Autopsies

[dhm37]

I've been interested in Pathology and consider it one of my top specialty choices. I love the science and detective work in finding disease. However, I find I really don't care for autopsies. I've been through 3 of them now and while I do feel I'm getting more used to them, I've been having trouble mentally "detaching" myself from the humanistic aspect of the person. Have any of you dealt with this problem, and does it get better? Are there any solutions? Is it possible for a Pathologist to not do autopsies in private practice? Or, am I not cut out for this specialty? Thanks to anyone with comments or answers.

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[Mindy]

Hello DHM!

First of all, you will have to minimally do 50 autopsies to be board-eligible in anatomic pathology. I am certain that after that you will be able to find a position where autopsies are not required...but it will decrease your versatility and make your job search a little more difficult.

Secondly, I like autopsies. This is not because I am some particular fan of blood, guts, and other gruesome nasties. Or that I think that the deceased are just full-sized specimens, but rather because of the "humanistic aspect." I see the patient (I never think of an autopsy as anything less than my patient) as needing one final voice to speak up about what happened to them. I see this as post-mortem communication with those that may care. Such as the 35-year old MI with severe atherosclerosis despite reasonable weight and apparent conditioning. I feel that this patient is speaking up to their siblings about watching their own cholesterol. Or the peaceful looking 18-month-old with unanticipated methadone on board, and the loud clear message he sent after death and with handcuffs to his abusive parents. Turns out they used methadone to keep him quiet. Or the marfanoid german exchange student who's parents had to fly in from overseas to retrieve him s/p aortic rupture. I am not sure there is a neat or positive message to that one, but it put me in the thick of how fleeting life is. Maybe a message to me.

In any case, all human drama plays out in the morgue. And if you open your eyes to it, you can see the fascinating, rewarding, and frightening cycle of life play out over and over again. Of course this is not for everyone....

Mindy

 

[Weil-Felix]

Mindy,

Thank you for sharing your fascinating perspective with us all. I have yet to observe an autopsy (hopefully I will have the opportunity when I do my path rotations next year), and I have often wondered how I will react when I see my first few.

I think it is wonderful that you have found such a positive outlook on what may otherwise be a heartbreaking situation. In fact, your post has been quite inspirational. I hope that I can have your attitude when I am someday faced with the task of doing an autopsy on a young person who died tragically.

Cheers,

WF

 

[augmel]

i can't add much to this discussion that hasn't been beautifully stated by CP and Mindy, but I would like to affirm what they said. When you are engaged in trying to sort out the puzzle, you forget all about the smells and grisly aspects of the autopsy. Even after witnessing quite a few, I still found myself getting quesy (sp?) the other day when I walked into the middle of an autopsy at the ME's office. Just kind of shocking looking when there is no context. That being said, the private practice pathologists I worked for before med school each probably did 4 autopsies per year. Not too much of their time, but of course they did have to do enough to become proficient.

hey CP, would you mind pm'ing me where you will be next year? I know we have some of the same interests and want to be in the same part of the country. I'd appreciate it.

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[dhm37]

Thanks everyone for the great replies! Mindy, you put an excellent perspective on how you view autopsies. It really makes sense when you put it that way. I suppose I should try to keep focused on the real purpose of the autopsy: to learn and further medicine advancement. I can definitely relate to what CF said with the sights and especially the smells of an autopsy. I imagine being more involved than just an observor would diminish the sensory aspects of the event. Again, thanks for all the wonderful insights, I think I'll be staying around!