Dr. Emily Russell-Kinsley didn’t always want to be a forensic pathologist, but unlike most middle schoolers, she did know what the title meant. Growing up in an Oklahoma family of physicians, she was a grade-school fan of the popular series of crime novels by Patricia Cornwell following Virginia medical examiner Kay Scarpetta.

Scarpetta, victim of her main-character status, is constantly in the crosshairs of fictional bad guys. That kind of attention, even more than the duties entailed by the job, put Russell-Kinsley off the profession as a child. She has always been a self-described behind-the-scenes person.

Her thinking changed when the aspiring pathologist did a required rotation at the Dallas County (Texas) medical examiner’s office. Once satisfied with the detached work of identifying disease and injury for surgeons in a lab, Russell-Kinsley fell in love with the hands-on nature of investigating death.

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“I went into this rotation thinking it would be the worst, most depressing, you know, most disgusting thing I had ever done, and by the third day I was completely hooked,” she said.

While forensic pathology hasn’t yet embroiled Russell-Kinsley in the plot of a crime thriller, it has recently put the doctor in the public’s eye. The 13-year veteran of the El Paso County Coroner’s Office was appointed late last year to replace departing coroner Dr. Leon Kelly, who resigned, as the head of Colorado’s largest and busiest coroner’s office.

Kelly carved out a larger-than-life profile in his six-year tenure in elected office and 17 years as El Paso County medical examiner. The former coroner was an organizer of horror film screenings and Halloween parties. He also became highly visible in the community as an advocate for suicide prevention and as a public health leader during the COVID-19 outbreak.

Now, Kelly hopes events will allow his replacement her preference on staying out of the limelight. 

“If you know the name of your coroner or recognize them on the street, then something’s gone wrong,” he said. 

A striking painting of a pale woman in black with crows perched on her arms hangs behind Russell-Kinsley’s new office desk, which might suggest a similar aesthetic taste between the incoming and outgoing coroners. They are both among just a few hundred forensic pathologists in the U.S. — a profession that requires a medical degree as well as specialized forensic training.

Kelly had high praise for his colleague with a “dark streak.” He quickly promoted Russell-Kinsley to deputy chief after taking office. During his tenure, Russell-Kinsley took over operations at the coroner’s office while Kelly worked with El Paso County Public Health as an emergency deputy medical director at the beginning of COVID-19.

“She was the boots-on-the ground leadership during that initial and very chaotic phase of the pandemic,” he said.

Russell-Kinsley also led the county’s Child Fatalities Review Team organized by Kelly. 

“I would not have left office and stepped away if I wasn’t 100% confident in the leadership of this building,” Kelly said. 

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Still, Russell-Kinsley says she is not trying to fill the skull-patterned shoes of her predecessor, who will continue to take on occasional work at the coroner’s office.

“There’s no one that I would rather discuss cases with,” she said of Kelly. “Outside of that, we’re very different people.”

Instead, the new coroner will be focusing inward on restructuring the office to attract and maintain qualified employees. In December, the county lost two medical examiners, leaving the coroner’s office with only three doctors out of six authorized. Russell-Kinsley said her goal was to prevent burnout among her chronically overworked staff through continuing education opportunities.

The El Paso County Coroner’s Office handles deaths in 22 Colorado counties, consulting on complex cases that require the expertise of a forensic pathologist. It’s also the only coroner’s office in the state with an in-house toxicology lab.

“The volume for El Paso County is huge,” she said. “It’s just coming at us constantly.”

Russell-Kinsley was on hand for the identification of nearly 200 bodies discovered in Fremont County, improperly stored by Return to Nature funeral home and discovered in fall 2023. She worked with colleagues in the receiving bay of the county coroner’s facility to process remains too numerous for space in the autopsy room.

“What that taught me was that we can find a way to handle anything,” she said.

Despite her new role, Russell-Kinsley is emphatically not a politician. She wrote a letter of support last year for House Bill 24-1100 establishing minimum requirements for coroners in Colorado, calling the new law a way to “bring us out of the Old West.” She said the elected coroner system, as opposed to appointed medical examiners in some states, was one reason that recruiting forensic pathologists was difficult due to potential instability in leadership.

Russell-Kinsley plans to run for coroner when the remainder of Kelly’s term is up in two years.

In the interim, Russell-Kinsley’s most meaningful interaction with the public probably will continue to be on the individual level with loved ones of the dead, when her unique brand of bedside manner comes into play.

“Sometimes people just want to vent. Sometimes they want to tell me the special things about their person, and I’m happy to hear it,” she said. 

“She has always been someone who has been masterful in relating to families,” Kelly said of the new coroner. 

In contrast to most doctors, Russell-Kinsley said the uncertainty and pain of medicine for the living was too emotionally stressful for her. When people enter her care now, the journey is over. 

“Watching the grief, watching the sadness, watching people be scared, it was really hard to separate myself from that,” she said. “And so in a way, when folks come here, the suffering is done, right? And now, we can get answers.”