Stuff You Should Know - How Autopsies Work

Episode Date: February 16, 2012

In the 400th episode of Stuff You Should Know, Josh and Chuck take a trip through the morgue and look over the shoulders of the often controversial coroners and medical examiners that open cadavers to determine how someone died. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

Flooring contractors agree. When looking for the best to care for hardwood floors, use Bona Hardwood Floor Cleaner. The residue-free, fast drying solution is specially designed for hardwood floors, delivering the safe and effective clean you trust. Bona Hardwood Floor Cleaner is available at most retailers where floor cleaning products are sold and on Amazon. Also available for your other hard surface floors like Stone, Tile, Laminate, Vinyl, and LVT. For cleaning tips and exclusive offers, visit Bona.com slash Bona Clean. The War on Drugs is the excuse our government uses to get away with absolutely insane stuff. Stuff that'll piss you off. The cops, are they just like looting? Are they just like pillaging? They just have way better names for what they call,

like what we would call a jack move or being robbed. They call civil acid work. Be sure to listen to The War on Drugs on the iHeart radio app, Apple Podcast, or wherever you get your podcasts. Brought to you by the reinvented 2012 Camry. It's ready. Are you? Welcome to Stuff You Should Know from HowStuffWorks.com. I would say hey and welcome to the podcast, but I'm not going to yet because this is an add-on to what you're about to hear, right? Chuck, let's be quiet because we don't want our normal selves to hear us. Oh, gotcha. I wonder why you were talking about that.

Do you understand now? Yes. Chuck, do you know what this is? Do you know why we're doing this? Yeah, I do. What is it? It is pretty freaking exciting. What? Josh, we are about to release in just a few seconds. Show number 400. That's huge. There should be some sort of fanfare. I hope there was just now. I think so. There are 400th episode of Stuff You Should Know. That's a big deal, dude. Dude, I can't even like when people ask the requisite, hey, what's your favorite show? It just melts my brain now. I can't even think of it. I used to have stock answers and now there's so many. I look through and I don't even remember some of them. I'm like, what? We did that. We talked about that. I'm with you. Crazy. Well, let's hope we

can do another four shows. Exactly. Here's to you, Chuck. 400 more. Congratulations, buddy. Right back at you. And Jerry, thank you. You've been here since day one, aside from a few guest episodes where you're lazy. Jerry, congratulations to you. Pretty much been Jerry the whole time. Yeah. What would it be without the three of us, you know? Yeah. It would be crud. Well, thank you, dear listener, for listening to all 400. Do you know what some of you out there have? Because we would not be around if you never listened. In the first place, we would have done four shows. Yeah. And yeah, those of you who've listened to one or two or just discovered us or whatever. This is your first one. Welcome to the dollhouse. Hey, and welcome to

the podcast. I'm Josh Clark with me is Charles W. Chuck Bryant, and that makes this stuff you should know. Dead and rotting. I just made you shudder before we pressed record. I'm out. It was an actual. No, I thought you did that. Well, yeah, but I was doing it in response to your face. You made that face, but you didn't make the noise. Were you doing it on my behalf? Exactly. Oh, thank you so much. I feel so cared for. So, Chuckers. Yes. This is a little kind of a podcast. This this has got to complete our suite on death. You would think so, but it doesn't. No. No, we still have how dying works left. We still have what it's like to be dead. We've got a lot of stuff. We haven't even touched like what happens to the nails after that. True. So we're

getting closer though. We're creating a larger body of work. Yes. And this one, this is going to be a big one you predict. And I think I agree with you. It's just long. It's detailed too. Yeah, it was based in part on the an interview with the Fulton County Deputy Medical Examiner. Yeah. He knows what he's talking about. Hey, if you're in Fulton County, you're going to be investigating a lot of foul play. Yeah. Atlanta and Detroit used to go back and forth for the murder capital of the US. They used to shoot out for long distance. Yeah, exactly. And then bullets would fall somewhere in the middle. Yeah, DC's up there too, I think. Yeah, DC is up there. I think Atlanta's out of the running the last several years. Well, that's sad. I know. It lost its place.

We just don't murder like we used to. Yeah. But I mean, like the numbers all pale in comparison to like Juarez. It's like, oh, sure. You think that's a big number? Yeah. How about 15 times that? Yeah. Yeah. So, Chuck, have you ever seen an autopsy? Like a real deal film of one? No, I saw that alien autopsy, but that was quite fake. Have you not seen Faces of Death? The original? No. I never saw that. There's an autopsy in there. And I can't remember if we talked about it during the Exploitation Films episode, but part of Faces of Death was real and some was staged and fake. Right. But the autopsy was definitely real. Wow. And you can tell after reading this, it's like, oh, yeah, they do pull the skin flat from the top of the scalp down over the face and

under the chest. I felt really bad for the human face reading this. Yeah, it's kind of pliable. Yeah. Well, and it's always got some flap of skin folded over it. Yeah. Like, I don't know, we don't want to look at that. So let's just fold the chest over it. Exactly. What is this? What is that called? The scalp. Scalp. Yeah. I was going to say skull, sorry. The skull's under the scalp. No, I knew that. There's the fact of the podcast. So why do people do autopsy, Chuck? It's not just so ghouls can be paid to do their thing. No. There's actual reasons for an autopsy, which by the way, it doesn't say it's in the article, but autopsy is Greek. It's based on the Greek autopsy, which means to see for one's own eyes. That's pretty much as a self. Yeah. Yeah.

