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THE COUNTY MEDICAL EXAMINERS LYRICS
"Forensic Fugues and Medicolegal Medleys" (2002)
1. Autopsy Suite
2. Medicocriminal Entomology
3. Vitreous Humor
4. Epicedium For Epidermal Slippage
5. NH2(CH2)4NH2 & C5H14N2 (Putrescine & Cadaverine)
6. Organ Harvest (The Anatomical Gift Act)
7. Rigor Mortis: Posthumous Muscular Rigidity
8. Algor Mortis: The Linear Rate of Cadaveric Cooling
9. Livor Mortis: Gravitational Blood Pooling
10. Pugilistic Burn Postures
11. Y-Shaped Thoracoabdominal Incision
12. Y=1285/X
1. Autopsy Suite
My beloved autopsy ward, the product of hospital architects
Inspected and approved by the College of American Pathologists
Adjacent to the morgue and behind the administrative receptionist
Kept under lock and key, available only to us morbid scientists…
Two stationary MedRax® dissection slabs and a moveable body hoist
Their stainless steel plating scrubbed, sanitized, and still moist
The tables are set at regulation height to avoid unnecessary strain
Disinfected water pumps and aspirators wash debris down the drain…
White tiled walls…epoxy sealed floor
Adequate overhead lighting…to grossly explore
Tools of the trade…filed away in drawers
10,000 square feet…of legally sanctioned gore
Morgue design, of the most practical kind
Dictates the efficient dissection of your fellow mankind
The layout of the autopsy ward should be nefariously refined
And elevate necropsy to an art, for those so inclined…
Air conditioning design and primary system ventilation
Enable complete aeration of formaldehyde fixative in dissection stations
The ventilation hoods and exhaust design steal the odor of putrefaction
And are in accordance with the Occupational Safety and Health Administration…
Cabinet space…for microbiological supplies
Medical twine…for the closure stitches I tie
Bone saw whine…a postmortem lullaby
Dictation equipment…court records to testify
For my Stryker® saw, disassembled and cleaned
I pen this requiem, in honor of the remains it’s seen
For my Stubenhauer® scalpel, sharpened and honed
I compose this sonata, for the autopsies it’s performed…
The whiteboard conveniently located next to the hanging organ scale
Lists charts lucubrately completed with organ weights and interesting details
Close by, the x-ray facility and the many knobs and dials it entails
Will ensure, with accurate forensics, that diagnostic truth shall prevail…
The adjoining dressing room houses lockers and showers
So that medical personnel will be routinely scrubbed and scoured
Hands are cleansed with Iodophor soap; germs are devoured
Surfaces are soaked with phenol-based detergents at any given hour…
Pressured Autoclaves…cook instrument debris
Disposal bins…full of pieces disembodied
Spare flash bulbs…for body photography
Specimen bags…hold paraffin-set tissue trophies
The science of death…a morbid philosophy
Death certificate pad…the coroner’s eulogy
My beloved morgue…home of forensic pathology
The autopsy suite…for life’s final catastrophes
2. Medicocriminal Entomology
When unidentified remains are relinquished to our care
That are so decayed and liquefied as to make diagnosis quite a chore
When the putrescent canvas of death is teeming with bristling life
With tiny anthropoid stowaways nestled in every pore…
My autopsy technicians mistake the corpse shudder for a cadaveric spasm
But upon closer inspection they witness the nauseating wave of insect activity
The feasting and chatter drowns the neon hum from the morgue lamps and fans
And the ambient temperature rises 5 degrees as their chitinous bodies skitter in putridity…
The corpse is alive...reanimated through entomological means
The John Doe swells...as parasitic activity literally bursts through his seams
Seeping rivers of eggs...hatching larvae are hurriedly washed down the drain
Call the Forensic Entomologist…everyone knows he’s got bugs on the brain…
…Carcass hive…
…Cadaverine nest…
The Forensic Entomologist is a specialist in this field
Of which there are three separate and distinct components
The Urban field deals with insect/human environment matters
Stored-Products handles infestation of commodities and products…
But the one that we require is the Medicolegal Entomology field
With its eccentric bug experts and their forensic Ph.D.’s
They’ve classified and catalogued their necrophilous winged friends
And can determine PMI by the stadiums and stages of insect activity…
…Blowflies…spiders…beetles…mites and lice…
