Kidneys Are A Bit Awesome. Fact.

I can only apologise for my lack of posts recently, it feels like ages since I’ve posted anything particularly informative other than my regular weekly updates! I have been distracted by my life outside work of vets visits for my poor cat Rockstar who had me worried senseless alongside some other life stuff. I’d love to say I’m on my way back to some kind of normality at some point but who knows!

Obligatory Rockstar photograph, with his little cute bandage!

For now, I’ve got some time so let’s look at one of the body’s most interesting organs (my own point of view) the kidney! I’ve had some of my own kidney issues in life, namely multiple kidney infections including one time in Greece on an Archaeology trip where I ended up urinating in a plastic cup in a doctor’s house and walking past his family watching tv holding it. That time I had pain so bad I vomited and I think possibly hallucinated. Some say kidney pain can be as bad as childbirth, I can’t comment having only experienced one but it was a pretty rough time.

Flashback to archaeologist Gem who always seemed to have sunburn and a kidney infection of some variety

The little kidney is a thing of wonder. You need only one functioning one to live but it has to work. Without that you need dialysis to keep you alive or a full on transplant. On a basic level your kidneys filter your blood and remove out waste alongside fluid which produces urine. The urine travels to your bladder and its removed when you urinate. There’s a highly complex structure of nephrons (the tiny parts that do all the hard work) and a filtration system that works together to do this. They are bean shaped (hence kidney bean!) and look kind of smooth and purple when healthy. Inside they are often a yellow or white. The pathologist removes them from the fat they reside in during a post mortem and has to separate them from a capsule that surround them, often by sliding a finger around them. They sit nearby the adrenal glands that produce necessary hormones, including that lovely stuff called adrenaline.

My drawing of a sectioned kidney in a jar for display

Sometimes the kidneys have cysts on them that can be quite large and burst when removed. These are known as cortical cysts and are generally harmless unless affecting the function of the kidney. I’ve seen quite a few, and a couple go pop. I’ve also seen kidney scarring where the surface is pitted or mottled rather than smooth. Again, scarring can be harmless and is caused by numerous trauma or conditions in the kidney, unless the scarring affects the function. I once asked the pathologist if all my infections would have scarred mine but truth is I wouldn’t know without taking a look, and I’m not that desperate to know.

This week I was lucky to see an example of a horseshoe kidney, where the two kidneys are not separated as normal and are linked at the bottom in a U shape. This can be completely harmless in people and you may have this without even knowing. It can cause some symptoms but there is no known solution. According to Wikipedia it’s a 1 in 600 chance of having this and is more common in men than women. There’s more information and images on Wikipedia.

In some cases, people are born with only one kidney, or only one functional kidney and one kidney that is not functional. In this situation you may, once again, never know you have this. It is possible to never have any problems! I myself know that I don’t have this because I had several scans in my early twenties to find out. Unfortunately I have abnormally short ureters from my kidneys to my bladder that allow infection to travel upwards. Hooray for anatomical abnormality, a slightly sarcastic but there’s no denying they are extremely interesting. The best I can do is ensure I take care of bladder infections or UTIs (urinary tract infections) effectively and drink lots of water. I was also advised to not have baths and avoid citrus or caffeine among other things.

Lastly I’d like to mention kidney transplants. I think the coolest things about transplants are twofold. Firstly, you can donate a kidney while alive and well, and live a normal life after. It’s one of the few things you can give as a living donor. As said above, you only need one functioning kidney to survive. Secondly, they do not remove the non or poorly functioning kidneys of the recipient and they can end up with three or even four kidneys in total. I think someone once even ended up with five (something I think I saw on QI episode once upon a time!). There’s more information on kidney donation on the NHS website.

Aren’t kidneys great? I had a love/hate relationship with mine for a long time but I can only be grateful they do work well most of the time. Give yourself a little pat on the back (pretty much just below your ribs) and thank your kidneys for the hard work they do!

Tomorrow I am off to the AAPT annual conference in London, and I’m very excited! This is how it all began a year ago when I started my career, and I can’t believe how much I’ve progressed in a year. I will write an update shortly after so keep an eye out.

