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.