An autopsy is a postmortem procedure done by pathologists, who attempt to determine the cause of death, trace the extent of known diseases and conditions, and confirm medical diagnoses.
In the early years of Mayo Clinic, according to Louis B. Wilson, M.D., “the checking of clinical diagnoses and operative procedures at autopsy of patients that died had been as extensive at Rochester as in most hospitals elsewhere,” with autopsies performed on about a quarter of deceased patients in 1904. Stimulated by the quest for knowledge, “though it was with difficulty I induced those persons particularly interested in securing – or blocking – consent for postmortems to keep out of the picture,” Dr. Wilson claimed to have performed postmortem examinations on 70% of the patients who died under Mayo Clinic’s care in 1905.
Belgian physician Pierre Depage, M.B., a Mayo Foundation fellow from 1922 to 1924, recalled how autopsy results were routinely discussed at staff meetings:
"Every Wednesday evening, before the members of the permanent 'staff', cases of death for the week are reviewed. A resume of the clinical history, the preoperative diagnosis, the operation and the autopsy findings are projected on a screen. The clinician gives the case as he has seen it at consultation; the surgeon gives his motives for intervention, taking account of what happened afterwards; then the anatomist, supported by his sections, explains the result of the autopsy, and his frankness spares neither the errors of technique nor the errors of judgment."
Despite the invaluable information autopsies provided in improving knowledge of pathology, it became increasingly important in the 20th century to maintain a sense of dignity and respect for the deceased and their relatives, leading to the implementation of a strict policy of obtaining consent from family members. The policy, written circa 1924, made it clear that Mayo Clinic had moral and legal obligations to uphold.
In May 2016, the Office of Decedent Affairs opened. Offering 24/7 assistance for autopsies, organ and tissue donation, death certificates, and other elements of end-of-life and postmortem care at Mayo Clinic, the office strives to provide compassionate and knowledgeable support to patients, families, and staff.
At present, the Department of Laboratory Medicine and Pathology’s Autopsy Laboratory performs over 900 autopsies per year, with 1,084 cases in 2022.
Photographs: At left is Louis B. Wilson, 1909. At right is Pierre Depage, undated.
This style of bone saw is known as a Satterlee saw. During the US Civil War, surgeon Richard Satterlee was commander of New York City’s Medical Purveyor’s Office, which distributed medical instruments – including bone saws for surgical amputations – to the Union Army. Many of the instruments were manufactured by George Tiemann & Co. After the war, Tiemann & Co. began selling a bone saw featuring a pistol-grip handle, designed by Edward Pfarre; by the late 1870s, this design was being marketed as “Satterlee’s saw”. Although motorized bone saws are now popular in autopsy and surgical settings, Satterlee saws continue to be issued by the US military to surgical teams in combat zones facing a potential loss of electrical power.
Wax model, after 1935
This farm accident wax model was once one of the most visited objects in the Mayo Medical Museum (1935-1983). Decades after the Museum closed, visitors to the Plummer 3 Historical Suite still ask staff about “the model with the pitchfork.”
Autopsy record of a pitchfork case, 1910
Clipping, Olmsted County Democrat, August 12, 1910
Though it does not have a patient number, it was thought to have been identified by an August 1910 article that appeared in multiple Minnesota newspapers. However, 1910 predates the documented creation of the first Mayo wax models in 1925 by dental surgery resident, Kenji Hiyama. It is possible that the pitchfork model was made using earlier photographs of the accident, or perhaps another accident of the same nature occurred later when clinic artists were available to depict it in wax.
These excerpts are from a document found in the papers of Harry J. Harwick (1887-1978). Mr. Harwick joined Mayo Clinic as a bookkeeper in 1908 and was appointed business manager in 1918. He was instrumental in developing the Mayo Foundation and served as chair from 1939 to 1953. Mr. Harwick also served as executive officer of the Board of Governors from 1933 until his retirement in 1952.
In this document, staff were instructed to obtain consent from family members before performing an autopsy. This was not simply an ethical issue, but a legal one, as anyone who performed an unauthorized autopsy would be “guilty of a gross misdemeanor and punishable by imprisonment for not more than one year or by a fine of not more than $1000.00 and…likewise liable for damages in a civil action.”
Casual postmortem examinations of surgical patients’ bodies were strictly forbidden: “The fact that an operation has been performed and that you can make a partial examination through the incision does not justify you in doing so without consent.” Staff were strongly reminded that both individuals and Mayo Clinic itself could be held liable for any “unnecessary mutilation” carried out on the premises.
Dr. Donald R. Cahill performs an autopsy as medical students observe the procedure, 1986.
Dr. Cahill was appointed head of the Section of Anatomy at Mayo Clinic in 1984 and became professor of anatomy at Mayo Clinic College of Medicine in 1985 where he received two Outstanding Faculty Recognition Awards. He also instituted the Convocation of Thanks, a closure ceremony for families of donors to the Anatomy Donor Program at Mayo Clinic.
The Ohaus Dial-O-Gram balance was introduced in 1957. The Ohaus company was founded in New Jersey in 1907 by German immigrant Karl Ohaus and his son, Gustav, and specializes in producing scales and balances for diverse applications in the medical, laboratory, education, jewelry, and industrial sectors. In an anatomic pathology setting, balances and scales are used to weigh organs and tissue.
This exhibit was designed and curated by the staff of The W. Bruce Fye Center for the History of Medicine and the History of Medicine Library. All images and artifacts are from the Fye Center or Library unless otherwise stated.
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