Who Owns Me Once I’m Dead?

Somehow, the last week came together in a nice neat epiphany last night. I think you would call it an epiphany anyways, or at least I had one of those ‘this is all connected!’ moments that forced a big grin on my face and I knew I had to write about it. As you may know, I went to the AAPT Consent Training day last Friday, and Monday I attended a talk by Sarah Wise on grave robbing in London. I happened to find myself chirping in with the discussion after the talk on Monday with my two pence about the Human Tissue Act and the relevance between the modern day issues and the grave robbing issues. Then yesterday I had booked to see a talk by Dr. Ruth Richardson at the Old Operating Theatre and little did I know it would nicely tie all of my thoughts and feelings together in a big ball of understanding and new found enlightenment. Sounds dramatic I know, but it certainly felt that way so bear with me while I explain.

Dr. Ruth Richardson is the author of many books, but arguably her most important publication is the 1987 ‘Death, Dissection and the Destitute’ which although over thirty years old is an incredibly relevant and thought provoking book. As she discussed in her talk yesterday, Ruth neatly tied together the impacts of the grave robbers, the later introduced Anatomy Act and the arguments against involuntary dissection taking place and heavily influenced the introduction of the Human Tissue Act and the HTA. A lot of what has taken place in the past would make people shudder, knowing that we went from an illegal trade in body snatching and selling to the anatomy schools, to a law being passed whereby if a body remained unclaimed and no relatives objected it could be dissected by an anatomist at a licensed institute.

My signed copy I will treasure for a long time!

My thoughts and feelings here turn to the fact that ever since the days of the early anatomy schools there has been debate around who owns a human body once the person is deceased. It had come down to money and to progression in science and healthcare for a long time. This is, however, very much a debate that still burns brightly today, as Ruth highlighted in her talk, with the moving forward of the opt-out organ donation scheme. Luckily we stand at a place now where you will not have anything happen to your body without you or your family’s consent. Briefly I will mention that people feel strongly about the fact the opt-out organ donation movement would feasibly take away this consent process and could consequently end up with someone who is against their organs being donated having them taken for this purpose had they not let their feelings known and opted out as required. I tend to stand on the side of that if you are strongly against your organs being taken you are given the opportunity to opt out and I would assume that you would do so. However, I also accept that this could not happen for reasons unknown and ‘absence of evidence is not evidence of absence’. From my previous discussions of organ donation, I know there are strong thoughts and feelings around this and I can very much see both sides of the discussion.

Back to my original point, who does own a body when the person has died? Grave robbers clearly thought it was whoever literally had it in their possession, whether this came through digging it up or buying it from those who did. The Anatomy Act legislated that if you had enough money and we’re claimed your family owned it, but if you were poor and no one came forward then wherever you died owned it whether that be a hospital, prison or workhouse. Obviously a slight progression from the grave robbing days but still very abhorrent to our modern minds. The Human Tissue Act dictates that consent must be given for human tissue to be retained or used in all scenarios (apart from Coronial matters) whether that be from the deceased prior to death or from their family once deceased. In no situation can tissue be retained indefinitely without this permission. It is still not clear who ‘owns’ a deceased person as such, I would suggest that we have only moved forward to a point where nobody does. People look after and care for them until they are safe in a state where they are no longer disturbed, or they remain in an institute for research purposes with complete permission. No one owns them as such and they still have a real sense of agency of their own continuing into death. Is this the peak of post-mortem progression or do we still have a way to go? I’d be interested to hear thoughts on this because I have a lot rumbling around in my head!

Huge thanks to the Old Operating Theatre Staff and to Ruth for the great evening last night. Thanks to you too for reading and please do get in contact if you have any thoughts on this.

MG x

A Good Reason to Stay Hydrated

Well the really lovely weather left us as quickly as it came, and currently it’s a weird combination of windy, sunny and rainy. I can’t complain as such, there are some great rainbows when it’s like this. This might be a death blog, but I’m British therefore I still must refer to the weather a lot and rainbows are just pretty.