So they want to see for oneself how somebody died. Yes. The manner of death and time of death, which we'll get into. Yeah. But I think there are five certain types of death. One, two, three, four, five, six that they require an autopsy. If you die by injury, delayed complication of injury, poisoning, infectious complications, foul play, or if you die with no attending physician. So those are the reasons that they were requested an autopsy. Right. And if the cops come out or somebody, the funeral home comes out and says, whoa, whoa, whoa, this guy may have been poisoned or he's injured and he died, we need to call the coroner, the medical examiner. They're going to perform an autopsy. Yeah. And there's a couple of types of autopsies. There's two, really. And

the one where the cops are involved, where the medical examination is carried out on behalf of law enforcement. Yeah. That's a medical examination of forensic autopsy. AKA the sexiest of all autopsies, because that's what you're going to see in movies and on TV quite often. Right. Unless it's like contagion or something. Right. Exactly. So in a movie like, oh, contagion, the, any autopsy performed is going to be a clinical autopsy, which is usually performed by doctors who are trying to figure out what the heck happened, what went wrong in the treatment, how a disease took its course. And they're basically documenting maybe an interesting case through autopsy for the medical literature. And for, well, in the case of a contagion,

even though I haven't seen it for the good of humanity, immediate good of humanity. Right. Like if there's some fast spreading disease or something. Or there's faulty cribs. Autopsies were instrumental in finding, getting to the bottom of like product recalls like faulty cribs that are killing kids. I didn't think about that. Yeah. That's one of the benefits of autopsies. Yeah. Makes total sense. So those are the two kinds of autopsies you get for forensic and clinical. And basically we're going to be talking mainly about law enforcement autopsies. So when we say autopsy for the rest of the podcast, we're pretty much talking about a forensic autopsy. Yeah. One that's trying to figure out if somebody died naturally, accidentally.

Or someone's hand. Yeah. Foul play. At their own hand. Suicide or undetermined. Those are the five legally defined manners of death. I didn't see very sleepy on here. I thought that was a six. That would be naturally. Where they go to cut into you and you're like, oh, you wake up and they're like, oh, he's not dead. Right. Well, there's no manner of death then yet. That's true. That's going to be done by a forensic pathologist. Most often. Or a medical examiner. Or a coroner. And we'll get into that toward the end, right? Yeah. About the difference. Yeah. Well, ideally it's going to be carried out by a forensic pathologist, which is somebody who's trained to perform autopsies looking for a mode of death, right? Quite often a doctor, but not

always. Almost always. Yeah. To be a forensic pathologist, you have to be a doctor. Oh, really? You sure about that? Yeah. All right. Yeah. To be a medical examiner, you have to be a doctor. You don't have to be a forensic pathologist to be a medical examiner. Well, and you ideally should be accredited, but that's not always the case either. Yeah, you don't even have to be. Yeah. Yeah. So let's say you're a forensic pathologist or a coroner, you're going to try to assign one of these manners of death to a dead person. Yeah, like Quincy. Yeah, exactly. And what you're going to do is you're going to take not just the findings from your autopsy, but you're going to put them in a context with, say, a police report or something, right? Yeah, but you're not cops,

like TV, as usual, overstates it as far as how involved the medical examiner is, like as far as being on the scene and collecting DNA and all that stuff. That's it's not usually the case. Yeah. As Mr. What's his name? Dr. Kaisal or Kiesel? Let's go with the let's go Kiesel. Kiesel. It's like Kiesel with the K. Yeah. So you take all this stuff like so for example, Robert Valdez, who wrote this article says, so there's head trauma on a dead man or a dead woman. Sure. Doesn't quite make sense. You know, is it a homicide? Yeah. Is it's probably not a suicide, but is it accidental? We know it's definitely injury, right? Yeah. Which is why somebody called the coroner or the medical examiner in the first place. But the exactly whether it was at someone else's hand

or accidental is still up for debate. Well, you take those head trauma, those head wounds. Yeah. And you put them together with the police report that said that there was an iced over ladder laying beside the dead body when it was found. It was probably an accident. Right. The coroner of the medical examiner is going to say this guy's probably it was probably just slipping off the ladder. Yeah, like the gutters are half cleaned out. Right. He has like a big hunk of leaves in his hand. Right. And he didn't write someone's name and blood on the sidewalk beside him. It was Josh. Exactly. And then, you know, if you have the old that old yarn about a gunshot wound to the head, is it a homicide? Well, I don't know. Is there burn pattern really close by? Is there gunshot

residue on the on the hand, the dominant hand of the victim? That's also probably a suicide. Yeah. And as we'll point out here in a minute, one of the steps, which I didn't even realize this, you always see him zipping them up in the body bag, but they actually bagged the hands. Yeah. And in a suspected suicide homicide. Yeah. Because you bag the hands because you want to just make sure that you can check under the fingernails to make sure that there's not like skin cells from the guy who attacked you under your under your fingernails. People get real grabby when they're being murdered. I know. So grabby. So, so we apparently I didn't realize this, but Dr. Kiesel, we went with Kiesel, right? Yeah. He pointed out that so he gave an example

