Sometimes the Dead Need a Primary Care Physician


Photo NOT from this story

❝ He was found dead in the doorway of a restaurant, under a tarp, huddled in the rain. He came to my office because his death was in public view. We didn’t even know his name. A search of the police fingerprint database gave him an ID and revealed he was homeless, a veteran, and had no living next of kin. We found no medical records under his name. His body was a testament to hard living on the street. The dirt was so ingrained into his palms and soles that even when I laid into it with soap and an abrasive kitchen pot scrubber (looking for injuries or track marks) my efforts barely managed to uncover his natural flesh color. His face carried wrinkles beyond his 57 years. Dead people generally look like they are sleeping. This man looked worn.

❝ The autopsy was one of the strangest I have ever performed. When I cut into the flesh, there was no passive blood flow. Instead of red fluid, his veins and arteries contained … pink noodles. His circulatory system was filled with what looked like spaghetti — the blood had congealed inside the vessels, in thin branching ropes. He had a moderately enlarged heart and a bit of black pigmentation of the lungs, and his toxicology report came back clean of alcohol or any drugs of abuse. The answers came to me under the microscope. His blood had been replaced by large white cell progenitors. It was ropy because it was mostly white blood cells, and not normal ones, either, but blasts. He had leukemia…

❝ Little did I know that by going into forensic pathology, a subspecialty of a subspecialty, I was going to end up practicing primary care medicine. My patients are frequently the under-treated and under-diagnosed, the uninsured and under-served — which is why they end up on my autopsy table. We don’t autopsy those who have had medical attention and who are under the care of a physician who is willing and able to sign a death certificate for a natural cause. We bring in and autopsy those who die suddenly, unexpectedly, and violently. This includes those who die at home or on the street and those we can’t identify. They include the drug-addicted and the homeless, and those who are too poor to seek medical care. Sometimes I am the only doctor my patients have ever seen.

A worthwhile read, my friends. Please click the link – and read on.

2 thoughts on “Sometimes the Dead Need a Primary Care Physician

  1. fare-thee-well says:

    “His Body Was Behind the Wheel for a Week Before It Was Discovered. This Was His Life.” https://www.nytimes.com/2018/10/23/nyregion/man-found-dead-in-car-new-york.html “…The chain of events serves as a stark reminder that even in 2018 Manhattan, a city that lives beneath the nonstop gaze of countless surveillance cameras, one that for years has urged its citizens, if they see something suspicious, to say something, it is still possible for a dead man in a parked car on a busy block to go unnoticed for days.”

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