In the middle of a late-June night, an ordinary condominium building fronting a beach in Surfside, Florida, collapsed suddenly. When I first heard the news about Champlain Towers South, I shared with millions of other people a wave of panic — did I know anyone living there? And, like millions of other people, I watched the heroic efforts of the first responders to rescue their neighbors buried in the rubble. While I did, though, I also thought of the unseen work that would soon come to colleagues of mine at the Miami-Dade Medical Examiner’s Office. They are the last responders.

I’ve done that job before. I knew that during the immediate response, the medical examiner’s office would have been mobilized to the scene and would have set up a staging area at a distance from the emergency operations. While the focus on the ground would be to search for and rescue anyone trapped alive in the building’s ruins, it was clear from the size of the structure that there would be dead bodies down there too. The first responders would be putting their own lives at risk to work fast and save whoever they could. Structural engineers would have been at the scene, too, evaluating the stability of the rubble pile and monitoring the remaining tower of Champlain Towers South for any signs of further collapse.

After the Search and Rescue

I knew that the likelihood of survival after a week of anyone still trapped in the building was so low that it would warrant a re-evaluation of the rescue plan, especially since the ruins of the structure were not stable. Authorities in Surfside demolished the structure’s remaining tower by controlled implosion on the night of July 4. The mission changed from rescue to recovery: The search for the living was over, and the exhumation of the dead took its place. I knew the medical examiner would set up a temporary morgue close to the scene to triage the human remains as they were pulled from the rubble. A forensic anthropologist would be a key figure among the staff at the temporary morgue. As time passes and decomposition sets in to further disfigure and damage the crushed bodies, it would be the anthropologist’s task to assess whether commingled remains belonged to a single victim, or whether they needed to be considered as the remains of multiple people. Since there were almost certainly pets killed in the building’s collapse, another job for the anthropologist is to determine whether biological material pulled out of the rubble belongs to a human being or not.

The Miami-Dade Medical Examiner’s Office is a big and busy one. It’s got a lot of material and personnel assets, and manages a heavy caseload as its daily routine. Considering the shrinking number of people still missing and the current pace of the recovery, it seems unlikely that Miami-Dade would require extensive on-the-ground involvement by federal emergency agencies like the Disaster Mortuary Operations Response Team (DMORT), which exists to help support county death-investigation offices when they are overwhelmed by a mass fatality incident. DMORT can also supply specialized staff — experts in identification such as forensic odontologists and radiologists, and scientists with fingerprinting and DNA expertise.

In a mass fatality incident like the collapse of Champlain Towers South, the medical examiner’s primary focus is on identification of the remains, rather than the determination of cause and manner of death. The county will have set up a center for victims’ families where they can get information as it becomes available. Volunteers and healthcare workers will be on hand there to collect DNA exemplars from biological next of kin of the missing; some of the recovered human remains might be too damaged or decomposed to be identified in any other way. The recovery of bodies, DNA testing, and return of remains to the families will take weeks or even months to complete. In the end, though, it is likely that all the missing people in the Surfside disaster will be identified.

Reflect and Redress

The next questions will revolve around how and why this catastrophic structural collapse occurred. Already there are reports of failures in the building design, maintenance, and repair. Legal wrangling will likely go on for years. Many forensic experts, medical examiners among them, will be called upon to help explain what happened in Surfside on June 24. They will be asked about patterns of injury, conscious pain and suffering, and survival interval. Their answers will be hard to bear. But painful as these legal proceedings will be, the survivors of those who perished in this building collapse deserve to hear the whole truth if they want to. They deserve both legal and personal closure.

Bigger questions will remain. How frequently do we need to be inspecting our multistory buildings? Is 40 years after construction enough? What do we do with neighborhoods built on reclaimed land as the seas continue to rise? How should our existing infrastructure be maintained and buttressed — or abandoned — as global warming changes everything about our lives? Political decisions made in the light of these new challenges will impact coroner and medical examiner offices tomorrow and into the indefinite future. Extremes in weather will kill more people. Deadly pandemics like the one we’re still battling could come at regular intervals. Other waterfront buildings might fall. Another condominium in Miami was recently inspected and evacuated. We’ll have our work cut out for us.

We have just finished applauding the heroic labor of the rescue workers in Surfside. Soon the structural engineers will be telling us why we had to call on those rescuers. The lawyers will hash out who is responsible, and how recompense should come. However, there is one more set of public servants who will have the greatest impact on our rapidly changing needs on a rapidly changing planet: Our political leaders — local, state, and federal. Let’s make sure, when the dust has settled, we’re still making ourselves heard to them, and that they are also held accountable for their policies, so that in the future, buildings don’t “just collapse.”

Judy Melinek, MD, is a forensic pathologist and CEO of PathologyExpert Inc. She is currently working as a contract pathologist in Wellington, New Zealand. Her New York Times bestselling memoir, co-authored with her husband, writer T.J. Mitchell, is Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner. The duo have also embarked on a medical-examiner detective novel series with First Cut, available from Hanover Square Press.