of how it's not really that clear cut, right? Oh, with the gunshot wound? Yeah. Yeah, it was interesting. So say you say I shot you in the head. That would be very sad. 30 years ago. And you survived, but you've developed a seizure disorder. So you're fine, but you have seizures. Okay. 30 years later today, you keel over dead from your seizure disorder. Right. That death would be ruled a homicide because you develop the seizure disorder as the result of a gunshot wound, which is an unnatural event that I inflicted on you. So even though Emily can't come after me and be like, I'm going to sue you, she could be like, I'm going to kill you. Yeah, she couldn't she couldn't sue me. Yeah. Because the apparently the the the courts don't allow that after 30 years

of survival. Sure. But the the coroner or the medical examiner would rule it a homicide. Yeah, it's not like he points out it's not their call to say like, you got to go after and prosecute this dude or Emily can sue you or she can bring you flowers and candy. They're just saying this is how it died, how it went. Exactly. Supposedly in an ideal vacuum world, we should say. That's right. So you were talking about the difference between medical examiners and coroners. You want to you want to give up the yeah, from what I understand, and especially by reading that article that you sent, coroners are sort of the more part time, although they can do it full time. But a lot of times it's in these underfunded counties and counties where they don't have a lot of crime.

There will be a coroner because there's only what did that article say like four to 500 professional medical examiners in the United States. Yeah, that's crazy. There's plenty of medical examiners, but they're not forensic pathologists, which in this case is like the most highly qualified person in that field. Right. So that's the main difference. It all depends on the county where you live. There's different laws as you know, as far as what they require. But if you're not in a big city, you may not have the resources or the equipment or you may be so far out of town that, you know, it's hard to get people there. So you might just have a coroner driving up that was is also your contractor for your house. Yeah. As the case

will set and where was that? Was that in Louisiana or Texas? It was in Washington, Washington. Yeah. There's 1600 counties in the US and there's like 3400 counties total and 1600 of them use the coroner system. Right. And you know, medical examiners and appointed physician, county coroner is an elected official who in most cases just has to have a high school degree for to be qualified for the position. Sometimes it's the sheriff. I saw in that one county it was the local county prosecutor. Yeah. Is also the coroner. Yeah, you're not supposed to do that because you want an impartial person ruling on the manner of death, especially say if like it's a police death, you know, the police killed somebody. Sure. You don't want the sheriff

judging whether or not his deputies were to blame. Looks like suicide to me. Exactly. Well, that happened. That was a pretty good example in New Orleans. There's the coroner there's been coroner for like 35 years. Oh, really? He he's very, very cozy with law enforcement or he's been accused of it many times. And there was a guy who stole one cop's gun and shot another cop's death and started to get away and was finally caught. And when he was caught and brought in finally, he died supposedly after being given iodine for x-rays. But really he died because he was beaten to death. He had like a bruised testicle and like all these cracked ribs in the corner. Still this day refuses to rule at a homicide. It's like a movie plot. Yeah. All of a sudden Richard

Gehr gets called in to investigate and things get sexy. Exactly. Yeah. Because of course the cop is, you know, Angelina Jolie. Is that how it goes down? Yeah. All 80 pounds of her. Yeah, right. She's one tough cop. So there are problems with the coroner's thing. And that you read that article too from PBS Frontline. That was awesome, by the way. People should read that. Yeah. I can't remember what it was called. I got it right here. Okay, good. It is called the real CSI colon, how America's patchwork system of death investigations puts the living at risk. It's a very eye-opening article. Yeah. Where basically they say that the members of this field quite literally bury their mistakes. Yeah. There's some really bad people who are really bad at their jobs out there

doing it. But the problem is it's like if you have a coroner who doesn't know what he's looking at and rules something, a homicide, then there's somebody who's going to be put on trial eventually. Well, exactly. Right or wrong. If you have medical examiners who don't know what they're doing or do a terrible job, one guy in Tennessee was accused of his dog eating some human remains because it was allowed to roam free in the examination room. Wow. You can't do that. Another guy supposedly allegedly was drunk while he was doing like thousands of these things. Wow. That's probably the only way he could get through it because he wasn't a real forensic pathologist. Right. But there's a huge, there's this huge battle going on between how qualified you have to be. It's the

medical establishment trying to take over this lucrative field. Well, it's not so lucrative because that's one reason it said in the article that there's a shortage is because they get paid on average less than a doctor would. So if you're going to go through medical school, plus I think an extra year of training for this to get paid less money. And the one guy pointed out, it's like you really do this because of love for your fellow man. Yes. That was the guy who refused to rule the homicide. I don't know what that means then. But also, I'll bet their malpractice insurance is like next to nothing compared to a regular physician. Yeah. Well, because you're using, well, we'll get to that. So the coroner also is responsible for identifying a body,

