Announcements, Goodbye Daisy & Some Thoughts

I have a cold. I’ve tried hard to ignore it but my cough is actually exhausting now. My poor immune system has really taken a battering this year, I’m feeling so very run down but that’s not my announcement. I would like to warn you all now that I will be scheduling in some Mortuary Gem downtime coming up starting the 28th March and ending 8th April where I’ll be back and firing on all cylinders hopefully. It’s not that I need time away as such, but I do feel the need to remove myself completely for a short while for my mental and physical health. I will spend that time mostly reading books for pleasure which I haven’t done in a long time!

The first on my my reading list!

It’s been a calm week in the mortuary so far, but a busy one otherwise. We had our March Upminster Death Cafe yesterday which we muddled through with my cough, Rachel’s sinusitis and me forgetting the crucial name stickers I always use! It was quiet as a lot of people are unwell or busy at the moment, but I think we had some of the most poignant discussions we’ve had in a long time talking over the topics of the recent violent crimes around our local area and the suicides in the media of high profile individuals.

Goodbye Daisy

We also discussed a book that was shown to us by our regular attendee Becky. The book is called Goodbye Daisy and is to help children and children with learning disabilities process the death of a friend. It’s a wonderful book that can be purchased here, I can thoroughly recommend it as it really made me think about some new perspectives on dealing with death. I also love the fact Daisy loved glitter and I’d chosen to wear my glitter boots that day. It was better than coincidence! Our next Death Cafe is the 16th April, please get in contact if you are interested in attending.

Daisy loved glitter so would have loved my boots!

My final thought for my midweek catch up is suicide. There’s been some events and media coverage recently that has really got me thinking about it. I would just like to say that there are always people who can help, even when you think you might be completely alone. There is always hope, even when you feel utterly hopeless, and there are always other options even when you feel like you have none. Please share and use organisations like the Samaritans and Mind who are there to help and solely exist for that purpose. You are not and never are a burden to them. Take care of yourself and those around you because you really cannot know what people are going through in their own minds. Please be kind.

MG x

How Splenunculus!

Doesn’t it sound like something completely amazing and fabulous. I think I will refer to anything wonderful from now on as splenunculus! It’s actually a little thing that the human body can do, where the spleen doesn’t form in the usual way and creates a little tiny accessory spleen. That little guy is called a splenunculus. Cool right?

A tiny accessory spleen, or splenunculus if you will

Another crazy busy week spent filled with anxiety about not getting enough done while actually doing an awful lot. On Tuesday I attended a talk with Laura T where Dame Sue Black was interviewed about her life as a forensic anthropologist and about her book. It was a fascinating talk which I enjoyed, even if I don’t always agree with her opinions on certain aspects. I can’t lie, her book I had borrowed from Laura D and has been on a huge pile I’ve mentally noted as ‘to read at some point or another’. I now have my own copy which I can place there so at least I can give it back!

Terrible lighting and a poor attempt at an arty photograph

It was my turn in the post mortem room this week, most notably was the day that I spent asking people if they could smell poo on me. Sometimes certain smells, no matter how much you scrub, just won’t come off. Luckily no one actually said they could smell it, so it would appear it was one of those times the smell has just kind of got stuck in my nose (for want of a better term!) and I could smell it only myself. At the same time, I had quite a difficult evisceration to complete but gave my best shot at doing the three block technique and the pathologist seemed quite impressed. I then mistook a rather large spleen for a liver later on and I think she stopped being impressed with me at all.

Outside of that I’ve been cracking on with my assignments for my course, sneaking a bit of typing or reading whenever I can. I’m aiming to have them all at least in rough draft soon so I can feel a bit more chilled about it all and focus on some revision for the exam in May.

As part of my Health &. Safety assignment my camera roll has been filled with amazing photos like this one of a fire extinguisher

Rockstar the cat was back at the vets this week, he had to have four of his teeth removed as he’s an old little chap and they had rotted. That all happened a day after I had a visit to another East London hospital to find out that I have to have my four wisdom teeth removed in May. I’m not really happy about the fact I’ll be having my first very general anaesthetic too. Not very splenunculus at all.

Post-teeth removal Rockstar cheekily lying on all my reading material for the evening

Next Tuesday is the March Upminster Death Cafe which I hope will be a good one. Have a lot of people who have been in touch. The April and May dates have been confirmed which is great too. I was hoping to be involved in a project called Departure Lounge which is upcoming in May and June but sadly I can’t make the training dates. However I have just been asked to do a talk to some junior doctors about evisceration in September which is very exciting!

