The autopsy suite is a mysterious place to those of us who don’t work behind the scenes. You could tour an autopsy suite with groups like Mystery Writers of America or Sisters in Crime, both of which I highly recommend. Otherwise we’re on our own. For readers and writers alike, I think you’ll find this information interesting and hopefully, it’ll help with your research. Here we go…
The autopsy suite is staffed by three main groups.
In the early morning hours the autopsy suite comes alive with autopsy technicians, who are the first to arrive. Depending on the size of the department, the Chief Autopsy Technician (<- in caps for clarity purposes) oversees numerous subordinates (to have personality clashes might be a cool way to add conflict to an already stressful scene). When they arrive they change into blue or green scrubs and a disposable apron, slip their fingers into two layers of latex gloves and slide disposable booties over their shoes. A mask and a face shield completes their assemble.
The Autopsy Technician is responsible for obtaining the death investigator’s report, prepare the paperwork for the pathologist (the doctor who performs the autopsy), and set up the autopsy table for each death. Each case folder contains a copy of the death investigator’s report, an examination sheet, and a temporary, or draft, death certificate.
The autopsy table is set up with an organ bucket lined with a red biohazard bag, two jars filled with formaldehyde, a stock jar, a histology jar, and a test-tube rack that holds glass tubes of various sizes for blood, bile, urine, and eye fluid. At the head of the table two scalpels are arranged, along with scissors, forceps, a ruler, and a cranial saw.
To the side of the table you’ll find a smaller exam table where the pathologist examines organs and slices samples that will go into formaldehyde for testing. The Autopsy Technician places another set of tools, which includes several long knives, scalpels, scissors, a ruler, and forceps. Once both tables are set up the Autopsy Technician waits for the pathologist to tell them which body will be examined and the type of examination to be performed.
The Autopsy Begins
The Autopsy Technician takes the body from the 40 degree Fahrenheit (4 degree Celsius) cooler. With the help of another Autopsy Technician they remove the corpse from the body bag and set it on the stainless steel exam table, with a block under the head. Then they proceed to photograph, notate clothing descriptions, and collect forensic evidence such as hairs or stray fibers. After this procedure, the body is stripped and the clothes are placed on a sterile white paper sheet. These enormous sheets are later folded in a manner to protect trace evidence from being lost, and then taken to a forensic lab for analysis. After an additional set of photographs, the body is washed.
Under the supervision of the pathologist, the Autopsy Technician slices open the body using a Y incision, collects bodily fluids, and weighs the internal organs. S/he also operates the x-ray machine. Once the pathologist completes the autopsy, the Autopsy Technician adds a small amount of formaldehyde to the red biohazard bags, ties them, and places them inside the chest cavity. The chest plate is set back in place and the wound is stitched closed. The body is then washed again, dried, and returned to the cooler.
It is the Autopsy Technician’s job to input information into the database. Things like, the weight of the organs and the amount of fluids taken. They pass on the collected evidence to the lab and wash the tables, floor, and walls with disinfectant. At the end, the apron, gloves, booties, and masks are placed in biohazard containers and the scrubs are sent off for laundering.
The Autopsy Photographer differs from the Autopsy Technician, which I found fascinating. All bodies are photographed by the Autopsy Photographer upon first arrival to the coroner’s office. Their responsibilities include documenting the condition of the body, the injuries sustained, and the internal organs through photography. Autopsy Photographers are specifically trained in anatomy, physiology, ways to orient images of an anatomical body, and the use of manual and digital cameras. (That would be an unusual job for a character, huh?)
When the body arrives full body shots are taken, front and back, which may be required later if identification comes into question. If the body comes in with any apparatus, such as ECG patches, endotracheal tubes, or IV lines, these are also documented. Once the clothes are removed and the body is washed, the Autopsy Photographer takes another set of full body shots, front and back, and snaps close-ups of wounds, bullet holes, fractures, surgical scars, and other identification marks such as tattoos. (It’s kind of creepy to think someone will zoom in on my tattoos. Brr…) The scars and tattoos are important because they help in identifying the deceased.
During the autopsy, it is the Autopsy Photographer who snaps photos of the internal organs. Twice: first “in situ” to document the location and severity of the disease, if the person died of natural causes, and second, after they have been removed and cleaned. The pathologist often leads the Autopsy Photographer. Over a period of time injuries, especially bruises, change color or appearance, fade, and can disappear altogether. A pathologist could conduct over 300 autopsies a year, which is why the job of the Autopsy Photographer is crucial.
The central figure in the autopsy suite is the Forensic Pathologist. It is his/her job to determine what type of autopsy is necessary, internal or external or both, and then to carry out the autopsy and determine “manner of death.” “Cause of death” refers to the physical factors that caused the body to stop functioning and refers to the way in which this occurred. Such as, repeated blows from a blunt object or gunshot to the head. “Cause of death” also refers to the classification such as “severe cranial trauma.” Whereas “manner of death” refers to how the death occurred i.e. natural, suicide, accidental, homicide, or undetermined.
To become a Forensic Pathologist the doctor must take an additional year of forensics training in a busy coroner’s office. They are trained in anatomic and clinical pathology. Anatomic pathology refers to the diagnosis of disease based on gross and microscopic study of blood, urine, and other bodily fluids to determine the chemical levels. Clinical pathology looks at the body’s biochemical process i.e. hormone and enzyme levels.
Forensic Pathologist vs. Coroner
As stated above, the Forensic Pathologist is specially trained to determine the cause and manner of death. And s/he can be hired to perform private autopsies and/or testify in court. Whereas the Coroner is a lay person elected or appointed to oversee the operation of the coroner’s office. Coroner’s hire Forensic Pathologists to perform autopsies.
Readers: which job did you find the most fascinating? Writers: will you use one of these professions in your next novel? In my latest novel, Wings of Mayhem, I concentrated on one job in particular. Can you guess which one?
For those interested in reading Marred, where I concentrated on crime scene forensics, this is the final day to get your copy for 99 cents. Tomorrow it goes to full price.