notifying the next of kin. That's Billy. Collecting and returning any personal belongings that's found on the body, which I'm sure in rural counties that, you know, there's probably been more than one wallet go missing during that process. Maybe. Maybe. Not calling out coroners. You never trusted farmers, have you? No. And then signing the death certificate. Right. And this kind of goes along with the origin of coroner, which is derived from the old English crowner. Yeah. I think Richard Lionheart was when it first really came into effect because he wanted, I guess he wanted the money of dead people. So he would send out his crowner to gather it up, right? He's like a Democrat. And they would say, well, he died of a wound from a sword

and then take his gold trinkets. Yes. And return it to Richard. Yeah, exactly. And then apparently over time, they were like, well, while you're out there, why don't you just start taking vital records and let's make you like an official guy. Yeah. And that's how the crowner became the coroner. That's right. And Dr. Dr. Diesel even knew that. Kiesel. Dr. Kiesel, because he's the one in the article that even pointed that out. And I thought, well, that's good. He knows about the history of his profession. He seemed like a pretty sharp guy. I imagine so. So Chuck, we've been beating around the bush quite long enough. Do you feel like it's time for people to put down their lunches and us to go through the autopsy procedure? Yes.

Step by step. Yes. I think that's a great idea. Step one, as I have it, is a body bag or an evidence sheet. Got to use a new brand new body bag and a brand new evidence sheet. Don't want to reuse those. No, I didn't think that was worth pointing out. But I didn't need that. I couldn't even bring myself to highlight it. I know. He was thorough though. So you definitely want to use new ones because you don't want obviously any contamination. Right. The body is moved by a dener. Make about 37 grand a year. I look that up. Is that right? On average. If you're a more attendant or a dener. And that is a D I E N E R. And they will take the body in the bag or sheet to the examination suite. And it stays in the bag for a little while. At first, at least.

Isn't that right? I didn't run across that. Yeah. Because if you have to, you can unseal the bag, but you have to take note of the clothing. Oh, yeah. Yeah. Sorry. The clothing. I thought you meant like they just put the body in the side for a day or two. Well, they do put it in the fridge. If there is some delay, like if the bodies are stacked up or something. Or I would imagine to let rigor stop. Sure. Right. To cease rigor. Exactly. Very good shot. But you leave it in the bag at first. You want to take note of the clothing after unzipping it. And the position of the clothing is very important because if the guy had, let's say, his turtleneck pulled up over his nose, he might have died by some stinky chemical in the air. That's good. You paint a

heck of a picture. I imagine a Frenchman. With a little mustache. You want to begin with the external examinations. Obviously, it comes first. You don't want to go cutting into the body. You want to look at hair samples, fingernails, gunshot residue, fibers, paint chips, anything on the body, hairs that is worth noting. Right. And the bag itself or the evidence sheet is kept as evidence as well. Because stuff might have stuck to it. True. That's gross. Yeah, it is kind of gross. But it happened. You also want to keep the body in the bag to x-ray it as well. X-ray or CAT scan the body in the bag. I didn't think about that. No, but it's true. I mean, things get lost in the bag. You want to make sure they're there. True. You want to be able

to see through the human being. Find maybe a bullet or something that's missing. It's in the bag. It says in here, sometimes they'll use UV radiation, special technique, to basically make secretions glow in the dark or become fluorescent. Like, hey, this guy's got some sort of sputum on his turtleneck as well. And it's glowing now. And I see that. Right. Well, you'd have to use the correct reagent to make sputum glow under a black light. But I'm sure it's out there, right? Yep, sure. You can get it in Spencer Gifts. So after you've made this initial external examination, it's time to get the body nude out of the body bag. That's right. You want to weigh it. Yeah, you don't clean the body up too. No, not yet. Very important. You got to leave it as is.

So you make your first examination with the body fully clothed. Make a second examination with the body undressed, but still bloody, right? And then after that, you clean the body up and make a third external examination. Well, the dean will clean the body up while you go have coffee and serve the internet. They're like rusty. Yeah. Gene. Exactly. Go clean that body up. And then finally, after that, the cleaned naked body is placed on the autopsy table. Yes. Which is, I mean, everybody's seen one of these. It's a big stainless steel table with raised sides, and it's slanted toward the middle with like a drain. No, why would it be slanted and stuff? Well, there's a lot of blood and fluids that come out when you cut into a body.

They probably figured that out after prototype one that was bed level and stuff oozed out of your hair. Yeah, exactly. To allow for drainage. It doesn't make any sense. So yeah, you have the body prepared. Also, I forgot. I'm sorry. You want to know the characteristics of the body, race, height, sex, scars, tattoos, all that kind of stuff. Hair color, eye color, age. And all the time they're looking for things like wounds, modes of injury, anything that could kind of give them an idea of what this person died from. Yeah. And then the body's on the examination table, Chuck, and it's time for, well, it's time for the internal exam. Well, yeah, it's time for something called the body block, which I tried to get a picture of this,

but I could not find one. I imagine it's just a... I guarantee it's a yoga block. You think? I'm sure. Maybe a wider figure of it's the exact same thing. So they put this body block under the back at first, the body's face up, and that will protrude the chest and have the arms kind of fall down so your chest is sticking out, which makes it much easier to get into. Yeah, your chest is raised up. Yep. Okay, so Dr. Bryant, would you like to make the first decision? Sure, Josh. I'm going to take that scalpel or that kitchen knife, but probably a scalpel initially, although they use all sorts of stuff we'll find out. And I will make a large and deep Y-shaped incision from shoulder to shoulder and meet at the breast bone and then down to the pubic bone. Yep. So you've