Death Cafe is next Tuesday!

That’s all from me for now, hope you have a splenunculus weekend!

MG x

So You’re Dead… Were You Prepared?

I think one of the biggest things I seem to metaphorically bang my head against the wall about is the fact people have no idea what to do when someone dies. Culture appears to have, for the last several decades, really tried to put people off discussing death. Especially with our nearest and dearest. In very simple terms, this means as and when people do die, those left behind are very much left at the mercy of those in the business and trust them to do the right thing. But what is the ‘right’ thing that needs to happen? Well in reality there is no right thing, there is only what people truly want and often this is not what happens.

In the past, undertakers have been very good at recommending what should happen to us after we die. They sell plans aplenty to the ageing population and service the bereaved left with the task of arranging funerals for their loved ones. The problem I have with this is two fold, they sell plans that often are not quite as clear and straightforward as they seem and they are selling funerals to people at one of the most vulnerable times of their lives. I am in no way saying that all undertakers are money grabbing vultures, but they have become very good at making a lot of money out of their businesses that’s for certain. I do see a lot of very honest people working in the profession too, newer businesses starting up with clear and simple upfront prices that don’t bamboozle the grief stricken.

There really is only one way of combatting this and that is to arm ourselves with the knowledge we need to make an informed decision. The best time to do this is well before we are in a position to have to make it, well before the emotions involved may take the wheel and steer us in a direction we wouldn’t normally choose. Haste is not something you would want to have when deciding something very important like this.

Personally I think just having a think about what you wouldn’t want is a start. Would you rather be buried or cremated? Would you like neither? Do you even know what other options there are? Do you want flowers or think they’re a waste of money? Would you like people to wear a certain colour other than the standard black? Do you know what your family would want? What they could afford once you are gone?

It’s a matter with so many involving factors it’s something that needs to be discussed. One thing I think is the least helpful is something I have witnessed a few times at work when a deceased loved one has told their next of kin ‘I want as little fuss as possible and as little as possible spent’. This rules out the expensive but easy funeral director route and leaves a lot of people scratching their heads. The issues here is, it can be done for very little when done yourself but do you really want to be finding out how at that stressful time or know well in advance what needs to occur to make it happen. I hate to say I told you so, but the death anxiety in our culture has made this so very hard and it’s only damaging ourselves.

If I have one piece of advice it’s to do some research. Have a think about it. Approach the conversation with someone close to you. I promise you this can only be a help for a time when you either can’t or don’t want to do it.

MG x

The Smelly World

What an odd week it has been. I can’t deny that I’m very aware of how often I say that but it has been a very odd week. I won’t go into too many details but it’s noticeable the nicer weather is having an impact on the deaths around here, and by that I mean they appear to be decreasing in numbers! I’ve said that and next week will be busy now, but that’s always the way it seems.

On Wednesday I headed with Laura D to The Vaults festival at Waterloo to see Dead End, a play about death (or so it advertised!). Honestly, I don’t mean to be cruel and I did find the play very funny in parts, but it had little relevance to death in the whole. It’s set in a graveyard of a church, it would seem that there is a body found at the start, and it is hinted that there is a real feeling of grief and bereavement in one character that is never really explored. I can only say it seems a shame that they could have done a lot more with the subject, however I did appreciate the leaflets spread about the seats before the play started pointing the audience in the direction of sources of support for anyone experiencing similar feelings. I have attended the Vaults before and this year I was pleased to see they have joined with St. Thomas’ Hospital to discuss death and bereavement, a great way of reaching out to people!

I gave the usual Care After Death training to the nursing staff this week, crammed more people than usual into the smaller of our two mortuaries and went through with them what we do there. It’s really pleasing to see these numbers of people attend (because people want to be there I hope and not because it’s mandatory training!). It’s so important people across the hospital understand what we do and don’t add to the myths and mystery surrounding the mortuary.

Unfortunately spring time does have one impact on those that have died. We get a little influx of decomposed people. Putting it in the nicest of ways, as the weather warms up these people are often found easier because of the smell. It’s a good job we took a delivery of what I call smelly sand, but officially known as Odour Neutralizing Granules. It’s wonderful stuff you can put with people who have, well and odour about them, and it helps to keep the smell down. I wanted to share the slogan on the bottle because I think it’s wonderful!

“Saving you from a Smelly World”!!

