Most living people never visit the morgue.
Most never speak of the morgue, except during shows like CSI, Bones, or Hawaii 5-0. The popularity of forensic TV series, however, is social proof that there’s hidden interest in finding out just what goes on behind the autopsy suite’s closed door.
The word autopsymeans ‘to examine for yourself’. It’s a medical procedure that sounds simple in principle – taking a look at the outside and inside of a cadaver to establish cause of death. In practice, a post mortem (PM) examination can be highly complicated and time consuming; employing leading-edge scientific expertise.
There are three types of PM’s. A hospital autopsy is a non-legal process where the cause of death is known, but the caring physician wants to confirm a specific issue – such as a cancer tumor. A routine autopsy is conducted when the cause of death is not known, but foul play is not suspected. Then there’s a forensic autopsy – the one that’s going to be torn apart in a murder trial.
All autopsies follow a standard protocol. It’s the nature of the investigation that determines just how in-depth the procedure gets. The deceased arrives at the morgue and is catalogued with personal details and a registration number. Yes, they really do use toe-tags. The body is then placed in a refrigeration unit and waits its turn for examination. In a busy morgue this can take several days.
Usually two people conduct the autopsy. The pathologist, or medical doctor who is trained in the study of death and disease, is assisted by the deiner (German word for helper). Often there’s observers present; police officers, students, or technicians who come and go. The length of time varies – fifteen minutes to confirm a tumor, two hours routinely, and up to eight for a complicated forensic ordeal.
External observation can take a good portion. The body is removed from its shipping shroud, stripped, photographed, X-Rayed, weighed, measured, and identifiers such as race, age, hair and eye color, markings, abnormalities, as well as evidence of trauma or medical intervention is recorded. In homicide cases, the bulk of the evidence can be recovered in the external exam – clothing perforations, gunshot residue, lacerations, abrasions, hair, fiber, DNA, chemical contamination, or foreign objects. The observations are recorded on notes, diagrams, photos, and verbal dictations.
The corpse is placed supine, on its back, on the examining table which is an angled stainless steel tray draining fluids to a disposal sink. A plastic block is placed under the back to elevate the chest and recline the head and arms, making internal operations practical. A Y-incision is sliced from the tip of each shoulder, horizontally to the center of the chest, then vertically down to the pubic area. The skin is scalpeled back in a butterfly pattern accessing the thorax and abdomen, then the ribcage is removed exposing the upper and lower organs.
The major ones are removed, weighed, and cross-sectioned – lungs, heart, liver, kidneys, spleen, stomach, and intestines. Tissue sections are exscinded and fluids are extracted – blood, urine, vitreous humor, and digestive contents. These can be of immediate visual interest, or may tell later tales in toxicology and microscopic processing.
Cranial examination is the part that most newbies find difficult. The neck is now propped to elevate the head and the scalp is cut from ear to ear, peeled over the face and down the neck, then the skull cap is severed with a vibrating saw. The brain extracts easily and is often preserved in formalin to gel for later sectioning.
Completion involves returning the organs to the central cavity and sewing the incisions before releasing the body to a funeral home. Tissue and liquids are retained for histology and toxicology. In forensic cases, exhibits such as bullets, trace evidence, DNA standards, and clothing are transferred to the crime lab.
Often the cause of death is conclusive at autopsy. Occasionally nothing is known until the lab results come in. And sometimes… it’s never determined just why the subject died.
Our scientific understanding of life and death is extensive, but it’s far from perfect.
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Garry Rodgers has lived the life that he writes about. Now retired as a Royal Canadian Mounted Police homicide detective and forensic coroner, Garry also served as a sniper with British SAS–trained Emergency Response Teams and is a recognized expert-witness in firearms. A believer in ‘What Goes Around, Comes Around’ Garry provides free services in helping writers throughhis crime and forensic expertise. Garry’s new supernatural thriller No Witnesses To Nothing is based on a true crime story where many believe that paranormal intervention occurred. An Amazon Top 10 Bestseller, it’s available on Kindle and print on demand. You can connect with Garry via his Website: www.dyingwords.net 
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