Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Friday, November 01, 2002
    Gather round, boys and girls. I have a mildly ghoulish story for you, appropriately as today is Dia de Los Muertos (Day of the Dead) here in Los Angeles. This is the Story of Why Alice Named Her Blog "Feet First."

    Years ago, when I was a high-school student and trying to figure out what I wanted to do when I grew up, my father (also a physician) figured he'd try to help me along by arranging for a tour of the hospital where he was on staff. A primary care doc himself, he wanted me to consider something in medicine where I wouldn't actually have to deal with people - thus he sent me on a tour of the pathology department.

    It was more fun than you'd think. The doctors were rather social actually; not wildly busy, they seemed to enjoy a chance to talk to an appreciative audience about what they did. I've liked pathology ever since - this came in handy when I got to med school - but still I wound up in primary care, same as Dad did (I just liked it better). The day of my visit I got to wander around, peer at slides, and look at a couple of specimens and hear the patient stories behind them. You know, mildly gross-out stuff but not that gross. I got my first smell of formaldehyde (ugh), listened to the head pathologist bitch and moan about hospital administration, procedures, and policy (I was no stranger to this either, as I got a lot of that from my dad every dinnertime), and finally they showed me the morgue.

    "Morgue" was an overstatement, as most hospitals don't have that much body storage space - they don't need it unless you're in a trauma center or a big academic hospital. Unless you're doing an autopsy, and most patient deaths don't require one, the mortuary will trot along and pick up the body right quick. What I recall is seeing a few storage cases where bodies are kept until picked up or the autopsy is completed. These were cold storage, as usual, but they weren't fitted with drawers as you often see in TV shows; instead they had hatch doors like you'd see on a submarine. They opened one, I peered in (there was no body resident at the time), and then I saw a small label posted just above the door.

    The label read:




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