Day 17

2.23.10

Case 1

FW 53
Hx renal failure, chronic nephritis
Pacemaker
Called 911 with CC stomach pain, walked into ambulance, died on way to ED
Extremely granular kidneys
COD renal failure

Case 2

MB 25-30
Homicide GSW to head
Entrance on R cheek, no exit
Bullet graze on nose
No suspects
COD GSW to head

Case 3

MW 77
Suicide GSW to chest
Hx coronary bypass, hip surgery, multiple cardiac issues, pulmonary fibrosis

Case 4

MW 54
Hit by tree
COD massive blunt force trauma to head

Case 5

MW 45
Fall
Decedent had not been heard from in several days, friend checked on him when he did not show for work. Decedent was found lying w/ legs on sofa bed, upper body on floor. Blood all over, head lac.
Decedent apparently fell down stairs, got up, washed face in kitchen, and lay down on bed. Should not technically have been able to, due to extent of hemorrhage in brain.
COD massive basilar bleed

At one point, a case came in with the scene report giving an emphatic statement by the mother that her 19 YO daughter had recently had “the Smilin’ Mighty Jesus.” She was very sure that this was exactly what it was…”Oh no, she was real sick with that Smilin’ Mighty Jesus, officer.”

Opened her up, turned out she had spinal meningitis.

Day 16

2.22.10

Case 1

MW 22
Poss. OD
Hx. Etoh, marijuana

Case 2

S/O
MW 56
Fall, app. Nat.
Hx. Etoh
Family objects

Case 3

S/O
MW 58
App. Nat.
VA pt.

Case 4

FB 29
Homicide GSW to head

Case 5

MW 67
Fall from roof
Hx. CA/HTN
Family strongly objects
Laceration on crown of skull

Case 6

MW 86
Suicide GSW to chest

Case 7

MW 41
Poss. OD
Hx. Recent depression, per girlfriend
Needle tracks on R arm, axilla
Drug paraphernalia found at scene

Case 8

MW 54
S/O
App. nat
Hx cocaine abuse

Case 9

Processed only today
MB 25-30
Homicide GSW to head

Today, I learned that when you are a diabetic cocaine addict (Great combination there, sir! How’s that workin’ out for ya?), you should not dissolve a large amount of coke in tap water, mix it with meth, and inject it into your eyeball with the needle you use to skin-pop your insulin. Turns out this will kill you.

Day 15

2.19.10

Case 1

MB 42
GSW suicide (head)

Case 2.

FW 38
GSW homicide (chest)

Husband locked bedroom door (after children (9 and 3 YO) were in bed. Wife was asleep next to him in bed, found on floor next to bed. Husband shot her twice in chest w/ .45 Glock. Husband then called 911 for EMS, immediately afterward shot self under jaw w/ same weapon. Found in bed, holding gun and Bible. EMS/police were greeted at scene by 9 YO running out onto porch crying about “the bangs.”
Sealed envelopes, addressed to different family members, found throughout house.

Case 3

FW 58
Natural vs. OD
Deceased had friend over for dinner. Friends left for “20 minutes” or “one hour” (depending on story) to go to the store. Decedent set the table for them when they got back, seemed unwell, short-of-breath, later collapsed.
Hx obesity, prior strokes, MI, walker, was on oxygen, heavy smoker, diabetes, HTN, COPD.
310 lb.
Syringe/spoon W/ heroin residue found in house.
Decedent’s boyfriend is a heroin addict, said she was “high,” but son said that decedent had never used, would do anything to help BF get clean.
COD poss. nat/cardiac

Case 4

MW 73
Poss. nat.
No medical hx, refused to see doctors.
COD advanced pharyngeal cancer

Case 5

WM 59
Fall
Hx. HBP, recent surgeries, nausea, back pain.
300 lb.
Decedent fell from roof while clearing ice.
Found unresponsive, wedged between bed and heater.
Lg. 10 in x 2.5 ft burn from R shoulder to L hip.

The murder/suicide was terribly sad, but I fear we handled it with our usual sort of gallows humor. Saw my first breast implants today, floppy bags of saline, clean and shiny, in smooth little pockets of fascia over the ribs. I would not initially have suspected their presence, except for the little semi-circular scar in the top part of the navel. The areolas were grossly stretched for the size of the breasts, despite the otherwise apparently skillful work that had been done.

Day 14

2/18/10

Case 1

60 YO WM
Nat. vs. accidental
Homeless
Reported Hx of ethanol abuse
Hx unspecified heart valve problem (untreated)
Recent “brain infection”
Found in basement of vacant building.
Poss. hypothermia
Cod unknown, probable natural

Case 2

Out of county
23 YO WM
MVA
Deceased worked on a garbage truck crew, reportedly felt ill all morning, had vomited.
Deceased left truck, apparently fainted out of sight, driver pulled forward, heard “crushing sound” under L front tire.
Deceased was still breathing when EMS arrived at scene, but died very shortly afterwards.
Ecchymosis on upper chest
Lungs were bloody, crushed.
COD massive crush injuries to the head.

Case 3

OOC
56 YO WM
Poss. OD
Hospital pt (BIBA)
Hx cocaine/marijuana use, multiple myocardial infarctions
Found unresponsive on bathroom floor during party at own house.
Was witnessed flushing lg. amt of cocaine down toilet.
Lg. amt emesis all over bathroom
Died at ED
COD MI

Case 4

Processed: murder/suicide

There were almost no signs of injury of the body of garbage-truck guy. His right earlobe had been slightly torn from the head, and there was very faint bruising on the upper chest. Blood ran from his ears and nose, but washed easily away, though from the ears, the flow renewed when the clotted blood was cleaned from them. Apparently, he had still been breathing when EMS arrived on the scene, and when we opened his up, this seemed inconceivable. The lungs were pulp, crushed and dripping and red.

The head bore no signs at all of injury, though fx were palpable under the scalp. When Greg cut, shattered pieces of bone fell from the brain, which was, remarkably, in one piece. We did not need a saw to remove the skullcap, which had been crushed into multiple pieces for us, easily sliding from beneath the scalp or popped off over the brain.

Day 13

2/17/10

Case 1

38 YO WM
Poss. suicide
Looked much older
Hx depression, schizophrenia
Reported to live in an apartment complex for the mentally ill/those just out of acute care facilities. Little surveillance.
Neighbors reported that deceased seemed depressed, had not been seen for a few days.
Found in bathtub full of water, w/ approx 1 in. over face.
Smashed glass by sink, blood pool nearby.
Deceased has an open sharp-force trauma on R knee.
COD drowning (?)

