The Chick and the Dead

by Carla Valentine

  I know the secrets of love … It is I who set the Rose in motion and move the hearts of lovers.

  —Farid ud-Din Attar, The Conference of the Birds

  Watching someone carry out an autopsy is, in many ways, like watching someone have sex. This is what struck me the very first time I saw one. Before you close this book in misplaced disgust – or, conversely, read on with expectant carnal glee – let me explain.

  An autopsy presents as an intimate process between two people: eviscerator and ‘evisceratee’. The eviscerator, or technician, removes the organs, the other – the cadaver – is eviscerated. Under normal circumstances a person wouldn’t be privy to this activity so it feels forbidden, taboo and voyeuristic. There is a transgressive element to just standing there, watching. There is nudity (the cadaver; hopefully not the technician), body fluids, musky odours and maybe some awkwardness and tentativeness at first. Then hands begin to move deftly across naked flesh, knowing the best moves to make; knowing the dance because it’s a dance that’s been done a thousand times before. It’s an intimacy you feel privileged to be a part of.

  The eviscerator may be someone you’ve seen in person frequently, but never like this. You may have discussed post-mortem procedures over and over again with him during your training, as one discusses sex over and over again with friends, but you’ve never actually seen him do it. Not until now – the first time – when you’re invited to lose your PM room ‘virginity’ and witness the act in all its technicolour glory. I think the poet-undertaker Thomas Lynch put it best when he said, ‘Both sex and death are horizontal mysteries that possess similarly disconcerting effects.’ Horizontal, yes. Mysterious, certainly. Disconcerting? Absolutely – for most. But for us in the business of death, the autopsy is a mystery that needs to be solved.

  * * *

  I’d lost my autopsy virginity when I was in university, but everything I’d done in my life had been building up to that moment. During my gap year, serendipity struck for me. My estranged father moved to a large house in Worthing with a self-contained flat in its annexe, and it just so happened a friend’s mother, Sarah, was an embalmer at a funeral home in a town not far from Worthing. At around seven months pregnant with a little girl, Sarah needed someone to help her manoeuvre the heavier cadavers and undress them, rather than constantly ask funeral directors at their company, J. Ellwoods and Sons, to assist – they were usually busy with their own tasks. This was the ideal experience for me. Young, strong and very enthusiastic, I slipped into the voluntary role in order to learn all I could about embalming.

  While some of my friends took their year out in exotic places, to me it seemed worth heading to an unfamiliar little town on the south coast for a while in order to strengthen family ties as well as gain some experience with the dead and find out if I actually had the stomach for this type of work. So that’s what I did. I remember having coffee with my three closest friends a day or two before I hopped on to the train with just one large case and a handbag. We were all the same age and embarking on completely different journeys: one was pregnant, one was heading to live in France and then Spain to study languages, and one was going travelling in South East Asia.

  I was off to wash and dress the dead.

  This might have been my year off from education, but it was really the period when I learned the most. It was there that I experienced a funeral home for the first time, because I’d been far too young to visit either of my grandparents when they passed away. It was all new to me: the solemn, quiet hallways of J. Ellwoods and Sons, the ever-present soothing scent of flowers, the warmth from the heaters, and the ambient lighting casting shadows that softened every sharp edge. Even people’s grief seemed softer here, the general hush instilling a cloistered calm into everyone who passed through. All of this was juxtaposed with the sound of the boisterous boys in the ‘back’ as they washed down hearses and trimmed coffins, and the tinny radio in Sarah’s prep room that belted out popular music that hadn’t really been popular since the seventies and eighties. In an unusual way, this was heaven for me, and I never felt uncomfortable. For the first time in my life I was independent, following my dreams, and doing something I’d wanted to do for years. Unlike much of the population, I associate funeral homes with peace and tranquillity. I’d wake up at the crack of dawn to be at J. Ellwoods and Sons a couple of towns away at an early hour, so sometimes, when fatigue hit, I would wander off into one of the suites adjoining the chapels of rest and take a nap on the sofa – obviously only when it wasn’t otherwise occupied – much to the distress of the company’s long-suffering cleaner who’d often jump out of her skin at my unexpected presence. Spending a drowsy hour on the sofa after helping to prep the decedents gave me time to reflect on what I’d learned and consider my future path. I was at peace there.

