How forensic odontologist Dr Alain Middleton identifies the dead to help the living. By Harry Pearl
The NSW Department of Forensic Medicine is housed in a drab building adjacent to the state Coroner’s Court in inner Sydney. In the waiting room, on the ground floor, not even potted plants can brighten the dated and austere atmosphere. The complex has played a crucial role in solving many of the state’s most high-profile police cases and inquests since it was built in 1968. But the old morgue is starting to show its age.
Alain Middleton has been applying his considerable experience here as a forensic odontologist for nearly three decades. The 65-year-old dentist, who is still in private practice, spends about half his working week at the mortuary, carrying out dental identification of corpses, age determinations and bite analysis of injuries.
He shares an upstairs office with a colleague, who laughs and rolls her eyes when I say I’m a journalist. Another story on Alain, she says to him in jest; you’re so famous.
Middleton is, at the very least, well regarded. His expertise in victim identification has set him apart from many in the field. His technical skill has seen him called on to work a slew of the world’s worst disasters over the past two decades: the Bali bombing, the Concorde crash, the Boxing Day tsunami, to name a few. He was made an officer of the Order of Australia this year for his distinguished service to dentistry as a forensic odontologist. In 2016, he stepped down as the chair of Interpol’s odontology group after seven years. It’s usually a two-year position. He’s still involved, but says he didn’t want to be “the old fart” that wouldn’t move aside.
Middleton is wearing a blue shirt and loose-fitting khaki pants. He has greying hair and a few days worth of stubble on his face. He peppers our conversation with stories and anecdotes from his work and travels, and he has a knack for recounting blocks of dialogue.
One formative case he worked on early in his career was identifying the skeletal remains of a young woman, he says.
“I remember I was down in the mortuary with the pathologist handling the case and the detective handling the case. They obviously knew each other reasonably well and I was the newbie. They both looked at me and said—because in those days we didn’t have counsellors—‘You can go and speak to [her mother].’ I was thinking, ‘Hang on, I’ve been never taught to deliver a death message.’”
Middleton walked out to the small, public waiting room on the ground floor of the building. The young woman’s mother, who was upset, was standing there.
“I introduced myself and I just said, ‘Listen I’m a forensic dentist and I’ve just identified those remains as being your daughter.’”
He stepped back and braced for the response.
“One part of her was glad to hear the news, another part was distraught. The next thing she sort of wrapped her arm around my neck, pulled me close and whispered in my ear: ‘Thank you for telling me she is dead.’”
“I just said, ‘Listen I’m a forensic dentist and I’ve just identified those remains as being your daughter.’ […] She wrapped her arm around my neck [and] whispered in my ear: ‘Thank you for telling me she is dead.’”
When we lose somebody, we want to know if they are dead, Middleton says. Providing closure to bereaved families is a big part of why he’s still doing the job.
Middleton grew up on Sydney’s North Shore, the oldest of three brothers. He doesn’t remember why he chose dentistry, but some impulse steered him away from civil engineering in his final year at high school.
He studied at the University of Sydney between 1971 and 1976, then took a job in Dubbo. After 12 months in the country, he went to Europe with his then-wife, only to cut the trip short because her father became ill.
He became interested in forensic odontology after the Granville train disaster in 1977. Eighty-three people were killed and 213 were injured when the commuter train derailed at Granville in western Sydney. “It was just curiosity about how the hell did they identify the individuals,” Middleton says.
About the same time, South Australian dentist Ken Brown was establishing Australia’s first dedicated forensic odontology unit at the University of Adelaide. Middleton travelled south to attend a short course held by Dr Brown, who had gained some renown after helping identify the victims of Adelaide’s Truro murders.
Not long afterwards, a chance conversation at a function with the then-director of dental services for NSW landed him some work with the state’s forensic group. He’s been walking the halls of the morgue on Parramatta Road ever since.
Middleton has seen a lot change since he first started in the field. Identification has gone from a cold, black-and-white process to something more compassionate, he says. Religious and ethnic considerations are now part of the job, and there has been a move away from invasive procedures, such as cutting the lower jaw away from the skull. Overall, standards of identification have increased considerably, he says. But despite its importance to the justice system, there are no full-time forensic odontologists in Australia. Middleton, who is second in charge at the NSW odontology unit, is paid for two-and-a-half days a week. Other members of the five-person team essentially work on a volunteer basis, he says. They average about one identification a day.
“The biggest problem with that is as the standard required increases, who pays for the training path if there is no money at the end of it?” he asks.
The piecemeal nature of the work, which frequently takes Middleton overseas, has at times made for an interesting juggling act with his general practice.
“The most memorable one was in 2000. I was sitting on a committee for the Olympics that had to develop disaster-response scenarios. Terrorism was about number 10 or 12 on our likely scenarios. Our most likely scenario was collision of mid-air craft over Sydney. At the end of July, there was the Concorde crash,” he says.
“I got a call at three in morning, ‘You’ve got to be out at the airport at seven to get on a plane to Paris.’ I went to bed expecting to go to work at the surgery the next morning. Here I was at six o’clock ringing my secretary saying I’m not coming to work today and I don’t know when I’m coming back.”
Dr Middleton has seen a lot change since he first started in the field. Identification has gone from a cold, black-and-white process to something more compassionate. Religious and ethnic considerations are now part of the job.
Still, you get the impression he wouldn’t have it any other way. Being thrust into the thick of different legal systems and navigating different international perspectives at Interpol. Taking a last minute flight to reach ground zero of a global disaster. Doing his part to help in a terrible human tragedy.
Take the catastrophic Boxing Day tsunami in 2004. The magnitude-9 earthquake which struck off the coast of Indonesia triggered a devastating tsunami across the Indian Ocean. Waves of up to 30 metres swept through the Indonesian province of Aceh, where more than 160,000 people alone were reported dead or missing. Middleton travelled to Phuket, Thailand in the wake of the disaster.
“The Thai tsunami … was just overwhelming in terms of the volume of deceased and the degree of devastation,” he says.
Holed up in a partly-used telephone exchange some distance from the devastation, Middleton was involved in the reconciliation phase of identification. More than 8,000 people died in Thailand. Middleton’s job was to match anti-mortem information, like dental records or photos, with bodies.
It was grisly and, at times, upsetting. He remembers trying to identify a little girl —just a bit younger than his two daughters at the time—who was thought to be Russian.
“I pulled up some family happy snaps that were on the file and there was this photo that the dad had taken of the kid with her hands out so it looked like she was holding the sun. She was kissing it goodbye,” he says. “I immediately burst into tears.”
Middleton has had a career surrounded by death. He’s had colleagues who have burnt out, unable to cope psychologically. And he admits grief doesn’t lie far below the surface. So how does he put it aside and get on with life?
“Well, I’m either lucky or I kid myself. But I can partition fairly easily,” he says. “You’re examining human remains from a scientific point of view. Usually you’re doing it without a clue who that person is, certainly without any personal relationship with that individual.”
But the way Middleton describes his work, there is also something distinctly humane about it, too. He recalls another identification following the Boxing Day tsunami in Thailand. After some trouble, he was able to determine the identity of a deceased woman who had been holidaying with her husband and children, who were also dead.
“That wasn’t the important part,” he says of proving who she was. “It was knowing that I’d identified the last member of that family, but they were now a family—deceased.
“Dad and the kids had been sent back to Britain, where they had come from. You knew there was a larger family group out there waiting for the last piece of the jigsaw to come in.”