Copenhagen Medical Museum

Copenhagen was the perfect break for November. Laura B and I had planned it for a few months, we reacted to the intense heatwave of the summer by booking a trip to somewhere that would definitely be cold. I spent many a hot summers day dreaming of blankets, scarves and thick socks. I’m a Winter person as well as a cat person it would seem.

Always perfectly happy in the cold!

One thing I had discovered upon researching the sights of the city was that there was an ‘anatomy’ museum or medical museum. I knew nothing about it apart from a glance at the website to find out where exactly it was, because I had to visit no matter what. As it turns out, the medical museum is nestled in a grand looking building next to the more popular Design Museum. The door as you approach is closed, sensible in the climate, but automatically opens as you approach which is not something you expect from a very tall, old looking wooden door. Once inside, the museum is made of wooden floors and steps, the different areas of the museum separated by split levels and short flights of stairs.

I try not to make a habit of taking photographs in toilets…. but this arty display of sharps bins caught my eye while using the facilities!

Fortunately, the people of Copenhagen do generally have everything in Danish or English so we were given an English leaflet guide to take around with us. I had tried my hand at Duolingo before we went but I was hardly fluent. The museums we went to all asked that we left our coats and bags in either a locker or at a cloakroom, something which felt like a very sensible idea and a good way to feel the benefit of your coat upon leaving!

Cool display of pacemaker devices

The first room we entered was a history of psychiatric care and the different approaches. Most notable of this room was the display of a large lockable box with a bed inside which looked mostly terrifying, and the different therapies shown such as electric shock therapy and a really disturbing box of props used for children’s therapy including a creepy mask.

Next we found ourselves in a room with a large glass table which turned out to be a game. After a good ten minutes of trying to Google Translate the Danish, I turned around to find the English version behind me. It was a game of luck, selecting body parts at random each turn via a spinner in the centre of the table. A bit like Anatomical Twister but each body part came with its own disease or trait that added or subtracted years from your life. We both started off at 80, I was taken years for having some mild complaints and died at 76. Laura B was given a great head start and added many years to get life by being a widow! I can’t remember at what age she died but it was at least twenty years on me. I really liked the concept and playing this game, and once we had finished the guide from the front desk came to find us to tell us a tour in English was starting soon if we would like to join. Of course we obliged!

The back wall of the teaching auditorium

The tour took us through the remaining rooms, starting of looking at some early surgical procedures such as trepanning and amputation. We then moved onto the early thoughts of the four humours of the body and how this developed through time to what we know today. This was very interesting, and included a look at the auditorium that was used for early anatomy and surgical demonstrations and lectures, and also a discussion of how the concept of miasma formed and was then forgotten. This is the belief that infections and diseases were carried in the air, which later changed once we understood infection control a lot better!

Dry specimens displaying various pathologies

The final room of our tour took us into a large area packed full of specimen jars like those I’m used to seeing in the Gordon Museum or at Barts Pathology Museum in London. The first cabinet we looked at was packed full of pre-natal and full term babies with various defects and deformities. It turns out this is a collection formed to better understand these problems and find ways of preventing them. The second and third cabinets were full of other specimens showing various pathologies both in dry and wet specimens which was really interesting. I didn’t ask at the time but I think this was a fraction of the teaching collection from the hospital.

Some wet specimens and also the child with Rickets in the lower left corner

One thing I noticed while there was that there were no issues with taking any photographs in this museum. I know from experience of those in London you are not allowed to take photographs, particularly close up of specimens and I would never wish to because I feel it inappropriate especially in the case of babies. I asked our guide Rasmus after our tour had finished if there were any particular laws around display in Denmark, he said there were no laws as such but there were guidelines which allowed display of specimens over 70 years old and there were no issues with photography. He also commented that they had prepared for controversy when the museum opened in regards to the displays but so far none had been received! It was very interesting to see this difference in attitude here and how they chose to display items.

I loved this display but in hindsight I can’t remember exactly what it was!

One final thing, there was a skeleton of a child displaying the effects of a severe vitamin D deficiency. We in the UK know this as Rickets, however in Denmark it was known as the English Disease! Rasmus said he did not know exactly why, however there was a tendency in the early medicine stages of naming illnesses after nations you did not like. As we found out on our boat tour the day before, the English stole the Danish navy at one point so I can see the justification here.

I hope this was interesting, and has tempted you to visit the museum if you ever find yourself in Copenhagen! Link for the museum is here.

MG x

Mystery Tool Number One Revealed- Rib Shears

(Apologies for the delay, this was written on Wednesday waiting on the tarmac and later during take off at Stanstead. A basic introduction to a tool we use, hopefully you will find interesting!)

