Over this week I have realized how incredibly nieve I was a month ago, when I first applied for this new role. Believing I knew what I was getting my self into, I was so excited at the prospect of working with human bodies. I had no idea what that would realistically entail. Imagining the work to basically be human eye "dissection", akin to the bird and mammal dissections I perform at museums, I could only speak toward the importance of the role. Now my tense shoulders feel that importance, and I should find a chiropractor.
I am having a hard time chewing. Probably from clenching my jaw muscles 12 hours a day, for a week straight. Or maybe its a reaction to all the vaccinations that were poked into my arms.
Either way, this is not dissection work. It is surgery.
Precision, sterility, and a recently deceased person.
Its surgical grade organ procurement. The corneas recovered from the donor's eyes will be stitched delicately onto a living person's eye and you do not want to accidentally infect that person.
For my friends who remember the 80's, think back to Operation, the board game. Oh, those times of playing that game that buzzed loudly and sent an electrical vibration through your fingers anytime you bumped anything beside the plastic organ you were removing. I HATED that game. It made me cry. To this day, I remember how much it frightened me. My parents had to get rid of it.
It takes me two hours to perform the entier process. People who have been doing this for a year take a little over an hour. For me, its an hour to set up, an hour to do the surgical recovery of the cornea and to draw blood. (Shout out for phlebotomists! Mad respect for you people. ) For blood, we start under the clavicle and if we can not find the artery there or happen to collapse it due to too much pressure, we head next to the femur. If you are really desperate for blood and the donor is not a candidate for heart recovery, then you take out whats called a heart stick. Find where the sternum meets the third and fourth rib, head an inch over, and stick the syringe straight down between the bones. You'll pass the lung and into one of the ventricles of the heart. Still cant find blood? Hope you find the other ventricle, or else the cornea can't be used. No pressure, right?
These are honestly the nicest people I have met. Truth be told to the extent that I had to correct my sentence from "some of the the nicest people" to "the nicest people".
Just in case you do not realize it, recoveries happen in the morgues of various hospitals, funeral homes, and occasionally in the ER, all within a two hour radius.
My first case, I scarcely remember. I do remember feeling dizzy when we first unzipped her bag, having to turn away from the body for a moment. She had severe trama to her legs, had been bleeding profusely, and was around 300 pounds. She already had extensive lividity.
My second case, I was lifting the head of a 93 year old woman with painted fingernails.
"You've got some of her hair on your sleeve. " My supervisor told me.
"I've had worse." I was serious, but it made him laugh loudly enough that it echoed against the body refrigerators.
Third case. The man had turned to his side from the waist up when he died and stiffened that way. Interesting angle to get to his eyes. I got better at what I was doing and my supervisor did a little dance when I was separating the iris from the cornea.
After a visit to the morgue is completed, my supervisor and I would head back to the lab where we clocked in our donor's information, set the blood to centrafuse, and placed the corneas in a fridge.
One of these times, a fellow wearing scrubs and face mask strutted through the door with long strides. I was sitting at the computer. My supervisor bro nodded toward him and said with some song in his voice, "Hey hey, we went to your faaavorite!" My supervisor then nudged me and told me that the guy was stuck in there for 10 hours once. Strutting guy tilted one shoulder up. "Heeay!" I could tell he was smiling under his face mask as his eye brows bounced up and down twice. He snapped is fingers and pointed a finger gun at us, "Great bathroom, eh?"
And thats what they call morgue humor, folks.
(apparently, morgues don't often have bathrooms. But this one did. With a shower.)
In the lab, the other techs would ask me, "What did you do before you started working with us?"
"I currently work part time at a science and art museum, and am opening a little gallery based on anatomy and death culture."
"Oh really. That's different."
"What about you?" I'd ask. Every one of them told me they were or are in medical school and see this as a first step toward what they want to be doing.
The body arrived shortly after I set up my instruments. It was a 29 year old female. She just stopped breathing, having a history of asthma. I helped lift her onto the table with the help of two others. While the tissue girls began their blood draw, I took on inspecting her body. I always begin with the toes and legs. When I got to her right hand, I held it in mine and saw that she had a small amount of firehouse red paint under her thumb nail and between her last three fingers. There was one sequin of red glitter in her hair.