Case 2

29 YO WM
Hx of epilepsy
Found unresponsive on floor of apt near bed, friend called 911.
Deceased had not been seen for several days.
No signs of drugs or foul play.
Body in early decomp
5.5x3 in. area of skin slippage on inner R wrist, discoloration on lower abd.
Lips bitten, pale; peeled skin from inner lips stuck to teeth.
Eyes pale, clouded.
COD epilepsy (?)

Case 3

Sign Out
56 YO WM
Poss. nat
Insulin dept diabetes
Had not been seen recently, friends called for welfare check
Hep C +

Case 4

Sign Out (?)
68 YO WM
Poss. nat
Collapsed at home in front of daughter, who called 911
Found in asystole by EMS
Very recent multiple surgeries
PCP “does not sign death certificates, will not sign this one”.

The water in the tub on case 1 was pinky with blood, apparently from the incised wound on his knee, said the report. Everything glass or ceramic in the apartment had been smashed, but there was no sign of any intruder. The body was lying in the tub with the head toward the spigot, shoved against the tub’s margin and about an inch under water, the back arched, shoving the torso up and out of the water, and the legs curled back underneath the body. The spigot leaked slowly into the tub. There was a pool of blood on the floor in front of the tub, with streaks of clotted, dripped blood leading down to it from the rim, where the man had apparently sat down for a while.

Bizarrely, underneath the body in the tub, lay the shattered and sharp-edged remains of a large number of coffee mugs. During the external, there were no visible wounds from these on the body.

Everything in the apartment was in tens. There were ten $10 bills in the wallet (on the counter). There were ten containers of cleaning solution in the closet. Ten rows of ten items each in the fridge. The clothes in the closet were separated into ten groups of ten with collections of ten hangers in between each. Previously in the cupboards (now on the floor), the remains of ten plates, ten glasses, ten bowls. Ten forks, ten knives, ten spoons in the silverware drawer. Ten coffee mugs, shivered into soggy pieces, at the bottom of the tub.

Day 12

February 11th, 2010

Case 1
Black M, approx 55 YO
Homicide GSW
Deceased was shoveling sidewalk in front of house when he collapsed. EMTs thought at first that it was a cardiac event, found wound over L nipple.
ED doctor diagnosed as “puncture wound”, opined that it was not very deep.
Morgue staff immediately recognized as GSW upon receipt of body.
Organ donor; eyes, skin, long bones, and short bones taken.
Multiple lacerations of organs, lg amt blood in R and L chest.
Bullet recovered.
COD homicide GSW to the chest

Case 2
Caucasian M, approx 18 YO
Homicide GSW to the head
Deceased suspected to be a “drug mule”, had just returned from a trip “down south”, per mother.
Man attempted to enter house through back door, shot decedent in head, may have been shot by decedent.
Deceased spent 3 days in hospital.
Organ donor
Projectile recovered from skull
COD massive avulsed injuries to brain, skull.

Case 3
Caucasian F, approx 80 YO
Suicide
Deceased found in bathtub, believed to have cancer.
Cut on L wrist, two GSWs to head, poss. OD
COD multiple (suicide)

Case 4
Caucasian M, approx 10 YO
Suspicious fire
Deceased recently informed an adult friend that father was physically abusing him.
Father was witnessed leaving the house 10-15 min before fire
When mother woke up to smoke, she attempted to wake the decedent, but could not. There was no fire in the room at that time.
Body was recovered by firefighters some time later.
Massive fire damage to body.
Soot found in airways.
COD smoke inhalation, burns

When Greg flipped open the body bag (black, unfamiliar—this was an out-of-county case), little black flakes and chunks of something, clothes, skin, flesh, hair, unrecognizable, gently pattered onto the wet floor. This was both my first child case and my first fire victim, and I had somehow expected to be more horrified. I had seen photos of fire vics before, I knew pretty much what to expect, and it was bad. It was bad, but I was, again, as in every other time I had been worried, I found myself impassive. We joked with the Fire Marshall who had come to view the autopsy, laughed and sang as we waited for Dr. O., gloved and gowned and masked over the little, skinny body.

There were fragments of carbon, unidentifiable, blackened debris, a wet sludge of ash surrounding the body in the bag, and Greg lifted the whole body one armed as Matt dragged the dirty bag from underneath it and folded it to contain the sludge and ashes, lifted it one-armed, and he could because it was a skinny little boy, because burn victims bake into one very set position and don’t flop about like traumas or naturals. The Marshall held open a Mylar bag for the remains of the clothes, and they had to be peeled from the body, sometimes indistinguishable from the black and flaking skin. All that was left was the collar and a little bit of shoulder from a T-shirt of unidentifiable color, black and soggy, and a little of the back and waistband, adhered to the body, of a pair of SpongeBob Squarepants pajama pants.

The skin was partially spared on areas that had at some time been covered by clothing, brown and spotted with flaky, burnt flecks of flesh instead of black and crunchy and charred. Where the body was not black or brown, it had split from the heat, the skin bursting open to reveal yellow, cooked seams of fat. Lifted, it was light and stiff, cooked into pugilistic position. The tongue was pressed against the teeth, protruding slightly, and where it did, it was yellowed and blistered and speckled with charcoal. The teeth themselves were similar, burned unevenly, yellowly spotted and whitely mottled, the lips pulled tightly back around their margins. There was no hair left, the head and face had been subjected to too fierce a fire for anything but black, crusty, thin skin to be left, but the face and ears, though the same color and texture as the scalp, was surprisingly intact, though the eyes had sunken when their boiling vitreous steamed away. They were tightly closed, and I had to use tweezers to move the cooked-hard lids so that Greg could try to get some vitreous. The eyes were still round, but there was no way to discern their color. The pupils were opaque white, the iris nearly the same shade, and the surface of the eyeball thinned and stiffened. The white eyes in that black-burned face were shocking and hideous, ugly because they were unexpected, flecked with charred flesh that fell from the lids and tweezers.

The child’s arms were almost devoid of skin, bumpy, burned, yellowish fat and stringy, dried, red muscle taking its place. The flesh of the hands, particularly the fingers, which were clenched before the sternum, almost touching, had apparently melted away, hanging from the undersides of the stiff fingers in hard, black curves. The bones of the fingers were black, the nails sloughing with the degloved skin at the finger’s tips. When cut, the skin was hard and leathery, stiff, hard to keep back from the incision. The muscle beneath looked like nothing so much as rare-cooked meat. The organs were mainly unharmed, but awfully small. The tongue and trachea were badly burned, covered in soot. At least the child had not been murdered before the fire started. He had probably died of smoke inhalation, would have had no idea that his body was burning. There was no trauma to be found at all. There was also no smell when the body was opened—it was overpowered by the scent of the burned body itself, and, god help us, it smelled, just as burn victims always do, exactly like hot dogs.