MG x

Death Cafe, The London Podcast Festival & a Very Important Question

The fourth Upminster Death Café, which is our fifth that we have hosted and was somehow, utterly unintentionally, an all-female attended event, which I think definitely influenced the mood of the evening. By this I mean that I feel it allowed the people there to open up a bit more about some of their personal experiences and be totally honest about some things they might not have wanted to in front of any male attendees. Of course I could be totally incorrect about this and we could well have had exactly the same experience with men in the room! I also would like to just say that it does not mean that men are unwelcome from now on and it was just a funny occurrence, everyone is welcome of course.

Not sponsored by Coca-Cola, unless they would like to…

I was really pleased that we hosted 15 people this time around (in that I include myself, Rachel and the lovely ladies of the Sweet Rose Cakery because we all get involved) and to have people bring with them some topics they wanted to discuss. We had a great range of conversation and went off on a few tangents as always, but the conversation did come back to death every time. We covered old age, how our parents or relatives reacted to bereavements, how to talk to people who are grieving, whether or not you have to have a funeral, and ‘death denial’ among many other things.

The atmosphere of the night was overall a very happy one and there was a lot of laughter with some sadder moments in between. For anyone curious, this is the general tone of the Death Café events that I have noticed, it’s very positive and often funny but people are safe to express other emotions and will be listened to. I think that by the fact people have opened up in this environment shows that people feel comfortable enough to do so. I will always totally understand if people are worried about what these events contain, but the only way I can help is by recommending you attend one if you are interested and find out.

The rest of the week has been quite eventful for me! At the weekend I attended the London Podcast festival and saw live my two favourite podcasts of them all- Griefcast by Cariad Lloyd and Wooden Overcoats written by David K. Barnes. I’ve banged on about them a lot on here before but if you’re interested give them a google or iTunes search.

Wooden Overcoats- a comedy about rival funeral directors on a fictional Channel Island

Griefcast- Cariad Lloyd interviews comedians about when they have experienced grief

This week I’ve been back and forth to our other hospital covering the afternoons, as well as there all day today to give some training sessions to staff members. As mentioned before, we give training to the nurses and other staff who do end of life care to ensure they are giving the patient the best start in death for when they come to the mortuary. As well as this we also train the portering staff on their work in the mortuary. We think it is important too that they get to know us friendly members of staff who they won’t be afraid to contact if they ever have a query or are unsure about something. This was my first time doing this training on my own and I think I did okay, although I introduced myself to be told ‘We know, we saw you on the Intranet!’. Apparently people know me, might explain some of the smiles and looks I get around the hospital, I thought I just looked weird!

A little while ago I saw on Twitter a company called Death Deck who were producing a new card game that caught my eye. Death Deck is a game to encourage people to have the difficult conversations about death with their loved ones, the cards having some questions which prompt these discussions. I was so excited I ordered as soon as it came out and it finally arrived yesterday, after some hefty customs charges. I’ve been speaking to them about it being available on the UK Amazon soon, but it’s available in the US now. Planning on busting it out at an event soon, really looking forward to playing it!

The Death Deck game

I’ll leave you today with Funny Things I’ve Heard on the Staff Bus- Part 1, my new mini feature. Well, let’s see if I hear anything else at any point for a Part 2! Three, I think junior doctors but I could be wrong, were sat behind me on the bus and were discussing healthy eating. One of them said that she had tried being vegetarian but would still eat fish, justifying this by saying ‘Well would you rather punch a fish or punch a cow?’. This is now a question I think I will be asking everyone I meet just to hear what they think. So, what would you rather punch, a salmon or an Aberdeen Angus?

MG x

If You Go Down To The Crem Today…

You might well be in for a big surprise. Who knows! Way back in March, I had seen that our local Crematorium, either known as Corbet’s Tey or the South Essex Crematorium, runs tours for interested local people. I emailed on was offered one in September but made sure I could go, so I found myself on a rainy Wednesday afternoon at the Crematorium. The tour covered the building only, which is comprised of the chapel areas and the actual cremation area. Please note, I asked at the start if I was allowed to take photos fully expecting to be told that the area where the cremations taking part would be off limits. I respected this so there are no photos of what we saw there, but tours like this run throughout the year and you are able to go and see them for yourself if you are interested.