The tissue team left me and waited patiently in the next room knowing I was new at my job. While I was cleaning her face, I could hear them laughing about some guy who peed in a cup in his car, spilled it on his pants, and missed a date with a girl due to embarrassment.
My supervisor's voice came through my focus. "Remember, when they are this age, you've got to check for contacts before proceeding." "Okay."
Her iris did not want to be removed from underneath her cornea. My arms actually went numb with how long the procedure took this time. That did not make things easier. It was beyond frustrating, knowing that her tissues were so young that they could definitely help someone in need. If I screwed up, it would all be for a loss. Her vitreous was incredibly thick, so much so that it did not run down her cheeks like the older people I had worked on. It stayed in place and was a fortress to get through to reach her iris. Once I actually removed the cornea, her lens actually slipped out from the socket and laid on her lower eyelashes.
At least I found her subclavian artery within 5 minutes. A record for me. You have NO idea how difficult it is to draw blood from arteries that no longer circulate. While I was throwing all my needles and scissors into the sharps container, the tissue recover girls returned to the room and began suiting up. As they began doing their inspection, the shortest blond girl began to hiccup. We left as they began to clean her chest to find her heart. Right before the door closed behind me, I heard another hiccup and a burst of giggles.
Outside, walking to the car in the drizzling rain, my throat clenched and I choked up. My eyes began to feel that way they do when you auto withhold tears from over flowing from your eyelids. But for the first time in my life I was able to stop the tears from running down my cheeks. (If you know me outside of this blog's context, you know that I am usually a gusher at the drop of a hat). I felt like I could not let myself cry infront of this staff. I had to be strong, because this work is vitally important. The drive back was quiet and a blur. My supervisor comforted me, he could tell that I was frustrated. He told me he felt so helpless watching me durring the procedure, knowing how difficult it is to separate young irises. "Sometimes," he said, "you just get tough cases and there is nothing you can do about it. Its just how it is." In the elevator headed up to the lab, I reminded myself that just 12 hours ago I did a good enough job that my technique spawned a little morgue dance from the head supervisor. The memory made me smile and I felt some relief come over me. I have a new respect, beyond words, for surgeons and any medical professional.
On my fifth day I did not get called in immediately at 6am. I waited until noon. I realized stretching would do my body some good and while rolling around on the floor I imagined the bodies I had been working on. With a listless mind, I thought of them as shells. To me, those forms were no longer the personalities that sparked the body into activity. They were shells. I imagined placing one of the bodies into a wooden casket, I then filled the empty spaces around their legs and waist, framing their neck and head, with cleaned oyster shells. Peeling the iris off from the cornea is comparable to peeling oysters from their shell. I returned to the living room I was stretching in, I laid down on the couch. I was utterly exhausted from all this learning and exposure.
I guess sometime just before that fifth day, I forgot there was anything else beside going into morgues and handling dead bodies. I had difficult thoughts. It flashed through my head that I just couldn't do this. I just couldn't do it anymore. I spent time on that couch, wrapped myself in a blanket, and just cried. I had not realized I had been holding myself back from those tears.
I haven't even told you the half of what its like being initiated into this world of seeing dead human bodies. Some are still warm, some cold. If you do not have a cooling time for when they were placed in the morgue, you have to guess it by touching and feeling their temperature. They are all stiff. Fifty percent of the cases, these people were traumatized in some way. I thought my experience with roadkill animals would prepare me for handling humans leaking bodily fluids. People are heavy. Dead ones don't help you lift them as you roll them over to inspect them toe to head, front to back.
On the couch that day, my body released all this tension in the matter of minutes. But then and there, I got another call from the coordinators and was dispatched on another case.
Today, on my first day off, I'd forgotten how to sleep in and woke straight up at 5:20 am. Opening my computer, I began compiling this week in writing. While making my second cup of coffee I turned on some music. I guess I had not heard music in 6 days. I began to collect my things from around the apartment to prepare to catch my flight and head back to San Francisco. There was something about hearing that music, getting dressed in my everyday clothing (that were not blue smurf colored), and placing my books in my suitcase. I still have a outside life to live.
I've wanted to know what death was all about. Thats that. And I have been consumed with needing to understand it.
Over the last 7 days, you could say that I've figured some things out. I have an entirely new perspective.
Moving on and refreshed by a single day off, I am going to continue on and try to help people who are going blind, by fulfilling the wishes of people who have died.