Conversation with the doctor who performed my son’s autopsy

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*** TRIGGER WARNING***

The content discussed in this article is at times graphic.

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Over eight years stand between the present moment and the day my husband and I decided to allow our son’s body to be autopsied. I remember the all-consuming grief. I remember making unfathomable choices, one after the other. I remember feeling anguish as I thought about a blade touching my baby.

Are you reading this article as you wait to deliver your dear child? Do you feel uneasy allowing your baby to be autopsied? Do you wonder what good can come from it? Are you overwhelmed with numerous decisions coming at you amidst your grief? Or is it a decision from the past that now haunts you in the present?

Today we plan to demystify the autopsy process by having a conversation with my former colleague, the doctor who performed my son’s autopsy.  

Please introduce yourself to our readers:

“My name is Christopher S. Murphy, M.D.

I am the Chief of Pathology and Laboratory Medicine for Gateway Regional Medical Center in Granite City Illinois.”

What certifications do you hold that allow you to do autopsies?

“I am board-certified anatomic and clinical pathologist, subspecialty board-certified in pediatric pathology.”

Who initiates the autopsy process?

“The pathologist is requested to perform an autopsy by either the supervising physician of the patient or the patient’s family.”

Help our readers understand the role that autopsies play in determining cause of death:

“An autopsy is an educational tool for both the family and the deceased’s physician.  All of the major organs are examined as they appear within the body and under the microscope, although restrictions can be made on the permit, such as “chest and abdomen only”.  We are looking for any specific process which may have contributed to the cause of death, whether it is infectious, developmental, accidental, or congenital.

While the autopsy rate has fallen significantly over the last 25 years, the knowledge that can be learned from an autopsy is important to enlighten the family of the specific circumstances that resulted in the death of their loved one.

Despite the diligence and care of the medical team, sometimes death is an unexpected outcome. The autopsy can help the family “close the loop” regarding the medical care that their loved one received.”

Dr. Murphy, in the case of an intrauterine loss, what role can an autopsy play in planning for future pregnancies?

“Sometimes an autopsy can reveal a genetic defect or abnormality within the deceased that may have been previously unknown.  In addition, in a significant number of still births, the cause of death is due to placental problems or abnormalities.  This can reassure the family that the stillborn was otherwise normal.”

If a parent is uncomfortable having their stillborn baby’s body undergo an autopsy is it possible to just have an examination of the placenta? What benefit is there in this more limited investigation?

“Sometimes in a fetal or neonatal death, a placental examination can be extremely helpful as a starting point in answering the family’s questions.  In many hospitals, a placental examination is required by policy in cases of stillborn or neonatal death.  However, it is important to remember that it may not provide a cause of death and will not elucidate any genetic or developmental abnormalities. “

In the days following my son’s autopsy I wondered what care was taken to respect his body. Please talk a little about the ways that individuals who perform autopsies work to respect the bodies of the deceased:

“The pathologist and his/her team do their best to maintain the integrity of the body of the deceased as it was received. 

An autopsy is a medical procedure; however, we take the utmost care to be as little disruptive as possible.

The body for burial after an autopsy should be as presentable as those who were not autopsied, i.e. with the assistance of the mortician, it will not overtly obvious an autopsy has been performed.”

What words of comfort or encouragement do you have for a parent who is on the fence about having their child’s body autopsied?

“Having an autopsy on a child, regardless of age, is a significant event, most likely following an unexpected death, in the vast majority of cases.  To help alleviate any questions which may arise immediately after death or at some point in the future, an autopsy can provide peace of mind about what happened.  An autopsy is not, however, a “be-all, end-all”.  Some questions may be left unanswered.

It is important to remember that despite any concerns about the autopsy, the parents should be made aware that everything that could have been done to investigate the death was done to the best of the health team’s ability.”

Dr. Murphy, what closing words would you like to leave with our readers?

“Pathology is often considered to be ‘behind the scenes’ in today’s health care system.  We appreciate the opportunity to help patients’ families understand the circumstances that led to the death of their loved one so that their lives can move forward.”

I remember the day Jon and I got the autopsy report back. In it, many questions found answers. Without the autopsy we may have groped about in the dark for some time. Instead, we found a path forward. Bereaved parent, I hope that with the help of Dr. Murphy, we have demystified this hard subject. We wish you the best as you make hard decisions with your healthcare team, decisions no parent should ever have to make.

This interview is published by National Share as part of their education for healthcare providers and share volunteers.