If you’re heading out to buy a lottery ticket in South Africa, you may want to think twice. According to forensic pathologist and author Ryan Blumenthal, your chances of dying an unnatural death on the way there are higher than actually winning millions.
It sounds like a line from a Tim Burton movie, but it’s an uncomfortable truth. And Blumenthal has seen it all, and then some. He’s a senior specialist forensic pathologist and professor at the University of Pretoria and has spent nearly three decades working in mortuaries, examining the dead to understand how they died.
With more than 13,000 autopsies behind him, his latest and fourth book, Trace, is more than just case studies of how people died in unusual cases. He said it’s an attempt to speak to the living through the dead.
“Writing is my therapy,” he said. “And there are lessons that have to be told to the living. Otherwise, all these deaths that landed on my table have been in vain.”
His life view runs through both his work and his writing. Every case included in the book represents something unusual. “These are not your day-to-day cases,” he said, describing them as the far edges of human experience, the rare instances that fall on either side of the statistical curve. In those extremes, he said, lie insights into behaviour, risk and the decisions that can lead people to his autopsy table.
Life decisions that lead to death
He said the Easter weekend period had been particularly busy, with a high volume of cases passing through the pathology slab. But the bigger picture, with between 60 000 and 80 000 unnatural deaths recorded annually and fewer than 100 forensic pathologists serving a population of more than 60 million, the system is always under pressure. High caseloads, backlogs in toxicology and DNA testing, and the steady loss of skilled professionals mean the work is relentless. It is no coincidence that Blumenthal describes the country as “forensic pathology paradise”, a place where the volume and variety of cases expose practitioners to situations rarely seen elsewhere.
Some of the cases are unsettling in their simplicity. In one instance, a murdered man was buried in a shallow grave with his severed finger, removed so the perpetrator could bypass a fingerprint security system. The detail is disturbing, but it also illustrates the principle that underpins the book: every contact leaves something behind, and even the smallest trace can reveal what happened. These days, it extends beyond physical evidence at a crime scene. Blumenthal noted that modern investigations can hinge on digital behaviour, from language patterns to the use of emojis, each forming part of an individual’s identifiable signature. Trace evidence is no longer limited to what can be seen under a microscope; it also includes the subtle ways people interact with the world.
Some cases are unsettlingly simple
In Trace, he wrote that death does not confine itself to dark alleys or isolated places. It happens in hotels, on sports fields, in shopping centres and on mountain trails, leaving behind a map of moments that only someone in his position carries. Driving through the city, he penned down how he is often reminded of specific scenes, whether a building, a roadside, a patch of ground, each linked to a life that ended there.
Blumenthal said he is careful not to feed into the public’s fascination with killers and unnatural death. The work is not about spectacle, and even after thousands of cases, he does not approach it with detachment. Instead, he returns to a single idea: understanding risk. “I can see it happening almost in real time,” he said, noting behaviours in the living that often lead to the outcomes he sees on the autopsy table. It is what drove him to write the book, even though he knew it might make people uncomfortable. “No one’s talking about this stuff,” he said. “At least let me say it. Then I’ve done my duty.”
The final chapter of the book, he said, brings those lessons together in a way that may unsettle some readers. “It sounds preachy,” he admitted, “but who else is going to tell you this?”