Day 11

February 10th, 2010

Case 1
Caucasian M, approx 75 YO
Suicide GSW to the head
Deceased shot self intraorally, during the night. Wife slept downstairs that evening, reported hearing no sounds.
COD suicide GSW

Case 2
Black M, approx 17 YO
Homicide GSW to the head
Deceased had close-range entrance wound in R cheek, no exit
Multiple skull fractures
Bullet recovered in L parietal lobe of brain
COD homicide GSW

Case 3
Caucasian F, approx 45 YO
Unknown
Hx depression, bipolar disorder, paranoia
Found on couch by teenage children, thought to be asleep, but children called 911 when mother was unresponsive.
COD unknown. Samples sent to Tox.

Case 4
Black M, approx 25 YO
Adrenal insufficiency (?)
Brother died several years before of same.
Massive amts blood in pericardium, R and L chest
Could not grossly identify adrenals
COD unknown, samples sent to tox.

The H GSW was shot through the right cheek, at very close range (muzzle impression/powder blackening around wound). It was a small projectile though, or his head would have been unrecognizable as that crucial appendage. As it was, the face and skull were swollen and shiny, unblemished except for the purplish entrance wound from the bullet. He hadn’t been alive long enough for much ecchymosis to surface, though the head and face had suffered multiple fx in the impact, easy enough to feel through the hard, cold, swollen skin. The enlarged head with its thick, fluffy mat of hair seemed unnatural, unstable, on the skinny, little-boy body it belonged to.

The right eye had not withstood the impact. It had not avulsed, but rather, had apparently popped, leaving a black, glutinous-looking, bulging and shiny line of discharge under the stuck lashes of the eye. When the lid was pulled back for withdrawal of vitreous, the globby-looking but surprisingly hard lump of bloody vitreous had to be pulled up with the upper eyelid that it had stuck to, and underneath the lump, where it attached redly to the white of the eyeball, the iris was semi-intact, cloudy and streaked. It was a fish-eye, burst, the white dyed red with broken vessels, the same as the intact left eyeball. It was a fishy, cloudy, passive, dead eye, and as Charity ran the hose over the face and neck, the black discharge glued it shut and ran in snotty lines down the cheekbone and into the ear.

An open casket funeral was definitely not an option.

Day 10

February 8th, 2010
Case 1
Caucasian M, approx 45 YO
Ingested Drano
COD poisoning (suicide)

Case 2
Caucasian M, approx 55 YO
Fall
Hx ethanol abuse, intravenous drug use
COD blunt force trauma to skull

Case 3
Caucasian M, approx 40 YO
MV vs. Pedestrian
COD blunt force trauma

Case 4
Caucasian M, approx 55 YO
Poss. OD
COD TBD

Case 5
Caucasian M, approx 75 YO
Slip/fall
COD blunt force trauma

Black M, approx 20 YO
Homicide GSW
Deceased had 3 bullet wounds to upper/lower torso
Long vert. scar on lower abd, recent
Hx indicated that the deceased had been shot previously to this incident.
First bullet passed through heart, both lungs; second punctured bowel; multiple other injuries to internal organs.
One bullet recovered from T4 vertebra, found to be from prior shooting.
COD homicide GSW

Hispanic M, approx 35 YO
Homicide GSW
Deceased had multiple bullet wounds
Deceased was lured to abandoned apartment building by a woman, who planned to have her boyfriend rob him. The decedent resisted, was shot twice by the boyfriend.
First bullet passed through heart, L lung, transected spinal cord.
COD homicide GSW w/ massive hemorrhage

Drano guy sparked an unusual conversation. At some point, somewhere in this country, a man found that he was very constipated. The man was later admitted to the ED and soon died. He had given himself a Drano enema. This is not a medically recommended method of staying alive or of having an intact GI tract that doesn’t look like charcoal.

Thus:

Rectal FBs (Or, Someone, Somewhere, Put This in Their Butt.)

Pickle jar
Trailer hitch
38 ping pong balls
6 tennis balls
Glass Coke bottle
12 Barbie Doll heads
Paper towel tube/hamster (now dead)
Ruler
Handgun
23 Sharpie markers
48 various needles and pins
Ceramic teacup
Terra-cotta pipe
PVC pipe
Axe handle
4 lightbulbs
Bundle of twigs
Dull knife
Inflated balloon
3 pool balls
12 rose stems
Onion
Curling iron
Air pump
Nailgun
Shampoo bottle
Bundle of fabric (previously set on fire)
Parsnip
Plantain (w/ condom)
Cow horn
Snuffbox
Ice pick
14 toothbrushes
Salami
One dozen eggs
402 pebbles
Magazine
Jeweler’s saw
Perfume bottle
Backscratcher
Flashlight
2 beer bottles
Tire iron
Car gearshift (still attached to car)
15 razor blades
Cement enema (hardened)

Day 9

February 5th, 2010
Case 1
Caucasian M, approx 55 YO
MVA
Deceased was rear-ended by an unknown driver, got out of car to check damage, was then hit by unknown driver and dragged approx 350 yds.
Two tubes in mouth, one in trachea, one in esophagus, bent upwards onto itself.
Multiple abrasive lacerations, both ears gone due to skidding.
Multiple fractures of ribs, fractured L humerus.
Hinge fracture of base of skull.
COD blunt force trauma/devastating head trauma

Case 2
Caucasian M, approx 80 YO
Medical misadventure
Deceased was undergoing a medical procedure when an artery was nicked.
Damage to artery could not be found, it is assumed that the nick healed in the interval.
COD exsanguination

Case 3
Caucasian M, approx 50 YO
Probable OD
Vietnam vet
Hx of PTSD, depression, ethanol abuse, prescription drug abuse, cocaine use, marijuana use, heroin use.
Hepatitis C +
Deceased was found surrounded by pills, etc, some pills were crushed in hair.
Deceased had vomited.
COD OD (pr. unintentional)

Case 4
Caucasian M, approx 80 YO
MVA
Deceased was driver in collision w/ tree, was found conscious and responsive, report of injury to abd. organs, brace on healing fracture of R shin, sutured cut from repair to hip fracture, abd was open, taped over, packed w/ 3 blk sponges, 5 wht, foley catheter, copious other signs of therapy.
Deceased was hospitalized for 3 weeks.
When opened up, found to have massive peritonitis w/ necrotic tissue on duodenum, peritoneum, etc.
COD massive septic shock

Greg 2 untaped the abdominal opening and immediately, milky brownish fluid dribbled in a thin stream from the lowermost point. He took out the soaked sponges, the white ones now brown and spotted, and the flow increased, though the peritoneum was firmly sutured shut. We could see dark, loose splotches on the pinkish surface, necrotic tissue, and it did not bode well for the condition of the man’s internal organs.

