Saturday, August 1, 2009

Conversation Killer

I finished autopsy. Well, at least this round of it. There will be a few more months coming up in the future. I'll let you in on a little secret: most people in pathology do not like autopsies. There seems to be this assumption, especially among other doctors, that we must love autopsies. Some people do. If they really do they might go into forensic pathology or take an academic position at a place where a lot of autopsies are done. But many do not, and in this day and age of declining autopsies one can generally find a job where doing them is rare.

Long ago I blogged about what happened when I told people that I was a medical student. Now I can tell you that announcing you are a pathology resident inspires even more weird awkwardness. "Oh, like on CSI, right?" "Pathology?" "Oh, that must be interesting." Or (usually from people with some knowledge of the health professions) "hmmm..." with a stare that implies that I must be social inept/lazy/a serial killer/all of the above. And occasionally, usually from really burned out residents/clinicians, "you are so lucky you made the right choice: no patients, good money, and nice hours."

But imagine the conversation either: 1. actually progress beyond that initial phases or 2. is with someone I know who knows a bit about what I am doing. Now someone asks what I am doing right now. "I'm doing autopsies." Can I just say CONVERSATION KILLER?

Remember what I said above about CSI/social ineptitude/serial killer associations? It all comes back right in that moment. The look of horror comes up. Awkward silence reigns.

Or, the other alternative usually occurs with people who have had some medical training. I am not talking about other MDs. Most MDs I have talked to go into the horror camp, though they don't react as strongly. These other folks react with this very genuine "that must be so interesting!" They then launch into a ramble about how cool it must be, and then suddenly will say something like, "I know it is morbid but I have always wanted to see an autopsy." If the person works at my hospital I usually tell them it could be arranged. I wonder if anyone will ever come and watch one, and would it really be that interesting?


Marcia said...

haha. i like the serial killer connotations.

i like autopsies, not doing them, but finding out what the hell just happened.

does that make me an accomplice?
(or actually, that makes non-radiologist and non-pathologists serial killers, no?)

Ewok said...

I've actually had an interest in pathology since seeing my first autopsy while a junior in undergrad. I'm currently a 3rd year medical student and am fighting the urge to declare I want to do pathology as to keep an "open mind" throughout my 3rd year.

For the record, I am itching to see another autopsy because it's like you never know what you'll find. I like the mystery behind path.

I enjoy reading your blog whenever I pass through. It gives me an insight i otherwise wouldn't have.

Congrats on finishing another round!

Rach said...

I'd love to see an autopsy... But I dont live anywhere near you.

Bostonian in NY said...

My school requires that we suffer through an autopsy during pathology and write up a group report. It was kind of cool to watch, but definitely the closest to puking that I've ever gotten in medical school in a professional setting. And then the misery of having to gather all of the clinical data to correlate with the gross and the histo/tox/etc was just awful.

Hope PGY2 is treating you well!

The Lone Coyote said...

Marcia--glad to hear from you... hope R2 is going well. Sure, you can be an accomplice :)

Ewok--I would definitely fight that urge to declare... remember that serial killer thing might pop into mind when your evaluation is being filled out.

Rach--I bet it could be arranged at a med school near you or a coroner's office.

Bostonian--great to hear from you too. Hope 4th year is going well. Next year you'll need to save all your pts in the ED so they don't end up on my service. Good luck with ERAS/Match/ETC