I came to work with the dead in a roundabout way. I was an emergency medical technician with my local fire department, and often crossed paths with funeral directors or deputy coroners when our attempts at resuscitation had been in vain. I discovered I had a knack for speaking to people who had just lost a loved one. I became skilled at what I would later come to know as “funeral speak,” the relatively monotone speech pattern characterized by euphemisms cleverly designed to soften the blow of death. A person hadn’t died, he’d passed. It wasn’t a corpse, it was remains.
As the years passed in my work as an emergency medical technician, and later as a paramedic, I became increasingly frustrated with the shift in our clientele from those who were deathly ill and needed urgent intervention, to those that chose to use our mobile intensive care units as expensive taxi cabs. Thirty years ago, few people would think to call 911 if they had experienced flu-like symptoms for a week. Sure, there were a few folks, even then, who struggled with the concept of what constituted an emergency (and struggled with life in general, for that matter). But the 911 “system” had become a victim of its own success. Ingrained in the public consciousness was now the notion that if anything went awry, from an infected toenail to an airline disaster, one must summon the cavalry in the form of men and women in crisp blue uniforms, arriving with great fanfare, in a blaze of multicolored lights. In this modern world of instant gratification, “toughing it out” seemed to be a lost art. It was as though people expected to feel good all the time, and if they didn’t, something must be done. Somebody must be responsible.
I saw the changes in society as a whole reflected in an attitude towards laziness, learned helplessness, and instant gratification. Many times a week I would respond to a report of a “slumper”—somebody pulled over to the side of the road, leaned over or appearing unresponsive. A passerby, not wishing to be bothered with actually checking on the person’s welfare, would call 911 and set into motion a fire engine, an ambulance, the local police, and possibly other authorities, who would rush, lights and sirens to the scene and invariably find the “patient” taking a cat-nap, reading a map, changing a tire, or engaged in extra-curricular activity with a friend.
With the advent of text messaging and smart phones, the art of conversation was being lost, replaced by terse, often ungrammatical sound bites. Online news articles became truncated to a single paragraph. Sitcoms solved massive problems in the course of half an hour. Forensic dramas proliferated, misrepresenting the tedious and labor-intensive world of applied science and replacing it with a non-stop series of brilliant insight, clear-cut, black-and-white answers, and the near-instantaneous return of lab tests, which in reality, take weeks if not longer. Entertainment seemed to become more and more banal. One could become famous for really no reason at all. Perhaps our rising star is a gay dwarf who bids on abandoned storage lockers. Within months he has his own show and becomes more famous than Elvis. Talent be damned. Hard work? Unnecessary.
And so it was with emergency medical services, a microcosm of a populace that craves instant results and feel-good medicine. Welcome to our Emergency Room and Psychotherapy Department! Shorter waits than those guys across town! Leave your dignity and common sense at the door!
While certainly my job as a paramedic involved its share of legitimate calls for help, much of it seemed to be so much whining. When a person is able to call 911 and then lumber about his or her apartment, gathering shoes, clothes, cigarettes, and a cell phone, he or she damn well has enough energy to take a taxi to the hospital, or, better yet, an urgent care clinic. I had heard more times than I care to recall, “I don’t have the money for a taxi.” When I pointed out that a $15 taxi ride is a hell of a lot less expensive than a $700 ride in a mobile intensive care unit, I was often met with the response “But I have coupons.” Since we couldn’t legally refuse transport, we simply wheeled or walked these decision-impaired folks out of their malodorous hovels, past their seventy-inch TVs, and shipped them off to the ER to be evaluated by overworked ER physicians who would sigh, dip their urine, and boot them out the door with a prescription for Cipro. Sometimes the bill was paid by the state. Often it was written off.
For all the time I’ve spent providing a taxi service to those with poor decision-making skills, I have spent easily twice as much time ferrying nursing home patients to and from the emergency department. It seems that nobody is allowed to die anymore. Those who are clearly moribund are perpetually sent to the ER in the vain hope that something can be done to interrupt their natural and inevitable slide into total body failure. So when ninety-eight-year-old Maude won’t wake up and has no blood pressure, we MUST ship her off to the ER in the hopes that she will recover enough to go back to work as a lion tamer and live to be one hundred and twenty. But what kind of a life are we really bringing her back to? Another, perhaps more painful illness or mishap that will finally take her life in a matter of weeks or months? It got disheartening.
So, after a long and illustrious career in the business of taking care of sick people, I took a much-needed hiatus from the care of those with warm blood still flowing through their veins and opted for more quiet customers. There were advantages, to be sure. My dead customers never swore or spat at me, never whined or demanded pain medications, and were generally much more agreeable than the living. On the other hand, though, the dead completely refuse to stand up and sit on the stretcher, and are a little leakier than their living counterparts—but not much.