Fancy Double Rainbow

I’m not certain I’ve mentioned it before, but we have another hospital mortuary that we cover as part of the same NHS trust. The other one is smaller, there are no post-mortems or community deaths there and it is only open for regular hours in the afternoon. Recently I joined a rota where we cover for week long stints and this week just so happened to be my first week. I was a little apprehensive of being there on my own but the afternoon flies by because it’s quite busy and it’s good for gaining confidence in doing tasks. People seem to think that being on your own in a mortuary is the worst thing because you are alone with the people there. Hardly, I think the worst thing is being ridiculously busy with the phone ringing, doorbells going off and not being able to cover it all!

My confidence levels with completing the evisceration have come along leaps and bounds too. Maybe that’s why I had a small accident this week. Every single APT I have spoken to has a story about hurting themselves at some point in their career, and numerous other stories about colleagues injuring themselves. Probably not unlike when I was an archaeologist and everyone had a story about hurting themselves somehow. I was lucky that the worst that ever happened back then to me was a severe case of sunstroke in all honesty. Comes with the territory of a physical job as such but that doesn’t mean I take it less seriously I must assure you!

I slipped during evisceration and managed to cut a very tiny slash into my glove, and my second layer of glove and right through to my top knuckle of my index finger. Teensy cut, a bit like a paper cut. It doesn’t hurt, but I had to follow the protocol of what you do when you hurt yourself which is wash and bleed repeatedly, bandage, report the incident and then get myself up to Occupational Health for an appointment. They advised that they take bloods and then again at six weeks for comparison, they also gave me a booster for my vaccinations. I had heard the common phrase in hospitals of ‘needlestick injury’ before from my induction trainings and I knew these were taken very seriously. My cut is technically not one of these but is treated exactly the same. It’s great to know that in the event of something a lot more serious I would be covered by this and seen as quickly. In hindsight, I can only say it was a mistake and I will be more vigilant in future. Please let me also assure you that though there are stories, incidents are few and far between and this is not on everyday occurrence!

My plaster collection is coming along nicely

The title this time around refers to when they tried to take blood from me. Apparently, as I was told, a glass of water and one cup of coffee is not enough to be hydrated by mid morning. They couldn’t find a vein in my arm and had to go in the back of my hand. They also notified me this will bruise nicely although nothing has appeared as yet and it just aches quite a bit.

I shall leave you midweek with a recommendation- Monday night I went to see a Funzing talk by Sarah Wise on Grave robbing and grave robbers in London. It was fascinating and such great value for money! After having a look at some of the upcoming talks, if you are in the city or able to get there I cannot recommend them any more highly.

Thank you for reading, and I’ll update you at the weekend after a very exciting cemetery visit.

MG x

A Sunny Day in London Town (Part Two)

Old St. Pancras Church

Hidden in a street behind St. Pancras Station is Old St. Pancras church, small in size and atop a kind of hill up some stone steps. Surrounding the church are the remnants of a churchyard. I say remnants because at first you don’t really see much of a graveyard as such. There’s a lofty memorial sundial surrounded by some grave stones and a few here or there where you can’t read any of the writing. I had wanted to come here for a while since I heard about a particular tree.

Burdett-Coutts Memorial Sundial

The Hardy Tree stands to the left and rear of the church. It’s surrounded by a hedge and you don’t notice what is special until you get quite close. Tightly packed all around the base of the tree are gravestones sat face to face so you can only read the writing on some. This is the spot where people’s remains were relocated when the next door railway line was built. It stands as a reminder that a final resting place is not always so final, and is often quoted as being a symbol of the moral and ethical problems that can arise. The sundial is also a memorial to these graves but the tree is far more emotive in my mind.

Tightly packed graves around the Hardy Tree

It is called the Hardy Tree named after the Victorian author and poet Thomas Hardy who worked in the graveyard clearing the graves as an apprentice architect. He wrote a poem titled The Levelled Churchyard about his not so pleasant experiences there moving coffins and remains away from the planned train line.

Not only is this an impressive and unusual sight to see, it does make us notice and question the fact that once we are gone there may not be anyone to stop our remains being interrupted. Space issues and new developments will often encounter human remains, and they will be moved to another spot, bringing to light all kinds of questions around what is happening.

