One summer at college I took an EMT class. I didn't want to be an emergency medical technician; I just wanted the experience, and the nine credits of night and Saturday school, which I thought would be a cakewalk for an Army medic. (As it turned out, I did have to study, and I was hopeless at administering oxygen.)

Anyway, we were required to arrange half a day either observing autopsies or hanging around an ER. I chose the morgue because it was so much less popular.

It must have been around nine in the morning when the coroner started working on her first body. He was a 13-year-old boy who'd been riding a three-wheeler up in the mountains the day before, and it had turned over on him and he died. I couldn't see anything wrong with him that should have killed him, though. He was very pale, and his freckles were just little spots that were slightly less pale. He had curly red hair. His eyes were closed.

The coroner examined his limbs and the outside of his body, and spoke her observations into a hanging microphone as she worked. A few bruises and scrapes were all the damage he had. Then she examined the brain. She cut the skin in back of the scalp and peeled the face down from the skull like a rubber mask. I was surprised to see the back of someone's face. I'd always thought of my face as "me," not something that could be removed and replaced so neatly. The coroner sawed away the bare skull to reveal the boy's pale yellowish brain. There were little pools of inky blood, but no massive hemorrhage. Nothing conclusive.

Next she opened the rib cage to look for internal damage. She sawed big saloon door cuts through the sternum and chest. With the skin peeled back, the ribs were indistinguishable from racks of pork ribs you could buy at the supermarket. A boy that age is just the right size, and the fluorescent light on the day-old muscle makes it look exactly like pork ribs. I would dare any layman to tell them apart.

There weren't any gory injuries in the chest or belly, either, and the spine was intact. The coroner concluded the boy had died of spontaneous asphyxiation -- the three-wheeler’s weight had forced oxygen out of his lungs really suddenly, and … he was just dead. For some reason, just getting the weight off his chest hadn’t sent him back over to our side of the line. “A pity. A lovely boy,” the coroner said, and she put his rubbery face back over his skull so he would look good in his casket. Later, I found the boy’s obituary and cut it out. I liked his picture. His eyes were open in the picture, of course, and I had never looked into them before.

The term autopsy derives from a classical Greek word compound that means 'seeing for oneself' (auto + psy). It refers to an external and internal medical examination that is performed on a dead body by a medical examiner, pathologist, or other trained person for the purpose of determining or confirming cause of death. As such, it is a favored, if generally misrepresented, scene in fictional police procedurals.

The post mortem examination can be ordered by the government (i.e., the Coroner) when there is concern for criminal activities or public health. Autopsy may also be requested by the attending physician or by a family member. Privately ordered autopsies may cost between $1500.00 and $3,000.00 or more in the US.

Generally, an autopsy will include gross examination (well-named) and microscopic examination, and may also include laboratory work on body tissues or fluids. Gross examination (well-named!) is done with the unaided eye, with observations recorded by microphone or by writing. Microscopic examination is done afterwards on prepared slides of tissue sections made from samples collected during the autopsy. Laboratory tests may be ordered to find evidence of disease or drugs.


First, the exterior of the body is examined for abnormalities and findings are noted by voice, on charts or by written description.

The internal examination usually includes the vital organs: the brain and the organs of the neck, thorax and abdomen.

To remove the brain, a deep incision is made down to bone with a scalpel from the bony bump behind one ear, across the crown, and down to the same place behind the other ear. The top flap of the scalp is pulled forward and down over the face and the bottom flap is pulled down to the neck, exposing most of the skull. A bone saw is then used to cut through the skull in two intersecting arcs. That is done so the cut off part won't slide around when it is later replaced. The brain is severed from the spinal cord, which is pretty much all that holds it in. It is then carefully lifted out and placed in a jar of formalin solution, suspended by a string. The brain is very soft, and so must be 'cured' for a week or more in formalin before it can be manipulated.

Next, the internal organs and glands from the neck down to the pelvis are removed. There are a number of techniques for doing that, ranging from removing them item by item to cutting out the whole kit in one piece from top, above the larynx to the bottom, at the pelvis. (This is called the Rokitansky method.) It all begins with the 'Y' incision made with a large scalpel and now universally known from TV and movies. First a' V' cut is made from each shoulder down to the bottom of the sternum. This cut detours below the breasts if the subject is female. The chest flap is cut away from bone and underlying tissues and then pulled up over the subject's head. A straight cut is made downwards from the sternum to the pubis, cutting through the abdominal wall but avoiding the belly button, and the side flaps are laid back. Then, the ribs are detached from the sternum with an bone cutter (a large frightening thing with curved blade that you may have seen in a horror movie or two) or an electric bone saw. (The Stryker autopsy bone saw, by the way, is not at all as intimidating as it looks and sounds when turned on. Its serrated cutting edge vibrates rather than rotates, so it cuts bones neatly but does not easily damage soft tissues.) The sternum is lifted out, and the ribs are pulled back, exposing the lungs and pericardial sac.

The organs are moved to a dissection table, which is often placed above the legs of the body. There, the organs are sliced open to reveal the internal structure, and are examined for abnormalities or disease. The esophagus, stomach and major blood vessels and ducts are also cut open and examined. Samples are taken and placed in formalin. The last and least pleasant job is 'running the gut'. The intestines are taken to a sink with lots of running water and cut open for internal examination. This job may fall to a lower ranking assistant.

After curing, the brain is also sliced and examined.

After examination, the brain is usually incinerated. The remnants of other dissected organs are either sloshed back into the body cavity or incinerated. The skull and sternum are returned to their original positions and the incisions are sewn up with coarse thread, usually with the same kind of stitch used on baseballs.

As with many old crafts, there is a separation between the older purists and the impatient youngsters. The purist works with scalpels and a large, long knife, known as the 'bread knife', which takes skill and produces elegant, clean cuts. Many younger prosectors prefer scissors where expedient.

The decision on cause of death is the job of the pathologist. If the pathologist was not the prosector, which is what the person who does the autopsy is called, then the judgment is made on the basis of the prosector's notes, photographs, direct microscopic examination, and lab results. The final result is a report signed by the pathologist.

If you want to try your hand at a pathologist's job of determining cause of death, try this Virtual Autopsy

Au"top*sy (?), n. [Gr. , fr. seen by one's self; self + seen: cf. F. autopsie. See Optic, a.]


Personal observation or examination; seeing with one's own eyes; ocular view.

By autopsy and experiment. Cudworth.

2. Med.

Dissection of a dead body, for the purpose of ascertaining the cause, seat, or nature of a disease; a post-mortem examination.


© Webster 1913.

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