Friday, September 17, 2010

Guest Blogger - A Funny Thing Happened on the Way to My Autopsy!

Our guest today at Robert W. Walker's invitation has a harrowing tale to tell of a real-life autopsy. Andrew E. Kaufman is an award-winning writer and author of Savages. He lives in Southern
California, with his Labrador Retrievers, a horse, and a very bossy Jack Russell Terrier (who thinks she owns the place). After receiving his journalism and political science degrees at San Diego State University, Andrew began his writing career as an Emmy-nominated television writer/producer, working in San Diego and Los Angeles. For more than ten years, he produced special series and covered many nationally known cases, including the O.J. Simpson Trial. He has also written stories for the Chicken Soup for the Soul books, one due out later this year.

For more information about Andrew and his work, please visit: The Bottom Line -   NOW here is Andrew in his own words and talk about DEADication to Authenticity!  Papa Hemingway would be proud of this young author. 

It was a horrifying realization. In the midst of my revisions for While the Savage Sleeps, it seemed painfully obvious that one of the most important chapters in the book, my autopsy scene, had fallen flat. Sure, it had all the technical jargon—that was fine—and the characters appeared genuine in their reactions to what was going on around them. Even the procedures sounded believable. Still, it lacked depth. There was no sense of what was riding just beneath the surface.

As a former television journalist, I know how to craft words and pictures to tell a story. However, fiction, I'd discovered, is a different universe. Unlike TV, in novels there are no images, no video to convey the tone and mood of a particular scene. Here, your words are your pictures, and if the reader can't see them, they're as good as gone. I couldn't afford that. I knew I could do better.

I also knew that in order to do better, I needed to do something I dreaded, and that was to witness an actual autopsy. I shuddered at the thought, and my stomach ... well, let's just say it did far worse.

You may find that odd, considering I'm often accused of writing some very gritty stuff in my novels (I'm not exactly known for warm and fuzzies about puppies and kittens). Beside that, I'm no stranger to blood and guts--I'd seen my share during my tenure in television news. Still, somehow, the autopsy room seemed different to me, like an intimate dance with death--one I'd much preferred to sit out on.

Of course, as it often goes, logic won out. I knew that being a good writer often means getting your hands dirty (or in this case, a lot dirty) and that sometimes you have to push the envelope and venture into places unknown. Experience had taught me that if you run toward the uncomfortable instead of away from it, that's where amazing things start to happen. So logic be damned, off I went to my first, and hopefully last--at least from a vertical standpoint--real-life autopsy.

What was it like? I won't go through every gory detail—there's plenty of that in my book—but I will tell you this: it was pretty disgusting. Not just a little. A lot. Walking into a room filled with corpses is no picnic; in fact, it's an all-out assault on the senses. Not that I was expecting pretty, but the surrealism of it all surrounded me like, well ... a bloody blanket. And there would be blood, lots of it. My first indication? When they handed me my autopsy attire: a white sort of affair, complete with matching facemask. Yes, folks, cutting, drilling, and sawing human remains is messy business. Of course, I couldn't much complain; this was what I'd asked for, and this was what I was getting.

And the getting got better—or perhaps I should say, worse. As an added bonus, not only did the doctor carefully explain everything he was doing, but he also handed me each organ as he removed it so I could fully describe them in my book. Kind of gross, I know, but nevertheless, one of those important and necessary experiences for a writer. After all, you just never know when you might need to introduce a disembodied organ or two into your story—a kidney here, a spleen there. Like I've said, I'm known for grisly scenes.

Overall, I wouldn't say the experience was the most pleasant I've ever encountered, but as a writer, it quite possibly may have been my most valuable. Taking the reader by the hand and bringing them into our imaginary world is what we as writers do, but we can’t accomplish that if we haven't gone there ourselves. Doing a Google search or interviewing a subject can certainly be one part of the process, but if I just did that, I'd only be doing half the work, and in the process, losing at least half of my audience. The other part is bringing the reader in as close as I can to that which I create.

As for the autopsy, would I do it again? Not if I can help it. Was my story better for it? You tell me:

Excerpted from While Savages Sleep's Chapter Fifteen

Office of the Medical Investigator, Albuquerque, New Mexico

Ben Foley’s remains lay on a stainless steel autopsy table. The child-sized body bag surrounded him like a cocoon, zipped tight and topped off with a tamper-proof tie-seal. He was nothing more than a number now, one scribbled across the white plastic with a dark marker.

