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The job of a medical expert is traditionally on the list of the most unwanted jobs in the world. But many people don’t even know much about this occupation — everything they know is based on movie stereotypes. We know very little about this job because frankly, we’re afraid of thinking about death. But we shouldn’t be because death, as strange as it sounds, is a part of life.
Bright Side asked a medical expert with 30 years of experience to tell us about his profession. Aleksey Kupryishin was the head of a regional forensic morgue. Today, he’s a pathologist and a forensic medical expert. Kupryishin also provides non-governmental medical forensic expertise. Recently, Kupryishin started his own blog where he refers to his job as “lively and interesting”. And we can’t exactly disagree with him.
Choosing this profession
The main reason why I became a medical expert is the investigative aspect. It’s like a drug. It’s boring to live without it. What’s the point? Nobody except you knows what there is behind the appearance, the skin, and bones of a specific person. Only you know that. Often, only you know why a person died. Sometimes, medical experts are people who were not able to become other doctors. I, for instance, can’t imagine myself as a surgeon. It is completely impossible for me to mess with something alive. All I can do to a living person is give them an injection. People often confuse forensic medical experts with pathologists but they’re not the same thing. They are different specialties but they have a lot in common. They have the same object of research — a corpse. The general autopsy technique is the same, just the details are different. The goals are also different: pathologists are part of the treatment and diagnostic process while forensic medical experts work for justice. It is really hard to find nurses. People often come, work for a month, realize they can’t do it and leave even though they’ve received a stable and pretty high salary. Once, we spent an entire month looking for a nurse. My wife (she used to be a pathologist) was in a taxi once and talked to the driver. It must have been the way she talked about the morgue that made the guy want to come and try the job out. In order to become a nurse in a morgue, you don’t need a special education, you simply learn when you get the job. The taxi driver came and stayed. He still works here.
One medical expert performs 300-400 autopsies per year in a city with 1,000,000 inhabitants. Sometimes, even 500. This is way too many: the normal number should be around 100 but it is never achieved. This is terrible. There is too much work for people to take the time to learn and develop. There are not enough medical experts, and medical students are not really eager to work in morgues. A medical expert spends far more time in their office than in the room with bodies. The research of bodies is not the only way to receive information. In my practice, I’ve had cases when a study lasted for several hours, and the analysis along with any conclusions took several days. A good sense of smell gives medical experts certain advantages when the job is to determine what poison was used to kill a victim. During the research period, there are a lot of different smells. If a person was poisoned with ammonia, there is a smell of carbolic acid; dichloroethane gives a smell of rotten dry mushrooms; hydrogen cyanide or nitrobenzene smells like bitter almonds; amyl alcohol smells like fusel alcohol; butyl alcohol smells like fruit; and metrifonate smells like garlic.
About his routine
Many years ago, a nurse named Anna Nosova worked in my first morgue. When I was hired to work there, she was already an old lady. She always wore a headscarf, she had a crooked nose, huge wrists and we, young medical experts, often asked her to smell bodies. She put her long scary nose to the body and said in a hoarse voice, “acetone,” or something else. Quite often, old ladies who think they are psychics come to the morgue and ask us to give them the water that was used to wash the bodies. They do all kinds of things with it — make love potions and so on. Nurses just pour some tap water, and we have enough. The nooses, underwear, and personal belongings are of interest to these people as well. Sometimes, our job can be extremely dangerous. You never know what you are going to deal with during research. There have been cases (quite a lot actually) when experts, nurses, and other personnel were infected with tuberculosis. And sometimes even the plague, cholera, or anthrax.
I think that starting from high school, children should be taught the basics of human health. By the age of 15-20, people are supposed to know when they are healthy and when they aren’t. If you develop symptoms you’ve never had before or if you have some pain that doesn’t go away, you should see a doctor. You should never just wait until it goes away by itself. Many people want to seem strong but what’s the point if you could die from it? Very often, the “silent killer” known as high arterial blood pressure can appear. Who measures this when they’re young? I would say that only fools don’t measure it. When we have the slightest headache, we take a painkiller — or we don’t. This can go on for several years. During this time, the elasticity of the blood vessels gets much worse and the same happens in the brain. The next time this person has high blood pressure, they have a stroke and die. Once, I was researching the body of a young female student. She died when standing in front of a window. 2 weeks before that, she had a common cold. It was treated but she still had some shortness of breath and tingling in the chest. None of these symptoms worried her so she didn’t see a doctor. However, she really should have. She had myocarditis (it’s basically heart inflammation) which is a complication of the common cold.
