Surgeons Can Do Autopsies If They Want

Much to the apparent discomfort of screenwriters, modern medicine is a team sport. Writers naturally want their protagonists to perform all of the interesting medical work that week's cases will allow, but this understandable desire flies in the face of a reality in which a dozen different specialists may divide the tasks necessary to care for a patient. The same doctors will not likely care for a pregnant patient and her unstable newborn; surgeons are rarely seen in the Emergency Department unless called (and sometimes, as many a cynical ED doctor has been known to remark, not even then). The bottom line is that board certification in a specialty takes many years of work, meaning that the overwhelming majority of doctors have one, or rarely two, specialties. And in the large, modern medical centers where television dramas are typically set, specialists are expected to be consulted in the matters in which their expertise lies.

As a side note, the principle of specialization goes back to ancient Greece. The Hippocratic Oath forbids doctors from practicing surgery (or, more specifically, removing bladder, kidney and gall stones, the only real surgery that existed at the time), telling them to withdraw in favor of surgeons.

It's worth noting the title of the page can often be Truth in Television; surgeons and family practitioners may indeed be called upon to perform autopsies in smaller communities, especially on patients who died of natural causes, accident, or suicide. In many smaller jurisdictions there is no full-time forensic pathologist: suspicious cases may be sent to the big city (or even out of country - the Ontario medical examiner's office earns a lot of money performing autopsies for Caribbean police forces), but the drunk who wraps his car around a tree might instead be autopsied by the local general practitioner.

A subtrope of Economy Cast. Related to Composite Character, Omnidisciplinary Scientist, and New Powers as the Plot Demands. When this trope is taken to ludicrous extremes, it becomes Open Heart Dentistry.

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Examples:

Comic Books

• Justice Society of America: Doctor Mid-Nite is frequently portrayed as being the only actual physician in the DC superhero community, and as such he did everything from fix broken limbs to doing the autopsy on Sue Dibny in Identity Crisis (2004).
• The Mighty Thor: Because Thor has Dr. Donald Blake as his alternate identity (sometimes), Blake is called in to do all sorts of medical things, including rebuilding Iron Man's mind and being the general physician for Broxton.

Film — Live-Action

• In Primal, Dr. Ellen Taylor is a neurologist who has to treat Morales who has been bitten by a bushmaster, which is properly a job for an emergency physician or a toxicologist. Justified as she is the only person on the ship with any medical training. It is also obvious that she has very little idea how to treat an exotic snakebite and has to ask the Great White Hunter for advice.
• In Romasanta: The Werewolf Hunt, Professor Phillips is an alienist who is brought in to consult on the Serial Killer who conducts an autopsy on one of the victims. Justified as the film is set in 1851 when medicine was less specialized than it is now, and Professor Phillips is an expert in criminal insanity and so probably has a lot of experience with dead bodies.
• In The Film of the Book of Twilight (2005), Carlisle examines the body of Waylon after he is found in his boat. Justified from the audience's perspective, since we know he is old enough to have studied many branches of medicine, but the locals shouldn't know that.

Literature

• In Death Star, conscripted surgeon Uli Divini is called on to perform routine checkups. He's not happy about it (he's a surgeon, not an internal meds doctor!), but he's fully capable.
• Inverted repeatedly in The Dresden Files: Waldo Butters, Harry's go-to person for medical emergencies, is a coroner who in multiple books explicitly points out that he isn't properly trained or equipped for this and the patient in question would really be better off in a proper hospital. (He does have an MD, but is somewhat out of practice with living patients and lacks any specialist emergency medicine training, and his workplace isn't really equipped to deal with people who aren't quite dead yet.) He'll grudgingly accept when this isn't practical for reasons of secrecy or on account of a wizard patient's Walking Techbane status, and he actually ends up doing pretty good work in spite of his protests, but happy about it he's not.
• Pocket in the Sea:
  • Jensen does autopsies and even dentistry. This is justified by the fact that he's the CMO on a Submarine of 80 men — he has to be able to do it all.
  • Later in the book he appears to take over as a recovery nurse as well. However, he's shown to be overprotective of the men he views as 'his' so he may have pushed the actual recovery nurse out of the picture.
• This is used in an autopsy scene in Twig, with the head of the dissection team identified as a "surgeon" and Lillian, the team medic, providing commentary and speculation much to the surgeon's annoyance.

