(Don’t worry, no graphic descriptions or pictures, just details about the procedure.)
For our pathology class, we had to attend an autopsy at the coroner’s office. I was really not looking forward to this assignment; I had a hard enough time with Gross Anatomy lab and the Fresh Tissue lab during first year (and to be honest, just thinking about it makes me nauseated, because I remember having morning sickness while having to go to those labs… yuck!). So I, along with some friends, scheduled our date to go early in the year to get the assignment out of the way since second year is so busy.
We arrived at the Office of the Chief Medical Examiner bright and early at 7:30. We signed in and donned our gear, gowns, gloves, masks, bouffants, and booties, while we waited to be called into the autopsy room. While we were getting ready, the pathologists were setting up and taking pictures of the body. It’s important to document any lesions, bruising, or anything else that may be of importance later, especially if there’s a chance the pathologists will need to testify in court if need be.
When we were called in, I noticed that the room was really cold, and it didn’t smell anything like the anatomy labs we’d had before, not even the fresh tissue labs. It looked a lot like the autopsy room on Dr. G, Medical Examiner (so, no surprise there). The body was on the autopsy table in the supine (or anatomical) position.
The pathologists follow a systematic approach. We observed how they opened the body and examined the internal organs, taking them out one by one, weighing them, and placing them on the table for the attending. The most senior member of the team was standing on a platform at the foot of the table, on a raised stand, that had a flat top to work on. She would take an organ, like the heart, and make consecutive linear cuts with her scalpel through the muscle and along the coronary arteries. (I heard the residents call it “breadloafing”.) This way, she can see if there are any lesions and if so, how it changes or how extensive it is through the tissue. (We could actually see plaque buildup in the coronary arteries of this particular heart.) pieces of tissues were saved to go to the pathology lab, and notes were taken about damaged organs or any other findings.
I have always thought surgery was awesome because you can open someone up, fix a problem, and restore them. I think what jarred me so much about anatomy lab was that we couldn’t restore the person’s structures. Autopsies, for me, are nearly the same–it still doesn’t appeal to me because there is no way to restore, although pathologists do provide a valuable service to patients and families.
I think it would have been fine if the coroner wouldn’t have shared the details of the case with us. The more he spoke, the more I didn’t want to know. The case was complicated and heartbreaking, and I wound up crying on the drive home. I’ve thought about that case many times since then, and it still breaks my heart.
What I was surprised by most is that this was yet another version of death that felt different than any of the others I had experienced. Being with a patient when they die, attending a funeral, dissecting in anatomy lab, observing an autopsy… each has had its own, different effects on me. I’m fairly confident that I can forego pathology (or at least forensic) off of my specialty list.