In contrast to my work as a medic, my vocation as a death worker brought to the surface a sort of compassion in me that I was sure had long ago gone the way of the Dodo. It was hard not to feel sad for those who had lost a loved one, even if that loved one had led a derelict or unsavory life. Even if a family had long ago lost hope, at some point, these silent clients were loved, had hopes, dreams, and aspirations. Those inert and insensate bags of protoplasm had once been animated with the soul of a brother, sister, father, mother, aunt, or uncle.
I worked for a short time as a death investigator in a major metropolitan area before transitioning to a mortuary service just south of there, in the same county. I generally enjoyed the work of a death investigator, though the transition from emergency medical services to death care was a bit abrupt, and I wasn’t as focused as I should have been. There was still a part of me that wanted to continue in EMS, so for a time I continued to work as a paramedic and took a part-time job as a removal tech at a funeral home that represented other funeral homes.
The mortuary service couldn’t be found in the phone book, and our business was located in a large warehouse which housed two gigantic walk-in refrigeration units, an embalming room, and three roaring crematory retorts. We did the work that other funeral homes didn’t have the time, the facilities, or the inclination to do. In our gray, unmarked minivans, we would be called at all hours of the day and night to pick up bodies and transport them either back to our facility, or to the client funeral homes.
The death call would come in, and we would travel, to a home usually, and identify ourselves to the family: “I am Matt and this is so-and-so, representing Apex Funeral Home.” This was especially odd when I, a white man, was called to represent a black-owned funeral home. The family usually caught on pretty quickly that I was a vendor, instead of an actual funeral home employee. Families would ask us questions specific to the funeral home, and we would have to tell them, “The funeral director will answer all of your questions on Monday.”
Simple paperwork was involved. We obtained name, address, date of birth, time of death, and we documented any clothing or valuables on the body. On a house call, we would attach an ankle tag to the body, wrap the remains in plastic, zip them up in a bag, and wheel the body to the van. Simple stuff.
At the client funeral home, the procedure was pretty simple: log the body into “The Book of Death” and place it on a shelf in the cooler. A couple of homes wanted us to elevate the head on a block, to prevent engorgement of the facial features an
d inconvenient “drainage,” and to paint an anti-dehydration cream onto the face, in case there was a viewing.
Few people realize that a good percentage of the anonymous minivans zooming past them on the freeway are actually removal vehicles. If the driver of a minivan is wearing a suit and tie, chances are good that he is hauling a silent customer or two. The dead are closer than we think.
Driving the Death Wagon
A light but dreary drizzle spatters the windshield of the gold Chevy Astro van as I make a right turn out of the mortuary toward the freeway. My companion is Mr. Anthony Trevino, who reclines silently on the mortuary gurney in the back, zipped up snugly in a maroon pouch, oblivious to the weather or anything else for that matter. Embalmed and dressed in a yellow moisture-proof garment known as a Unionall, he is on his way to a Seattle funeral home to await his viewing and funeral service. Unlike some of the other bodies I transport, his needs to be handled with the utmost care, since he is destined not for cremation, but for burial. A half-drunk cup of coffee sits in the cup holder, lukewarm from sitting in the van as I had gathered paperwork.
I approach the first intersection, a block away from the mortuary. I slow briefly for the red light and then, as the light turns green, accelerate through. Just to the edge of my peripheral vision, I catch a green blur approaching at high speed. Then, before I can take any evasive action, I feel the impact on the passenger’s side. The van spins 180 degrees and comes to a screeching halt on the other side of the intersection, facing the direction from whence it came.
I step out of the van and survey the damage. An older model sedan is stopped in the middle of the intersection, its hood caved in, steam rising from the fractured radiator. Glass from a broken headlight gleams in the rain. The left headlight, more or less intact, points absurdly towards the sky amid crumpled metal. Tentatively, the driver exits, followed by three short Hispanic men, who appear unfazed by the event.
“Is everybody okay?” I ask.
“Yeah, we’re fine. I dinnit see you coming,” the driver says. “Sorry, man.”
Another car approaches. The driver flips on his hazards, gets out, and begins to direct traffic around the wrecked vehicle. The intersection is completely blocked. I make my way around to the passenger’s side of the van where the impact occurred, in order to survey the damage. The sliding door is caved in and inoperable. I cup my hands to peer through the tinted side windows and notice that the gurney has slid all the way to the right and upended itself, its wheels pointed towards the ceiling, like a beetle flipped on its back.
The men mill around on the sidewalk, seemingly unsure of what to do next.
“I guess we should exchange insurance information,” I say wearily.
The driver pipes up, “I don’t know, man. This is my cousin’s car.”
I take my cell phone out of my pocket and dial 911 for the police to come and take a report. Then I dial the number for Jerry, the mortuary owner. He says he will respond to the scene shortly. As I wait for them to arrive, the rain dumps.
“Hey, can I borrow your phone, man?” says the driver. “I gotta call my cousin.”
With irritation, I hand him my phone and he proceeds to monopolize it for the next ten minutes. Later, I will curse myself for letting him use it. He’s just hit my van in a car that isn’t even his, doesn’t appear to have insurance, and now he wants to borrow my phone?
