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ng sympathetic。 She could not be sure。 Now one of the other girls； was putting a question。 She sounded uneasy； almost afraid to ask。 〃The body…is it buried then 。 。 。 just by itself？〃
This was an old one。 Pearson answered it。 〃It varies。 Teaching centers such as this usually do more study after autopsies than is done in non…teaching hospitals。 In this hospital just the shell of the body goes on to the undertakers。〃 He added as an afterthought： 〃They wouldn't thank us for putting the organs back anyway。 Just be a nuisance when they're embalming。〃
That was true； McNeil reflected。 Maybe not the gentlest way of putting it； but true all the same。 He had sometimes wondered himself if mourners and others who visited funeral parlors knew how little remained in a body that had been autopsied。 After an autopsy like this one； and depending on how busy a pathology department was； it might be weeks before the body organs were disposed of finally； and even then small specimens from each were kept stored indefinitely。
〃Are there never any exceptions？〃 The student nurse asking the questions seemed persistent。 Pearson did not appear to object though。 Maybe this is one of his patient days； McNeil thought。 The old man had them occasionally。
〃Yes； there are；〃 he was saying。 〃Before we can do any autopsy we must have permission from the family of the deceased。 Sometimes that permission is unrestricted； as in this case； and then we can examine the entire head and torso。 At other times we may get only limited permission。 For example； a family may ask specifically that the cranial contents be undisturbed。 When that happens in this hospital we respect those wishes。〃
〃Thank you； Doctor。〃 Apparently the girl was satisfied； whatever her reason had been for asking。
But Pearson had not finished。
〃You do run into cases where for reasons of religious faith the organs are required for burial with the body。 In that case； of course； we ply with the request。〃
〃How about Catholics？〃 It was one of the other girls this time。 〃Do they insist on that？〃
〃Most of them don't； but there are some Catholic hospitals which do。 That makes the pathologist's work difficult。 Usually。〃
As he added the last word Pearson glanced sardonically at McNeil。 Both of them knew what Pearson was thinking…one of the larger Catholic hospitals across town had a standing order that the organs of all bodies autopsied were to be returned to the body for burial。 But sometimes a little sleight of hand was practiced。 The busy pathology department of the other hospital frequently kept a spare set of organs on hand。 Thus； when a new autopsy was done； the organs removed were replaced by the spare ones； so that the body could be released and the latest set of organs examined at leisure。 These organs； in turn； were then used for the next body。 Thus the pathologists were； in effect； always one ahead of the game。
McNeil knew that Pearson； though not a Catholic； disapproved of this。 And whatever else you might say about the old man； he always insisted on following autopsy permissions both to the letter and the spirit。 There was one phrase； sometimes used in pleting the official form； which read 〃limited to abdominal incision。〃 Some pathologists he knew did a full autopsy with this single incision。 As he had heard one man put it； 〃With an abdominal incision； if you've a mind to； you can reach up inside and get everything； including the tongue。〃 Pearson…to his credit； McNeil thought…would never permit this； and in Three Counties an 〃abdominal incision〃 release meant examination of the abdomen only。
Pearson had turned his attention back to the body。
〃We'll go on now to examine 。 。 。〃 Pearson stopped and peered down。 He reached for a knife and probed gingerly。 Then he let out a grunt of interest。
〃McNeil； Seddons； take a look at this。〃
Pearson moved aside； and the pathology resident leaned over the area that Pearson had been studying。 He nodded。 The pleura； normally a transparent； glistening membrane covering the lungs； had a thick coating of scarring…a dense； white fibrous tissue。 It was a signal of tuberculosis； whether old or recent they would know in a moment。 He moved aside for Seddons。
〃Palpate the lungs； Seddons。〃 It was Pearson。 〃I imagine you'll find some evidence there。〃
The surgical resident grasped the lungs； probing with his fingers。 The cavities beneath the surface were detectable at once。 He looked up at Pearson and nodded。 McNeil had turned to the case…history papers。 He used a clean knife to lift the pages so he would not stain them。
〃Was there a chest X…ray on admission？〃 Pearson asked。
The resident shook his head。 〃The patient was in shock。 There's a note here it wasn't done。〃
〃We'll take a vertical slice to see what's visible。〃 Pearson was talking to the nurses again as he moved back to the table。 He removed the lungs and cut smoothly down the center of one。 It was there unmistakably…fibrocaseous tuberculosis； well advanced。 The lung had a honeybed appearance； like ping…pong balls fastened together； then cut through the center…a festering； evil growth that only the heart had beaten to the kill。
〃Can you see it？〃
Seddons answered Pearson's question。 〃Yes。 Looks like it was a tossup whether this or the heart would get him first。〃
〃It's always a tossup what we die of。〃 Pearson looked across at the nurses。 〃This man had advanced tuberculosis。 As Dr。 Seddons observed； it would have killed him very soon。 Presumably neither he nor his physician were aware of its presence。〃
Now Pearson peeled off his gloves and began to remove his gown。 The performance is over； Seddons thought。 The bit players and stagehands will do the cleaning up。 McNeil and the resident would put the essential organs into a pail and label it with the case number。 The remainder would be put back into the body； with linen waste added if necessary to fill the cavities out。 Then they would stitch up roughly； using a big baseball stitch…over and under…because the area they had been working on would be covered decorously with clothing in the coffin； and when they had finished the body would go in refrigeration to await the undertaker。
Pearson had put on the white lab coat with which he entered the autopsy room and was lighting a new cigar。 It was a characteristic that he left behind him through the hospital a trail of half…smoked cigar butts； usually for someone else to deposit in an ash tray。 He addressed himself to the nurses。
〃There will be times in your careers；〃 he said； 〃when you will have patients die。 It will be necessary then to obtain permission for an autopsy from the next of kin。 Sometimes this will fall to the physician； sometimes to you。 When that happens you will occasionally meet resistance。 It is hard for any person to sanction…even after death…the mutilation of someone they have loved。 This is understandable。〃
Pearson paused。 For a moment Seddons found himself having second thoughts about the old man。 Was there some warmth； some humanity； in him after all？
〃When you need to muster arguments；〃 Pearson said； 〃to convince some individual of the need for autopsy； I hope you will remember what you have seen today and use it as an example。〃