Should I still give pathology a try? I need advice!

[eatapita]

I saw one autopsy done on a motor vehicle accident. Very gruesome. Every bone in that guy's body was broken...limbs twisted and torn off here and there. Going in, I figured it'd just be like another gross anatomy dissection. Instead, I found that my heart was beating fast and that I had a mixture of feelings I never expected. I felt shocked and sorry for the guy 'cause we knew he died earlier that same day. I also felt grossed out to the point where I wasn't interested in how he died anymore. The idea of digging out his organs made me want to vomit. I had an appointment to go to, so I had to leave before the autopsy was done and found myself relieved to take off early.

I'm disappointed at my reaction at the autopsy, because all the personality tests I've taken named Pathology as being one of the top 3 fields best suited for me. The others were Radiology and Emergency.

I heard that you can practice Path without doing a lot of autopsies. Should I still give Pathology a try?

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[Adolf]

Respected collegue

If you are going to choose pathology as carrer you will not do much autopsy. This kind of austopsy is usually done by forensic pathologist. What you will do are hospital cases which are, form visceral point of view much more sterile than this. And what is more, the number uf autopsies is probably going to stay low in the span of our natural lifetime...

However, the workscope of pathology still includes some obsolete skills (e.g reading, writing) where doing autopsies has remained the part of curriculum. In some medical facultites in central europe 50 years ago actually doing an autopsy was essential for medical students during pathology lessons. This was excellent opportunitiy to learn in depth the clinical-pathological correlation.
Furtnermore the physicians gain valuable feedback info about theri patients and quality of heakth care provided. There was an excelletne article in NY times, look through the posts and you will find the link...

Now back to the track, if you have never saw an autopsy before maybe starting with case like was not the brightest idea... Perhaps starting with something like sudden cardiac death is more apropriate for getting the scent of a corpse... Afterward one can procceed to the state of expulsio organorum et putrefactio progrediens...

And to finish I would like to stress that it is very essential not to get emotionally involved with cases (also applicable to clinical work). Maybe is this harder for you Americans, since your are "forced" to to ever kind of charitiy work before medical school (As one of the poster pointed out "tuchy-feely doctor"). You shall see corspe as a piece of raw material, meat or even carcas which hides some intelectual questions. This is perhaps barbaric (especially for hypocritic religious fundmanetalists) but on the long run it will save to to become emotionally overbourdened prevent form becoming a hopless alcoholic or drug addict

Regards
Adolf

 

[eatapita]

Respected collegue


And to finish I would like to stress that it is very essential not to get emotionally involved with cases (also applicable to clinical work). Maybe is this harder for you Americans, since your are "forced" to to ever kind of charitiy work before medical school (As one of the poster pointed out "tuchy-feely doctor"). You shall see corspe as a piece of raw material, meat or even carcas which hides some intelectual questions. This is perhaps barbaric (especially for hypocritic religious fundmanetalists) but on the long run it will save to to become emotionally overbourdened prevent form becoming a hopless alcoholic or drug addict

Regards
Adolf

Thanks Adolf!

 

[yaah]

The first autopsy for everyone is generally difficult. There are the rare individuals who have no reaction to it - but in general almost all will have a fluttering heart, feeling a bit faint, nauseated, dizzy, even repulsed. It is a common feeling after witnessing your first autopsy (and even the second or third) to question whether you have the aptitude for such a business.

What I suggest is not to try to hide your feelings or attribute them to something that will hinder you in your career - but realize that it is a natural reaction. The colors and smells are not like anatomy lab. Some people are more bothered by autopsies on children - some by autopsies on older individuals. Quite often, the patient will remind you of someone you know.

Some people learn to distance themselves emotionally - they shut out their feelings and treat the autopsy as a collection of organs. Others embrace their emotional feelings and use them to make sure they do a better job. Most of us are somewhere in between. We don't necessarily take pleasure in carving up a body - but at the same time we are not doing the autopsy just for this purpose. There are unanswered questions or medical mysteries, and it is a rare opportunity to see the human body at a different level.

 

[eatapita]

The first autopsy for everyone is generally difficult. There are the rare individuals who have no reaction to it - but in general almost all will have a fluttering heart, feeling a bit faint, nauseated, dizzy, even repulsed. It is a common feeling after witnessing your first autopsy (and even the second or third) to question whether you have the aptitude for such a business.
.

Thanks for the advice!

 

[cytoborg]

I heard that you can practice Path without doing a lot of autopsies. Should I still give Pathology a try?

I detest autopsy (sick to my stomach, fainting, etc. and I am not usually a squeamish person), and I am starting my path residency shortly. There is a LOT more to path than autopsy, and depending on the program, you may not spend much time doing it - it's just something you have to get through. The minimum requirement is 50, though if you're at a busy center, you will likely do more. In my first year I will have 1 dedicated month of autopsy, and two additional month of mixed anatomic path (surg path and autopsy). I don't think that's too bad for the first year, especially seeing as some programs have 5-6 mos autopsy in the first year.

Once I'm done with residency, I will happily never do another autopsy.

 

[cytoborg]

The others were Radiology and Emergency.

Oh, and just a heads up, if you felt sick seeing the autopsy of the MVA, you will likely also feel sick in the emergency department when the major traumas come in. I for one stood in the corner and tried not to faint/vomit, and after a month I still couldn't get used to it, even though I really liked everything else about the ED. One of the ED attendings advised me that you do get used to it after a while though, so maybe it's like autopsy, just something you learn to live with.

I've heard radiologists say they like that their field is "cleaner" than path so perhaps that's what they're talking about.