“Did you already go in the nose?” Nicole is holding aloft tiny chrome scissors. Theo says no. She goes in, first to trim the hair, then with the disinfectant. “It gives the decedent some dignity,” she says, plunging wadded cotton into and out of his left nostril.
I like the term “decedent.” It’s as though the man weren’t dead, but merely involved in some sort of protracted legal dispute. For evident reasons, mortuary science is awash with euphemisms. “Don’t say stiff, corpse, cadaver,” scolds The Principles and Practice of Embalming. “Say decedent, remains or Mr. Blank. Don’t say ‘keep.’ Say ‘maintain preservation.’…” Wrinkles are “acquired facial markings.” Decomposed brain that filters down through a damaged skull and bubbles out the nose is “frothy purge.”
The last feature to be posed is the mouth, which will hang open if not held shut. Theo is narrating for Nicole, who is using a curved needle and heavy-duty string to suture the jaws together. “The goal is to reenter through the same hole and come in behind the teeth,” says Theo. “Now she’s coming out one of the nostrils, across the septum, and then she’s going to reenter the mouth. There are a variety of ways of closing the mouth,” he adds, and then he begins talking about something called a needle injector. I pose my own mouth to resemble the mouth of someone who is quietly horrified, and this works quite well to close Theo’s mouth. The suturing proceeds in silence.
Theo and Nicole step back and regard their work. Mack nods. Mr. Blank is ready for embalming.
Modern embalming makes use of the circulatory system to deliver a liquid preservative to the body’s cells to halt autolysis and put decay on hold. Just as blood in the vessels and capillaries once delivered oxygen and nutrients to the cells, now those same vessels, emptied of blood, are delivering embalming fluid. The first people known to attempt arterial embalming* were a trio of Dutch biologists and anatomists named Swammerdam, Ruysch, and Blanchard, who lived in the late 1600s. The early anatomists were dealing with a chronic shortage of bodies for dissection, and consequently were motivated to come up with ways to preserve the ones they managed to obtain. Blanchard’s textbook was the first to cover arterial embalming. He describes opening up an artery, flushing the blood out with water, and pumping in alcohol. I’ve been to frat parties like that.
Arterial embalming didn’t begin to catch on in earnest until the American Civil War. Up until this point, dead U.S. soldiers were buried more or less where they fell. Their families had to send a written request for disinterment and ship a coffin capable of being hermetically sealed to the nearest quartermaster office, whereupon the quartermaster officer would assign a team of men to dig up the remains and deliver them to the family. Often the coffins that the families sent were not hermetically sealed—who knew what “hermetically” meant? Who knows now?—and they soon began to stink and leak. At the urgent pleadings of the beleaguered delivery brigades, the army set about embalming its dead, some 35,000 in all.
One fine day in 1861, a twenty-four-year-old colonel named Elmer Ellsworth was shot and killed as he seized a Confederate flag from atop a hotel, his rank and courage a testimony to the motivating powers of a humiliating first name. The colonel was given a hero’s send-off and a first-class embalming at the hands of one Thomas Holmes, the Father of Embalming.* The public filed past Elmer in his casket, looking every bit the soldier and nothing at all the decomposing body. Embalming received another boost four years later, when Abe Lincoln’s embalmed body traveled from Washington to his hometown in Illinois. The train ride amounted to a promotional tour for funerary embalming, for wherever the train stopped, people came to view him, and more than a few must have noted that he looked a whole lot better in his casket than Grandmama had looked in hers. Word spread and the practice grew, like a chicken heart, and soon the whole nation was sending their decedents in to be posed and preserved.
After the war, Holmes set up a business selling his patented embalming fluid, Innominata, to embalmers, but otherwise began to distance himself from the mortuary trade. He opened a drugstore, manufactured root beer, and invested in a health spa, and between the three of them managed to squander his considerable savings. He never married and fathered no children (other than Embalming), but it wouldn’t be accurate to say he lived alone. According to Christine Quigley, author of The Corpse: A History, he shared his Brooklyn house with samples of his war-era handiwork: Embalmed bodies were stored in the closets, and heads sat on tables in the living room. Not all that surprisingly, Holmes began to go insane, spending his final years in and out of institutions. At seventy, he was placing ads in mortuary trade journals for a rubber-coated canvas body removal bag that could, he suggested, double as a sleeping bag. Shortly before he died, Holmes is said to have requested that he not be embalmed, though whether this was a function of sanity or insanity was never made clear.
