For soldiers, "surge" means more troops. For hospitals, it's patients lined up for beds due to an epidemic or mass-casualty accident. Grey doesn't want to contemplate the word. "We simply deal with everything that comes down the pike at us." For several years, they've had shortfalls, although they've cut out staff training or trips to conferences to learn about advances in forensic medicine and they rarely buy new textbooks or other nonessentials. This year, they've asked the Utah Legislature for $270,000 in building block funds, half of it to cover an existing shortfall. The rest is keep-up money. If they can't cover the shortfall, the cost of transporting bodies may be passed on to families or, in criminal matters, police forces or prosecutors' offices.

Nationally, the per-capita cost of an effective death-investigation system averages $2.50. Utah's office operates on 83 cents per capita. Bringing funding up to the average would provide "a depth of coverage and a depth of ability we don't have," Grey says.

Sundwall worries about the growth in cases and their impact on bereaved families. "Like all parts of public health, they're always at risk of being overwhelmed. If you have a loved one who died under circumstances that merit investigation, you really don't want to be waiting days and weeks to learn the cause of death. It's a humane thing to do in a timely fashion."

The office has benefited recently from anti-terrorism and flu pandemic grants. That kind of money, Grey says, "is good for getting your goodies, like computers, but I need funding for ongoing operational expenses."

He'd just like to hire another investigator and an autopsy assistant — forget the staples of other ME offices that have a full-time photographer and evidence archivist, or someone to see all the data is clean, collected right, the reports are together, etc. Even the process of certifying medical-legal death investigators is too expensive for the Utah ME's office to afford.

"If it's working 'well enough' there's no incentive to try to do anything. You only see change when something happens that underscores and prominently displays the inadequacy of a death-investigation system," he says. "I feel like we're standing in the middle of a rainstorm without a raincoat."

---

E-mail: lois@desnews.com