“Next the sternum and the anterior part of the ribs are removed. I will use these curved scissors to cut through the ribs”—his wife uses an identical pair in their garden and swears by them—“making sure not to damage underlying organs. Now the innards are exposed, lying in a colourful mass. I will look to see how they sit with each other. Organs are siblings that work in the same family business. Is there any obvious abnormality that has thrown the family into disarray? Any swelling? Any unusual colouration? Normally, the surface of the viscera should be shiny and smooth.
“After this overview, I need to look at the organs individually. Since we don’t know what brought on your husband’s death, I am inclined to take out his thoracic contents altogether to examine them in continuity, before separating them and studying each component on its own.
“I will ask of each organ roughly the same questions. What is its general form? Is it shrunken or, on the contrary, swollen? The surface of the organ — is there any exudate, that is, any matter that has flowed out? Does the exudate crumble easily, or is it stringy and difficult to remove? Are there any areas that are pearly white, indicating chronic inflammation? Are there cicatrices — scars — or rugosity, wrinkles if you want, a sign of fibrosis? And so on. Next will come the internal examinations. I will incise each organ — I will use this knife — with the idea of assessing its inner condition. The heart is the locus of many pathological possibilities, and I will examine it with extra care.”
He pauses. The woman says nothing. Perhaps she is overwhelmed. It is time to abridge and sum up.
“The abdominal viscera will be next, the small and large intestines, the stomach, the duodenum, the pancreas, the spleen, the kidneys — I will be thorough in my approach.” He sweeps a hand over the torso. “The king is done. Now we can move on to the queen, that is, the head. Examining your husband’s brain and stem will involve removing the scalp by means of an incision and sawing through the skull — but never mind that. Details, details. Lastly, I may examine peripheral nerves, bones, joints, vessels, et cetera, if I feel there is a need. Throughout, I will be excising samples — small bits of organs — which I’ll fix in formalin, embed in paraffin, then slice, stain, and examine under the microscope. This lab work comes later.
“At this stage the essential work on your husband’s body is over, Senhora Castro. I will return his organs to his body and fill any hollowness with newspaper. I will replace the sternum and sew the skin shut, the same with the top of his skull. There, the job is done. Once dressed, your husband will look as if nothing has happened to him and no one outside this room will know better — but science will. We will know with certainty how and why your husband died — or, as you put it, how he lived. Do you have any questions?”
The old woman sighs and shakes her head. Did she roll her eyes?
All right, then. Reluctantly, he picks up the scalpel. “This is the scalpel,” he says.
The sharp blade hovers over Rafael Castro’s chest. Eusebio’s mind is racing. There’s no way around it. He will have to open the thorax. But he will zero in quickly on an organ — the heart. Oh, this explains it. We clearly have our answer right here. We need proceed no further.
“Well, here we go…”
“Start with the foot,” Maria Castro says.
He looks up. What did she say? Did she say pé or fé—foot or faith? And what does that mean, Start with the faith? Does she want him to say a prayer before he starts? He’s happy to oblige, not that he’s ever done that in the autopsy room. The Body of Christ is elsewhere. Here is more simply the body of a man.
“I’m sorry. What did you say?” he asks.
Maria repeats herself. “Start with the foot.”
This time she points. He looks at Rafael Castro’s yellowed feet. They are as far away from the acute myocardial infarction he wants to diagnose as is physiologically possible.
“But Senhora Castro, as I just explained to you, in fact using that very example, it makes no sense to start an autopsy with a patient’s foot. Feet are peripheral organs, both literally and pathologically. And as concerns your husband’s feet, I see no sign of fractures or any other injury — no, nothing at all — nor any sign of a skin tumour or other disease, or any condition at all, bunions, ingrown toenails, anything. There’s some slight peripheral oedema — swelling, that is — but that is normal for someone who has been dead three days. There is also a trace of livor mortis around the heel. Once again, that is normal.”
Maria Castro says it a third time. “Start with the foot.”
He is silent. What a disaster of a night. He should have stayed at home. Not only will he get no work done, but now he has an insane peasant woman in his autopsy room. This is precisely why he went into pathology, to avoid situations like this. He can deal with the clogging and liquefaction of bodies, but not the clogging and liquefaction of emotions. What is he to do? Say no and tell her to go slice her husband’s feet on her kitchen table if she’s so keen on it? That would mean stuffing the old man in the suitcase again, naked this time. And would the old battleaxe go quietly? He doubts it.
He gives up. She will have it her way. He feels like a hawker at a market, selling his wares. Autopsy, autopsy, who wants an autopsy? Don’t hesitate, step right up! Today’s speciaclass="underline" Pay for one eyeball, get the other free. You, senhor, how about a testicle, just one testicle for starters? Come on, get your autopsy! Why not start with the feet? If she wants her husband’s autopsy to start there, then let it start there. Whatever the customer wants. He sighs and moves to the distal extremity of the body, scalpel in hand. Maria Castro joins him.
“His foot, you say?”
“Yes,” she replies.
“Do you care which one I start with?”
She shakes her head. He is closest to Rafael Castro’s right foot. He looks at it. In his medical student days he dissected a foot, he vaguely remembers, but as a practicing pathologist, beyond the occasional surface excision, he has never worked on one. How many bones is it again? Twenty-six, and thirty-three joints in each foot? All bound together and operated by an array of muscles and ligaments and nerves. A very efficient arrangement that can both support and transport.
Where should he cut? Better the plantar surface than the dorsal, he thinks. Less bony. He takes hold of the ball of the foot and pushes. The foot flexes with little stiffness. He examines the sole. The callused skin will part, subcutaneous fat will show, some jellified blood might seep out — just a foot with a random cut in it. No indignity to the body, just an indignity to the attending pathologist.
He presses the blade of the scalpel into the head of the medial metatarsals. He lets the blade go in deeply — it doesn’t matter what it cuts — and he pushes down, towards the heel. The scalpel easily slices through the ball of the foot and into the arch, along the long plantar ligament. He brings the blade out as it digs into the fat pad of the heel.
A thick substance pushes out of the cut. Blobs of it start to drop onto the autopsy table. It is whitish and lumpy, covered in a sheen of brightness, with a slight yellow runoff. It has a pungent smell.
“I thought so,” Maria Castro says.
He stares in amazement. What in God’s name is this? Though he has not uttered the question aloud, Maria Castro answers it.
“It’s vomit,” she says.