When you go into the hospital, you probably don’t expect that your tumor, gangrened leg or, God forbid, dead body will wind up on Instagram. But thanks to one local hospital’s pathology assistant, who moonlights at Drexel University as a teacher, it could happen. South Jersey’s Nicole Angemi routinely shares pathology and autopsy photos with her 350,000-plus followers on Instagram (she swears none of them are her patients), so we reached out to her to find out how a mother of three wound up with such a gruesome hobby. As a condition of the interview, we agreed not to reveal the hospital where she is employed.
See below the interview for a gallery of some of the photos she has shared.
How did a nice girl from Glendora wind up working with dead bodies and amputated limbs?
When I was 19, I was just a punk rock kid. I had no direction in my life. I had a 4-year-old kid, and I was delivering pizza and working at a scrapbook store and my mom was like, What are you doing with your life? You have a kid! So I decided to enroll in Camden County College to be a nurse.
Why a nurse?
All my cousins are nurses. That was just the thing that the girls do. Because I dropped out of high school when I was 16, I had to take basic stuff, including biology. I instantly fell in love, looking at cells under the microscope. I asked my teacher, who happened to work in the medical lab at Kennedy, if there was some kind of job where I could do this kind of stuff instead of being a nurse. I’m not a nurturing kind of girl that wants to take care of people like nurses do.
My teacher introduced me to the world of the laboratory, and I was interested right away. I knew I was going into the med lab. So I took a bunch of classes to get into Jefferson, which is where I got my undergrad degree, and that’s where I got my first job, looking at cells under a microscope.
So how do you get from that to what you’re doing today?
I had no idea that all this autopsy stuff was out there. Then one day in 2001, I’m working at the hospital, and it smelled really bad. Everybody was freaking out. I asked what the smell was, and someone told me that the fridge in pathology was leaking and that the legs were leaking everywhere.
I said, “What do you mean the legs are leaking?” And they told me that the gangrened legs of amputees were in a refrigerator and that the refrigerator was leaking. I couldn’t wrap my brain around what they were talking about. I wanted them to show me, so somebody walked me into pathology.
And you saw what?
It’s a fridge like you would see at a pizza place that would have Pepsi in it. It’s filled with red trash bags with people’s legs inside. I was like, Oh my God, this is the craziest thing I’ve ever seen. I didn’t care about the smell anymore. I was so fascinated.
I made friends with the residents and doctors over there, and they would come to me and say, “Nicole, look at this cool thing we got.” Even if it’s a crappy little thing like an appendix. I was interested in every little thing.
And finally, there was an opening, and I talked to the director and asked if I could quit my job and go work in pathology. “You wanna quit your job and go cut open colons full of poop and stuff?” Yeah. A lot of people don’t want to do my job. It’s gross.
And what is it exactly that you do now in your current job?
There are two different things we do basically in the hospital. First, we get specimens from surgeries and specimens from things that aren’t surgeries, like colonoscopies. So if you have a colonoscopy and they find a polyp or suspicious tumor, we get that. If a mom has a baby, we get the placenta. If you have colon cancer, we get the colon they take out. If you have breast cancer, we get your breast.
So basically, they’re sending you body parts and tumors all day.
Well, we also get really crazy stuff, like the foreign bodies removed from people’s butts. Anything taken out of a patient, we get it. Kid swallows a quarter, it comes to us. Dog bites kid and tooth gets stuck in kid, we get the tooth. We document all of this.
And why is this important?
What we’re doing is really cool. With breast cancer, we measure the tumor and let the oncologist know the stage. We’re the ones that decide that, and the difference between 1.5 centimeters and 2 centimeters is the difference between no chemo and chemo, and possibly the difference between life and death.
And the other part of the job that I wanted to tell you about is autopsies. They’re not as common as back in the day, because we have so much diagnostic testing when people are alive that we usually know why they’ve died. But when a patient in the hospital dies and the family wants an autopsy, we do the autopsy. We determine the cause of death, we take out the organs and slice them up.
Do you have empathy for the people whose illness or death result in the specimens or bodies that you receive?
I do for a second, and I kind of move on. Yesterday, I did a specimen on a case of — I don’t know if I want to say this… I don’t want to do a HIPAA violation. I’ll put it like this. I did a specimen on a case of a baby that died. I’m very sensitive to mothers who lose their babies. I’m a mom. That will always get to me.
All I think about is a mom in the hospital I am in who is leaving without her baby. And then I stop and try not to let my mind go there. I could make myself crazy. If I sat there and thought about all this stuff, I would be in a fetal position crying all day. Instead, I need to get it together and get mom some answers.
But why post photos of specimens and body parts and corpses on Instagram?
I want to bring awareness to what else happens behind the scenes. Everybody knows what breast cancer is and that women get their boobs cut off, but nobody really thinks about it. I like talking about that kind of stuff.
Your Instagram stream is pretty gross. Is there anything that grosses you out?
Yes. Stomach contents. When you open the colon, it’s poop, and you know it’s poop. It’s fine. But when you open the stomach, stomach contents are basically throw up. It has that look and that smell. I could look at poop all day long, but stomach contents, no.
And the other day I had a specimen with a lot of really gross pus inside of it. It stunk so bad. Sometimes, things sock me in the face unexpectedly. I have a ventilation hood that sucks everything up, but sometimes I have gloves on and I answer the phone and forget to take off the gloves, and it smells so bad. I just try to kind of hold my breath a lot.
Are there lines you won’t cross as far as the Instagram is concerned due to their rules?
I know a person who works closely with Instagram, and they told me that they have issues with videos of surgery, and I’ve had multiple videos deleted in the past. So I don’t post videos anymore.
Also, I try to avoid nudity. But there are a lot of cool cases of gangrene of the genitals. I can’t show them because of the penis. I did show a case the other day, a breast cancer case, but there was no nipple. I showed as much as famous people show with side boob, so it was OK. But now I have this big tumor coming out of the anus, and I want to show it but I have to respect Instagram.
That’s the stuff you don’t post because of Instagram’s boundaries, but what about your own? Is there anything you won’t post for your own moral or ethical reasons, or just as a matter of taste?
I try not to post anything that won’t have an impact or educational value to anybody. I get a lot of messages with people sending me photos from gore websites, but I’m not looking to post a picture of a person spread all over the sidewalk for no good reason. I like people to take something away from it with every picture I post.
I’m sure you’ve had a lot of people report your photos.
All the time. This is my third Instagram account. I’ve had accounts deleted, but I wasn’t actually breaking the rules. No violence. No nudity. I did get them reinstated after pleading with Instagram. They told me they don’t have measures for accounts like mine. I had the normal anatomy of a colon, and people reported that. I have haters who want to see me fail.
Is your employer OK with all of this?
They like the education aspect of it. The thing is, I would like to word this in a certain way … My job is supportive because I am not using … I am respectful of the patients. I’m not using my patient material on Instagram.
Where do you get it?
All over. Other people in the field. Archives. There are multiple places.
But you are saying that you never use photos of your patients or subjects on Instagram?
Have people complained to your employer?
Yes. There are always a couple of douchebags out there that have to be heard. They have to give their stupid opinion. But if that’s all you’ve got to complain about, then you’re an idiot.
What about mom, the woman who got you to go to college in the first place? Is she a fan?
She thinks it’s cool. She doesn’t follow me on Instagram, because she doesn’t know what that is. But she gets it. When we’re in public, people come up to me to talk about it. She likes it. She always supports me.
My mom watches Forensic Files and all those kinds of shows. My grandmother was an 80-year-old woman watching Dexter and True Blood.