HUMAN SUSHI
The sign said,
"AUTOPSY IN PROGRESS. NO UNAUTHORIZED ENTRY."
So I knocked twice, and walked right in.
I had brought my team there an hour ago but the pathologist was gone with nobody and no body to be found. The sign said the same thing then as well.
There were two techs there this time. One (male) didn't seem to notice that another living person (me) entered the room. The other (an older female) smiled and said the pathologist would be back any minute, and then she continued to toil with other people's dead organs as if she were chopping liver (and indeed, she may have been).
The autopsy room is a fun place. It's quiet. Non stressful. Dead people are not stressful. They have nothing to worry about and I don't have to worry about them either.
Pathology would be a nice field. I can see the appeal. No vague theoretical guess work based on the tip of the iceberg vague symptoms. You look and you see. I'm sure it can still get stressful when looking for cancer on biopsy specimens. But the advantage being like Snow said back then, "You don't have to deal with … people." I can see the appeal.
I looked around.
The wall across from me had an X-ray of a baby on it. I had no idea what was wrong with it, but I didn't want to look too hard either.
I turned around to see a pillar with various postings and notes on it.
One post said, "Call ESCORTS (#####) to help move bodies."
Another had the cardiology number for pacemaker removal. Huh, it never occurred to me that the pacemaker might still be beating after a person is dead.
The next one had the initials "M.E." (medical examiner) with a number.
I recognized the name on the note that said, "Call Dr. Batmanbaum for autopsies on weekend."
Dr. Batmanbaum is practically a fixture at The Empire here. He was my first attending when I was an intern on the floors in fact. One of the most impressive and charismatic ones with his knowledge of almost gothic yet practical medical arcanum. He's also got a very dark and sarcastic sense of humor.
I remember him giving us a mock tour of the medical library and saying in typical sardonicism, "Now THIS strange place is called a LIBRARY. Use it some time."
Then he showed us the Indicus Medicus. Sort of a cross reference catalog that would have been useful in the pre-internet days. This was just before the net and Palm Pilots exploded with medical information sites (and before I even had a webpage in fact - I started in my 2nd year of residency). Now the Indicus is practically as dead as the language it's title is in.
I also remember Dr. Batmanbaum driving a very old car (older than my 1987 station wagon) and having a Batman figurine on his keychain.
Just then Dr. DeHyde the pathologist entered then.
She wasn't the platinum haired femme with the intense dark eyes I had stared at in our shared college microbiology class (Dr. Snow). This one was still very friendly, and even glad to help though. Plus I didn't get that funny knot in my stomach while talking to Dr. DeHyde that I usually got with Dr. Snow.
Dr. DeHyde was a shorter Indian woman with glasses that made her eyes look bigger than they were. (My glasses make my eyes look smaller.) She seemed really happy to see me. I bet they don't get too many (live) visitors down here. (Not counting bodies flopping from out-of-control defibrillators.)
"Sorry, I was at lunch," she apologized and rushed over to one of the white buckets sitting on the metal slabs.
Hmm. I don't recall ever seeing any pathologists in the cafeteria. Maybe they know something the rest of us don't.
"The body has already been sent but we have the interesting parts in these buckets. We found over four liters of blood in his abdomen," she said as she spun around almost bumping me with the 2 day old bucket of blood. To which she added in what seemed like a slight Transylvanian accent,
"We saved it for you."
"Great, thanks. Just in case …" I nodded and she nodded. Just in case of what I had NO idea.
"Here are some of the other interesting parts," she said.
As she grabbed another bucket, I tried to anticipate which way she was about to turn so I wouldn't end up with intestine and heart muscle stains all over my clean white coat.
She rushed over to another empty slab and laid out the organs, as I peeled myself off of the slab I had leapt backwards upon a second before.
Organs. They were all so smooth and shiny and pure in color; they practically glowed. They looked much more alive than the layer of dead skin cells we see when we look at each other.
The liver was a little fatty. Sort of a shiny grayish-brown. Smoother than skin. She ran her gloved fingers over its slick surface as she spoke. I was tempted as well.
