In writing my most recent book Fight Write, Round Two: Crafting Chaos, Combat and Crime, I took a deep dive into autopsies. If an autopsy is your work, this post is for you!
The word autopsy comes from the Greek word autopsia which means, “to see for one’s own eyes.” Auto – self, opsis – sight. In forensic speak, it may also just be called a post mortem, from the Latin “after death.”
Before we get to what happens in an autopsy, let’s get a few things out of the way.
Why an autopsy?
Autopsies may be formed for several reasons such as:
- When the death is suspicious
- When there’s a public health concern such as with a pandemic
- When a doctor, family member or legal representative requests one
- To gather evidence
- To confirm a diagnosis
- To determine the cause of death
- To conduct research or for academic purposes such as at a medical school
Who performs autopsies?
If the autopsy is ordered by the state, it may be done by a county coroner who is not necessarily a doctor. Clinical autopsies, done to determine cause of death, are done by pathologists. Pathologists are medical doctors with extra training in lab techniques used to study diseases. A medical examiner who does an autopsy is usually a pathologist. The assistant to whomever is doing the autopsy is knowns as a diener, a German word meaning “servant.”
How much is an autopsy?
Autopsies cost between $3,000 – $5,000[1]. And there may be a charge to transport the body to the autopsy site. Autopsies are not paid for by most insurance plans as insurance tends to end at death. (go figure) But, teaching hospitals may not charge as much if at all. If an autopsy is required in connection to a crime, it is paid for by tax dollars.
Can family members block it?
In some states, if family members can prove that autopsy would be against the deceased’s faith, it can be blocked UNLESS it is part of a criminal investigation, if the death is related to a major health crisis or there is a formal petition from the court.[2]
Is an autopsy bloody?
Not really. There is blood present in the body but it is not pumping. It also will have coagulated a bit. Blood loss can be anything from .1 liters/3.3 ounces to 1.3 liters/43 ounces or 5.3 cups[3]. If it escapes the body it will drain from the exam table through a drain and will be collected in a receptacle.
How is an autopsy performed?
Autopsy procedure begins very generally and gets increasingly specific. All observations are written down and recorded verbally. It is best to perform an autopsy within 24 hours of death. What happens in an autopsy is pretty linear and from a medical and forensic standpoint, there’s can’t be much deviation.
- External examination of the body as well as clothes on the body if there were any present. Height, weight, eye color, hair color, ethnicity, gender and approximate age are noted. All of these may be used to identify the body.
- X-rays are done to assess bone abnormalities or the presence of foreign objects.
- Hair and nail samples are taken.
- Internal examination includes examining the brain, chest and abdominal cavities.
- Prior to beginning the autopsy, a rubber block is placed under the torso to arch the back and extend the body
- The chest and abdominal cavities are accessed with a Y or U shaped incision which starts at the shoulder joints. If the incision is Y shaped, the shoulder incisions will meet at the sternum and go down to the pubic bone. In women, the top arms of the Y incision should go under not over the breasts.[4] This is a common error on screen.
- Organs are all observed whole and in place, or in situ.
- Ribs are breached with bolt cutters. If fluid is present in the chest cavity, it is removed, measured and weighed. Organs are again observed untouched.
- Major organs (heart, lungs, liver, stomach, and spleen) are removed, observed and weighed. Blood and tissue samples are taken. Contents of the stomach are removed and can be used to help determine time of death. Fecal matter is collected as well. The lungs may be inflated and fluids such as bile, urine, vitreous gel from the eyes may be collected.
- Before accessing the brain, the rubber block is removed from under the body and the neck is placed on a support. The skull is breached with an incision ear to ear over the crown of the head, the skin is peeled back and then a special saw is used to remove the cap of the skull. Brain tissue is the consistency of firm tofu.[5]
- Organs are weighed and examined for abnormalities.
- Any samples taken from organs may be placed in paraffin to be more easily sliced later for microscopic slides.[6]
- When the autopsy is complete, organs are returned to the body except any that need to be preserved for further examination or evidence. The organs can also be cremated, whatever the family or the faith of the deceased determines. Before being returned to the body, the organs are put into a bag to prevent leakage. The entire bag(s) are put back into the body. Yes, really. The body may also be lined with cotton or wool.
- The breast bone and skull cap are put back in place.
- The body is sewn shut with a baseball stitch that look like stitches on a baseball. Thus, the name.
- The body is washed for the mortician.
And there you have it. That’s what happens in an autopsy. The bagging of organs surprised me! Who knew??? Choose the thumbnail below to go to a youtube video all about autopsies.
Until the next round at FightWrite™, get blood on your pages!
[1] https://www.pbs.org/wgbh/pages/frontline/post-mortem/things-to-know/autopsy-101.html#:~:text=A%20private%20autopsy%20by%20an,and%20from%20the%20autopsy%20facility.
[2] https://science.howstuffworks.com/5-things-didnt-know-about-autopsies.htm
[3] https://pubmed.ncbi.nlm.nih.gov/15075683/
[4] https://www.livescience.com/32789-forensic-pathologist-perform-autopsy-csi-effect.html
[5] https://www.livescience.com/32789-forensic-pathologist-perform-autopsy-csi-effect.html
[6] https://www.youtube.com/watch?v=aqzC9Cb_VVM
