I work in a Mortuary - AMA

What is the most interesting case/post mortem you've worked on - if that's an ok thing to answer. Please ignore if not!

It's fine, I can share with you. The ones I find the most interesting usually yield an unexpected element. I have worked on people who have supernumerary organs (such as a biconcave womb and once an extra spleen!).

So with that in mind, the case I found the most interesting was a lady who had apparently had a heart attack while in hospital for treatment for a broken femur.

When we examined her we found that she had indeed suffered a hear attack. However, upon examining her brain we found a large tumour. She had no history of symptoms usually related to brain disorders in her notes and herself and the family had no idea. Completely unrelated t her heart attack, too.

OrchidFancy

With everything we do in the mortuary we try our hardest to make is as pleasant as we can possibly strive to for the family. I hope you can rest assured that your dad and all the other patients are dealt with respectfully and, even when we have to do a post mortem, we are careful and will only ever do what is necessary.

You are welcome, and I am sorry your family and yourself had to go through it all.

MaitlandGirl

Thank you. I believe it is so important to recognise them as a human being. I don't ever want to lose that and I will always respectfully call my patients, my patients.

I don't work at the Royal Berkshire, and 1999 is a bit before my time, however I am pleased to hear your experience was as positive as it could be in these circumstances.

Arkengarthdale

Thank you. It's so nice to hear that. I was a bit worried about starting this thread, but knowing it is appreciated has reassured me [smile

Where do the babies go? Is there a special room for them?

There is a special room for our babies, yes. We have baskets, blankets and little outfits we put them in, and teddies we have for them too, all kept neatly. We also have the hand and foot printing memorials taken there. Our room is yellow and has a lovely picture of elephants on the wall.

That feeling of them being alone isn't pleasant at all. There is always someone around for them though, and for the families, whether it be us, the midwives, our amazing chaplains and ourselves.

Do you mean there are 4 staff, each working on one patient at the same time, or does one member of staff go from patient to patient, carrying out one type of procedure on each and then moving on to the next sort of procedure on each, if you see what I mean?

I think I understand. Yes, of a morning we will have 4 patients (we have 4 tables in our suite). Each PM is done by one person, and completed in one go before moving on to the next patient. So we will have, for example, two staff to two patients. We both complete one each at the same time as each other and then move onto the next, so we both do two PMs. I hope my reply now makes sense

TheGoldenWolfFleece

I am sure they would have. Of the trusts i've worked in and people I have met in the profession, they have all been kind and respectful to their patients.

ggirl

No problem! I am insure about upward weight criteria, but I know that they generally don't accept very underweight patients.

lightonthewater

I am sorry about the feelings this thought has left you with. Everything we do has reason behind it and we never go further than is absolutely necessary.

We weigh the organs because they can give us a clue, if it isn't obvious, as to any underlying conditions which may have been a factor in a patients death. For example is a patients lungs or lungs are heavier than expected it could indicate there is fluid in them, or a light brain may indicate a neurological disorder.

Unfortunately you or yourself cannot decline a PM if one is necessary. However, you can rest assured that we would only, ever do one if it really, truly is necessary.

How do you deal with the smell though? I couldn't wait to get out and shower

From the other way round, I've observed surgeries, which i find equally fascinating. The sheer precision needed compared to us is astounding. We recently had junior docs in to practice laparoscopic surgery on donated patients, which was a nice meeting of both worlds.

As for the smell, It becomes bearable after a while, although every once in a while it will catch me unawares. It does cling to you though, it gets into your senses and I can smell it in my hair after work sometimes (although others don't appear to notice). We have the added bonus of showers at work, so once the PM's are done - if they were particularly smelly - I will grab a shower afterwards.

can I ask what happens when the patient is from a culture where these are unwelcome? Would the procedure have to go ahead all the same, or would it be waived?

At present they are unable to prevent a PM happening if it has been ordered. The decision can be appealed but it's very rare that the appeal comes through in their favour.

However, we are currently trailing the use of CT scanning to determine the cause of death, and we have representatives from religious communities who we can work with to facilitate this. Unfortunately it can't always detect a cause of death, so in these circumstances a full PM will then be required. We will always try and do this as soon as possible if needed, and can even request a male or female pathologist if this is required (although this cannot be guaranteed).

Overall we try out best to respect the spiritual wishes of the family and will do what we can to assist them in that.

Are babies placed with an adult corpse still?

No, they are kept in an area especially for them. It wouldn't be seen as appropriate, unless the baby was with it's mother, to keep an adult and baby together.

Have you dealt with many murder victims? Do you deal with many that have in a bad condition, like from a car crash for example, and does that make is harder for you?

I'm afraid so, on both counts. We recently had a very harrowing murder case a year or so ago that hit all of us incredibly hard, because of the age and circumstances in which the person had died. I had to take a couple of days off after that one actually.

Violent deaths which aren't murder can be equally horrific (crashes, falls from height etc). I am going to spare the details but some of the states people come in to us are unimaginable, but we do everything we can to put someone back together and make them look like they did in life. Reconstruction is something I am learning from my manager at the moment, and you wouldn't believe some of the people they(manager) had worked on had ever been in an accident.

As a completely unrelated aside, if you (or your family) are a motorcyclist, regardless of how unbearably hot it can be, wear your leathers (or make your loved ones wear them)!!!! A bit of sweat is nothing compared to losing your life. Same goes with seat belts.

Anonnymouse54321

Ironically, I am a biker myself. There is something about this job that can make you incredibly reckless, and I guess having the bike is my one, big, reckless pleasure, although I am reckless in other ways, too.

pud1

That practice sounds incredibly disrespectful to all involved and I apologise for your experience. As far as I know, most PALS complaints will be forwarded straight to the management of the department involved unless the incident is serious and involves them directly. I have never seen this practice anywhere myself and any coffins I see are brought via the back door by funeral directors!

If you walked past a deceased patient in our trust you wouldn't even know it. We are very, very discreet and you would have to know what our trolley looks like to recognise it.

Does your hospital have separate mortuaries for adults and children? Is it common for them to be separate?

Ours doesn't but I know of hospitals that do, and of course GOSH and other childrens hospitals will be solely children.

Id say we are lucky in that we don't see many children come through our doors. Unfortunately when they do though, it is forensic or coroners cases. Kids are hard enough but it's especially heartbreaking and makes it incredibly difficult. As a mother I have to remember that it's not my grief though, and make sure I occupy my mind in my downtime.

You said earlier that one of your roles is to remove and weigh the organs. Do you do all of that, including making the incision etc yourself? Or does a Dr do the actual cutting and removing and you do the next bit?

Yes, we make all the incisions, remove all the organs and put the patient back together afterwards. The pathologist takes the organs to a separate table and inspects them.

covetingthepreciousthings

IT can be difficult to switch off at times. That is why having a supportive team, a loving husband and family and a good friendship group is important.

Some people, like me, are surprised by how well they cope. Others realise it's not for them at all, but you will never know until you see it if you know what I mean. We have had interviewees, trainee police officers etc faint on us, and that's just in the viewing gallery!