  Even then I knew that positions in mortuaries opened up very rarely and embalming could be an alternative career for me, or even a skill I could perfect and have under my belt before a job opportunity in a mortuary came about. I learned exactly what an embalmer does, and it’s a procedure I passionately believe everyone should know about for two reasons: so that it doesn’t get confused with the role of the APT, and so that an informed decision can be made about whether or not you’d like it for a family member, or even yourself, because it’s not required by law. Embalming is an aesthetic, cosmetic process that is carried out at the undertaker’s, rather than at the mortuary, although it can happen at the family home. Autopsies, on the other hand, can only happen at mortuaries, or specially designated temporary mortuaries in the case of mass fatalities, for example. There’s no such thing as a ‘home autopsy’ or a ‘DIY post-mortem’… at least, not a legal one.

  I didn’t know what to expect and I had no idea what spending time with an embalmer, particularly a female one, would be like. One thing missing from B-movie horrors are females in antagonist roles, so I’d always imagined embalmers to be like the weird male scientists seen in those films: Bela Lugosi in The Corpse Vanishes or Vincent Price in Scream and Scream Again (of course, Sarah was nothing like that). Instead, the only image I associated with Sarah was that of Fenella Fielding in Carry on Screaming. It may sound silly but if you’ve seen the film, in which Fenella’s character, Valeria, and her brother carry out a strange procedure on beautiful young living women to turn them into shop mannequins, you might not be entirely surprised to learn that there is actually a similarity when it comes to embalming.

  Modern embalming is the process of replacing the deceased’s body fluids with preservative chemicals in order to retard decay. It’s the story of Pygmalion’s statue in reverse; that which was once human and vulnerable becomes serene and azoic – just like in Carry on Screaming. It’s done so that the vibrant palette and infernal stench of decomposition (see last chapter) isn’t witnessed or experienced by the family and friends of the deceased if the funeral requires an open-coffin viewing and the disposal isn’t happening for a few days. It’s not as common in the UK as it is in the US. But for those who do require it, it will cost extra and is often called ‘hygienic treatment’, although the term is a bit of a misnomer as the deceased are no more dangerous if they are not embalmed – except in the case of some infectious diseases – which is why it’s important to note that it’s not required by law. Some funeral directors are very upfront about their costs: they explain that the procedure will add around £150 to the bill (outside London it can be as low as £70) and they won’t perform it unless they receive prior informed consent. Others, however, will call the procedure ‘cosmetic treatment’ and railroad the bereaved into paying for it at best, or at worst just go ahead and do it without permission, adding the cost on later.

  On my first day at J. Ellwoods and Sons, after I’d satisfied myself that Sarah was nothing like Valeria from that cheesy film, I asked her why she’d wanted to be an embalmer. She simply said ‘to help people’. She assured me that at J. Ellwoods and Sons the procedure was only carried out when families were fully aware o
f the costs and requested it themselves.

  I wanted to gain some experience myself so I dived straight in. The case in question was an old lady, around seventy-five, and nothing too dramatic for a first-timer like me. In the prep room, heavily pregnant Sarah waddled towards me with the garments I was soon to become so familiar with: a surgical cotton gown and plastic apron. While I covered my clothes she pulled her long, dark Jane Russell hair up over her ample bosom and into a ponytail, then swaddled her swollen belly with a green plastic apron stretched so taut around the bump that horizontal white streaks appeared. She seemed glamorous and competent, and younger than her forty-odd years, but maybe it was the pregnancy glow giving her a youthful aura? It struck me as odd to have so many archetypal stages of female development in one room: the unborn baby, myself as The Maiden, Sarah as The Mother and the deceased as The Crone,* all of us overshadowed by the final, unapologetic figure of Death itself.