The wall of the railway looms behind the tree.

Let me know what you think on this! Would you like to see the Hardy Tree? What does it make you think of? Thank you for reading as always and enjoy the nice weather if you have it where you are!

MG x

P.S. don’t forget the upcoming death cafe from my pervious post! If you are thinking of coming let me know.

A Sunny Day in London Town (Part One)

Well in case you didn’t know, we have had some very Summer-esque weather here the past couple of days. I feel that I have fully immersed myself in this by having drunk cider in a beer garden and got my first sting of sunburn that I always do as a pale, basement dweller.

Friday I had the absolute pleasure of spending a day at the AAPT (Association of Anatomical Pathology Technologists) head office in the city. This did mean getting on the tube in rush hour, but it also meant getting to spend some time with some great people. I was lucky to have secured a place on the Consent Training Day 2018 where professionals from all across the specialism from midwives and APTs to pathologists got together to learn about post-mortem consent.

The structure of the day was a talk from Lisa Carter, a representative of the HTA, regarding the regulation of consent, another talk from a member of the AAPT, Martin Goddard, around the different types of consent and how they are given/taken and then an afternoon in a workshop group discussing scenarios. I took my seat second row from the front (my eyesight is not the best) and studiously took notes the whole day determined to get out of the sessions what I could.

Consent is something that is hugely important in our role. Our most common type of post-mortem is a Coronial one where it has been ordered by the Coroner. This is unavoidable and consent is not required from the deceased prior to death or from their relatives. However, in the case of research or for other interests there are post-mortems undertaken and for these full consent must be granted. This consent process is not complicated but is thorough and there are a number of guidelines around how best to approach and record. I won’t go into heaps of detail here but it is a fascinating and intricate process to ensure that the family receives the best for their relative and nothing happens they wouldn’t want it to. This particularly focuses on the retention of any tissue and what it is used for, ensuring that nothing is kept unknowingly or for purposes unknown.

Unfortunately this has come off the back of a few ‘scandals’ that occurred where tissues or deceased were kept without the knowledge of the relatives. This led to legislation being passed to ensure this could not happen again and this is excellent for securing trust back in institutes. It would seem the media loves a mortuary scandal and the reporting of it, even recently. It’s a shame when the good work of the institutes are not highlighted as often!

I had a brilliant day at the course and saw a few people I had previously met and also met some new people which is great. So pleased to be a part of this and hope I can help with the progression the profession continues to have.

Look out for another post later today as I took a wander through the city afterwards, and between leaving training and ending up in a beer garden I had a little adventure I’d like to share!

Thank you for reading and if you have any questions please do get in touch!

MG x

Announcing- Hornchurch Death Cafe May 2018

I have some incredibly exciting news that I’ve been wanting to share with you all for some time now. It’s not that I couldn’t, only that I thought exactly one month before the event was a great time to let you all know. So if you’re free on the 16th May, can get to Hornchurch and fancy a night in a pub talking about death then please keep reading! (I mean, if you’re not free, can’t get to east London or hate pubs you’re more than welcome to keep reading also, don’t worry.)

On Wednesday 16th May I will be hosting a Death Cafe. What is a Death Cafe? Well, I knew you’d ask. Death Cafe is an organisation who advocate and promote the discussions of death in a positive way. You can find out more about the history and how they started at http://deathcafe.com/what/. A Death Cafe event itself is a place to go and talk to other people about death. It is very much in the vein of the Death Positive movement that I am a full supporter of. I honestly think that the world would be a better place and we would all be a bit happier about it if we just spoke about death a bit more!

The event on the 16th May also coincides with Dying Matters week. Dying Matters is an organisation based in England & Wales who encourage people to talk about death, dying and bereavement. They were originally started by the Department of Health and now work with NHS UK. They aim to get everyone to the stage of ‘a good death’ where people are aware of the wishes of the dying and deceased. Dying Matters week 2018 runs from the 14th to the 20th May and their homepage has a lot more information and details of events that may be closer to home for you.