…Maggots…larvae…pupa…hatch and fly…
…Crawling…squirming…breeding…burrowing…
…Medicocriminal entomology…
The Forensic Entomologist will analyze the cadaveric colonization
Taking samples and noting the current state of the Blowfly population
After determining the extent of the recent Coleoptera infestation
He will estimate the time of death so that we may continue with the examination…
…When tissue liquefies and attracts the clavicorn …
…The flies are drawn and oviposit their eggs…
…From this predictable process, tiny maggots are born…
…Named Instar Larvae, which then grow to Prepupae…
The maggot molts through three instar stages, plumping as they gnaw
Colonies hatch together and migrate across the corpse as a collective group
As a result of this infestation, they disseminate bacteria and secrete enzymes
Which enable nearly all of the soft tissue to be dissolved and consumed…
Depending on the habitat and the abundance of the region
The expert can determine if the Diptera is currently in season
Whether the Bottle fly prefers bright sunlight or shade
And if the Coleopteran is nocturnal or active during the day…
Oviposited eggs encrust the natural orifices and moist recesses
Maggots swim in wound sites consuming rotting necrotic flesh
The examiner’s gloved hand is thrust wrist-deep in this bug colony
Searching through the thriving mush for additional squirming evidence…
…Parasitic swarm…
…Maggot colony…
…Blowflies…spiders…beetles…mites and lice…
…Maggots…larvae…pupa…hatch and fly…
…Crawling…squirming…breeding…burrowing…
…Medicocriminal entomology…
3. Vitreous Humor
Between the deceased eyeball’s crystalline lens and retina
A clear gel-like mass that constitutes 80% of the eye
This volume of lubricious fluid is named vitreous humor
And can tell the toxicologist relatively when someone died…
The unblinking eyes of the stinking corpse…
Reveal time of death of the forensic sort…
Vitreous humor so oily and viscous…
Make the stiff a posthumous eyewitness…
Hours after death, body potassium levels rise
Vitreous humor is not affected by this change
We can test the ocular fluid for an accurate PMI
The toxicologist will compare it against the normal range…
Hypodermics filled with watery slime…
From eyeballs to test tubes, ocular grime…
Toxicologists measure potassium levels…
From the decedent’s vitreous humor samples…
…Disgusting muck…
…Optic gunk…
…Punctured orb…
…Eyeball gore…
Perspicaciously evaluating the toxicologists findings
Illuminating the dead with a method so blinding
Glomming the fluid from the posterior compartment side
Determining PMI from the postmortem faculty of sight…
…The sunken eyeball…
…Has secrets to tell…
…With its vitreous gel…
4. Epicedium For Epidermal Slippage
Festering tumefied remains…
…Stinking upon the dissection block…
…Cellular structure autolyzed…
…Dermal adhesion run amok…
…Slipping skin…
…Marbled flesh…
…Sloughing dermis…
…Discolored mess…
…Odorous putrefactants…
…Seeping from bloated pores…
…Ptomaine vapors sting sinuses…
…Hemolysis burns and gnaws…
…Slipping skin…
…Marbled flesh…
…Sloughing dermis…
…Discolored mess…
…Cadaver thorax shedding rot…
…Outer layer peeling green…
…Flays of skin rind in coils…
…As gasses burst through the seams…
…Vitiated fetid tissue…
…Autolytic vitriolic decay…
…Necro-dermatological issues…
…As the epidermis flakes away…
…Slipping skin…
…Marbled flesh…
…Sloughing dermis…
…Discolored mess…
5. NH2(CH2)4NH2 & C5H14N2 (Putrescine & Cadaverine)
Putrescine and cadaverine
The pungent twins of putridity
Colorless and syrupy
Biogenic amines...
Putrescine and cadaverine
Vapor of ornithine
The stench of death visits me
In the morgue laboratory...
(Perfume of rot…heady, thick and hot)
Putrescine and cadaverine
Brothers in liquidity
Fuming stench of carcass stink
Noisome gas, fetid glee...
Putrescine and cadaverine
Ambassadors of ripened reek
Breaking down dead protein
Egressing odors miasmically...
(Sickening stink…makes watering eyes blink)
These dual chemical compounds, released shortly after death
Cloud the pleasant morgue ambiance with their foul, rotten breath
Fraternally bound to haunt swollen distended bodies
Their chemical reactions clash amidst rank autopsies…
NH2(CH2)4NH2…Putrescine!
C5H14N2…Cadaverine!
NH2(CH2)4NH2…Putrescine!
C5H14N2…Cadaverine!
Gorges rise and heave with the stench
A symphony of sickness, perfumed with putrescence
While affronted senses nauseously totter and lurch
The carcass breeds odor, and chemically gives birth…
NH2(CH2)4NH2…Putrescine!
