Who, me?
Sheer suck up. Come over here and put gloves on. I don’t banter with people who flatter me unless they work.
You wanna separate the pancreas from the duodenum, Happy Clam?
No, that was “You wanna”. I think you ought to start slicing up the liver and the spleen.
The liver is fun. Here’s the long knife. That thing is really sharp, you’ll have fun. It doesn’t look impressive because it has a rounded tip, but that’s to keep you from sticking yourself accidentally (see Hepatitis C, no vaccine to).
You want to section it at about thumb’s width distance over and over, but I hafta have a long really thin slice to put in the save jar, say about deli meat thin. Formaldehyde will only soak into liver about 3 mm on each side, so max thickness of 6 mm, fudge factor means 1 cm might be okay. So start with thumb’s width, then try to make two or three really thin cuts, and show them to me when you get a nice big thin piece. If I like it, then go back to thumb’s width sections. We’re looking for focal lesions (cancers) but I can tell there is already a cardiac pattern of congestion, and I won’t be at all surprised if there’s fatty change (from drinkin’).
I also need a little piece of liver for the microscope slides. Heart, lung, liver, kidney. And brain.
Reminds me. Mr. Bus Guy, you got that brain in your hands yet?
OW! Shit, I cut myself! Ow ow ow ow ow!
(hangs head, mumbling) [sub]I can’t know everything.[/sub]
I vaguely remember from the first post I watched, something about “fixing” the brain before cutting into it. Am I remembering right?
You gotta love a teacher like that.
Amazing how much the appendix looks like a fishing worm. Its official name is the vermiform appendix. This is Latin for “looks like a fishin’ worm”.
You will still meet lay people who think the appendix has no use and is a vestigial organ. This point of view was heavily promoted by surgeons in the 1910’s who wanted people to give up their antiquity-long terror at being cut open. They did it by linking the idea of surgery to the idea of Progress. You weren’t Progressive if you hung on to this outdated, vestigial organ.
Actually the appendix is an immune organ. It is heavily lined with lymphoid tissue, particularly in infants and children. It has a sampling area in the center for the shit. It appears designed to pick up dangerous pathogens in the fecal stream and get the body ready to fight them. It is located just where the pathogen level goes from 10 to the 3rd per ml (small bowel) to 10 to the 10th (large bowel). What do most kids in the 3rd world die of before their second birthday? Diarrhea. Many more of them would die without an appendix.
But by the time you hit forty or fifty, it turns fibrotic in most people and dries up, likely because in the ancestral environment, you weren’t designed to find any new pathogens in the shit after four decades or so, and its design before it turns fibrotic does guarantee the occasional case of appendicitis, which was fatal in the ancestral environment.
After it’s fibrotic, it’s vestigial. Appendicitis in the elderly is rare and a bitch to diagnose. Better off without it.
Of course I still have mine. Doctors don’t believe in medicine. Picunurse, tell me if I lie.
Are the tonsils kind of like that, too?
Hey, can someone had me a rag or some paper towels or something, before I bleed all over here?
Crap! I turn my back to give Lissa an interesting lecture on the appendix and this happens! Oh, shit!!!
YaWanna, we have only two choices here. Either you can do the right thing, which is to report your injury at once, go over to Public Health, fill out 22 forms, endure the scrutiny of that lizard-eyed doctor in charge over there, have 4 vials of blood drawn from you and 5 from the patient, and start on antivirals overnight that will make you sick as shit, while we wait to find out if the decedent had AIDS or Hep C.
Or you can do what many people might do: quietly put a bandaid on it and pretend it didn’t happen.
Up to you.
If the latter, I would either do it when picunurse isn’t looking, or I would quietly engage picunurse with the responsibility of putting on the bandaid.
Band-Aid! And maybe some pepper…
Of course you can’t know everything. That one’s one of my cherished pimp questions. I’d have been disappointed if you knew it.
We fix the brains if we need someone official to look at them, but if we’re very sure they’re normal, sometimes we cut them raw.
Hm. This is a Doper brain. Get me a bucket of formaldehyde to fix it. Hell, we might want the NSA and the CDC to study it.
Picunurse, you’ve got “hands” - you want to take over sectioning the liver where YaWanna bled all over the cutting table?
Pepper?
Pepper??
The cops in the break room have Mace if you need it.
No, no - pepper will stop the bleeding.
Mace will - I dunno, probably hurt like hell.
YaWanna, I was just about to tell you to be careful. Come over here so I can look at it, and wash it off.
gabriela, where would I find a sterile dressing and some tape?
YaWanna, it doesn’t look like you’ll need stitches, it’s starting to clot already. Had you cut the liver before you cut yourself?
gabriela, do you have a protocol for HIV/Hep B testing of the cadaver when someone is, er, I mean, hurts themselves?
OK, it’s time to dissect the block. Find the adrenals first; they’re a bitch to locate if you don’t have landmarks. Yes, they’re on top of the kidneys, but they’re not right on top of the kidneys where you expect them, and they’re hidden in the perirenal fat.
The right one is sandwiched between the liver and the kidney but it’s right up against the inferior vena cava. The left one is behind the tail of the pancreas. Which has Mr. Bus Guy’s bite marks all over it - sheesh, useless as a landmark. Let’s look between the diaphragm and the kidney. Make a few cuts. OK, there it is.
All right, let’s expedite this autopsy. YaWanna, peel the right kidney out of the fat and capsule. Mr. Bus Guy, you’re so into spleens, you get the spleen. Lissa, if you’ve finished with that hyoid, dissect the uterus for me - I’ll show you where to cut. That’s the vagina. Look, there’s some white opaque fluid in it. Wonder what that could be.
I’ve taken the duodenum off the pancreas and checked the ampulla of Vater and the biliary tree - I do all the hard stuff. Okay, we’ve weighed the liver, spleen, kidneys, adrenals, now it’s time to cut them up. We gotta find out if indecisive1 has any kidney stones.
Well, there’s the clothes that indecisive1 came in with. Since this autopsy isn’t looking for data for a criminal investigation, I don’t think gabriela will mind if we use them. So…
bra or panties?
I just started cutting the first slice when WhyNot elbowed me. Yeah, that’s it.
I knew you’d take care of us, Picunurse. There’s no one I’d trust more. Hm, maybe the combination of you working in tandem with QtM.
Sterile dressing? Sterile? Are you joking? We don’t keep sterile stuff in the morgue. We don’t even wash our hands before starting an autopsy. Why would we?
That protocol is, er, the 22 page document I mentioned before - YaWanna, you’re in for it now. Try to enlist picunurse in secrecy. Tell her you’re afraid of needles or something.
Hey, if I take this bladder and cut it off at the urethra, can I squirt **Hal **with the contents?
YaWanna, I think there’s some salt and pepper packets in the take out bag with the last egg salad sandwhich. You choose - salt or pepper.
For you??