Cameron just stared at it.

It was hard to believe someone so small could inflict harm on such a large scale. So tiny, so fragile, he thought, so broken. Had he not known better, he could just as easily have mistaken Ben for the victim.

All autopsies in the State of New Mexico came to the Office of the Medical Investigator, located at the University of New Mexico School of Medicine in Albuquerque. For Cameron, that meant a three-hour-plus trip. Although he didn’t normally attend autopsies, he knew he couldn’t afford to miss this one. Too much was riding on it.

Now he stood at the head of the table observing, along with Assistant Chief Medical Investigator Russell Gavin standing at the broadside, and his assistant, Shelia Murphy, to his left. A microphone dangled loosely overhead to record the doctor’s comments while he performed the autopsy.

Cameron shifted his attention away from Ben’s body and around the room, but the picture there wasn’t much better; in fact, in some ways, it seemed worse—three other bodies lay off to his right, two more on the left, each in various stages of examination … and decomposition.

Without thinking, Cameron breathed in deeply, then realized it was not the best idea, as a strong odor of ammonia, blood, and decaying flesh filled his lungs. He forced the air out quickly, turning his attention back to Ben, back to the body of an eleven-year-old killer.

Investigators had removed his clothing at the scene, bagged and tagged as evidence. All lint, fibers, or other substances that had managed to cling to them would be collected and catalogued for the investigation.

Cameron was intent on staying professional, on not letting memories and feelings from his past cloud his thinking about this case. It wasn’t that he didn’t think about what had happened to his son—that was with him all the time. It was that he couldn’t allow it to intrude.

“Ready, doctor?” Sheila asked.

Gavin nodded. He cut the seal on the bag, drew the zipper down toward the bottom, and reached into the opening with both hands. Working from top to bottom, he pulled the two sides apart.

If Cameron thought seeing Ben’s body in the closet had been the worst of it, he was in for a rude surprise; this topped it. Before, in the dimly lit closet, the boy had been crouched down, his body oddly twisted, and a good part of it barely visible. Now, laid out flat under the bright fluorescent light, there was nothing left for the imagination—it was all right there in front of him. Ben’s body was coated in a layer of dried blood, everywhere, and in some spots, caked thickly.

Standing only inches away, Cameron could see with alarming clarity the kind of damage a .30/30 round can do when it intersects with flesh and bone. The gun blast had blown the back of Ben’s head apart, shattering the skull like an eggshell. This caused the facial features to collapse, leaving them spongy and unrecognizable. Scattered across his face were cuts and bruises, the heaviest of which on the right forehead, nose, and left cheek. Cameron studied the cracked stretch marks on the boy’s lips. He knew expanding gases from the gun barrel had caused them when it went off inside his mouth.

The odor took things a step further—it reminded Cameron of rotting meat. Not only could he smell it in the air; he could taste it on his tongue. Cameron swallowed hard, trying to fight back his nausea, felt a tingling sensation in the pit of stomach as it began to churn.

Gavin spoke suddenly, his voice much louder than seemed necessary considering the intimate surroundings. “The body is that of a white male, appearing consistent with the stated age of eleven years. Four-foot-one, eighty-five pounds, with a birthmark observed in the small of the back, approximately a half-inch in diameter. No other identifying marks or features.”

Using his fingers, the doctor reached into Ben’s mouth and pulled it open easily, helped by the gun’s powerful discharge—it had broken the lower jaw, leaving it hanging loose. Then he lowered his head and looked inside. “There’s extensive destruction to the oral cavity, with the hard palate nearly gone. Several attached molars show a grayish-black soot deposition, and the tongue is covered with multiple, purple contusions ranging from one-eighth to one-half an inch at its lateral aspects.”

The doctor pulled his hand away, and the mouth remained open. He closed it and examined the rest of Ben’s body, lifting the arms and checking a few other less exposed areas. “There do not appear to be any other signs of injury or damage to the body’s exterior.”

He stepped back an inch or two and frowned, staring at Ben’s body for a moment. Then Sheila moved in and placed a body block under Ben’s spine, causing the arms, head, and neck to fall back and the chest to protrude forward, making it easier for the doctor to cut his incisions.

