So… as I’ve mentioned before, I am in the process of learning how to “cut”. Which is to say, I’m learning how to function as an autopsy technician… or pathology assistant- the job title varies depending on who you ask. It’s always tricky to learn something new as an adult. I think we kind of get mired in a set habit of knowing and performing our daily tasks and then when we try something else… we don’t want to do it because we don’t already know how to do it… which totally defeats the purpose of doing something new and doesn’t make any sense… but there it is. We don’t want to learn to do anything we don’t already know how to do.
Maybe it’s the fear of looking or feeling stupid… or it’s the fear of failure… in my case, it’s the fear of accidentally sawing off my own hand… or stabbing somebody with an AIDS infected scalpel. Learning to “cut” is scary.
But I’m trying it… I’m doing it… I’m learning it… and I’m fortunate enough to have Barb as my teacher. Barb is one of the two pathology assistants at the state office. She’s a dainty little Asian lady who’s always happy and super helpful. Whenever I’m at the state office with a body, Barb always wants to stop and chat for a few minutes… ask how things are going… and for some reason, Barb always feels compelled to tell me how skinny I am, which I think is a compliment… Anyway, Barb rocks… and she’s been super extra wonderful as a teacher as I go about the messy business of learning how to properly field dress a human being
Barb is always telling me to cut with longer strokes and more conviction. “Be more confident!” she chirps at me as she grabs a hold of a wad of intestine and forcibly rips it free of its mesenteric mooring… Barb has been doing this for years, and the state office usually boasts about 4 autopsies a day… all of this to say that Barb is an expert in her field and acutely and terrifyingly aware of exactly what kind of force and how much effort it takes to remove any limb or organ from a human corpse. As a result, bodies just seem to fall off the bone under her touch… like tender beef sliding off the bone in a crock-pot… a few small, decisive cuts and she’s successfully extricated a liver, a heart, two kidneys, all five lobes of the lungs, a pancreas and a spleen… all in one lump of viscera that we in the industry refer to as “the organ block”. Dead bodies just disintegrate in front of Barb… she’s astonishing. And she smiles the whole time
My technique isn’t quite as fluid. I still wade through the whole process, tentatively pulling and making tiny, repetitive jabs with the scalpel as though I’m an Australian cattle-dog trying to herd the organs out of the body like livestock through a gate. It takes time… I’m not good with dead bodies… at least not as good as Barb. I thought I was super hard-core until I started hanging with Barb. It’s easy to do… when the police all marvel at your nerve as you dive right into a decomposed corpse… or when you stomp up to a traumatized fire crew and announce your presence by barking, “Okay ladies, who can tell me who’s in charge of this shit show?” It’s easy to think of yourself as being super hard core…. mega-gangsta… but the fact is I could try for all my life and never be as Gangsta as Barb. She’s O.G.
Never has this fact been more obvious to me than during my last autopsy. I had scheduled the time to come in when I knew Barb was going to be there, along with one of my favorite forensic pathologists, Dr. Olds. Dr. Olds is actually quite young… the youngest of the doctors at the state. To say he’s quirky is putting it mildly. The first time I met Dr. Olds he had dressed up like Tiny Tim for the office Christmas party… he was wearing argyle socks and knickers… yes… knickers. He’s currently sporting a marvelous handle-bar moustache and is known to wander around the morgue in his bright orange crocks and favorite t-shirt which proudly proclaims “I think I’m a lesbian” on the front.
As it had been a while since my last autopsy lesson, I was relatively solid with the first two gestures of the y-incision… However, as I was dragging the scalpel down the center of the sternum toward the abdomen, I found myself wobbling off the axis. What was supposed to come next? I couldn’t remember. The pointers Barb had given me before were a bit hazy. How deep was I supposed to go? How far? What was the best technique for getting through the fascia? Did I cut through the diaphragm first or deflect the soft tissue of the thorax?
My nerves weren’t helped by the fact that this dead person was, quite frankly, a bit of a surgical anomaly. She’d had a few abdominal surgeries and was ….a little on the large side . I was worried about how difficult it would be to find my anatomical markers in the midst of these factors. Dr. Olds noted my hesitation and charged right in with his own scalpel as if he was leading an expedition into a lost continent.
“Just go long!” he bellowed at me encouragingly as he swept his scalpel down the length of the abdomen… all the way to the pubis. I noted that Barb was backing up slightly as he did this, and all things considered, it seemed prudent to follow her lead. I’m glad I did because in his enthusiasm to demonstrate sweeping, fearless cuts, Dr. Olds went a bit too deep and managed to slice a big-ass-hole in the large intestine…. Which is something I suddenly remembered Barb telling me on my last autopsy… that you wanted to go long… but careful…because you’d nick the transverse colon and then you’d have shit everywhere.
And literally, suddenly there was shit… everywhere. For those of you who aren’t up on your anatomy, the large intestine is the victory lap for your digestive track- it’s the last path that solid waste material travels before it leaves your body and becomes the sanitation department’s problem.
The woman had, undeniably, been an eater and whatever she’d consumed roughly 16 hours prior to her demise was now seeping through a gaping hole in her large intestine and into her abdominal cavity. It was… shitty. But Barb just smilingly carried on as Dr. Olds retreated back from the fecal fountain to busy himself with making labels for the tissue sample containers.
