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Doing the work of 'CSI' for real

San Antonio Express-News

Jeyling Chou

The Bexar County coroner's newest toxicologist glances up at a board containing a long list of the recently deceased.

"They're dying to get in here," Tiffany Flowers says, grimacing in acknowledgement of a bad joke frequently made.

The board is her to-do list, a dry-erase whiteboard filled with color-coded numbers in columns, detailing tests to be performed. DWIs are in orange; rush orders are in red.

Cases are assigned numerically from No. 1, the first death of the year. On this day, the whiteboard ends with Case No. 1282.

Flowers, 34, is a forensic toxicologist at the Bexar County medical examiner's office. She takes fluids and tissues from bodies and performs the tests to determine what killed the deceased.

Her job is familiar to fans of the "CSI" programs on TV. It's a show she doesn't watch.

"Forensics is a sexy topic right now," she said, adding that the TV shows have provided a lot of publicity for her field, which has a less-than-sexy name: clinical laboratory sciences with an emphasis in toxicology.

"We're vampires," said Dr. George Kudolo, an associate professor at the University of Texas Health Science Center and Flowers' academic adviser. "We just take the blood, and then we're gone."

Since she completed her thesis for her master's degree last year (on how to isolate the so-called date-rape drug GHB) and began working in the lab, Flowers has marveled at the vast array of substances that can prove deadly.

"Anything can be a poison, depending on the dosage," she said. "Even water."

Her drug extraction tests have revealed spray paint, antifreeze and air fresheners as culprits.

Then there are the substances of abuse ? heroin, cocaine, alcohol and combinations of them.

"But even with the drug abuse cases, that's someone's son and someone's family member," she said.

A walk-in refrigerator in the forensic lab holds innumerable test tubes of biological samples ? blood, urine, vitreous from the eye, bile and organs ? and each tube is labeled with the name of the deceased.

The trick, of course, is finding and identifying foreign substances in the remains.

Toxic liquids can be extracted from organs after the tissue ? usually from the liver, kidney or brain ? is mixed with water and minced.

Volatile gases can be identified by extracting a puff of air from the lungs.

After the substances are identified, Flowers reads the medical investigator's report on the physical evidence at the scene.

"I read the narratives, and that's real life; that's not TV. Truth really is stranger than fiction," she said. "People do weird things."

Once the case is solved and the death certificate is signed, the samples go into the freezer and are kept for five years.

Flowers grew up in the tiny Hill Country town of Hico. Her father taught school, and her mother was a nurse.

Her mom, she says, is fascinated by her job; her dad finds it creepy.

As an undergraduate at Texas State University-San Marcos, she knew she wanted to be a scientist. She found herself drawn to pharmacology, the study of drugs.

Flowers used to work with the living, but that proved too stressful. As a lab tech at a hospital, she raced to cross-match blood samples and do other tests while the patient ? often a gunshot or auto accident victim ? waited for a transfusion.

Some have compared the stress level of that job to that of air traffic controllers.

Working with the dead is less stomach-churning, in this sense, although deadlines are still critical. But court dates and insurance claims, although important, are not quite as urgent as the needs of hospital emergency rooms.

The humor is a little blacker here, but Flowers is well aware of her responsibilities to families and loved ones. It has given her some perspective, as well.

"Live life to the fullest, because you never know what's going to happen tomorrow," she said.