Theo is feeling around on Mr. Blank’s neck. “We’re in search of the carotid artery,” he announces. He cuts a short lengthwise slit in the man’s neck. Because no blood flows, it is easy to watch, easy to think of the action as simply something a man does on his job, like cutting roofing material or slicing foam core, rather than what it would more normally be: murder. Now the neck has a secret pocket, and Theo slips his finger into it. After some probing, he finds and raises the artery, which is then severed with a blade. The loose end is pink and rubbery and looks very much like what you blow into to inflate a whoopee cushion.
A cannula is inserted into the artery and connected by a length of tubing to the canister of embalming fluid. Mack starts the pump.
Here is where it all begins to make sense. Within minutes, the man’s face looks rejuvenated. The embalming fluid has rehydrated his tissues, filling out his sunken cheeks, his lined skin. His skin is pink now (the embalming fluid contains red coloring), no longer slack and papery. He looks healthy and surprisingly alive. This is why you don’t just stick bodies in the refrigerator before an open-casket funeral.
Mack is telling me about a ninety-seven-year-old woman who looked sixty after her embalming. “We had to paint in wrinkles, or the family wouldn’t recognize her.”
As hale and youthful as our Mr. Blank looks this morning, he will still eventually decompose. Mortuary embalming is designed to keep a cadaver looking fresh and uncadaverous for the funeral service, but not much longer. (Anatomy departments amp up the process by using greater amounts and higher concentrations of formalin; these corpses may remain intact for years, though they take on a kind of pickled horror-movie appearance.) “As soon as the water table comes up, and the coffin gets wet,” Mack allows, “you’re going to have the same kind of decomposition you would have had if you hadn’t done embalming.” Water reverses the chemical reactions of embalming, he says.
Funeral homes sell sealed vaults designed to keep air and water out, but even then, the corpse’s prospects for eternal comeliness are iffy. The body may contain bacteria spores, hardy suspended-animation DNA pods, able to withstand extremes of temperature, dryness, and chemical abuse, including that of embalming. Eventually the formaldehyde breaks down, and the coast is clear for the spores to bring forth bacteria.
“Undertakers used to claim embalming was permanent,” says Mack. “If it meant making the sale on that family, believe me, that embalmer was going to say anything,” agrees Thomas Chambers, of the W. W. Chambers chain of funeral homes, whose grandfather walked the boundaries of taste when he distributed promotional calendars featuring a nude silhouette of a shapely woman above the mortuary’s slogan. “Beautiful Bodies by Chambers.” (The woman was not, as Jessica Mitford seemed to hint in The American Way of Death, a cadaver that the mortuary had embalmed; that would have been going too far, even for Grandpa Chambers.)
Embalming fluid companies used to encourage experimentation by sponsoring best-preserved-body contests. The hope was that some undertaker, by craft or serendipity, would figure out the perfect balance of preservatives and hydrators, enabling his trade to preserve a body for years without mummifying it.
Contestants were invited to submit photographs of decedents who had held up particularly well, along with a write-up of their formulas and methods. The winning entries and photos would be published in mortuary trade journals, on the pre–Jessica Mitford assumption that no one outside the business ever cracked an issue of Casket and Sunnyside.
I asked Mack what made the undertakers back off from their claims of eternal preservation. It was, as it so often is, a lawsuit. “One man took them up on it. He bought a space in a mausoleum and every six months he’d go in with his lunch and open up his mother’s casket and visit with her on his lunch hour. One especially wet spring, some moisture got in, and come to find, Mom had grown a beard. She was covered with mold. He sued, and collected twenty-five thousand dollars from the mortuary. So they’ve stopped making that statement.” Further discouragement has come from the Federal Trade Commission, whose 1982 Funeral Rule prohibited mortuary professionals from claiming that the coffins they sold provided eternal protection against decay.
