‘You know Sebastian?’
‘No,’ I said. I really didn’t.
‘You do,’ she insisted. ‘You were talking to him for ages yesterday. The southern one.’
‘Tina, they’re all really southern to me. I’m gonna need more.’
‘Last Wednesday, you must remember.’
I thought for a moment, ‘Ohhhh, yeah, I know. What about him?’
‘Well he’s asked Thomas to ask me if I can give him your phone number. He wants to ask you out.’
I tried to remember mine and Sebastian’s various conversations over the last few months. Yeah, he was quite funny; there had been a bit of chemistry there, I thought. I remember he smelled nice. (Always good to be able to smell someone other than the deceased you’re releasing.) It might seem weird to have flirty banter over cadavers in a hospital mortuary but no disrespect is meant by it. Love and death are intertwined in ways we can’t even imagine. It’s just the norm in that situation, the cycle of life in action. Plus it takes your mind off life’s various atrocities. But did I want to go out with him if he couldn’t even pluck up the courage to ask me out himself? Still, it was sweet …
My mind wandered back to the day I first saw Tina’s husband Thomas in Maxim. She the mortuary manager, he the embalmer at the undertakers: it seemed like a match made in formaldehyde-scented heaven. When they were at home together they would be able to discuss everything that had happened at work and totally understand each other. It must be the best relationship in the world ever! I realised I wanted that. That’s what had been lacking in my broken relationship and that’s what I’d sought in my friendship with Josh. I wanted someone who could understand me and the job I loved, someone I could chat to properly about my working day. Sebastian was different from Thomas, who was quiet and shy; he was a bit of a lad, but he did make me laugh. Now that I’d remembered him I became quite keen on trying it out and seeing what it was like to be in that sort of relationship.
‘OK, OK,’ I said to Tina, who was looking at me with expectant glee. ‘Fine – give him my phone number.’
* * *
So Sebastian and I dated; we were ‘together’. I’d been in London for a while now and it was time for me to have a boyfriend. He lived with his parents and he drove so he usually came to see me or we’d meet up in central London. It was nice. We went out to eat and he always insisted on paying, we went shopping and he bought me gifts, he often turned up at my house with flowers, he took me to the cinema. We did all the things that young lovers do.
Sometimes, when I was in the PM room and the mortuary intercom buzzed, Sharon would shout, ‘Lala, your other half is here!’ (she always called me Lala rather than Carla), and I’d have the privilege of seeing my boyfriend at work. The novelty never wore off: I had another half! I was therefore, by definition, whole. I loved my job, I liked my home, I had my own perfect formaldehyde-drenched relationship of mutual understanding like Tina and Thomas. I’d moved to London like Dick Whittington with nothing but the clothes on my back, a few books and some dreams – and I’d made it.
Life was good.
* * *
‘Oh, for God’s sake,’ I moaned one morning, after opening up the fridge, ‘the nurses have done it again.’ I was looking at a deceased baby who’d been placed in the fridge overnight, wrapped in a blanket but with her tiny face left uncovered.
‘What is it, Lala?’ asked Sharon, walking over, measuring stick in hand. As soon as she saw the uncovered face of the baby she understood why I was annoyed.
The concept of ‘dignity in death’ is relative. Many of the nurses in hospitals I’ve worked in felt that babies shouldn’t be placed in plastic body bags as it was ‘too creepy’, and many felt that their faces shouldn’t be covered in the fridge at all as it was undignified: they wanted the babies on the trays to simply look like they were sleeping. The problem, which they weren’t aware of because they weren’t qualified APTs, is that the delicate facial skin of a baby can succumb to fridge burn, effectively disfiguring them and making it harder for the parents to view them. Despite the fact that we routinely gave new nursing staff official lectures on the topic during their induction, many still continued to leave babies’ faces uncovered in the cold – a misplaced attempt at their idea of post-mortem decency.
‘Well, at least this one isn’t too bad,’ Sharon continued. ‘Not much damage.’
