My first postmortem experience was gruesome, absolutely gruesome! For someone who had undergone two years of anatomy dissection, to categorically state this, it was definitely something.
We were introduced to anatomy dissection as soon as we started medical school. It was important to learn the geography of the human body as a first step to understanding it. We were taught to hold in great respect, these departed people through whom we had the privilege of peeking into our physical inner selves.
We named our cadavers and formed a bond with them as we took them apart from skin to bone, layer by layer over 20 months. At the end of our sessions we would wrap them up ceremonially and put them back in the refrigerator with a promise to see them again in a few days.
What we did not appreciate at the time is that we were only exposed to the finest of specimen. Perfect bodies with intact skin, intact muscles and intact bones. The eyes were perfectly in their sockets and the eyelids closed, the gut was intact all the way from the mouth to the anus and the heart was definitely four-chambered with intact valves. We quickly got accustomed to the smell of formalin, the preservative that prevented the cadavers from decomposing.
While we pored over our fine specimen with our Anatomy professors, the Pathology professors next door went on with their work, diligently documenting the cause of death of dozens of people all year long, bringing closure to families around the country, but most especially helping close court cases. Our forensic pathologist, one of the best in the world, I believe, would spend a few days a month in court, giving evidence as a state witness in murder cases.
To say that we were unprepared for a real autopsy is an understatement. We learnt Forensic Medicine and Toxicology in our fourth year, taught by the most fascinating Ukrainian professor, Kozlova. She made forensic medicine look very romantic based on her persona. She was larger than life, extremely brilliant, forthright and had a daring fashion sense. At 60, she strolled around the morgue in six-inch heels and capri pants like she was out shopping in the streets of Paris.
On our first day, we trooped into the autopsy room and were instantly greeted by a smell so pungent smell of decomposition that even our face masks did not help. Our first case was a middle-aged man who had been missing from home for 10 days. His decomposing body was found in a maize plantation and brought in to the morgue over the weekend.
He was covered in mud and most of the flesh was eaten away by decomposition. His distraught family had to identify him before the postmortem began and it was heartbreaking to see their kin in that condition. I suspect the only evidence they had that this was their brother was his clothes. The missing person notice they had filed in the local dailies described his clothes exactly as the ones he had on, save for the missing shoes.
Being a police matter, the police officers had to be in attendance during the autopsy. I highly doubt they have this kind of training at Kiganjo Police Training College. The two officers present stood at the far end of the room and conversed in low tones. One of the brothers stoically stayed through the procedure while the other two sat outside on the grass in shock.
We were mostly mute, while the good professor dispensed with the formalities. She verbally gave a commentary of her findings as she proceeded with the autopsy with the help of her extremely adept assistant, Harun. While we struggled to look professional and ignore the stench that covered the room, Prof Kozlova documented the clothing and appearance of the body then cut away the fabric and exposed the body. Harun washed away the mud to expose the putrefied skin, allowing the professor to inspect the body before making the incision that opened up the chest and abdomen. Most of the organs were green and liquefied, giving a tentative timeline on when the death occurred.
Usually, the internal organs would be removed wholly, washed and examined separately, but in this case, not much of gut was left. The liver was already partially decomposed, as were the kidneys and spleen. The heart was fairly spared and was recorded as normal.
The most traumatising experience for the family was to see the opening of the skull. I would never wish to observe this being performed on my loved ones. The manner in which the scalp is peeled back and the skull opened with an electric saw is not for the faint hearted. The brain was already fully liquefied and literally just spilt out.
The departed had suffered multiple blows to the head with what appeared to be a rounded weapon, causing multiple skull fractures. This was documented as the cause of death. The poor man appeared to have been violently murdered. The rest of the bones remained whole.
It was a wonder his body was intact, considering he had been outside, exposed to the elements of nature in the rainy season of the North Rift. He had not been cannibalised by animals out there, but bacteria that lived in his gut, coexisting with him while he was alive, had turned on him in death and eaten right through him viciously. Clearly nature takes no hostages.
I knew right there and then that I would never be a pathologist. I have no idea how relatives without medical background survive this harrowing experience. It is numbing, to say the least. The stench of the decomposed body stayed in my mind for weeks on end. Let’s just say, few of us had lunch that day.
I’m always in disbelief whenever crime dramas make autopsies look so romantic. The truth is autopsy rooms always carry the smell of death, the only variance is just how bad.
Dr Bosire is an obstetrician/gynaecologist