(no subject)
I joined a website recently that is devoted to swapping letters and mail art with people from around the globe. When I have downtime, it's a great excuse to challenge myself to write a letter or draw a picture.
I joined a swap recently called "morbid curiousities". It's a letter-writing swap. I wrote about an autopsy I went to.
Hello swap partner!
This is my Swap-bot letter to you for the morbid curiousities penpal swap. I am writing this letter to you today, before I even know who you are, but will sure to include an extra note to you personally once I do know who you are.
So why am I writing this letter before I even know you? Because this is the perfect day to do it. You see, today, I saw an autopsy. So, you might want to stop reading if this is just a little bit too morbid or personal or whatever for you. But this is a morbid letter swap, so here I am, delivering the morbid.
I am a student of medical laboratory technology. Basically, I'm training to be one of the nerds in white lab coats who works behind the scenes at a hospital, performing scientific tests on all the bloods and urines and sputums and what-not that the doctors send up. I'm in my third and final year of this school program, and this is my clinical placement year. I've already been through the chemistry, haematology, and microbiology labs. Now, I'm in histopathology. This is where all the tissues, organs, and limbs go to be prepared for the pathologist to examine.
The workflow of the histopathology lab is like this: After the specimens are brought to the lab (usually in jars of formalin), a pathology assistant does a gross examination of the tissue or organ and then dissects the tissue, saving little pieces for microscopic examination. The technologists take over from there onwards, and the little pieces of tissue are placed into these plastic casettes (I put an unused one in the envelope for you - don't worry, it's never been near any bodyparts!) and placed in fixative for at least four hours. The fixative keeps the tissue from rotting. Once the tissue is fixed, it needs to be infiltrated with wax and then embedded in even more wax to make a little block that is firm enough to be sliced on a microtome. A microtome is essentially a meat-slicer, only it slices veeeery thinly. The slices are floated out on a water-bath and picked up on microscope slides. The slides are then treated to remove the wax, and then stained with special dyes to highlight tissue elements such as nuclei and collagen. After that, they're sent on their merry way to the doctors to examine microscopically.
So that being said, why on earth would it be relevent for me to go see an autopsy? Well, I'm not sure what the reasoning is for making the students go see these things. I guess it's to give us a crash-course in anatomy and to give us a new appreciation for how some of the samples are retrieved. Or the pathology residents like to watch the students faint. Who knows.
March 5th, 2010
I ran out of time to finish my letter yesterday, so now I continue.
Yesterday morning, the morning of the autopsy, my strategy to get through it was to eat a huge breakfast before-hand. This may seem counter-intuitive, but I'm a fainter rather than a puker, and after The Incident With The Bone Marrow Aspiration (don't ask - I nearly fainted), I decided that a full-belly and a nice even blood sugar level would keep me from getting woozy during the procedure.
I have to admit, I had an odd and ambivalent mix of emotions yesterday. There was this feeling of anticipation, excitement and slight dread that comes along with being about to do something interesting and unusual, something that could be really cool but also intensely uncomfortable and mildly disturbing. It's like that same feeing you get just before getting your nipples pierced. I'm sure you can relate, whoever you are.
The first thing we did in the autopsy lab was to prepare the room. The room was bright and clean and lined with counters that had sinks and cutting boards in them. At one end of the room was a biosafety cabinet with a small counter and a small sink in that, too. At the other end of the room, a cart with gloves and aprons and things on it. The centre of the room was dominated by a large metal table. The table-top was made out of metal with holes in it, and this was placed over what was essentially a very large sink basin. Another small table nearby held a variety of scalpels and other implements. My very simple task was to make sure that the counters were well-stocked with towels. The technologist, meanwhile, filled jars with formalin and put a new card into a digital camera.
Two pathology residents joined us, and we all gowned up. I had come to the hospital that morning wearing my scrubs and white shoes, and I swapped the shoes for a pair of rubber boots. Over my scrubs, I donned a blue gown, a white plastic apron, a pair of latex gloves, a paper hat, and not one but two face masks; the outer face-mask included a plastic shield to protect my eyes. The technologist and pathology residents wore these as well, but they wore two pairs of latex gloves with a pair of thin chainmail gloves in between, to avoid cutting themselves. They also had waterproof sleeves that they put on their arms. It was difficult getting used to wearing so much clothing; I felt like I might suffocate under two layers of face masks. Luckily, it only took me a few minutes to adjust to the masks, otherwise, I surely would have fainted.
Once gowned, the technologist went into the morgue and came back wheeling a gurney with the patient on it. I guess I should say the cadaver rather than the patient. I've never coped very well with death, though,and the word cadaver sounds so impersonal to me.