C5H14N2…Cadaverine!
NH2(CH2)4NH2…Putrescine!
C5H14N2…Cadaverine!
The ripened tang of gaseous decomposition let loose in the morgue
Overtaxed fans strain to aerate the grave-ly polluted ward
Tumefied decedents belch their chemical cohorts into the air
The airborne corpse-whiff adheres to fabrics, skin, and hair
(Acrid reek…odiferous cadaver leak)
6. Organ Harvest (The Anatomical Gift Act)
Before the effluvial corpse is consumed
By gastronomic decay and suppuration
The stiffening husk is surveyed and tested
For suitability of organ donation…
Tissue typing…
Donor screening…
Biopsy testing…
Organ dealing…
Postmortem examination of cadaveric remains
For a harvesting effort deemed most humane
Splayed open cadavers where organs are obtained
Crumpled wax paper and body parts are exchanged…
Kidney transplantations…
Corneal donations…
Liver procurations…
Anatomic emancipation…
For us prosectors to peculate
According to stringent procurement laws
Mandated and regulated by the state…
Fuliginous, fulvous, and glaucously blue
Organs are retrieved and prepared for transference
Haruspicating the dehisce corpse
Divining life from death in this graveolence…
Permission is garnered from next of kin
Embrangled in anatomical waste
Taking comfort from this rebarbative task
I altruistically dissect without haste…
Forensic scientist…
Transplantation artist…
Autopsy altruist…
Organ harvest…
7. Rigor Mortis: Posthumous Muscular Rigidity
The tepid carcass examinately reclines on my table
Its peculiar muscular activity, rigor mortis, works in my favor
Determining PMI through rigid, bone-cracking means
Postmortem rigidity occurs through the depletion of ATP…
Adenosine triphosphate is required for muscle relaxation
But metabolic activity continues after death and creates a reaction
Lactid acid is spent and exhausts the store of glycogen
Muscles go hard from the abnormal links between actin and myosin…
This maturating stiff…
Becomes quite stiff…
Positioning the corpse can be quite a Herculean task
As I bend the crepitating unmalleable limbs with revolting cracks
Obstinate appendages stubbornly give way under my dragoon efforts
My aching muscles are overtaxed and pushed well passed discomfort…
…Paralytic legs, unflexing arms…
…Carrion with all its frozen charm…
…Unmoving torso, intractable neck…
…Deplorable corpse a total wreck…
Between 2 and 12 hours is the solidifying time required
For abductors and adductors to become unyieldingly mired
It will take a day for outstretched extremities to acquiesce
Finally amenable to my adroit limb-wrenching finesse…
The lampooning hu-mannequin’s muscle proteins are devoured
As the taciturn body achieves maximal rigor in 12 hours
12 hours more and the muscular fiber grudgingly give way
When the proteolytic enzymes in the lysosomes of muscle cells escape…
…Corpse piquantly olid…
…Now maceratedly flaccid…
Barring rare cadaveric spasms, a PMI timeline can be mapped
Factor in environmental variables and the effects they can have
Ripening malodorous remains can speak from the grave
And tell us their time of death by how their muscles behave…
…Paralytic legs, unflexing arms…
…Carrion with all its frozen charm…
…Unmoving torso, intractable neck…
…Deplorable corpse a total wreck…
8. Algor Mortis: The Linear Rate of Cadaveric Cooling
Ravaged, torn, and punctured—the carcass oozes from multiple wounds
Avulsed and sliced, the dermis weeps pus and purge fluid with clear, viscous goo
Prior to the initial incision, before my scalpel is baptized bloody wet
We determine the postmortem interval using a simple algebraic formula for death…
A direct body core temperature measurement, postmortemly taken, is the order of the day
The corpse is lifted on its side and a slit in its pants is cut in the most delicate way
Lacerations leak wasted heat and fluid, as the body cools in a predictable manner
My assistant lubricates the thermo-couple probe, a massive 12-inch long chemical thermometer…
…Freezing hold…
…Corpse gone cold…
…Cooling blood…
…An icy flood…
…The body a husk; its innards are spilt…
…This ferocious anal probing causes no guilt…
…A facet of my profession, this duty I’ve sworn…
…I stab forth the thermometer as the anus is torn…
Environmental conditions of the crime scene are meticulously recorded
And the room temperature of the dissection room is dubiously noted
The core temperature of the carcass plummets through means of convection
Physical science triumphs over life as heat escapes through radiation…
Moritz’s formula is the rule of thumb from which I can derive:
“98.6°F – rectal temperature ÷ 1.5”
This equation produces the time of death, though nothing is quite this ideal
Whether oral, rectal, brain or liver, I shall monitor the temperature with the greatest zeal…
This gelid method of detection has a cold-bloodedly frigid appeal
Observe the sanguine-streaked suppuration chill, pool, and congeal
Witness my barbarous severe intubation with unsanitized tools
Truculently sodomizing corps-icles, making purple raw recta drool...