I said I would write a post on tools starting with the photo at the end of my last post, then I got either another cold or my original one came back with a vengeance and now I find myself on a plane heading for Copenhagen. Life really does take us in some funny directions, this time to the cold land of pastry and schnapps that is Denmark.

Ceiling of the auditorium at the Medical Museion in Copenhagen. More on this in another blog post soon!

However I do also find myself with a little under two hours to kill which seems like a good time to get the article I had planned out of my brain. No one actually guessed what the tool was, well no one who didn’t work or previously work in a mortuary so that doesn’t count! One guess for their similarity to scissors used in fabric cutting with the curved edge underneath to protect the fabric below. That guess made me realise why the bottom of this tool is curved to protect the organs below.

Many different types (and brands!) of rib shears available

The tool in question is a set of rib shears. They do come in many different shapes and sizes, I’ve tried out many different ones and I do have a preference but they all very much work the same way. Rib shears are used to remove the sternum and the area around it, opening up the cavity of the body to access the organs underneath. I’ve been shown that the right way is to remove them from the areas of the ribs made of cartilage, this means the edges left behind from the cut are smooth and do not leave sharp edges to tear your gloves or yourself on. Although you can place a pad or similar over these edges if this happens.

Before using these, we expose the ribcage from the initial incision and ‘loosen’ the clavicles (collar bones) at the top by cutting them free from the attachment to the sternum. Sometimes the clavicles come away easily and pop upwards, other times they can be harder to cut around and this has even snapped the blade of the scalpel I have been using on a couple of occasions. Note, if a blade snaps like this it can be very dangerous so it is important to locate the tip of the blade (probably stuck inside the patient somewhere) and remove it with tweezers or another tool before continuing to work.

The lower ribs cut through easier than the upper ones, and the first rib is the toughest. Sometimes so tough it requires you to rock back and forth a bit to get it to go, I have broken out in a sweat before in all the PPE trying to do this. Once the ‘plate’ consisting of the sternum and ribs sections is cut, we raise the edge from the base and lift while cutting it free from the attachments underneath. I’ve been told this is a common time to accidentally cut yourself and it’s easy to see why. I’ve also been shown how to make a notch between two of the ribs about halfway up while cutting so you can use this to grip better. When I’ve witnessed people come in and watch post-mortems I’ve noticed that they mainly wince at the noise the rib shears make, a loud crunch occasionally when a bone is tough.

The Medezine saw like we use (I’m not being paid to advertise!) with the round blades we use for the cranium and the other ‘fan’ shapes blades.

In really tough cases or other scenarios we can use the bone saw. For example, I recently used the bone saw on the spine to remove the spinal cord from a patient who was donating it for research. We mainly use the bone saw for the skull, but there is another blade you can use to cut through other bones like below.

There you have it, the rib shears! I wanted to start my tool posts with something interesting so I hope this has been a good place to start. If you think I’ve missed anything or have any questions then please let me know by the usual ways, you can see my contact page if you’re not sure.

MG x

Sweet Rose Cottage

I’m not going to lie, it’s been a fairly frustrating week all round. I caught the man flu, which turned out to be close to actual flu in some ways and still has me feeling terrible. On top of that, add some insomnia, anxiety and general joint pain, I think feel close to the classic ‘death warmed up’. She writes during a sneezing fit on the bus.

Wednesday Addams & Antigone Funn inspired generic tired mortuary worker look.

I was in for two days this week and I’m only in work for one next week. I’m then in for the rest of the year, and I’m starting to do some on call type work. In the last two days that went fast, I did some more nurses training in the big auditorium style training room. I get to feel important and stand on a stage with the presentation projected either side of me. For those that have known me a long time, bet you never thought this nervous wreck would stand there confidently and do that!

A selection of stills from the Just Five Minutes More video by Michelle Lancaster at North Tees and Hartlepool NHS Foundation Trust

At the start of the training we play a video made by another NHS trust which demonstrates as well as possible our roles as APTs. It perfectly describes the care we have for our patients and our characters, particularly the ‘cheerful disposition’ we all possess. The link to the video on YouTube is here, Michelle Lancaster who made it and stars in it is someone I have a lot of admiration for and had the pleasure to meet at conference two years in a row, she is a really lovely human being.

There is another line in the video that I’d like to discuss where Michelle mentions the use of the term ‘rose cottage’, describing the phrase as sweet. This hit home upon hearing it yesterday because it sounded so much like the Sweet Rose Cakery where we host our Death Cafe each month, how appropriate and coincidental we found a location named that!

