Eviscerated & Sewn

By Katie T Wilson

We’ve been waiting days for you to arrive, tirelessly tracking down your body and paperwork, making sure we gather every piece of information. You are an afterthought to many of the clinical teams now that you’ve crossed to the other side, but this seems to be a recurring theme after death. When everyone is overworked and burnt out, with too many living patients to care for, it can be difficult to remember their humanity in death. We in autopsy know the privilege we have in your care, the special language we speak as we let the body tell your story. Recording every tattoo, scar, and scrape; every line and tube; every burn and bruise that came from CPR. Every stitch and suture, broken bone, and remaining organs. We measure the length of your hair and describe it, and record the color of your eyes even though they are still. We feel the cold of your limbs as we cover you in surgical towels before we start. It’s a different experience to be in a theater without the beeping and sounds of machines, about to perform surgery and investigate without checking vitals or asking you if you’re ready. We talked to your family of course and hope we are carrying out your wishes.

You were different for me, one of those cases they say that stays with you. When I unzipped the bag and saw you, saw what happened. I know your wishes were not to be here, but in death we hope to honor you and bring closure to your family. The color of your skin and history tells me all I need to know about how you ended up on our autopsy table, and how important our job is at this moment. Not for the system, but for you and your family. We know your family wanted more time to say goodbye, to hold you and freeze time, to find that tiny bit of peace when the world is still, before it all comes crashing down when they let you go.

I choke back the emotions and tears of knowing that you should have never ended up on our table, whether it was getting the care or support you needed or being prioritized in death. We know the system has failed so many and that is what brought you here, like many of our relatives who deserved more. Your hair is perfectly braided with colorful ties, clearly done with so much love in each braid and twist. I use surgical towels to carefully wrap your braids and protect them from our work, ignoring the looks from others around me. My dear friend and teacher comforts me, showing true allyship and a commitment to justice in the moment we go to proceed with your exam.

Our patient-physician relationship is quite different, full of privilege in caring for the deceased and often the lasting impression on families and communities. How we treat you and give you justice is what communities will remember, and is what will influence their relationship with medicine. We are the last chance to make this right for you, your family, and your community. You left this world too soon, but not soon enough for us to cut you open, remove your organs, cut the brain from the cord and bleed you dry. I hope you saw how much we cared for you and meticulously documented every single finding. We took great care in sectioning your organs and removing your brain and spinal cord, as we carefully placed them into the formalin bucket. Autopsy isn’t the most gentle of procedures, but it is invaluable in giving you and your family the closure you they may crave. Healing hands has such a different meaning in the morgue, as we use our hands to investigate and get to the answers. As we carefully weigh, slice, and palpate for anything to give an explanation.

I’m sorry that was our first and last interaction with you, eviscerated and sewn, in our job of giving your family closure and justice in your death, so that they may find peace. No matter what we do or despite our intent to help, the system will continue to fail you as it has for many of our relatives. You were a priority to us even though you should have never been there. I went home and cried about you, thinking about your braids and the many more that were to come after that. Tears of rage, frustration, and defeat. There is peace in crying and letting it out of your system because if you don’t it will just eat away at your spirit. Our job in autopsy is special and full of privilege in providing answers and justice for the deceased, a different way of healing ourselves and our communities. Sometimes this process is at our own physical and emotional expense, with the hours standing over the table and sewing you back up. The things we see and are expected to go home as if nothing happened; because it’s “normal” for us to use a bone saw to open your skull, pull off the dura, and cut your spinal cord to free your brain. Some people get to go home, lay their heads down on their pillows, and have peace in sleep. While the work of the day sometimes haunts my head, I find peace in giving families the answers they need to grieve and to start healing. Healing our communities are often deprived of in light of the ongoing violence, murder, and systemic marginalization. A healing I can do for our people. That’s the beauty of Autopsy.