Cases that are being investigated by the police are placed in black body bags and kept in the refrigerator at UMMC’s mortuary. — Photos: AZHAR MAHFOF/The Star
When someone dies unexpectedly and the cause is unknown, it can be a difficult and distressing period.
Emotions swirl, and understandably, family members want answers ... fast.
This is where a post-mortem or autopsy is necessary; but there must be a formal request for it.
There are two kinds of post-mortems: clinical and forensic/medico-legal.
A clinical post-mortem is done by a hospital’s general or anatomical pathologist to confirm the cause of death for medical or research purposes, with family consent.
A forensic post-mortem, on the other hand, investigates suspicious, violent, unnatural or unexplained deaths for legal reasons.
It identifies the deceased, as well as the cause, manner and time of their death, to aid law enforcement.
It is carried out by a forensic pathologist via a forensic post-mortem order (Borang Permintaan Pemeriksaan Mayat, Polis 61 Pindaan 4/68) from the police officer investigating the case, and focuses on evidence collection.
The order can also come from a magistrate and consent from the family is not required.
According to our Health Ministry’s standard operating procedure, forensic post-mortems in Malaysia can only be performed in public hospitals.
Usually a police request
There are currently 71 forensic pathologists in the country registered under the National Specialist Register.
Among them is Dr Shatishraj Jothee from Universiti Malaya Medical Centre (UMMC) in Kuala Lumpur.
“Annually, only 5% of clinical post-mortems are from deaths in hospital wards.
“The family members might request for a post-mortem or the clinicians may be unsure of the cause of death and want further information.
“The biggest bulk – about 90% to 95% of cases – are medico-legal post-mortems requested by the police for suicide, homicide, accidents, etc.
“Say someone is at home alone and dies suddenly and his body is found, then the police have to bring the body to the nearest government hospital and may order a post-mortem to rule out foul play,” he explains.
In cases of the elderly or someone who has an underlying terminal illness and dies at home, the police may not order a post-mortem.
If the police suspect the case might be a homicide (e.g. murder), they may pre-consult a forensic pathologist before shipping the body over.
Dr Shatishraj says: “If they invite us to the crime scene, we go over to do the external examination and help them look for clues.
“Or they may find skeletal remains scattered around and they don’t have the expertise to know which is a twig, bone or stone, so they call us.
“Instead of bringing everything to the mortuary, we sort out these things at the scene.”
Examined inside and out
UMMC medical assistant Hasrul Haziq wheeling a body into the autopsy suite for a post-mortem.
Once the body is brought to the mortuary, it is immediately tagged in multiple areas and kept in the refrigerator.
The temperature is maintained at 2°C to 8°C to preserve the integrity of deceased bodies and slow down decomposition.
After the authorisation documents are in order, the post-mortem is carried out as soon as practicable – usually within 48 hours.
During the post-mortem, Dr Shatishraj and his team will perform a detailed external examination of the body.
This is followed by an internal examination where the body is dissected, organs are removed for inspection, and samples are taken for laboratory tests.
Sometimes, a computed tomography (CT) scan may be necessary, depending on the case.
Photographers from the police and the hospital are also on site to capture visuals for the record.
Once the forensic pathologist is satisfied he has all the specimens needed, the organs are put back in, the body is sutured, cleaned and placed in the refrigerator again.
It can then be released back to family members for last rites.
“We only have one shot to do a post-mortem so we try to get all samples, especially for cases we can’t conclude.
“In complicated cases, e.g. with more injuries or stab wounds, more photographs are needed and the procedure can go on for longer than six hours,” he says.
After the post-mortem
While the post-mortem can be done in a day, the report can take weeks to months to finalise.
This is as time is needed for lab tests, such as for toxicology, to be done.
Such tests are done by the Chemistry Department.
Once the post-mortem report is available and presented to family members, reactions can vary, including denial or disbelief.
“We have a wide spectrum of people: ones who are angry, in grief over the loss, or completely accepting.
“We try to remain professional as we explain the findings,” says Dr Shatishraj.
He adds: “If we have to go to court, a major challenge is social media that brings perceived notions that are untrue or inaccurate.
“I don’t know where they get this twisted information; once it spreads, everybody takes it as fact and forms their own conclusion.
“When we give a statement in court that is contradictory to what is being put out on social media, it looks like we are the ones who are covering up or bluffing!
“That’s our biggest challenge at the moment.”
From vomiting to a calling
Dr Shatishraj showing the board where his team records measurements from tissue samples collected.
Growing up, the 38-year-old specialist had a penchant for classic murder mysteries and novels, especially death investigations.
“Somehow I ended up becoming a doctor, but I didn’t know what I wanted to specialise in.
“When I was posted to Duchess of Kent Hospital in Sandakan, Sabah, I was put in the emergency department.
“At that time, there were only two forensic pathologists in the state and they were based in Kota Kinabalu, which was seven hours away by car.
“Back then, all dead bodies were brought in via the emergency department and the doctors here had to do the post-mortem.
“Since I was a junior, I had to do most of the cases,” he shares.
The first time Dr Shatishraj did a post-mortem on a decomposed body, he had to run to the toilet and vomit from the nauseating smell and shocking sight of rotting flesh.
It was simply too overwhelming to stomach – especially on a full one as he had just eaten a hearty breakfast!
Over time, his nose adjusted to the stench – although he also stopped having meals before cutting up a body – and he started enjoying his work.
He recalls: ”In a disaster like the 2015 Sabah earthquake where there were many victims, we tend to get only body parts, e.g. torso without limbs or separated limbs.
“We treat each body part as a separate case and do DNA sampling for each one.
“Like a jigsaw puzzle, we have to match the parts (e.g. which head belongs to which limb), then we try to suture them to the best of our ability to have some semblance of a human body.”
As he worked on more cases, his interest in the field deepened and he knew forensic pathology was his calling.
“Dealing with dead bodies is easier than the living ones, who have a lot of doubts (about going under the knife),” Dr Shatishraj says, chuckling.
He furthered his studies, completed his specialisation, and now he is perfectly at ease in the mortuary, his second home.
Any ‘disturbances’?
“Perhaps I am now desensitised or don’t believe in ghosts so I don’t have any taboos or feelings when I do a post-mortem.
“But a lot of my staff here will tell you they hear noises, etc.
“In all my years, I have not heard or been afraid of any sounds; some days I even sleep in the mortuary, especially when we have cases at night.
“Or when we go to the crime scene at an ungodly hour, and the next day is a working day, we just spend the night here,” Dr Shatishraj shares.
However, when his children were born, the family would insist he wash his feet in water mixed with turmeric and salt before entering the house, and shower immediately before touching anything.
They were afraid he’d bring spirits back home.
He complied obediently to assuage their fears.
“But I was doing this every time as I work in a mortuary every day, so after a while, they relented and said I don’t have to do it any more,” he says.
On average, the UMMC forensic pathology team receives about 500-600 requests for post-mortems a year.
Dr Shatishraj says: “There are days when we receive nothing for a few days, then there are times where we get six bodies a day.
“Thankfully, there are four of us now, so we can divide our workload.”
Is he good at butchering farm animals?
“My skills are only in the mortuary!
“I know how to cut through chicken joints – it’s kind of similar to humans.
“I can identify the organs and fillet the skin, but sometimes, I’ll be complaining to my wife that the kitchen knife is not as sharp as the post-mortem knife!”
The excuse doesn’t fly with the missus though and he still has to cut up the chicken.
See StarHealth on Feb 1 (2026) for a firsthand account of witnessing a post-mortem.