Live-Action TV

• Babylon 5: Dr. Franklin was hired specifically because he's good at nearly everything instead of having a narrow specialty, and he's stated to have a large support staff and do a lot of delegating. This gets Deconstructed eventually when it's shown that he takes on more than his fair share of the workload, and it leads to him becoming addicted to stims.
• Justified in Battlestar Galactica (2003): Doc Cottle is perhaps the last doctor in the universe until we learn there's also a neurologist in the fleet late in Season 4.
• In Body of Proof, a neurosurgeon becomes a pathologist practically overnight.
• In one of the best episodes of Buffy the Vampire Slayer, the title character's mother dies at home and is brought to the hospital for an autopsy. The doctor who comes to tell Buffy about it is the neurosurgeon who performed her mother's brain surgery a few weeks earlier. It's just about possible he was called in for his opinion, since she died of a brain haemorrhage, maybe?
• Justified when it appears in Code Black — the overwhelmed, understaffed emergency department frequently doesn't have any specialists available, particularly in the middle of the titular scenario, when the hospital's resources are overwhelmed by the sheer number of people who need help. As such, Dr. Leanne Rorish and her colleagues will hand off to specialists whenever they can, but when they can't, Rorish will either do it herself, hand it off to someone who is available and more qualified than her to do it (usually Ethan Willis, an Army trauma surgeon who works in the ER instead of as a surgeon), or improvise something that will keep the patient alive long enough for a specialist to get to them. The show also portrays this trope in a realistic manner when brought into play — namely, having the offending doctor be read the riot act by the higher-ups for doing something outside their specialty.
• Crossing Jordan:
  • Inverted when coroner Doctor Macy is almost forced into performing a sick surgical procedure on a captive boy by a psycho, despite vehemently claiming he can't do it, at least not well.
  • Played straight in another episode when two of the coroners had to fix a punctured lung in the autopsy room on a teenage girl. Justified as there was a massive riot going on in Boston at the time, and even if the ambulance crew was able to get to the ME office it would be far too late.
• CSI:
  • Inverted when ME Doc Robbins and Nick find a pregnant teen very soon after she hung herself in her closet. Doc realizes her almost full-term baby is alive and kicking, so he performs an emergency C-section with Nick assisting a bit. Back at the Lab, he tells Nick it was nice to help the living for a change.
  • Averted with CSI level 1, Dr. Langston, who sometimes helps Doc Robbins in autopsy. He was a pathologist before changing careers.
• Averted in CSI: NY. Sheldon Hawkes was a doctor/surgeon, but later became a trained pathologist, making him qualified to do autopsies. (Although after his departure to the field, Sid Hammerback handled them...except for the one Sheldon did the day Sid skipped out of work while selling his pillow patent, and those on the day Sid was hospitalized due to exposure to radiation.)
• Dempsey and Makepeace: A variation. In “Judgement” due to Sir Lionel Hardcastle’s interference meaning that an official autopsy can’t be carried out on Sarah Hardcastle but due to their investigation hitting a brick wall, Dempsey resorts to the audacious plan of them smuggling a heroin-addicted surgeon whom they busted a few weeks back who is out on bail into the morgue to perform the autopsy, then breaking into a university to carry out his tests. Whilst Makepeace is rightfully sceptical, the plan ends up succeeding in discovering the key evidence needed to find the murderer.
• The titular Dr. Quinn, Medicine Woman. Justified by her (a) being a doctor in an era in which doctors practiced all forms of medicine, and (b) being a rural country doctor where she was the only physician around for miles.
• Elementary has former surgeon Joan Watson performing autopsies from time to time. First time, it was because Sherlock Holmes attempted an autopsy, was going about it the wrong way, and Joan's exasperation got the better of her and she stepped in. In the later cases, she's performing them of her own accord.
• Both averted and played straight on Emergency!. Brackett and Early were both Fellows of the American College of Surgeons [(FACS)] yet spent a lot of their time treating emergencies in the E.R.. However, there were occasions where specialists were called in. A neurologist was called for one episode involving a head injury. Early was a cardiologist and sometimes was called in on cardiac cases. May have been partly justified as Rampart was a public community hospital and may not have had as many available resources as private hospitals might.
• Empty Nest's Harry Weston spent the first few seasons of the show as a pediatrician before abruptly switching to adult medicine.
• ER of all shows fell victim to this. One of its signature episodes, "Love's Labor Lost" had ER residents Mark and Susan grossly mishandling a routine delivery (possibly deconstructing this trope, as it's possible that the very reason they screwed up was because they didn't have the necessary ob/gyn experience). This gets a callback when surgeon Benton panics when a woman goes into labor, "I haven't delivered a baby since medical school!" But even though many surgeons sub-specialize, he and fellow surgeon Elizabeth are seen doing things that range from cardiac surgery to abdominal, to neurosurgery, etc. Additionally, ER chief Kerry had OB/GYN nurse Abby abruptly reassigned to the ER. Aside from the fact that Kerry would have no authority whatsoever to do this, even if this were something Abby wanted—she vehemently objected before being told she had no choice—an OB nurse would have been out of her element in the ER. This is especially glaring in light of the fact that during the show's early years, a major storyline involved the ER nurses being sent to departments that they weren't trained for.
