I do autopsies, record them, livestream them, & photograph them by family consent. This is my 3rd AMA!

Have you ever watched the video and found something that you missed during the actual procedure?

No. But we just had a case with a massive recent MI. The finding was a subtle color changes over a broad area of heart muscle. And it jumped out dramatically in the photo. Digital is not the same as the naked eye. Sometimes I'm arm deep in the case and will forget to remove the patient label if we photograph and also video. Then I have to crop it out if I see it in the video. It never goes out on any of our platforms or live stream.
Livestreaming is different and we put a lot of stop-gaps in for patient confidentiality. Video is a go pro on my forehead and I know I can crop out later.

Assuming MI is Myocardial Infarction

yes. Thank you myocardial infarction.

I'm surprised no one has asked you yet, or maybe I missed it in your profile, but have you gotten used to the smell, or you just breath through the mouth when it's particularly bad?

Pretty used to it. Used to be a purist - I want to smell everything. Know the whole case.

Now, for a decomp - a nurse taught me - there's this magic peppermint you can put a drop on your mask. Totally makes it breathable. No problem doing that.

Pretty sure they had a massive Michigan

A massive Miami.

Ha ha “arm deep”. Is that coroner humor?

No. Not at all. Not my speed. Just descriptive.

How many other people do this?

None that I know of. It's like 21st century autopsy amphitheater, IMO. Surgical livestreaming is rare. I have not heard of another autopsy live stream, if that's your question. Video is occasional for medicolegal. Photography common.

When this thread is dead, are you going to autopsy it live?

Ha ha

Did you work for yourself? If not, how did you approach your boss about recording/streaming?

Did you have to clear this with your respective Board, associations, etc?

What was the response from all of the above with your concept?

I work for myself. The beauty of running my own practice. I spent 8 years building my practice, have read every autopsy law in every state legal code in the U.S., spent 3 years writing about autopsy legislation, studied the uniform anatomic gift act, reviewed 20 different hospital consent forms and combined every feature into my own consent, reviewed research practices, combed every inch of the hipaa law before ever attempting this. And most importantly, I don't pressure the families. I understand that they want to do this to help the death "not be in vain" and believe in the fundamentals of informed consent. It, amazing, becomes a healing part of the greif process like body donation or organ donation.

Don't do it unless you know what your doing. (That's my cocky doctor side)

See I’ve just been doing it as a hobby at home, it’s nice to talk to a professional about it sometimes.

Ha! You should watch the Death Investigation in America series from a few years ago. Meet the blind coroner, or the one who does cases in his garage. You'll have good company.

Have you listened to the Swindled podcast? There’s an episode about a company that swindled organs to “sell” them! It’s titled The Body Snatcher

No. Tx. Might check it out.

There's a difference between being "cocky" because you put in the work and really know what you are doing, vs. the person who just thinks they know what they are doing...

Yes. Guilty of some anxious false modesty. I'll think about that. Thanks for calling out.

Don't do it unless you know what your doing. Period.

So who pays for the autopsies? Is it the hospitals that ship you the deceased and then they pay you to figure out the cause of death?

Or is your income mostly from subscriptions to your video/streaming service?

Ah, a lot to back up behind the question.

I have but typically don't work with hospitals. When I do, they foot the bill.

My role is to function as an independent check and balance on hospital and medical exminers, who typically have a lot power in a case. The family then has an alternative to trust, or in the case of the ME, a second opinion. Especially when they worry about malpractice, or if there' s a trust issue with a coroner/medical examiner.

The families contract with me directly. They do not pay for video. We do not charge for that. They pay for an autopsy for closure, and we may or may not record if they wish.

Our wish is that the subscriptions will start to tip the scales, because then we can do more pro bono for families, and record more for education, etc.

What would you say has been the most surprising cause of death you have come across in your career? Like where the initial diagnosis was way off.

Often medical examiners will clear a case, especially elderly in nursing homes. When they do that, I can take the case if the family wants the autopsy. I had a case where the patient was cleared. The body bruising on his palm, side of his face, shoulder and side. He denied anything but tripping to his family. And then it turned out to be a rash of batteries of which he was one victim. The medical examiner got involved.

But the most surprising was a recurrent pneumonia that wouldn't go away for 6 months. Despite treatment. under the chest was mold -- like on old cheese in the back of the fridge -- he had an undiagnosed fungal infection and needed antifungals not antibiotics.

Are lung fungal infections common? And would you be able to even check while the patient is living?

