‘It is a powerful reminder of mortality’

Q: What is an autopsy?

A: An autopsy is an examination of a dead body to determine the cause of death. Around the world, autopsies are done for diagnostic purposes as well, but we only deal with cases where a person has died under suspicious or violent circumstances. We work with the police and other law enforcement agencies to help them determine the cause of death and solve cases.

We do require permission, in theory. But in our country, there is no system for granting permission because no departments have yet been formed to deal with such requests.

Q: What is the procedure?

A: When the police want us to determine how someone died, they write a letter requesting an autopsy. The hospital administration then forms a medical board that is made up of specialists from different departments of medicine.

We collect all the information we can about the deceased, their medical history and the way they died. When the body is moved to the mortuary, all board members then work together on it.

There is an external examination first in which we record eye colour, hair colour and length, ethnicity, sex and age. We report the clothes on the body; see if there were any tears on them. Absolutely everything we see goes in our report.

We then examine the body from head to toe and look for clues. We look for gunpowder residue for example, or burns, bruises, rope marks from hanging, scars or any other deposits. If the victim was shot, we record the location of the bullets.

Then comes the internal examination, for which we begin to dissect into the body from the chest and abdomen. If a brain dissection is required, that comes after examining the abdomen.

Sometimes, we need small pieces of tissue from different organs to send for testing and at others, we need to take out whole organs, preserve them and inspect them later.

[When an autopsy is complete] all the organs are put back and the body is properly stitched up. An autopsy does not disfigure a body and no one will be able to tell if the body is clothed.

The body is then kept in cold storage until all the formalities have been dealt with and the family can take it home. If we have taken out organs or pieces from tissue, we preserve them and hand them over to the police who then send it off to a laboratory in Lahore.

We make a report of what we find and the lab in Lahore makes its own report. Both are then tallied so the margin of error is significantly reduced. The authorities can then make their decisions, legal ones, according to these two reports.

Q: What types of autopsies are hard to do?

A: Where the cause remains unknown and no positive findings can be recorded. It then becomes very tricky to tell the family that we cut open their loved ones and could not find the cause of death. For example, if someone dies from suffocation or from going into syncope, that is, just faints and dies.

Q: Have you ever been in a situation where you were required by law to do the autopsy but the family did not want to?

A: All the time. We are legally bound to perform autopsies and we have to obey the law. So, you have to do your best to calm the family down and tell them it is illegal to stop us and that knowing the cause of death is in the interests of justice and in the interests of so many people.

I have been threatened many times. There was a case recently where a woman had committed suicide. Her parents wanted me to write that the in-laws had killed her while her in-laws wanted me to write the same about her parents. When I wrote in my report that it was a suicide case, both were angry that I had sided with the other family.

Q: How do you deal emotionally with your job?

A: I have spent some 40 years in this profession. I am used to it now. Whenever there is a particularly bad case that disturbs me I tell myself if I don’t do this job, then this person who has died will not get justice. It won’t change the fact that he is dead, but he will be denied justice.

But, however used you get to autopsies, you do get shaken up when you have a kid on the table. The children who end up on my table have usually died violently. You get to know how they have died and it gets you every time. I don’t think you can have enough experience for that to not happen.

Q: What is the weirdest case you have seen?

A: It always surprises me when I see a body that has been in the river for some time. It gets bloated and distorted and you cannot see what has happened clearly.

Also when we deal with exhumations – when bodies are dug out from their graves. There is usually nothing left but the skeleton. It is just always a powerful reminder of mortality.

Published in Dawn, July 14th, 2018