That’s all from me this week, I’m keeping very busy with my coursework and other things. Thankfully not feeling overwhelmed just yet, but I’ll try to keep that feeling away for as long as possible!! Also, a belated Happy International Women’s Day to all the women out there, I celebrated by going to see Captain Marvel which I cannot recommend more highly if you’re stuck for what to do this weekend.

MG x

So You’re Dead…. Where Are You?

Everybody knows that one day we are going to die, sorry to break that to you if you didn’t. However we usually never know when, how, why or where that will happen (that Uncertain Certain I wrote about previously). ‘Where’ is a big issue amongst the dying industry of late because it would seem more and more people are dying in hospital. The reason this is an issue is because most people would, when asked, choose to die at home. A lot has been discussed on this topic in the media recently, and I think this has a lot to do with the death positivity movement and the move towards a form of ownership over our own deaths.

If you thought that was a discussion around your spiritual location as opposed to your physical one, sorry that’s not really anything I know or discuss very often. I usually get asked on a regular basis if I believe in any religion, the answer is no. I also get asked if I believe in ghosts, and the answer to that is a shrug of the shoulders and I’d tell you that I don’t really know.

Back to your physical body. Chances are in the current circumstances you will be likely to die in a hospital. Either as an admitted patient on a ward or in an emergency department or A&E. I can only use our hospital as an example but when this happens the patient is ideally moved within four hours of death to the hospital mortuary. The porters transfer the patient who is then moved to a fridge space accordingly. During their time in the mortuary they might move around, only within the confines of the mortuary but they could be taken out of the fridge for a viewing, post-mortem or both during their time with us. Occasionally there might be a need to move people to contingency spaces which are slightly smaller than normal so small people are moved to make spaces in the average sized spaces. If their length of stay is anticipated to be lengthy then we may also move people to our freezer, or for other reasons.

If you die at home, you pretty much have three possibilities. If you require further investigation or a post mortem then you would go to a mortuary either public or in a hospital. If you don’t, then you go straight to the funeral directors, or via a combination of discussions you could remain at home until the funeral. Many are not aware that this is a viable (or believe it to be a preferential) option but it is available if you would like it to be. It is actually becoming more common that people arrange funerals themselves without involving a funeral director which would also involve the deceased being at home for some time unless they are at the mortuary for longer until burial/cremation.

I think the point of this post is to inform that there are options and you do not need to be dictated to about where you die or where you end up once dead. The only aspect there is no choice behind is whether or not you need a coronial post-mortem, if the coroner decides that you do then this must be enforced. It is important that people think and discuss these, if only just to be aware and be able to be informed of a decision needs to be made. I don’t believe in people being dictated to in death just as you would not accept it in life.

If there’s anything I have not covered or you would like more information then please get in touch!

MG x

Things I Learnt In Hartlepool (Part 1 of 5)

As I mentioned before, my training requires me to go to Hartlepool five times this year to study for my Diploma. The last three days I have spent in the North-East having a lovely time, learning lots and meeting some great people. Here’s a quick update of where I’m at as my train speeds it’s way back to London.

Getting a group of people together who work in mortuaries is like giving us all a licence to talk. It’s a bizarre thing to witness, discussing mortuary work in fairly hushed voices in a pub like some secret society. However, we got slightly louder when discussing the course and then more trainees joined us after hearing our conversation and realising we were on it too. So then the hushed conversation became bigger but still hushed nonetheless! It’s not as though we ever discuss anything we shouldn’t, but we’re not sure how people would react listening to us discuss was protective equipment we use or how many post-mortems we’ve completed!

In that vein, it is a strange thing but it cannot be denied that every mortuary seems to do something very different to somewhere else. Our dinner on the second night consisted of eight of us from all over the UK (fairly widespread), comparing everything from our equipment, to team sizes, to tools used, to how our department fits in with the hospital or wherever it may be based. Turns out this is a discussion that can go on for some time, with so many differences it seems strange and a bit baffling.

Hartlepool itself is lovely, even if I’ve only really seen the Marina area. Our first evening there it was really sunny and warm which was nice, the other days it’s been a bit more grey but not raining which seemed good. One thing we were advised to do was to give the Monkey a visit. The full back history of the Hartlepool Monkey can be found here, but the basic story is that it’s thought in the Napoleonic Wars some locals mistakenly thought a shipwrecked monkey was a French sailor and he was hanged. A bit along the marina from our hotel is a bronze monkey hanging out by a lock with a bowl to throw money into. One of our course facilitators told us to do this and it ensures that we will pass, so of course we obliged!