Deaths that could have been avoided
When working with any kind of high danger like with electric appliances, for example, you should follow the safety rules. People are usually very irresponsible about the rules. If there is a fire at your home, don’t look for your money, jewelry, or ID — you can always replace these things. Save yourself and others first. It takes only a moment to get burned. Also, carbon monoxide appears very fast during a fire. Sometimes, there is so much carbon monoxide that it takes just several breaths for a person to lose consciousness, die, and burn in the fire. Water reservoirs and alcohol are a dangerous combination — in many cases, people who have drowned were intoxicated. Lightning-fast hypothermia can also play a crucial role here. The skin vessels shrink quickly and the heart has to push a lot of blood through the vessels but it fails. The person loses consciousness. On the ground, they will most likely wake up after some time, but in the water, the lungs get filled with liquid and the person dies. Several times, I had to research the bodies of drivers who died in the city when they crashed into obstacles at a relatively slow speed — about 25 miles per hour. Their death was immediate and caused by myocardial rupture. During the collision, the heart was filled with blood. This phase is called diastole. Because of the collision, the blood exploded the heart. If a seatbelt had been fastened, the strike wouldn’t have been as powerful. Several ribs would have broken — but this wouldn’t result in death. At high speeds, the feeling of being protected by the metal parts of a car is an illusion. During a collision, the car gets deformed like a milk carton when you step on it. So, when you’re driving at a crazy speed, you should imagine that the body of the car is made of paper. This would be the right way to look at it. During fights, people often hit each other on the head unintentionally. Usually, there are no serious consequences aside from some bruises on the face. But I work in a morgue and I see only the lethal cases. No person who strikes someone else on the head thinks that the hit can cause a stroke or swelling in the brain, and they most likely didn’t mean to do it. And if they had stopped and taken the time to think about it, they wouldn’t have struck — this could save a life. In one of Anton Chekhov’s stories, a man who almost drowned was medically treated but still died. How did this happen? At that time, people didn’t know much about medicine and didn’t watch medical shows on TV or read any first aid brochures. Today we have tons of resources including the internet and YouTube. But do any of us have the skills to perform СPR correctly? We have to help people survive, not help them die.
The life of a medical examiner
When I had just started to work as a medical expert, I had this annoying habit of picturing what was inside other people. So when I was taking a bus and saw an attractive woman, I would think of how her internal organs must have looked. After some time, I managed to kick this habit. My wife and I met each other in a morgue. On that day, there was a terrible accident on a highway and I had to work a lot. She was a doctor and was supposed to take part in the autopsy of her patient. This was how we met. We spend our first Christmas together in the morgue — I had the night shift. Later, my wife became a pathologist and of course, we often talk about our favorite jobs when we are at home. When lying on my back and looking at the cloudy sky one day, I realized that they reminded me of something. I noticed that if you cut the heart across, parallel to the front and back sides, it forms the trail of myocardial infarction. But instead of the blue sky, there might be a red-brown muscle on the edges. This is called cardiosclerosis.
There are a lot of stories about dead people who come back to life in morgues but in my practice, there have been only 2 cases of this. Both times, it was an alcohol-induced coma. Drunk people were put in a freezer where they woke up and when they became sober, they left the morgue on their own 2 feet. It’s not true that we’re cold cynics. We’re no more cynical than any other doctors. There is no such thing as death from old age. Old people die from diseases. I’ve heard an opinion that our job is not as responsible and intense as those of surgeons since no matter what mistake you make, there’s no way you can harm the person. This is true — you can’t harm the person on the table, but you can harm someone else. An innocent person can go to jail and a guilty person can get away with it. The lives of many people often depend on my job. Some people also believe that a lot of forensic medical experts are alcoholics. But I don’t think so. I have met more non-alcoholic medical experts than alcoholics. Just like in our regular lives, there are fewer drinkers than non-drinkers.
You must’ve heard stories of morgue personnel eating at the operating table. This has nothing to do with reality even though it’s actually much cleaner than a regular table at a restaurant. After doing any research, the space is thoroughly cleaned with a special disinfecting solution. I don’t know any medical expert or nurse that would eat at this table. But sometimes I have to chew food in the operation room. This happens when my colleagues ask me for a consultation. In morgues, people celebrate birthdays, sing, and dance, but not in the operating room.
We hope you don’t assume that being a medical expert is boring and dark. We are grateful to Aleksey Kupryishin for letting us see his job through his eyes and we wish him good luck in this difficult but necessary and interesting profession. What other professions would you like to learn more about? Tell us down below!
Preview photo credit Aleksey Kupryishin / Facebook