Blood has a Voice: Stories from the Autopsy Table

Hestelle van Staden, Blood has a Voice: Stories from the Autopsy Table (Cape Town: Tafelberg, 2023)

SHE describes herself as a normal middle-aged, suburban woman; but her profession would be regarded by many as highly unusual. From childhood, Hestelle van Staden wanted to be a forensic pathologist and her ambition has led her to conduct 7 000 autopsies on bodies suspected of unnatural death. It is a world of intimacy with total strangers and, usually at a distance, with their families.

Van Staden qualified as a doctor at University of Pretoria and did her internship and community service in Mpumalanga. Here she encountered Cuban doctors and she has pertinent things to say about the suitability of their training for South African needs outside the main centres. At Evander she complained so successfully about hospital shortcomings that she was made acting superintendent. After experience as an assistant surgeon, she successfully completed her forensic pathology training and worked as a registrar for four years at Wits where she subsequently occupied a specialist post.

Pathologists work at the interface of medicine and the law, although they rarely appear at inquest and criminal cases as their reports are affidavits. Nor are they often called to the scene of a crime as should be the case for context. By the time they are involved, the worst has happened and their role is to act as the ‘last voice of the dead’. This can contribute to closure for families and the successful pursuit of justice. The Inquest Act 1959 provides no options: the law determines that an autopsy will take place if unnatural death is suspected. The police are supposed to attend autopsies but attendance is at minuscule levels, a serious flaw in the judicial process.

‘Not for sensitive readers’ says a mock sticker on the cover. Van Staden describes the noise and smells of the autopsy room and doesn’t neglect the maggots (often important evidence in themselves). A full autopsy is performed on every body regardless of apparent cause of death in case it has been staged. Old injuries are noted to provide a complete picture and impeccable record keeping is paramount in case the pathologist is called to testify. For all involved – the pathologist, the scribe and the cutters ‒ alertness, mental compartmentalisation and full protective clothing are essential.

Having described the generalities, Van Staden moves on to some of her experiences. Celebrity cases have been those of Lucky Dube (murder) and Heidi Holland (suicide). In all cases what she experiences is deeply disturbing, so lack of contact with families is appropriate. However, on one occasion a woman was convinced her sister had killed their father and subjected Van Staden to a barrage of abusive allegations of incompetence based on a smattering of medico-legal knowledge. This is a good example of the vulnerability of experts to fantasists. On the other hand, Van Staden expresses frustration that she often has no knowledge of the eventual outcome of a case in which she has had such intimate involvement.

Deaths are not always what they might seem. A deliveryman whose motorbike had been stolen was assumed to be a murder victim. But careful examination of his skin and a tree next to his body showed that he had been killed by lightning. Van Staden naturally avoids passing judgement but does allow herself to describe the Rhodes Park double murders and double rapes of 2015 as sheer evil.

She has been presenter of the Afrikaans-language TV series ‘Outopsie’; recounting that her work has made her wary and to look differently at people. Van Staden comes across as highly committed and professional, while open and realistic about herself. Such are the people who keep society honest and we could do with more readable and informative books like this.


Book review by Christopher Merrett, reproduced from his web page, From the Thornveld