You may be one of the 11.7 million people who looked at when, MD houseThe Genius Diagnosticia Gregory House is ruined midnight by a beating at the door. A man who has just given a clean health bill has collapsed and died. House and his colleague Eric Foreman decide to make an autopsy. Looking forward to seeing the man’s heart, House pushes for Foreman to immerse themselves in a mountain range that was seen in the patient’s sternum. They look down: the blood seems to be removed from the wound. “It’s strange,” says Foreman, “almost seems to be … bloody?” There is a rhythm. Then man’s eyes open and shout.
If you missed this particular episode, you’ve surely seen something similar. Autopsies play a leading role CSI, BonesAnd many other first -hour dramas on medicine and forensics. The medical procedure that the North -Americans have been most exposed through their screens and still among the worst understood, may be very good. The way these shows represent the autopsies is so disastrously wrong that not only do families discourage these vital procedures; They even decrease doctors’ understanding of the functioning of autopsies.
On television, autopsies occur in dark rooms with blue light. They involve scalpels, bone mountain ranges. Laboratory technologies in laboratory coats discuss links and defensive wounds. The doctors frowned on something mysterious and disturbing. Many (but not all) of the pathologists who make autopsies are strange; Non -special doctors, like the house, do things that would lose their medical license. In an episode of Gray AnatomyThe characters of Sandra Oh and Katherine Heigl make an autopsy directly contravening the orders of the patient and the family, that is, I need to say, illegal; In another, autopsy pathologist chews chewing gum and reserves dinner while cutting. To almost every episode of CSITechnologies that do not carry protective equipment in rooms illuminated as immersion bars, feeding human tissue lengths on machines that are briefly released and spit a clean list of all foreign substances in the body.
Most North -Americans will never see real autopsy, so our impressions are made up of television portraits. So it was for me, until I spent two weeks watching autopsies in a Hospital in Pittsburgh as part of a novel’s research. In real life, autopsies are made in lit rooms. (Forensic autopsies must sometimes be completed in the field if, for example, a body cannot be safely moved.) The autopsist begins with an incision in the form of y in the sternum and works methodically through the body. Sometimes the internal organs are inspected in situ, but more typically they are eliminated, washed and dissected at a water table. Not only does the autopstist collect an organ, looks, makes a diagnosis and makes it again; Rather, they catalog as many pathologies in the body as possible, whether or not they are suspected or not to cause death. They are also responsible for ensuring that none of the inspection tests would be visible in an open chain funeral. It is a slow and complete work rarely involved in luxury electronics.
By Samuel Ashworth
Perhaps the most subtly ridiculous aspect of television autopsies is the lack of personal protection equipment. In the real autopsies, the people involved carry PPE from head to toe: surgical scrubs, weapons, booties, a apron, a facial mask, a splash shield and a lid, because when it opens a human body, all the blood, the bile and other liquids that a person had in life. Blood can still be removed from a wound, even when it is not pumping on the body. Writers did MD house Does the episode think that the human body is spontaneously stirring when the heart stops?
Errors like this in television performances reduce autopsies to fantasy shows, when the procedure is in fact a respectful and unique tool to understand how a person lived and died. Families could reject an autopsy for a number of reasons: cultural taboos, simple search, a sense that the decent has suffered enough, the desire to take possession of the body immediately. But death does not have to reach a threshold of suspicion or mystery to deserve the investigation; Many teaching hospitals, where residents could observe autopsies to deepen the understanding of anatomy, will make an autopsy free of charge to any patient if the family asks it. Anyone can get one and more people should do it.
Autopsies, even in cases where death was expected, can be used for real life. They help to present a complete narrative of the disease, which can help doctors treat other patients and, if they communicate well, to bad families to move towards acceptance. Autopsies can capture hereditary diseases that doctors often lose, such as sign -ring cell carcinomas, and reveal causes of dementia that may have been misdiagnosed as Alzheimer’s. Even in suicide, where the cause of death is usually evident, autopsies may reveal underlying problems that could have contributed to the deceased’s hassle.
Despite the utility of autopsies, they have become an endangered species. In a survey conducted at Massachusetts General Hospital in the mid -2000’s, residents said that they had never seen an autopsy, much less. And doctors are not always comfortable arguing with the families of patients. Autopsy rates more than mid -1972 to 2007, increasing up to 8.3 percent. In many other countries, the rate is even lower.
Not all hospitals provide autopsy services; In many of those who do so, asking the family of a dead patient if they would like an autopsy to fall to residents, many of whom do not have the training to describe and clearly clarify the process. At that time, there is little to prevent the family from calling all the high images they have probably seen on television. Take, for example, an episode of 2020 of The good doctor literally called “autopsy”. Shaun Murphy operates in a patient Er, a Jane Doe, when his carotid artery “blows” and bleeding in death in seconds. During the next 40 minutes of screen time, the following things happen:
Hospital denies Murphy’s permission to make an autopsy. (Apparently the arteries explode every day.) So he traces the woman’s odd son, who also denies him, inspiring Murphy to attack the man’s car, shouting. However, the head of the pathology (which has just broken with Murphy) allows him to do the procedure. He makes the autopsy himself, in a dark room and does not carry any PPE beyond a beautiful apron, while the pathologist is indulging behind him. It eliminates the woman’s liver and considers her briefly, then she returns to it, without sewing -or taking a tissue sample. Finally, he presents himself at the son’s house to say that his mother had the Ehlers-Danlos syndrome, which is hereditary and that the child must receive treatment. Everything is forgiven.
This is an episode that makes a case for Autopsies. The only remote realistic thing of the episode is the reluctance of the child to consent. And after seeing that horrible exercise, right?
In these shows, the true truth of a dead body is milked by a shock factor or is softened with holograms. Each chemical in a person’s body can be identified with a machine and each story has a satisfactory ending. Everyone knows that life is not. We must not accept that death is not.
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