Still, it made me feel like all our efforts were being ignored. I covered the baby’s face, sighed and slammed the fridge door shut, a little too hard. I think she could tell my mood wasn’t really about the current issue, though, because she put the measuring stick down and asked, ‘Lala – what’s up?’
The truth was I hadn’t been feeling myself for a while, and it wasn’t being helped by Sebastian displaying some odd behaviour despite us having been together nearly ten months. Even though we spoke every day there had been a couple of times when he had completely disappeared for two or three days, falling off the face of the Earth. I’d had to have surgery on my birthday and had been unable to get hold of him that day or the next; no text or call from him asking if I was OK. He had disappeared again, which was making me understandably suspicious. Still, my mood really didn’t seem like my own. I didn’t like being made miserable and I had no idea what to do.
The decision was made for me anyway. That evening, I was caught completely unaware by a call to my mobile phone from an unknown number which I answered with the very customary ‘hello’.
The return greeting was a rather uncustomary ‘Are you Carla?’ asked by a female in a spiteful tone. It caught me off guard. I skipped a beat before answering ‘Yes’, but I said it like a question, like I was unsure who I was when really I should have wondered who this curt person on my phone was.
‘Can you tell me why my partner has your phone number written in a little black book which he hides under our bed? In our home? The place where our child sleeps?’
And I made a sound like a whimper as I dropped the phone.
The missing days.
The fact he always came to me.
The absence the night I’d had surgery.
It all began to make sense: I wasn’t his girlfriend – I was the other woman.
* * *
Immediately after the phone call I felt odd. In fact, I’d never felt sicker in my life. It was as though the hands of some malignant entity had thrust rotten eggs, razor blades and maggots right through my abdominal skin into my stomach. I felt the blood drain from my face – a cold, tingling sensation caused by that vital fluid leaving my capillaries and depriving my flesh of necessary oxygen. The blood also fled my extremities: icy pins and needles travelled from my fingers and toes, up my arms and legs until my abdomen was just one cold pit. I looked at my hands and my nails were blue. I was dazed. Where was my blood? Where could it possibly go? Was I going to vomit it out? No – the pressure in my chest made me feel like it was all in my heart; as if that resilient yet fragile organ Galen described was so stuffed with blood it couldn’t beat and was close to bursting. But I also felt a heaviness in my lower belly that was so strong my hand groped beneath it protectively.
I stumbled into the bathroom and saw a corpse in the mirror, just like those I worked on daily: pale, waxy skin, sunken eyes, blue lips. I’d never fainted in my life but I’d seen other people do so and could partly understand what was happening. I slumped closer to the mirror. My pupils were so dilated my eyes had gone black. I stared and did not see myself reflected back: I saw something other, some shade of a person trapped inside the glass like Bloody Mary. I placed my hand on the mirror to steady myself, seeing at first only the beads of cold sweat on my upper lip; then, as I began to fall, I saw a smear of blood on my reflection. That crimson smear, glowing like fire in front of my icy countenance, was the last thing I saw.
I collapsed.
I was having a miscarriage.
* * *
I don’t know how long I lay on the floor in the bathroom, the cheap bath
rug my only source of comfort as I drifted in and out of consciousness. I don’t think my lack of consciousness was due to a serious loss of blood. I simply just didn’t want to wake up.
Not yet.
As a lawyer, my housemate, Denise, worked much longer hours than I did and when she finally came home she entered the bathroom to find me lying, ironically, in foetal position on the rug.
‘Oh my God, Carla, what’s happened?’
‘I’ve had a miscarriage,’ I answered, quietly. ‘I don’t know how … I didn’t even know…’ My sentences were trailing off because I didn’t have the energy to finish them.
‘We need to get you to a hospital!’ Denise shrieked, as she fell down to her knees beside me.
The hospital was ten minutes away – I knew that because I used to work there. I had autopsied babies there.
I knew I had to go.