got a big Y in your chest, you fold that front flap up over the face, and I guess the other ones just fold over to the side. Well, I mean, it's not that easy. You have to kind of pull it back and dissect with a scalpel the connective tissue as you pull back, but then yes, that V-shaped chest flap goes back over the face. Yes. And then what? The next step, you're, right now you've got the rib cage and neck muscles all exposed. Also, probably you've pulled open the stomach flaps too. Yeah, I figured those are just off to the side. Yeah. Yeah. Because you, you know, where else are they going to go? The organs are exposed at this point. You're going to make a series of cuts. You're going to detach your goal here is to get

the organs out in a big unit. And wait, wait, you didn't take the rib cage off yet. Oh, I didn't. I'm sorry. You're going to, you're going to cut the rib cage off using everything from pruning shears that you would use in your backyard. The special rib cage cutters. Yeah. What are those called? Rib cutters. Of course they are. Yeah. So okay. Now that the ribs gone, your organs are exposed. You're going to make cuts that detach the larynx, esophagus, arteries and ligaments. Then you're going to detach it from the spinal cord. Yeah. Then you're going to detach everything from the bladder and the rectum. Right. And then after that, your whole organ set is able to be lifted out as one whole, as one whole unit. Yeah. Pretty cool. Pretty cool. So now it's kind of

time to get busy on the organs. You want to take slices of them? Want to weigh them first though. Oh yeah. You want to weigh? Yeah. You want to note their appearance, character, color. Yeah. They're funny. And then you're going to take some slices thin enough to be viewed under a microscope. Right? Yeah. Because that's part of this too. It's not all fun and games. Like you have to look into microscopes and stuff like that too. Sure. And then also the star probably is the stomach. Yeah. You're going to cut the stomach open and examine the gastric contents because that will tell you something about the time of death that we'll see. Or cause of death maybe. Possibly. If there's a small watch in your stomach. Maybe you swallowed it and choked or something like that.

Yeah. You never know. Right. And also they're probably going to examine the heart for cardiac bands. Yeah. They're going to bisect major arteries to see if there's any kind of blockage. Maybe it was a heart attack. Yeah. Maybe there was some sort of poison. Who knows. But basically they're just going to go through all of your internal organs. One by one. So you've got the chest cavity cut open. Yeah. But the head's just sitting there like, what are you going to do now? What are you going to do now? He's got a flap of face over the skin. Flap of skin over the face. What I say? Flap of face. You're all turned around. I am. So the body would say, hey, what's up with my brain? And then the examiner will say, hold tight. I'm getting right to that, sir. Right.

And then you're going to use that scalpel to make incisions from behind one ear across the forehead to the other ear all the way around. Like a cantaloupe, let's say. Yeah. Or let's say grapefruit. That's what you typically split into. Okay. And you divide that cut as well. So you have two separate flaps. One going over the face again. Yeah. And then fold that rear flap back over the neck. And then you've got an exposed skull. Right. And they use this special kind of saw called a striker saw, which is capable of cutting through the skull, but doesn't pierce the brain. It's pretty cool. Yeah. Is that what they use when they take casts off? You know? Probably. Because isn't that the same deal? We'll cut through your cast, but not through your skin. I would imagine.

I mean, it looks like this. Have you ever had a cast? I haven't, but yeah, I bet you that's may not be the exact same thing though. Well, at any rate, they use that. And then they use a clawed hammer. Not the kind that you think it's a hammer where at the bottom of the handle, there's a claw. Yeah. They use that to pry the cap of the skull off. Right. If you, once you get the skull cap off, if you look inside of it, you're going to see that the dura, which connects the brain to the skull, and by the way, which shrinks when you have a hangover is stuck to the inside of the skull cap. Right. So if it shrunk and they could determine if he was hung over when he died, they could. They'll also cut away the tentorium, which connects the

cerebellum and the occipital lobes. Right. Yes. And all of a sudden, voila, you have an exposed brain where once you detach it from the spinal cord, you are absolutely ready for it to just be lifted right out of the skull. And again, this whole time you're taking notes on your little voice recorder or you're telling Rusty, the, the dener to write that down. Right. And so it's not just, you're not just taking all this stuff out willingly. You're observing noting anything you see. Yeah. And then what do you do? You're done. It's been four hours. You did a really detailed examination inside and out. And you have this body that's just all kinds of messed up now. But the family's like, uh, we've got a funeral tomorrow. We can't do this. Sure. We shouldn't

even be here seeing this. Yeah. Put uncle Ted back together and the, uh, the coroner or the medical examiner will say, just chill out. We have procedures for this. So the internal organs either go back into the chest cavity or the abdomen. Yeah. Why would they do that? Religious purposes. Oh, really? Yeah. Interesting. Didn't think about that. Or more typically, they're incinerated. Yeah. Or in the case of really horrible medical examiners, they're fed to their dogs, right? Yeah. Or, or the bodily fluids are pumped back into the body because their draining system is clogged up. Yeah. As your message is in Massachusetts state medical examiner's office. Crazy. Yeah, it is. Um, the chest flaps are closed and sewn back together. The skull

