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MORE FORENSIC DETAILS

August 30th, 2007 15 comments

R. C. Jones

The buzzing sound began as I started down a narrow set of stairs leading to a large basement room. I had never been there before, but I knew what the source of the buzzing must be. It was the sound of a small vibrating saw cutting off the top of someone’s skull.

READER ALERT! Anyone with an especially queasy stomach might wish to abandon ship here.

In my last essay, we got as far as what happens forensically to bullets, cartridge casings and primers when cartridges are fired in revolvers and semi-automatic pistols. But what happens forensically to bodies of victims who do not survive being caught in front of those weapons when they are fired? The following gives some details about that. The details are described as I observed them on a visit to a county morgue to observe autopsies performed on two such victims. Trainees at a local police academy were required to attend a post-mortem examination (autopsy), and a trainee-friend invited me to accompany him and four others.

For reader convenience, insider jargon and certain key terms are presented in uppercase letters.

A forensic autopsy, as contrasted with a clinical or academic autopsy, is performed when a death might be related to a crime. The word “autopsy” refers to a post-mortem examination performed on a human; “necropsy” refers to one performed on a nonhuman.

There was an expected chemical odor present in the basement room, but it was relatively mild – - what I would call a force-1 odor. There were no seriously decomposing bodies to be examined that morning so we were fortunately spared any full, force-10 odors. We six observers took up station in a small, slightly elevated, viewing area disposed at one end of the room. The room housed a number of autopsy tables. The tables were formed of stainless steel and were tilted a bit so that water and body fluids would run toward drains at their lower ends. Each table had raised edges to prevent fluids from running onto the floor. Above each table hung lights, a weight scale, a microphone for recording notes and a water hose for rinsing away fluids.

Upon the first table lay the body of a 28-year-old man who had been shot during a fight in a pool hall. A small, dissecting table was mounted above the body’s legs. A block had been placed under the head so that the scalp faced upwardly. A pathologist had made an incision that began behind one ear, passed across the top of the scalp, and ended behind the opposite ear. He had then pulled the front portion of the scalp over the face and the rear portion over the back of the neck to expose the top of the skull. Next, he had used the vibrating saw, which is usually referred to as a STRYKER SAW (no matter which manufacturer produced it), to cut through the skull. The saw had a semicircular, toothed blade that oscillated back and forth rapidly over an angular displacement of only about 20 degrees. It thus cut through bone but not soft tissue. If you have ever had a plaster cast cut off, you have
probably seen such a saw in action.

After having cut and removed the upper skull portion, called a calvarium, the pathologist extracted a .32 caliber bullet from the brain with forceps, usually referred to as PICK-UPS. He rinsed the bullet with water and dropped it into a small metal tray with a clink just like that heard in many CSI episodes. (Those readers who have seen the brain transplant scene in Robocop 2 would also have recognized the sucking-grating sounds created when the calvarium was removed.) The brain was then cut loose from the spinal cord and other attachments with a scalpel, weighed and suspended by a string in a jar filled with FORMALIN, which is a buffered-water solution of formaldehyde. A brain is very soft, and suspending it prevents it from becoming flattened as a result of resting upon the bottom of the jar. The formalin preserves the brain and, after a few weeks, also makes it sufficiently firm to resist falling apart during an examination.

The pathologist recorded descriptions of any abnormalities on exterior surfaces of the body and positioned a BODY BLOCK under the back of the body. The block forced the chest upwardly in preparation for an examination of interior organs. Using a large scalpel, the pathologist made a Y-shaped incision. Upper portions of the Y extended from each shoulder to the lower end of the sternum (breast bone). From that
point, the lower portion of the Y extended to the pubic bone. The lower incision detoured a bit around the umbilicus (navel). If the body had been that of a woman, the upper incisions would have detoured around and below the breasts.

Using a scalpel, the pathologist separated the skin and muscle from the chest wall and pulled the resulting flap up over the body’s face to expose the rib cage. The odor at this point had elevated to force-2, which was still relatively mild. If you can recall the odor of raw lamb meat, you are now as good as being in the autopsy room.

The pathologist used a large, curved bone cutter to snip ribs along each side of the rib cage. This, with the aid of a scalpel, separated the chest plate (the sternum and ribs connected to it) from the remainder of the skeleton and exposed the lungs and heart, the latter still being enclosed within a pericardial sac. Slicing the abdominal muscle away from the diaphragm and the bottom of the rib cage exposed the abdominal organs. The pathologist severed all the connections of remaining internal organs to the body with a scalpel and placed them on the dissecting table. Using a scalpel, scissors, forceps and a very long knife commonly referred to as a BREAD KNIFE, he separated the organs. He simply pulled several items apart, a technique referred to as BLUNT DISSECTION. He separated the lungs, weighed them and sliced them with the bread knife into bread-slice-thick portions. He removed and weighed the heart, opened it and examined it, and systematically removed, weighed and examined remaining organs and glands.

