Sunday, September 22, 2013

The Way We Live



[Advisory for the Faint of Heart:  Among other things, this post will discuss, but not show, an autopsy and a slideshow of unpleasant corpses.]

Two days into my new job, I saw the top of a man's head taken off and his brain cut free.  He was already dead, no harm done, but still--there's no putting things back together after something like that.  I think that's what lingered with me the longest: the finality of it.  Once you're dead, it doesn't much matter what someone does to even your most essential organ.  You're done with it, right?

I should emphasize that I was just a tourist in this scenario, as superfluous as that man's brain.  My new employer, the attorney general's office, was giving its summer interns a tour of the state medical examiner's office, and I was tagging along as a curious chaperone.  Mind you, I didn't know when I signed up that we were going to get a live demonstration, so to speak.  I don't know what I was expecting--maybe livers in jars or, at most, a sheeted corpse on a gurney, toe tags peeking out.  Nope.  Here was blood and tissue and bone, all in messy disruption.

There was nothing glossy about the examiner's office, with the seedier part of town visible on the other side of the interstate.  The conference room where we met the chief medical examiner was a shrine to mid-seventies masculine professionalism, all dark wood paneling and leather chairs, befitting the gray-bearded chief himself, the very model of a competent, slightly pompous New England doctor.  He quizzed the interns, via Socratic method, about causes of death, toxicology, DNA testing, and arson investigations. Then the real tour began.  The other deputy attorney general, a longtime veteran of the homicide unit, warned the squeamish to stay in the conference room as we descended two flights of stairs into the autopsy room.

Paradoxically, I think I was expecting the morgue to look like a sterile environment, but there in the floor was a drain, and there on the table was the body, face up, flies buzzing around its head.  He was naked, about my age, piercings in his eyebrows and tattoos on his arms.  He had not been dead a day, and already there were rough stitches running up his arms, across his chest, and all the way down his strange, skinny legs.  Under his skinless back I could see blood seeping in a large, absorbent pad--he had been a tissue donor.  All the visitors stood a very respectful distance from the body, and no one seemed to know quite where to look.  Not in the face, certainly, not at his splayed feet, and not at the rest of him either.  Flies would land on the face, buzz around, and then land on you.  Up in the corner, a blue bug zapper hummed and crackled.  I got the sense that our discomfort was not unpleasing to the chief--he seemed a little more quippy, a little more inclined to show how routine was the sight before us.

The deceased suffered from both drug addiction and seizures, thus the need to determine cause of death, thus the need to get at his brain.  A stout, frizzy haired woman with a thick slavic accent, looking for all the world like a Polish grandmother or butcher, started slicing back the scalp while I and many others began to look away.  The ears wiggled as she folded back the skin, and I tried not to think about the man's face.  Then an interesting thing started to happen.  As the autopsy progressed, members of our group tended to drift in two directions--either farther away, to the edges of the room, or closer to the corpse, peering deeper into the secrets of the human machine.  I was surprised to find myself in the latter group.  The less the cadaver resembled a human being, the freer I felt to marvel at it--wondering at the framework of meat and bone left behind when the spirit flies away.

With the skull exposed, out came the circular saw, attached to a suction hose for reasons which were obvious once explained.  The grandma made an "X" in the front of the skull, forming a notch that would keep the pieces from sliding once the top of the cranium was sawed loose.  Off came the top, the inside grooved with the imprint of blood vessels and lobes.  Then she went to work on the dura mater, slicing it away, pulling it back and suddenly there was the brain--everything the man had been and was rapidly ceasing to be.  It looked soft when she pulled it out, already starting to liquify, and she held it in her hands for us to see--so terribly easy to ruin, the most fragile thing in the world.  She dumped it on the hanging scale (just shy of three pounds), then set it on a cutting board to slice and dice.  The brain cut easily--far too easily, easier than cheese or butter--and she soon had it cubed and put into containers.

By this point I was standing maybe four or five feet away, looking at where the brain had sat in the skull.  It was fascinating how much inhabits such a small space.  Grandma dug out the pituitary gland with a scalpel, scraped it onto the table for us to see, and we all marveled that something smaller than a pea could regulate so much of our destiny.  After that, the show was mostly over.  As we filed out, I saw the other deputy, standing back.  "I've given this tour many times," she said, "but it's not something I relish."  She had been running on very little sleep, looking at murder scenes all hours of the night.

Back upstairs in the auditorium, the chief began to show off in earnest.  Up on the big screen, almost too big to ignore, he clicked through his slideshow of interesting corpses.  They were all local, all of them from the last decade or so.  Here was the blunt-object trauma of two murder victims, their bodies left in a torched vehicle less than a mile from my house.  Here was the man ravaged by flesh-eating bacteria after only a sharp bump to the elbow, and the man who had the misfortune of dying in an apartment full of hungry, neglected Nile monitors.  Here also was an anorexic suicide, an autoerotic asphyxiation, and a man accidentally drowned in a garbage can full of spackle (don't ask).  "You would be surprised," the chief told us, "how many corpses we find in the nude."  It's nice to think we can leave with a little dignity, but it became clear that not everybody gets to choose when and how they go.

On a relative scale, the least disgusting slide showed the body of a retired highway patrolman, his skull repeatedly fractured by a lifetime of crashes in the line of duty.  Addicted to painkillers, one day he got hopped up on morphine and began firing an assault weapon into his suburban neighborhood.  The SWAT team pinned him down on his porch, and in the ensuing firefight a sniper shot him right through the nostril, leaving barely a mark.  Another slide showed him where he fell, naked, lying like a baby in the doorway.  Another slide showed his bedroom, the bed piled high with weapons and ammo.  "Maybe it's not a good idea for a morphine addict to have all those guns," said the chief.  "But I guess that's the way we live."




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