Medical Examiner's Eve

Tomorrow morning, I head out to the medical examiner's office. I have been asked to bring my own medical protective wear, shown here in two giant bags. Included are giant Tyvek suits, and N95 respirator masks. I'm not even sure what else is in the bags, as they were packaged for me and I was instructed to take them, and that they contained everything I will need.

I approach this rotation with the common medical school/residency combination emotion of excitement and dread. I felt this way with my first autopsy, my first Whipple specimen, the first time someone told me "you have a toxic megacolon waiting for you in the fridge".

I spoke with one of the assistant medical examiners last week and she told me which alleys I needed to drive into to find the back entrance of the ME's office. Apparently, I'm supposed to travel from one alley into another, then go into a parking lot that says, "Ambulances Only", then press a button that has a musical note on it, and wait for someone to let me in. I like how these instructions seem vaguely out of a spy movie, or, are strangely reminiscent of this old Macintosh game Deja Vu, where you have lost your memory and have to do all these crazy things to try to figure out who you are, or who you used to be.

That game kind of enmeshes, in reverse, with this feeling in medicine, where you are changed by random events you can't control, like watching a child die in the ICU, or doing an autopsy on a man while his watch, removed, is audibly ticking on the table beside you, or you hold a "dead" man's heart, still beating, in your hands, after the trauma team has pronounced him dead -- these events that you can't predict, and didn't think you would see, but then, all of a sudden, because you happened to be there, you've seen them, and you can't go back to the person you used to be. Then, you have to try and figure out who you've become.

It's strange to know this will happen this month - that I will see things that I don't want to see, cannot predict, and will not forget. Things that will change the way I see people and the way I think about life. I sometimes obsess about the last moment I remember before something big changes -- like the day before school starts, the day before you meet someone and fall in love, how I was watching War Games the night before September 11th. I think that people don't spend enough time thinking about the end of an era, so to speak, before an era is over. But perhaps my definition of era is quite loose. But, to me, memorializing these moments is part of figuring out who I'm about to become, and who I was right before I became someone else.

My above conversation with the medical examiner also included recommendations and advice:
"Eat a good breakfast. The smells in the there are easier to take on a full stomach."
"If you don't want to do the decomps, that's fine. If you don't want to see the decapitations, that's fine."
(In response to my subsequent necessary question "ARE THERE A LOT OF DECAPITATIONS?!?!?"): "No, but this week has been burn victim week. I'm not sure why."
The medical examiner also mentioned that I might be labeling evidence. I am also apparently not allowed to talk to local newspapers about any of the cases I see. Other residents have mentioned having to pick out maggots and put them in a jar, and having to measure the length of maggots to determine the time of death. I have heard many colorful accounts of what the smell of decomposing bodies smells like. Other residents have told me how great it is that you learn how to withdraw vitreous fluid from dead bodies (that's EYE fluid, people).

All these things are why I seem to be spending the night not diligently reading my Forensic Pathology textbook, but rather nursing a Bass and playing a seriously pathologic amount of Super Mario Galaxy.