First forensic pathology PhD almost gave up

Wednesday, 14 July was a red-letter day for University of Cape Town (UCT) alumnus Dr Sipho Mfolozi, marking the end of 21 years as a registered UCT student and the country’s first PhD in forensic pathology. But, he almost gave up.

Dr Mfolozi was one of 117 doctoral graduands capped virtually during UCT’s mid-year graduation season. He first graduated from UCT in 2001 with an MBChB, followed by a Master’s in Medicine (MMed) in forensic pathology in 2013. He registered as a PhD candidate the following year. 

If 21 years seems like a long time spent in the halls of academia, Mfolozi is quick to put it into perspective.

“It’s almost half my life!” he said.

The graduation was an occasion of mixed feelings.

“It’s difficult for me to use the word ‘enjoyment’ alongside ‘PhD’.”

Now head of the Department of Forensic Medicine at the Nelson Mandela School of Medicine at the University of KwaZulu-Natal (UKZN), he said it was tough balancing work, study and home.

“Time for the PhD was a scarce commodity: my job description involved performing autopsies daily, teaching, giving expert testimony in court, etc. Things became slightly better after I became the head of department from 2018, where obtaining a PhD within five years of assuming the position was a condition of employment.”

“Personal achievement on its own is meaningless if it does not translate to measurable change to one’s society, in one form or the other.”

The fire had been lit but close to the finish line, he almost turned back.

“A PhD is a journey that changes one’s thinking and feeling,” he said. “Plus, I took quite a bad bruising during corrections and I was ready to give up and walk away from it all. But now, being the first PhD in Forensic Pathology from UCT makes me feel honoured – and deeply privileged.”

Mfolozi is also acutely aware of “an overwhelming sense of responsibility to the profession, to my peers, my students and my family”.

“And any personal achievement on its own is meaningless if it does not translate to measurable change to one’s society, in one form or the other.”

Forensic pathology and society

Forensic pathology is not a common specialisation despite its critical role in the issues around death: determining the decedent’s identity and the cause, time, and manner of death, whether by natural causes, homicide, suicide or accident.

Forensic pathologists are also part of a broader team of players, and work alongside other forensic scientists: DNA analysts, forensic toxicologists, forensic odonatologists, forensic entomologists, blood-splatter analysts, forensic radiologists, fingerprint analysts, ballistic/tool-mark analysts, footprint analysts, the list goes on.

‘How?’ and ‘when?’ are critical questions when someone dies, especially when police are called to investigate. Forensic investigators rely on the time of death as evidence to support or deny the stated actions of suspects in a crime. But it was the ‘when’, the interval between death and the body being found (the post-mortem interval or PMI), that was to underpin Mfolozi’s postgraduate research, later fully explored in his PhD.

Novel death-time device

His doctoral thesis, titled A Numerical Protocol of Death-Time Estimation, proposed a new device for post-mortem body temperature measurement, along with a new method of death-time estimation using temperatures from the new device.

The idea for the device originated from an ‘unexpected’ finding during his MMed research project, which had underpinned the design of his NecroChronometer for death-time estimation.

“The unexpected finding hadn’t been described in any forensic pathology literature at the time, but mechanical engineers were well familiar with it. The MMed research then continued into the PhD,” he said. “It was in the middle of the PhD that the ‘unexpected finding’ was finally clearly answered, paving the way for the novel body-temperature measuring device and the novel numerical protocol of death-time estimation that goes with it.”

In November 2020, UCT filed a United Kingdom patent application for the proposed device and the novel numerical protocol of death-time estimation. The next step will be to refine both the device and numerical protocol, for eventual commercialisation. The device and numerical protocol are a major contribution to the body of knowledge in the field.

“I’d like to believe that the research work that underpins this PhD will place UCT, UKZN and South Africa in general on the global map of forensic pathology, particularly in the niche sub-specialty of death-time estimation that today is dominated by mainland Europe,” said Mfolozi.

“The ultimate goal of death-time estimation lies in the administration of justice.”

He also anticipates that these proposals will make their way into the literature taught at undergraduate and postgraduate levels.

“We are incrementally improving the accuracy of death-time estimation methods and we hope that this PhD will play a small role in that. The ultimate goal of death-time estimation lies in the administration of justice.”

He has only praise for former colleagues in UCT’s Division of Forensic Medicine (and to the staff at the allied Salt River Mortuary), its head of department and co-supervisor, Professor Lorna Martin, and supervisors Professors Arnaud Malan and Tunde Bello-Ochende of the UCT Department of Mechanical Engineering. Their support over the long haul was invaluable, he said.

Advice for PhD candidates

Mfolozi also has some candid advice for those thinking of tackling a PhD.

First, the decision to register for a PhD should be informed by a clearly defined research question, whose quest at answering may extend well beyond the PhD.

“I say this because sometimes the motivation is academic rivalry or that obtaining a PhD is perceived as the next logical academic goal. Proposals of such PhDs often indicate poor research motivation and usually lack depth.”

Second, a PhD in a given speciality should contribute new knowledge to the scope of that speciality — in his case, forensic pathology.

“This scope is often presented as distinct chapters in many textbooks of forensic pathology. A PhD about, for example, water-quality improvement, falls outside the scope of forensic pathology even though water quality may affect the rate of human decomposition, which would then make it appear relevant to forensic pathology. For the PhD to be ‘in forensic pathology’, the scope must be restricted to forensic pathology.”

Popular culture

The last question for Mfolozi involves the role of forensic pathologists and how they are painted in popular detective series. Think of the witty Dr Max DeBryn in Endeavour, or the testy, dismissive Dr Malcolm Donahue in Vera, both called on to answer the ‘how and when’ on behalf of the shows’ protagonists.

Mfolozi understands the allure of the riddle-involving unnatural and unexplained deaths in fiction. But reality is seldom as mysterious or compelling, he said.

“I used to watch a lot of Crime Scene Investigation, or CSI, when it was new to South African television screens. But soon I noticed that the causes of death were often exotic – possible but rarely encountered,” he said.  

“And the conclusions are not nearly as neatly timed. The cause of death is deliberately kept obscured, even to experienced forensic pathologists, until the last few minutes of an episode. Today, I much prefer non-fiction forensic and investigative documentaries!”