“Put the bodies in the freezer, not the cooler,” I told the men. Most maggots can survive those sub-zero temperatures, but at least the freezer's extreme cold would arrest their appetites and make them sluggish. Let's take every opportunity we humans have-the maggots will get their turn soon enough.
The next day at autopsy, the victims' chest cavities were indeed packed tightly with maggots. For now, they were immobilized-stunned from the cold-but in less than an hour, they'd start to move again. John and I would have to hurry.
I was dressed in the usual blue-green scrubs, surgical gown, gloves, mask, and face shield. My gear protects me from everything but the smell, which always seems to soak right into my skin, my hair, my nose, even my taste buds. Menthol cream smeared under my nose doesn't seem to help, either-it just adds more noxious fumes to the mix. When I first started in this line of work, I thought someday I'd get used to it-but I haven't.
This would be a conventional autopsy, so I was only responsible for the teeth and skull bones. I'm always grateful for the “learning by touch” that Tyler and I had practiced in osteology class, given how many times I have to resort to compressing soft tissues manually in order to retrieve bone and teeth fragments, much as I'd done with the children at Waco. Skull fragments and teeth often filter down into the base of the skull, the neck, or even the victim's decomposing chest cavity, and then I have to grope around to find them, feeling through dark brownish-green tissues that resemble nothing so much as chocolate pudding into which someone has stirred a few cups of chunky vomit.
Meanwhile, the body is still home to tens of thousands of maggots, boiling up out of the chest cavity like suds overflowing from a washing machine. Someone once naïvely asked me why I couldn't simply remove the maggots before doing an autopsy, and all I could do was shake my head and chuckle. By the time we got rid of the maggots, there'd be nothing left of the body.
Still, the notion of fumigating a maggot-filled body is an appealing fantasy, because after my hands have been dipped in this cauldron of gore for a few minutes, the maggots start to climb up my sleeve, coated with a sticky mucus that allows them to cling to a number of different surfaces. Over my gloves and arms they crawl, migrating up toward my face, with its tempting facial openings… I am so repulsed by their slow, determined journey that my reflexes often take over, causing me to flick my wrist and send several maggots hurling to the floor. That seems like a good place for them-until they start to wriggle off under the counters or climb up the leg of another lab worker or an unsuspecting med student who's come along to observe. So once those maggots hit the floor, you've simply got to step on them-even though stepping on an engorged adult maggot is like smashing a miniature grape. They pop-and their pus-colored innards smear over the floor, making yet another mess. To me there's no contest, though: better underfoot than on my face.
Over the years, I've developed a number of little tricks to cope with my maggot friends. I've learned to work quickly and to keep the autopsy room as cold as possible. That at least renders the maggots a little sluggish, giving us humans a slight but crucial advantage. Even more than the cold, maggots hate bright light, so whenever possible, I put a large black trash bag over a central portion of the body. After a while the maggots migrate underneath. Slowly I slip the bag down to the other end of the gurney, with many maggots following desperately along, leaving me to work in relative peace. It's nice to feel smarter than a maggot.
“Well, Emily, you're certainly starting off with a bang,” John commented as we began today's autopsy. He looked like your stereotypical college professor-kind of handsome in a studious sort of way, tall and a bit stooped, with his glasses perpetually dangling from a cord around his neck. He always wore a soft brown Mr. Rogers sweater to ward off the chill in the morgue, and he puffed continually on a large wooden pipe to help kill the smell.
“I know,” I said as he cut into the body and flipped a few maggots of his own onto the floor. “A double murder. Not bad for three days on the job.”
“Don't forget to find some tenants for your ‘maggot motel,'” he said with a grin. I knew he understood the science behind it, but I defy anyone to say “maggot motel” with a straight face. Since many maggot species look similar, the entomologist needs to see the adult flies, and so it was my lucky job to collect another dozen larvae from the body and raise them to adulthood. Although all of the pathologists know how to do this, they're even more squeamish than I am when it comes to maggots, so if I'm around, my colleagues are more than willing to pass this duty on to me whether or not it's a skeletal case. I use a simple milk carton with some dirt on the bottom and a small chunk of chicken liver wrapped loosely in aluminum foil. The maggots gorge themselves on the liver, then bury themselves in the dirt to pupate. One of the weirdest parts of my job is my nightly bed-check at the maggot motel, making sure my little charges are alive and well and have plenty to eat.
“I'll never get used to those things,” I said now. “Hey, John, do me a favor, will you? Take a few more puffs of your pipe.” The secondhand smoke covered the smell for me, too.
After John and I had finished the autopsy, I cleaned the skulls and skull fragments, submerging them into warm soapy water and scrubbing them clean with a toothbrush, just as I'd done at Waco. I left them to dry overnight and returned the next day to begin the laborious process of gluing the skulls back together.
In this case, all my questions centered on the skulls, but later I'd run into cases where I had to clean and examine every single bone in a body, searching for skeletal trauma or maybe evidence of an old injury to help me make an ID. This doesn't happen very often, maybe one case in five, but when it does, it's a real chore-messy, time-consuming, and smelly. It's something like deboning a rotten chicken though, of course, on a much larger scale. I use x-rays and photographs to help me figure out some way of working the bones free from the decomposing flesh without damaging them. After all, some of the bones might hold tiny cut marks or other evidence of a murderer's actions, and I don't want to leave my own trace evidence alongside of his.
If there's not too much flesh, I can usually pull the bones out of the soft tissue with a very tiny tweak, like twisting a stem off an apple. If I meet even the slightest resistance, though, I'll dissect the bones away with a small pair of blunt-tip, curve-bladed scissors. Again, my main concern is not to nick or cut any of the cartilage or bone. As I remove each bone from its fleshy casing, I place it on another gurney, aligning my collection in anatomical order. That way, I can do a skeletal inventory while I work, noting what's missing and checking each bone as I lay it into place-my first chance to look for breaks, bruises, or other anomalies that might offer us clues.
If the bones are still too fleshy to reveal their secrets, I'll take them to the corner of my lab that my colleagues jokingly call “Miss Em's kitchen.” There I boil the bones gently, cooking off any remaining flesh in a process we call “thermal maceration.”
Like any good cook, I have my system. I fill two Crock-Pots and a large covered roasting pan with water and some mild dish-washing detergent, which helps cut the grease. I like to have my pots full and ready to go before I even start recovering the bones, so I can drop everything into the water and turn on all the devices at the same time. That way, I know exactly how long each bone has cooked, and I can be certain nothing cooks too long. I make sure that the water heats up gradually, too, so that each bone can adjust to the heat.