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A Hardened Heart: Lessons from the Autopsy Room

As I lifted my head away from my work, I realized that I was being watched. On the other side of the window was a group of five young women, mouths agape and eyes wide open. They were students, up and coming radiology technicians, brought here to observe. Their instructor was hoping to desensitize them to the harsh reality of death and prepare them for the day that they would venture here alone with mobile x-ray machines. As I looked out across their faces, I could almost read their minds. Their uneasiness was palpable, their fear and disgust so clearly marked by their furrowed brows. Their awkwardness and discomfort were evidenced by the way in which they held their arms — some tucked firmly across their chests and others hanging limply at their sides. I lingered for a moment, making eye contact with a small blonde girl. She looked at me as if she had seen a monster. I smiled slyly behind my mask and quickly returned to my work with a new sense of purpose and resolve.

It was my fourth day in the autopsy room and the pathologist had just handed me my first task of the morning. “Three eighty-four,” he stated, haphazardly dropping the organ down in front of me. As the scribe quickly jotted down the weight of the human heart lying before me, I secured the organ on the cutting board and prepared to make my first slice through the left anterior descending artery (LAD), one of the main vessels supplying blood to the heart. The objective was to section serially through the artery in search of blockages, potential causes of death. My blade cut easily through the surrounding fat but was unable to slice through the vessel wall. I cautiously removed my scalpel and pinched the artery between my thumb and forefinger. It was unlike the soft and pliable arteries that I had felt before. This was different. It was hard and crunchy, unyielding as a piece of cold steel between my fingertips. “I think we killed him,” I stated plainly and looked around.

To my right lay a pile of internal organs, indiscriminately tossed beside me as they were removed from the corpse on the table. The autopsy tech finished with the abdomen and chest, leaving nothing but an empty shell of a human behind. As he made his way to the head of the body to retrieve the brain, I looked back to my task and realized that the man on the table was not the only one in that room with a hardened heart.

I was holding in my hands the very organ that once supplied the lifeblood for another human being, a heart that was beating just a few hours ago. It had been less than a day since this powerful structure made its last valiant effort to push vital blood to the furthest reaches of this gentleman’s body. And here I was, unceremoniously slicing my way through its precious vessels trying to maintain an air of indifference and control.

This was not the first time that I had handled a human heart, but this time was different. My first heart had belonged to an elderly woman. I had watched with awe and excitement as my professor carefully cut around the organ and delicately placed it into my waiting and eager hands. I had looked down with wonder and amazement at that heart as I uttered a silent prayer of gratitude for the woman who had so graciously donated her body to medicine and to my education. That was 23 months ago. Gross anatomy was new to me then. I had not yet undergone grueling pre-clinical medical education, I had not yet taken my board examinations and I had not yet been hardened to the realities of life and death. In just 23 months I had learned a lot, but I had also lost a lot. My sense of wonder and excitement were gone. The sense of respect and gratitude that I once held for the workings of the human body had been replaced by a desire to save face and a need to appear strong.

I braced the LAD on either side of the presumed blockage and purposefully made a firm clean slice through the middle of the artery, revealing the plaque that I had felt before. Just as this large collection of cholesterol and calcium had prevented the gentleman on the table from receiving the blood he needed to survive, the stress of my training had clogged my heart and prevented me from experiencing emotion.

I looked back at those nervous faces behind the window and resolved to fight. I made a decision to stand up for what I had lost and to do everything in my power to once again feel the types of emotions so clearly playing across the faces of those students. I made a decision to fight for my humanity — for fighting is the only way to make it to the other side with heart and mind intact. We must all fight against the pressure to toughen up and we must all constantly remind one another of the significance of a living, breathing, beating human heart.

Taylor Turnbull Taylor Turnbull (1 Posts)

Contributing Writer

Medical University of South Carolina

Taylor is a third year medical student at the Medical University of South Carolina. She completed her undergraduate education at the University of South Carolina and is a proud gamecock. Her plans are to pursue a career in general surgery and to one day provide surgical care to patients in the rural southeastern United States. Her passions include rural healthcare, medical history, and humanism in the practice of medicine.