Using a scalpel, Gavin made a deep, v-shaped cut going from shoulder to shoulder, then another that cut vertically, looping around the navel and continuing on toward the pubic bone. He pulled the two chest flaps open, immediately launching an even more potent odor into the air, a combination of human feces, trapped gas … and more blood.

Oblivious to Cameron’s discomfort, the doctor went to work immediately, and began by inserting a syringe into the ascending aorta to extract blood samples. He would do the same with the bladder, in much the same manner, only this time removing urine samples. Both would be sent off to the lab for analysis to see if Ben had any drugs in his system, or an illness relevant to the case.

After that, one by one, he began removing and inspecting organs. Later, in the interest of saving time, he would weigh them all at once.

“The heart appears to be normal and free of abnormalities,” Gavin said, “as do the lungs, intestines, liver, and spleen.”

He removed the stomach, which he placed on an adjacent table. After dumping its gray, soupy contents into a plastic measuring cup, the doctor began the dissection process. Suddenly, he stopped.

“See that?” he said to his assistant, still looking down, pointing.

Sheila leaned over with interest. “Yep … sure do.”

Gavin directed his voice toward the microphone. “The gastric mucosa reveals extensive ulcerations along the greater curvature of the stomach.”

Cameron leaned in, trying to figure out what was happening.

Gavin, catching this, looked over at him to explain. “Although possible, the condition isn’t common in a child his age. We’re going to have to do some further microscopic evaluation here.”

Cameron responded with a nod.

The doctor turned back toward the body and began taking small tissues samples from the stomach, placing them into small, plastic cassettes.

After examining the remaining trunk organs, he nodded to Sheila, who moved the body block up a few inches toward the back of the neck.

There was no need to cut the skull open—the rifle round had done that work for him, shattering the back of Ben’s head, leaving the insides in plain view. After making a few small incisions, the doctor grabbed onto the scalp, then peeled the face flap down and away from the skull, much like a latex mask. He examined the underlying, bony surface, then moved toward the back of the head.

The force from the gun blast had obliterated most of the brain, transforming it instantly into pulp and bone fragments. Using a gloved hand, the doctor reached in and scraped out the soggy, mashed contents. After that, he scooped them into a weighing pan where he examined them.

Gavin continued calmly. “The cerebellum and brainstem are largely intact, as are portions of the posterior occipital lobes. The calvarium is extensively fractured. The remaining brain fragments are a pulverized, gelatinous, and partly clotted subdural mass—about ten milliliters’ worth.”

He stepped back. “Cause of death: Intraoral gunshot wound to the head. Manner of death: Suicide.”

He walked to the head of the table where Cameron stood, removing the latex gloves from his fingers as he spoke. “The toxicology tests normally take several weeks.”

Cameron nodded, still staring at the body. “Those stomach ulcers you mentioned … you said they’re not normal.”

“Ulcers in children, while not entirely common, do occur, but the vast majority of patients are adults.”


“Meaning, the most common cause of ulcers in adults is H. pylori, or Helicobacter Pylori, a bacterium often associated with peptic ulcers. Of course, we also see them in people who abuse alcohol or crystal meth.”

“But in kids?”

“In kids it’s different. Theirs tend to be more of a gastric nature, often brought on by certain medications. Do you know if the boy had been taking any, or if he’d been previously diagnosed as having stomach ulcers?”

Cameron shook his head.

The doctor shrugged. “No worries. The tox screen will tell us if he’d been taking anything, and I’ll have a look at his medical records to see if he had a history of stomach ulcers as well. Easy enough to find out.”

“What kinds of medications would cause them?”

“Most common are the anti-inflammatory drugs—over-the-counter meds— things like ibuprofen or aspirin and a few others.”

“So if Ben was taking aspirin or some other pain reliever, they could have given him the ulcers?”

“Not necessarily,” the doctor said, shaking his head. “Not if he was just taking them on isolated occasions. Now, if he’d been popping them like Tic-Tacs—well, then we’d have cause to be suspicious, but ulcers as widespread as what he had? A few days’ worth of use isn’t going to do it. Those look pretty severe. It takes a lot of something, over a long time to cause that.”

“But what that something is, we don’t know yet, right?” Cameron asked.

“Not until we get the toxicology results,” Gavin repeated patiently.

“Anything else that could’ve caused them?”

