Next, the coroner photographs the scene, beginning with “the big picture,” photos of the rooms of the house, including the bathroom and kitchen, the position of the body from several different angles, the toilet, the refrigerator, and possibly even the ceiling. A seemingly pointless photograph could lend valuable evidence to a case when it is reviewed later in light of new information. It is easy to focus first on the body, and in the process, miss valuable clues from the surroundings.
After photographing the scene, the coroner turns his attention to the body. The nightgown Mary is wearing, as well as her necklace and rings, are carefully documented, in photographic and written form. As well as speaking for the dead, death investigators have an obligation to safeguard their belongings and return them to the next of kin.
With the assistance of the deputy sheriff, the coroner turns Mary onto her back and continues his examination. Mary has a greenish discoloration of her lower abdomen, as well as dark, bloody fluid exuding from her mouth, both signs of early decomposition. The coroner manipulates her limbs to ascertain the degree of rigor mortis, or stiffening of the body. Her rigor is described as “easily breakable” since decomposition has caused rigor mortis to fade. The anterior or front surface of her body is stained maroon, owing to her blood settling due to gravity, the phenomenon known as postmortem lividity. Lividity that is not consistent with the position the body was found in is often a tell-tale sign that the body has been moved. For example, if she was to be found facedown, but the lividity was evident on her back, she would have been moved after her death. In Mary’s case, her lividity is considered fixed; it does not blanch to light pressure, indicating that she had been dead at least ten hours.
Further examination of the body includes checking for petechiae—pinpoint hemorrhages visible in the inner membranes of the eye—sometimes (but not always) an indication of strangulation. Her head is felt for obvious fractures and her clothing is moved to check for obvious injuries.
Since Mary has medical history—diabetes and high blood pressure—and is of an age when death is not necessarily expected, but not out of the ordinary, considering her medical history, the coroner is coming close to reaching a conclusion that Mary died naturally, as a result of the devastating long-term effects of her disease processes.
But there is a problem. In the wastebasket to the left of Mary’s head, the coroner discovers two empty medication bottles, both labeled Hydrocodone, one prescribed a month prior and the other prescribed three days prior. There was no way Mary could have been taking the medication as prescribed. The empty pill bottles cast doubt on the coroner’s previous assessment that the death was natural. Was it suicidal? Was it accidental? No suicide note is found, though Mary’s brother said she had been depressed lately. The coroner decides to have an autopsy performed after a consultation with Mary’s personal doctor.
The time has come for Mary’s body to be removed from the residence and taken to a location where she will have an autopsy performed.
Since the County Coroner has relatively few cases per month and thus no pressing need for his own transporting vehicle, he relies on the services of several funeral homes in the area that have contracts to perform removals.
In about twenty minutes, a silver van pulls up to the curb. It’s subtle and unmarked with the exception of the telltale curved Landau panels covering the rear windows, indicating that it is a mortuary vehicle. A man and woman in dark suits step out, the woman carrying a clipboard.
The woman introduces herself as a funeral director and expresses her condolences to Mary’s brother before speaking to the police officer and coroner. Meanwhile, the man, a removal technician, silently surveys the scene, his experienced eye noting obstacles, the presence or absence of stairs, and the size of the hallway before viewing the body.
As the funeral director writes down information given to her by the deputy and coroner, the technician snaps an identification bracelet on Mary’s ankle with her name, case number, and date. To mix up bodies is very embarrassing.
Since there are no stairs, the removal crew can wheel their cot directly into the apartment. However, getting Mary from where she is in the bathroom to the cot is a somewhat more complicated affair. The cot will not fit into the bathroom, much less the narrow hallway that leads to it. The cot, a narrow bed with collapsible legs, is lowered to the ground inside the living room, the zippered shroud is opened, and two seatbelt-style straps are unbuckled and extended.
