Maine Perspective Front Page
Noted Forensic Expert Combines Nursing, Anthropology
Marcella Sorg's career is about life and death.
As the director of the Interdisciplinary Training for Health Care for Rural Areas (ITHCRA) project with the Margaret Chase Smith Center for Public Policy, Sorg and co-principal investigator Joann Kovacich develop ways to provide better healthcare for Maine's rural population.
Sorg also is consulting forensic anthropologist for the Maine Office of Chief Medical Examiner. Sorg conducts postmortem exams of all skeletonized and poorly preserved human remains in the state. She also consults for deaths in New Hampshire.
The latter work, she says, is much less sensational than its portrayal in popular media. It's no case for Patricia Cornwell's Kay Scarpetta.
"Those books or movies that imply that either the medical examiner or forensic anthropologist goes out chasing criminals are just nonsense. We don't do that," says Sorg, a faculty associate in the School of Nursing and the Department of Anthropology. "It is intellectually stimulating work. Each case is interesting and unique, because each time, it's the reproduction of a unique event - the death of a person."
Sorg graduated from the Fairview General Hospital School of Nursing and spent seven years as a practicing RN. During that time, she worked toward advanced degrees.
Sorg earned an M.A. in anthropology in 1975 and a Ph.D. in physical anthropology in 1979. She became certified in forensic anthropology in 1984.
"When I came to Maine, although I had been trained to do skeletal analysis, I never imagined that I would do forensic anthropology," says Sorg.
The year after Sorg moved to Maine, Henry Ryan, the state's Chief Medical Examiner at that time, called and offered her a consulting position. She declined at first, but relented after Ryan insisted.
"It is morbid work, the very definition of that word. It can be quite nasty, but it's interesting scientifically," Sorg says. "What we learn about human remains is applicable not only to the recently dead but also to the fossils, so my work has an application in the study of human evolution."
Sorg says the work allows her to look for patterns in the condition of the body, which can lead to theories about the processes involved in death and decomposition.
"We can tell from the condition of the remains how long the person has been dead. There are patterns we see that allow us to tell whether bone injury is the result of carnivores in the woods or the events that caused the death."
It is not only the scientific interest in this work that motivates Sorg. She says part of her work is to tell the dead person's story.
"From a humanistic perspective, the forensic investigator is frequently the last bastion of victim advocacy. Whatever happened to this person will not be known unless we do our job right. In investigation, you try to determine not only what caused the death, but who the person was," says Sorg, whose two newest books are Advances in Forensic Taphonomy (with William Haglund) and Cadaver Dog Handbook: Forensic Training and Tactics for the Recovery of Human Remains (with Andrew Rebmann and Edward David).
In her work, Sorg sees a wide variety of cases, including instances when remains turn out to be animal bones.
Next semester, she will offer a graduate course in forensic death and injury investigation for nurses and other health practitioners, in cooperation with Maine's Chief Medical Examiner, Dr. Margaret Greenwald.
"Nurses are all the time dealing with death and injury, and are frequently the first responders to a situation. In New Hampshire, all of the routine death investigations are done by nurses," says Sorg. "In Maine, forensic nurses are being trained to investigate sexual assault cases when the victim is still alive."
Sorg says nurses are often put in the role of examining and documenting injury or death when people enter the emergency room or are admitted to the hospital.
"The interface between the law and medicine frequently involves nurses," says Sorg.
At the Margaret Chase Smith Center (MCSC), the Interdisciplinary Rural Training Center is in its 10th year. Federal funding from the Bureau of Health Professions is dedicated to improving the training of healthcare professionals in rural settings, emphasizing interdisciplinary teams, community- based training and healthcare informatics.
Informatics includes computer-based information and communication technologies. For example, rural practitioners can share patient care data with specialists and other medical personnel at larger facilities.
"When an X-ray is done in a small town, it can be sent to a radiologist miles away," says Sorg. "We are trying to improve the abilities and comfort level of professionals in using computers and related technology."
As part of the project, MCSC helps the academic community develop partnerships with communities and healthcare providers in the state in two major areas - mental health of infants and their families, and aging.
In the first project, Partners for Underutilized Systems of Health, MCSC has been in the center of a collaboration between UMaine and Husson College, Penquis CAP, EMMC Family Practice Residency clinic, Bangor Public Health Nursing, and other partners.
"What we do is provide clinical experiences for the students, and involve them and clients in developing on-line curricula for teaching infant mental health topics," says Sorg. A similar project coordinated by the University of New England, Healthy Aging Project Year 2000, works with the aging populations in Bucksport and other communities.
"With the infant mental health project, students will go out in the community, making home visits to high-risk families in their supervised clinical rotations," says Sorg. "With Husson and UMaine, it's an unusual setup because both institutions are working together with the community to improve healthcare in the local area."
The students involved in ITHCRA's projects have contributed to CyberEd, a part of their Website that serves as a healthcare resource for people in the community (www.ume.maine.edu/~ ITHCRA/CyberEd). It provides information regarding healthcare providers and facilities, public transportation, spiritual organizations and related topics.
The issue is of particular interest to Sorg, who was in private practice as a healthcare informatics consultant from 1980-1995.
A CD-ROM on aging also has been produced as a result of the project. The Aging in Rurality CD features interviews with rural elderly about their issues with healthcare and everyday life. The CD allows healthcare professionals and students to learn from the sources about the choices an individual must make regarding informal and formal support systems.
"The focus of the CD is on issues in successful aging in the home setting," says Sorg. "The interviews with the elderly on the CD explore what they think their needs are for healthcare."
Another project MCSC coordinates is the Maine Consortium of Partnerships, a statewide group of stakeholders in health professions education that works to educate the state about issues related to the health workforce - aging, mental health, dental health and lung health.
In the future, Sorg says she hopes information systems can be developed to track the distribution and demographics of Maine's healthcare providers.
"Healthcare is a major economic force in Maine, so statewide decisions about healthcare worker distribution and retention are critical to our economy," says Sorg.
"We're promoting the idea that it needs to be done and it needs to be funded."