Suspicious mind required for county coroner

Dr. Warren Keene deals with death for a living.

But for Kootenai County’s coroner, it’s not all doom and gloom. There’s an intriguing amount of sleuthing involved in his oft-misunderstood job.

Keene, a medical doctor who has dedicated his career to keeping people healthy as a family physician and saving lives as an emergency room doctor, spends his working hours these days solving the mysteries of death.

Some sensational, but mostly unexceptional.

Inside Keene’s quiet office, a virtual hole-in-the-wall at the county’s election headquarters on North Third Street in Coeur d’Alene, Keene pieces together the circumstances leading to often untimely deaths.

And while a majority of the bodies that end up in his jurisdiction are not the victims of foul play, his job requires a suspicious slant.

“Everything starts as a homicide,” said the 63-year-old, board-certified physician whose career in medicine spans 38 years. “If you treat every scene as a homicide you’ll never miss anything.”

As coroner, Keene’s scrutiny may be summoned for any of the five types of death: natural, accidental, homicide, suicide or undetermined. He works closely with local law enforcement when necessary to close cases. It’s a good relationship with mutual respect that requires the expertise from both sides.

“It’s their (law enforcement’s) crime scene, but it’s the coroner’s body,” Keene said.

The coroner’s office is tapped to probe all suspicious deaths. It must determine a cause of demise even for seemingly innocent unattended deaths if those deaths are not attended by a physician or healthcare provider since the last illness.

Keene must also sign off on all cremations before the body is incinerated and potential evidence is destroyed.

When you add all the circumstances that require the county coroner’s involvement, the numbers are impressive — and growing.

Since Keene was elected five years ago, the body count his office sees has risen steadily — from 1,323 cases in 2015 to 1,542 cases handled last year, an increase of 14 percent, surpassing the county’s growth rate of about 3 percent. Overall, Kootenai County recorded nine deaths per 1,000 people last year, above the state average of fewer than eight per 1,000.

And with the county’s senior population growing exponentially faster than elsewhere in Idaho (57 percent of the county’s growth since 2000 has been 55 and older), Keene expects the mounting workload to continue.

“Every year my caseload increases and I don‘t foresee any changes,” Keene said.

It’s a daunting challenge for an elected position that ironically doesn’t require a medical background. In Idaho, a coroner may be duly elected as long as he or she is at least 21 years old and a resident of the state. However, those elected must complete, on a yearly basis, at least eight hours of training in subjects including Idaho coroner law as well as death investigations and protocol.

While he holds an elected position, Keene doesn’t consider himself a politician.

“Politics pretty much stops at the door,” he said.

Still, the coroner supports the accountability that comes with being voted into office.

“I’m responsible for the people I serve, the electorate,” Keene said. “If I was appointed, I’d be responsible to those who appointed me.”

One of nine elected officials serving Kootenai County, Keene oversees a budget of $414,029 — or a meager 0.4 percent of the county’s $94.1 million spending plan. When he ran for election in 2014, Keene said one of his goals was reducing his department’s budget.

He says he’s been able to lower spending and will continue to focus on fiscal prudence.

During his first year in office, Keene says he was able to return about $30,000 of his budget to the general fund through reduced spending. During subsequent years, the coroner has also cut spending, shifting dollars earmarked for his office back into the general fund.

Prior to taking office in January 2015, Keene’s “office” was the emergency room at Kootenai Health. While it’s been a dramatic career change, the coroner said his work ethic remains unchanged.

“I’ve always been a consummate professional as far as doing the absolute best job I could do,” Keene said. “The coroner’s job is obviously not as stressful, but there will always be a vital job to do.”

Working in an ER, Keene dealt with his share of death. And although he currently holds a job that is defined by death, the physician said his new position did require a shift in his mindset.

“The job of coroner has its sad components,” he said. “I have to compartmentalize and put things into perspective and understand the wide scope of work the coroner is responsible for.”

That includes processing grisly crime scenes. While such scenarios make up only a fraction of his work as coroner, Keene said it’s the most memorable part of the job.

“I remember them most because you’re dealing with the most evil part of life, the bad things people do to other people,” he said.

Dealing with homicides, Keene added, “gets me stimulated to help law enforcement find the culprit. It’s the coroner’s responsibility to do everything we can to make sure all the evidence is brought forward so the legal system can pass judgment.”

No matter what the cause of death, Keene appreciates working hand-in-glove with professionals to bring closure to death — by doing his part to put the pieces together.

“Everybody likes to solve puzzles and I use my experience and education to solve puzzles,” Keene said. “It’s a satisfying part of my job.”