• Firefly: Simon Tam trained to be a trauma surgeon. However, in an early episode, he makes it clear he's used to handling dead bodies and in a later episode states he can perform autopsies though the "corpse" in that episode turns out to be still alive. As the only medically trained professional on Serenity, he has to perform ad hoc medicine by circumstance which gave the writers an excuse to give him any medical skills the plot demanded. Somewhat justified in that he's "Gifted" and can thus be expected to pick up things quickly, especially in medical skills.
• This has been mostly averted on General Hospital, where the doctors' specialties have been specified—cardiology, internal medicine, pediatrics, neurosurgery—and stuck with. That said, there have still been some slip-ups—the legendary Steve Hardy was seen practicing various types of medicine, and despite the fact that most nurses specialize as well, they too are seen doing various things as well.
• In The Glades, Carlos is always at pains to point out that he is the chief medical examiner for the FDLE. However, this does not stop him being posted to a hospital to perform emergency medicine during a hurricane in "A Perfect Storm".
• Gotham: Dr Leslie Thompkins is first seen as a physician at Arkham Asylum. A few weeks afterwards, she takes up the post of medical examiner. Two very different specialties are involved here.
• Numerous episodes of Grey's Anatomy have general surgeons sent to work shifts in "the Pit" [the ED], although they occasionally call in specialists for help. Very slightly justified by these being interns who allegedly mostly do diagnostics and sutures, but still... Grey's plays this trope so straight that you often wonder if there are non-surgeon doctors in that hospital. To the point where the Chief of Surgery is the boss of the entire hospital and the board only deals with problems relating to the surgical department. Seattle Grace Mercy West Grey Sloan Memorial has also never had an ER doctor or an internal medicine specialist on staff since surgeons do all that work. One might wonder how small the hospital really is since it seems to have only one attending per specialty and each doctor only deals with one patient at a time, often for several days.
• Hannibal may have the strangest, as CSIs who are stated to specialize in latent fingerprints and fiber analysis respectively have not only been seen performing autopsies, but also tracing cell phone calls. They do it all!
• Handled realistically with Dr. Grace Molyneux in Harrow. Grace is a neurosurgeon making a career change to being a pathologist. She is retraining under Dr. Harrow's supervision and is not permitted to perform postmortems on her own.
• House:
  • In many episodes, the protagonists (non-surgeons all) are shown performing invasive surgical procedures (for example, a brain biopsy). They also all seem to be radiologists, phlebotomists and lab techs. (While all of these things might be done by ordinary doctors in Real Life occasionally, that's only when there's no specialist available. There's rarely any reason that would be the case on House.) On at least one occasion in season six, Foreman did an autopsy as well. In the later seasons, Chase sticks to surgery and Cameron sticks to the ER...which is still problematic, actually: Chase performs a ridiculously wide variety of surgeries, and Cameron's specialty is immunology, not emergency medicine. Even the line between medicine and psychology is not safe. In the episode "One Day, One Room" House asks members of his team for advice on how to deal with a rape victim. Instead of, you know, asking an actual therapist about that.
  • Averted in one episode when a disease is striking newborns. The couple calls the obstetrician who delivered the baby to come look; he informs them that he'll do it this time, but next time they need to call the pediatrician, as an obstetrician specializes in pregnancy and delivery. Some obstetricians also practice pediatrics, but most obstetricians who have a second specialty also practice gynecology (for reasons which should be obvious).
• In the Heat of the Night: The local doctor was frequently seen practicing all types of medicine—in the midst of performing an autopsy on a woman, he mentions having delivered her two children and having been the family doctor. Though this might be justified as (a) given the doctor's age, he probably became a doctor in an era where doctors did practice all types of medicine, and (b) Sparta is a small town unlikely to be teeming with medical specialists.
• Justified in M*A*S*H. They try to call in experts whenever possible, but that obviously doesn't always work, what with being located within spitting distance of the Korean front. This leads to surgeons doubling as vets, psychiatrists performing surgery, priests performing tracheotomies, and once the non-medical population of the unit muddling their way through nursing duties when the women were evacuated.
  • In one instance when the hospital is short on surgeons, psychiatrist Sidney Freedman happens to be on base and is called into the operating room. As he points out, "The last surgery I performed was lancing a boil on my kid's tuchus."
  • Lampshaded in one episode:
  Hawkeye: Can we get a neurosurgeon from the 8063rd?
  Col. Potter: No chance.
  Hawkeye: He needs a laminectomy.
  Col. Potter: You've just changed specialties.
  Hawkeye: You always give me the cuties.
  Col. Potter: Well, I sure as hell ain't gonna give this one to Alice.^note Referring to fellow surgeon Frank Burns, who had earlier been grabbed by a soldier mistaking him for his girlfriend