The cadaver was pulled onto the table with the little holes on top, and the gurney was moved out of the way. Photographs were taken, and a thing that looked like a small anvil was placed under her back to bring the torso into a position that would be easier to work with. This surprised me, since I thought that cadavers were laid flat on their backs during autopsies. Seeing a body in a back-bend over an anvil like this looked so uncomfortable and unnatural to me.
I guess that was the jarring part; before the body was opened, the person just looked like they were sleeping in a very uncomfortable position. Some part of me cringed when they first started cutting and opening her up. The first incision was hard to watch, but once the skin had been cut back and the muscle exposed, I started to relax a little; I guess because there was no longer some part of my brain insisting that she must be asleep. She was starting to seem less like a person and more like a specimen to examine.
I think the first thing that occured to me during the autopsy was how bright and colourful the human body actually is. Beneath the skin is a bright yellow layer of fat, followed by a bright red layer of muscle. And then, below that, all different shades of pinks and reds and whites. And the gallbladder, which is emerald green. We're actually quite vibrant inside; all of us.
The next thing that occured to me is just how small everything really is. You can hold a heart in the palm of your hand. Think of that.
The first organs out of the body were the heart, the liver, and the lungs. The technologist was the one removing organs. The pathology residents were weighing them, doing a gross examination, and then selecting tiny pieces to go into those tissue casettes I told you about earlier. Little bits of heart, little bits of artery, little bits of lung, of liver. I embedded those cassettes in wax just this morning. When the slides are made and stained, the pathologist will be able to get a close-up look to see if the cells look normal or if abnormalities were present. As a technology student, though, I don't get those pieces of the puzzle. I wouldn't, even if I were a technologist. The doctor gets the most puzzle pieces to play with, but even they don't get the entire thing; I heard them discussing amongst themselves over whether the cadaver had had a surgery years ago or not, and no one was certain since the medical records revealed nothing about it. Maybe only God gets the whole puzzle, if there is a God, and if there is a whole puzzle.
As the pathologists were examining the organs i told you about, the technologist was carefully tieing off the ends of the bowels to keep the contents from getting all over the place. The bowel was cut out and placed in a metal bowl, and this was placed in the biosafety cabinet to be rinsed out and examined later.
"The block" was the thing removed next. "The block," is, to the best of my knowledge, the term the autopsy people use to refer to everything between the lungs and the bowels. In one fell swoop, the rest of the guts were placed into a metal bowl; the stomach, pancreas, kidneys, gallbladder, ureters; all of it. The bowl was placed on the counter and the organs were removed from it, one at a time, to be weighed and examined.
The head was hard for me to watch.
Because I was busy averting my eyes, it's hard for me to tell you exactly where the cuts are made. Behind the ears, along the hairline, I think. And then one across the top of the head to conect them. This divides the skin of the scalp into two big flaps, one to be peeled forward and one to be peeled back. The sound of this process sticks with me more than anything. I'm choosing not to describe the sound to you, just as I'm also choosing not to describe the smell of the autopsy to you. It's better this way, just trust me.
Once the skull is exposed, a small hand-held electric saw is used to remove part of it. Beneath it, there's a thin but tough membrane, like the membrane inside of an eggshell. This is peeled back and the brain is removed. I was relieved to see that the brain looked exactly as I had expected it to, and that I was able to identify the cerebrum, the cerebellum, the pons, the stem....Everything looked exactly the way the textbooks had portrayed it, even right down to the layers of white and grey matter.
The brain was the last of it, so the top of the skull was replaced and the scalp stitched back into position. I was surprised to see that the chest was left open and merely covered with a towel. I guess this is to allow the mortician access to better do whatever it is that morticians do; I understand that they inject some of the veins with some fixatives, but I'm a little fuzzy on all the details.
It would probably be a breach of confidentiality for me to tell you exactly what was wrong with the cadaver, so I won't, but I will say that it was pretty wishy-washy; one tiny thing wrong here, one tiny thing wrong there. Who knows what the actual cause of death was. I'm not sure if the puzzle pieces the doctors picked up actually fit together well enough for anyone to say "Yes, this thing here definitely was the cause of death." And if they did, I'll never find out anyways, so there's that.
Three hours after walking into the autopsy lab, I walked out of there with a renewed appreciation for life and for just how fragile we all really are. I walked out with a better understanding of human anatomy, and with a sense of the bigger picture of histopathology. Later that day, I ran into a friend of mine, a friend who didn't know what I had been up to that morning. "How are you?" I asked him. "Still alive," he replied." "Me too," I said, "and it's awesome."