When the Y was made and the stitches cut, the abdominal incision immediately overflowed hideously with the brownish exudate, at least 1000 milliliters of it in all, and the organs were pale and peeling wetly, mottled and slimy with necrosis, all grown together. The autopsy was hideously difficult, the organs foul and connected indescribably, and more and more brown fluid kept welling from somewhere, fecal and rotten and swirling, the table and body and sink and us all beslobbered and befouled with it. The body’s scrotum was grossly swollen with the liquid, the penis almost inverted on itself, hidden in that swollen balloon of thin, goose-pimpled skin.

The gall bladder was the worst part, somehow, for when Dr. Gr. nicked it with his scalpel, the bile did not flow out easily and slightly glutinously as usual, it was not that dark yellowy green that dilutes into brilliant yellow with water—it welled up in the incision, sure enough, but it was the blackest thing I had ever seen, grainy and sludgy, a heavy, necrotic, asphalt, and it would not wash away, so concentrated it was.

Day 7

February 4, 2010
Case 1
Caucasian F, approx 30 YO
Deceased was in prison, hanged self with sheet.
Deceased was intubated, had EKG pads on both thighs, defib pads on chest.
COD suicide (asphyxia)

Case 2
Caucasian F, approx 20-25 YO
Suspected OD (suicide?)
Deceased was in good physical condition, except for general hygiene.
Teeth were in very poor condition.
Deceased had admitted past abuse of cocaine and marijuana, started smoking at age 10.
Medical history of spinal bifida.
Had witnessed cardiac event in front of mother, who called 911. Medics intubated, placed EKG pads and defib pads.
COD pending, samples sent to tox.

Case 1 was a prisoner. Two people who were apparently members of the staff where she was incarcerated attended the autopsy. On top of that, we had a class of EMTs in training coming through. It was a crowded room in which we conducted the exams, both at the same time, as was customary. The class was observing the OD case. The two prison people were supposed to be observing their own case.

One was a woman, maybe in her thirties or very early forties. The other was a very short, bald, and rather pudgy black man, who I took to be the prison’s doctor. I don’t think anyone really knew why the woman was with him, but he sat throughout the entirety of the autopsy or leaned on the metal shelf near the door, not really going anywhere near either body or even observing. He just looked bored. The woman, by contrast, was very interested in both autopsies. In fact, obtrusively so. She got off to a good start with me by treating me like I was important and knew things, asked me what the COD was on the younger woman, but soon saw that I was drawing the girl, and without a word from me, launched into a monologue about how she was a designer or something and how she had tried illustration in college and one of the options was to go to the morgue and draw dead people and isn’t that terribly exciting look how similar we are! And then she told me my “line was nice”.

I was drawing in ballpoint pen on printer paper clipped to a paper-towel covered clipboard that had chipped corners, spots of blood on the back, and a crusted smear of tissue on the clip. My line was bumpy and irresolute. All I had drawn was the neck and breasts. I stared at her stonily over my mask, which, thank heaven, concealed enough of my face that I didn’t appear rude. Unfortunately, this apparently translated into “interested” to her, and she talked some more, asked me what college I was from. I slowly told her I was in high school, that I was here for 8 weeks, and that yes, I had seen autopsies before today stop asking me if this is my first one, no I didn’t pass out or throw up on my first day and yes, I do know what I’m doing.

She told me she was very very very interested to see the autopsies today, with the earnest expression of someone who is trying to be too dramatic. She thought she was on CSI, I guess, because later, when Greg stitched the prisoner’s scalp back together, she slowly and dramatically, making sure people saw her, pushed the woman’s long, tangled brown hair away from her face and stroked it a couple of times. Greg and I gave each other puzzled, vaguely disgusted looks over our masks.
Before that, though, she behaved in an even odder way, all too interested in the pelvic block. She asked to hold the uterus. Greg let her. She stroked the fallopian tubes in much the same way as she would later stroke the dead woman’s hair and bade me come closer and look. I declined, told her it wasn’t my first uterus and I was trying to get down the neck muscles as Greg delicately sliced them back to reveal the glabrous white rings of the trachea. She asked again if it was my first autopsy and I rolled my eyes behind my clipboard. She held the uterus for a long time, then seemingly, dramatically, just noticed the floppy, pink-lined hunk of muscular tissue hanging from it.

“Is this,” she said to Greg, breathlessly, “the…vagina?”

“Uh, yeah,” he said.

“Oh, wow,” she breathed, “It’s so…smooth.”

She palmed the little, muscular egg of the uterus again, running the fingers of her other hand over the rippled pink skin of the vaginal canal, as though feeling a strand of beads. “Can you tell if she’s ever been pregnant?” She asked Greg, who was trying to concentrate on the neck, holding up the pink muscle.

“Um, no, but the doc might be able to.”

She had actually asked this same question of Greg 2, who was the tech on the other autopsy, as he removed the pelvic block there, but I had initially thought nothing of it. She set the uterus down, for the moment, between the inmate’s cold ankles, and I quit my station at the head of the table for a second to examine the aorta. This placed me right next to her, as she washed her gloved hands, though they were not particularly dirty. (She had not double-gloved, as all were supposed to have, and I could just imagine bloody water dribbling up the plastic sleeves of her gown, and maliciously relished the fact that it would be her own fault.)

“Do you want me to turn it over for you?” She asked me, solicitously. It took me a second to figure out that she was referring to the organ she had just set down.

“No, thanks, I’m really focusing on musculature and skeletal structure right now,” I said.

“But it is a muscle, you know. I would have thought you’d know that by now.” Condescending breathy voice.

“I do know that. Thank you. It’s not a visible, essential muscle.”

“Oh, okay then. Whenever you’re ready,” That breathless voice again.
When she decided I probably wasn’t going to be drawing the uterus any time soon, she handed it over the ankles to Dr. O., though he was inspecting the adrenals at that moment.