“Hypothermia can produce a condition that resembles ulcers,” Gavin said, rubbing his chin while thinking aloud, “but not much chance of that happening this time of year, and certainly not in this situation. Besides, those kinds of hemorrhages look smaller, and Ben’s are much larger.”

Cameron looked up toward the ceiling, thinking. “You know, come to think of it, I don’t remember Ben having any sort of medical condition. I was his Little League coach—all team members had to get physicals in order to play. I would have been told if he did.”

“I’ll double-check his medical records, just on the slight chance it got past you, and the lab will take a closer look at those ulcers under a microscope, as well. We should be able to come up with some answers.”

Answers, Cameron thought as he left the building and headed toward his car—the autopsy hadn’t provided any. It had only raised more questions.

He was getting used to that.

Dead men tell no tales. Cameron shook his head. But what about boys? Tell me, Ben—tell me what really happened that night…

And while you’re at it, tell me… what’s happening to this town?

ROUND of APPLAUSE. I coulda pulled off that scene so well myself, and I've done wrote a lotta autopsy scenes in my day!  Do leave a message as we at Make Mine love to hear from you, and we made it easy to leave word. -- Rob Walker


Jim (and Karen) Overturf said...

I would say the trip did provide you an educational experience! The details you were able to add in terms of reactions and observations made it incredibly real, and proves that even a movie or television autopsy room is "cleaned up" for the viewer. Excellent work! Thanks for sharing that! Karen

Earl Staggs said...

The excerpt was what it was intended to be -- interesting and gross -- which made it quite effective. I felt I was there with Cameron (and slightly nauseous myself) and that only happens when something is well-written.

Andrew E. Kaufman said...

Thanks for the compliments. It was important that I bring the readers in and as close to experience as I could. As unpleasant as the chapter is, I knew it would never fly otherwise. Readers are too smart. It would be an insult to them to do otherwise.

Nissie said...

Wow, you're dedicated! I've read plenty of autopsy scenes and seen plenty in movies. I've always had the same reaction to all of them...ewww! But with yours, my stomach actually turned over a little bit.

Oh, that's a good thing! :)

lil Gluckstern said...

I came to this from DorothyL which I usually read during dinner. This is not necessarily a good idea. Your writing was super, and I will now track down your book.
Very nicely done.

Andrew E. Kaufman said...

Well, I guess I did my job, but that's not always a good thing! Thanks, Nissie--and lil Gluckstern, sorry I ruined your lunch! If it's any consolation, being there was far worse!

Andrew E. Kaufman said...

Well, I guess I did my job, but that's not always a good thing! Thanks, Nissie--and lil Gluckstern, sorry I ruined your lunch! If it's any consolation, being there was far worse!

Andrew E. Kaufman said...

Well, I guess I did my job, but that's not always a good thing! Thanks, Nissie--and lil Gluckstern, sorry I ruined your lunch! If it's any consolation, being there was far worse!

Andrew E. Kaufman said...

Well, I guess I did my job, but that's not always a good thing! Thanks, Nissie--and lil Gluckstern, sorry I ruined your lunch! If it's any consolation, being there was far worse!

Nissie said...

In this case I think it was a good thing. I really don't like to read books that get NO reaction from me! I should have the book any day now. I'm really looking forward to it.

Mark W. Danielson said...

Very interesting post. I'm not sure I'd attend an autopsy after hearing my father speak of the many he witnessed as a pre-med student. However, I highly recommend visiting the Body Works display if it comes to your area. These are real bodies stipped of their skin and posed in various positions to give you an excellent understanding of how our bodies work. Body Works is a traveling show and is well worth the price of admission.

Andew E. Kaufman said...

I hope you enjoy the book, Nissie. Feel free to contact me after you've finished. I always enjoy hearing comments from my readers :)


Candy's Creations said...

Great post and of course great book loved every word. you do have a way with words Andrew can't wait for your next book.

Carrie said...

I think it was very impressive that you checked out where all the autopsies go in NM, which was one thing I struggled with. Information is hard to get!

Reference is everything for sure, and what an ordeal to go through for a few pages of realism. Kudos to you for putting that extra effort into your work. I'll be picking your book up next time around.

Rob Walker said...

Andrew's throwing a launch party over at his place for the book now, so I urge y'all to go and see the comments and who shows up at the party. Just click on his name here in the comment section and it will take you to the party. The hot buttered online rum was great for my head cold.


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