I am involved in the autopsy of a person who has died in an explosion and who is almost unrecognisable as a human being. As the forensic pathologist seeks to document each mark and injury, and to determine the exact cause of death I, in my role as an anatomical pathology technician, think about what I can do to attempt a reconstruction.
The trauma is so overwhelming I’m almost tempted to admit defeat and give up, but this is a person – someone’s loved one – and walking away is never really an option in the mortuary. We will always afford the patients as much dignity as we can, even if it’s almost certain no one will see them again once they leave our care; it’s a basic human instinct that makes us able to process what we’re dealing with.
I begin the long and difficult process of rebuilding the damaged cranial and facial structures and restoring them to something like their original shape. The patient is now, at least, looking relatively peaceful, and I feel a sense of accomplishment, albeit one tinged with sadness.
Saturday and Sunday
I’m on call this weekend, but I only have to facilitate the viewing of a patient by their family. Again, it is a sudden death; this time a young person who has killed themselves and whose family are devastated. As I sit with them and talk through what will happen next – the autopsy, the administrative processes that accompany any death – I feel desperately sorry for them and for the patient.
The family decide they cannot face going into the room and ask me to pass on a message to the patient, which I do, holding their hand and telling them how much their family loved them and how they wish they could have taken the pain away. This is a fairly common request, especially in cases where death is very sudden or unexpected and where a goodbye has not been possible.
After an intense call-out like this one, returning to the energy and chaos of my young children is always a slightly jarring shift of gears, but I arrive back home and carry on with my weekend feeling lucky to have them safe and well when things could be so different.
As well as my technical role, I’m responsible for managing the department as a whole, as well as the coroner’s administrative and support staff, and today I have a day of challenging budget and planning meetings.
It’s my responsibility to ensure we maintain a quality service in the face of the severe budget pressures that all local authorities are experiencing, as well as a national shortage of consultant pathologists (without whom the coroner’s autopsy service cannot be sustained).
Today was a series of disjointed tasks, from business case writing, staff appraisal and objective-setting via training technical staff in the principles of disaster victim identification, to completing the removal of a spinal cord. It can be demanding to have to switch tasks and my focus so frequently, but equally, one of the things I love most about my job is its varied nature.
Today was a long day out of the office as I spent a leave day attending a council meeting of the Association of Anatomical Pathology Technology.
We are an unregulated profession – this is despite the harm that poor practice can cause to the deceased, the wellbeing of bereaved people and the integrity of forensic examinations. I am proud of my profession and, with my colleagues, will continue to lobby government for statutory registration in line with medical and laboratory staff.
• In the UK, Samaritans can be contacted on 116 123, or email firstname.lastname@example.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.
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