The Hartlepool Monkey Just hanging out by a lock

So what did I actually learn while studying? A fairly in depth exploration of Health and Safety in the mortuary and an introduction to Microbiology which nearly made my head explode. My poor cell anatomy knowledge was really put to shame finding out that a lot of cells are a lot more than cytoplasm and nuclei. Therefore I discovered I have a lot of work to put in before I’m back there in May, got three assignments to be getting on with, a portfolio to build and an exam to study for. Feeling slightly overwhelmed is an understatement but I’ll get there. I threw money to the Monkey after all.

MG x

Platform 9 3/4

Or actually Platform 8, but I can dream that I’m finally aboard the Hogwarts Express and not a Grand Central train about to depart for Sunderland swinging by Hartlepool on the way.

It’s actually happening. I’m off on my first of five trips up North to begin learning and training for my qualification. I’m going to learn the ins and outs of being an APT with a whole bunch of other cool people doing the same thing. Plus I bagged a window seat which makes this trip even better. The train is warm and stuffy, but the sun is shining and my sunglasses are in reach at least which is good because I think once we’ve pulled out of the station the sun will be directly in my eyes. After note, I wasn’t wrong about that.

All-Weather Gemma (my alter-ego) is always prepared

I had a good start to this week, I had a busy day on Monday in the post-mortem room and felt good about my skills leading up to today. Then yesterday I had a great day, performed two eviscerations and then assisted the pathologist and felt like I was so happy with where I am at right now. The brain count is up to 78, surpassing my 75 milestone that I was aiming for and already made a start towards 100. The skills I want to try and improve in the post-mortem room going forward are to perfect the three block technique because I tend to not be able to get the organs out correctly when I attempt this.

On a personal level, I’ve had a noticeable improvement since the first two weeks of the year where I had a panic attack followed by a bout of gastroenteritis. I’ve been having some counselling sessions and focusing on small achievable goals with the ‘Counsellor Man’ as I’ve been referring to him as. We discussed how nervous I was about this trip today, turns out in my classic way I’m more nervous about this journey, the hotel and the people I meet along the way than I am about the actual studying. I don’t want to sound arrogant, I’m a natural Ravenclaw and study is my strongpoint.

I am looking forward to beginning and understanding a bit more about what this course entails. I’ve got a few bits and bobs to keep me busy while I’m on the train, a few emails and things to read plus a catch up of a couple of tv shows. I just finished Umbrella Academy this morning annoyingly but I might have to rewatch it at some point.

For now, I’ll post again when I’m on my way back and I’ll be working on my next ‘So You’re Dead…’ post too. I also just misplaced my favourite pen and I’m stuck in a window seat surrounded by passengers. This could be a long journey after all.

MG x

So You’re Dead… Now What?

I thought this week I would discuss a bit about the different stages of death, or what happens after we die. Most people will have heard of rigor mortis and know that this is a stiffening of the body, but you might not know that there are other stages and aspects to death that the body goes through. Here’s my whistle stop tour of some of them and what happens in each one!

Now what happens?

Obviously, death occurs when the body stops functioning as it should. This can be classed as either a brain stem death, or a cardiac arrest, or respiratory arrest. In order to be alive you need those three to be working together so you can breathe and pump blood around. Hence why life support machines provide these functions for you if necessary. People clearly can and do die in a number of ways but ultimately they all cease to have a functioning brain, heart and lungs in whichever order.

Immediately after death four things occur in the body which signify the changes occurring. These are known as the familiar rigor mortis, alongside pallor mortis, algor mortis and livor mortis. After these processes the processes of decomposition follow which I’m sure you all know too. In case you need reminding Wikipedia states that this is “accompanied by a strong, unpleasant odour”. While decomposition is interesting and something I find fascinating, it’s the subtler four initial stages that are also really quite interesting.

I’ll just say here that this is a super simplified version and there are many other things that can happen to the body depending on the situation or condition it is in. Also, there is not an easy timeline for these changes which again depends on the condition or situation of the body, which further supports the need for research and human taphonomic facilities (body farms). These can be proven to occur at set times but they overlap and coincide with each other. For want of a better term, when these things occur is complicated with many factors to consider and for now I will leave it at that.

