It’s kind of like that>
but worse…
(not my white legs, the deer)

I’m in my last rotation of my program, the autopsy rotation!  I’ve been very excited about this one and now that I’m doing it, I am most definitely not let down.  It is completely fascinating and there is so much to learn, knowledge-wise and skill-wise (actually performing the autopsies).  I’m slow at it right now, but I’ve just begun, and after a couple weeks, I’m sure I’ll be cutting through them like a pro. Just as fascinating as performing the autopsies are the millions of things I’m learning about forensics.  The only downfall is I’m doing this last rotation during the spring and summer weeks, which are getting warmer and warmer… use your imagination.  When I finish this rotation, I’ll have tons of interesting and fun things to write about, so keep stopping by!

Yes, I’m sorry to my vast amount of readers that I haven’t posted in, well, months! I really am trying to sit down and post, but like the title says, I’m in rotations. Let me first tell you that I am enjoying this year much better. And it is way more interesting than the first year, although the first year is great and I will be posting about that soon too. So here is how rotations go: I start at one hospital and stay there for 5 weeks, then move on to the next one for a certain amount of time and so on. My second rotation has started already and I’m 2 weeks into it.

I also have quizzes and tests this first semester. Every wednesday we have a quiz from the previous weeks’ lecture. And coming up very soon, we have our Robbins exam. Robbins is our bible for the rest of our life. We need to memorize it because that is what our certification test is on when we graduate and get a job. So it is very important that I do well on these tests too! I will post on what Robbins has in it and provide lovely pictures.

What I plan to do from now on, is give you posts about first and second year, but not in order. The first year was all book study and this year is all about hands on training-which is the REALLY interesting stuff! So be prepared to be amazed at all I am experiencing, I’m sure you’ll love it!

So, I thought I would take a break from the Autopsy Series-not that I have been writing ANYTHING this semester! I will continue the series when I am actually doing autopsies so that I can tell more information. I hope that will be soon, I will be starting my clinical year in a few weeks!

        (If you don’t want to “know guts” don’t read on!) After the external inspection, the autopsy technicians get to work.  This is where the fascination of the human body takes over, and I’m so thrilled to see it. I know, it sounds a little morbid-being excited to see a persons insides, but if you have the stomach for it, you would be fascinated too. 

      The autopsy techs start what is called the evisceration.  This is when they make that Y-incision-they start cutting the skin and muscle away from the ribs and sternum, to open up the body cavity.  What you see when that skin is removed is the chest wall: ribs and sternum. To remove the chest wall, some people use either a stryker saw or the rib cutters (see the tool box).  The chest wall is removed and now you see the organ block.  I was amazed to see that the all the organs actually looked like what they do in text books! Go figure! The techs remove this organ block by cutting the large intestine off the rectum and removing all the attachments all the way up to the tongue. This is amazing. They pull the entire organ block out, holding the tongue on top and the colon on the bottom. I know you’ve seen in the movies where someone’s intestines fall all over the place when they have some major stomach wound, right? Well, that might happen, but not here. When the organ block is removed, the intestines stay all connected and cinched together. No falling all over the place, no hanging wildly, just together. It looks kind of strange at first. But this all makes sense if you think about it: our bodies are connected all the way through from our mouth to our hineys, so why wouldn’t they hang out in our body all together?

        Next the organ block is laid on a table with a big cutting board with very large knives. The knives look like your large knife in your knife set. This is when the doctor gets to work. Every organ is cut away individually and weighed, then they cut into the organs (not the intestines-thank goodness-unless it’s called for!).  They look for any obvious signs of problems, but they more see normal healthy tissue. (I will go into the major individual organs in the next few posts-it takes way too long to talk about otherwise!)

       When the doctor is done with each individual area, he takes a sample of the organ and places into a container with formalin and places the rest into a bag. After the entire process is done, this bag with the organs is placed back into the body cavity and sewn up. Then the decedent is picked up by the funeral home.  Funeral homes are involved in what is called mortuary science, which is a cousin to the APA’s and we are under the mortuary science umbrella. 

Ok, I promise not all my posts will be this graphic!!

*The Autopsy series is what I saw while job shadowing. I haven’t had my forensic rotation yet, so if these descriptions aren’t right-I’ll fix them next year!

