Sunday, September 6, 2015

Autopsy


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http://www.pbs.org/wgbh/pages/frontline/criminal-justice/post-mortem/without-autopsies-hospitals-bury-their-mistakes/

Four years later and autopsies remain the forgotten basis of scientific medicine. Headlines read, autopsy rates are falling, but they cannot fall from the near zero percent presently undertaken. Some new hospitals do not even provide examining space for autopsies. The NEJM publishes CPCs on living patients. A pity today's epidemic of curriculum reform does not include autopsies, a further sad accommodation to today's reality. Check the PBS link, it's well done.

The renaissance of modern medicine was lead by the microscope and the study of anatomy; it became clinical with the routine practice of autopsy by Marie Francois Bichat in Paris 1793, the stethescope, Rene' Laennec 1822 and the classical bedside teaching of the great Scottish and Irish physicians in the early 1800s. From Bichat, over the door to his autopsy room, "Death comes to the aid of the living." 

Cynically speaking -- we have all but legislated these practices out of existence, the autopsy for money, bedside teaching for privacy, basic science for curriculum reform with greater emphasis on preceptors and, ah the stethescope, it hangs around the neck in color coordinated pastel colors only to pretend to hear something through the patient's clothing. An anatomy professor recently commented, "They have a microscope down in Seattle under glass so students can see what one looks like."

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