Laura T at the Sweet Rose Cakery

I should explain, the term rose cottage is used by hospital staff to describe either the mortuary, or has further extended to mean a death on the ward either in full form or shortened. The porters use it to ask where the death is, I hear them using our phone to call the ward and ask ‘Do you have a rose cottage?’ or more often it is ‘Do you have a rosie?’. It’s a sweet term indeed, not necessarily one I agree with because I’m fairly certain it’s born of avoiding talking about death, but it’s a tradition that has existed for a long time and I’m sure will continue. I believe other hospitals have other terms they might use, but the Rose Cottage has firmly stuck at ours. Although I believe you can encounter staff who have still yet to hear it and then assume you are asking after a patient called Rose Cottage which would be unfortunate if there was someone with that name!

Have a watch of the video and let me know what you think! Also, as promised I am working on a post about tools starting with the handy device below. Anyone want to take a guess what it’s used for? Mortuary workers past and present need not comment! If you’re Hospital has another term used to mean a death please get in touch also. Have a great weekend everyone.

Mystery tool… what could it be? It’s quite easy (I think!)

MG x

AAPT Annual Conference London 2018

It’s a most excellent start to any morning when you make a cup of tea only to realise that the milk’s gone off. However I wouldn’t let that ruin or darken my day for I was off early to the AAPT 14th annual conference and this year I had some pretty awesome reasons to be excited.

Cup of tea attempt #2

I arrived at the Holiday Inn Regent’s Park to a crowd of people outside. Some people I recognised, fewer I actually knew and a lot more I had no idea who they were. I’ve been lucky to attend a few AAPT events before including this conference last year, it almost feels like I have a tick-list of people to check off each time to speak to, and this year I got a whole load of new ticks. One thing I will say, the people of the AAPT are always so very friendly and just, well, normal people. I don’t think I’ve ever felt more like I fit with a job I’ve had, good news really when I’m pretty certain I’ve got my dream career.

Got a little beefeater bear to go with my Cardiff dragon

When I got there I saw an open door towards the registration desks so I rushed in to get my lanyard and bag of goodies. A little pre-emptive as I was immediately told they weren’t open yet and to go stand outside! Oops! Outside I stood nervously catching people’s eyes and trying to figure out who was an APT and who was a bog standard hotel patron. The doors opened not long after and I got registered, then walked through to the conference room to grab a seat and dump my coat. Then it was time to grab a cup of tea and settle on in for the morning session.

Trusty notebook bought by Laura D and the conference programme

There was an array of talks in the morning and the afternoon of a very high calibre. I particularly enjoyed a presentation by a member of the air ambulance crew who described East London as being ‘well, yes, a bit stabby’ while discussing the kind of call outs he went to. I’ve seen the kinds of procedures they use on people who have arrived at the mortuary but I’ve never been sure exactly how they are carried out or why, now I know! In the afternoon session there was also a presentation by a Sergeant from the Metropolitan Marine Police who look after the river along with other areas, for example I never knew they did high areas like rooftops too! Her presentation was a brilliant and informative one, largely explaining what happens to people if they end up in the river and how they are found. Her presentation ended on discussing the SS Princess Alice disaster where a passenger paddle steamer was struck and sank in the Thames in 1865. A larger part of my notes from this section includes a direct quote of a description of the water at Woolwich where it sank being ‘fast flowing poo soup’.

Thought you might enjoy my little sketch titled ‘how people float’ drawn from an impression the speaker did on stage, fish was not in demonstration.

It was a fabulous day and I got to meet some wonderful people. Right towards the end I found out that I was going to receive a certificate for my CPD (continual professional development) achievement over the last year with others, which I then spent the last hour worrying about going up the front. Typical of me! The AGM (annual general meeting) after the main conference also had the very exciting announcement that I have been appointed the Student Representative on the Council for the AAPT. This mean some hard work but I’m so looking forward to working with the Council going forward. I guess this is also a good time to announce that, all things going to plan, I will be starting my full training course in February 2019. It’s going to be a very exciting time coming up!

CPD certificate and my mugshot on the council listing!

Sadly I didn’t get to attend the evening event, I had to get home early but I was also a little grateful for other commitments. When your last talk of the day is about boat disasters and pulling bodies out of the Thames, a not very confident swimmer like me would be a little anxious about a party on a riverboat!!

I’d like to take an opportunity to thank the hard working people of the AAPT who put together and awesome conference again this year. I loved every minute and I am very much looking forward to the next one in Edinburgh in 2019!

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

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