“Can you tell if she’s ever been pregnant?” She asked him.

When we were done with the autopsy, had stitched the inmate up, and body-bagged her, and placed the giblets in on top, Dr. O. and Matt and I, with the prison doctor, retired to the quiet, clean (relatively) decomp autopsy room just across the hall to inspect the sheet used in the suicide. It was not remarkable, and was consistent with the ligature marks on the body’s neck.

We went back and I stood in the door of the main autopsy room, waiting for the class. Greg was just zipping the inmate’s body bag, and the woman was saying “That was so interesting. Are you sure you couldn’t tell if she had ever been pregnant?”

I caught her again asking the same question of the doctor on the other case.

No. I promise. We couldn’t.

Day 6

February 3, 2010
Case 1
Black M, approx 25 YO
Suicide by carbon monoxide inhalation from car exhaust
Deceased had a history of threatening self-harm “to get his way”. No signs of self-mutilation on body, no trauma.
Gastric contents were thick, tan-white, and oatmeal-like, smelled strongly of beer. Investigator reported that three cans were open in the car.
Deceased reportedly committed suicide over a girl.
Upper body was very pink due to CO inhalation.
COD CO poisoning (suicide)

Case 2
Caucasian F, approx 20-25 YO
Suicide (OD)
Deceased had received medical attention, was intubated.
Peculiar brownish-green bruising over upper eyelids of both eyes (similar to “raccoon eyes” found in victims of basilar skull fractures)
No trauma to body
COD OD (suicide)

I drew the CO suicide, young and strong and lean. His skin was light and his upper body was bright pink from the CO inhalation. When cut, brilliant red blood, movie-red blood, flowed surprisingly copiously from the severed neck vessels, bottom and top, side and side. The muscles were as bright a red as the blood, pinker, even, and the organs were likewise, the lungs dark, resonant crimson splotched with lighter red, the tiny vessels over every organ flushed and fine. The arteries in the brain were beautifully visible, latticed and fanned and lacey-red over the pinky pale crevices and bulges of that great organ.

He committed suicide over a girl. He closed the garage door, climbed in his car and drank three beers to bolster his courage, and turned on the engine. First, he would have developed a headache. He’d feel nauseous and tired, and then his heart would have sped up and he would have been dizzy, confused, maybe he hallucinated. His vision clouded with darkness, he convulsed, couldn’t breathe, and passed out, slumped over between the driver’s and passenger’s seats, and died. He killed himself over a girl.

“You showed her!” Greg 2 told him, as he sawed through the clavicles.

Day 5

Tuesday, February 02, 2010
Case 1
Caucasian F, approx 40 YO
Hx of Lupus
COD poss. aortic embolism.
Deceased was not posted yesterday due to workload.

Case 2
Caucasian M, approx 25-30 YO
MVA
Multiple fractures and soft tissue injuries.
Ring fracture of the base of the skull.
Severe, multiple subdural hematomas
Lacerated spleen.
Gastric was plentiful, but dark and frothy, essentially composed of blood.
COD injuries due to MVA

Case 3

Caucasian M, approx 60 YO
Natural(?)
Deceased was tissue donor, full-thickness skin stripped from both legs, entire back.
COD advanced atherosclerotic cardiovascular disease

Case 4

Caucasian M, approx 40 YO
MVA
Deceased had lg. quantities of blood draining from ears when turned.
Multiple fractures and soft tissue injuries
Severe multiple subdural hematomas
Ring fracture of the base of the skull, completely separated and mobile.
COD injuries due to MVA

Case 5

Asian F, approx 45-50 YO
Suicide GSW to the head
Bullet entered L. parietal, exited slightly behind on R. pariental
Small caliber weapon
R. eye bulging, lacerated
Hyper-hydrated
COD suicide GSW to the head.

Case 6

Black M, approx 25-30 YO
Suicide by CO inhalation
Not autopsied today due to workload.

The first autopsy assisted with today was the younger MVA. He was tall and thin, and perhaps would have been handsome in life, but now, his two front teeth had been punched from their sockets by his impact with the windshield and made a blood-crusted V, a little pointed canal with a rusty line in its center, in toward his throat. His lower lip, I could see, when Dr. O. pulled in down to check the teeth, was badly, deeply bitten on the inside, and a laceration from the canine ran down from the left corner of the mouth. He had fairy-specks of greeny windshield glass scattered over his shoulders and stuck in the blood-matted hair at the back of his head and when we turned him to his side for photos, very dark blood dripped sluggishly from the downward-facing ear and ran over the blue plastic of the autopsy table to the drain at the bottom to dribble into the sink.

He was the youngest autopsy I have yet had. His organs were beautiful, the lungs pink and healthy, though sopped with blood from soft tissue damage, his heart dark browny-red and lined delicately, minimally, along the valves with tiny flattened buttons of fat. The spleen had only minor lacerations, but it is a blood-rich organ, delicate and easily ruptured or split, perhaps the very easiest to bleed out from internally.

The liver was very pretty indeed, as livers go, deep, dull purple-red, and smooth, the head bulging and the tail flat and tapered all around the edges, like the dark, smooth flipper of some aquatic mammal.

I had intended to take drawings from this autopsy, for the body was lean and the muscle and bone structure clear and elongate, the man young and in good health. I was unable to, for as soon as I recalled I had meant to, we had begun. Later, I took plentiful drawings at autopsy of the 40 YO MVA. Though his external structure was less clearly defined, his organs were equally healthy and normal, the lungs even pinker and stronger.

The 60 YO tissue donor had a distinguished walrus moustache. The 40 YO MVA, the one I drew, had a completely detached ring fracture of the basilar skull, the second that day, which, given pressure, would allow the entire skull to be pushed in, pop back out, push in, pop out. The GSW was over-hydrated, the abdominal cavity overflowing with clearish bloody fluid, the copious fat gloppy and gelatinous. Snot-colored gastric still flowed sluggishly from either side of the mouth and the face was swollen and shiny, the tissue surrounding the popped eyeball purple and puffed. The bullet holes, both entrance and exit, were precise and absolutely textbook, beveled and round for the entrance, pulpy and stellate for the exit.

