Newsroom With A View

When we die, our families remember our smiles and laughter, tears and tantrums, the animals we cuddled and the games we enjoyed. Our mothers remember what we smelled like. Our fathers remember how helpless we made them feel. Friends and relatives alike linger on our photos, mentally caressing the memories.

An autopsy report is the opposite. It is striking for its clinical distance, the dispassion that renders a human being into a collection of anatomical descriptions. It carries and conveys no memory or warmth, just the immediate nature of the cold, decaying tissue on the table in front of the medical examiner, who tries to thoroughly document what was and was not wrong with the body before it died, and especially what precisely may have killed it.

“The body is that of a well-developed, well-nourished, adult Caucasian woman who appears consistent with the stated age.”

Her stated age was 18. She died in Lenoir. In family photos she has long, straight, light-brown hair and a radiant smile, whether standing alone modeling a dress or cuddling with a younger brother.

She arrived at the medical examiner’s office at Wake Forest Baptist Medical Center in Winston-Salem in a body bag, her hair 16 inches long. She wore black shorts, a black shirt, a black bra, and an ankle band with her name on it. “Personal effects accompanying the body include a hair tie and flip-flops,” the autopsy report said.

In its way, the report describes a young woman who by all appearances had many years ahead – a young woman who matched the one her family and friends could see in their treasured photos. The clinical version of that, though, is the absence of abnormality, the cataloguing of healthy tissue, using the same terms over and over.

“The ears are not unusual. The lips and gums are pale and atraumatic. The teeth are natural and in fair condition. … well-developed … without injuries … unremarkable … symmetrical … intact … free of abnormality … normal … intact … intact … smooth … usual … unremarkable … unremarkable … intact … free … unremarkable … unremarkable … unremarkable … unobstructed … unremarkable … unremarkable … unremarkable … unremarkable … normal … without focal abnormality … not unusual.”

The medical examiner noted a spot of bleeding under her scalp near the base of the skull – perhaps from where she fell backward and hit her head as she died? The report doesn’t offer the examiner’s opinion.

She had only two other injuries, extremely minor, that could have come from everyday activity: a very small bruise over her right shin, and a slightly larger, lighter, yellowish bruise over her left shin.

She had a very small amount (less than 5 percent) of abnormal or scar tissue in her heart, which may or may not have pointed to future heart disease many years ahead.

The answer to what killed her came not from anything on the table in front of the medical examiner that September day in Winston-Salem, but from blood drawn from an artery in the young woman’s thigh the summer day she was found dead.

She had taken cocaine apparently mixed with a few other things, but the fatal mix was cocaine and cyclopropylfentanyl – a chemical cousin to a powerful opiate, fentanyl, that has been implicated in a rapidly escalating number of drug overdoses and deaths nationwide.

There probably wasn’t much cyclopropylfentanyl at all. In fact, there was nearly 10,000 times more cocaine in her blood, and there was less than half a gram of cocaine. If all the cyclopropylfentanyl in her system were spread as powder on your living room table, you wouldn’t notice it among the dust — but it could still kill you.

That’s all it takes to end a life. One day perhaps your life.

Your laughter, your tears, your rages, hugs, joys all pass into memory, while you and that poison in your blood lie inert, waiting to be coldly examined by a stranger.