      Yes, I did actually ask that in the morgue. Let me explain myself. I have never smelled death. I was expecting this horrid stench. When I walked in, I was overwhelmed by a scent I couldn’t put my nose to. Come to find out, it’s the death smell-go figure. And maybe some chemical smell too, like cleaner. So, I’m escorted in to a large room with sinks and tables on the left and a couple of small rooms on the right. There is a gallery also on the right with windows. In front of me were about 17 dead naked people laying on gurneys. No white sheets, not just feet sticking out. Talk about a weird feeling. I wasn’t expecting fully naked. But what I didn’t know was that I missed the part when they were all covered up in body bags.
         The pathologist start out the day by dividing up the bodies: I’ll take this suicide and you’ll take the drug overdose, etc. They talk about each person: where they were when they died, how they were found, they read the police report and so forth. Then they start their external examination. They look for tattoos, scars, bruises, piercings, you name it. They are very thorough.
         This is when the room started getting very small. I started seeing everything with a whitish hue and spots. So, remembering the cardinal rule of the morgue: I sat down! Not on the floor, mind you. The morgue has this very convenient bench that is down the hallway, away from the bodies. I sat there for a few minutes with my head down. After a minute or two, I felt better and tried it again. I was doing really well, and then the spots again!! Darn it! I’m a weakling! At least I didn’t actually faint and or throw up, so I’m thinking that maybe I can do this!

            I loved job shadowing. It was very cool because I was right up in the action. I job shadowed with the Godfather of APA’s, Joe . He’s the coolest guy. When I first went to job shadow, I dressed professionally, I brought a note pad and pen and had a lot of pre-written questions to ask. I figured this was standard procedure to have all these things. Apparently not, but it was impressionable. All three APA’s that worked there remembered me with the notepad and questions, while one histotech (and future classmate) remembered me as the girl who almost biffed it walking down the freshly waxed hallway with my cute dressy shoes. First impressions: check.
       

Diverticulitis

I saw the coolest stuff that day and I didn’t faint which was really good. I saw diverticulitis of the sigmoid colon-and yes, I had to google what diverticulitis was, I saw a knee cap which made me feel like there wasn’t quite enough oxygen in the room (bones makes me queasy) *side note: I now know that it actually wasn’t a knee cap (patella) but the cartilage between your femur and tibia-it still makes me queasy! What didn’t make me sick was learning that you can tell the difference between rheumatoid arthritis and osteoarthritis (my mom had R.A.). I also saw a full breast removed for cancer, lots of placentas, moles, a stomach with ulcers, numerous unidentifiable pieces of tissue, and a man’s toe-which I didn’t actually didn’t look at as I was still a little traumatized by the knee cap.
           I was one of the lucky few to be able to get into the Wayne County Medical Examiner’s office for a job shadow. (You have to know people-I feel so cool!) I got a call Saturday afternoon telling me to be there at 8a.m., I was gettin’ in! Yay for me, right? I was more than a little nervous. I’d only seen one dead body up close in my life and we all know that was a traumatic experience. What was I going to see, green rotting flesh? Serial killer murder victims? Needing to make an even bigger impression on this guy, I still dressed up even though, hello-green rotting flesh! I had even more questions than before. So, I arrive and sign in. The receptionist was very nice and clearly deals with new people all the time, so she had a relaxing way about her. She told me a story of how there has been only one day in like 20 years where WCME has not had an autopsy to do. You see, the city of Detroit is in Wayne County, and if you have ever seen the movie “Goonies,” you know that Detroit has the highest murder rate in the country. So this morning, we had plenty to see. I met Dr. B., “the man.” First thing he says to me, “if you’re gonna faint, sit down. If you’re gonna puke, sit down.” Sitting down was my highest priority of the day.
           Now, if you have ever seen a movie or watched T.V., you probably have the same vision of a morgue that I did: stainless steel everywhere, coolers, gurneys with a decedent covered in a white sheet with just the feet exposed. That would be in Never-neverland. This, my peeps, was Wayne County.

                                                                                  Let’s start with what APA stands for: Anatomic Pathologists’ Assistant. OK, what’s that? It is an assistant to a pathologist in a hospital or a medical examiner. They do the diagnosing of cancer/tumors/cause of death-you name it. I will be assisting them. Basically I’ll be doing the dirty work/fun stuff so they can have all the glory. Obviously it’s a lot more than just that, but this is my blog, not a professional journal. I’ll be taking whatever tissue (breast, tumor, mole, intestine) gets removed from a person in surgery and dictating what I see, taking measurements, staining, dissecting and so forth. I found out about this program while searching for forensic psychology, oddly enough. I have a bachelor’s of science in psychology-which is a useless degree unless you actually want to be a PhD.  I live in the Detroit area, so when I saw that one of the 8 APA programs in the country was at Wayne State University, I was elated. 

                Here is a little background about myself.  I have always wanted to be a nurse. Then my mom died-didn’t want to be a nurse after that. I was terrified of death and dying and would have nothing to do with it.  I was also 12 at the time, not that it makes a difference about being scared, but when choosing a major in college, nursing was not one.  Long story short, I eventually became a nursing assistant in labor and delivery and loved it. After 5 years of doing it, I realized this: there is no way I want to be a nurse.  Not that they aren’t the best, because they truly are (shout out to Wyandotte Hospital Labor & Delivery nurses!!). I realized that it was the science and the medicine that I wanted to know. I also knew from hospital life that I did not want to go to med school either.  So, here I am, in a perfect balance of science and medicine.

Whew…