Angie invited me on a call, a suicide by CO poisoning. I would have liked to go, it would have been my first scene, but Matt wanted to see it, and since it was outside and I liked being relatively toasty in the morgue (50 to 60 degrees is better than 21), I told him he should go. He seems a bit more confident and, though still awkward, bright and friendly, now that he knows everyone a bit more. Meanwhile, I’ve been promoted to the status of “the intern who actually knows what she’s doing” from “dweeby, awkward high school student”, and now I get to help on externals officially, take photos, help with the class that stopped in today. Greg and Angie and Charity and even Dr. W. know my name by heart, finally, and call on me to give assistance in things, usually minor, which is nice of them. I really do have a bit of respect now, from Greg at least, since he saw a bit of pre-autopsy sketching I did of that MVA and gushed about it almost embarrassingly.

“That’s damn good,” he said, and he was right—despite the workload today, everything was damn good.

Day 4

Monday, February 01, 2010
Case 1
Caucasian F, approx 40 YO
Hx of Lupus
COD TBD
I was not present at autopsy.

Case 2
Caucasian F, approx 25 YO
Multiple scars and lacerations from apparent self-mutilation on thighs, stomach, arms, wrists, chest, hips.
Finger and toenails very dark in color.
COD probable suicide (OD)

Case 3
Caucasian M, approx 75 YO
Multiple medications
Had witnessed choking episode
COD asphyxia
Poss. signout.

Case 4
Caucasian M, approx 40 YO
Vietnam vet
Pectus excavatum
Very thin
“Deceased woke up, told brother ‘Let’s party.’ Brother declined this offer and deceased returned to room.”
COD undetermined. Gastric sent to Tox.

Case 5
Caucasian M, approx 60 YO
Vietnam vet
Hx of cardiac problems
Chronic back pain
Severe genital warts
Black mold recently (past 3 days) discovered in house of friend where deceased was living. Deceased found on mattress in room “clutching at his throat”.
COD poss. cardiac event.
I was not present at autopsy.

Case 6
Caucasian M, approx 45 YO
Hx of heroin abuse
Deceased shot self in R side of head w/ large-caliber handgun while fleeing police on a domestic violence charge
COD self-inflicted GSW to the head

The second autopsy of the day was the skinny guy, the “let’s party” guy. Charity was the tech, Dr. W. the pathologist. Charity was having trouble with the saw blade for the skull—it kept coming loose. When she finally got the skull open, she popped the brain out triumphantly. “It’s a boy!”
Dr. W. noticed the pituitary, in its bulgy little cradle and cover of fascia, had not been removed. “Charity, I like my pituitary.”
“How do you like it?”
“Sunny-side-up,” I said.

We got a new med student today, to replace Jen, Matt. He was nervous and awkward and uncomfortable, and I felt like I knew something as I showed him where everything was, as I gave him booties and showed him the gloves and gowns and face shields. For all he knew, I had been there a lot longer than three days.
Someone mentioned it, though, and I had to say that I was indeed in high school. I wish I didn’t have to tell people I am, for the moment I do, they say “Oh,” and immediately get a little condescending tilt to the nose, or they nod a little faster and smile a little wider. I got the feeling Matt was uncomfortable with the fact that I was a high school student, but that I knew what I was doing--at least, more than he did.
Dr. W. gave me an air of importance that I didn’t ask for or even necessarily want, had me do the external exam, since I had done them on previous bodies. She told him, over the transected liver, that by the end of the month, she liked to have med students do at least one external, preferably an organ exam (In Jen’s rare case, an autopsy). This, while I was hovering around the body and noting marks on my fourth day, abrasion, puncture, stellate laceration, ecchymosis, contusion. A high school student! he must have been thinking. He was too nervous for questions, but Dr. W. kept asking them, and his discomfort increased palpably as I was able to answer questions about the pancreas that he had not been able to, and I felt terribly sorry for him. He was nice, and anxious, and probably didn’t really care what I was.

He shouldn’t worry. If I can learn in three days, he must be able to. It was thanks to Jen, and to my first body, anyway, she taught me how to do an external on my second day and showed me everything in a normal body, taught me the difference between the left and right lung and told me what a pancreas does.

Greg and Dr. O. were finishing up the gunshot suicide, the wife-beater, across the room. Michael Jackson’s “Beat It” started to play on the radio, and we all sang along.

Day 3

January 29, 2010
Case 1
SIGN OUT
Caucasian M, approx 60 YO
Autistic
Hx of cardiac issues
COD presumed from external inspection of body to be large GI bleed, probably due to impressively large inguinal hernia w/ presumed descended loop of bowel.

Case 2
Caucasian M, approx 45 YO
MVA
Victim was driving through a green light at intersection when hit (driver’s side) by car driven by a suspect fleeing police. Victim taken to ED, died despite care.
COD multiple fractures and bleeds due to collision
I was not directly involved in this autopsy.

Case 3
Caucasian F, approx. 25 YO
MVA
Victim rolled her car down an embankment. Came in from ED after bleeding out internally. Fracture of L humerus, multiple spinal fractures, severe multiple rib fractures, severed massive branch of lower aorta resulting in probable extremely quick death. Victim’s stomach had been cut open by trauma team, was packed w/ at least 8 gauze, 1 towel, taped over on receipt. Lacerations of most organs. Peculiarly severe cirrhosis of the liver, necrosis of part of bowel. Portion of spinal cord removed for inspection.

She was in the paper. Her accident. It’s strange to be on the other side.
Today we sang along with the radio again over the body, noting injuries on our little models, on our little clipboards. “Celebrate good times, come on!”

Day 2

January 28, 2010
Case 1
Self-inflicted GSW to the chest.
Caucasian M, approx 35 YO
Single shot to center chest. Projectile was recovered.
I was not directly involved in this autopsy.

Case 2
Motor vehicle accident
Caucasian M, approx 70 YO
Complete open fractures of both femurs, one shin, one ankle, completely avulsed. Head completely detached from C-Spine, spinal cord, connected to body solely by skin. Broken clavicle, multiple fractured ribs, multiple skull fractures, multiple spinal fractures, severed aorta due to osseous pinch of collision.
Head-on collision w/ semi truck at 55 mph. Poss. Suicide.