  Sarah told me to pop some gloves on and instructed me to just feel the hand of the deceased. ‘It’s important to get used to the cold,’ she said. ‘It can be a bit strange initially.’ I reached out tentatively to touch, for the first time, someone who had died, acutely aware that I was crossing a boundary. Not only was I about to have an experience there was no going back from, I also realised I was doing so without the consent of the woman on Sarah’s table. Yes, I was only touching her hand, but she wasn’t present to tell me whether or not I had permission to, so I had to project it to her myself, mentally explaining that I was part of the embalming procedure – the process her family had agreed to – and it was therefore not a violation. And while her cold hand was in mine I realised I had never held my own nan’s hand. Never. I couldn’t, not with those weird brown arthritis contraptions she used to wear on both wrists, her twisted fingers popping out of the tops like curled twigs. Instead, I had this moment of intimacy with a stranger.

  The lady had been in the fridge for a while and the skin of her hand was firm like pale putty, yet cooler than a pint of milk. Sarah was right – I’d never felt anything quite like it. I had the sense of dipping my toe into very cold water, and even after I’d removed it the cold remained – a constant reminder of that other subterranean world.

  It was time to undress the deceased, which is usually the first part of the embalming process, as the existing clothes may be soiled. Families tend to bring in new clothes for their loved ones to be buried or cremated in: their best outfit or something they may even have picked out themselves. It seems like a simple and practical step but, as Christine Quigley puts it, ‘the withered body of a cadaver, minus clothing and eyeglasses, provokes the distancing necessary to cut it up’. With the accoutrements of life removed, the task is easier both practically and psychologically.

  So this would be my first time undressing someone who was dead, and again there was that sense of transgressive intimacy: I had seen few people naked in my life, yet here I was with a naked stranger.

  Soon we began the embalming, which is nothing like the Ancient Egyptians’ process and doesn’t even have the same principles. Sarah gestured to a huge vat of cheerful pastel-coloured liquid. ‘All the blood in their veins and fluid in their cells needs to be replaced with this,’ she said. The fluid, a concoction of formaldehyde, methanol and other solvents, is mixed in a pump and is usually a pink- or peach-coloured milkshake with a name like ‘natural tone’ or ‘perfect tone’. It reminded me of vintage pancake make-up; sickly sweet. Sarah bent down and deftly made an incision into the neck with a scalpel, causing me to take an involuntary step back, assuming I was going to be sprayed with blood. Of course, there was no blood flow, as the heart had stopped long ago, so I was able to inch forward and bend over to take a closer look. What I saw was just like in my anatomy books. Well, the vein wasn’t blue and the artery red like in many of those typical medical illustrations, but to me the different layers of the flesh were distinct enough: the muscle, the fat and the vessels Sarah was incising with the scalpel. She easily made another incision directly into the carotid artery and inserted a thin metal pipe linked to a rubber tube and the huge vat of pinky-peach liquid. A different tube and pipe were inserted into the jugular vein for drainage. Once the pump was turned on, the pastel fluid was forced into the arteries, at the same time pushing the blood out, or displacing it. This process not only removes bacteria in the vessels and therefore most of the cells of the body as it seeps into them via the capillaries, it also gives the flesh a more lifelike tone; there are slightly different colours of fluids for the vast ranges of different skin tones. It even changes how the skin feels, creating plumpness and curves which will eventually harden or ‘set’. I had to massage the limbs as the fluid flowed to ensure an even distribution, again creating an intimacy I hadn’t anticipated.

  Once that was complete and the last of the woman’s bodily fluids had gurgled down the drain, I thought that was the end of the fluid part. But then Sarah pulled out what looked like a long metal sword attached to a rubber tube, and I guessed it was the trocar. This is an aspirating tool which I’d read about during my research. It had a sharp pointed end with lots of tiny holes around it and the idea was to perforate the abdomen and the organs, then suck fluids through the holes and into the pump. But the words ‘perforate’ and ‘aspirate’ sound more clinical than the procedure actually looks. Sarah appeared to be practising her fencing technique as she repeatedly inserted the sharp point through the skin of the abdomen and manoeuvred it at different angles, jabbing through the maze of organs. Simultaneously, fluids and gases were pulled up through the trocar and into the collecting drum with a hissing, gurgling sound, just like someone draining the dregs of a drink from a paper cup with a straw. Then the reverse occurred as preservative was introduced into the abdominal cavity in place of the fluids, creating a sort of viscera chutney.

