Obesity: The Post Mortem Page #3

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the human body is an incredibly

complex machine.

To open a human being, to see all of that

absolutely perfect jigsaw of organs

perfectly in place,

it really did make me feel very awed.

When you do an autopsy on

somebody whos very slim,

the organs are there

and theyre very evident.

Its like a game of Operation or like

one of those anatomical models

that you would use at school.

In a woman this size, a lot of it is

really hidden by this extra yellow fat,

it is making it quite difficult

to see the structures,

much more difficult than it would

if she was a thinner person.

[Vinette] Before Carla removes

the heart and lungs,

Mike wants to take a look at the organs

while theyre still in the body

to see if well discover any early

indications of trauma or damage.

You can see the heart here.

Theres a large amount of fat

around the heart.

Theres more here than you

would see normally,

quite considerably more.

Underneath the heart and lungs,

in this area here,

is what you call the diaphragm,

thats a big muscle

that helps you breathe.

[Carla] Even the diaphragm seems

very fatty to me.

Even on the surface where the heart fat

and the diaphragm are meeting,

there is more fat than usual.

And actually the thing that you can

see most is an extremely enlarged liver.

This is very, very large, and its got

what we call fatty liver change.

So this is a fatty liver.

And a fatty liver is very much associated

with obesity.

You can see, theres a lot of fat

around these organs,

so what would be between my hands now

would be the kidneys.

Now the kidneys always have

fat around them.

I think its important while we are

talking about the fat to realise

fat is a normal thing.

Everybody has fat in them. However

thin you are, there will be some fat

and fat has got very, very important roles

and one of those roles

is to protect things.

Its the too much fat that is the problem.

Fat is made up of cells called adipocytes,

which are fat cells,

and really for a long, long time

until very recently, people thought that

fat was just an inert substance

that just sort of sat there and

didnt really do anything,

but its becoming increasingly

understood now

that fat is actually a very

active substance.

Fat cells work almost like

an endocrine organ.

People will have heard

of some endocrine organs,

things like the thyroid gland

which is related to how much

energy you have, how cold you are

and so forth, the ovaries,

the testes, so obviously these hormones

related to the ovaries

and the testes define

whether you are going to be a man

or going to be a woman,

so those are the sorts of

activities hormones

have so they are very, very

powerful things.

Now it has become obvious

that the adipocytes, the fat cells,

do play an endocrine-type role

and so have some very powerful effects

that were previously unknown.

[Vinette] Exactly how fat works

and what it does is still far

from completely understood.

But the day-to-day reality of obesity

can be devastating.

I wish I hadnt left it till so late

to start trying to lose weight.

Its not good on your back,

its not good on your knees.

God knows what it is doing inside.

I thought, "All right, okay, Im 30,

lets try to start thinking about

trying to have a baby,"

but with the size that I am, you wont

even get any help with sort of IVF

and things like that because the answer is

you are too big.

I have always felt insecure thinking that

I would perhaps never find love

because I am fat.

Even if it is practical things such as

travelling, going to a fun fair

or going to a theme park and knowing

I have to sit in a seat that is tiny,

things like that and there are so

many things... My wedding day,

preparing for that, preparing my body

for that as to how it would

look in photos, and even social media,

in fact my whole life is surrounded by it.

I have got sleep apnoea because

of my weight

and what that means is when I lie down

to go to sleep at night,

the extra weight on my neck and on my face

actually compresses my airways

so that it stops me breathing properly

and therefore wakes me up.

It was waking me up about every

two minutes throughout the night.

So I wear a machine and it is essentially

a small air pump.

It just keeps pressured air going

into my airways through the night,

so I dont wake myself up so my sleep

is a lot better.

Very glad to have the machine,

but I would have been much gladder

to have not needed it at all.

When I first properly started

thinking of myself as overweight

was when I started looking

at wedding dresses.

It is meant to be a really, really

happy time

and I just felt uncomfortable

and just ugly and disgusting and

I didnt want to be there.

The woman said that they were going

to have to order me a size 20

and I thought it was going to

be like a size 16

and I was just absolutely out of my mind.

I had no idea I had got that big.

It was really, really awful.

I think I cried most of that night.

I was angry at myself to have got so big

and not have noticed. I just felt stupid.

[Vinette] The next stage

of the post-mortem

is the dissection of the heart and lungs.

For Mike to be able to do this,

Carla needs to remove the

cardio-respiratory block from the body.

I'm cutting through the diaphragm here

just to make sure that Ive freed

the lungs completely.

Free them along the spine here.

Im going to do the exact same thing

on the other side.

And then chop across the oesophagus

and the trachea here

and then all I need to do is basically

pull the organs towards me

at the same time as releasing

these sort of

white fibrous tissues that are holding

the organs to the spine,

and then well get to a point

where this block, the cardio-respiratory

block, is completely free.

And then we can take this out as one block

and weve got the heart and the lungs

and the heart sack, the pericardium.

When you initially carry out a post-mortem

and you hold an organ such as the heart

in your hands,

and the heart is very symbolic,

you know, we use it in all sorts of logos.

It has a sort of power

and a sort of agency

that makes you kind of stop and think.

Because it looks so mundane,

but then you realise that within it has

the electrical impulses to keep

a person alive.

[Vinette] With the cardio-respiratory

block removed from our donors body,

Mike can start his dissection

of her lungs.

Will we uncover any evidence of damage

linked to her obesity?

I am going to detach the lungs

from the heart,

so well start off with the right lung,

so just cutting through

where the lung is attached,

and thats the right lung detached.

This is the left lung

Im detaching there.

Im just going to make some cuts

across the lung

just to see what the surface

of the lung looks like.

These lungs actually look quite healthy,

theres no tumours or masses or anything

like that in these lungs.

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