Sally Aiken became president of the National Association of Medical Examiners at the start of 2020. The first calls about the novel coronavirus came in early March.

Since then, she’s talked about the pandemic with reporters from Politico, Vice, Chicago Tribune, Miami Herald, Washington Post, Wall Street Journal, USA Today, Rolling Stone, Daily Mail, Associated Press, CNN, CBS, NBC, ABC, and more.

Spokane County Chief Medical Examiner Sally Aiken, M.D., poses for a photograph at the Forensic Institute (Spokane County Morgue Facility) inside Holy Family Hospital in Spokane, Wash. on Tuesday, January 12, 2010. Young Kwak for Pacific Northwest Inlander
Sally Aiken (Photo Young Kwak/Inlander)

“You name it,” says Aiken (’78 Bacterio. & Public Health), who’s become a go-to expert source for the media and the main spokesperson for the association while maintaining her demanding day job. “It’s been crazy.”

Aiken, a board-certified forensic pathologist, serves as Spokane County medical examiner, overseeing an annual budget of about $1.4 million and an office that performs more than 575 autopsies each year. She’s held the position for 20 years, performing more than 9,000 autopsies in all and testifying in court so many times she’s lost count.

“I stopped counting after 400 times and that was a long time ago,” she says, noting her role has become even more challenging in the face of COVID-19, which she says is one of the most unusual experiences of her career.

But, long before the pandemic began, her field experienced another challenge: a shortage of board-certified forensic pathologists during the ongoing national opioid crisis. The country’s premier professional organization for medical examiners that Aiken heads is working on a number of initiatives to increase numbers. Aiken, the sixth woman president in the association’s history, was elected to the top post in fall 2019 while serving as its vice president. Her one-year term ends in December.

Meantime, she represents more than 1,300 members, including nearly 600 board-certified forensic pathologists with specialized training in investigating deaths and performing autopsies in unnatural deaths, such as homicides. In Washington state, a medical examiner must be a board-certified forensic pathologist by law. This differs from coroners, elected officials who are responsible for investigating unnatural deaths but don’t perform autopsies.

The role, Aiken notes, is often misrepresented on screen. “You’ll see women in leather and full makeup,” she says. In real life, “It’s not as glamorous. We’re wearing full PPE, especially now. You’re wearing three pairs of gloves, and your hair is covered—the whole thing.

“We’ve always been at risk for infectious diseases, from COVID-19 to AIDS and more,” she says. “One of the changes because of the pandemic is we have to wear PPE when we go out to scenes. Also, we now screen everyone for COVID-19. If any of those 12 symptoms we use for screening are positive, then we need to test. We’ve been very fortunate in Washington because the state has been very proactive in dealing with people who die of COVID-19. We’ve had test kits available the entire time and can get results in a day or two.”

Other tests take longer than portrayed on TV. “It takes a long time to get DNA back,” Aiken says. And, “We don’t always get the answer. In TV shows, there’s always an answer. But, sometimes, a death remains a mystery, something medical you haven’t seen before, something unusual. You’re always learning.”

This year, the number of deaths is up “and mostly not because of COVID-19. The uptick started in January before we really believed COVID-19 was circulating that much. Suicides have been up 15 percent nationally for the last three years, and we’re seeing an increase here. We’re also worried about opioid deaths. And, people are staying home a lot more these days, so a lot of unusual home accidents are happening. It seems that people are driving faster and taking more risks in general.”

Some of the high-profile cases she’s worked include one of the victims of “Yosemite Killer” Cary Stayner, who was convicted of four counts of first-degree murder in 1999; Chanin Starbuck, a mother of five who was strangled in her home in 2001; and Summer Phelps, a 4-year-old who died in 2007 as a result of child abuse. But, Aiken notes, high-profile cases are not any kind of a benchmark in her practice. Attempting to find answers for grieving family members is more important to her, regardless of whether the case is mentioned in the media.

Aiken comes from a big Coug family. Her sisters Kathy Aiken (’80 PhD Hist.) and Mary Fishback (’76 Comm.) and brother Jerry Aiken (’81 Hist.) are all WSU alumni. Her father, William David Aiken (x’47), attended then-Washington State College before and after serving in World War II. So did her mother, Dorothy Louise Snyder Aiken (’47 MA Phys. Ed).

Aiken met her husband, Bruce Fitterer (’78 Zool. & Pre-Med.), at WSU Pullman. Her sister-in-law, Carol Aiken (’82 Bacterio.) and brother-in-law, Doug Fishback (’77 English.) are also Cougs, along with two nieces.

“I had a great education at WSU and really valued my time there,” Aiken says. “It was a great preparation for graduate school. Some of the things I learned in my biology classes, I still think about.”

Her department recently moved into a $12.7 million state-of-the-art building near WSU’s Elson S. Floyd College of Medicine. The new 24,000-square-foot facility is designed to handle a mass-fatality event, with room for 100 bodies compared to 15 at the former site. The added space and design also make it easier to do autopsies while social distancing. Aiken says she hopes more first-year medical students will have a chance to visit and observe autopsies and maybe even get inspired to pursue forensic pathology.

She approaches her job as the ultimate physical exam, treating decedents with care. “I’ve never regretted this line of work,” Aiken says. “It’s a privilege. You speak for the dead. But you do this work to benefit the living, for adjudication and also for public health, which is really apparent right now during COVID-19.”