Once Removed

I once watched a doctor remove a man’s heart. Admittedly the man was dead already — lucky for him. A confluence of uninteresting details led to my presence in the room as this autopsy was conducted, but it is the sort of experience that demands you remember every detail, from the vivid colours to the smell to the cloud of pale dust as a bone saw connects with a skull. But what I really remember is the heart.

The man was still sealed in his bag when I entered, but the bulge made his girth immediately clear (“Did you know he was pregnant?” joked one of the accompanying police officers). The demeanour of the team of four actually conducting the procedure was relaxed but professional. The coroner leading the team was an older doctor, a tell-tale early morning tremor to his hands. His golden-haired assistant exuded a quiet confidence, whilst the young intern struggled to hide the glee in her eyes at being involved. All three were grateful for the presence of the larger man in scrubs who would be throwing his weight around to move the body.

The coroner sat quietly while his team prepared the body to the incongruous soundtrack of Singer/Songwriters of the 80s. As the bag was unzipped, I was pleasantly surprised to find the chilled body and cold room led to a less pungent odour than I had expected. As the assistant called on her colleagues to slow down, however, it became clear that the body had been marinating in a pool of its own juices. With the effluent pumped away, Scrubs grabbed an arm, stiff with rigor mortis, and hauled the body off its arrival gurney and onto another. His back had a slick sheen in contrast to his dry front but in short order he was flipped over once more. I was intrigued by the impassive expression he wore, indifferent to those struggling to shift his considerable weight. It would change only once, towards the end of the procedure, when they pushed forward his scalp to access the brain, forcing the skin down until his face scrunched to form artificial concentration, as if he were exerting some strenuous effort.

With the body prepared, before I had even noticed, the coroner was on his feet and had already made three swift incisions. The man’s ebony skin pulled back along the Y-shaped cuts, revealing streaks of yellow fat from each shoulder and down the sternum. The coroner began to cut through the fat with a long-handled scalpel, nodding to a second blade and inviting the intern to join him on the other side. They worked quietly together, separating the skin from the ribcage. Meanwhile the assistant retrieved an oscillating saw from the other side of the room, carefully trailing the power lead across the floor and firing it up to ensure it worked. It whined its way through the front of the ribcage, which was lifted away as a single plate, leaving the chest organs displayed for inspection.

Each was removed in turn, studied, sliced and then discarded into the red waste bag that would wind up between the man’s legs when his body was stitched closed and returned to a shelf in the morgue. It left me wondering about the American preference for open casket funerals, though a funeral director would later explain to me that clothes obviously cover the main incisions, whilst examination of the brain leaves its marks on the lower back of the head, which is obscured by a pillow during the viewing.

The oversized liver, the lungs discoloured by blood that had settled in them, the missing right kidney, and of course the extracted brain, these were all fascinating. But what I really remember is the heart: large and red, powerfully muscled, and utterly deserving of the mystique and mythology that organ alone has long commanded in myriad cultures over the years. The coroner cut through the inflow and outflow blood vessels to free the heart and remove it from the chest, raising it grandly in his hand. Starkly contrasted against a trail of fatty deposits was the dark line of the coronary artery that once quickened this machine, now silent and still.

There is a hole in my heart. I suppose there were two. The congenital septal defect with which I was born has long since been repaired; I have seen it during an echocardiogram and seen its effects on the readout of an ECG. The other hole — the one I can only feel — is more serious. I could see no sign of it in this man’s exposed heart. The intern inserted her fingers into the arterial pipes to check for blockages before the older doctor sliced lazily through the organ in strips to check for irregularities. He found none.

As he discarded the heart and continued, satisfied it held no secrets, I wondered whether perhaps, when I am a cold slab lying upon a similar table, my heart will finally have healed itself too.