* * *
I was off work for a few days and in the interim I was prescribed anti-depressants, painkillers and sleeping tablets as well as antibiotics. They all danced in my stomach like fire imps because I was supposed to take them with food but I didn’t want to eat. I didn’t want anything.
Upon waking in the late afternoons I’d lie on my bed with the curtains open. I liked to watch the sky through the window particularly as twilight descended: there was something comforting about everything I could see being veiled in a dusky blanket, becoming darker and darker until nothing existed, only the moon. I reverted to something I hadn’t considered in a long time for any form of comfort: religion. Not in a particularly coherent way; I just liked the feel of the cold haematite beads of my favourite rosary pressed against my feverish forehead. I took another sleeping pill at dusk, and as I began to fall asleep my fingers loosened their grip on the now warm beads. The last thing I’d see before my eyes closed was the blood of my miscarriage, still staining the underside of my fingernails.
Eight
The Head: ‘Losing My Head’
I don’t wanna know your secrets,
They lie heavy on my head.
—Richard Ashcroft, ‘Break the Night with Colour’
I was completely in the moment. The only thing I could do was focus; focus on the task at hand and take one minute at a time. I had already wet the hair of the deceased female lying on the tray and used a comb to create a horizontal parting at the back of her head – a thin thread of white skin connecting one ear to the other. With the same implement, I combed half of her hair forward over her face and half down the back of her neck, which was elevated up from the post-mortem table by a rubber head block. I swapped my comb for a scalpel, exactly traced the line of the parting with the blade, although with much more force, and the thin scalp yawned open, revealing the eggshell surface of the skull: a huge incision at the moment, but one that would be barely visible when reconstructed. Using one hand to grip the upper flap of scalp I pulled the skin over the top of the skull towards her face, with all my strength. There was a ripping sound and every now and again my progress would be foiled by some white connective tissues determined to keep the scalp attached to the bone. All it took to release them was a gentle caress of the blade, and the scalp would continue to peel forwards as I tugged hard, until the skull’s bony forehead came into view. This was quite an easy head to open – I hadn’t had to slice behind the ears for a bit of extra ‘give’. Some heads are more difficult than others in that way. It made me think of a lovely APT from the Midlands who’d once joked to me, ‘I think we should all be born with no ears and a zip.’
This was the way we dissected all adult heads. The large incision at the back could be stitched tidily after the examination and any hair combed down to cover it so it was hardly noticeable. If a decedent had very little or no hair we made the incision as far back as we could so that perhaps a pillow could hide it. We certainly never took the easy route and sliced through the forehead, something the creators of that movie prosthetic had wanted the world to believe …
Using a similar technique, I also dissected the lower part of the incised scalp at the back of the head down towards the neck – a much easier task – then whipped my scalpel in a V-shape around the temporal muscles, both visible at the sides of the skull as two islands of striated muscle. These had to be dissected away from the bone and flattened against the displaced scalp to make way for what came next: the saw. Electric head saws used in autopsy rooms have oscillating blades, which means they can cut through bone but not skin or other soft tissue. They are, in fact, the same as those used to remove a plaster cast from someone’s broken arm or leg after it has healed. Head saws create a lot of debris in the form of skull fragments and bone dust. For this reason, they often have a vacuum attachment and hooded suction tube to catch most of the dangerous particulate matter so that we APTs don’t breathe it into our lungs, but it makes them incredibly loud and cumbersome. We can also opt to wear a paper surgical mask as well.
‘Ready for me to remove the brain, Prof?’ I asked, as I stood to attention, saw in hand like a member of the Queen’s Guard holding a rifle. You always had to ask permission to begin this process because it also warned the doctor you were about to turn the saw on – very important given that he was handling sharp objects and the sudden electrical whining of a power tool could make him cut himself in fright if he wasn’t expecting it.
‘Yes, Carla, no problem,’ Professor St Clare said.