The removal technician brings a zippered canvas bag known as a disaster pouch, the politically correct term for a body bag, to where Mary lies. Why this is the preferred term, I will never know, as it seems that disasters are things generally to be avoided.
The crew rolls Mary to her side and she emits a groan, startling her brother, but not fazing the removal crew in the least. The groan is caused by residual air escaping her lungs and passing through her vocal cords. After being zipped into the disaster pouch, she is slid along the floor to the waiting cot. Such a maneuver may seem indelicate, however, since Mary weighs north of two hundred pounds, but it is saving the backs, and thus the careers, of our two mortuary folks.
The crew places Mary on the cot, straps her in, zips the shroud, and lifts the cot into the upright position. They wheel her to the van and load her in the back, the wheels collapsing and sliding in at the pull of a lever.
Mary’s body is brought to the funeral home where the autopsy is performed. The practice of conducting autopsies at funeral homes is quite common, especially in small communities. In fact, the popular image of an autopsy suite as a vast, sterile sea of stainless steel tables, glowing computer screens, and dim lighting is by far the exception. Many autopsies are still performed in the bowels of hospitals, the basements of old houses, and even in retrofitted barns. If the dead could vote, they may opt to fund the CSI version, but unfortunately, in our death-denying society, they don’t.
The following morning her autopsy will be performed by a contract pathologist, akin to a “rent-a-doctor” who also serves three other counties and carries his supplies around with him in a 1995 Nissan Pathfinder.
Later that afternoon, Mary’s brother meets with a funeral director to discuss “disposition” as it is known—the choices of burial, cremation, shipping out of state, or donation for medical research. As luck would have it, Mary already had a “pre-need” contract signed with the funeral home, indicating that she would prefer to be buried, following a traditional Catholic recitation of the Rosary and funeral service. Since Mary has already made her own arrangements, she has signed her own embalming authorization, chosen the music she would like played, and specified the clothing she is to wear in her casket.
Hospital Removals
Nowhere is the specter of death more unwelcome than in a hospital. In an institution seemingly bent on preserving life, no matter what the cost, hospitals seem to treat the logical end of life as a failure or even as an embarrassment. While the ER and main entrances are emblazoned with neon signs and decorated with carefully sculpted shrubbery, the morgue is banished to the rear of the hospital or to some obscure, unmarked side entrance, flanked by dumpsters and full biohazard bins. If the ER entrance is a toothy grin, welcoming all comers, the morgue is the asshole, grudgingly jettisoning the effluvium of failure.
A hospital removal is a pretty simple affair. Unless the body is very large, only one person is dispatched from the funeral home. The technician arrives, backs up to the loading dock, and then enters with the empty cot. A security guard usually meets the technician, points out the correct body, and directs him or her to sign the necessary paperwork. Security is generally not thrilled with this aspect of their duties. Many a security guard I have met has stood in the corner, arms folded, and scowled at me as though I am some sort of hunchbacked ghoul. If I try to make small talk or crack a joke, the security guard usually responds with a weak smile and a mumble.
Usually I unzip the bag and check the ID tag on the body as well as its general condition
. The funeral director usually wants to know if the body is viewable as is or if further preparation is required. Patients who have been in an intensive care unit for weeks are often waterlogged and swollen, necessitating special embalming treatment. The bodies all wear the uniform of the deceased—hospital gown with an incontinent pad under the derriere. Besides the variation in size, they pretty much all look the same: pale, mouth agape, and eyes half-closed.
The dead are not received from the morgue into shiny black hearses, but instead into unmarked, inauspicious minivans in all manner of dull colors. From there, they are made to disappear, perhaps to warehouses full of humming refrigeration units and roaring crematory retorts, to be consumed by flames, only to reappear again as breadbox-sized urns, labeled in simple block letters with the dead person’s name, years of life, and the name of the funeral home that directed the cremation. Or perhaps they are to be encased in oak or semi-precious metal caskets and consumed by the earth, their headstones the only visible reminder of their past existence.
