In the early hours of Saturday, May 21, staff at Zuckerberg San Francisco General Hospital began the process of moving more than 150 patients into its newest facility — a state-of-the-art building recently constructed in the heart of the campus.
News reports abounded on opening day, providing a detailed first look at the building, from the dramatic (the ER received its first ambulance at 7:04 a.m.) to the mundane (the building contains 284 hospital beds, a gain of 32 on its predecessor).
But beneath all this commotion, and outside the sweep of the public eye, another important move was taking place: the relocation of the hospital's morgue.
The day before the new building was made available to the hospital's living patients, the non-living ones — five in total — were removed from their crypts and wheeled through an underground tunnel to their new home.
For more than 50 years, SFGH's morgue was housed in an aging, unremarkable building on the property's outskirts that was erected in the 1960s. (ZSFGH's current Potrero Hill location dates back to the early 1870s; no one I spoke to was able to say for sure where the morgue had been during the first 90 years of the hospital's life.)
Used mainly for research and office space, the building is both quiet and empty. I paid a visit the week before the morgue's relocation; true to form, I got lost and spent a good 15 minutes wandering its halls without seeing another person.
I was there to interview Dr. Walter Finkbeiner. As chief of ZSFGH's department of anatomic pathology, Finkbeiner performs nearly all of the hospital's autopsies, and it was based on his expertise that the new morgue was constructed.
Also a professor at the University of California San Francisco, Finkbeiner is patient and enthusiastic in describing his work. Showing me into his office, he told me that he hoped we could keep our conversation to under an hour. Our meeting ended up running more than twice as long, as after giving me the rundown on his department — using props and books to illustrate his speech — he offered to give me a tour of the hospital's old and new morgues.
To my surprise, our tour did not initially take us down into the depths of the building. While most morgues are situated in basements, ZSFGH's old one was right down the hall from Finkbeiner's second-story office.
"It's the only one I've been in that's above ground," he said.
The entrance opened into a small room, plain and inconspicuous, until I realized that one wall consisted of airtight, floor-to-ceiling doors. Behind each was an individual crypt, which could be rolled out like a drawer. Finkbeiner strolled over to the wall and yanked one to demonstrate, revealing a relievingly empty crypt.
Then he showed me into the "autopsy suite," where autopsies and biopsies were performed. Centered around a row of steel operating tables and flanked by windows, the room was flooded with warm light, an aesthetic detail at odds with its solemn nature.
While autopsies can provide a wealth of information to both families and doctors, they can also be useful in discovering "risk factors to the public, whether infections or things in the environment that are toxic," Finkbeiner said.
The hospital's history proves it, too. SFGH was first established in the 1850s in response to a cholera outbreak; in the 1980s, autopsies performed at the hospital uncovered information that was instrumental in helping to understand the AIDS epidemic.
While ZSFGH's old morgue defied my expectations by being eerily ordinary and bright, the tunnel used by hospital staff when transporting the deceased had the opposite effect. Low-ceilinged, dank, and lit by fading fluorescent lights, the tunnel — traversed by the roughly 270 bodies that come through the morgue every year — was creepy.
Emerging by elevator into the new building, however, we were greeted by a much different vibe. At the time, the building was not not open to patients or the public, and although bustling with staff, it felt immaculate. Many of the halls we walked down on our way to the morgue — floors not yet scuffed or trodden dull — were lined with crisp hospital beds.
Whereas the old morgue, open and exposed, offered visitors no buffer against the reality and mechanics of death and disease, the new one was designed with discretion in mind.
To the left of its entrance is a viewing room, a feature that the old morgue didn't have. Although unflinching about his work, Finkbeiner is also quite thoughtful about it. He spoke of what he does as having the power to facilitate grieving.
"An autopsy can help in closure," he said.
Having long been self-conscious about people seeing their loved ones rolled out from a wall of crypts, he designed the space to give families the chance to view bodies in a private setting.
So in the new morgue, that wall has been replaced by a large, communal crypt, called the "cold room." Bodies can be rolled in and left on gurneys, eliminating the need for anyone to lift them.
While arguably safer, the setup gave me goosebumps, and not just because of its temperature — having worked in restaurants for years, I couldn't help but notice its similarity to a walk-in refrigerator, a comparison that has haunted my shifts ever since.
Then there's the new autopsy suite. Equipped with a "modern area for dissecting tissues," and a special ventilated shelf for storing specimens, the centerpiece is an L-shaped operating table, illuminated by a powerful surgical light. The table can be lifted and lowered as needed and, for additional assistance in loading bodies, a small forklift — just the right size for a human being — stands in the corner of the room.
Amid all the gleaming machinery, I felt suddenly unnerved and slightly sad. I knew that soon the space would start to collect samples of people fighting battles and, sometimes, the bodies of those who had lost them. Their families would come and sit with them, privately and undisturbed, to grieve.
Looking down at the autopsy table, I asked Finkbeiner if it has any other functions that might advance the way ZSFGH performs the procedure. He shook his head.
"The actual autopsy procedure hasn't changed much in the last 150 years," he said. "But what we can do and learn from it has."