They are notoriously a missed diagnosis. Typically go along with diabetic and immunocompromised. It's something to know to think of with this patient's history of long course unresponsive to antibiotics. But did not happen.

Do you every have medical students do a pathology rotation with you to learn more about the ins/outs of forensic pathology?

Yes. Love students. Not a forensic pathologist - more of a hospital pathologist (heart attack stroke). But love students.

Do you ever see things that could improve a populations health mental or physical in your work?

Smoking smoking smoking

Diet diet diet.

----> Heart attack, stroke, emphysema, cancer ---> my autopsy table.

Also, there's one particular condition (well a few) people (and clinicians) don't know about or check for:

Bicuspid valve (looks like a heart attack because is later in life, but is often inherited). Aorta tears open. Two (bi) parts (cusps) the aortic valve.

Marfan syndrome: Tall stretchy people who also tear open their aorta, but can be followed and treated if diagnaosed.

Big one: Alzheimer's disease is usually sporadic (means not inherited). Families worry. But if there's no family histoy onset is elderly, typicallynot inherited.

Same for cancer. Colon cancer in an 80 year old without family history is typically mother nature doing her thing after a life time - not inherited.

Mental health. It's ok to advocate. Trust your gut feeling if you don't think the doctor/provider is saying/doing something that feels right, speak up. Either learn or find out but participate.

And a ton more.

How much is the individual subscription?

Thank you. I got Reddit-slammed last time for seeming to turn this into a marketing session (not my goal). If you have a way, message me or via [info@autopsy.online](mailto:info@autopsy.online) Tx.

how do you deal with this kind of job mentality??

Take breaks. Bike in Wisconsin (The "Kettles" as they say - Kettle Morraine Valley). See Toy Story 4 and stay away from horror. For the balance.

But care about the family and do a good job with the case. That feels great and is often energizing to hear them feel "at peace." It's a different practice from a coroner becuase I work closely the family, meet them, talk to them before and after. That becomes the focus, and the dead body is there to find the information that will help them feel better. I say it's like changing a diaper. If it's someone else's kid - yuck. Poop. If it's you kid, you love them and you do it. These are my families. (cue angel chorus....). So I love it.

And I write. Poetry and fiction.

I don't have anything significant to add, just wanted to say that I live in the Kettle Moraine area and it's a great place for hiking and biking!

Also am in the medical field, but as a medical laboratory scientist, so this is all super interesting to me!

Lucky you. Know the "Fire wud" Ice cream shop in Dundee? How about the Lumber Inn.

Love it. Can't wait to go back.

God's country.

Jealous.

Do you cover the faces?

Is there a part of a body that when you look at it it makes you feel like this is a person and not a body? I don't know if that makes sense. When I did anatomy and physiology we had a cadaver lab and we had to cover the hands because it made people uncomfortable seeing them. Like it made it more of a person than a thing.

Yes, always. Part of the agreement with the family is that we can have people learn from their loved one but we'll protect the confidentialiaty. Face, name labels, tatoos, etc. Off with the sound for confidential discussions, etc.

I remember that from med school. The hands are particulary emotional -- fingernal polish adds to it.

It's always a person's face, mostly. When you're in the middle of it focusing in the chest cavity, it's all work and investigation although you don't every forget it's a person.

Teenagers and babies it's the whole thing from head to toe. No one part of the person is different or less emotionally laden.

At my med school gross anatomy lab always starts with the cadaver face down and we do the back structures for the first block. That way students can get used to working with a real human body for a little while before they ever see his/her face.

Sensitive and practical. Interesting.

I can see this going the other way too though. Without seeing the face, students might start off not seeing the human side and then when you flip to the anterior muscles, they've already developed habits. Unfortunately, I'm speaking from experience because we did the same thing at our school.

Yes. I wondered that too. We started face up.

Ever consider speedruns?

I don't know what that is.

I bought your app last year and I absolutely love it! I'm no doctor (I work in I.T.) but I have always been interested in the body, and being able to see these autopsies and have them clearly explained in the manner you do is incredible.

Question: What is your favorite animal and why? And since you're a writer, if it pleases you, please phrase your answer in the form of a haiku.

Ha! Challenge - no leash.

Summer's scattering feet can

Chase the ball. Or bark.

What qualifications are needed, and do you recommend it? I've always been interested in medical stuff, but schooling is proving too much, so gave up on being a vet. Oh, and the smells. I am now used to the smell of death (Practicing taxidermist), but do you reckon human decay/innards smell different than animal, like squirrel and armadillo smell different? Sorry for the rambling, I'm tired. Thank you for this!

