This is an irreverent title for a very serious post, and I chose it specifically to show that sometimes, we need some irreverence to deal with things in our life. Humor heals all wounds, and writing cop novels means I’ve dealt some really off color moments which defuse the tension of the situation at hand. Humor helps with most every circumstance—with nervousness, with fear and tragedy. Thank goodness we have that, at least.
I attended my first autopsy this past weekend. Allow me to amend, I spent a full morning at the Medical Examiner’s office, which meant not one, but four autopsies. Don’t worry, I’m not going to gross you out with freaky details. Not too many, at least. But I’d be remiss if I didn’t discuss some of what I experienced and the way the day is haunting me. There are images seared into my brain now that I’ll never erase.
Names, places and details have all been slightly altered to protect the innocent.
I recently received an invitation to attend a postmortem, and I honestly didn’t want to accept. I’ve done a lot of boots on the ground research for my novels, but attending a real post wasn’t something that I’d ever really felt the need to do. There are great virtual autopsies online, and with my truncated pre-med background and subsequent fascination with doctors, I have enough of a familiarity with anatomy that I can manage. I’ve worked with the Manhattan Medical Examiner’s office to get specific details so my Medical Examiner in the book, Dr. Sam Loughley, doesn’t make too many egregious mistakes or misstatements. But I’ve always felt like a fraud. People ask all the time if I’ve attended autopsies, and the answer is always no.
But in the book I’m writing, Sam is a point of view character. So it was time. Plus, I mentioned the invitation in an interview last week, effectively outing myself, which meant culpability. Damn it. After a week of hemming and hawing, I accepted the invitation. We set the day for Sunday.
I dreaded Sunday all week.
I didn’t eat Sunday morning. I got a green tea from Starbucks. I figured that was as safe as anything. I was to call when I was in range. It wasn’t a quick drive, so I had plenty of time to think about backing out. I will freely admit to pulling into a gas station and sitting for about ten minutes, getting up the courage to make the call that I was close. Finally berating myself for being a total idiot, I called. I was ten minutes away, and I did my best not to think about what I was about to do. Or rather, I imagined fourteen different scenarios, in which I passed out, threw up, freaked out or otherwise embarrassed myself.
They met me outside, and whisked me in. I’ve been in this particular morgue before for identification of skeletal remains, passed a few spots I recognized, then suddenly, we were in the changing area. I handed over my purse, pulled on tons of protective gear, and grabbed my notebook. The following conversation ensued:
Tech: “She’s going to get blood on that. I’d leave it.” (She being the M.E.)
M.E.: “Hey, I’m pretty neat.”
JT: “She’s just kidding, right?”
Tech and M.E. have small, secretive smiles on their faces, which remain blank. I am certain they are teasing and decide to bring my notebook. My mask is around my neck. My heart is doing double time. I have enough familiarity with panic attacks to know that I’m pushing into the borders of one. I breathe deeply, square breaths.
JT: “You should probably have the smelling salts ready, just in case.”
M.E.: “You’re going to be just fine. I’ll take good care of you.”
JT: “Seriously. I have no idea about how I’m going to react. I’m not kidding.”
Tech and M.E. realize that I’m quite serious, and make a plan for me.
Tech: “If you start feeling hot, step out. I’ll come and give you a coke or something.”
ME: “Are you ready?”
I swallow, hard, and nod. In we go.
It is white, clean, pristine, with shiny stainless steel and a man lying naked to my left. This is not my first dead body, but it is my first unclothed, which is momentarily shocking. My greatest fear is that there will be one of two demos: a man my father’s age, or a child. I immediately see the board says the man is in his 70s. Shit. I realize I’m breathing through my mouth, which isn’t necessary, there’s no real smell. The M.E. checks if I’m okay, and says we have four autopsies this morning. (FOUR? WTF? I only signed up for one. Panic sets in again, then abates. Surely I'm only going to observe one. I can handle this.)
We move further into the morgue. I immediately see a young boy on a gurney further away from the sinks. Nightmare scenario two. I stop cold. The M.E. asks again if I’m okay, tells me not to personalize. There are two more bodies, one woman with blood on her face and a young man with tattoos along his ribcage. I feel the urge to run and not look back. I also have the most absurd reaction—I keep looking for chests to rise, for eyes to open, for bodies to sit up. I’ve got a full-fledged horror film running through my brain—one that never really goes away.
Everyone is waiting for me. The techs are standing at the ready by their bodies. The guests, they call them. All the bodies have been stripped, weighed and measured. Since none of the deaths are criminally suspicious, evidentiary precautions are not in play. Each station is set up with a white board with things written on it like heart, liver, kidneys. I know enough to know that’s for weight measurements of the organs. I am still on my feet, though looking over my shoulder expecting a ghostly white hand to grab me. When we’ve established that I’m not going to barf or bolt, the M.E., who is no nonsense and an excellent teacher, takes me to the computer and we review the cases.
