My name is Carla Valentine and I’m the technical curator at Barts Pathology Museum. Prior to working in Barts Pathology Museum, I was an Anatomical Pathology Technologist or APT. It’s easier to call us morticians – I think people are really more aware of what a mortician is than an APT. An APT is the assistant to the pathologist, so an APT actually carries out the eviscerations of the deceased during the autopsy. A lot of the time on TV you’ll see the pathologist doing that themselves but it doesn’t really happen unless it’s a forensic case. So my role was to learn how to take all the organs out, how to do an internal and an external examination and then how to restore the cadaver or the deceased afterwards. If you see a doctor within two weeks of your death and the doctor is sure that it’s a natural cause, then you won’t need a coronial post-mortem. If you die in hospital you won’t need a coronial post-mortem either really. But for the most part everyone will need to have one. The point of the post-mortem is to find out who has died, why they’ve died and usually where they’ve died and it’s also to collate the statistics of people’s health and any underlying conditions for the World Health Organisation. So just because somebody may have jumped in front of a train or they may have hanged themselves and we’re obviously sure of the cause of death, they may have done that because they had an underlying cancer or underlying HIV. So those statistics need to be collated so that we know where the money in the National Health Service should go. It’s difficult to say in general how long a post-mortem will take because a forensic for example can be 8-12 hours. A regular coronial where somebody may have had a heart attack may be about 45-50 minutes for the actual examination. Of course the sort of external examination and the reconstruction afterwards will take some more time as well. So I think on average about an hour and a half. The way it starts is that the deceased needs to be weighed and measured. An external form is filled out usually by us, the APTs, where we might notice some bruising, we might make a note of tattoos or scars, or anything unusual, and then the pathologist will be called over and they’ll have a look and they’ll corroborate our findings. Then we’ll eviscerate the patient, the pathologist will then go through a specific procedure with the organs. They tend to follow the same pattern every single time so they don’t miss anything out – just a standardised method. And then one-by-one we can place the organs back into the deceased and start the reconstruction. During a forensic post-mortem things are a lot more stringent, There’s a lot of people involved. We have scenes of crime officers, a pathologist, and different officers from the scene and investigating the case. The forensic pathologist will do a lot of the work so they will, for example, do the evisceration themselves and they will do an external examination. So we’ll be there just for the whole initial period to help out. We might help to move the deceased, we might help to measure any external marks or wounds or tattoos. We’ll be there to assist with the evisceration, we’ll carry organs from one side of the room to another, we’ll help the SOCO – scene of crime officers – and the photographers to set up their shots. Once all of the evidence has been amassed, once the sort of very typical specimens have been taken from underneath the fingernails, maybe some hair, and all the organs have been looked at, then we will proceed to do the reconstruction as we normally would. Generally in an autopsy the organs are removed because the doctor wants to look at them and check for signs of illness and disease. In a forensic autopsy it’s slightly different. You want to check the organs, check for bruising, check for injury, and of course any underlying disease. But you also need to check for trace evidence. You’re looking to find any points of contact between the victim and their possible murderer. So as well as examining the organs you would take body fluids, check for drugs, you would also check underneath the fingernails, maybe check within the hair for fibres. Once all that’s been done then you can proceed into the internal investigation because you don’t want to contaminate the trace evidence with the internal fluids. Then you can reconstruct as usual. Sometimes cases which come in look like they can be straightforward and it turns out different evidence comes to light. And a good example of that was a female I worked on a few years ago who appeared to be an alcoholic. She had very typical symptoms of alcoholism, sort of yellowish skin, a lot of bruising on her calves which is quite indicative of alcoholism because people who are drunk stumble around their houses a lot and they kind of bash into tables and chairs. However, once we took her clothing off the top of her we found very distinctive finger marks on her arms and all of a sudden the picture became something slightly different, somebody had been with her when she received all this bruising and she may well have been an alcoholic but that wasn’t the full story. Restoring the patient after every autopsy can follow the same general pattern. The brain is quite soft once it’s been dissected so it tends to go in a plastic bag along with the rest of the organs. It’s a biodegradable plastic bag and it goes into the abdominal cavity and it’s stitched in. Some absorbent material is placed into the skull and then the scalp is sort of pulled straight back over, you can’t see any joins or any stitches, and the patient looks as if they’re asleep. Sometimes it can be far more difficult than that and I’ve dealt with many situations such as train deaths or people who may have jumped off tall buildings and they will arrive to us in several sections. I particularly remember a case where I stitched a man back together who had jumped in front of a train and it took five hours. However, he was viewable to his family, they were able to say their sort of final goodbye and I remember the coroner’s officer couldn’t believe that it had been possible. And it’s worth all that hard work just for the family to be able to see the deceased and say a final farewell, really.

13 thoughts on “Examining the body and post-mortem | The Morgue”

  1. It might be an inappropriate question, but was that the actual morgue, where that "riding crop experiment" bit of BBC Sherlock was filmed?

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