Fascinating. I wouldn't anticipate much of a difference between animals. You should do an AMA! I couldn't do the comparison for you. Humans don't smell much at first (like a meat store doesn't smell, really). And then it's pretty similar.

​

M.D. Pathology Residency. I love it, although wasn't till later in residency that I could say that dt sleepless call nights. But pretty cool to have an impact on a family and do something interesting. We need good people everywhere so whatever floats your boat.

what is your advice for someone who's starting on this field?

Care about the family.

Presume that everything you say and do, every word on your report can be a 1 ton knife sitting on a nerve or the kindest most gentle breeze soothing a tragedy

So just be clear and through and compassionate.

Also -- if you don't know, wait to talk. It's worse to give information if you know it could change.

And more. Read my book (if and when I write it...).

Have you ever had a body come in and thought 'GAT DAMN, this guy went out the hard way'?

That sounds like medical examiner coping language.

I rotated at the ME in residency. The guy had a tattoo on his penis "Eat Me." They called him a pig.

I don't think about families that way.

I had a 12 year old who went joy riding with some other tweenish teens after a parent handed over the keys. They drove the vehicle in to a tree. The bottom half of the spine was two inches ahead of the top and took the aorta with it. Horrible tragedy.

WOW that last one! That must have been a violent crash. Was the cause of death from internal bleeding?

Yes. Tore aorta and inferior vena cava through and through.

Oof. Terrible, but at least it was fast.

Yes. Correct.

my kid seems to have an interest in the human body, especially internal organs

can I show them an autopsy without making them a serial killer?

Based on your question, no, but not because of an autopsy video. Something tells me it might be too late.

Are you ever shown a before death photo of the deceased and how does that effect your mentality during the autopsy, if any?

Those are amazing and shocking. The life in the person radiates out of the picture in a way I can never imagine looking that the body. Suddenly they have a personality. If it's before, it's usually the family has shown me during -- we have a family meeting before the case. It's just one more thing that builds a connection between me and them, on top of their sharing the "medical history" and all the stories that are part of it. Doesn't change the work, just strengthens the commitment to getting in there and making sure to help how I can.

How desensitized would you say you are to corpses and general human gore? Is there anything that still freaks you out in autopsies, even if just a little?

Corpses, and it was not that way a few years ago, probably a used to it now. I recall recently walking in and chatting with a funeral director and suddenly telling my assistant -- wasn't that a bit odd, saying a warm hello and witnessed by two still bodies in the room.

Gore - not desensitized at all. Avoid it. Hate it. People say "your an autopsy pathologist!" I don't care. I'll never go to horror movie. Don't seek out images or video's. It's different when it's my case becuase it's also my family so that's my focus and I'll do the work I need to to help.

You seem like an intelligent, caring person. How can I assign you to perform my autopsy in the event of my death?

First I'll take the question literally.

Not everyone has an autopsy. It's not required. You don't need to plan for it.

The state decides if they take it, but if they release the case then your next of kin will be able to make a request.

Legally, in Illinois you can also request your own, but it's best to talk with your legal next of kin. There's no "first person consent" like organ donation so you'd need their participation to make it work.

If you want for some reason to have one/donate to science that's another story. I run Autopsy Center of Chicago. We also do things like brain donation to research and sometime, cancer/tumor donation to research. And of course, video for education.

Or if this is just a wish -- then, simply, thank you for your kind words.

When someone’s death is ruled “natural causes” what exactly does that mean? Does that mean there was no determined actual cause of death?

No. It means the cause was a medical condition.

It's a "manner of death" and there are 5.

Homicide

Suicide

Accident

Natural

Undetermined

Undertemined is it's own category.

Also, medical malpractice is, although debated, commonly considered a Natural cause of death, even if the family has strong feelings, etc.

Is there a clip you could share or some sort of other info we can look at? $10 isn’t a lot of money but I’m curious but unsure what to actually see.

Sure. Go to the home page of www.autopsy.online There are some demos. That's the desktop platform for schools, mostly. But the videos are up on the Autopsy App (minus the interactive/searchable/school-related stuff). App's at www.autopsychicago.com/app but it sounds like you found it.

Lol my crap phone decided to mix two videos and I heard “this is the cerebellum...and the optic nerves...etc etc” while you were clipping away at fat in a leg! Anyway, great content and will be super helpful with school. I’m downloading the app now.

tx!

Seeing you flip a skull up like its a lid on a jar gave me maybe one of the most odd feelings ive ever felt in my life.

