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Transcript by the Center for Medical Progress
7 April 2015
Savita Ginde, MD, Vice President and Medical Director, Planned Parenthood of the Rocky Mountains
J.R. Johnstone, Clinical Research Coordinator, PPRM
Jess, Medical Assistant, PPRM
Two buyers and a nurse
Ginde: Intact. So we do basically D&Es. Intact is less than ten percent.
Buyer: Okay. Less than ten percent..
Buyer: OK. So, if they know that what we're looking for is intact, and gestational age later, are they able to – I'm ignorant of this, so I'm relying on you. Are they able to adjust the technique to provide that?
Ginde: No. Because we're not – It's not like we do inductions or anything where we would have an intact delivery of any type. So, it's really hit or miss on how everything comes out in the cannula.
Buyer: OK, and you can't control that at all? It's just what presents.
Ginde: Sometimes we get – if someone delivers before we get to see them for a procedure, then they are intact, but that's not what we go for.
Buyer: … Chemical contamination is the only contamination that we would be concerned with. Which is why, you know, for providers that use dig., they're can't use dig because it nukes the stem cells. ….
Ginde: …. we're planning on going from eighteen to twenty weeks by the end of the year....
(In the lab)
Jess: I just want to see another leg, with a foot.
Ginde: It's a baby. The question is. So –
Buyer: This is the placenta. This part of –
Ginde: This is part of the head.
Buyer: Oh wow. That – This is high quality.
Ginde. Yeah. The nose?
Buyer: Yeah, I see the mouth and everything.
Ginde: Oh look, here's some intestines. Once we take it out of water it will be harder to identify.
Buyer: This is –
Ginde: That's the pelvis.
Buyer: This is pelvis with rib cage.
Ginde: That's thorax
Buyer: Here, right?
Buyer: So maybe –
Ginde: Look, something is attached to this.
Buyer: If we flip this over, maybe that's stomach.
Ginde: This is the head, I think. This is the cervical spine, and this is the lumbar/thoracic spine.
Buyer: Got it. This is the beginnings of the – so maybe if I flip it over, we might see heart.
Ginde: Possibly, it looks like a spleen. (Inaudible)
Jess: Usually the organs are cleaner –
Ginde: Oh, look, here's the heart. Is that right?
Ginde: Here's the heart.
Jess: I'm trying to get in on it.
Ginde: My fingers will smoosh it if I try to pick it up. The heart is right there.
Buyer: You found the heart right there. I wonder if this is spleen. I'm sorry, not spleen, pancreas.
Ginde: So, what would be – the spear? Is that the best thing to use?
Buyer: Oh, this? This is just to hunt around and look. Then obviously, you'd have tweezers as well, to pick up certain pieces.
Ginde: I was going to get you some as well, but obviously that's not good use because it was possibly stretch out – so I just don't know. We probably have to get some proper instruments.
Buyer: Yeah. We would provide that. What have we identified? So, calvarium, in three pieces. With, this is –
Ginde: So you said they would want the cal?
Buyer: Yeah, they want the cal because they want the brain. This is neural matter over here, because here is the lower part of the law and cervical spine. So this is spinal cord and –
Ginde: So, that's what you want?
Buyer: So, yeah. This is neural matter. I believe this might be thymus and stuff.
Ginde: Let me see if I can rinse that a little more so it's not so bloody. You might be able to see a little better.
Ginde: So, that would be it, because no one ever wants hands or legs, anything like that.
Buyer: Probably from larger gestations though because they want muscle or bome marrow like, from the long bones. And that would – this is very tiny. It would be difficult to extract bone marrow from this. You would want something a little bigger, it's easier to get in there. Oh, we've got a whole – is this long bone, Jess?
Jess: No. I think it's shoulder.
Buyer: It's just shoulder muscle.
Ginde: But sometimes with the residents, I tell them to poke around, and sometimes embryology will come full circle. Find all the parts you know, see what you can see. Especially with the thirteen, fourteen, fifteen weekers, I think it's pretty amazing. We find heart, we've seen kidneys andrenals, sometimes there's a thing I don't know what that is but it's a part.
Buyer: What's this? This is another six or seven –
Jess: This is nine.
Buyer: Oh, this is nine.
Jess: Yes. I think this has a lot of spinal fluid.
