The refugee

‘Who do we have today?’ Jay asked as he hung his coat on the rack in the corner.

‘Latino male. Late twenties, early thirties. Drowning,’ his assistant Drew replied as he sorted the necessary plastic tubs and tubes on the bench.

The body lay naked on the stainless-steel table, assuming the appearance of a man napping on the couch, if it weren’t for the unnatural hue of his skin. Jay rolled up the sleeves of his dress shirt and tugged on the Tyvek gown that protected his clothing. Picking one foot up at a time, he donned the booties that would protect his shoes. As he looped the face mask over his mouth and nose and tucked the top edge under his glasses, he thought how much things had changed over the last thirty years. His pathology professor used to only wear gloves. Sometimes.

‘Ready to start the external?’ he asked Drew.

The young man nodded, turned on the overhead microphone and picked up an e-tablet and pen to take notes. Jay looked at the corpse’s face, handsome enough, but with a worn out quality to it. He ran his gloved fingers around the sides of his head, and pushed down on his jaw to see into his mouth.

‘Bloody foam in the mouth and nasal passages, consistent with drowning. Abrasion on the right cheek and top of the right ear.’

Jay continued to scan down the deceased’s neck and torso looking for hallmarks of injury. He continued calling out his observations for the microphone to record and so Drew could mark off the anatomy schematic on the e-tablet.

‘Slight abrasion on the right shoulder. Occurred post-mortem and likely at the same time as the cheek and ear. None of the sites have bruising or clotted blood. Looks like he bounced around the river bed a bit,’ Jay paused for a moment and turned the dead man’s hands over, flattening out his fingers, ‘Right index and middle fingers previously broken. Healed crooked. Numerous scars on palms and digits. Definitely manual labor.’

Shifting down the table, he continued his assessment, ‘Ten-centimeter scar on the left thigh. Thick and raised. Looks like a homemade suture job. Feet calloused and blistered. Left foot; third, fourth, and fifth phalanges also appear to have been previously broken. Okay, let’s take a few photographs and then flip him over to look at the back.’

Drew, wordlessly laid down the tablet and picked up the Cannon from the side bench. Standing on a footstool, he hung over the body and took close up shots of the face, the ring flash whining after each photo. Once he snapped the remaining full body photos, he placed the camera back on the bench and stood on the opposite side of the table as Jay.

‘On three?’ Drew asked the pathologist.

Jay nodded and began his count. At the agreed timepoint, Drew pulled the left side of the corpse toward him and Jay pulled the opposite arm and leg from under the body, flipping the dead man over like an unwieldy mattress. They were always heavier than they looked, Jay thought.

‘Well, you don’t see that every day,’ Jay remarked as he surveyed the enormous tattoo of the Virgin Mary on the man’s back. The artwork was colorful and masterfully drawn, the Lady beneficently smiling down at the lamb seated at her feet. Beautiful, Jay thought, but spoiled by three pucker mark scars across the man’s right side.

Drew stood on the footstool again, capturing the tattoo in a closeup, before shooting the entire backside of the body. Jay continued his assessment, running his hands over the back of the man’s head. Grit and small amounts of duckweed came out of the body’s hair and stuck to his gloves.

‘How long was he in the water?’

Drew picked up the tablet and flipped through a few screen pages. ‘Says he was found at dawn by the border patrol. They think he came across at midnight about five miles up-river. They arrested a coyote transporting thirty others just outside Laredo. He was probably originally with them.’

‘Okay. Five miles is long enough to pick up some of the river in your hair,’ Jay waited for Drew to flip back to the anatomy schematic before continuing, ‘Three prominent scars on the right back, approximately between the 8th and 10th rib. Possibly gunshots. All healed. At least a year old. No exit wounds, so small caliber. We should see if the projectiles are still inside when we do the block. No other obvious trauma on the posterior.’

Jay paused while Drew finished his note taking and placed the tablet back on the bench. They repositioned the body back to a supine position and Jay moved to the head of the table picking up a scalpel. He cut a V-flap in the corpse’s scalp and yanked the skin off the skull, folding it down over the dead man’s face. The position of the scalp always made Jay wonder what it would feel like to kiss the back of your own head. If the dead man could still feel, would his own hair tickle his lips? Drew handed him the Stryker saw and he made quick work of the skull cap, popping it off and setting it on the table next to the dead man’s head.

‘Edema of the cerebral tissue. Consistent with drowning,’ Jay said as he pulled out the brain and set it on a cutting board.

He made gross serial sections, looking at each slab. Aside from the swelling, there was no evidence of stroke, hematoma, or disease. After removing a strip of brain tissue and dropping it in a small plastic tub of formalin, he returned the brain slices to the cranium, approximating its original position. Once the skull cap was back on, he pulled the skin flap back over and stapled it in place to hold everything in. The mortician would sew it back with small stitches and make it look presentable. He just needed to keep things from sliding out.

‘I’m ready to do the block. Do you need to take a break?’ Jay asked his assistant, who was impassively writing the date and time on the brain tub lable.

Drew glanced up and just shook his head. Jay was glad he wasn’t as chatty as his last assistant, Clara. She talked constantly, even when the microphone was on. Still, he could do with a little conversation. Drew was as unemotive as a guy selling shoes in the mall. He would have the same look on his face whether he had his hand in a chest cavity or a leather pump.

Making a Y-incision in the cadaver’s torso, Jay folded back the skin and muscle flaps. The dead man had very little body fat and mostly lean muscle, so there wasn’t much to cut down. The block consisted of all organs from the bottom of the trachea to the pelvic floor. Each organ would be removed, weighed, and evaluated for abnormality or injury. Jay was grateful that they found the deceased early this morning, rather than days later. More than 24 hours in the water made the autopsy difficult. And incredibly smelly.

He and Drew got into a rhythm; removing, weighing, and sampling. Most of the organs were within the expected range of normal for a man his age. Still, the cadaver’s insides told the same story as the outside. A difficult life, filled with deprivation and violence. As he worked, Jay read off his findings for the audio recording, ‘Hemolysis found in both lungs, consistent with inhaling a quantity of water. Scar tissue found in the right lung, matching the location of the presumed gunshot wounds external, same side. One small caliber bullet located in scar tissue in the right, inferior lobe. No additional projectiles found. Gut contents were minimal. The deceased appears to have not eaten in the last 24 hours. Inflammation of the jejunum, indicating possible parasite load. Fecal sample collected for reference, if needed.’

Once the block was complete, Drew shut off the microphone and lined the body cavity with a plastic garbage bag and began reinserting the removed organs. Jay removed his gloves and sat down at the side bench to review the autopsy notes. By the time he had reviewed Drew’s notes and added detail where necessary, the garbage bag was full, tied off, and Drew was pulling the Y-incision back in place.

‘Which mortuary is picking him up?’ Jay asked, glancing up from his note editing.

‘State. He is unclaimed and unnamed,’ replied Drew.

That meant a John Doe grave in Potter’s Field. There would be no funeral, just a pine box and a marker with a number, in the event anyone ever came back for the remains. Jay sighed. A young man in his prime; shot, injured, broken fingers, without a last meal. He fled his home, crossed the hot Mexican desert at night with strangers, and then drowned a short distance from a better life. What a tragic waste, Jay thought. The poor man deserved better. Jay stood up and crossed to the autopsy table, taking the suture and needle from Drew with a sad smile.

‘Let me sew him up. He should look tidy, before he’s buried.’