After weeks of waiting, I was finally able to start my “observation period” at St. Barnabas Medical Center’s pathology department in the second week of March. On my first day, my supervisor brought me from office to office, introducing me to other physicians. We seemed to catch every doctor at a busy time - one was rifling through a stack of papers, several were hunched over computers, and one was caught in what appeared to be a moment of meditation over the tall glass of water he held in one hand and a small red water pitcher he held in the other. In the age of sickness, I was confused as to how I was supposed to greet them, and often stood several feet away and smiled with a nod in lieu of a handshake. This did not alleviate the awkwardness, and no one seemed to understand why a highschooler with purple hair was standing in their office.
Within two hours of my arrival, I found myself in the morgue with two residents and a technician, preparing for an autopsy. The technician, Chase, is a lively young man that always seems to be smiling, even when he is wrist deep in a cadaver. While we stood over a body, he told me about his childhood in Pennsylvania, his degree in philosophy, and the ex-girlfriend whose aunt got him his current job. One of the residents, Buket, has a strong Turkish accent and speaks with urgency, as if she believes the body will get up off the table and walk away if she makes it wait. After donning multiple layers, including three pairs of gloves, we opened the drawer to remove the body. It came out slowly, giving the removal of the body an ominous effect that made me almost expect smoke to come out with it. We moved the body, in its bag, onto the metal table, and the bag was unzipped to expose the cadaver it contained. The first thing that hit me was, of course, the smell; it resembled fermented fruit to me, though the technician described it in much more colorful language than I. The second thing I noticed was the lack of humanity. The body belonged to an obese woman, middle aged, with two missing legs and nails painted bright pink. The body was called she and its organs were called hers, but there was no dignity given to her with that speech. It was like calling a boat a she. It was a cadaver, and she had ceased to be a woman. Her name was never mentioned, and I still don’t know if that was a good or bad thing.
As the autopsy progressed, I found myself more and more involved in the procedure. The technician had me hold flaps of fatty skin in certain places, at one point covering the cadaver’s face. I held a piece of metal above a flame and pressed it against the empty red lungs. I poked and prodded and squeezed various parts of the body, and when the skull was cut open with a saw, I held the brain in my own two hands. With the skull exposed and the face skin slid down, the body lost even more humanity. When I asked the technician about remembering that the body once belonged to a person, he told me he “never really thought about it.”
And yet, after I helped the technician sew her body up, from the groin to the shoulders, her humanity returned to me. When he was sewing up her scalp, I held her hair tenderly, and brushed it out of her face. When the technician squirted water in her face to clean her off, I expected her to sputter. When I held her lungs, I could not picture these organs coming from her chest, which was now filled with fat, fluid, and operating room materials. And while I didn’t feel nauseated or faint at any point in the procedure, I felt a twinge of sadness then. She was a person, a woman lying naked on a cold, metal table, surrounded by her own blood and tissue. I wanted to cover her up, tell the technician to look away. The smell of that autopsy stuck with me hours later.
I spent most of my second day shadowing an older Ukrainian pathology assistant in the gross anatomy lab. While we grossed various organs (for some reason, it was mostly uteri) and made slides of the frozen sections, he berated the American medical system while refusing to tell me anything about the Ukrainian medical system. He, as many doctors and medical professionals have, attempted to convince me to go into a different field. My favorite quote from one of his many lectures about my future career in medicine was “if you’re sane, you’ll cry the whole time.” He told me, over and over again, that physicians don’t save lives, they only “prolong suffering.” Elon called me sweetheart, got very concerned when I only brought a small sandwich for lunch, and seemed offended that I wouldn’t sit and get comfortable when viewing slides; I very quickly started following him around like a baby duckling, and this activity lasted for the most of the day, until Buket started grossing a uterus and a full human ear still attached to a chunk of neck (but not to the person to whom that neck previously belonged).
My third day was another autopsy, again with Chase and Buket. This body, unlike the last, did not at all seem dead. Rigor mortis had set in, and the body was able to hold its head up and keep its arms in place, crossing its torso. It was well kept and somewhat fit, as if just that morning he had woken up and shaved to get ready for work (unfortunately, he was young enough to still be part of the workforce). I had expected the body’s chest to rise like the lungs were expanding, or perhaps for the fingers to twitch and the eyelids to flicker a bit. But there was no movement, no signs of life. When I pushed my gloved finger into his arm, the surface acted like one of those stress balls filled with sand; it briefly retained the shape of my finger, an indent, and then slowly returned to its original shape. The smell was stronger this time, as he had died several days before, so I stayed several feet away for most of the autopsy, only getting involved when the skin had to be sewn back together and when the organs had to be measured, weighed, opened, and sliced to put in cartridges. I wrote the data on a white board, with the resident drawing the letters she was dictating in the air because I couldn’t hear her through two masks, a splash shield, and a thick accent. At this point in the autopsy, Chase had already put the body back in its drawer and was standing in the corner of the room, drinking chocolate milk from a small carton and eating peanut butter crackers. I was twenty hours into my internship at this point, and I had already held a human brain, found the center of the best gossip in the pathology department (hint: it’s histology, look for Kristin and Doreen), and gotten lectured by a massive Ukrainian man (whom they call “big guy” more than his actual name).