The East Chapel

We started off outside the smaller East Chapel. The building itself has two chapels, the larger South chapel and the East. First we were told a bit about the building itself. The crematorium opened in 1957, we were told this was the year when cremations first overtook burials as the most common method of ‘disposal’. The two chapels are equipped with a media system which allows music to be played, as well as recording and live linking of the ceremony online. The larger South chapel has the ability to show tributes on screens at the front also. It is all very modern and the person conducting the ceremony can control this alongside the curtain around the coffin, or someone in an office outside the chapel is able to do it for them.

Small office where the controls are

I am quite familiar with these chapels as I have been to several funerals at this site. I remember seeing the coffin led in, and placed upon the stand (which has a name I can’t remember!) at the back. Behind the stand are two doors which I always believed didn’t actually open. I’m unsure why but I always thought the crematory workers would come into the room and get it after everyone had left. More on that later. While we were in the chapel, the person showing us around gave a little talk about how to organize a funeral and the costs involved, including interestingly how to keep the costs down. I can definitely recognize a shift in focus of people who work in the death industry towards keeping the costs as low as possible.

Inside the chapel

As for the area with the ‘hearths’ as they called them, I think of them as furnaces for some reason but I’m guessing that’s the wrong word, it amazingly wasn’t as warm as you would think. Those doors do open and the people that work out the back bring the coffins through into the next room on hoist trolleys like we use at the mortuary. Four cremations can happen at a time, although only three were in use when we were there. We saw the different stages of cremation through the peep holes at one end, the raking process to remove the cremated remains and then the placing of a coffin into the hearth. The room itself was tiled and quite large, with waiting coffins on one side and the office and raking area on the other. To one side of the office is the room with the Cremulator, possibly the best named piece of machinery ever and then a further room with the containers of remains with names all stacked and waiting to be collected. The Cremulator not only sounds awesome, but it also finishes off the process by grinding up all the remains to the fine powder we know as cremation remains. Before this there are recognisable bits of bone alongside whatever else there may have been in the coffin. We saw the charred evidence of false knees and picture frames for example. We were also told about how items left in coffins can explode during the process, one pacemaker has exploded here costing thousands of pounds of damage, but also cans of beer go bang if not opened.

Interestingly, the metal left after is placed into a bin if the ‘recycling’ option is selected by the family at time of organising the cremation. These are then recycled, the titanium of knee and hip joints fetching a very pretty penny. The money is received back to the crematorium in the form of a cheque and that money is donated to some great local charities like St. Francis Hospice and Mitchell’s Miracles.

Side view of the building

After visiting the crematorium I do still feel like cremation is the biggest waste of energy it could be. The gas pipes going into the room are huge, and I dread to think what their gas bill comes to. I also think it a shame that you need to have a coffin to be cremated here, they will accept the wicker and cardboard types but I really don’t see the point in having one if you’re going to be burnt to ash. This really only strengthened my desire to see Alkaline Hydrolysis become legal in this country to save waste on coffins or gas! Please don’t cremate me when I’m dead, simple shroud in the ground thank you until other methods are available!

The other thing that I found astounding was their encouragement for to people to be embalmed. The comment was along the lines of the smell isn’t pleasant for them if you aren’t. There was a lot of nods in the room and my little voice from the back cried out ‘find out more about the process before you make that decision!’. Honestly, the lady showing us around told me that at the funeral directors you would be asked if you would like to see your relative before the funeral, if the answer is yes then off they go for embalming. I’ve not gone too much into the process before because I would like to see it one day properly, but I don’t like the sound of it and I’m not sure others would either. In my mind it’s mostly unnecessary apart from in a few occasions, particularly unnecessary if refrigeration is used and the funeral is within a couple of weeks. Plus it’s another charge to add on your bill that makes funerals so expensive. However, I’ll save my full embalming rant for another time.

In other news this week, totally smashed my 50 brains target and currently sitting at 54. My manager showed me the most effective way of completing a brain removal and I’m going to have a go at some point replicating what he did. I will explain when I do!

Death Cafe is coming up on Tuesday, hoping for a good turn out so if you would like to know more or are thinking of attending do get in touch.

MG x

#OOTD

(Outfit of the Day!)

