Health Sciences Internship

Mike CoyleHLTH 4200, Summer 2015

Site: Greenville Memorial Hospital & Greenville County Coroner’s Office

Intern Title: Morgue Assistant

Preceptor: Dr. James Fulcher, M.D., Greenville County Medical Examiner

Internship Introduction

During the summer of 2015, I was fortunate enough to be an intern under Dr. Fulcher and Dr. Ward, forensic pathologists who work both at the Greenville Memorial Hospital morgue and Greenville County Coroner’s Office

The focus of my internship was to learn techniques useful for performing autopsies, put these techniques to use, and to learn more about anatomy and pathology through observing the doctors dissect the various organs

My preceptor was Dr. James Fulcher, who is the Deputy Medical Examiner for Greenville County

Forensic Pathologist What does a forensic pathologist do?

They are medical examiners who examine the bodies and perform autopsies for people who have died suddenly, whether it was unexpected or violently

They are responsible for determining the cause and manner of deaths

They may have to testify their findings in court for certain investigations

Site Description The Greenville Memorial Hospital morgue

performs autopsies for suspicious deaths for three different counties: Greenville, Pickens, and Laurens

The morgue consists of one autopsy room, an indoor cooler as well as a larger outdoor cooler for storing bodies, an X-ray room, and a ground scale in the hallway to weigh the bodies

The autopsy room consists of an autopsy table, a smaller table beside it where the doctor dissects the organs, an x-ray viewing machine, and a hanging scale to weigh the organs

Autopsy Room

The room in the morgue where all of the autopsies are performed

Refrigeration Unit

• The morgue consisted of two refrigeration units where the dead bodies were stored

• The indoor cooler, pictured to the right, could hold up to 20 bodies in it

• The outdoor cooler is able to hold up to 40 bodies in it

Morgue Staff Dr. Mike Ward, M.D., Chief Medical

Examiner

Dr. James Fulcher, M.D., Deputy Medical Examiner

Sharon and Heather, Pathology Assistants

At various times throughout the summer, medical students from the medical school in Greenville would join us and assist with the autopsies as well

Intern Duties

1. Prepare morgue for autopsies

2. Remove the brain

3. Obtain vitreous fluid from the eye

4. X-ray retrieval from the radiology department, if necessary

5. Clean the morgue in between autopsies and prepare for the next one as well as cleaning it when the day is over

Autopsy Preparation

Preparation for autopsies included several things:

Retrieving the body from the indoor refrigerator, weighing it, and removing any clothes they were wearing

Obtaining and setting out stock jars and histological slides for dissected parts of the persons organs

Setting out needles and test tubes needed for toxicology purposes

Washing the table and mopping the floors to ensure there is no blood from the previous autopsy

Brain Removal

1. First, you have to make a U shaped cut in the skin from ear to ear

2. Use a scalpel to cut away the connective tissue between the skin and the skull

3. Use a bone saw to remove part of the skull to get to the brain

4. With a couple of cuts to the brain stem and optic chiasm, the brain can now be removed

Several steps must be followed in order to remove the brain from the skull so the doctor can dissect it like the picture to the right

Internship Goals At the beginning of this internship, I set

several goals for myself which were:

To become an “expert brain remover,” mastering the tools needed to be capable of removing the brain during an autopsy

To improve my knowledge of human anatomy

To be aware of what policies and protocols must be followed for an autopsy service to become accredited

To articulate how I feel about pursuing a career in the pathology field

Achievement of Goals

I achieved all of the goals I set for myself

By the end of my time at the morgue, I was removing brains flawlessly with ease, improving drastically from my first week at the morgue

I greatly improved my knowledge of human anatomy, being able to look directly at the organs was a great help

I rewrote and added several policies and protocols, and my knowledge of all of them helped me to understand what needed to be done in certain situations at the morgue

Interest in Pathology

After two months of working in the morgue with the forensic pathologists, I have realized that I definitely would like to pursue a career in medicine

However, this internship has also made me realize that I would rather work with living patients, but I still would not rule out the possibility of pursuing a career in forensic pathology

From this experience, surgical pathology, where they study the tissue that is surgically removed from live patients to help determine if they have a disease, has climbed up high on my list of interests

Greenville County Coroner’s Office

When I wasn’t at the morgue, my time was spent here. The office is located about half a mile away from the hospital. Here I was able to

work on the accreditation project I was given, which will be explained later, as well as observing Dr. Fulcher dictate cases, and observing

histological slides of organs under a microscope.

Accreditation Project

I was in charge of completing the NAME Inspection and Accreditation Checklist for Autopsy Services before the inspection, scheduled for later this summer

I had to go through the 30 page checklist and ensure that we had everything we needed to pass the inspection

I wrote several new policies as well as edited many of the already existing policies to bring them up to date

I worked on this project in the afternoons, and I was able to complete it and have it ready for when it is inspected later this summer

A huge thank you to Dr. Fulcher for allowing me to have this opportunity, I learned a vast amount about anatomy and pathology and further confirmed my interest in pursuing medicine.

I would also like to thank Dr. Ward, Sharon, and Heather for all of the help and advice they provided to me, my experience wouldn’t have been the same without all of you guys!