whilst being familiar with the general concept, what are the particulars?
- when is it been done?
- what do you search for?
- how long does it take?
- how do different ways of death manifest?
- things/thoughts/stories you feel to share
thx
alfred
This is a good introduction.
I assume you mean autopsy? This is a virtual one.
Have fun with it.
Autopsies can be mandated by a coroner, if there are any suspicious features surrounding the death. More commonly, autopsies are done at the behest of the physicians caring for the patient, who must, of course, receive permission from the next of kin to do so.
Just to be clear, the autopsy is performed by a specialist - a pathologist - and not usually by the physician(s) who had been taking care of the patient.
The autopsy is usually divided into three parts or four parts: 1) grossly examining the body and organs, removing the organs, and taking samples of every tissue - requiring about an hour or so 2) microscopic examination of the various tissue samples so removed - taking days to weeks to prepare the microscopic samples for analysis 3) removal of the brain, “fixing” it, and then (weeks later) examining it macro- and microscopically 4) if indicated, toxicologic testing of the tissues and body fluids is also performed.
In addition to searching for the immediate cause of death, the pathologist looks for other factors that may have contributed or predisposed. In fact, the immediate cause of death can be very difficult to determine, but other autopsy findings (eg. hardening of the arteries, scarred heart) may suggest the cause (eg. heart attack).
Common things being common, there is always careful check made of the status of the coronary arteries, the heart muscle itself, the arteries entering the lungs (looking for clots, i.e. pulmonary emboli), and, of course, the lungs too. Regardless, a complete autopsy checks every organ, both macroscopically and microscopically. In fact, careful note is made of the ante-mortem symptoms and test results of the patient, with the autopsy tailored, to some extent, with those findings in mind. So, for example, if before death a person was known to have cancer in his lymph nodes, but it wan’t clear where the cancer began, the autopsy would include a careful search for the primary site of the cancer. Another example might be the patient who, before death, had signs of infection (fever, weight loss, high white cell count, etc.) but no clear source/site/cause of infection identified. The autopsy would probe for occult sites of infection and would also include post-mortem cultures and stains for micro-organisms.
In the case of sudden, unexpected death, particular attention would be paid to the heart and blood vessels, as well as to the brain.
You wondered if, perhaps, we could share stories or feelings about autopsies. Well, I was impressed by the fact that people look the same whether they have a brain in their head, or whether, beneath their peaceful looking face, there’s simply airspace, with the brain having been removed and now floating in a jar down the hall. I was also impressed with how gross autopsies can be in some instances - a visual and olfactory assault by a nicely mixed mess of blood, pus, feces, and miscellaneous bits of tissue that became separated from the rest of the body and its organs during the autopsy process.
Finally, despite advances in diagnostic testing, autopsy results still frequently reveal important and unsuspected diagnoses.
I suspect and authopsy involves cutting up a novelist.
Wow, this is cool, thanks!
Although the first two I have done (case 1 and 2) were both rather easy. I mean, I jsut have a couple physilogy courses under my belt, and I got them.
Considering in both of the first two cases, the patients had HUGE sections of their brains that were either dead or hemmoraged into, it wasn’t that hard to determine it was the cause of death.
Haven’t seen the autopsy explanation site before - very nice. Thanks also to KarlGauss and PicuNurse.
Forensic autopsies differ from hospital autopsies in one basic way. No consent.
If your loved one dies in hospital and you don’t want an autopsy, no autopsy. If your loved one dies in hospital of a stroke or a heart attack and you want something insane like an autopsy limited to the belly, autopsy limited to the belly is what will be done. (Had to do one of these when I was a resident - family was sure the peritoneal dialysis catheter killed her. Wrong.)
If your loved one dies in your arms of murder, doesn’t matter what you want, even if your loved one is 3 months old and you are the sole guardian, autopsy will be done.
For the first one, the hospital pays. For the second one, the State pays. Thank you all the taxpayers out there who pay my salary and keep my morgue open. Neither one costs the family anything.
Also, in a forensic case, we document with pictures and gather evidence to an extent no hospital autopsy does, and we routinely send blood to be tested for cocaine and heroin in the state lab, and we pick up bullets and keep them for the cops. Stuff like that.
Also, I get fistfuls of subpoenas every week (most of which end up continued or pled out - right, Straight Dope lawyers?), and I testify two or three times a month, which is a frequency that would turn most hospital pathologists’ bowels to water.
But that would be a diarrhea thread. Something to do with collard greens.
Last note: It is very, very difficult to gross out a pathologist. Don’t even try unless you’re brave, foolhardy, and have a stronnnnng stomach.
Gabriela
Lemme just also add that the Rokitansky method is pretty striking.
The diener at the county hospital here probably has ties with a crime syndicate. Y cuts, clip the ribs, and then he digs around for a few minutes. Without warning, he yanks and all of the organs – from the rectum to the esophagus, with the heart, lungs, liver, everything – out by the larynx.
Then they make that ear-to-ear incision and peel the cadaver face off to open the cranium. This too, is also pretty striking.
Just out of curiosity, I thought I’d google ‘ortopsy’. 2,710 hits. 
Thank you very much! I just wish they had included hypertext on the medical terms. As the HBO series Autopsy-Voices Of The Dead is ample proof that the site is of interest to many people with no medical training.
I still got the first two right. I needed two tries on the second. My performance on the fourth was shameful.
Luckily the patient was already dead.
I got the first three right on my first try, but #4 was shameful for me as well. I think by the time I got the right one there was just one other choice left. But as said, I have no real medical training, so that’s to be expected.