I am often asked what I wear at work, and to start with on the first few occasions I kind of just assumed it was a slightly odd and prying question. Maybe it would be to see if I was wearing the correct stuf, like checking up on a trainee. However, I am asked quite a lot what I wear, what personal protective equipment (PPE) is worn in the post-mortem room, or even very specific questions about what brand of gloves we use. Here I want to provide you an insight into our outfits and equipment we use to work and keep us safe. Please note that as far as I know, through my limited experience in the past year, each mortuary and person who works there is different and has different preferences! This article only gives you an insight into the mortuary I work at and what I do or have learnt from those I work with.

To start, each morning when I arrive I change from my own clothes into scrubs. There are lots of different colours of scrubs available but I tend to wear green for post-mortems or work like that, or black if we have visitors, meetings or training sessions inside or outside of the mortuary. A lot of people around the hospital wear green scrubs every day, including doctors so i’ve occasionally been mistaken for a doctor while walking around the hopsital. No one else wears the black scrubs so this often prompts questions of where I work. I personally prefer our black scrubs, purely because they have a load of pockets whereas the green ones have just one. Anything with multiple pockets is amazing in my eyes.

In true Mortuary Gem style there had to be a photo with a Snapchat filter. Green scrubs vs. black scrubs.

On my feet most of the time are clog type rubber shoes. Like Crocs but without the holes on the top. Plus stripy Harry Potter socks, because why not. Everyone wears these (clogs; not the socks) but I have a purple pair that I acquired when I started working here. Other people wear black ones or blue ones. They’re as comfy as slippers but as ugly as actual clogs. I have a massive love/hate relationship with them.

I have all four Hogwarts Houses socks which I wear whichever I think suits my mood that day. Plus some generic Hogwarts and Fantastic Beasts socks. Yep, some days are Slytherin days.

The gloves we use in the fridge room are thin enabling you to work easier. They come in four sizes (small to extra large) and are placed in racks around the room at the doorways. I tend to wear medium but I can squeeze my hand into a small. They are usually purple or light blue like the photo below. They come in a box of loose gloves and you can take any to fit any hand.

Fridge room gloves, in the lovely purple colour.

The only time we add extra protective equipment really is inside the post-mortem room. The full outfit is the scrubs on underneath a surgical gown, apron, plastic oversleeves, gloves, hair/head cover and eye protectors or glasses. On our feet we wear wellies, or some people enter the post-mortem room with shoe covers over their own shoes, for example the forensic team when we have a forensic post-mortem.

The full stunning outfit with gown and without so you just have scrubs underneath

The surgical gown can be a blue silk gown like you see surgeons wear on tv. They have a high collar and tie at the back. Some are long and others are shorter but they come in so many different sizes and lengths it’s pot luck really. We get these from the hospital laundry along with the green scrubs. We also have once use only gowns that come in vacuum packs. They have a Velcro neck that I’m never sure if I’ve fastened correctly because it either is too tight or comes undone, and tie around the middle again. The upside to the disposable ones is that they breath a bit better I don’t sweat all the time when it’s hot. Obviously they do go in the waste after but the silk gowns are sent back to laundry to be treated and washed.

A not-very-helpful photo of a pile of silk gowns

The disposable gown packaging

A green plastic apron goes over the top of the gown and is to stop splashes or blood soaking through. They are long so cover your front all the way down to your wellies, pretty handy if someone accidentally fires a hose of water in your direction. I find the neck is low on these so I tend to stretch the loop and then knot it tighter so the neckline is higher. Just a personal preference I’ve figured out.

Apron-over-gown-over-scrubs-under-wellies and clogs to one side

The plastic sleeves are for a similar purpose. Water or other fluids splash up our arms and the last thing you need is that soaking through. Also sometimes you’re required to go further that glove deep into something. Not always as bad as you might think, occasionally it’s a bowl or sink of water! Although, all this plastic does make for a very hot outfit that’s just made for sweat. If you need to flex your muscles to do something or move around a lot then I nearly always break out in a sweat. I accept I’m not the fittest of them all but I think most people are in the same boat.