For the most part, the rest of the autopsy went on without incident. We deflected back the epidermis, hacked through the ribs with a bolt cutter and removed the organ block without getting too messy. Barb managed to almost magically avoid coming into contact with any poop… while still finagling out the intestines in such a way that she was able to show me where the decedent had undergone a gastric bypass surgery. The procedure had turned the already labyrinthine structure of the small intestine into a hopeless knot and I resisted the urge to quip that maybe we’d find the Minotaur wandering around in there somewhere. As the new kid, I didn’t want to get too out of hand with the morgue humor.
Everything was going really well, actually. After Dr. Olds faux pas with the guts, I had managed to get my sea-legs under m a bit more and the removal of the trachea had gone just swimmingly when Dr. Olds asked us to finish up with a radical hysterectomy.
A radical hysterectomy is the removal of all the female reproductive organs… all at once. I’m not sure what the difference is between a radical hysterectomy and just a plain-old mundane hysterectomy… maybe one just listens to thrasher metal during a radical hysterectomy… or performs the procedure while also engaging in some form of extreme sport. Hysterectomy while wake-boarding… or bungee jumping. Anyway, it was new territory for me and Barb was more than happy to guide me through yet another aspect of the human autopsy. She reached down into the already vacant abdominal cavity and wrapped her hand around the light-bulb-sized lump of muscle that made up the woman’s cervix and uterus. Explaining as she went, Barb traced the uterus and then the twin fingers of each fallopian tube as they extended upward towards the ovaries.
“Oh,” Barb flinched as she palpated each ovary in its little flesh-sac. “She had ovarian cysts.” Barb’s fingers gently probed each ovarian capsule with a delicacy I had never seen her employ. “Okay,” she said as she motioned for me to step forward and traverse this, latest challenge. “Now, you’ve got to be careful, because these ovarian cysts are under pressure and they can rupture.” Following Barb’s lead, I reached in and wrapped my hand around the uterus, then watched as she motioned for me to simply cut a swift, horizontal incision across the cervical opening…
… I was so intent on watching Barb’s demonstration, that I failed to notice that I had not only grasped the uterus in my shaking hand, but I had inadvertently also managed to capture a fallopian tube and an ovary as well. Furthermore, in anticipation of this new-and-latest task, my grip had tightened on the organ until I was, literally, squeezing it as though I was hoping to drink its contents for breakfast. I was squeezing it so hard that, as Barb leaned in to watch my cutting technique, one of the ovarian cysts gave way and popped like a zit.
The following mili-seconds went by with the gruesome slow-motion clarity of a fatal auto-wreck. I watched in suspended horror as the encapsulated pocket of fluid shot out of the body as though fired from a squirt gun. With sniper-like aim, the missile rocketed straight out of the abdominal cavity, past our flailing hands as we reached up to shield ourselves… and struck Barb square across the face… making a sickening “SPLAT!” as it found it’s mark.
(It may occur to one to ask the question at this moment, why wasn’t Barb wearing some kind of a face shield or eye protection? Well, the fact is most autopsy techs usually do, but since Barb is such a bad-ass and never spatters anything… Like EVER. She stopped wearing anything that impeded her vision or made her feel claustrophobic.)
No one said anything for a moment. I stood, trapped in the hanging breath of my gasp, frozen in place, scalpel still in my hand as Barb calmly walked over to the sink and began rinsing her face off. Dr Olds, who witnessed the entire event, was likewise completely motionless as he stood at the cutting board with a dripping kidney in his hand. When he did move, he glanced to me wearing an expression of intermingled disgust, amusement and pity… And was it my imagination, or did I see a bit of relief? Likely because his poopy-faux-pas was no longer the grossest thing that had happened that day. When I finally did re-engage my brain-stem and start breathing again, the garbled apology tumbled out of my mouth like a mud-slide of contrition.
“Oh my… Barb, I… Oh GOD, ummm. I’m SO… Oh jeez..”
And, true to form, Barb responded with what I can only imagine was the most gangsta statement ever made by someone who cuts people up for a living…
“Oh don’t worry about it,” She soothingly cooed as she walked back to the autopsy table. “My mouth was closed.”
She went on from there, telling me that at least the decomposing body fluid with which I had just lacquered her cheek was clear… So it didn’t smell too bad and, theoretically, it was free of infection. I can’t remember what all she said… More than anything, I was shocked and overcome with hero worship for the woman who was inexplicably trying to make ME feel better about the fact that I had just popped a dead woman’s ovarian cyst on her face …
Dr. Olds shook his head and went back to sawing the dead woman’s organs into pieces. Barb and I finished up without further incident. Every now and then I would, again, attempt to apologize… And Barb would, again, casually wave off my pleas with such benevolence, it really made me wonder what the hell else had happened to her during autopsies that made my transgression so benign…
But I’ll never ask her.
Barb’s not the kind of person to whom you ask the question, “What’s the grossest thing you’ve ever seen?”
Whatever it was, I’m pretty sure I couldn’t handle it… I mean, I can handle a lot. The cops live in awe of my ability to wrestle decomposing corpses. The fire department cowers whenever I produce an 18″ long hollow needle and announce that it’s toxicology time… But I’ll never be as gangsta as Barb…
… Not by a long shot…
… Right across the face….
… With an ovarian cyst…