Don't diss them, just 'cause they're dead

kw: book reviews, nonfiction, occupations, mortuaries

When the discussion turned to the dissection of a well-rotted, 560-pound man, I had to close the book until I'd completed breakfast. Over the past few days I have read Down Among the Dead Men: A Year in the Life of a Mortuary Technician, by Michelle Williams. I quickly learned the limits to the steadiness of my stomach.

Ms Williams, now a Mortuary Manager in Cheltenham, England, began a career among the non-breathing at the age of thirty, when she was hired at a trainee MTO (Medical Technical Officer), now called APT (Anatomical Pathology Technician), at least in Britain. On this side the pond, the only title I find in the job ads is Mortuary Technician.

What does an MTO/APT do? Typically, keep track of the body of a deceased person and preserve it between the time of death and its transfer to the undertakers for burial or cremation. In one-third of cases, perhaps more, the cause of death must be investigated. Then a PM, a Post-Mortem dissection and investigation, is performed. The technician is usually responsible to remove the organs from the chest and abdomen—which are typically separated into two large stainless steel bowls—and the brain, which goes into a smaller bowl. The pathologist examines the body and the innards and the brain to determine cause of death.

On occasion, the death is a problem occasion: A questionable accident, a murder, or a few other causes trigger a forensic PM, which a forensic pathologist will usually perform, unless he or she decides to simply direct the dissection by a technician.

There are a lot of ways to die, and most of them are unpleasant. Things that happen to a body after death, particularly if too much time passes, make matters even more unpleasant. The author was endowed with a curiosity that overcame her distaste and fear. She repeats several times throughout the book how impressed she was by the profound respect and care for the dead that she saw in her mentors, Clive and Graham. This kept her going, this and seeing how crucial the work was to proper care for both the dead person and his or her family.

A major aspect of the work was arranging for family viewing, frequently for identification purposes. She describes some of the tricks of the trade needed to make a body presentable after PM; how the eyes are kept closed, for example, or how one hides the slice behind the head where the brain is removed. In one case, a man had been crushed by a combine. His head looked more like a flounder. One of the men took great care reshaping the head and making it presentable, and arranging the whole body, badly damaged as it was, so that viewing by family members could be allowed.

I read nearly all of this with equanimity. But, I have to admit, the obese man got to me. He was too big for the cooler, so he sat for a few days at "room temperature", and was green and slimy when they got the go-ahead for a PM. This was not a case of a "big-boned" individual, as so many fat people claim they are. Ms Williams writes that it was a very small man who'd clearly struggled against suffocating under hundreds of pounds of fat. Just getting to the body cavity was a major excavation. The entire crew needed a few stiff ones afterward.

It is one thing to get well set into a career working with the dead. Before long, one has seen it all, and gets inured to experiences that few of us would wish to have. A person also sees every kind of reaction by the next of kin, all of whom mourn, but who also feel remorse, or fury, or dread, or all of that. And, as her first year of the work drew to a close, it was the author's turn to be "next of kin" when her beloved grandfather died. It is one thing to watch others fall apart. It is another to be the one falling apart.

We have become insulated from death. I think its very unfamiliarity underlies much of the fear of death. I confess, I've seen only one dead person who was not nicely arranged and made up in a pretty coffin in a funeral parlor. Seeing someone suddenly die made me realize how fragile life is. I don't think I'd have the steadiness to do the work of an MTO. I'm glad there are people who can do that, and I'm glad for this window into their world.