And that is embalming. It will make a good-looking corpse of you for your funeral, but it will not keep you from one day dissolving and reeking, from becoming a Halloween ghoul. It is a temporary preservative, like the nitrites in your sausages. Eventually any meat, regardless of what you do to it, will wither and go off.
The point is that no matter what you choose to do with your body when you die, it won’t, ultimately, be very appealing. If you are inclined to donate yourself to science, you should not let images of dissection or dismemberment put you off. They are no more or less gruesome, in my opinion, than ordinary decay or the sewing shut of your jaws via your nostrils for a funeral viewing. Even cremation, when you get right down to it—as W.E.D. Evans, former Senior Lecturer in Morbid Anatomy at the University of London, did in his 1963 book The Chemistry of Death—isn’t a pretty event:
The skin and hair at once scorch, char and burn. Heat coagulation of muscle protein may become evident at this stage, causing the muscles slowly to contract, and there may be a steady divarication of the thighs with gradually developing flexion of the limbs. There is a popular idea that early in the cremation process the heat causes the trunk to flex forwards violently so that the body suddenly “sits up,” bursting open the lid of the coffin, but this has not been observed personally….
Occasionally there is swelling of the abdomen before the skin and abdominal muscles char and split; the swelling is due to formation of steam and the expansion of gases in the abdominal contents.
Destruction of the soft tissues gradually exposes parts of the skeleton. The skull is soon devoid of covering, then the bones of the limbs appear…. The abdominal contents burn fairly slowly, and the lungs more slowly still. It has been observed that the brain is specially resistant to complete combustion during cremation of the body. Even when the vault of the skull has broken and fallen away, the brain has been seen as a dark, fused mass with a rather sticky consistency…. Eventually the spine becomes visible as the viscera disappear, the bones glow whitely in the flames and the skeleton falls apart.
Drops of sweat bead the inside surface of Nicole’s splash shield. We’ve been here more than an hour. It’s almost over. Theo looks at Mack. “Will we be suturing the anus?” He turns to me. “Otherwise leakage can wick into the funeral clothing and it’s an awful mess.”
I don’t mind Theo’s matter-of-factness. Life contains these things: leakage and wickage and discharge, pus and snot and slime and gleet. We are biology. We are reminded of this at the beginning and the end, at birth and at death. In between we do what we can to forget.
Since our decedent will not be having a funeral service, it is up to Mack whether the students must take the final step. He decides to let it go. Unless the visitor wishes to see it. They look at me.
“No thank you.” Enough biology for today.
4
DEAD MAN DRIVING
Human crash test dummies and the ghastly, necessary science of impact tolerance
By and large, the dead aren’t very talented. They can’t play water polo, or lace up their boots, or maximize market share. They can’t tell a joke, and they can’t dance for beans. There is one thing dead people excel at. They’re very good at handling pain.
For instance, UM 006. UM 006 is a cadaver who recently journeyed across Detroit from the University of Michigan to the bioengineering building at Wayne State University. His job, which he will undertake at approximately 7 P.M. tonight, is to be hit in the shoulder with a linear impactor. His collarbone and scapula may break, but he will not feel a thing, nor will the injuries interfere with his day-to-day activities. By agreeing to be walloped in the shoulder, cadaver UM 006 is helping researchers figure out how much force a human shoulder in a side-impact car crash can withstand before it registers a serious injury.
Over the past sixty years, the dead have helped the living work out human tolerance limits for skull slammings and chest skewerings, knee crammings and gut mashings: all the ugly, violent things that happen to a human being in a car crash. Once automobile manufacturers know how much force a skull or spine or shoulder can withstand, they can design cars that, they hope, will not exceed that force in a crash.
You are perhaps wondering, as I did, why they don’t use crash test dummies. This is the other side of the equation. A dummy can tell you how much force a crash is unleashing on various dummy body parts, but without knowing how much of a blow a real body part can take, the information is useless. You first need to know, for instance, that the maximum amount a rib cage can compress without damaging the soft, wet things inside it is 2¾ inches. Then, should a dummy slam into a steering wheel of a newly designed car and register a chest deflection of four inches, you know the National Highway Traffic Safety Administration (NHTSA) isn’t going to be very happy with that car.