The pancreas, after it was washed free of blood, was unremarkable as well. No evidence of pancreatitis or even ruptured vessels. Dr. Dehyde placed it beside the liver, in roughly its anatomically correct position.
There was no stomach she mentioned, due to the gastrectomy history. The lungs were devoid of abnormality or clot as well.
She brought out the heart next. Some cardiomegaly she said. But no M.I. … or myocardial infarction, a.k.a. "heart attack."
The heart wasn't red and blue. More like brown and purple; clean pretty colors that no artist has been able to match. A mighty fist of muscle. It didn't look nearly as large as I would suspect from a man as big as Mr. G. though.
The heart looked so vibrant and alive that I was reminded of talking to Mr. G. just a couple days before. I was wrong about his Russian girlfriend. She was actually his wife, and mother of his two children. He was a teacher himself.
This was the heart that he spoke to her with so tenderly when she visited him that one time. She should have been able to see this heart now. It looked beautiful and alive, despite being cleaved in quarters sitting on a cold metal bench.
What we see on the outside of people and even the world around us is coarse obtuseness compared to the intricate complexity of the organs inside of us. This is what I envy about a surgeon's or pathologist's career. They get to see this all the time. What I don't envy is their work hours (surgeons) or average room temperature (both).
Then she pulled out a long strip of yellowish tissue with holes in a vaguely familiar pattern in it. The holes almost looked like a face, staring at me with dark accusing eyes. I couldn't tell if they were natural or just man-made by some extremely bored pathologist with a sick (and very funny) sense of humor.
"And this is the aorta," she began, "These are where the mesenteric and renal arteries came off of it." She pointed to some of the holes.
"Was there any dissection (i.e. a split in the wall) or aneurysm?" I asked as if confessing to the mighty fist of heart muscle staring at me.
"No. The aorta was completely intact. Even the renal arteries were fine. Not even a shade of atherosclerosis or plaque," she said caressing the lovely yellow strip.
Oh God. I was so glad. So relieved. He was still dead, but at least I didn't miss the obvious (or did I). I could have. His history was entirely consistent with an aortic dissection in every way. But that's not what killed him. And hence, if only by sheer luck, my ignorance had not killed him. (And despite some controversy over the case, I still do not believe he had pancreatitis either.)
"This was very strange. His splenic artery, here, ruptured and bled," she said holding a violently purple spleen.
"Could this have happened from trauma or because of the chest compressions?"
"No, some of this clot at the splenic hilum is organizing, older. It may have leaked in the past, but the microvessels completely ruptured before the CPR," she said better than Quincy or any of those wanna-be's on E.R. could ever Thespianize.
"This is very odd. Very. Odd. We took some biopsies," she said with large magnified eyes and a smile.
I glanced at the metal slab. She had almost placed the organs in their anatomically correct positions on the bench. I was looking at the internal organic soul of a man I had spoken with just days prior. A man who joked and smiled and thanked us and wanted to go home to his wife and children.
He crossed the threshold between life and death. I was there, before and after. And all he left was this skeleton of his soul.
People tend to think pathologists are cold or unfeeling. That's not necessarily true. I don't think it would be very hard to dissect a body when you've never seen them while they were alive. Corpses just look so different than their living counterparts to me.
The hard part is seeing the same person while they are living and after they cease to be. Mr. G. seemed even more real to me then, staring at his vibrantly beautiful organs splayed in perfect order. It reminded me of those people you made out of carrots and baby pumpkins and branches in grade school projects around Halloween.
I thanked Dr. DeHyde as she replaced the disembodied organs back into their formaldehyde containers. What do they do with that stuff when they're done examining it anyways?
I closed the heavy door behind me, wound through the labyrinth of The Lower Level, and looked at the time on my beeper.
1:55 P.M.
"Cool," I thought to myself, "the lines should be short in the cafeteria by now. I wonder what kind of mystery meat / soup they'll have today."
I never did figure out what was in that soup.
Hey, GG, try some of this sushi !!
Guaranteed to make you feel better ... or was it "badder?"
(Maybe I had too much myself.)