The internal organs were almost pulped. The smell this time was worse, for the bowel was punctured. Greg was cutting, Dr. Gr. was in charge, Jen and I were helping out. We talked about our favorite fruits while picking bits of dashboard stereo and cell phone out of the mass of dirty, stringy, red muscle that constituted the legs. The feet were intact, separated from the main body by the avulsed, sagging mass of the lower limbs. The femur protruded spongily, whitely from the thigh, a large portion of marrow ripped from it and resting above.
I feel like I’ve been working here for weeks. Entirely comfortable. Everyone is cheerful and funny and takes everything in stride. Dr. Gr. and I discussed Latin origins of words while feeling the crepitus in the organs and slicing the lacerated, pulpy liver. Jen and Greg talked about concerts they wanted to go to while siphoning blood from the body cavity. The radio was on and Angie and Dr. A. were doing another autopsy across the room, the GSW, at the sink we were at yesterday.
It sounds as though we were being irreverent, but I must assure the reader that we were not. We were professional and thorough in the autopsy. When bending over the broken, pulpy body of a man who drove into a semi truck, you can’t focus on that. You can’t think about the guy on the table in a way that suggests you might end up that way someday. You can’t think of what you’re doing as cutting up a person with a dog or a cat or kids or a spouse. If you do, you leave after the day is over and every person you see, you can suddenly envision lying on that blue nubby table, blank-eyed and gape-mouthed, and you start to think of what you would look like on that table. If you’re lucky, it passes quickly. It’s disconcertingly easy to disassociate the gaping Y-incision and the floppy straps of the neck muscles from the face. The face, the head, the hands and feet, that’s the person. It looks like a person. The body, split and red and yellow, is just a body.
A song began to play from the radio, one everyone knows.
“Since you been gone,” we sang as we started to sluice water over the table and the body, “I can breathe for the first time!”
It seemed a little unfair to our patient.
We mopped the room to the strains of “Brown-Eyed Girl.”

Day 1

Jan. 27th, 2010
First autopsy
Approx. 50 y/o M
COD undetermined, no apparent underlying pathology.
Gastric contents were homogenous, mucus-like and dk. yellow-green. No evidence of pills or any food; sent to tox.
Slight cardiomegaly