A police car arrives, lights whirling, and blocks off the intersection. The officer interviews the driver of the car before speaking with me.
“The guy has no license and no insurance,” he says. “This your van?”
“No. It’s a company van.”
“What company?”
“It’s a mortuary van.”
The police officer smirks. “You got a body in there?”
“Yes, I do.”
Jerry shows up in his pickup and I explain the circumstances. He asks me if I’m okay then turns his attention to the damaged van.
He opens up the back doors to reveal the upended gurney.
“Where were you transporting to?” he asks.
“Evergreen-Washelli.”
“Let’s get this thing right-side-up again.”
I climb up into the van, taking one end, and Jerry stays outside on the other end. We flip the gurney and its oblivious cargo back over again. Mr. Trevino has just been in a postmortem car accident, and he didn’t realize it. Even if he did, he probably wouldn’t care.
I unzip the cot cover and partially open the bag. Mr. Trevino doesn’t look bad, though his nose is a little more askew than I remember it being.
“You know what would make the other driver really feel bad?” Jerry says, a broad grin beginning to creep across his face.
“What?”
“Put the dead guy in the front seat and say it was a fatality.”
The Death Business
On those rare occasions when I take time off for leisure and associate with “normal” people, I sometimes am asked about my work and the role I play in the Business of Death. Coroners and funeral directors are but two of the more well-known players in a rather more complex cooperation of individuals whose job it is to get the dead to their final destination.
Depending on local protocol, resources, and customs, when a dead body is discovered, it may put into motion a response involving police officers, paramedics, hospice nurses, coroner and/or medical examiner personnel, removal technicians, pathologists, embalmers, crematory operators, funeral directors, clergy of all conceivable faiths, gravediggers, and various bureaucratic offices such as the County Health Department and Social Security Office.
So, let’s consider the fate of one such dead person, the entirely fictional ex-taxpayer Mary Jones, aged sixty-two years, whose brother finds her dead in her apartment one fine summer day.
Mary’s brother hasn’t heard from her in three days, and after calling her home phone, cell phone, and attempting to message her on Facebook, he decides to pay a visit. Finding the door unlocked, he enters and notices a faint odor that, from a year he spent driving a rendering truck, he recognizes as decomposition. After finding Mary facedown in the bathroom, he calls 911.
County paramedics arrive first, and after a cursory examination, declare her dead. Because she has signs of early decomposition, they choose not to slap EKG electrodes—or “fairy stickers” as they are sometimes derisively known—to confirm the inevitable, represented by a very straight line running across the EKG screen. On the heels of the paramedics comes a sheriff’s deputy, required to respond to all cases of “unattended deaths.”
The paramedics clear the scene within minutes, leaving the deputy to ascertain any obvious signs of foul play. Though Mary’s door was found unlocked, there are no signs of forcible entry, no blood spatters streaked along the walls, no knife sticking out of her back. He finds three medication bottles, which her brother thinks are for her high blood pressure and diabetes. If the deputy were to note any examples of foul play, his next call would likely be either to his sergeant or the on-duty detective, either or both of whom would respond to the scene and conduct further investigation, sometimes lasting many hours until the body is removed.
Since there are no obvious signs of foul play, the deputy calls dispatch and requests the County Coroner respond. If the death were considered suspicious, the coroner might respond with detectives or be asked to wait until a preliminary on-scene investigation had been completed. It all depends on local protocol.
The deputy is not allowed to touch or move the body until the coroner arrives, except in exigent circumstances, such as the need to establish identification. State laws designate law enforcement as being “in charge of the scene” while coroner personnel are considered to be “in charge of the body.”
Since Mary’s death occurs in a relatively small county, a coroner system is in place. A coroner is an elected official charged with determining the cause and manner of death. The coroner is usually not a medical doctor (but can be) and there a
re few qualifications for his office other than to be a resident of the county and have no felony convictions. Many elected coroners are funeral home owners, retired police officers, or paramedics. Experience counts, but there is currently no formal education required. A coroner can employ one or more deputies to act on his or her behalf, and usually contracts with a pathologist to perform autopsies when needed.
If Mary had lived in a larger county, her death would be handled by a medical examiner’s office. The chief of such an office is a medical doctor, usually a board-certified forensic pathologist, whose job it is also to determine the cause and manner of death. The Chief Medical Examiner may also employ other pathologists as well as medico-legal death investigators—the equivalent of deputy coroners, to assist in these endeavors. Whether a county uses a coroner system or a medical examiner system comes down to cost and population. Most small counties cannot afford full-time forensic pathologists, who may command upwards of $200,000 a year.
The coroner arrives and begins his scene investigation, beginning with interviewing both the deputy and Mary’s brother to determine the circumstances of the death. When did Mary’s brother last speak to her and did she seem to be in her usual state of health at that time? Did she have any health problems? Who was her doctor and did the brother know when she might have last seen that doctor?
The Removalist Page 2