If you do fancy it, come along to the pub on the 16th and join us. There will be drinks, food available if you would like it and plenty of discussions around death. As someone with anxiety, I understand if you would like to come along but would like to listen to the discussions rather than participate and this is totally fine! My friend Rachel, who attended the Death Cafe event in November with me, has kindly agreed to cohost with me too and we are looking forward to meeting everyone. If you have any other questions or concerns about the evening please do not hesitate to contact me either through comments here, @gemmanorbs on Twitter or at gemmanorburn@icloud.com and I will respond to you as soon as I can.

The evening will have no specific themes or objectives, other than the fact I’d like to get a group or groups of people together and chatting about death. I’m eager for the conversation to flow naturally and there’s no pressure to share anything you don’t want to. The flyer for the event is below for more information, if you want to print this or would like a printed copy to display somewhere please also get in touch.

I’m very excited about this event as you can probably tell and I hope to see some of your faces there on the night!

MG x

Want To Know An Interesting Fact About Enrique Iglesias?

As I sit here typing this out I have hiccups. I actually got annoyed at my diaphragm for spasming just now, a little reference to a previous article there! I often get hiccups, not for very long but my diaphragm must be prone or something.

It’s been an eventful and enjoyable week I’m pleased to say. I am at 17 brains now, feeling pretty good about that. I put up a post-it on the wall of the office by where I sit with a tally as I’m sure I’ll lose count at some point. I think it’s good to count as it will be fun later on to recall for people as well as it being a good track of progress. I don’t think I’ll bang on about it quite so much going forward but I’ll probably just mention milestones. I think I’ll aim for 25 as my first milestone, should get to that in a couple of months I predict.

My work in the post-mortem room is coming along as I’ve definitely got better at everything. I can see my confidence growing each day, and I’m stupidly close to being able to do it on my own now for straightforward cases. It’s partly my own confidence holding me back, I struggled with a bladder today for no reason other than my own hesitance. Must remember to believe in myself more!!

A few notable things, in my mind, happened this week and are as follows. A colleague and I got to take one of our patients to Radiology for a CT scan which I have never seen before. CT stands for Computed Tomography, I just had to google that so don’t worry if you didn’t know that. The images produced are a complete 3D image shown in slices across planes of the body. This was absolutely fascinating and a change from the normal day to day work! Huge thank you to the staff in radiology for being lovely and for also finding it quite funny when the machine asked our patient to hold their breath.

At one point this week a patient in the post-mortem room had a tattoo with someone’s name on it and two other people in the room with that name. This made me chuckle a bit at the irony of them all there together. In the office one day we discussed something called situs inversus I’d like to mention to you all. This is where the organs of the body are completely reversed in location. For example, their spleen will be on their right side where in majority of people it’s on the left. From a little bit of research I found that this is a very uncommon occurrence although it is hereditary. Further to that, Enrique Iglesias has situs inversus according to Wikipedia! As far as I can see this condition will not cause you any problems, although it can cause confusion in situations like appendicitis and the pain is on the wrong side which can delay diagnosis if the condition is not known. Fascinating stuff!

Next week I’m off to a training course I will be certain to update you all on. No planned trips anywhere else but the training does take me into the city so I might see if I can include a little cheeky cemetery visit somehow.

Have a great weekend everyone and a huge thank you to you all for reading as always. Keep the comments and questions coming as I love hearing from you all!

MG x

A Night at the Old Operating Theatre

Along St. Thomas Street, just up the road from Guy’s Hospital where I used to work last year and the fancy Shard building, there is a doorway that most people just walk past. Tucked in the corner of that doorway to a restaurant is another door that opens to a spiral staircase that appears to go on for ever and ever. In fairness, it is only 52 steps. But 52 rather narrow, winding and enclosed steps where the only place to hold on is a rope which winds around the middle with you. It’s intimidating, scary and a little exciting. At the top of those stairs is a pretty awesome gift shop I won’t let myself spend too much time in for the fear of also spending far too much money. I would really love a giant plush of a red blood cell, alas my bank balance cannot justify that purchase.