Gown sleeves with and without the plastic oversleeves

Glove wise we have two types in the post mortem room. We have these thicker blue gloves that are like rubber gloves with a rolled end and again they come in a box where you can just take two and they fit either hand. These blue gloves are also labelled Small, Medium, Large and Extra Large; again I take a medium. The other type are cream coloured and come in a box of paired packets which are labelled left and right. They are thinner but stronger and fit snugly to the hand, sized with numbers. I tend to use a 6.5 or a 7, and everyone seems to double up on these so I often do too. This can mean wearing a 6.5 and then a 7 on top. I like these gloves a lot as you can feel a lot more of what you are doing.

The blue thicker gloves not unlike but slightly thinner than the washing up gloves my mum used to own

The thinner gloves shown over the oversleeves, the boxes and the packet with right and left denoted

There’s two types of head or hair covers, one with an elastic back and one with a tie back. I always wear the yellow elastic back type and it fits snugly that most of the time I forget it’s even there. Which suits me fine! I haven’t actually tried the blue type but I probably should at some point. I wear my glasses and consider that eye protection as you’ve probably noticed from photos, but I know I should wear the proper stuff and have done before. We also have full face visors for when you need extra protection, or just masks for the mouth. Although I have found that masks just fog my visor or glasses when I breath which is not at all helpful.

Wellington boots are a must in the post-mortem room because of the water and other fluids that are on the floor. Other footwear is actually really slippery! I remember seeing in a Green Wing episode the mortuary team walking in file around the hospital all wearing wellingtons. Well we never do that; they don’t leave the post-mortem room and only go into the changing area after a good scrub with water and bleach!

In the photo above with the mask on my face, I am wearing a full body suit which zips up the front like a onesie, it even has a hood. This is used mainly for ‘high risk’ but also for messier than usual cases. Not pictured, but we have some respirators that are used for airborne or other situations when you might not want to breathe anything in. They are a full face mask that is sealed around your head, but with your ears on the outside which feels bizarre. There is a long tube that runs down your back to a pack that has filters which is fixed around your waist. I’ve only tried them on and I put them together with a colleague when they arrived, I’m not permitted to work on high risk cases yet so I won’t use them for work for some time.

In addition to what I wear, another question I was asked is if the different items we wear are recycled in any way. Waste and what we do with it has been a big focus of the mortuary and the hospital as a whole for some time. We recently switched a proportion of our waste to a different kind so it isn’t so costly or damaging to the environment when disposed of. Unfortunately however, some of our waste must be incinerated due to the danger it poses if it has been for a patient with a particular condition or illness. This is both costly and damaging but necessary. All of the packaging and non-infected waste is recycled or sent for recycling. The rest is given treatment which I believe means it is disposed of in the best way possible. What I do know is that although there are limitations as to what can be done with a lot of hospital waste, improvements are being made all the time to reduce the environmental damage caused.

I hope that this post has been as accurate as possible, has answered many questions and has been informative for everyone. If it has led to further questions, please do get in touch as I am happy to answer anything else you want to know!

MG x

Tower Hamlets Cemetery Park

We did it! We have visited all of the Magnificent Seven London Victorian cemeteries this year. Yesterday Laura D and I paid a visit to the final, closest to my home and last to be established of them, Tower Hamlets. This cemetery is also known as Bow Cemetery and is now closed to burials but has become a local nature reserve through the work of the local people. When you walk through the gates there is a smallish building to the left that looks official, and very closed. On the right is a stunning more modern looking building with graffiti and incredible animal sculptures outside. This is the Soanes Centre and is a resource for local primary and secondary school children to learn about the sciences. I immediately liked this place when I stepped inside, it has a charm that felt neither pretentious nor boastful. Tower Hamlets Cemetery Park knows what it is and celebrates it justifiably.

Particularly love the elephant sculpture and bee-themed graffiti

I do not know for certain, but I would guess that this is the least well known and the least visited of the Magnificent Seven. It was considered to be neglected not long after it had opened and it suffered badly during the bombings of the Second World War. None of the original chapel buildings still exist, and it feels considerably smaller than the other cemeteries we have visited. In addition to this, it does not boast famous or notable people that the majority would recognise today, although there are numerous interesting people once you look into this a little deeper into history.

The grave of Will Crooks ‘servant of the People’

Lots of Bears and a Peacock- not certain who this family were but I love to corn iconography

A monument for the children who died under the care of Barnardo’s and for Dr. Barnardo’s own children who died.