I got a little gray electronic key, gets me through any door in the building. I’m authorized personnel. I got scrubs, size small, yellow and cheerfully decorated on top, maroon pants. (I’ll have to get some plain ones, these are ill-fitting and tacky.) I got a desk and a microscope and a surprising amount of free time, freedom, and even respect.
The door is heavy, equipped with a little nook of a scanner for keys. It says MORGUE and AUTHORIZED PERSONNEL ONLY and BIOHAZARD.
We went in for the morning meeting. On the wall above the rusted plate scale was painted, muralled, a long section from the Ancient Egyptian Book of the Dead, and as a circle of doctors gathered in the room, I found among the illustrations, with a thrill, the weighing of the heart against the feather of truth, Nut, Set, Osiris, Anubis, the mummified body of the deceased on the lion-pawed and –headed table, the shaven-headed priests and the jackal-masked chief placing the organs in the canopic jars, and the jars and the mummy on the table in the papyrus-bowed and painted boat to the fields of paradise.
There was a quick circle of the room, doctors going over the bodies that had come in, the bodies in the fridge, and the bodies to be autopsied today and what had brought them there.
When I went back to my desk for my old shoes, the medical student, the other intern, (the real intern) was at her own, next to mine, already scrubbed. We talked. I liked her.
Back to the morgue. Greg, a stocky, powerfully-built sort of man with a shaven head, one of two autopsy techs (the other wasn’t in today but was also named Greg) and a thin woman with long, blondish brown hair I had seen earlier were taking record photos of a naked and very large black woman, obviously dead, lying on the big-wheeled steel gurney.
As I hung in the doorway, they turned her effortfully onto her side, and one held her there while the other took photos of the livor mortis that must adorn her back. They had turned her so that her front was half-facing me, and as I watched, brownish-red purge dribbled in a thin stream from her nostrils and half-open mouth, openly hitting the nubby floor and spattering alarmingly.
I found myself (oddly?) passive in the face of this, and as they turned her back onto her back and flopped the opened half of the white plastic body bag back over her to zip it, I entered the room, rounding the gurney and avoiding the rusty puddle of purge, to where the medical student was hovering around another body, this one on a rimmed blue table perpendicular to and shoved against a long set of sinks adorned with various trays, tools, and a large, stilted cutting board. The faucets had rubber tubing attached and a large scale was hung over the body’s feet, just in front of the sink basin. It was the kind that looks like a big double-sided clock with a metal bowl hung underneath, the kind you use to weigh fruit in the supermarket.
The man on the table was our patient. Jen, the other intern, the real medical student, introduced us. He was about fifty, a bit thin, with graying, pale red or mousy brown hair and beard. His rigor was set, and he was lying on the table in the position in which he had been found on his couch. He was pale and yellow-tinged where his blood hadn’t settled. In movies and shows, in books, people always say dead people look waxy, doll-like, unreal. It isn’t true. Dead people look exactly like living people, despite the blotchy purple spots of livor.
We went back together to the office-room outside the autopsy room, for neither Greg nor Dr. G. (the presiding doctor) was ready yet for the procedure. We waited there for quite some time, read a bit. Greg and Angie, the skinny, long-haired woman I had earlier seen, entered. Angie went off to the autopsy room and rattled around a bit, doing something or other. Greg told us it was time to get suited up and asked if I was excited to see my first autopsy. I told him I was excited to see it but perhaps not to smell it, and he told me that they had huge firefighters faint while witnessing autopsies simply due to the smell, and I could just leave if I felt dizzy. Don’t leave because when you leave and come back, the smell is ten times worse. Don’t lock your knees.
I wasn’t nervous anymore anyway.
We suited up. Small gloves, blue plastic gown, open in the back with thumbholes at the ends of the sleeves, stick your thumbs through those and glove again on top of it, the fine grade sterile gloves with the long, elegant wrists, folded neatly, Left and Right, in their little nest of tissue within the sterile packet. Next, elasticated booties, blue to match the gown but fabric rather than plastic, and last the mask, white side goes in, blue side goes out, bend the metal bit to fit your nose, and the elastic always gets caught on your glasses.
I stood to the side as people turned and prodded our patient, asked questions and noted minor scars and abrasions on the body. My feet wandered a little. I had already gotten used to the morgue’s distinctive smell, antiseptic, sweet, not bad but not great, and no specific derivative that I could name. As Dr. G. and Angie (who ended up doing the cutting because Greg was busy) and Jen wandered about the body, my eyes slid to the huge steel fridge door, which opened and disgorged Greg, with a gurney occupied by another white body bag for simple documentation. I returned my attention to our Patient, and watched as Angie turned him on his side and Dr. G. poked him sharply in the livor mortis spots with a pencil eraser, to check how much it faded with pressure. It only left faint whitish spots in the purple pools, and Angie turned him back to his original position. She lifted the arm nearest me to check it for distinguishing marks (Our Patient had several tattoos), and when she let it go. It flopped limply down, sending waves of motion across the thinnish body, just as it would have done in life.
I looked again at Greg, who was photographing and measuring the body he had just taken out. It was that of a very old woman, probably one who had come from the Medical Center. She had a wrap of gauze and pads around her wispy-haired head that nearly obscured her eyes, and several large band-aids scattered in other spots. She was very white, her pelvis protruded, and because she was on her back, her breasts had fallen or sagged to either side, under her arm-pits, completely obscured, pooling on the cold metal gurney under each arm. The flesh was so thin and the breasts so obscured, however, that the skin across the sternum was pulled against the ridges of bone there, and the body looked as flat-chested as a child, though disturbingly nipple-less.
I once again returned my attention to Our Patient, and observed closely as Jen, having obtained permission from Angie, withdrew vitreous fluid from each eye. Greg, at the margin of my attention, plunged a long fat needle into the lower stomach of the body in his charge and with a single fast pull on the plunger, sucked a splatter of blood into the bottom of the tube. Angie got a long stool from its place leaning against the wall, and, standing on it, lifted the body. Greg took a moment to push his blood sample into a test tube with an orange rubber seal, and then took a section of wood, a four-by-four perhaps two and a half feet long, the greenish brown kind used for fence posts, and placed it under the lower ribcage of Our Patient. With the chest pushed up thus, Angie produced a scalpel, and whipped it swiftly across the body’s chest, from right shoulder to mid chest, from left shoulder to mid chest, the top of the Y-incision. She finished the bloodless Y and pulled up the edges of the top cut, the point, to cut the gristle and connective tissue from under in order to pull it up. Our Patient lay upon his blue plastic table with a jacket and pointed scarf of surprisingly thick skin, striped red with muscle and yellow with the thin, globby layer of subcutaneous fat. It was as though she had cut butter, and not simply because of the quick, easy movements she had used. The fat is truly butter-yellow, or more accurately, margarine-yellow. The sliced skin looks like prosciutto and butter, pinky-red muscle, skin and fascia white, subcutaneous fat yellow,
She began to remove the organs as Jen attempted to draw blood from the femoral artery repeatedly and had a hard time getting it to flow. I was distracted again by Greg, who had put his first body away and brought out another, this one an elderly gent clearly in from the Medical Center, as he had a foley catheter placed and several other signs of recent treatment. His perineum was grossly swollen, bloodless, perhaps the result of a hernia. His hair was thin, but what I noticed most was his eyebrows—white, but missing their tails, so that he looked like a Vulcan.
Eventually, Our Patient was resting quietly on his blue, rimmed table with his organs around his feet and legs and his sternum resting between his thigh and hand. Angie lifted out the last looping curves of bowel, pink and yellow and shiny, butterfly-wing ruffles. I found myself gazing into the cavity where the organs had rested. It was filled with blood at the bottom, but the blood had little golden-yellow bubbles of oil floating in it, like soup broth. (It has to be said that an inordinate number of things having to do with dead bodies require food similes.)
I rounded the head end of the table again, noting with strange amusement that the body had not only its yellowy-red skin cradle from below, but had somehow acquired a splotch of red blood on his nose. Rudolph, the red-nosed reindeer.
As Jen and I weighed bits and pieces, Angie withdrew the urine and then went and retrieved the electric, strangely-shaped saw that she had used to open the chest and set it beside the body’s head. She made a cut like a halo around his scalp with the scalpel, then cleared connective tissue from the skull, pulling the scalp back from the bone and forward over the face, and then circled the skullcap with the saw blade. It was not neat, as it somehow appears to be when described in books. It’s like clumsily cutting wood, with a lot of jittery stop and start marks. As she rounded the head, starting to finish, blood began to flow from the cut, bright red, and it sluiced merrily, obscenely, down the curved, thick surface of the scalp and onto the table.
I was unaffected by this. I hardly noticed the smell. I held his heart and spleen and kidneys, soon his brain.
Jen turned to me, handed me the spleen. “I saw the coolest bladder stone with Dr. W. the other day!”
Near the autopsy’s end, I picked up the trachea. It had a lump of tissue attached that I did not recognize, until a second later, with a jolt—it was the tongue.
We use cutting boards at autopsy, the white plastic kind. We use scalpels, and tweezers, and pliers to pry the dura mater from inside the skull, and we use scissors and wide-bore needles and rulers, but we also use long graceful kitchen knives. The liver is the largest organ to make its way to the cutting board, and it is, when cut, porous. The slices are the size and shape of slices cut from a loaf of ciabatta bread, and the bile distends the gallbladder like a little balloon, browny-greeny-yellow and dark, and floods out glutinously when you cut it.
I peered into the open skull when Angie had finished wrenching out the dura mater, and she popped out the pituitary gland to show me, the size of a fingernail but so important, and plopped it into the sample cylinder, and I saw the optic and olfactory nerves and the bulges of the eyes and sinuses. The back half of the scalp sagged down and the short hair was drawn into black, curved spikes with blood from underneath. Throughout the entire thing, I was impassive, merely fascinated. The only part that truly bothered me, and this only for a moment, was the dandruff on the skin of the scalp and around the livored blue-purple lobes of the ears.
We could not determine COD.
Later in the day, Charity, the other investigator (Angie was the first I met) brought in a new body. He became “stinky guy”, for he was an old hoarder who had not bathed in months. Charity showed us the scene pictures and the house was unlivable, filthy, with crates of vodka scattered about. Apparently, since his chair was so comfortable, he had not wanted to get up and simply sat there for days at a time, urinating out onto his front porch and defecating in paper bags. Paper bags! It was unimaginable, and Jen and I were as horrified as Charity must have been.
When Greg opened the flap on the body bag, which had bulged with the occupant’s weight, a palpable wave of stench rolled out. It was not decomp. The man had died not a few hours before. It was the stink of an unwashed body, and it revolted all of us far more than the sweet, meaty, thick smell of autopsy. Jen was more daring than I, for she got close enough to inspect the body as Greg undressed it.
“Oh my god,” she said. “He has mold between his toes, under his toenails.”
I edged closer. The nails were over-long and yellowed, and under them and between the toes, even on the soles of the feet, were spots of black and green mold or mildew, fuzzy. Jen checked the mouth as Greg took pictures. He hadn’t brushed his teeth in weeks. Possibly years. Possibly ever. He had EKG pads on each forearm, puzzlingly, that the paramedics had not placed there.
As luck would have it, Stinky Guy was a sign-out, a body with no suspicion of foul play and known to have had prior conditions. The family had requested no autopsy.