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Articles  »  Medical Examiner

Mortui Vivos Docent: Let the Dead Teach the Living

     In few words, "Certainly not!" and for a simple reason; life in the world continues. Dr. Schiller offers up death to his audiences as the beginning of a vast and wondrous learning process. For to truly understand the complexity of life, one must also comprehend that which takes it away. "After all," say Schiller, "learning is in inherent in the term autopsy (one of the common tasks of a pathologist)." This word itself means "to see for one's self". Yet, with all our technology and knowledge today, many people still do not appreciate this learning process. As a result, only a mere 10% of those who die are autopsied. As a result, in many cases, causes of death, origins of disease, and other illusive factors are left unknown.

     How then can this trend be reversed? How can we begin to accept the education that the dead can offer us? Dr. Schiller believes that education is the simple answer. Yet, still, people will ask, "What is there to know about an autopsy? You cut someone open and see what's inside, right?" At this, with a smile of almost paternal caring, Dr. Schiller tilts his head and invites you to listen and learn.

     Everything has a history of some sort and the autopsy is no exception. Beginning almost 3,500 years ago in ancient Babylonian society, researchers have actually found some of the earliest true analytical observations in ancient Egyptian writings. The Greek scientist Hippocrates called the autopsy a "cruel and unusual'' process and centuries later, in medieval Europe, autopsies were not approved by the church under any circumstances. Yet, soon thereafter, upon the death of Pope Alexander, the church approved them for non-Christians, with the exception, of course, of the Pope. This process of approval and disapproval, both religious and social went on for years, until today, when autopsies are, in a sense, common practice. Yet, what remains fascinating is that over thousands of years of history and refinement of the medical field's procedures, the basic method of using a Y- shaped incision has remained the same.

     While history can be very interesting, history will not clearly answer our contemporary question concerning the reasons behind an autopsy. After some thought and almost oversimplifying the issue, one can elucidate three main reasons why autopsies are important. The most simple of which is that autopsies make it possible to learn from mistakes so that they are not repeated. Whether it be in the case of new technology that has not been perfected or an operation gone bad, the autopsy, many times makes an otherwise unforeseen incident not only predictable, but preventable in the future.

     Second, the effects of certain environments can be deduced based on autopsies. A prime example is the discovery of how asbestos can cause an asbestosis, a debilitating breakdown of the lung due to exposure to asbestos.

     Last, but in no light the least important reasons for an autopsy lie in the realm of public health and vital statistics. Such serious diseases as HIV, A.I.D.S. and the Hanta virus have been first identified in a population on the autopsy table. These identifications can give organizations such as the Centers for Disease Control and World Health Organization warning to issue notices and treat those who are in need. Also, by increasing the autopsy rate, statistics on disease and causes of death can be improved. As of now, 90% of all vital statistics are tabulated from death certificates from cases where autopsies were not performed. This, in turn leaves the true cause of death questionable and throws a shadow of doubt on the validity of statistics, which, in some cases determine monetary allocations.

     To conclude, Dr. Schiller stresses the fact that autopsy rates remain incredibly low, despite the clear advantages to the public and family of the deceases of having one performed. Before leaving, he throws one more fact to the audience saying that one of the main reasons that many Americans (26% to be exact) do not have an autopsy is because they fear not actually being dead at the time of the procedure.