• Copiously and notably averted in Miami Medical. All of the lead characters but the nurse are trauma surgeons — and just trauma surgeons, who hand over their patients to the required specialists as necessary. When they need to reduce cranial swelling, they call in a neurosurgeon. When a character gets stabbed in the heart, they call in a cardiology surgeon. And when a foot needs to be reattached, they call in a vascular surgeon. One plotline actually involves an attending specialist stealing a patient from the new resident. Moreover, one such specialist is actually dually qualified in both cardio surgery and vascular surgery^note not as much of a stretch as it seems, as the two specialties are very closely related:
  Dr Proctor: No one's 'both'. Not any more.
  Dr Sable: Cal-Berkeley and UPenn may disagree.
• At one point on NCIS, the Forensic Examiner, Ducky, does surgery...on a dog. In this case the dog's life hung in the balance and wouldn't have survived if they'd taken the time to find an actual vet, and the dog ended up solving the mystery for them. Also, Ducky assisted his assistant Jimmy Palmer, who did spend time working in a vet and knew the basic principles of dog surgery. Ducky had also been a surgeon earlier in his career.
• On Providence, Dr. Sydney Hansen leaves her lucrative practice as a plastic surgeon in Los Angeles to return home and begins working with her friend in a family practice clinic. She also handles another friend's OCD (psychiatry), her sister's boyfriend's impotency (urology), and her sister-in-law's infertility and OB/GYN care (fertility specialist/OB/GYN).
• A favorite Soap Opera trope, where doctors are seen to be doing just about everything. An especially bad example on One Life to Live, where throughout his time on the show, Dr. Larry Wolek was seen practicing as as an internist, a cardiologist, an ob/gyn, a pediatrician, a neonatologist, an oncologist, and yes, a coroner.
• Scrubs tends to have a good track record with this one. As the series progresses, the characters all choose their specializations and then tend to stick to them. This is especially true for the surgery/medical split. It's made quite clear that J.D., Elliot, and Cox couldn't perform surgery if their lives depended on it and Turk (as shown in one episode where he is temporarily turfed to medical as a resident after breaking his wrist) has (comparatively) very little knowledge of medical conditions and procedures.
  • Not only that, but the one time we DO see a character switch specialties, it's Doug Murphy, a known patient-killer who switches over to morgue work because he has killed so many patients in so many ways that he can instantly determine how other doctors screwed up from personal experience
• Most doctors on the various incarnations of Star Trek have this going on. You'd think the position of Chief Medical Officer on a massive, multispecies starship would be a largely administrative job that mostly involved delegating tasks to various specialists. Instead, CMOs in Starfleet usually seem to personally handle every possible medical complaint, from critical surgeries on members of obscure species right down to minor injuries, stress headaches and childbirths.
  • It's justified, however, in the case of the Emergency Medical Hologram from Voyager; he's only used when there's no other medical staff available, and as an artificial intelligence, he is stated to be programmed with all the Federation's medical knowledge. Also, Voyager is a pretty small ship by Starfleet standards, with a crew complement of just a hundred and fifty even before the whole "trapped in the Delta Quadrant" incident, so it's not unreasonable that they'd only have one doctor and a couple of nurses. Notably, when Tom Paris ends up being drafted in as a substitute nurse it's at least given an off-hand mention that he's going through the appropriate training classes in accordance with Starfleet regulations.
  • It might also be considered justified for Bashir from DS9, who was genetically engineered to be super-intelligent, although it's not clear whether he's that smart. On the other hand, the fact that he's genetically engineered is supposed to be a closely kept secret...
  • A reason for that behavior might be that the Chief Medical Officer is the most experienced or the most trained member of the team. Being the CMO might mean being on-call 24/7, even with other specialists to handle diseases and minor issues. Plus, in the original Star Trek McCoy was one of two named doctors and several nurses - perhaps the chief medical officer is the doctor in charge over lab techs, interns, residents, nurses, and other medical staff.
  • ALL the Star Trek series have a lengthy entry under The Main Characters Do Everything, but it's especially bad with the doctors: there is the chief medical officer and (in three out of five series) the nurse. Others are occasionally said to exist, or even be a once-seen guest star in a show that goes on years, but in practice, the overwhelming majority of the time, a Star Trek setting will appear to have a medical staff of two. From any and all injuries to mysterious never-before-seen illnesses that threaten to kill the whole ship to figuring out how to undo possession/brainwashing, to, yes, autopsies, one person does it all and maybe has one other to hand them tools. Surgeons can do autopsies if they want, and then turn around and whip up the Magic Antidote to The Plague. Some Extended Universe novels occasionally avert this by saying that there are crew members with first aid or EMT certification that the CMO has the authority to call on for extra assistance in situations where he/she needs more pairs of hands.
• Scully from The X-Files. Ironically, her specialty is autopsy, but she does a lot of other medical areas when the plot demands it.