caps placed back on and then held in place by sewing the scalp back and any decent coroner should make their incisions along the hairline or at least in well enough, precise enough that, um, it should be discreet once sewn back together. Yeah. And you're doing this with a Hagridorn needle. Yeah. Which is, uh, apparently when you're sewing human skin, you can't just use an ordinary sewing needle and you got to go James gum style and get this beefy skin needle. What? Nice. That was just great all over the place. Thank you. Um, so like I said, takes four hours by Dr. Kiesel's estimate. I love that he said that includes paperwork. Yeah. Well, I mean, you know, like the initial examination and writing it up and all that he said for a

homicide, it could take four to six hours. Um, and what's, what's behind, I guess, probably the, the lengthier ones are examining the wounds because you can't just say, well, here are the bullet holes. So this guy, you know, died from being shot. What do you want from me? Shut up. I'm a corner. Um, today you have to trace the path of each bullet hole and show where it went from entrance to exit or from entrance to where it stopped. Yeah. And in the case of, uh, any sort of police action and especially, I mean, if there's any sort of a shootout with like three or four guys and like 10 cops and there's people end up dead all over the place. It's a bad day for a corner. It's a bad day for a corner because you got to determine,

he said, uh, Kiesel said that, you know, what they want to know very specifically, especially in the case of police shootings is, all right, this bullet in this guy's shoulder, where did, whose gun did it come from? Right. And this other bullet in his chest, whose bullet did that come from? And see that guy, he's got five different kinds of bullets from these 12 cops. And we, we need to know where each of them came from. He gets really convoluted. Right. And same with, um, blunt force trauma. Uh, they, he has to determine not just like, well, something really heavy killed this person has to be this thing is probably what killed this person. Right. Right. Uh, because say that

they police find a bloody hammer at the scene, but the medical examiner says it was a hockey stick likely that killed this person. That's not going to help in the prosecution. Yeah. Or vice versa, you don't want somebody, you know, who has their prints on a hammer that the cops are trying to use against them to be used wrongly when it was actually that hockey stick that killed that person. True. That poor, poor person. And now while you can get some schooling for this stuff, I think, I think it said a year extra. Uh, a lot of it is just experience seeing the stuff. Yeah. Like, hey, I've seen that before. That's definitely a hockey stick. Yeah. You can go from rusty, the dean or to rusty, the, uh, medical examiner. Well, rusty, the coroner. Sure. Um, or rusty,

the medical examiner without having to go to med school, like the, the head of the, um, Washington, D.C. I know. Me's office is not a physician. That's crazy. Or not a forensic. He's not a forensic pathologist. I'm sorry. I don't want to sound like I'm disrespecting coroners. I'm sure a lot of them do great work. So, uh, I hope it didn't sound like we're slagging into the corners. It's a whole hornet's nest, man. It is. It's a big thing going on right now. So these are, you know, if the cops, uh, or the police department is doing some kind of investigation, you can get a private autopsy if uncle Ted dies seemingly naturally, but we just want to know what killed him. Was it his artery blockage or was it his awful liver? Cause he was

a raging alcoholic. Like we just want to know you can hire it out. And, uh, who wrote this? Was it the Grabster? No, Robert Valdes Valdes says 1500 to 3200. I saw 35 and up. Yeah, me too. So, uh, you can spend a little change on that. You are. Um, and it's especially frustrating if you're doing a secondary, um, oh, I bet basically getting a second opinion via autopsy because you don't think the first one worked. How do you do that? Like everything's already been prodded and yeah, it's going to be incomplete. But, um, apparently there's this guy in New Orleans under the main coroner who's like rude, whose work is routinely followed up by second autopsies. Really? And apparently his are easier because, um, the secondary autopsy, the secondary medical examiners

um, say like, he just like half autopsy's some people. So that's a crazy Cajun coroner. Right. Yeah. Wow. Yeah. Uh, so Josh, we mentioned a couple of tools like the Hagridor needle and the bone saw. Uh, they use something called, uh, an enterotome. I look these up. They're the scissors used to open intestines. It's, uh, sort of like one, one side of the scissor is longer than the other. And it has a little, little hook type thing on that end. Yeah. It looked baffling to me, but apparently that's what you need. Okay. Um, you talked about the hammer with a hook and the rib cutter, a scalpel, obviously, regular old scissors, gotta have a skull chisel. If you want to pry that, that skull open or that hammer with the hook, hammer with a hook,

forceps tooth forceps to pick up the heavier organs. And, uh, Kiesel goes on to elaborate a little bit and say, you know what, you put the words medical examiner knife in front of it, and you're going to be paying triple, buddy. Here's a little hit from your, from your uncle, Kiesel. You go to the hardware store and you get yourself a hex off or some pruning shears pruning shears, or you go to the restaurant supply store and get a nice cheap chef's knife. Yeah. And you're good to go. Yeah. Because again, they don't really have to worry about the person coming out of the procedure on the other end alive still, which is the big challenge for physicians. And not to say they do a hack job, but they don't have to worry about the precision,

