Just got back from the medical examiner’s office and was able to view my first autopsy. Thought I might give you all a recap and dispel some myths and/or misgivings you might have about trying to obtain access to your local morgue to see an autopsy. I hope in same little way, this brief (letâ€™s hope) recollection of the experience may encourage you to go see an autopsy for yourself.
First of all, I highly recommend that anyone who is actively pursuing medicine experience this as soon as possible. It is nowhere near as bad as you “think” it will be. My thoughts pre-autopsy were on the lines of “Dear God, what am I going to see?” But in turn, what I did see was truly a cross between art, science and expertise. Quite an amazing up close and personal view of the human body & its components.
Let me start first by saying that it is considerably difficult to get into to see an autopsy if you are not an enrolled student in a pre-med major (or med student) or know someone “inside” the medical examiner’s office. They keep tight reigns on allowing access to the morgue because of shows like “Dr. G, Medical Examiner” and “CSI” and the Forensic Pathology shows that are all over the tv nowadays. When I was speaking with the office manager, she said they field between 2 to 3 calls per day from people who are wanting to view an autopsy and they have to weed out 80% of those because they have no business being in a morgue. As she told me, “this is not a spectator sport, these are human beings that deserve respect, privacy & dignity. The only people that need to be in the morgue during an autopsy are those who have a definite purpose to be in there.”
That being said, I was welcomed in after I showed my credentials (my USF ID-showing my student status) and was walked back to the morgue to meet with the morgue tech who was there, who was a very nice guy. Great sense of humor and a passion for what he does. As I walked in, I was amazed at how immaculately clean and full of natural light the facility was. Then, when I walked through the morgue doors, the smell hit me.
Now, let me pause here and tell you that the smell is not as bad as your mind makes it out to be, but it is not pleasant either. Definitely not something you want to smell like when trying to pick up the ladies (or gentlemen) I was asked by a friend to try to describe the smell and it really is indescribable. All I can say is that it is pungent, rancid and doesn’t treat the nose very well. But after a few minutes, you switch your mind off from the smell and move on to the task at hand. After 10 to 15 minutes of being in the morgue, you lose consciousness of the smell that hit you when you first came in. The morgue is very sterile, ominous and cold.
Laying on the autopsy table was the patient, who was a 63 year old female, with an apparent cause of death being suicide by an overdose of prescription meds. This was the first time I had come face-to-face with a naked, dead human body. It is not what you see in the funeral home when the body is nicely made up when the mortician has worked his or her magic for the viewing. The body is intact as it was delivered to the morgue, complete with the defibrillator pads, endotracheal tube and IV lines that were administered en route to the ER before the patient was pronounced dead. Of course, the ever-present toe-tag was affixed to the right great toe. The body itself was very stiff and bloated, along with the appearance of some bruising and red splotches where the blood had settled in the lower back.
The medical examiner (ME) walked in and was a very nice guy, again, great sense of humor and very easy to talk to. He seemed very happy to show a young â€œupâ€™n comerâ€ the unabashed view of the human anatomy. He began by dictating the pertinent points about the bodyâ€™s appearance and the time of death. Due the sensitivity of this case, many members of the law enforcement community were present for the autopsy. While the ME was dictating, the crime scene investigation unit was taking fingerprints and photographs of the body. After the CSI unit had their time with the body, the technician did his duties of fingerprinting and photographing. When they rolled the body to one side, there was quite a bit of fecal matter present, which was cultured and capped.
At this point, the technician placed a block under the upper back area to arch the body so that the thoracic area is elevated in plane above the abdomen. The ME then asked if anyone had any objections to beginning the autopsy. Upon no, objections, he went to work immediately and grabbed the scalpel, made the traditional Y incision from shoulders to midline and down to the pubic bone. The first thing that really hits you is how the smell changes to that of a butcher shop. The smell is very similar to that of taking a piece of raw red meat and placing it under your nose. As the ME slices layer after layer of tissue, you begin to really see the body inside. Taking standard bolt cutters or lawn shears, he cuts away the rib cage on both sides to remove the sternum and expose the thoracic cavity. That moment was like a living anatomy manual. You could see every organ in the thoracic, abdominal and pelvic regions. It was extremely impressive.
Each organ came out and was weighed, dissected and analyzed. After the organs had been removed, the technician began drawing blood samples from the heart and chest cavity. The most interesting organ had to be the heart; being able to examine the coronary arteries, the aorta, the chambers. That was a very impressive moment seeing all the intricate arteries and chambers that make the heart. The ME dissected to the center of the heart where the bundle of nerves generate the electrical impulse that keeps the heart beating, pointed to it and said â€œnext to the brain Justin, that is the most important part of the human body. Thatâ€™s what keeps the electrical current flowing to your heart to make it beat.â€ Very amazing.