Once there was a garden here for the victims of the blitz bombings in Poplar

The distinctive shaped graves of the Charterhouse Brothers monks

One thing I noticed was that the range in iconography and monument types here is vast. Some areas do boast much of the same ‘clasping hands’ or ornate cross types, but the rows and rows of gravestones are much denser than any I have seen. Off the beaten track there are some hugely impressive monuments and interesting areas. There was one monument with a giant sphere on top that was very unlike anything I had seen before. The variance in urns atop graves was vast too. I’ll include some photos below of some of the more interesting graves that caught my eye.

The range of iconography in the cemetery, some classic examples of death symbols and some others I’m not familiar with.

Obviously I was there for the graves, but it’s new purpose is made clear with signs pointing out plants and conservation methods across the park which you can’t miss. I think we were the only people there without a dog, on our way out we met a lovely little thing called Ruby who made me throw her a ball several times!

Information boards for the cemetery and the woodland of the park

It’s pleasing to see that a cemetery transform like this. I have seen many listings on Eventbrite for different plant and animal events in this park. For example, there is an upcoming Bird Ringing event you can purchase tickets for. I got a good feeling from the cemetery, that although the focus was not on the restoration of the graves or the site itself like with Highgate or West Norwood, the cemetery is being cared for by other means and is looked after by the community.

This series of visits has sparked something in us that meant I have been downloading lists of London cemeteries today to eventually put into a spreadsheet. The Magnificent Seven are just the tip of the cemetery and crematoria iceberg when it comes to sites we can visit and our death adventures won’t stop now we’ve done all seven. If you have a cemetery you like and recommend visiting please get in touch and I hope you’ve enjoyed reading about our trips so far.

MG x

Updates, Apologies & September Death Cafe

I think this is the longest I’ve gone in a while without writing a blog post! There’s no specific reason other than I’ve been working on a post I wanted to get out but I’ve not been able to get the photos I wanted yet, so hopefully soon that will be with you.

Instead, I thought I would update you all on what’s been going on. We’ve had some crazy busy days and some crazily calm days at the mortuary. It’s a bit like the end of summer doesn’t really know what to do with itself in regards to deaths. Odd thing to say, but considering we never actually quietened down from Easter onwards like is common each year and therefore have no idea what the winter will have in store for us, it’s also really strange to have no idea what the morning holds for us!

I’ve also not had much chance to get in the post-mortem room unfortunately due to staff being on leave and training the new member of staff on the administrative side of things. I’m not too sad about this, because I know I’ll be back in there soon enough. I’m hoping to try and learn a few new things once I do. The brain count is up to a healthy but teasing 45, at rate I’m going I could reach 50 in a few weeks or in a couple of days, there’s no telling. Last weekend I tried to explain brain removal to a friend who works in a lab in another hospital and realised how hard it is without any kind of props. You simply cannot demonstrate on your own head.

At the weekend also, I caught up with a load of friends who I haven’t seen in such a long time. It was so lovely to see them all, and overwhelming to hear them say how interesting my job/blog is. I do feel like I talk a lot of death these days, which not everyone appreciates but I’m always shocked by how many people are intrigued and ask me questions.

The post I am working on is based upon the items of clothing and protective wear we use in the mortuary. Hence why it is going to be lengthy and many photos are required! If there is anything specific you would like to know please email or comment here as I’m definitely tailoring that to what people are interested in. So far I’ve had in depth questions regarding footwear and gloves- anyone out there got any burning questions about anything else?

Anyone got any questions about this stunning outfit?

The next Upminster Death Cafe is on the 18th September in just under two weeks. It’s been a bit last minute in organising but will still be a great event as always I assure you!

Full September Upminster Death Cafe Flyer

I’ll leave you all with a little embarrassing story. Sometimes, in fact a lot of the time, I’m in the habit of saying entirely the wrong thing for the situation. Not good when you work in a mortuary. I actually told someone today that standing in front of an open freezer door made me feel like I was, and I quote, “freezing to death”. It couldn’t have been more inappropriate and if the ground could have swallowed me up right then, I’d have been very grateful. Luckily I think they accepted my apology and found it at least mildly humorous. I so very dearly hope so!

MG x

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