This museum is the Old Operating Theatre of St. Thomas’ Hospital alongside the Herb Garrett. The Herb Garrett is part of the original church of St. Thomas and thought to be the place of storage of herbs and other medicinal plants. All of this sits in the rafters of the church and you would never know it exists from the street. The Operating Theatre is located at the top of another (shorter) set of stairs and is mind blowing. It is set out exactly as the early operating theatres would have been, with viewing galleries round the sides and a central wooden table. It is plain, simple and to me shouts out all of the things it has seen through it’s atmosphere. If you can visit, you should. The museum is open from 10:30am-5:00pm each day apart from Mondays.

Tuesday evening Laura D and I visited as the museum was open and hosting a talk by Bill Edwards. You might remember my mentioning Bill previously from talks on the wax models Joseph Towne at the Florence Nightingale Museum and from the Cellular Pathology meeting at the Gordon Museum. It’s fair to say I always enjoy a talk from Bill, he has a sort of morbid humour I think we share and clearly knows how to keep an audience interested. This particular talk was titled Dealing with the Dead – Sentiment versus efficiency and covered the ways in which the dead have been disposed of ranging from Neanderthal practices right up to modern day more unusual and, oddly, fairly unfamiliar options available.

The first part of the talk was great from my point of view of an ex-archaeologist who has covered lot death practices and enjoyed them from a different perspective. I am familiar with a lot of the different images shown, from bog bodies, mummies of all varieties, death monuments and structures to the more ‘modern’ structures in places like Highgate cemetery which we visited recently. If anything, it was really cool to see that my knowledge of death throughout history was as extensive as what was covered in this talk!

One example that I was not aware of was the Ukok Princess of Russia who was found in 1993 in Siberia. She is believed to be from the 5th Century BC and has some amazing examples of tattoos and clothing preservation that I think are incredible. The images can be found by searching for her on Google and I thoroughly recommend a search just for the awesome tattoos alone.

Another interesting thing that was discussed that I was not really aware of is the Catacombe dei Cappuccini in Sicily. There is a famous child mummy here, the little girl Rosalia Lombardo who more can be found out about here. She is an example of preservation that is breathtaking, she truly does look like she is sleeping. As Bill explained, the land of Sicily is not made for burial with most of the ground being made of hard volcanic rock. The way the locals got around this was to create the catacombs and literally hang people on the walls. Each one wearing their finest clothes. This place just made the bucket list of places to visit and I’m very jealous because Laura D has been there!

Lastly, I would like to leave you with one thought. Bill’s talk finished with a summary of what can happen now to your body once you die. I had no idea so many different things could happen, but I would ask you to consider them in your death plans people. Have a little search and you will find that you can become a number of things from pencils, be used in paint, be put in a bullet, have music made from your DNA and have your ashes scattered via firework. Why be interred when you could go out with a massive colourful explosion? Well, it’s up to you, but it does make me think about what the future of the death industry holds for us. Personally, I still haven’t settled on a final death plan yet but the more ideas I get the more I think it could be really quite a unique experience.

If you get a chance and fancy it, come along to the next event at the Old Operating Theatre on the 26th April. Please don’t be afraid to ask questions or give comments if you have any. I can be contacted via gemmanorburn@icloud.com or on Twitter @gemmanorbs. Thank you for reading and hope you enjoyed it!

MG x

My feet hurt. I’m tired. It’s Brilliant.

No sarcasm intended!

Before you think I’m being a rubbish wimp, please bear in mind I am on my feet for most of the day. I know, most people have desk jobs that don’t require this, but also I’m aware that some of you have jobs on your feet all day. So also bear in mind I am lifting people, quite often those a lot heavier than me and moving them about. This is the most physical job I’ve had since being an archaeologist and that was mostly digging holes for 7 hours a day! Now my days are split between lifting, moving and cleaning. As I said before, only apply for mortuary jobs if you are happy spending large amounts of your time cleaning.