The dead’s first contribution to safe driving was the non-face-gashing windshield. The first Fords came without windshields, which is why you see pictures of early motorists wearing goggles. They weren’t trying to affect a dashing World War I flying-ace mien; they were keeping wind and bugs out of their eyes. The first windscreens were made of ordinary window glass, which served to cut the wind and, unfortunately, the driver’s face in the event of a crash. Even with the early laminated-glass windshields, which were in use from the 1930s to the mid-1960s, front-seat passengers were walking away from accidents with gruesome, gaping scalp-to-chin lacerations. Heads would hit the windshield, knock out a head-shaped hole in the glass, and, on their violent, bouncing return back through that hole, get sliced open on the jagged edges.
Tempered glass, the follow-up innovation, was strong enough to keep heads from smashing through, but the concern then became that striking the stiffer glass would cause brain damage. (The less a material gives, the more damaging the forces of the impact: Think ice rink versus lawn.) Neurologists knew that a concussion from a forehead impact was accompanied by some degree of skull fracture. You can’t give a dead man a concussion, but you can check his skull for hairline cracks, and this is what researchers did. At Wayne State, cadavers were leaned forward over a simulated car window and dropped from varying heights (simulating varying speeds) so that their foreheads hit the glass. (Contrary to popular impression, impact test cadavers were not typically ushered into the front seats of actual running automobiles, driving being one of the other things cadavers don’t do well. More often than not, the cadaver was either dropped or it remained still while some sort of controllable impacting device was directed at it.) The study showed that tempered glass, provided it wasn’t too thick, was unlikely to create forces strong enough to cause concussion. Windshields today have even more give, enabling the modern-day head to undergo a 30-mph unbelted car crash straight into a wall and come away with little to complain about save a welt and an owner whose driving skills are up there with the average cadaver’s.
Despite forgiving windshields and knobless, padded dashboards, brain damage is still the major culprit in car crash fatalities. Very often
, the bang to the head isn’t all that severe. It’s the combination of banging it into something and whipping it in one direction and then rapidly back at high speeds (rotation, this is called) that tends to cause serious brain damage. “If you hit the head without any rotation, it takes a huge amount of force to knock you out,” says Wayne State Bioengineering Center director Albert King. “Similarly, if you rotate the head without hitting anything, it’s hard to cause severe damage.” (High-speed rear-enders sometimes do this; the brain is whipped back and forth so fast that shear forces tear open the veins on its surface.) “In the run-of-the-mill crash, there’s some of each, neither of which is very high, but you can get a severe head injury.” The sideways jarring of a side-impact crash is especially notorious for putting passengers in comas.
King and some of his colleagues are trying to get a handle on what, exactly, is happening to the brain in these banging/ whipping-around scenarios. Across town at Henry Ford Hospital, the team has been filming cadavers’ heads with a high-speed X-ray video camera* during simulated crashes, to find out what’s going on inside the skull. So far they’re finding a lot more “sloshing of the brain,” as King put it, with more rotation than was previously thought to occur. “The brain traces out a kind of figure eight,” says King. It is something best left to skaters: When brains do this they get what’s called diffuse axonal injury—potentially fatal tears and leaks in the microtubules of the brain’s axons.
Chest injuries are the other generous contributor to crash fatalities. (This was true even before the dawn of the automobile; the great anatomist Vesalius, in 1557, described the burst aorta of a man thrown from his horse.) In the days before seat belts, the steering wheel was the most lethal item in a car’s interior. In a head-on collision, the body would slide forward and the chest would slam into the steering wheel, often with enough force to fold the rim of the wheel around the column, in the manner of a closing umbrella. “We had a guy take a tree head-on and there was the N from the steering wheel—the car was a Nash—imprinted in the center of his chest,” recalls Don Huelke, a safety researcher who spent the years from 1961 through 1970 visiting the scene of every car accident fatality in the county surrounding the University of Michigan and recording what happened and how.