He and I had a perfect rhythm going when it came to these High Risk cases in our small, specialised autopsy room, but we still ran through protocol. He’d barely finished his sentence before I turned the saw on. It whined like a dentist’s drill yet growled like a vacuum cleaner. I manoeuvred the awkward hooded blade from the middle of the forehead in a straight line down to the left ear. I then did the same on the right. I repeated the process at the back of the skull: from the middle to the left ear and then to the right. This left me with an elliptical ‘eye-shaped’ piece of bone which was not quite free. There was one more thing to do: using the T-shaped piece of metal, sometimes called a skull key, I inserted the bottom of the letter T into the crevice created by the saw, hit it with a mallet, and then, using the top of the T, I twisted to the right. This immediately freed the skull from the tough layer of tissue beneath it, called the dura, with a sound like a crack and a rip at the same time. The skull cap – the calvarium – popped off easily and I laid it on the PM table beside the deceased’s head. I had revealed the glistening brain.
The brain looks so … unassuming. It’s hard to believe it contains around a hundred billion neurons and is the source of our personality, our memories – ourselves. Pink and shining, it seems almost a cheerful organ. Because it’s so delicate, I used one hand to hold it steady as I began to release it by slicing through the cranial nerves at the centre of the base of the skull. I then dug the scalpel deep into the foramen magnum – the hole through which the brain joins the spinal cord – and cut right across the cord to release it. I held it a little to the left as I sliced through thin connective tissue known as the tentorium on the lower right side of the skull, and then repeated the process on the left. This then freed the two cerebellar hemispheres making up the cerebellum, the lower part of the brain, and I was able to place the whole organ gently into the steel bowl of the weighing scales. Every organ was weighed during the autopsy process and usually the pathologist did that once he’d dissected them out of the organ blocks. The brain was my job, though. I wrote ‘1349g’ on the whiteboard – an average weight for a brain, which is usually between 1300g and 1500g – before carefully sliding it on to the dissection board next to Prof and watching it already begin to lose its shape; to deflate.
My brain felt like that: deflated and flat. But I don’t think that was my real temperament – it was caused by the medication. Still, I was glad of the predictable daily insipidity. There were two things that could have made my return to work difficult. One was the ever-present threat that Sebastian might actually turn up. Everybody else in my mortuary seemed to be
acting as though nothing had happened, as though I’d just been off with the flu, so why not him? The other was the fact that I had to continue my work burying babies. They were everywhere, these dead babies. I noticed them more now for obvious reasons: I had become a statistic. But I just felt numb thanks to the anti-depressants. I don’t know what I would have felt had it not been for them. Every day I just wanted to come to work on time, do my job, and go home. I was like a zombie. I took my sleeping pill around six p.m. every evening, woke up the next day at five a.m., went to work and did the same zombie routine again. I was a very functional, hard-working zombie. I was a good zombie.
I suppose that’s why I was fixated on the brain.
Prof snapped me out of it when he began slicing through the pink mass with a long, incredibly sharp brain knife, each thin segment of the organ flattening even further on to the bloody dissection board until it was just a pale puddle of mousse. He found nothing out of the ordinary. This was typical with High Risk cases such as this, which had been referred to us because of the patient’s intravenous drug use, the inference being that if they’ve been using needles they could be HIV positive. The likelihood was that our patient had died of an overdose, but we could only say we suspected that cause of death ‘pending toxicology’. I knew, therefore, what Prof was about to say before he said it, and I already had the syringe in my hand.
‘Carla, we’re going to need some vitreous,’ he confirmed as he pulled off his latex gloves and threw them in the yellow clinical waste bin, then began furiously scribbling his findings on the autopsy form.
Although some APTs hated it, removing vitreous humor from the eyes was one of my favourite jobs because it required extra precision. Wielding my syringe, I moved around the steel post-mortem tray so I was face to face with my patient. When I looked into her crumpled visage it reminded me of my face: the stoic facade sometimes collapsing with tears once I got home at the end of the day when I really felt the loss of not one important thing in my life, but two.
The Chick and the Dead Page 16