obviously, of a surgeon. Right. So, um, there's a lot of guessing involved in this. Like, if you think about it, the, the ladder with ice next to the frozen body with head trauma. Yeah. Um, that it's, it's a suggestion that that's how that guy died or the melted puddle with the old riddle. Yeah, that's a great one. Um, these are all guesses ultimately is Dr. Kiesel puts it like you have to have somebody videotaped dying next to an atomic clock to ever establish a certain time of death. And even as our understanding of death as a process rather than as a moment. Yeah. Um, increases even that wouldn't necessarily give you anything. So basically they're, they're trying to, make an educated guess at the manner of death, but also the time of death is a big one. And

we mentioned, um, gastric contents, stomach contents. Yeah. Why would those be important? Well, uh, because if there's a cheeseburger that still looks like a cheeseburger, then that means you died within the amount of time it takes for that cheeseburger to become kind, kind. Nice. It's still bolus, but let's say that you found also in that person's apartment, uh, receipt from McDonald's that had the time stamp on it there, but that together, you're going to get an even clearer, uh, time of death. And they work under something called the time of death certainty principle, which is, um, the laughing stock of principles. It is. Go ahead. Well, it's, it's about as simple as it gets. If you know for sure,

when the person was last known to be alive, say, he was in the bar at nine 45 and he left, I saw him, he was loaded. Uh, and then, you know, for sure, when he was found dead, a, a found him at 10 30 frozen, well, maybe not frozen yet, but in the back alley who's dead as a stump, then you know for sure that he died sometime between nine 45 and 10 30. Yes. And then they try to narrow it down from there. That's the time of death certainty principle. It really makes sense. Yeah. Um, and there's, we've talked before about rigor mortis. We made an excellent podcast on rigor mortis. Yeah. We've talked about, um, levidity, um, from the body farm podcast. Um, the vitreous humor, the corny is getting cloudy. Yeah. Uh, that happens after

death. Um, and then again, the gastric contents, bought flies, all that stuff, full bladder, bottle flies, not bought flies, full bladder. I never really thought about that. That makes sense though. Yeah. If you have like a full bladder of urine or a lot of poop near your rectum, ready to come out, then I don't know what that tells you besides stand back. They didn't be, they didn't be your poop before they died. Right. But I'm sure it could help in an investigation. Um, and then also they'll use some kind of non-scientific ones. Like, you know, if somebody's possibly been dead for a few days, you know, what day is their TV guide sitting next to him open to? That makes sense. Makes a lot of sense. Is it on NBC? Did they have, uh, 30 rock highlighted

in their TV guide? Quite possibly they died laughing. So what have we got? Uh, well, we should mention that a lot of those variables that happen to the body, they can, they can change according to like how hot or cold it is and, uh, what other chemicals you might have had in your bloodstream. So it's not super seeking formaldehyde that's going to delay the onset of these things. It will. Um, you got anything else? Well, I mean, I guess we could follow up a little bit more on that article. Um, apparently just the system in the United States is sort of a big mess right now. Yeah. As a whole. And they, you know, you told a couple of the stories. Um, but Tim Brown, a construction manager in Marlboro County, South Carolina, it's a $14,000 a year part time job

to be the county coroner. Right. And I'm sure he does a fine job and hopefully there's not a lot of malfeasance going on there. You know, where he's not investigating like these big homicides. Right. But, um, but the, well, the problem is, uh, you know, if he is investigating a homicide, the state will generally provide a medical examiner to carry out an autopsy. They're not going to be like, well, you're the coroner. Sorry. Here's a scalpel. They'll say you can send this body to the state medical examiner and they'll give you an idea of, you know, what you're looking at. But it's also up to the coroner to decide whether or not an autopsy should be performed. Oh, it is. Yeah. Okay. The cops can't call for it. I'm sure other people can, but I think

ultimately it's the coroner who, uh, is able to decide a rule on that. Right. And we did mention that not all, uh, doctors have even passed the test. I think, uh, NPR found that 105 throughout the country have not passed the exam and some aren't going to retake it. They're just like, well, I failed it. And I'm still totally employed. It's affected my career. Bagel. Bagel. Yeah. Zilch. And another part of the problem also is there's like four to 500, um, officially qualified medical examiners who are forensic pathologists. And that's about half of what's needed by estimates for the U S. Right. So they're underfunded, overworked, overworked. The National Association of Medical Examiners recommends no more than 250, um, autopsies per, per medical examiner per year.

And, um, I mean, that's easily exceeded by a lot of people these days. Yeah. And Oklahoma stopped performing autopsies on anybody over 40. And, um, anybody, uh, suspected of it being a suicide. Wow. And Massachusetts seemed like a big mess. I think they said they had lost five bodies. They, uh, incinerated one before the autopsies even took place. Yeah. Was that the state where they got the two people mixed up? No, that was, uh, that was a death and a fire. That was a different one. Gotcha. And then there was one case where they pulled a body out of a lake and, uh, well, he drowned and they didn't notice the bullet wounds in his neck. Yeah. And suburban Detroit. Yeah. Sounds like a gross point. I don't know. I'm just guessing. So, uh, yeah, I got nothing else.

