Uncovering Hidden Messages — Examining the Value and Benefit of Autopsy
The patient was a young, seemingly healthy female. Until she died suddenly one day in her home. "When we did the autopsy, we uncovered that she had a heart condition that was potentially heritable, which means it could have been traveling in her family," says Joseph Maleszewski, M.D., a cardiovascular and autopsy pathologist at Mayo Clinic's Rochester campus. "And lo and behold, when we found that, we also found out that her father had been diagnosed with a heart condition that his doctors couldn't quite put their fingers on." The autopsy finding led doctors to look for and find the same condition in her father.
It's cases like this that Dr. Maleszewski says show the importance and benefit of the autopsies he and his team perform. And while a recent article in The Wall Street Journal says the number of autopsies being performed in hospitals around the country has declined (slowing "scientific advances in diseases including cancer, dementia and heart disease," along the way), Dr. Maleszewski says that's not the case here at Mayo. "We do autopsies on about 25 percent of our in-hospital deaths," he tells us. And he says they're often full of surprises. "Between 30 and 40 percent of the time, we'll find something that was not known to the treating clinical team," he says.
Autopsies, Dr. Maleszewski says, can be very beneficial not only to clinicians, but also to a patient's surviving family members. "Being able to identify diseases that are unbeknownst to the patient or more fully characterized diseases that the patients have can be useful to surviving family members," he says. It allows the family to have a more complete picture and record of what was going on with their loved one, and it can provide insight into hereditary conditions their family member may have had, so they can be tested and treated accordingly.
Dr. Maleszewski tells The Wall Street Journal that Mayo Clinic keeps its autopsy samples on file "indefinitely" for that very reason. "If the family ever comes back to us and says, 'I have this disease. Can we look for evidence in my mother or father or grandfather?' we can pull that archive and see," he tells the newspaper.
And requests like that may be increasing. Dr. Maleszewski tells us that he and his team have seen an increased interest in their work since The Wall Street Journal article came out last month. "In response to us being showcased as a center that values autopsies and does a pretty high volume of them, we've actually been reached out to by a number of patients around the country who are interested in having autopsies themselves when they die," he says. "These are folks who typically appreciate the very comprehensive nature of the care here at Mayo. Not only when they're alive, but they also appreciate the fact that when they die, that care doesn't stop. It continues." And Dr. Maleszewski says that hallmark of his team's work that also will continue on.
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