Autopsies: Caesar's Fatal Wound, Missed ICU Errors and Wrong Death Records

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The word autopsy comes from the Greek autopsia, to see for oneself. This episode follows that idea from ancient Egypt, where embalmers removed organs through small slits to protect the body for the afterlife, to 44 BCE, when the physician Antistius found that only the second of Julius Caesar's 23 stab wounds was fatal. Pope Boniface VIII's decree against boiling the bodies of crusaders, a practice called mos teutonicus, chilled anatomical study for generations until Pope Sixtus IV allowed dissection in university towns such as Bologna and Padua, opening the way for Andreas Vesalius in 1543 and Giovanni Battista Morgagni.

Today the clinical autopsy works as quality control for medicine. A large meta-analysis suggests about one third of death certificates are wrong, and a systematic review projects that 8.4 to 24.4 percent of autopsies in modern US hospitals will find major diagnostic errors, often visible only under the microscope. The episode walks through the procedure, from the head block and the nearly bloodless incision to removing organs en masse and fixing the brain in formaldehyde for weeks. It ends with falling autopsy rates in the UK, Germany, and the United States.

Fetal alcohol syndrome, Legionnaires' disease, and viral hepatitis, all identified through autopsies
An ICU study where intubated patients' abscesses and bowel perforations went unnoticed
How red-staining dead neurons date a stroke to 1 to 3.5 days earlier
The UK Human Tissue Act 2004 requiring organs to be returned before burial
Consented adult inpatient autopsies in the UK down to 0.7 percent

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