Sincerely,
Kay
I joined a swap recently called "morbid curiousities". It's a letter-writing swap. I wrote about an autopsy I went to.
Hello swap partner!
This is my Swap-bot letter to you for the morbid curiousities penpal swap. I am writing this letter to you today, before I even know who you are, but will sure to include an extra note to you personally once I do know who you are.
So why am I writing this letter before I even know you? Because this is the perfect day to do it. You see, today, I saw an autopsy. So, you might want to stop reading if this is just a little bit too morbid or personal or whatever for you. But this is a morbid letter swap, so here I am, delivering the morbid.
I am a student of medical laboratory technology. Basically, I'm training to be one of the nerds in white lab coats who works behind the scenes at a hospital, performing scientific tests on all the bloods and urines and sputums and what-not that the doctors send up. I'm in my third and final year of this school program, and this is my clinical placement year. I've already been through the chemistry, haematology, and microbiology labs. Now, I'm in histopathology. This is where all the tissues, organs, and limbs go to be prepared for the pathologist to examine.
The workflow of the histopathology lab is like this: After the specimens are brought to the lab (usually in jars of formalin), a pathology assistant does a gross examination of the tissue or organ and then dissects the tissue, saving little pieces for microscopic examination. The technologists take over from there onwards, and the little pieces of tissue are placed into these plastic casettes (I put an unused one in the envelope for you - don't worry, it's never been near any bodyparts!) and placed in fixative for at least four hours. The fixative keeps the tissue from rotting. Once the tissue is fixed, it needs to be infiltrated with wax and then embedded in even more wax to make a little block that is firm enough to be sliced on a microtome. A microtome is essentially a meat-slicer, only it slices veeeery thinly. The slices are floated out on a water-bath and picked up on microscope slides. The slides are then treated to remove the wax, and then stained with special dyes to highlight tissue elements such as nuclei and collagen. After that, they're sent on their merry way to the doctors to examine microscopically.
So that being said, why on earth would it be relevent for me to go see an autopsy? Well, I'm not sure what the reasoning is for making the students go see these things. I guess it's to give us a crash-course in anatomy and to give us a new appreciation for how some of the samples are retrieved. Or the pathology residents like to watch the students faint. Who knows.
March 5th, 2010
I ran out of time to finish my letter yesterday, so now I continue.
Yesterday morning, the morning of the autopsy, my strategy to get through it was to eat a huge breakfast before-hand. This may seem counter-intuitive, but I'm a fainter rather than a puker, and after The Incident With The Bone Marrow Aspiration (don't ask - I nearly fainted), I decided that a full-belly and a nice even blood sugar level would keep me from getting woozy during the procedure.
I have to admit, I had an odd and ambivalent mix of emotions yesterday. There was this feeling of anticipation, excitement and slight dread that comes along with being about to do something interesting and unusual, something that could be really cool but also intensely uncomfortable and mildly disturbing. It's like that same feeing you get just before getting your nipples pierced. I'm sure you can relate, whoever you are.
The first thing we did in the autopsy lab was to prepare the room. The room was bright and clean and lined with counters that had sinks and cutting boards in them. At one end of the room was a biosafety cabinet with a small counter and a small sink in that, too. At the other end of the room, a cart with gloves and aprons and things on it. The centre of the room was dominated by a large metal table. The table-top was made out of metal with holes in it, and this was placed over what was essentially a very large sink basin. Another small table nearby held a variety of scalpels and other implements. My very simple task was to make sure that the counters were well-stocked with towels. The technologist, meanwhile, filled jars with formalin and put a new card into a digital camera.
Two pathology residents joined us, and we all gowned up. I had come to the hospital that morning wearing my scrubs and white shoes, and I swapped the shoes for a pair of rubber boots. Over my scrubs, I donned a blue gown, a white plastic apron, a pair of latex gloves, a paper hat, and not one but two face masks; the outer face-mask included a plastic shield to protect my eyes. The technologist and pathology residents wore these as well, but they wore two pairs of latex gloves with a pair of thin chainmail gloves in between, to avoid cutting themselves. They also had waterproof sleeves that they put on their arms. It was difficult getting used to wearing so much clothing; I felt like I might suffocate under two layers of face masks. Luckily, it only took me a few minutes to adjust to the masks, otherwise, I surely would have fainted.
Once gowned, the technologist went into the morgue and came back wheeling a gurney with the patient on it. I guess I should say the cadaver rather than the patient. I've never coped very well with death, though,and the word cadaver sounds so impersonal to me.