The first step is to cover the details of each individual case. We have an unattended death outside, an unattended possible overdose, a possible suicide, and the child with severe head trauma. I am hugely relieved to learn that his autopsy will be external only, the cause of death was established by the hospital. Thank God for small favors.
We step to the first body, the woman. On go the masks. The M.E. does an external exam, explaining to me in detail what she’s looking for. The woman has marks and scratches on her body, we spend some time determining what they might be. When the M.E. is finished, she nods to the tech, who takes a vitreous fluid level and begins to get femoral blood. I watch rather indirectly, really expecting the gorge to rise, but it doesn’t. So far, so good. A block is placed between the woman’s shoulder blades – not under the neck like we see on TV. I understand why moments later.
We’re standing in a spot when I can see all four bodies when the tech makes the Y-incision on the woman. This is quick, brutal and astounding. The pristine whiteness is replaced by glorious Technicolor. Things start happening very fast. We move to the next body, the probable heart attack, and start the external exam. Then on to the suicide. I know I’m not supposed to be personalizing, but I can’t help it. I feel horrible for these people. I am angry at the man who decided life wasn’t worth it. I feel sorry for the heart attack. I worry that I will look similar to the woman if I’m ever in her place. I am over-personalizing. I stare into a chest cavity, focus on the ribcage, and knock it off.
That's when I realize I will be attending all four autopsies, because they are done simultaneously. Oh.
We work in circles, moving from station to station. There are unexplained noises, and odd smells. Mostly alcohol, wafting from the bodies. There is a pattern to our concentrics. This is a team effort, a coordinated, choreographed dance. When the breastplate is off, the M.E. looks at the heart in situ, then the organs start to come out. The bone saw didn’t bother me at all, I’ve got contractors in the house laying a floor upstairs and it sounds no different. It is easier when I don’t have to look at their faces. When the skull is off, the tech yells what I think is “Head” and we go back to look at the brain before it too is removed.
Autopsy is a surprisingly physical job. It takes more than one person to move the bodies around on the table. It takes strength to get through bone.
We move on to dissection. Each organ must be looked over thoroughly for signs that the death isn’t what they think. I see things I’ve only read about—cholesterol, plaque, nodules, cysts—and make plans to lead a healthier life. Microsurgery suddenly makes sense. I’m going to stop with the description here and save a bunch of it for my books, but suffice it to say, it’s fascinating.
And bloody. Biggest misconception I had about autopsies—I always envisioned them bloodless, sterile, clean. Yeah. Not. The tech wasn’t kidding when she said I’d get blood on my notebook. It actually sat quietly on the counter awaiting my return—I really didn’t need it to take notes. Sometimes, visuals do all the talking for you. This would have been a bit different if any of the bodies had lost blood at the scene, of course, but these were all intact.
The boy was last, and that was as hard as you could imagine.
We wrapped at 11:30. We’d been at it for three hours straight. One of the techs asked me if I’d had fun. I told her fun wasn’t exactly the appropriate word, though it was a fascinating, enlightening and educational morning.
Remember the humor? There were some really funny moments, both during and after. A nicked aorta that had people rushing around for ladles. The M.E. getting the band wrong on one of the songs – it was David Essex’s ROCK ON, not New Kids on the Block. Listening to AC/DC while watching a liver dissection. Realizing when we finished that I was starving, and assuaging my hunger with Milk Duds. Going to Waffle House after and needing my bacon very, very well done. Freaking out a friend when I overshared about how to differentiate tissue samples from the lobes of the lungs. The rest goes in the books. Hey, a girl’s got to have a plan, right?
I’m so glad I finally broke down and did this. Sam will be a much, much richer character from here on out. And I was so proud of myself for actually making it through without problems. I'm still haunted by visions; I doubt they'll ever leave me. But I did it.
I will end with this. My own spiritual path has evolved from the dogma I learned as a child. I find beauty in all religions, can see that what I was taught isn’t the only path to God. But what of the soul? We are all the same inside. Organs designed to function in very specific ways, our body structure and development meant to be exact, past the point of similarity. So there is something that makes us all unique, special, different. Ourselves. Id. Ego. Superego. Soul. Spirit. Essence.
I felt God in the room, whoever he or she may be. I dare anyone to look into the human body and not believe that there is some kind of grand plan. The design, the way we fit together, is stunningly beautiful. Couple that with the knowledge of our differences, and trust me, I’ve been struggling with some weighty philosophical discourse ever since.
So tell me, have you faced your worst fears lately? Is there someplace you’d like to go that you don’t think you could manage? Any research you’ve skipped over?