Lessons From the Autopsy Room

For a year when I was studying science trying to get into medical school, I worked as an autopsy assistant (called a “diener”) at Herrick Hospital in Berkeley. Everyday, I assisted two pathologists dissecting the cadavers. My job was to prepare the bodies. I also disposed of various body parts that came down from surgery. After getting over the initial revulsion of my new job, I was amazed at how much I was learning. Here are a few lessons learned: 

 

• Not cocktail party talk. Describing to people at a party what a green gall bladder stretched tight over calcified gall stones feels like in your hand is a great way to clear a room. What? Not everyone wants to know what abdominal “adipose tissue” looks like?

• It can’t happen to me. During my autopsy days, I was a pack-a-day straight Camel smoker. So was the pathologist. We’d be working on someone who had died of lung cancer and smoking away while ashes dropped into the chest cavity. Specimens of the black lung tissue sank to the bottom of the formaldehyde specimen jar. Didn’t faze us. We kept puffing and laughing. 

 

 

• Diet and coronaries. 

The way that plaque hardens and calcifies the arteries was shocking to see and feel. On larger arteries, like the descending thoracic aorta, plaque would be so dense, it could be peeled away like bark from a tree trunk. In the coronary arteries, that plaque could make the arteries snap like a twig. That blockage, or stenosis,  meant that the heart muscles downstream got no life-giving blood. The heart muscle would be so necrotic, I could poke my finger through the wall of the heart (the myocardium.) 

 

Consistently we’d notice the coronaries of Asians of, say, 75, would be as flexible as those of Caucasians of 35. The Asian diet of less red meat and more fish and vegetables explained the difference in coronary plaque deposits. 

• The truth came out in post (autopsy). The patient was an overweight 45-year-old female. She had died that morning of complications from high blood pressure. The treating physician was in attendance along with three other doctors. He was explaining his diagnosis and treatment. He seemed confused about why she died, explaining that he gave her xyz drug to thin her blood. The other doctors looked concerned. One explained that a side effect of that medication actually caused blood thickening. 

Awkward silence. 

The doctor’s mistake had killed his patient. I looked at the floor. 

Overall, my year as a diener proved invaluable to my future undergraduate biology classes, especially anatomy and physiology. After a few weeks of getting used to working on dead people, I was slinging those corpses in and out of the refrigerators like a pro. Unforgettable.

5 thoughts on “Lessons From the Autopsy Room

  1. Good grief, Rick. I had no idea that was part of your experience. Your piece got me thinking about a million things about our bodies — like taboos and silences, ignorance, irreverence, and responsibility. Thanks. Great writing!

  2. I knew there was something wonderfully odd about you! Having worked for 8 years as Secretary to the head of Pathology at a hospital, (and having to put toe tags on, and get signatures from doctors in the midst of autopsies), I totally relate! I never quite knew what would be on my desk each day – from a pan of brains to various other organs, or fluids. But long before synthetic medications were available, I had the honor of sending off the collected pituitaries to be used to produce growth hormones for children. The letters from the children, in pencil with lots of erased and re-written areas, were priceless. Being able to reach a door knob, to sit in a regular chair at the table… priceless!!!! Thanks for sharing.

  3. I guess you just "let ‘er rip" in this article about what actually happens during an autopsy. Very eye-opening. Thank you for sharing and I honestly mean that! Your witty twist on this personal and serious subject really drew me in and I wanted to learn more. Is there another book in you? I never would have imagined you in a setting like that…oh wait, yes I would. Now, I know why you never brought this subject up during business or social engagements. But, I’ll be happy to do that for you now. 😉 Great article, Rick! Looking forward to the next newsletter.

  4. Dear Rick,
    Tremendously useful info. Especially now in our aging selves when we can recognize risks. When you were doing your job as a younger person, obviously you did not consider the risks of smoking. Perhaps this job could be part of everyone’s education. Thanks.

  5. Very interesting! What year were you at Herrick. I interned there in 1986. There was at least two deaths on the ICU during my tenure: one, was a male protester (It was the time of the People’s Park Riots) died of a buckshot nicked renal artery; another was a man who an internist didn’t diagnose a aortic aneurism; both led to bleeding deaths.

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