EDITOR’S NOTE: This story includes a graphic depiction of an autopsy.
On a recent weekday morning, a reporter and a photographer from The Olympian were allowed to watch an autopsy, from start to finish, at the Thurston County Coroner’s Office.
During the procedure, the autopsy team — a forensic pathologist and his assistants, dressed in surgical garb — was visible through the large glass window of the observation room.
The man to be examined was in his 50s, barefoot but still clothed in blue jeans and a black shirt.
He had been found at a local motel the day before, lying on the bed in his room. Suspected heroin paraphernalia, including a syringe, was collected from the bedside table.
When he was found, he had a burned-out cigarette sticking straight up from his lips, about an inch of ash still intact. Coroner Gary Warnock said that in all his years with the office, he had never seen that before.
The goal of the autopsy, Warnock said, was to rule out death by natural causes.
By examining the man’s organs, including his heart, lungs, liver and brain, the coroner could rule out circulatory issues, heart disease or cancerous tumors, he said.
The forensic pathologist, Dr. Emmanuel Lacsina, and his assistant, Jermane Evans, removed all of the dead man’s clothing.
An assistant went through the man’s pockets, removing crumpled dollar bills. He had $39 in bills and some loose change.
Police and first responders are not supposed to go through a dead person’s pockets — that is work for his office, Warnock said. The money will go to the man’s family once they’re found.
Assistant deputy coroner Joe West then took photos of the body.
Lacsina’s examination of the man’s arms revealed puncture marks from suspected heroin use, Warnock said.
Evans then performed a “femoral drain,” using a syringe to draw blood that will be sent to the Washington State Patrol Crime Lab for a toxicology exam.
It typically takes six to 10 weeks for the Coroner’s Office to receive the results of such an exam, Warnock said. The toxicology exam will tell investigators what drugs were in the man’s blood at his time of death to help determine if it was from an overdose.
Next, Evans used a scalpel to make a “Y” incision on the deceased’s body. The incision includes two cuts that begin at each shoulder and meet at the bottom of the sternum, continuing in one line to the pubic bone.
Evans used a pair of garden shears to snap off the sternum to expose the heart and lungs.
Then the team could remove the internal organs. They removed the lungs, liver and heart and examined them for abnormalities to rule out natural death, such as from cancers or circulatory issues, Warnock said.
Lacsina noted the dead man “loved his cigarettes,” alluding to the blackening of the lungs, a common trait in longtime smokers. The liver was cut into pieces and examined for signs of damage from alcohol or cirrhosis.
Photographs are taken of the organs before they are weighed and put back inside the chest cavity.
Evans then made a long cut at the back of the man’s skull and peeled the scalp upward, so that it covered the face. He used an electric saw to cut through the skull so the brain could be removed, weighed and photographed.
After the organs were returned, Evans sewed the man back up.
The autopsy took less than two hours.
Lacsina noted that a strong odor of alcohol came from the internal organs. The large amount of fluid found in the man’s lungs was consistent with a drug overdose, he added
“The autopsy indicates that the most logical cause of death will be confirmed by toxicology as a heroin overdose,” Lacsina said.