It’s complicated and difficult to predict but can be generalised fairly easily

Dead people have some traits you would easily recognise and be familiar with. I think if you were to describe one you would most likely use these words, ‘pale, cold and stiff’ and you would largely be correct. Firstly, the paleness is from the process of pallor mortis where the colour from the skin fades within two hours of death. I think dead people often look waxy too, although also sometimes people simply don’t have this at all and look pretty much asleep! This of course depends on the pigment in your skin and darker skin tones have less paleness occur.

The coldness is mostly from our fridges at work but a bit like a forgotten cup of tea, with nothing sustaining the body’s heat it sinks to the same as it’s surroundings, so without a fridge this would be the ambient room temperature thanks to algor mortis.

As you probably know the stiffness is the rigor mortis where the muscles have chemical changes that cause them to tighten. They are not impossible to move and you can often ‘break’ the rigor mortis simple by moving the arm or leg slowly but firmly. Once broken it won’t return and it does eventually leave the body to become floppy again. Rigor mortis can set in within four hours and stay for around two days or so but maybe longer.

The other stage mentioned above is the livor mortis which is subtle in some ways but also the most visible in most cases. In this process the blood in the body, no longer being pumped around by the heart, comes under the influence of gravity and sinks to the lowest point. Generally, with people lying on their backs this means to their posterior so the back of the head, chest, abdomen and legs. If the person was face down then this would sink to their anterior or front and if, for a strange example, the person was standing up somehow it would sink to their feet, ankles and legs. It is visible by a purple hue to the skin, sometimes very dark and sometimes just a hint.

It’s these stages that we see from our hospital patients who reside in or mortuary. My manager has instilled in me the knowledge to know the simple things, like if a patient isn’t laying with their head slightly raised and facing directly upwards the discolouration can show in their face and be not very nice for families coming to view. Also, until this stage where the blood has settled, removing any lines from drips or intravenous medicine from their skin can cause them to bleed uncontrollably thanks to the lack of clotting. We also use aspects of rigor mortis, for example closing a patients mouth before this has set in will ensure it is closed for family viewings and the patient looks peaceful. It’s these small things that I’ve learnt so far like this that I try not to take for granted because they are small but so important to our work.

If you have any questions about these things please get in touch, I might know or I can always try and find out!

MG x

The Certain Uncertainty of Death

Something I’ve noticed recently is how quickly time is moving for me. It feels like I blink and a month has gone, the days go fast and the seasons change quicker than I realise. I’m barely used to winter and it already feels like spring is on its way. Thinking about this made me realise some things I’d like to share. Some random thoughts about why we fear death so much and how we can recognise this in ourselves and other people.

One aspect of the modern world I find amazing is how long we all expect to live. People who die at 70 are considered to die young, whereas a several decades ago that would have been an achievement. Medicine progresses to cure more and more, so it feels like we’d only be happy to die of old age at 110 in our sleep. Sadly, very few of us will actually experience that and the truth of the matter is that we could die at any age. It’s the uncertain certainty, death will happen but rarely can we be sure of how and when until time is running out.

In this sense, the modern world prepares us to die at a ripe old age. We are advised to invest in pensions pots and plan for our retirements even though the pension age gets higher and higher. The world expects to live for a longer and longer time each year. This can only add to the sense of being robbed of this liberty when somebody dies young. I’ve noticed a large number of people dying in their 40s for example, for a range of reasons or illnesses. This is only about ten years older than I am now but the prospect of only having ten years remaining seems grossly unfair. Yet it could happen.

Once the fear of this creeps in, it’s hard to shift that thought and appreciate life in the way we think we should. The contradiction of living each day like it’s your last but saving money because you’ll grow old is around us everywhere. You can see in the same magazine two different articles about why we need to eat a healthier diet and then later on why we should just eat the damn cupcake. In a practical sense, we somehow have to accept that life is finite and varied in length, but in reality this is not a thought that comes easy. I remember learning once something like that a thousand years ago living past 35 could be deemed old age. These things change and develop through time and I wonder if their thoughts would have been any different or the same just on a much shorter timescale. Religion has had and does have a lot to say on accepting your time and the will of higher beings, but I think in a modern world where people rely less and less on religion we will of course question these things instead.

I do hope that this is thought provoking and not depressing as it could be interpreted. What I am trying to emphasise is that fearing something unknown will ultimately not lead to any good. Learning to accept the unknown and know it exists is key, and by understanding that you can see through the fear to some extent. I’m not saying that I am not afraid of death, or that I am not sad when those around me die. It doesn’t make grief or bereavement necessarily any easier, but it does make living with the inevitability of death a lot easier.

MG x

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