Gavin Francis

Gavin Francis observes the autopsy of a man pulled from a river.

A detective inspector once told me that the key thing to remember at a crime scene was to keep your hands in your pockets; the temptation to reach out and touch a murder victim, or a potential murder weapon, could be overwhelming. He had little faith in forensic pathologists. ‘I was at a scene where a dead man lay slumped over a desk,’ he told me. ‘There was a narrow entry wound on the back of his head, and a hole in the victim’s forehead. A Bakelite phone on the desk was shattered into pieces – he had obviously been shot. The pathologist arrived: “Hmm,” he said. “Looks like we’re searching for a stiletto, or maybe a knife.”’

Recently, on the phone with a pathologist about a post-mortem report she had prepared on one of my patients, I realised how rarely I had cause to speak to her or her colleagues. ‘So much of my practice is guesswork,’ I said to her, ‘trying to figure out what’s going on beneath my patients’ skin. I envy you being able to take a look inside and figure out what’s happening once and for all.’ ‘That’s a misconception,’ she replied. ‘We don’t have all the answers either.’ She invited me to come and see for myself.

The city mortuary in Edinburgh is a dull concrete building, squat and grey with a waistband of windows. It sits on a shadowy street in a district that has long been one of the city’s poorest; tiny cobbled alleys and tenements are knotted around it, and beneath its foundations lie the remains of the city’s 18th-century infirmary. I had passed it hundreds of times, but never given much thought to what went on inside. The little pathology I’d been taught at medical school had taken place in hospital; no one had ever suggested we visit the mortuary.

I met Charlotte Crichton at 8.30 a.m. sharp in her office, where she was busy with the police summaries for the morning’s cases. There was a man whose body had been pulled from a river; fishing tackle had been found nearby. ‘He might well have stumbled and drowned,’ Charlotte said. There was a woman in her fifties, found dead on her sofa; Charlotte wanted to find out whether the woman had died of a heart attack, which seemed likely, or had been poisoned by gas or drugs. Finally there was a man with morbid obesity, found face down in his kitchen, who could conceivably have choked on some food he was preparing.

I changed into blue hospital scrubs. Between the locker room and the autopsy suite was a tiled tray of the kind used to disinfect your feet at a swimming pool; rubber boots were lined up against the wall, next to a hose for washing them down. The suite was somewhere at the heart of the building and saw little natural light. There were three body-sized steel trays at waist height; when there were enough pathologists around, autopsies could be carried out three at a time. The ventilators in the ceiling were designed to push air down and away from the noses of pathologists. ‘At least that’s the idea,’ Charlotte said. ‘It doesn’t seem to work very well.’ Along one side of the room was a glass wall with seating behind it: a viewing gallery for students. A fluorescent purple Insect-O-Cutor blinked high on one wall next to a sign: ‘No eating, drinking or smoking.’ We tied on disposable aprons, rolled plastic gauntlets up our sleeves, tucked the gauntlets into surgical gloves, and were ready to start.

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