Hawkes was a child prodigy who graduated from college at eighteen, and by 24 he was a fully licensed board certified surgeon. After a tumultuous surgical career in which he was often at odds with his boss and after losing two patients on the operating table (shown in flashback in episode 309, "And Here's To You, Mrs Azrael"), he abandoned surgery in favor of the medical examiner's office. He evidently sleeps at the morgue sometimes, as he has a cot there in episode 103, "American Dreamers."