Canada's First Indigenous Forensic Pathologist Starts Work

The Ontario Forensic Pathology Service offered Kona Williams a job last November, the same day she found out she had passed the certification exam to practise forensic pathology in Canada.

"It was quite an exciting day," says Williams, who started as a forensic pathologist at the service in January after a one-year fellowship in the Department of Laboratory Medicine and Pathobiology (LMP) at the University of Toronto.

For Williams, the job caps 14 years of postsecondary education, which included four years of medical school and five years as an anatomical pathology resident at the University of Ottawa.

"My father asked if he could finally say I have a real job," laughs Williams, who is the first Indigenous person to practise as a forensic pathologist in Canada. Her father is Cree from the Peguis First Nation in Manitoba and her mother is Mohawk from Kahnawake, near Montreal. "But seriously, my father is very proud. I asked him to stop telling his friends and family about his daughter."

As a junior pathologist, Williams performs medical and legal autopsies when people have died suddenly or in suspicious circumstances, including homicides, deaths while in police custody and unexpected deaths of infants and children. She also teaches medical students, residents and fellows, and gives expert testimony in court.

"Forensic pathology provides the only medical and scientific answers for why people die," says Williams. "We give the end-of-line diagnosis, which in every case has huge implications for the family and often for the community at large."

In her new role, Williams signs out cases on her own. But if she has questions, she still consults with senior pathologists at the service, which is one of the most advanced forensics facilities in the world. "It's a lot of responsibility. When you're a student, there's always someone watching over your back. But I haven't been booted from the nest entirely — the staff here are really helpful."

The service's staff are glad to have her. "She is very intelligent, has a lot of drive and is a very good collaborator," says Michael Pollanen, the Chief Forensic Pathologist for Ontario who is also the Forensic Pathology Program Director and a Professor in LMP. "She is a benefit for our organization, for Ontario and for the students she'll teach."

As well, says Pollanen, Williams brings a unique outlook to issues that affect the health of Indigenous people, such as poverty, environmental pollutions and poor housing. Those factors also underlie many unexpected deaths in Indigenous communities.

"Kona's knowledge of mechanisms of injury and disease in the context of social determinants of health, together with an Indigenous perspective, is something really new that will lead to immense contributions in the future," says Pollanen.

Williams is just starting to develop her research projects, but one of her interests is the cause and manner of death in Indigenous communities. She says there are data that show trends for how Indigenous people die in Canada, but nobody is looking at it closely. "For example, a particular community had a certain number of suicides one year and fewer the next. Why? This kind of question needs to be answered," says Williams.

Williams is also interested in the relationship between Indigenous people and the organizations that investigate deaths in Canada. "There is a real lack of communication between the death investigation system and Aboriginal communities," says Williams. "And among the three entities that make up that system — the medical profession, the police and government — we need more open lines of communication."

Williams says an understanding of past relations between Indigenous and non-Indigenous Canadians would also help, especially when it comes to re-locating bodies for autopsies. "There is a whole history behind people coming into Indigenous communities and taking members away. We need a shift in how those communities are approached," she says.

Williams has let her colleagues at the service know she is available to help broker better relations with Indigenous communities during investigations, and she has already had opportunities to do that. She hasn't been approached to participate in the federal government's recently announced National Inquiry into Missing and Murdered Indigenous Women and Girls, but says she and her team are ready to respond.

"I think our facility could contribute to a project on that scale. Dr. Kathy Gruspier, a forensic anthropologist here, has spearheaded the Resolve Project, which includes a public website that deals with unidentified remains and has helped link individuals with families, usually through DNA. Considering our resources and what we do, we could play an important role in the inquiry."

Meanwhile, Williams says she will focus on death investigations — and keep learning. "It took a long time to get here, but I'm doing exactly what I want to do. Every case I learn something new because there is always a twist or challenge. It's such privilege to get up in the morning and be really excited about work."