The body is supine on the metal table. The eyes are often half-open, mouth slightly open. There is sometimes blood or sweat or vomit on the face and matting the hair. The flesh is mottled and red in places from where the blood has pooled, and it is obvious what position the person was in because of the pattern of the lividity as well as the impressions on her flesh, like the wrinkles from a pillow embedded into our cheek in the minutes after we wake up.

Pictures are taken–first using a stepladder and leaning over the body, moving the ladder down so that there is a series of overlapping images. Any clothing is then removed and the same pictures are taken again. Then close-up pictures of the face-right, front, left. The hands next, back, palm, fingernails. And then any marks or scars or tattoos. Every defect, every identifying feature, every trauma is documented and photographed. The decedent is rolled to the side–first placing a towel over the person’s face to catch any fluid that might spew from the mouth–and then the back is photographed in another series of overlapping images. The decedent is rolled back to supine and then, if needed, washed off.

Samples are taken for toxicology. Vitreous fluid is taken from the eyes: a needle is slid into the side of her eye to draw vitreous fluid (and if you look down at the eyes you can see the tip of the needle through the pupil.) A larger needle is used to poke down into the bladder to draw urine, and another is used in the groin area to draw blood from the femoral artery.

A thick block is placed under the decedent’s shoulder blades, leaving them arched over it, head hanging back but not quite touching the table. The pathologist makes a  Y-incision, filleting the flesh back between the skin and the ribs. The morgue tech then uses long-handled loppers–yes, the kind used to trim branches from trees–and cuts through the ribs, starting at the side and angling up toward the top of the sternum, crunching through each rib. Once  the ribs are cut, the pathologist finishes slicing the ribcage section away and sets it aside.

As the pathologist begins to remove and examine the organs, the morgue tech takes another block of wood and prop the decedent’s head upon it. If the decedent has long hair, it is parted from ear to ear over the top of the head, then the front section is secured with a rubber band and the ponytail is draped over the face to keep it out of the way. A cut is then made through the scalp along the part, from ear to ear, down to the skull. Once the cut is made, the scalp is peeled back, slicing the tissue that holds the scalp to the skull, and eventually folding the top of the scalp all the way down and over the face. Then the bottom section, peeling it back the same way, and folding it down, exposing the entire top of the skull.

The bone saw is next, and the top of the skull is cut, like a cap. (A filter mask and a plastic face shield is used during this portion, because the saw kicks up a lot of bone dust and blood spatter.) After the cut is made all the way around, the morgue tech takes the t-shaped tool, called a skull-breaker, and wedges it into the cut made by the saw. A few hard twists and the top of the skull comes loose with a loud crack, and the top of the skull is pulled off, peeling it off of the top of the brain. The skull cap is set aside, and the morgue tech begins to cut the brain out, slicing away the nerves and connecting tissue, and sticking the scalpel down by the brain stem and cutting the brain away from the body. After removal it is set aside for the pathologist to weigh and measure along with the other organs.

During this time the pathologist is examining and removing the internal organs, checking for disease or damage. If there’s trauma, that’s examined and catalogued as well.

Once the pathologist is finished, it’s time to clean the body up. The section of ribcage is replaced and the morgue tech takes a long piece of thick white string and begins to sew the y-incision back up, long inexact stitches that are just enough to keep everything together until the funeral home can do their work. (The funeral home will take all of the stitches out, and they prefer to have as few holes as possible in the body, which is why big stitches are used.) Then the skull cap is replaced, the scalp is pulled back down and over the top of the head, and the edges sewn together. The body is put back into the body bag, and the organs that have been removed go into a plastic bag that rests between the legs. Then back into the cooler until the funeral home comes to pick the body up.

–Diana Rowland

7 Responses to “The cutting room”

  1. 1 kmont
    February 21, 2009 at 4:26 pm

    I couldn’t read some of it (peeking-through-hands technique)but what I did read tells me this is a great research piece. I’m in awe that you did this kind of stuff for a living – or do you still?

    Very interesting post!

  2. February 21, 2009 at 6:20 pm

    I’m writing full time now, so I don’t do it anymore–though I still have permission to attend autopsies! And, I frequently text message the pathologist with strange questions: Hey doc-what would decomp of body look like after being in water for a few months if wrapped in plastic? He knows me well enough now that he doesn’t even bat an eyelash, and either gives me an answer or finds out the answer for me.

  3. 3 Matt
    February 21, 2009 at 6:55 pm

    As a lover of crime-dramas, this was awesome to read! It’s interesting to me, the tone that you take on when you write about the autopsy here – it’s detached, mechanical, precise, and very detailed. Is this the general mindset that you approach autopsies from? Was it different the first time you were present for an autopsy?

  4. February 22, 2009 at 1:00 am

    Matt, the first time I attended an autopsy I was a very new detective, and knew that I did not DARE show any weakness or squick-out at all! The detective I was with munched on M&Ms the entire time, and the morgue tech took great delight in showing me how the needle could be seen in the eye during the drawing of the vitreous. But I found it to be really fascinating, and when I had to chance to do full-time forensic photography/morgue tech, I jumped at the chance.

    As far as the mindset, yes, you have to be very detached. If you think about them as real people, it gets to you. There’s also a great deal of very sick humor that goes on during autopsies–classic defense mechanism at work. (Except with kids or babies. Those were always difficult and wrenching, because it was damned impossible to detach, and there was never any joking.)

  5. 5 Lindsay
    February 22, 2009 at 1:16 am

    This was absolutely fascinating! So many shows/novels/etc. hint at these procedures, but only enough to keep us amateurs guessing. Now, next time I catch an episode of Six Feet Under, you know I’ll be thinking about this entry….

  6. 6 nojojojo
    February 22, 2009 at 4:09 pm

    I’m actually interested in seeing an autopsy myself, but not sure how to get to see one. I’m concerned I might be seen as some kind of weirdo who’s disrespectful of the deceased, but that’s not it at all; I’m just fascinated by the human body. (Yeah, went to see the BODIES exhibit when it was in NYC.) So this has been really helpful, thanks!

  7. February 22, 2009 at 4:16 pm

    If you’re a writer–especially if you have any writing credits to back you up–you can at least start out with an interview with a pathologist. From there you can gently inquire about the policies for viewing autopsies. (Every agency has its own policies, so you kinda have to play it by ear.)

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