The cadaver was pulled onto the table with the little holes on top, and the gurney was moved out of the way. Photographs were taken, and a thing that looked like a small anvil was placed under her back to bring the torso into a position that would be easier to work with. This surprised me, since I thought that cadavers were laid flat on their backs during autopsies. Seeing a body in a back-bend over an anvil like this looked so uncomfortable and unnatural to me.
I guess that was the jarring part; before the body was opened, the person just looked like they were sleeping in a very uncomfortable position. Some part of me cringed when they first started cutting and opening her up. The first incision was hard to watch, but once the skin had been cut back and the muscle exposed, I started to relax a little; I guess because there was no longer some part of my brain insisting that she must be asleep. She was starting to seem less like a person and more like a specimen to examine.
I think the first thing that occured to me during the autopsy was how bright and colourful the human body actually is. Beneath the skin is a bright yellow layer of fat, followed by a bright red layer of muscle. And then, below that, all different shades of pinks and reds and whites. And the gallbladder, which is emerald green. We're actually quite vibrant inside; all of us.
The next thing that occured to me is just how small everything really is. You can hold a heart in the palm of your hand. Think of that.
The first organs out of the body were the heart, the liver, and the lungs. The technologist was the one removing organs. The pathology residents were weighing them, doing a gross examination, and then selecting tiny pieces to go into those tissue casettes I told you about earlier. Little bits of heart, little bits of artery, little bits of lung, of liver. I embedded those cassettes in wax just this morning. When the slides are made and stained, the pathologist will be able to get a close-up look to see if the cells look normal or if abnormalities were present. As a technology student, though, I don't get those pieces of the puzzle. I wouldn't, even if I were a technologist. The doctor gets the most puzzle pieces to play with, but even they don't get the entire thing; I heard them discussing amongst themselves over whether the cadaver had had a surgery years ago or not, and no one was certain since the medical records revealed nothing about it. Maybe only God gets the whole puzzle, if there is a God, and if there is a whole puzzle.
As the pathologists were examining the organs i told you about, the technologist was carefully tieing off the ends of the bowels to keep the contents from getting all over the place. The bowel was cut out and placed in a metal bowl, and this was placed in the biosafety cabinet to be rinsed out and examined later.
"The block" was the thing removed next. "The block," is, to the best of my knowledge, the term the autopsy people use to refer to everything between the lungs and the bowels. In one fell swoop, the rest of the guts were placed into a metal bowl; the stomach, pancreas, kidneys, gallbladder, ureters; all of it. The bowl was placed on the counter and the organs were removed from it, one at a time, to be weighed and examined.
The head was hard for me to watch.
Because I was busy averting my eyes, it's hard for me to tell you exactly where the cuts are made. Behind the ears, along the hairline, I think. And then one across the top of the head to conect them. This divides the skin of the scalp into two big flaps, one to be peeled forward and one to be peeled back. The sound of this process sticks with me more than anything. I'm choosing not to describe the sound to you, just as I'm also choosing not to describe the smell of the autopsy to you. It's better this way, just trust me.
Once the skull is exposed, a small hand-held electric saw is used to remove part of it. Beneath it, there's a thin but tough membrane, like the membrane inside of an eggshell. This is peeled back and the brain is removed. I was relieved to see that the brain looked exactly as I had expected it to, and that I was able to identify the cerebrum, the cerebellum, the pons, the stem....Everything looked exactly the way the textbooks had portrayed it, even right down to the layers of white and grey matter.
The brain was the last of it, so the top of the skull was replaced and the scalp stitched back into position. I was surprised to see that the chest was left open and merely covered with a towel. I guess this is to allow the mortician access to better do whatever it is that morticians do; I understand that they inject some of the veins with some fixatives, but I'm a little fuzzy on all the details.
It would probably be a breach of confidentiality for me to tell you exactly what was wrong with the cadaver, so I won't, but I will say that it was pretty wishy-washy; one tiny thing wrong here, one tiny thing wrong there. Who knows what the actual cause of death was. I'm not sure if the puzzle pieces the doctors picked up actually fit together well enough for anyone to say "Yes, this thing here definitely was the cause of death." And if they did, I'll never find out anyways, so there's that.
Three hours after walking into the autopsy lab, I walked out of there with a renewed appreciation for life and for just how fragile we all really are. I walked out with a better understanding of human anatomy, and with a sense of the bigger picture of histopathology. Later that day, I ran into a friend of mine, a friend who didn't know what I had been up to that morning. "How are you?" I asked him. "Still alive," he replied." "Me too," I said, "and it's awesome."
Sincerely,
Kay