Opening the skull and removing the brain was another interesting moment. The ME stressed the pituitary gland, its size & importance to me. After the brain had been removed, he laid it on the table and dissected it. Seeing a brain up close is very odd; such a complex organ to look so unremarkable. Upon finishing dissecting the brain and dictating his thoughts, the autopsy was complete from the MEâ€™s position.
The technician then placed the skull back together and folded the scalp back over it. After that portion was complete, the excess blood was suctioned out of the chest cavity and the organs that were dissected were placed in a bio bag inside the chest cavity. After the bio bag had been positioned, the tech quickly sewed the Y incision back closed and zipped up the body bag and that was that: autopsy complete.
The body was then rolled back into the cooler area and secured with a complete tag on the bag to indicate the completion of the autopsy. The next step for the body was for the family to claim it after arrangements had been made with the funeral home. The funeral home will then come retrieve the body and execute the final arrangements.
The first question that I was asked about the experience was â€œhow did you not lose your stomach over it? That poor lady. How sad.â€ Well, yes, it is sad. But like the ME explained to me, you have to divorce yourself from the emotion. That body laying there is just that, a body. It is a shell of the person and nothing more. In terms of not losing my stomach, thereâ€™s a bit of mental prepping that goes into the fact that what youâ€™re going to see by any standard is horrific, but it is medicine and itâ€™s a beautiful thing. By doing what MEâ€™s all across this country do, we have gained an incredible understanding of the human body and its systems.
This has gotten much longer than I wanted it to, but I hope that in some manner it may help some people who are â€œfence-sittingâ€ as to whether or not to go see an autopsy. I found that everyone in the MEâ€™s office was so kind and encouraging to me about not only being there, but my pursuit of medicine. The ME told me that if I ever wanted to go see another one or needed some lab time and instruction during my A&P classes, that I was welcome to come see him. It was truly an awesome experience.
If anyone has any specific questions, Iâ€™ll do what I can to answer them either in this thread or in private.
Thank you for the fascinating description, Justin. Your interest and appreciation really come through - as do all the other details.
You know that is one thing I just can’t get my arms around… kind of odd isn’t it even as a firefighter/paramedic for 8 years and a flight paramedic a fair part of that, I could not count all the grizzly and gruesome stuff I have encountered over the years, I was NEVER effected in the slightest as long as the person was alive or at least “fresh” dead. But by golly by the time of room temp a few hours post mortem, it all changes? Maybe the “death smell”, but I found the cadaver lab equally distasteful.
More power to you!
I need to update this story… I have been out of the loop for a month of so… for good reasons!
Because I matched into Med-Peds and I want to follow in the footsteps of my boss Dr Katherine Melhorn, who is a highy regarded expert on child abuse and neglect (if you google her name you will find many links to criminal cases), I decided that I had better get a grip (or at least find out if I have what it takes) to deal with the worst areas of “forensic pediatrics”. So, I signed up for a month of “Forensic Pathology”
I just came off the entire month assigned to work directly for the state’s chief medical examiner at the “regional forensic science center”. I must say my earlier assessment was based on the first year cadaver lab and was WHOLLY WRONG!
I found myself repeating to myself at intervals approaching “q 15 minutes” stuff like “well I’ll be damned”, “I had no idea”, “facinating”, “thats amazing” etc. I had to learn a whole new vocabulary! Imagine, the “subjects” are not even called “patients” anymore… they are “decedents”. I was allowed much more activity in a “post” (short for “post mortem”) than in somthing like a surgery rotation… after all you cannot kill someone! We averaged 4 “posts” per day and 4 “scenes” a week, I was allowed and greedily sought to be “on call” to go to scenes be they highway fatalities (in which case we took the black Expedition with “coroner” emblasoned on it) or crime scenes. It is interesting to come home from work and see aspects of ones daily activities described (or not described and guessed) in the paper…
Most importantly, I learned a lot about me, none of these experiences “bothered me” in the least, even the “decomps” (short for decomposed). I wanted to experience some pediatric cases to make sure. While uniformly sad, it was an odd amalgam of emotions that made these tolerable. As I later learned from the Pathologist this is the exact strategy she employs… First, you are sort of “pissed”, this beautiful child is dead and they shouldn’t be and we are the only people left in this world who may still speak for them or tell their story so that the CORRECT person (if applicable) is properly accountable. The second was the “pure science” which was frankly breathtaking, after all, lets face it, 18 month old children are like “hens-teeth” in a freshman anatomy lab and certainly not “wasted” on medical students! There in front of me was perfect anatomy (unless the cause of death was congenital) unsullied by 50 years of cheesburgers and beer. “Look at that perfect thymus! etc”
I also toggled through and had free run of the “shops” DNA, toxicology and firearms labs. I was introduced to investigators from all over the state. I was even the “guest” of the prosecutor for the duration of TWO murder trials (with confidentiality assurances), I was allowed to see the case file and all evidence which even those testifying do not get to see. I learned a great deal about the process of establishing fact in that milieu. It was a great primer in learning HOW to give good testimony.