Nowhere is this societal disconnection from death more evident than in the strange conveyances used to transport the newly deceased from the hospital bed to the refrigerator where they will chill for a while until claimed. The hospital trolley is, perhaps, emblematic of a death-denying society. It resembles any wheeled hospital bed, with two exceptions: the mattress is replaced by a cold steel tray, and a rectangular frame fits over the top, covered by a thick white canvas. The purpose of this frame is to completely obscure the shape of the body, so that when it is being wheeled down the hallway, nobody will be able to make out a head-like or tummy-like lump that would belie the trolley’s purpose. It may as well be the dinner cart.
The trolley and its cumbersome lid are the bane of my existence in the morgue. I am thankful we don’t have security cameras in our facility, as I would be caught swearing and fumbling around with the lid, attempting to get it to sit properly on the trolley without one end sliding off and banging onto the floor. And for what purpose? Patients and their families must know that death often occurs in a hospital. It has to happen somewhere. However, the physical representation of that death, the body itself, shrouded though it may be with sheets or in a bag, is banished from our awareness.
It is a relative rarity for a funeral director to make a removal directly from the hospital floor, and it seems only to be done when the cooler is full. When a man wearing a suit wheels a patient covered head to toe by a burgundy shroud, it is beyond obvious that the patient is not at all well. As I’ve wheeled my cargo into elevators or down a hallway, I’m given a wide berth by all I pass. Gazes are averted, nobody smiles or says hello. It’s as close as I will probably ever come to being invisible, barely human, Charon on the river Styx, ferrying the dead to Hades.
Morbid Questions
For those with a morbid curiosity, which I’m going to venture to guess is all of you, I’ll answer a few of the more commonly asked questions of those of us odd enough to get into (and stay in) this business. The first of which is, “Why the hell would you do this job?”
Most children are asked at some point what they would like to be when they grow up and they usually respond with doctor, astronaut, firefighter, ballet dancer, cowboy, or some other heroic occupation. Never have I heard of a child saying, “I want to pick up dead bodies for a living!” For that matter, I’ve never heard of a child who aspires to be a HVAC repairman or a software engineer, but in our death-denying society, those responses might be met with a smile and an exclamation along the lines of, “Oh what a precocious child!” A child who announces he wants to be an undertaker might be met with muted horror on the part of the parents, a tight-lipped smile and an, “Oh, that’s nice.”
I must admit I was one of those morbid little children and faced ostracism for it in my younger years. Nobody wants to hear a child’s detailed description of the embalming process over dinner, least of all my parents. Nevertheless, I felt an inexplicable calling to the death care field from an early age, and haven’t let the squeamishness of others dampen my interest in all things thanatological.
Other than my inexplicable fascination with all things dead and decaying, obvious from an early age, my desire to work in the dismal trade stems from a desire to witness a part of life normally hidden from view, to be a member of an almost secret club of morticians, coroners, and pathologists, a club in which the initiates are bonded by their unflappable ability to carry about their macabre business among the murdered, the decomposed, the vacant husks of former humans. To be able to thrive in a field most are terrified of is a source of pride for me. To be in the presence of those who have crossed over the great divide is oddly meaningful, in an ultimate sense.
Another question I am asked from time to time is, “How do you handle the smell?”
Your trusty flat-screen television brings you the gory spectacle of bloodied corpses on such popular shows as CSI and NCIS. Thus far, though, the technology does not exist to blast you with the vulture-gagging stench of a body marinating in a river for three months or the nauseating odor of an old alcoholic facedown in a puddle of vomit.
I had smelled a decomposing body before I came to work as a death investigator, but only at a respectful distance. As an emergency medical technician, I had pulled back the curtain of an old bread truck where an old man had been quietly decomposing in the summer heat for a week, took one belly-turning breath, and backed the hell out. Death confirmed. No further need for my presence. When I became an investigator, I no longer had the luxury of getting the hell out of Dodge. Decomps were our bread and butter. We had to examine them for injuries, turn them, rifle through their pockets for valuables, and even perform autopsies on their foul flesh.