Tabletop Games

• Specifically mentioned in one of the Deadlands supplements. Trained pathologists are few and far between in the Weird West and the Posse may need to rely on whatever the local Frontier Doctor can tell them about cause of death.

Video Games

• An adaptation of Murder on the Orient Express has an interesting variant — Veterinarians Can Do Autopsies if they want. However, this is justified - Dr Konstantine originally trained to become a doctor of humans, but then his family went into hard financial straits. The only way he could finish his training and paying off the debts was by becoming a vet. Note, however, that since he was originally trained to treat humans that his autopsy is still valid.
• As you might expect from a game called Theme Hospital, your doctors can do everything. Although there is some lip service to the specialists as they will need to learn titles (such as surgeon) but it only takes ~10mins in a classroom to gain these.
• Trauma Center (Atlus): Subverted in New Blood. When the heroes have to do a surgery on a dog, they have no idea how to do it, and all they can do is incredibly basic stuff, as none of them were trained in veterinary medicine.

Visual Novels

• Danganronpa 2: Goodbye Despair: As the only person on Jabberwock Island with any medical training, Ultimate Nurse Mikan Tsumiki is often called upon to do autopsies to the best of her ability. In chapter 3 she turns out to be the killer, and takes advantage of her medical knowledge to fudge the time of death in a double-murder.
• Averted in Umineko: When They Cry when doctor Nanjo says that he isn't trained in doing autopsies and is only able to state basic things about the murder victims.

Western Animation

• Dr. Hartman in Family Guy is not only a family doctor, he does sex change operations, leg transplants, and plastic surgery among other things.
• The Simpsons:
  • Dr. Julius Hibbert is an example of this. Over the show's 30-plus-year history, he has been portrayed as a general practitioner, hospitalist, cardiologist, orthopedic surgeon, neurosurgeon, OB-GYN, pediatrician, radiologist, anesthesiologist, and psychiatrist, amongst other specialties, as well as being proprietor of the local HMO.
  • Dr. Nick Riviera also fits this trope, although since he is supposed to be a Quack Doctor, showing him performing procedures that he is severely unqualified for is usually intentionally Played for Laughs.

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