of the puzzle together. It's like being a detective."
Blessing, who grew up in Minnesota, said it brings some closure for many families because the medical system can be hard to navigate and understand.
"It's a privilege to be in that position," said Blessing, who was previously the medical director at Texas Children's Hospital's Autopsy Service in Houston. "You can hear in their voices when they don't understand and then you hear the change in their voices when they do."
The answers may not end their grieving, but it's "something to grab onto and move forward," she said.
Clayton Schuneman, the administration director of the Johnson County Medical Examiner Department, said the department is "thrilled to have Dr. Blessing join our team."
"She has thus far proven herself to be exceptionally professional, and her previous experience and (curriculum vitae) speak for themselves, Schuneman said. "Our investigative staff has loved having the opportunity to work with and get to know her. We are truly fortunate to enjoy such a great partnership with our colleagues at UI Health Care."
Blessing said being recruited for the positions in the UI Department of Pathology and with the county medical examiner is her "dream job." Johnson County Medical Examiner Dr. Dennis Firchau and Dr. Marcus Nashelsky, a deputy examiner, have been "instrumental in running an excellent medical examiner service" for the county. The office and the UI Health Care Decedent Care Center also have impressive reputations in the pathology communities, and she noted that Nashelsky also is a former president of the National Association of Medical Examiners.
The university and the Johnson County Medical Examiner Department have been on her radar since her residency at the Mayo School of Graduate Medical Education in Rochester, Minn., in 2012. "There are not many locations where forensic pathologists are able to practice in an academic setting," Blessing said. "That relationship is unique and advantageous. All the autopsies here are performed at the Decedent Care Center at UI Hospitals and Clinics."
She also saw the opportunity at the university as being a place where she can practice her subspecialties -- pediatric and neuro pathology.
"It's extremely unique to have pediatric, neuro and forensic pathology all under the same umbrella," Blessing said.
The Johnson County Medical Examiner Department's resources are "incredible and they have skilled investigators, (who assist medical examiners with death investigations)," Blessing said. Her medical examiner work will account for about 80 percent of her time and the other 20 percent will be spent on neuro pathology and other specialties.
Blessing had some distinct experiences before going to Northern Arizona University in Flagstaff, Ariz., and medical school at A.T. Still University School of Osteopathic Medicine in Mesa, Ariz.
She lived at Black Mesa/Big Mountain, which is adjacent to the Navajo Nation and Hopi Reservation, as a volunteer with Black Mesa Indigenous Support from 1999-2003.
"I lived (during those years) without running water or electricity in support of traditional Navajo families impacted by coal operations," Blessing said. "This primarily involved herding sheep and goats in the high desert."
She said the volunteer work helped her as a pathologist. She learned a different way of life, how different cultures live and to always have an open mind to what she is seeing -- which can be applied to forensic pathology when determining cause and manner of death.
She then decided to pursue a more traditional way of life and completed a bachelor of science in biology and bachelor of arts in anthropology at Northern Arizona and then pursued her medical degree at A.T. Still. Her forensic pathology professor and mentor just happened to also be a county medical examiner, which ultimately influenced her career. She initially was interested in trauma and medical surgery and neuro pathology.
"I wanted to be there (in those situations) when everything is going wrong and it's a high -stakes environment where you have to use critical thinking in real time," Blessing said.
She did rotations in all of those, and then did an anatomical and clinical pathology residency and a neuro pathology fellowship at Mayo and decided to pursue forensic pathology. She completed a fellowship in forensic pathology at the Harris County Institute of Forensic Sciences in Houston, and a pediatric fellowship at Boston's Children's Hospital in Boston.
Blessing then joined Baylor College of Medicine and Texas Children's Hospital in Houston for four years practicing pediatric neuro pathology, perinatal and pediatric surgical and autopsy pathology, as well as serving as the medical director of the Autopsy Service.
Blessing said she was happy to move from Houston with her husband, John Van Arnam, also a pathologist, to a slower-paced environment. Both enjoy the colder temperatures and snow.
In her off time, she enjoys being with her five siblings and other family members, cooking Italian food with her husband, listening to music and practicing the martial art of Ving Tsun kung fu.
"One thing you learn as you see the underbelly of human behavior, especially as a petite female, you have to think about self-defense," Blessing said.