So despite being constantly around medical knowledge and situations, I still enjoy watching medical based television shows like House and Life in the ER. Another show I enjoy watching when I have time is "Dr. G - Medical Examiner". If you've never seen the show, Dr. G is basically the best at autopsy examinations. I got the chance to step into her shoes this past week.
Twice during 4th semester at my school, students are required to go to the hospital for rounds. My second trip was last week. The schedule is the same for everyone, in the morning you follow a physician and do whatever they do, sometimes participating, sometimes just watching. There were three girls plus myself that went to the Pathology department. The physician we followed was from Cuba and did not speak English very well. So...thank you to all the teachers who taught me Spanish in high school and college because it got me through the day :) We went through a short presentation in her office and then it was off to work. We left her office and went outside to what looked like a shed or something that should be on a farm. While looking a little shady on the outside, the inside was a fully functional lab. The man was a 76 year old Dominica with a cause of death of CVA - Cerebral Vascular Accident. Just before we began, the mans wife and two other relatives came in to identify the body. That was definitely tough. To see the mans widow walk in, see him, start crying, and with tears streaming down her face told us that was her husband. After that, the relatives signed some papers and then left...and it was time to start the examination.
So this is the part that will gross you out if you're squeemish...so there's your WARNING!
So the autopsy began with cutting the deceased from his throat down to the bottom of the abdomen. The autopsy technicians cut through the fat and abdominal muscle wall to expose the abdomen. A saw was used to remove the center of the ribcage and expose the chest cavity. And this was the part that amazed me...so as you may or may not know, there are large arteries that come off the heart and then the large intestine connects to the rectum. These are the major areas that hold everything in place. These two areas were dissected through, a couple other things happened, and then in a few minutes, all internal organs from the chest and abdominal cavity were removed in one big mass and layed on the examination table. This is where the pathologist takes over. She has to inspect each organ for other signs that could have lead to his death. Everything is cut open, weighed, and sometimes samples are taken to be looked at under a microscope. However, since the cause of death that was suspected was the CVA, it made sense to look at the brain first. So we did...we had to first remove what's called the calvarium..basically the top of the skull so the brain could be removed. Once the brain was on the table the pathologist started working her way through it. It didn't take long to find the cause of death. There is a group of arteries that runs through the brain, so if you know where to look, your job is much easier. There is a one called the basilar artery. It had an "atherosclerotic plaque" in it. That's the same issue we all hear talked about with high cholesterol and eating too many cheeseburgers. The plaque closed off this artery and prevented the blood, which carries the oxygen from getting to the brain. So basically this man died because he couldn't get oxygen to his brain.
Once the pathologies was finished looking through all the organs, they were put back inside the man and he was sutured up, which was impressive in itself because the incisions that were made were barely seen.
And that was it...I had seen my first autopsy and confirmed the diagnosed cause of death....something that is so gross to many people, and was one of the highlighted days in my life on this island.
During the afternoon at the hospital I interviewed a post surgical ward patient and performed a full physical exam for him. However, it pales in comparison to the excitement of the morning...and my class has started, so that's all for now :) I can't believe I only have 43 more days here!!!
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