Petrol or Horse power?

I was just having a look at The Good Funeral Guide blog and it reminded me of a funeral the other week which used horses.

It really is a sight for sore eyes to see the majestic beasts parading down the high street.  I particularly love the black horses and black hearse.  Then when the family chooses red roses as their coffin spray - woah!   Beautiful Gothic elegance.   Some horses are white and there are white hearses which I believe some consider more lady-like and modern.

There are a few other ways you can be carried to your journeys end, including a motorcycle hearse and here is a link to the website of A W Lymn in Nottingham who have their own double decker bus!

The places I work have their own fleets of black hearse and limousines.    One places sister company has a silver fleet so we are able to offer both from within the company which is nice.   Funeral directors will source whatever you would like and it really is something special when an alternative is chosen.

Glass of Claret anyone?

I love blood.

There.  I've said it. 

Whilst I was draining recently, I was completely mesmerised by the colour, viscosity, clots and the sheer volume.   We embalmers love a good bit of draining.   Of course, pretty much only because it means the rate of decomposition is reduced the more of it we can remove.   But we do love a good bit of drainage.

The largish chap I was embalming really needed a good saturation.  He was to be with us for a couple of weeks, and although its generally chilly of late, I wanted excellent, thorough treatment.  I raised both Carotid Arteries and the right Internal Jugular Vein as my initial injection/drainage points.    He embalmed very well and the quality of his draining blood was additional evidence to me that he would be able to be viewed easily until his funeral. 

Funerals for all to see

Watching some footage of Sir Jimmy Saville's funeral today has reminded me how scary it is to embalm someone who has been in the public eye.

Mentioning no names (sorry, BIE confidentiality etc), someone who I embalmed with a colleague a few years ago had a high profile and the funeral was photographed and filmed, and attended by a number of high profile individuals.

Sounds very mysterious doesn't it?  Well, it was a very nerve wracking event!   Having to ensure that the remains were embalmed thoroughly and maintaining a possibility for viewing until the funeral was absolute.  It always is I suppose, but knowing your work was being scrutinised for the world to see, if so requested, is a bum clenching experience.   My colleague and I steeled ourselves and got on with it. 

Of course, the hard work was really in the hands of the Funeral Director and the coffin bearers.    They did an outstanding piece of work and the resultant funeral was proper.

Questions?

I know it can be a pain to register to comment, but I would love to answer some questions and post them here.  Lots of people I meet ask me the same things.

So, please feel free to ask me any questions and I will do my best to give you an honest and personal answer.

Leaf Kicking

I've just got in from a lovely walk with the dogs through one of my local heaths.    I love Autumn so much, the colours, smells and the whole 'will it, wont it rain' challenge when dressing for a walk.

Kicking through the leaves made me think about decomposition and in particular, the work of The Body Farm.  The university is in Knoxville, USA and since 1971 has been studying all aspects of decomposition under the tutelage of Dr Bill Bass.   A few years ago, we were very lucky to have a lecture from one of his colleagues at Keele University as part of our BIE Educational Weekend.    

Maggot season has mostly finished for us now.   In the summer months we regularly have cases of maggots where the deceased unfortunately has been exposed to flies.   In colder months it is less so.   Maggots have a knack of emerging from nostrils and mouths, just like something from a horror film.   I abhor them.  Few things turn my stomach, as you can imagine, but snot and maggots manage to make me clench my gut everytime.    I have to remove every last one of them if there is to be any sleep for me that night.   Knowing that a family may need to say goodbye and that at any time a maggot could wriggle its way through the skin is my idea of hell.    We all joke of how we are 'merely maggot food' but that isn't something that needs to be witnessed first hand.

Before, during and after embalming, I use my forceps to pull away any maggots I can see.   Then I use something called 'Dry Wash' and inject it through the nostrils and use my suction tube in the mouth to flush the area through.   A friend of mine once told me that her father taught her how to do that with water to clear her nasal passages every morning!   Ewww....

Dry Wash has a good effect in killing maggots and not damaging the tissues of the deceased.  Often a maggoty case has had a post mortem so I am able to see right up through the throat from inside the open trunk and can get a clear view of any that may remain.  Washing and cleaning and plucking maggots away.  In any event, it really need constant vigilance.   Colleagues are warned to check constantly and certainly be in attendance during the viewing, ready to discreetly pounce with forceps and a tissue should something wriggle its way to the surface.    Ultimately, ensuring a peaceful goodbye is absolute.