One of the strangest and most profound experiences in medical school in my plastic surgery rotation. Not an autopsy. A surgery. A baby with a cranial deformity and bone restructuring. Did not see the early part of the case. When all done, they rolled the face back up and she was suddenly a person again. Just incredible.

Thanks!!!!

UW

Do you review medical records from when the person was alive before the autopsy?

Let's assume patient died because of an unrelated issue like a car crash.

For example, patient saw a doctor repeatedly for some ailment (headaches, testicular pain, knee pain etc) do you take a special look at that body part? Do you contact that doctor so he can be part of the autopsy? Do you report your findings to that doctor?

Yes. Can review medical records and do often.

Never speak to the doctor unless the family authorizes. The case is confidential and they may be litigating.

Family will request records.

I can't even acknowledge I know the family or the patient unless they give me permission.

Have you ever saw the movie “The Autopsy of Jane Doe” on Netflix? If so, what was your thought on it? If not, you should go watch it its really good!

Never. Ever. Ever.

No.

I do it for a living. As I say, Me: Disney.

Or green mountains of Wisconin or a summer fest band.

Ahh...life.

What shoes do you wear at work?

Let me check.

Skecher shoes.

New Balance sneakers sometimes for a case.

How's it going?

Oh just fabulous. Thank you.

There's an audience for livestreaming autopsies?!! What's the most number of people who have watched one,,,??

Over a million when we started. Then Facebook, I'm guessing, changed the algorithm

800K, 200k and so on.

Now, when we do it, it'll be on the Autopsy App or Autopsy.Online desktop.

When is your next live stream?

Wish I knew. Depends on family consent. I don't control that. Right now I'm also focusing on straight recording because we're getting the Autopsy App up and going and it's just simpler. But once, it's a little more full of content and going, I'll get back to live streaming.

As someone who has necrophobia, specifically fear of corpses. What are some ways to desensitize slowly and bulid up to watching your content?

Why is that a goal? Go enjoy living stuff. We need sensitive people everywhere.

"Individual" subscription has a "pricing" link but doesn't show anything, contact page asks if we're a student student/educator/medical professional/administrator.

Can the general public that's curious subscribe or do we need an official school affiliation?

We stopped the student subscription because we're engaging schools more now and want to be sure costs are through the schools not additional for students. I don't want to do this here because (even today a little) the Reddit police slam me for marketing (which I'm not). But if you can message or try email [info@autopsy.online](mailto:info@autopsy.online) that will work.

Have you experienced any paranormal activity?

No. I get asked that tho. In medical school a student from the anatomy table over -- sometimes you have to tuck the arm out and get between it and the body to do your work -- especially for a larger patient -- another medical student took the opportunity to prank me and moved the arm around me as though the patient were alive again and succeeded in getting a scare out me. Medical students....

I don’t know if this has been asked, but what was your first autopsy like? I imagine it’s a little different than gutting a fish? I couldn’t but i respect those who get the job done!

I was excited. An eager first year resident. They started you on babies because the anatomy is so compact and manageable and easy to see all the relatonships. I don't remember the case. Now I find babies (any children) extremely difficult. But I was more "sciency" back then and am more emotional plus science-application now so I respond to the case differently.

Thanks for taking the time to answer our questions.

Is there any concern at all about people viewing your material with the wrong intention? Not for educational purposes to help people, but instead perhaps for macabre reasons?

Yes, of course. And we banned a lot of people off social media when we posted more there.

But most people are genuinely curious and that outweighs the outliers. It's a fascinating look and I want people to learn.

That's partly why we've gone to the App. Free on social media attracts a drop-in trolling. And a bit a few bucks ensures a commitment. Then we can live stream and be a bit more ensured of the group.

Why did you use the same photo for both the bladder and the prostate on the body map portion of your site?

The body map does not end with the photo. They click into a video. That is the thumbnail for the video. It shows both organs. Subscribers know this.

Where can we see these videos?

The autopsy App.

Android

Iphone

Or desktop is for schools. autopsy.online

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You mean recording?

Many.

My husband was a science teacher.

My wife watched all the animal shows, she would love it.

My sister had cancer and couldn't be an organ donor. She wanted to do something.

I watch all the videos on YouTube and find this fascinating. Let's do it.

Sure, if it helps someone learn, I want to do it.

I'm a doctor/nurse/er tech I want to give back.

I'm looking for an alternative to body donation.

And so on.

I think this AMA would be more interesting if your first sentence ended “without family consent” instead. Do you agree?

You might be the first. Just getting ready to knock on the door.