…Freezing hold…
…Corpse gone cold…
…Cooling blood…
…An icy flood…
…Postmortem interval, the mystery at hand…
…Thrusting the probe past the prostate gland…
…The carcass is conquered by deaths cold will…
…Not even bactericidal rot can thwart its chill…
9. Livor Mortis: Gravitational Blood Pooling
Extravasated hemoglobular vitality
Vascular death, hematological finale
The postmortem settling of blood called lividity
A fascinating aspect of PMI morbidity…
Capillary beds…
Are sodden red…
Coagulants unglued…
Bruised black and blue…
Hypostasis, fixed and bruised
Blanched extremities a purplish hue
Sticky quagmire of darkened goo
The cadaver’s posterior grumously imbrued…
Paludal mess…
Blood-tattoo compress…
Maroon patterns in flesh…
Rot’s cruel caress…
The unmistakable gravitational pull after the cessation of breath
The tiny red blood cells separate from plasma and sink
Clotting inside the lower recesses until the decedent stinks…
Arteries leak…
Veins deplete…
Blood secretes…
Marinating meat…
10. Pugilistic Burn Postures
Carbonized extremities cooked and charred
Burst organs jellified simmering in boiling lard
Smoking slab of blackened burnt meat
Scent of immolation, sickeningly sweet…
Horrifying corpses posed by flame
Muscles constricted, melted, and maimed
Postures assumed from the singing heat
Posthumous pugilistic athletes…
Muscle fiber twisted, gnarled, and hard
Scorched arms in a feeble boxer’s guard
Superheated flesh chips excoriate and flake
From this repulsive side of cooked human steak…
Hardened skin dulls my blades
Incandescent embers stoke this flambé
Tangled remains of this funeral pyre
Increase morgue temperature and make me perspire…
11. Y-Shaped Thoracoabdominal Incision
Alphabetic diagram…
…Of the gross exam…
Medical examiners are detectives, who forensically sift through a body of evidence
It’s rarely simple, as you can see...the organs are on the inside
We open up the corpse to find the clues that point to an explanation that might make sense
Let’s crack the cadaver open for a little peek and document what we find…
…With scalpel in hand…
…I hatch the plan…
Whether man, woman, child—the procedure is always the same
Beginning the medicolegal autopsy isn’t very hard
The thoracoabdominal incision is the name of this turgidly morbid game
And the letter “Y” is the shape that we must carve…
All ME’s worth their salt keep a blade of their own
And have their scalpel professionally sharpened, polished, and honed
Because of its ability to cut through skin, meat, gristle, and bone
We keep track of it from the opening of the corpse to when it is sewn…
…I must confess…
…This will make a mess…
…The stiff is ripe and putrefied…
…I scalpel the mephitic skin…
…And trace the letter “Y”…
…So the autopsy begins…
In order to field dress this cadaver we cut from the bottom of the neck to above the crotch
Some pathologists prefer to first puncture the bloated corpse to release built-up methane gas
Simply grasp the scalpel and apply downward pressure at the jugular notch
You’ll find the skin will slice like butter, revealing subcutaneous tissue and ballooning yellow fat…
…No time to flinch…
…Only amateurs cringe…
Draw the blade down over the body of the sternum and breastplate
Past the manubrium and xiphoid process and costoxiphoid ligament group
Split the rectus abdominal muscle without a measure of haste
Then stop and wipe your brow and take a moment to recoup…
Peel back the flayed skin and shear it from the muscle sides
Taking the retractors, spread the carcass wide
Costal cartilage snaps from each of the ribs so we may look inside
The inner organs sit on display—glistening—with nothing to hide…
…You’ve earned your degree…
…In the art of necropsy…
…The stiff is ripe and putrefied…
…I scalpel the mephitic skin…
…And trace the letter “Y”…
…So the autopsy begins…
12. Y=1285/X
Soft tissue decomposition formula that expounds and elucidates
…Y=1285/X…
A rough estimate of putrefactive progression to stalwartly vaticinate
…Y=1285/X…
Where Y is the number of days to become completely skeletonized
…Y=1285/X…
And X is the average centigrade temperature with which to surmise
…Y=1285/X…
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