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.