Musings on an Autopsy

Let me go back in time, back to when I was a budding paramedic student, before I even knew there was such a field as bioarchaeology. Let me tell you about one of my early experiences with death, one that altered my concept of the “body” and forever changed how I view life.

I was in my first semester of paramedic school, barely twenty-two years old. I had already completed my emergency medical technician certification – a semester of coursework followed by months of fieldwork – and during that time, I had been exposed to the dead. But as an EMT student, I was relegated to the periphery. Paramedic school thrust me to the forefront of patient care, where I was suddenly forced to make treatment decisions that would correct, stabilize, or kill my patients.

The paramedic curriculum is designed to help students come to grips with this new level of responsibility. The curriculum also forces students to confront death, so that they may develop the emotional callouses necessary for the gory situations they will invariably face in the field.

The highlight of my first semester was a trip to the county morgue, where we would spend the day observing autopsies. In reality, the visit served two purposes: not only were we forced to confront death in all its cold, antiseptic reality, but the autopsies would provide lessons in anatomy and physiology we simply couldn’t get from a textbook or in a lab. This experience would leave a lasting impression on me.

The autopsy room was an assault on my senses. Bright lights glared against steel countertops, the sting of disinfectant pierced my sinuses, and the sight of sheet-draped bodies made my stomach flip in nervous anticipation. I followed the tech to the nearest table. He slowly removed the sheet, folding it upon itself as he worked his way down the body of a young female. Her jaw lay slack, her eyes closed and sunken. Blood and cerebrospinal fluid seeped from her left ear and her fingers lay curled at her sides. Her fingernails were painted a frosty pink. Her toenails matched.

The tech explained the scenario. A waitress at an all-night cafe, the girl had been driving home from work early that morning when the driver's door of her pickup gave way. She wasn’t wearing a seatbelt and was subsequently dumped onto the pavement where she landed on her head, suffering a fatal skull fracture. As I grappled with the reality of her recent demise, the tech reached for the gleaming scalpel and the autopsy began.

He made the typical Y-incision, starting at each collarbone, meeting at the sternum, and then drawing a deep straight line through her abdomen, unzipping her with smooth efficiency. He then pealed back her flesh and proceeded to give me a tour of her anatomy.

It was fascinating. Her glistening organs lay tucked within her belly, her heart and lungs nestled beneath the protective arch of her ribs. What captivated me even more than their organization was their stillness. The heart no longer beat, the lungs didn’t inflate, her bowels had ceased their churning, and her stomach would never again growl.

He systematically removed each organ. Some were weighed, some were sampled by taking thin sections of tissue, which were deposited in small formaldehyde-filled containers where they floated in isolation. He squeezed her stomach contents, representing her last and final meal, into a jar as my own stomach lurched in response. After a few embarrassing dry heaves, I was able to regain my composure and the autopsy continued.

Despite its clinical setting, the procedure was strangely intimate. Her heart fit snugly in the technician’s palm as he gently placed it on the scale. He carefully lifted a pale ovary from her pelvis and, with a delicate finger, pointed to the small, shiny bulge that indicated she had been ovulating at the time of death.

When he made the large incision across the top of her head and folded her scalp down over her face, tucking it neatly beneath her chin, the woman no longer appeared human. Her body, lacking the animation of life, was but a collection of cells, tissues, and organs. She was no longer a person. She was now meat on the slab. 

I thought about her often in the following weeks. I still think about her, decades later. That day in the morgue altered my perspective of life, death, and everything in between. An autopsy tears a person down to their foundation. It reduces the individual to his or her once-working parts and what is left is the stillness and silence of a lifeless machine.

But she and all the other dead I encountered as a medic taught me a valuable lesson. Now, when I peer into an ancient grave or examine the bones of those that lived thousands of years in the past, I force myself beyond their death to what they were in life. I think about their dreams, their fears, and how different those dreams and fears must have been from those we cultivate today. And, although their lives speak of a different time, we share a common thread. We are all descended from those ancient Africans whose bodies, through the slow accumulation of traits, would eventually become us.

We’ll explore that topic next.