I don't either. I think it's a noble profession to get into if you got the stomach for it. Yeah. And, uh, you don't like your patients talking smack back to you. Right. You don't like that to spend a lot of magazine subscriptions. Don't have to worry about your bedside manner. What else? Uh, uh, your dog is free to come in and out apparently. That's just so crazy. This one was surprising to me. Like remember when we did the bail system? Yeah. That was surprising. It's like, just seems like this innocuous normal thing. And then all of a sudden you start looking into, you're like, whoa, there's a lot of problems with this system. Yeah. So there you go. Great. If you want to know more about autopsies, um, including, uh, a lot of photos of dead bodies

with sheets draped over them, um, you can find that by typing autopsy, a U T O P S I E S in the search bar at howstuffworks.com, which means time for listener mail. Hold on, Josh. Before listener mail, we want to announce our South by Southwest goings on this year. Yes. We will be podcasting this year live from 3 30 to 4 30 on Sunday, March 11th. And, uh, we don't know the location yet. I'm hoping it's a Driscoll hotel again. Yeah, that was nice personally. Uh, and if you're a badge holder, please come out and see his podcast live. It'll be a lot of fun. And if you're not in town and you can't make it, we will release the live podcast. So you'll get to join in on the fun. Yeah. Yeah. Like if you never leave the state of Kansas.

Uh, Monday, the following day, March 12th, we're going to be throwing a party and we're not quite firm on the details yet, but there will be likely some live music and some live comedy and us and some other very, and when I say very special treats, you're really going to want to be there for this one. Yes. You know, it's going to be a good party. It is not like you're thinking though. I mean, like Chuck, this means it's going to be a good party. He's not like trying. There's no wink, wink, nudge, nudge for you college. Yeah. Not like an eyes wide shut kind of thing. Not that kind of party. Definitely nothing like that. It's going to be a nice, wholesome, fun party. Exactly. Uh, plus beer. Yes. So it will be counteracted by, um, dropping the closed pin

in the milk bottle games. That's right. Okay. Well drunk. Now listener mail. A listener mail. Josh, this is from Austin and I'm going to call this healthcare and you helped me through my healthcare. Uh, guys really appreciate the show. Went through a pretty rough healthcare recently and this is how I came to listen to your show. Um, I had some limp, uh, swelling along with other health issues and my doctor says, you know, we should test for the worst of the worst. Um, it took a couple of weeks for this, uh, these tests to get turned around and it was pretty much the longest time of my life. Uh, to me, all signs pointed, uh, pointed to cancer couldn't believe it sitting across from a doctor. I didn't know telling me we need Mandy to look into a possible death

sentence. And then my wife is at home, uh, losing both of her grandparents. It's Christmas time and her parents are stuck in two different hospitals and had to cancel plans for business. All the while feuding with blood relatives who were taking advantage of the financials of their dying parents. Here I was, a new father of a spectacular baby, an incredible wife, overwhelmed with her own terrible issues. And I think I could soon be having to tell her I could be terminally ill. Uh, having a new baby, she would often go to bed early and I would be left to try and sleep with my own frightening imagination of what was going on in my body. I started listening to your podcast to take my mind off of everything and it was really the most calming distraction I could

ever have wished for. Uh, laughing, wondering, learning and enjoying all of it until I would fall asleep. Uh, long story short, I got my scans back. My lymphatic system was normal, but my immune system was hyperactive, causing symptoms of node swelling, pain and fatigue, weight loss. Uh, great news compared to the mindset that I had, uh, of the worst thing imaginable. So he's okay. Yeah, very lucky. Uh, but still I look forward to laying down early with my wife and now the two of us listen to you guys before we go to bed to help clear her mind and hurt her. Wow, I can't believe we can do that. Crazy. It is crazy. I'm sure they fall asleep six to eight minutes later. Right. Tops. Tops. So that's from Austin and Austin. We're very glad to hear, uh, about your

diagnosis, my friend. Yeah, way to go, Austin. Um, that was great. That was a good one, Chuck. Thank you. Uh, thank Austin. Thanks, Austin. I already did. Thank me. I did. Did you thank Jerry? Thank you, Jerry. All right. Uh, thank you to everybody for listening to this one. Uh, if you have a, uh, an interesting story of how stuff you should know puts you to sleep or anything weird that it's done for you, we want to hear it. We like that kind of thing. You can tweet to us at syskpodcast. You can join us on Facebook at facebook.com slash stuff you should know. And you can send us a good old fashioned email to stuffpodcastathowstuffworks.com. For more on this and thousands of other topics, visit howstuffworks.com. To learn more about

the podcast, click on the podcast icon in the upper right corner of our homepage. The How Stuff Works iPhone app has arrived. Download it today on iTunes. Brought to you by the reinvented 2012 Camry. It's ready. Are you? The war on drugs is the excuse our government uses to get away with absolutely insane stuff, stuff that'll piss you off. The cops, are they just like looting? Are they just like pillaging? They just have way better names for what they call, like what we would call a jack move or being robbed. They call civil asset work. Be sure to listen to the war on drugs on the iHeart radio app, Apple podcast or wherever you get your podcast. I'm Nikki Lynette, the host of About a Girl,

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