The first five day week in quite some time for me started probably as it meant to go on. Busy as ever although I cheekily booked a couple of days off in May. Apologies for being quite quiet over the last several days, I prepped a post on Friday night but it never got posted and is now a bit redundant. For example, I’ve removed another brain since then taking the total count up to 16. At the end of last week I tried to think or count how many eviscerations I have now done (I think around 12) and how many people I’ve stitched up (utterly lost count of that one I’m afraid).

Brain number 16 was a relief today, I don’t know if I was having a bad day or if the person was particularly difficult but I struggled somewhat. I was pleased when the skull was open and the brain was out as it meant the process was complete and the reconstruction could commence. We begin the reconstruction often before the pathologist has looked over the organs unless they instruct otherwise. It may be that they want to examine something like the head or chest closer but generally they have all they need and we can begin. Me being new and therefore quite slow, I don’t keep up with my colleagues yet even remotely. However, in the time it took them to do two each on Friday I completed one evisceration so I figure I’m working about half the desired speed. Not bad for three months in to my training post!

One important thing I learnt today, don’t buy the same shampoo they use in the mortuary for yourself at home. Your sense of smell can be the most triggering when it comes to memory and that’s not what you need in that scenario. I’ll take my colleagues advice and spend a little more on products in future so I don’t make that mistake again (it’s fair to say that both myself and the mortuary have ‘owning items from the pound shop’ in common if you get my drift). We have shampoo, conditioner and shower gel that we use for cleaning the people during and after post mortem. We even have a hairdryer which I’ve now used a few times on those with longer hair. Very strange to start with when you stand there like a hairdresser at the end of the tray.

That’s all from me tonight, I can barely keep my eyes open right now. Tomorrow I’m heading into the city for a talk which should be fascinating, I will update you all on that towards the middle/end of the week. Thank you all so much for reading and getting in touch- keep your questions coming please!

MG x

Deterioration & Dancing

It’s been a strange start to the week. I can never get used to weeks that start on a Tuesday, it doesn’t feel quite right. Plus I have this thing where Tuesday is the worst day of the week and those who know me well will know this. Yesterday just so happened to be a Tuesday and we were back at the fullest capacity we have been for a while. While we have been really busy, my duty of checking our longest residents for deterioration slipped a little with checks not being done as regular as we would like. Yesterday was the first day in several weeks I was able to get round and check all the people to make sure they were in a good condition and not just the longest or those of concern.

I expect you have two questions relating to that. Firstly, I bet some of you are wondering why people are with us long enough in order for this to happen. Sadly, all manner of circumstances in life and death can lead to someone staying with us for an extended period of time. Ideally, I would like to check everyone who has been with us for longer than two weeks on a daily basis however sometimes due to the workload this is simply not feasible. However, the vast majority of people do not stay with us for this long so this should get easier as the year progresses and both days this week this has been the case.

Secondly, I would assume you would like to know what happens to these people. Once signs of deterioration are recognised these are monitored. If someone can be released and picked up by their funeral director, for example, we would encourage this. This is usually not the case however, and we need to act in order to try to at least pause the damage which may occur (you can’t stop decomposition happening as such, but you can slow it right down). This is done by placing people in the deep freeze unit. At our mortuary, we have one deep freeze with 12 spaces. The people in there are usually there for some time but it could also be short term and to prevent any smells or unpleasant side effects of decomposition. This freezer runs at around -15 degrees centigrade and that’s really cold. I don’t like standing in front of the open door for long at all. Bear in mind our normal fridges run at about 4 degrees centigrade and they feel very cold to me some days!

Two more days left this week and I’m glad to say some very exciting events are lined up for this month and the next. In addition, I gave my third blood donation today and I feel dutiful to request that if you can donate please consider. Blood banks are running low at the moment in the UK due to the poor weather conditions recently and they are in desperate need of donors.

I’ll leave you with a little lovely thing that happened today. I mentioned the funeral directors who comes in with a little blurb about the person in a previous post. Today we had someone collected from us who was over 100 and up until recently still went dancing. I love that so, so much.

Thank you for reading, commenting and asking your questions. Please keep them coming and I will do a post answering them soon!

MG x

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