Postmortem (less often spelled
post-mortem) refers to an event that takes place after death. However, the word is commonly used in many ways:
Postmortem, the adverb
The most common and literally correct use of the word is as an
adverb, used to describe some act or event that takes place after death.
Postmortem, the noun
The term
postmortem examination (see
autopsy,
necropsy) is often shortened to simply "
postmortem". A postmortem examination is performed by a
coroner or a
pathologist. One of the earliest known postmortem examinations was performed in 44 BC by a
Roman physician called
Antistius, who examined the body of
Julius Caesar.
The objective of a
forensic postmortem examination is usually to determine conclusively, that is more conclusively than the obvious signs of outward trauma would indicate, the cause of death. Other objectives include:
- determining the identity of the deceased
- establishing the approximate time of death
- distinguishing homicide from suicide or natural causes
- determining if a weapon was used and the type of weapon
The
cause of death is usually broken down into facts classified into four categories:
The contributing cause of death refers to any pre-existing or condition that may have only contributed to the cause of death but is not the direct cause of death. For example, an immune system deficiency might be a contributing cause of death, while the person actually died from pneumonia. A person without an immune system deficiency might not have died from the same case of pneumonia.
In some cases the contributing cause is also the immediate cause of death and the distinction is merely semantics.
The immediate cause of death is the actual reason why the person is dead; the true cause of death. Following the example above, the immediate cause of death might have been "asphyxia", because pneumonia caused the lungs to fill with liquid, effectively drowning the victim. The immediate cause is often a medical term that refers to some action that would cause the body to stop living.
The mechanism of death describes how the body died. The mechanism of death for our pneumonia victim might be that the lungs filled with fluid and could no longer transport oxygen. Another example could be a "gunshot wound to the head" - the immediate cause of death could be blood loss, but the mechanism is the extra hole in the head.
The manner of death is the opinion of the examiner as to whether the death is a homicide, suicide, accidental, natural or unknown. If the mechanism or immediate cause of death is unknown, the manner of death is usually ruled as unknown. If a death is a suicide but some other party was involved in anyway, the death is usually ruled a homicide and left to the legal system to elect to lay charges; such might be the case in an assisted suicide.
Clinical postmortem examinations are used for teaching and research. Medical students receive hands-on surgical training by dissecting and examining cadavers. Medical research by postmortem examination has also been indispensable for discovering causes of ailments such as tuberculosis and determining if a doctor's
antemortem diagnosis is correct or incorrect and why.
A postmortem examination is a serious matter that must always respect the body that is being examined. Inscribed over the entrance to the
New York morgue is the Latin phrase:
Taceant colloquia. Effugiat risus. Hic locus est ubi mors gaudet succurrere vitae.
Let idle talk be silenced. Let laughter be banished. Here is the place where Death delights to succour life.
Many morgues post a sign displaying the words "Hic locus est ubi mors gaudet succurrere vitae", which is often translated slightly differently from the above as "This is the place where death rejoices to teach those who live".
The postmortem examination is performed in stages, with each stage usually more destructive to the body than then previous. Therefore, the stages must proceed in order. The pathologist performing the examination will determine how the examination should proceed, depending on factors that are too numerous to detail and vary from case to case.
Regardless of how the actual dissection will take place, the procedure always starts with the
gross examination. This is generally a non-invasive examination of the body. The body is weighed and measured. The entire exterior of the body is reviewed and any injuries or abnormal features are documented. Some internal examination may take place, but nothing that couldn't normally be done to a live body, such as looking down the throat, ear canals, nostrils, etc.
When the body is opened and the internal workings and organs are examined, a tissue sample from each organ is preserved. Each organ may also be removed from the body, examined for any abnormality, its weight recorded. The brain may also be excised and dissected but it is often pre-soaked with a fixative liquid in order to help maintain is solidity and prevent it from falling apart once removed from the skull.
Once the examination is completed the organs are usually replaced within the body and it is sewn shut.
The postmortem examination of a newborn baby is different than the usual examination of an adult. This examination is often carried out by a specialist called a
neonatal pathologist. In fewer than 20% of cases, unless the mechanism of death is obvious, the cause of death for a stillborn child or delivered infant cannot be conclusively determined.
Postmortem, the buzz word
Occasionally the term "postmortem" is used to describe activities that take place after some final, irreversible and often negative event (that has nothing to do with an actual death) has occurred.
In the business world you might pitch an idea to a prospective client but fail to win their business. In this case the "postmortem" would consist of reviewing your approach, your presentation, etc. and trying to figure out what could have been done better or what went wrong.
This buzz word is most commonly used by
yuppie-types, who are also apt to call a business engagement a "
gig" and declare a job complete by saying they "
put that baby to bed".
Sources
http://www.pathguy.com/autopsy.htm
http://www.medterms.com/script/main/art.asp?articlekey=16565
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=476937
http://faculty.ncwc.edu/toconnor/425/425lect12.htm