Although the man on the table had been only 28 years of age, he had been a heavy smoker and a heavy drinker. Both his lungs and his liver were already black. Two of the observers were smokers, and both mumbled something at this point about never smoking again. One of them later lit up before he even reached his car.

The pathologist took samples from many of the organs and placed them in plastic cassettes. The samples were later to be fixed, waxed, sliced into sections five microns thick, mounted on glass slides, stained, coverslipped and examined using a microscope. The slides must be kept at least twenty years and are often kept indefinitely. Additional small samples are preserved in formalin, in what is referred to as a SAVE JAR, at least until a final report has been prepared, and are later incinerated.

As one can imagine, as the autopsy had progressed, the odor intensity had been creeping ever higher. By this time, it resided at about a force-5 level. When the pathologist opened the stomach, an unforgettable odor of gastric (hydrochloric) acid drove it up to a force-7 level. When he opened the intestines over a sink to flush the contents down the drain with water, a procedure referred to as RUNNING THE GUT, we were assaulted by force-9 fragrances normally associated with diarrhea and vomit.

At this point, the pathologist replaced the calvarium upon the lower skull and sewed the separated scalp together using a baseball stitch. The incision would be covered by a pillow in a casket. He then put the organs, glands and such removed from the body in a transparent plastic bag. He placed the bag within the empty body, balanced the chest plate atop the bag, and sewed the Y-shaped incision together, again using a baseball stitch. After rinsing the body using the water hose and a sponge, he covered it with a sheet. A mortician would later pick up the body, inject embalming fluid into the carotid and subclavian arteries in the neck and upper chest and the femoral arteries in the thighs, insert filler into the chest cavity to restore an approximately faithful exterior configuration to the body, apply makeup and otherwise prepare the body for public viewing.

After an appropriate fixing time, the brain would have been examined in much the same manner as were the organs and glands. Sections would have been removed for microscopic examination, a few portions put into a save jar, and the rest incinerated.

A subsequent autopsy was performed on a young policeman who had lost a desperate struggle with a motorist he had just stopped. The policeman had been shot in the right side of his chest with his own gun, a .38 caliber revolver. The bullet had punctured his aorta. The autopsy proceeded in the same order as the first except that removing his brain was left until last. I add this description to include an additional detail.

Four of our initial group of six observers had left by this time, but I had stayed to ask the pathologist some questions. One was about how he could estimate the path of a bullet inside a body. He invited me to stand across the table from him so that he could show me one of the tricks of his trade. He first showed me the entry wound from the outside and pointed out a darkened area of skin around one edge of it. He explained that the area was a burn produced by the rapidly spinning bullet as it had pierced the skin. When a bullet passes through skin along a path that is at right angles to the body surface, it leaves a fairly symmetric-appearing hole. If the path is not at right angles, skin along the side of the entry hole at which the angle of the bullet relative to the skin surface is less than 90 degrees will often be scorched by thermal energy resulting from friction between the spinning bullet and the skin. Don’t bother rereading the previous sentence, just imagine inserting a pencil through such a hole and inclining it toward the darkened edge. The inclined pencil will point in the general direction taken by the bullet.

The chest plate had been removed from the body, and the pathologist had pushed aside some of the intestines to give me an inside view of the hole made by the penetrating bullet. From the shape and location of the scorched, outside area, he had estimated where the bullet had probably stopped and found it within a few seconds. Of interest but of no particular relevance was the fact that the pathologist also discovered and showed me that the policeman had three spleens, an anomaly he said was not particularly rare.

I had been a bit concerned about what my reaction might be to watching a human body being cut open, but the only thing that bothered me was the force-9 odors. As the pathologist pushed intestines away from the bullet hole, the slippery conduits kept oozing between and around his fingers to refill the cavity he had just excavated so that he had to keep repeating his actions to maintain a clear view. Fortunately, I remained absorbed only in what he was explaining.

During a radio call-in show, a doctor had responded to a question about how he had overcome revulsion when confronted by the sight of the inside of a human body. He said that, just as he had always thought that the exterior of a body was beautiful, he found the inside to be beautiful also. When I considered the functional complexity of a body’s parts, I felt much the same way. In a college biology class, we students had to dissect a Necturus maculosus (mudpuppy, or waterdog). It was interesting, and I had no revulsion problems with it; but, for weeks thereafter, whenever I looked at anyone, I could not help visualizing their insides. I thought I might again experience this interesting phenomenon after watching the autopsies, but I did not.

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For the sake of brevity, I have referred to a single pathologist as being the one who performed the autopsies described. Often, there are a number of persons, having specific titles (e.g., dieners and prosectors), who perform different functions during an autopsy.

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I should have mentioned one more detail. A pathologist also checks a toe tag to ensure he has the correct body. Ideally, he does this before making very many incisions.

Robert C. Jones