Buyer: That's the whole bottom half of the cadaver, right there. You've got two legs and –
Ginde: There's two arms missing. Here's the head, is this spinal column? Because here's her thorax.
Buyer: Must be. Yeah.
Ginde. Interesting. It's so big. Here's her heart.
Buyer: Oh. Wow.
Jess: Here's something. I don't know what it is but it looks like more than two.
Ginde: But, you don't want these, right?
Buyer: Well that's a very intact looking heart.
Ginde: Yeah, it is.
Jess: So fast, it's the twelve weeks and everyone wants to know, is it twins?
Buyer: You've been looking for twins all day.
Nurse: This might be (Inaudible)
Jess: As a trainee m y blood pressure goes up any time I can't find it all right away. I'm like, “Ahh! Where is it?”
Nurse: I found it in there.
Jess: Oh, the other one? OK, great.
Buyer: The other leg?
Jess: Yeah, the other leg. That's why I said think you. It was stressing me out. She said she saw it – oh, there it is. There's a little foot. There's another heart, completely perfect.
Buyer: Is that the cal?
Jess: Yes. The cervical –
Buyer: Yeah, and there's brainstem in there.
Jess: Yeah. I don't see the eyeballs. That looks like an organ of some sort, but I don't know what it is. Maybe – No, that's just placenta.
Buyer: You squeeze to try to find the cal, all the little pieces of it because it will crack.
Jess: There's an eyeball. (Inaudible) enough of the calvarium given how, I should talk to Dr. Ginde and see if she's comfortable with this. What do you think of the size of the calvarium? It looks like we don't have the whole thing in here.
Nurse: I think you do.
Jess: Yes, it just looks weird. There's this part and I saw this part.
Nurse: Sure. And then there's this part right here, too. It's the front and then I saw an eyeball, there's an eyeball. (Inaudible) I thought I saw two. It's in there, the other one's in there. See it?
Jess: This is where the nasal bridge is. See it?
Buyer: Oh yeah. There you go.
Jess: So only one fetus.
Buyer: I think this big thing right here is liver.
Ginde: Yeah. It's so soft though, but I guess maybe it doesn't –
Buyer: No, it's definitely not like an older liver. It's not doing all the same functions. I saw a kidney in here. And the cal. At first there was brin in here but –
Ginde: It got blasted out.
Buyer: It got blasted out with water.
Ginde: Well you know a lot of times especially with the second tris, we won't even put water because it's so big you can just put your hand in there and pick it up, the parts.
Buyer: Right, just pick it up.
Ginde: And so, I don't think it would be as -- war-torn.
Buyer: Ha. War-torn? Oh, dear. Our tech [name] was telling me what I was looking at before and saying it was thymus, he's pretty sure that's what it was. So I want to show him that little one again.
Ginde: This little thing? Want me to clean it off?
Buyer: So that, that definitely looks like brain. I think this is pancreas because the pancreas has that shape. It's got that long corn shape with a head and the tail of the pancreas. Then there’s ducts running through it. If you look closely, it looks like this is maybe half of it. We found the heart in there but – Yeah, I'll bet, because you look at this rib cage here and I bet there was a lot more stuff in there before it got the fire hose. So that's the other thing.
Ginde: I wonder if that was part of this. But is it, you know, do people say, they want twelve-week, I don't know, liver?
Buyer: Yeah. It's a specific request at twelve weeks. Brain is typically a later gestation but I've read plenty of research studies where they were growing plenty of neural progenitors out of seven week brain.
Ginde: I was just wondering if we shuold know ahead of time if we had a twelve-weeker, our goal was to get –
Ginde: If they were going to hose it, they would take the cal out first.
Ginde: I think, my experience at least, anecdotally, if the patients could do something with that, they would donate it. I don't know if they want to know that we are going to pick it apart but –
Buyer: Organ donation.
Ginde: They want to donate organs, they don't need to know the process you go through – the deceased individual to harvest stuff.
Buyer: So, somebody else just did that procedure, right? Because you were out here talking.
Ginde: She did. There's some organs for you.
Buyer: They're all attached.
Ginde: Here's some stomach, a heart, kidney, and adrenal. I don't know what else is in there.
Jess: Head, arms, I don't see any legs. Do you see the legs?
Ginde: I didn't really look but –
Buyer: Yeah, there it goes. Yup, you got all of them right there.
Jess: Another boy!