In the first week of my employment as an investigator, I had asked another employee how she dealt with the smell. I was expecting an answer such as, “We use paper masks smeared with Vick’s Vap-O-Rub or canister respirators and a cigar and tons of those little tree air fresheners.” Instead she had replied, “We just gag and deal with it.”
The smell is overwhelming at first but is quickly attenuated by the body’s own defense system, the phenomenon known as olfactory fatigue. The longer we are continually exposed to the stink, the more bearable it becomes. When I go in on a “decomp” I bring all my equipment with me, camera, body bag, clipboard, stretcher. If I were to go back out into the fresh air and enter the death room again, my nose would have reset and I would once again be hit full-force by the smell.
I carry with me some odor blocker in small packets but have only used it once. The instructions indicate that a small amount should be smeared under the nose, but realistically, I think it needs to be shoved up both nostrils to be effective. The odor blocker gives off an aroma of baked bread, which is certainly preferable to Eau de Rotten Corpse.
So I guess the answer is…I just gag and deal with it.
When somebody dies on television or in the movies, it is usually preceded by a few poetic and well-chosen last words, followed by a deep sigh. Then the eyes close, the person stops breathing, and everybody cries. Most people who die suddenly don’t have much time to compose an elaborate soliloquy, so their last words may be some variation of “Oh, shit” or “I can’t breathe!” Yes, the eyes do seem to close at death about half the time, but what is usually not depicted on film is one of the more unpleasant but perfectly common aspects of death, losing control of your bladder and/or bowels. So the question is, “Am I going to crap my pants when I die?”
Maybe, but probably not. All sphincters release at death, including those controlling the bladder and the esophagus. As a funeral director friend of mine lamented one day, “You try to live your life with some dignity, and then they find you with a turd in your pants.” Depending on the consistency of the stool (solid versus liquid) and the effect of gravity, bowel contents may be retained or expelled. Most bodies I have picked up have not emptied their bowels. However, many still pass gas upon moving, often loudly, longly, and stinkily.
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nbsp; However, even if you are lucky enough not to crap yourself at death, you will still most likely be a little damp down there. In most cases of sudden death, the bladder empties. This makes searching for a wallet or keys in a deceased person’s pockets a bit unpleasant. When a person has been dying from a chronic illness over a period of weeks or days, the body may be so dehydrated as to no longer produce urine. I’ve noticed that victims of narcotic drug overdose often do not urinate at death. A pathologist explained to me that this is due to the drug’s effect on the nerves that control the bladder.
Since the sphincter between the stomach and esophagus relaxes as well, the contents of the stomach often burble up, sort of a like a low-pressure vomiting. In the hours and days following death and the body begins to decompose, a dark, bloody substance called purge fluid exudes from the mouth as well. This is often erroneously thought to be due to trauma. In fact, it is a perfectly normal consequence of even natural death.
Purge fluid and loose bowels aside, there is really nothing quite as disgusting as a bloated, decomposed body. How does one go about moving a rotting corpse?
Very carefully. One of the first signs of early decomposition is a greenish discoloration of the lower right abdomen, in the area of the appendix, indicative of intestinal bacteria escaping and invading the rest of the body. At this stage, between one and three days after death, the outer layer of skin—the epidermis—will begin to separate from the lower layer—the dermis. Unfortunately, this is not always visible on the surface. I have grabbed an arm or a leg in an attempt to move a body and had the skin slough off in my hand. I would describe the sensation like rubbing your thumb on an over-ripe plum. This is highly unpleasant. It is best to use towels or sheets to grab limbs in these cases. As decomposition progresses, the skin completely separates and forms huge blisters, called skin blebs. Again, sheets are helpful, as are plastic sheets to wrap the body in. Yuck.
The Removalist Page 3