from the pen of icarus blake

In 2022, I was forced to leave the best job I’d ever had for a number of reasons — not the least of which being that I technically was not allowed to have it past graduation in the first place.  The pandemic let a lot of things slide.  I found an adult job at a surgical pathology laboratory.

Surgical pathology marks a strange line between the hospital and the lab.  Very few patients inquire where exactly their burst appendix went or (god forbid) how their doctor knows there was a rare form of cancer in it that needs to be treated immediately.  All that viscera, those gallbladders swollen with stones and heart valve replacements and itty bitty skin biopsies, end up in piles upon piles of formalin-filled jars and tupperware where they become my problem.

The training process for this is long, lest we miss the cancer in an otherwise benign organ, lest we lose something because our ill-trained eye deemed it unimportant and dumped it down the drain.  The bane of those more well trained than me, were placentas — complex, bloody messes that come at random whenever someone new enters the mortal plane.  45 minutes for each organ if you’re not a prodigy, sometimes more if it’s big.  I was looking forward to my moment.  To have a real handful of an organ to pick my way through.  I got it back in August, like a late birthday gift.

The placentas come in plastic take out containers, covered in formalin like an afterthought so the surfaces of the tissue turns brown and grey, but the inside stays bloody.  Take it out, weather the chill of the formalin when it bites your skin through your gloves as you try to worm your fingers underneath the slick lobes of flesh without getting any on your lab coat or skin.  You’re fumbling blind, the formalin is opaque and red, and when you finally pull it out it droops like a jellyfish.  Arrange it on your cutting board, membranes and umbilical cord askew, and try to pull it flat so you can see the whole of the disk, still red where the rubbering effects of the formalin never touched it.  The coppery tinge of blood overwhelms the ventilation, you can smell it through your mask.

Your boss rubs the membranes between her fingers to show you how they come apart in two layers — one for mom and one for baby — and how to use forceps and scissors to cut a strip and roll it.  The roll crunches as the membranes give way beneath your scalpel, the snap of a rubber band releasing an unneat spiral to spatula into a sample cassette.  Slice away the rest of the membranes so the shape and size of the disc is clear.  

The requisition tells you the child was premature.  You measure the umbilical cord and cut it off at the base, where old blood oozes up from the veins and pools on the fetal surface.  Lay the cord out and cut it twice more, and confirm the three little vessels staring back at you from the cross section with a wonky smile.

Flip the disk to the maternal surface, meaty condyles in grey-brown to pink.  Slice the surface in quarter inch sections, your unpracticed hand sliding so that not all the sections are even.  Blood clings, then dries and cracks on your fingertips and the handle of your scalpel, leaching the warmth from your hands.  You leaf through the sections, blood vessels on the fetal surface popping through in white smears.  Purple-red and spongy.  Your boss tells you it’s texture is “beefy” — you can call it that if you want, but people complain when we compare food and human viscera.  In the other room, someone uses the dictation shortcut “taco”.

Your hands are numb by the time you replace it in the container.  It sinks and disappears beneath the little red lake of formalin.  A thick coat of blood crackles on your gloves.  The blue cutting board is stained a dark violet.  When you strip your gloves, all the blood goes with them, but you still scrub your hands like you’re trying to remove the stains.  This will be your only contact with the child that organ heralds.  They will never know you, and you will do another tomorrow.  And tomorrow.  And tomorrow.