The autopsy: It’ll get under your skin

Itís not a person.

Itís just flesh and bone. And hair. And oozing and pooling red- and yellow-shaded liquids. But, at least at first, itís imperative to keep repeating: Itís not a person.

In our society, an autopsy is a necessary and vital part in a death in which the cause is not obvious. Watching the procedure, however, takes some getting used to.

Why am I standing in this chilly downstairs room? Do I really want to watch chief deputy coroner Jann Smith saw into a human skull so that La Plata County Coroner Carol Huser can fish out the brain, weigh it and cut it into cross-sections?

Call me morbid, but Iím curious. I like to see how things are done, to understand how the world works. As a journalist, I attempt to remain open to new experiences, new ideas. Plus, I admire Huser from her no-nonsense opinions and the entertaining and educational columns she writes for the Herald. I want to hear Huser explain what she does and why.

So finish up your Raisin Bran, wash it down good and, if you dare, read on.

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Itís midday on a weekday as I join Huser, Smith and a local law-enforcement investigator at Hood Mortuary. Weíre delayed while an organ-donation team harvests the corneas from another body. They, too, use Hoodís white metal tables with built-in gutters that allow easy drainage.

Huser opens her toolbag and spreads out a long knife, scissors, pruning shears, pliers and a vibrating saw. This is my first clue that the body, still zipped into a black bag, is in for some harsh treatment.

Before the cutting and poking and sawing begins, Huser takes 10 minutes to inspect the exterior of the stripped body, looking for abrasions, bruises, broken bones or other suspicious marks. Strangulation, for example, can be indicated by petechiae (pa-TEEK-ee-uh) Ė red dots in or around the eyes where tiny capillaries have popped. Large, dark-red splotches show a condition called livor mortis Ė blood settling by gravity after death. She notes these marks on a notebook-paper-sized body outline attached to a clipboard.

Then itís time for the infamous Y-shaped incision.

From shoulders to lower sternum, from sternum to belly, the body is laid open, the flesh peeled back. Then Smith takes the pruning shears and, with stunning ease, cuts through the ribs and lifts out the breastplate.

A fetid stench emanates from the body cavity. Suddenly, youíre looking at body organs smooshed together in an impossibly small space. These are your vitals: heart, liver, kidneys, intestines, stomach, lungs Ė all compacted into an area not much bigger than a couch pillow.

Does it bother you guys, I ask, to take apart a body like this Ė particularly on the rare occasion that you actually knew the person?

ďItís evidence,Ē says the investigator, no stranger to the sights and smells of this room.

Says Huser: ďItís a puzzle. Itís a job. Itís evidence. As soon as you get inside, itís all the same.Ē

The soul that inhabited this body is gone. Itís no longer a person. Still, occasionally, people who witness an autopsy Ė even an FBI agent Ė get sick. Others have an emotional reaction, particularly if itís a child on the table.

ďSome people can separate it, and some canít,Ē Huser says.

As she examines the body, sheís trying to foresee what questions might come up during a possible criminal investigation. For this autopsy, that will mean looking under each neck muscle for bruising, for evidence of strangulation.

Autopsies are performed for nearly all unnatural or violent deaths, Huser says. Or when she or an investigator has any suspicions.

Surprises still occur, even though sheís done 4,000 or so of these by her estimate. She gets just one shot at each autopsy, so sheís thorough. This wisdom came from a colleague early in her career: ďItís a lot easier to explain why you did something than why you didnít do something.Ē

She gathers fluid from a blood vessel a short distance from the heart to send to the toxicologist. Then the organs come out Ė everything from the heart to the liver to the tiny wormlike appendix. She plops them individually on a scale and calls out numbers Ė 430, 950, 860, 1,600 Ė weights that the investigator obligingly writes down.

Then she slices each organ into cross-sections, looking for signs of disease, tumors or abscesses, for instance. During the autopsy, sheís seeking not just the cause of death, but anything abnormal; in some cases she has uncovered conditions that could be crucial to other family members. Then the organ goes into a bucket. The organs later will be put in plastic and returned to the body before itís sewn shut.

Meanwhile, Smith props up the head, parts the hair horizontally in the back, and cuts the flesh to the skull. In the next step Ė you sure you want to know this? Ė she peels the scalp forward and folds it onto the face. Smith takes the vibrating saw and gets busy. With no small effort, she makes a football-shaped cut into the thick skull, then pries it open with a screwdriver-like tool.

And wow, thereís the brain.

This mushy, maze-like mass makes us function. Astounding. Huser and Smith pull out the cranium tissue and weigh it.

Huser cuts open the stomach and strains the contents. Sometimes she finds bits of pills, sometimes a piece of undigested corn.

Lastly, Huser and Smith lay the skin back into place as best they can, hose off the table and, if thereís an open-casket service planned, leave the body for the embalmer. Thatís another story, but apparently the embalmer must know some good tricks.

Huser prepares the blood samples for the toxicologist. Drug and alcohol levels in an overdose death often are not as ďimpressiveĒ as you might expect, she explains. The body has had time to process the drug, and thereís no way to know what the highest drug level actually was. Test results take several weeks.

Weíre done, and other than the shock of seeing a human body taken apart, Iím left with one overriding reinforced understanding: The human body is amazing beyond belief. What all those organs do, even in their crammed-together state, awes me.

As I walk down the street, away from the mortuary, Iím seeing the world in a whole new light. Well, not the world, the people. Everyone who passes I envision lying on an autopsy table. Yes, Iíve had more pleasant thoughts.

Iíve experienced a lot in two hours. It was a bit upsetting, but Iíll recover quickly. Most of all, it was fascinating. Bottom line is I learned a ton and gained a greater understanding of death and criminal investigations.

And I think I can handle lunch, but I really do hope these visions go away soon.

johnp@durangoherald.com This was written after observations of two autopsies in the last several months. Every effort has been made to not identify the victims.