Enjoy your Sunday lunch my friends!

Location, location, location

Its all about where to start your injection from...

Modern embalming is replacing blood and body fluids with formaldehyde and other chemical preservatives to create a natural, peaceful appearance.   To do this we need to push the fluid under either manual or electrical pressure through the arterial system of the body.

In order to do this, certain legal requirements have to be carried out.   The death must be registered and permission from the family sought.   Often the funeral arranger will call this 'hygienic treatment'.   A good funeral arranger won't have any problem finding the right words to use to discuss this with their families.    In the case of a burial, only one GP needs to see the deceased but if there is to be a cremation, two GPs must sign the relevant papers.  

When the funeral home calls me to tell me they need me, they usually tell me how many people I need to embalm.  This helps me plan my day and prioritise those who need embalming soonest due to viewing commitments or funeral times.

I arrive at the theatre and fill the sink with hot water and disinfectant.  I undress the deceased, all the while observing the body assessing what fluids will work best, and looking for wounds or other medical conditions which will affect the process.   Whilst undressing, I gently move the limbs in their natural way, thus removing Rigor Mortis which goes when the muscles are moved.   At this time I also check names against wrist bands and also jewellery against relevant registers.   I place a piece of cotton wadding over the genitals, a Modesty Cloth, as no one wants to be staring at that for an hour, and of course, it's much nicer to retain a little modesty, even with me.  I then take my cloths and wash the deceased using my disinfectant water.

Now that I have seen all the deceased can show me, I start to mix my fluids.  I chose where I am going to commence my injection.   I favour the Axillary Artery in the armpit.   Firstly because it gives an even result to the face, but also because no cosmetic work is needed to hide my small incision as it is hidden away and open necked clothing therefore poses no problems.  If I chose to use the Carotid Artery (in the neck) my suturing and cosmetics afterwards can usually hide the incision.

I place my kidney dish as a receptacle under the armpit and using my scalpel, I make a small cut.  Using other embalming tools, I dissect the underlying tissue to seek the artery and vein.   When found, I ligate either end of the small section of artery with ligature and cut it a little open.   I then place two tubes, one distal, one proximal, a small way into the artery and tie off.   This is repeated with the vein except the vein tube can be presented much further into the vessel for good drainage..

When I have connected my fluid tank with the tube heading into the body, I commence injection.    My embalming machine gently pushing the fluid through the tube and into the arterial system all round the body.   I look for signs that the fluid is moving round, by checking various veins for protrusion.  Starting with the temporal, then left arm, then veins over the trunk, then veins leading into the feet.   Satisfied the fluid is moving well, I massage any areas of discolouration due to hypostasis (remember from my previous blog post?) and clean the nails.   All the while I am also moving the limbs in their natural manner, encouraging fluid into the tips of fingers and toes.   I am checking the fluid distribution in the facial tissues and ensuring the lips are also picking up the fluid. 

During this time, the vein will start to release blood into the kidney dish and this can be quickly taken away using the suction of the embalming machine.   The blood and any other fluids are held in a glass jar until disposal at the end, into the sluice.

When I am satisfied that sufficient fluid has been injected, I turn that tube off and remove it, ligating the vessel.   Then I repeat the injection into the distal tube to enable embalming of the arm and hand.   During this time, I attach to the suction tube an instrument called a Trocar, and make a small incision near the breastbone and puncture all organs and aspirate all other body fluids away.   For example, the stomach contains fluid, the lungs may contain fluid, as may the bladder and intestines.   All this fluid will do its natural job and speed decomposition, but we want to halt it for a few days so a lovely viewing experience can be achieved.  

Once all injection and aspiration is complete, a cavity chemical is injected into the abdomen using the trocar to aid embalming of the intestinal tract.  Then I use eyecaps over the eyeballs and gently close the eyes.  I place cotton wool into the throat from the mouth to prevent any fluids coming up and out (not something the families need to experience in chapel) and suture my incisions.   At this time I also take care of any wounds such as IV sites, or slipped skin etc...

The mouth is closed using another small suture (not using the lips!) and shaving is carried out.  It is also at this time that I wash the hair, dry and if needed tong it.   Moisturiser is then rubbed over the face to ensure it doesn't get sore and dry out.   Bottoms are checked for poop or wee, cleaned and if needed cotton wool is packed.

Eyelashes and eyebrows get a once over with a clean wand.  Ladies receive a light blusher.