  The trocar has become synonymous with the embalmer. The word comes from the French trois-quarts, which means ‘three quarts’. It was historically used on the living to relieve the pressure caused by a build-up of fluids – oedema – or gases in the belly, so the ‘three quarts’ likely refers to the amount of substance removed during its use. A ‘quart’ is two pints so that’s a heck of a lot of fluid, or gas, and should give you an idea how much I swallowed during my ill-fated first bloated decomp.

  The holes in the abdomen left by the trocar insertion are either stitched up or tiny plastic trocar buttons are popped in to ensure there is no fluid leakage, and with all these buttons and thick stitches I felt like I was in a craft class. In a similar attempt to prevent leakage, Sarah also introduced cotton wool to the nostrils of the patient with forceps (‘to stop any purge’, she explained) then asked me to gently turn the deceased on her side so she could add some to the rectum for the same purpose. It was an odd sight, this young woman thrusting reams and reams of white cotton wool into the old lady’s anus while chatting about everyday things.

  ‘How are you finding living in Worthing so far?’ she asked me as a huge wad of white fluff and the end of the long forceps disappeared about a hand’s length into the woman’s anal cavity.

  ‘Great.’ I couldn’t say much more than that, I was a bit mesmerised.

  ‘Nice to be by the sea air, isn’t it?’ Thrust. ‘I’m from Liverpool too and I feel the difference. It’s just so much fresher down here.’ Thrust.

  ‘Hmmmm,’ I managed to agree.

  When the thrusting was over, of course it crossed my mind it was a bit undignified. But then I’d had cotton wool shoved into my mouth at the dentist’s, and suffered worse indignities at the hands of a gynaecologist, so perhaps that’s just what it means to be a human? Even in death we remain a patient: we leak and we excrete. We can’t just ignore that and hope for the best.

  Finally, we dressed the old lady in fresh clothes (which remained fresh, thanks to all that cotton wool) and Sarah used special non-thermogenic make-up to create the illusion of life. This make-up, unlike our thermogenic make-up, is not made to react with heat from the
face. When finished, the decedent looked as though she was sleeping. The process only took about two hours, a lot less time than the Egyptians allocated to their process, and the embalmed woman had been treated as though she was on her way to some big celebration, not her own funeral. Many times after that experience, when I was beautifying myself for a date – applying make-up and choosing just the right outfit – it occurred to me I may well go to the same trouble for my funeral one day.

  * * *

  The current embalming method, and the one I assisted Sarah with all those years ago, involves a series of stages which may appear a bit unseemly. But the upside is that some decedents can be made to look much more at peace and presentable, certainly in cases of disfigurement or advancing decomposition, which theoretically smoothes the path for the next of kin’s grief. It’s a double-edged sword – or trocar.

  If the deceased has a slightly damaged or dainty circulatory system the incision process may be repeated on other parts of the body, for example, the femoral artery in the leg or axillary in the armpit. In the case of an autopsied body, the procedure is more difficult as the circulatory system has been compromised by organ removal. In that instance a six-point injection will be used, meaning embalming fluid is introduced via arteries in both sides of the neck, both armpits and both legs. The viscera bag containing the organs simply has fluid poured into it and is placed back into the cavity before the deceased is stitched up and the rest of the procedure completed as usual. Once the person is in the coffin the embalmer has, in some ways, worked a little bit of magic.

  In the twenty-first century the Western world seems to be taking this obsession with looking good after death too far. Embalming, which began during the American Civil War as a way for dead soldiers to be preserved long enough to allow them to return home for burial, has become a cosmetic and almost miraculous procedure. Families aren’t usually told the process will only delay decomposition; they’re given the impression it will stop it completely, leaving the deceased intact in their grave like an incorruptible holy relic. The process, with the embalmer being given the deceased’s own make-up (to compare shades) or hair products and photos of them in life to create as much realism as possible, has advanced. According to historian Brandy Schillace, the Victorians went to great lengths to ensure the deceased looked better in death than in life, even using false teeth and fake, dyed hair. More recently, there is a bizarre form of cosmetic surgery whereby customers are asking for pre-paid funeral plans that include filler injections in their lips and collagen in their wrinkles to ensure they look good on their big day. If you can’t afford this type of treatment you could pay for famous make-up brand Illamasqua to do your post-mortem make-up rather than the embalmer – at a cost of £450! But just who are these good-looking corpses trying to impress?