Why autopsy path is more fun than surgery

[augmel]

So I was working away at my station on my 3rd week at the ME's office and I realized that I am now proficient enough at this stuff to spend a little time ruminating on why this is so much more fun than surgery. So I thought I'd start a list. Feel free to add...


1. You want a larger surgical field? I'll show you a larger field.
2. I can mess with the pancreas as much as I want, thank you.
3. Time spent opening.
4. Time spent closing.
5. Time spent scrubbing.
6. No electrocautery smell (though some would say the trade-off is worse, see autopsy and poo thread.)
7. Not standing in one space for hours on end.
8. No holding the freaking laporoscope.
9. No pre-rounding, post-rounding, pre-op checks, etc.
10. Accidently poking holes in organs....not such a big deal.

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[Foxxy Cleopatra]

11. No one to yell that you violated the sterile field
12. The specimens don't b*tch at you the next day and threaten to sue
13. You don't have to get medical clearance from a PCP before you operate
14. The intern doesn't have to do a post-op check

 

[yaah]

No retracting!!!!
No infernal beeping machines!
No three layered closures!!
No instrument counts!

 

[kchan99]

Someone (not in a health care profession) once said that autopsy was surgery without the stress.

 

[salt]

!

 

[stormjen]

No surgeons

 

[yaah]

No surgeons

Ha ha! But not always true...We have cases a lot where the clinicians come down and hang around. They don't usually glove up and poke around but occasionally they will once we give them permission . Surgeons have very little power in the morgue though. Your powers are useless here!

You can also draw blood in autopsies directly from the aorta. Try that in the OR.

 

[kchan99]

Ha ha! But not always true...We have cases a lot where the clinicians come down and hang around. They don't usually glove up and poke around but occasionally they will once we give them permission . Surgeons have very little power in the morgue though. Your powers are useless here!

You can also draw blood in autopsies directly from the aorta. Try that in the OR.

Can you comment further on surgeons' limited powers in the morgue?

 

[yaah]

Can you comment further on surgeons' limited powers in the morgue?

Well, it's just that their intimidation factor goes down by about 30-fold. They can no longer boss people around. Stand here! Pull here! Retract that! What, are you stupid? Cut this knot! No, closer! Idiot, don't bury it! Suction! SUCTION! I can't see! Turn that music off!

The morgue is not the controlled environment that is the OR. More free for all. I think a surgeon should be entitled to act like a snot while in the OR though - they are the ones responsible for the patient. But that doesn't mean I have to enjoy being belittled. The time pressure is also not there. Aorta is cross clamped. We now have 36.5 minutes before his legs are dead. You want that responsibility, soldier? Then move over!

 

[kchan99]

Yaah, What other non-pathologist physicians have you encountered in the autopsy suite? Living persons only...

 

[yaah]

I have encountered:

Medicine residents
Medicine attendings (ICU types)
Heme-onc attendings and fellows
Renal attendings and fellows
Surgical teams (residents, fellows, attendings)
ID folks.
Pediatricians of various types (surgeons, specialists).

It doesn't happen at every autopsy, but occasionally a bunch of folks will come down. We had a rip-roaring endocarditis case which brought down about 10 clinicians.

Radiologists are rumored to show up occasionally, particularly for conferences, as are neurologists. But often a lot of contact occurs outside the morgue, when slides are reviewed.

 

[deschutes]

... often a lot of contact occurs outside the morgue, when slides are reviewed.

Other than venturing out to retrieve patients' charts for autopsy, what are the indications for pathologists to be out on the floor? (My experience of biopsies so far is that radiologists do them...)

 

[E Z Daring]

>>> 1. You want a larger surgical field? I'll show you a larger field.

ROFLMAO!

 

[BeastNovot]

Other than venturing out to retrieve patients' charts for autopsy, what are the indications for pathologists to be out on the floor? (My experience of biopsies so far is that radiologists do them...)

FNA's
Working up transfusion reactions
RARELY: getting more patient info for a surgical case (horror of horrors!)

 

[b&ierstiefel]

6-pack of Warsteiner ... $8.49
Light Microscope ... $199.99
Never having to do an H&P ... priceless

 

[kchan99]

6-pack of Warsteiner ... $8.49
Light Microscope ... $199.99
Never having to do an H&P ... priceless

Was that the actual cost of your light microscope? That's the cheap! The newer ergonomic microscopes with eyepieces at 30 degree angle with the horizontal cost a whole lot more.

 

[b&ierstiefel]

Was that the actual cost of your light microscope? That's the cheap! The newer ergonomic microscopes with eyepieces at 30 degree angle with the horizontal cost a whole lot more.

i made up the cost of the microscope...obviously

 

[Doctor B.]

-Playing "Creeping Death" by Metallica is more acceptable in the autopsy suite
-You can leave to use the facilities or eat lunch when you choose
-You never have to come in at 2 AM for an emergent case
-You can make jokes like "This guy gave himself blue eyes....one blew right, one blew left!"
-You get to gross out the rookie cops/detectives
-You can reenact that scene in Temple of Doom...you know, the one with the heart and the chanting and stuff (ok, just kidding)