Down Among the Dead Men (3 page)

By doing this, he had released all Mr Evans’ organs from his body, and was now holding what he told me was referred to as the ‘pluck’. Grasped firmly in Graham’s hand
were Mr Evans’ neck structures, his tongue resting on Graham’s hand while suspended below was every other major organ except the gut and the brain. He placed all this in a second
stainless steel bowl, and placed both of the bowls on the dissection bench ready for the pathologist. Graham got cleaned up and we both took off our protective equipment, changed into clean scrubs
and went back to the office for coffee. Clive had already rung the pathologist, Dr Ed Burberry, who had told him he would be down at ten thirty to start, so we still had an hour before he was due
to arrive. Graham and I took our drinks and went and sat under the canopy outside the double doors to the mortuary to have a smoke.

From here, at the back of the pathology building, you can see loads of staff walking about, but they don’t really see you. It’s as though this place is completely ignored – a
blind spot or something that they would rather not think existed – or maybe people are just not aware of it. We went for a little stroll around the car park. ‘So you can get your
bearings,’ Graham said. We didn’t get very far, as Graham knew so many members of staff that he spoke to everyone we met; he had worked at the hospital for years and years, first as a
driver before joining the mortuary. He introduced me to everyone, but I knew I would never remember them all, and I thought it would take a few weeks till I got my bearings.

After our break, we returned to the post-mortem room and Graham stitched up the lower half of Mr Evans’ torso, leaving the top half open so he could put the organs back when Dr Burberry
had finished with them. He removed the wooden block from under Mr Evans and rested his head on it. Taking a scalpel, Graham then cut behind Mr Evans’ right ear and ran the blade around the
back of his head to end behind the left ear. He informed me that it was important to make this incision on the head as low as possible. The reason for this is that if a family want to view the
deceased after a post-mortem, the lower the incision on the head, the less likely it will be seen as it will be nestling on the pillow. Apparently, the technicians have lots of little such ploys to
hide things from people. I thought it was good that Graham had thoughts for the family of Mr Evans, although it somehow made it all feel very real.

Graham then began to retract Mr Evans’ scalp from his skull. This is not an easy thing to do, because the skull and the scalp do not come apart readily; in fact, Graham got even redder in
the face than usual as he folded the scalp back to cover Mr Evans’ face. After he had loosened the scalp from behind the ears, he then took a wide wedge of the skull off with an electric
rotating saw to expose the brain; this he then removed by sliding his fingers between the brain and the forehead bone, then gently pulling it so that he could put a scalpel under the brain. I asked
what he was doing and he explained that he was cutting through a fibrous membrane that held the cerebellum in place, and then severing the cranial nerves and the spinal cord. Having done this, he
withdrew the scalpel and pulled out the brain with frightening ease and nonchalance.

Dr Burberry arrived shortly after this. Graham had been telling me that Dr Burberry is the lead pathologist for the department, so he takes the rap for the whole of the department when things go
wrong, and has the responsibility for the mortuary. Graham was proud of the fact that he felt he had a normal relationship with Dr Burberry; as he put it, ‘One that two human beings should
have. We can talk openly, but we both know where the levels of respect lie.’ I was intrigued to see what Dr Burberry was going to be like; Clive had spoken highly of him too.

Dr Ed Burberry gave off the aura of a very important person. Of average height and stature, he was in his mid-forties and very well spoken. I could see instantly why he was in charge. He
wasn’t what I was expecting at all, because he looked relatively normal and not at all the snooty professorial type. He greeted us both with, ‘Good morning,’ and once again, I
felt out of my depth, as if maybe I should be cleaning the toilets or something. How was I ever going to be able to hold a conversation with somebody so highly qualified? I suddenly found myself
staring at Graham and wondering how this was going to progress. Never had I imagined being in a situation like this. Me, a normal female (except that, OK, I was one with an interest that a lot of
people might find odd), Graham, an ex-slaughterman with no desire to better himself, just wanting to do his job and go home; and Dr Burberry, a highly educated consultant, who was about to perform
a detailed dissection of Mr Evans’ internal organs, and who would then be able to determine what killed him.

In the event, though, what happened I would never have believed, and you had to be there to see it. Graham and Dr Burberry chatted like old friends, which I suppose they probably were, as they
had worked together for a long time. They spoke about cricket, television, the weather and what they had planned for the evening. In the background, Dr Burberry insisted that we have Radio 2 on as
loud as possible. As he examined Mr Evans’ organs, he placed them in a plastic tray and Graham weighed them individually, making a record of each weight. While they were doing this, they
talked so normally it was obvious that they were immune to what they were doing. I stood in the background, watching in awe. It all felt comfortable and my thoughts of being out of place were
starting to fade.

Dr Burberry had finished his examination within thirty minutes and then left the post-mortem room. Graham returned all the organs to Mr Evans’ body and finished stitching him up. I was
asked to wash down the work bench that Dr Burberry had been using and disinfect it, which I did with pleasure. I actually felt useful at last.

FOUR

One of the things I had to learn about quickly was the Coroner’s system. The Coroner is effectively a judge – usually a lawyer, although there are some medically
qualified Coroners – who has legal jurisdiction over a corpse if no natural cause of death can be given by a suitably qualified doctor. If the medical cause of death is unknown or if there is
reason to believe that it may be due to unnatural causes, then the case has to be reported to the Coroner. He then has absolute control over that body – no one, not even the next of kin, can
stop him asking a pathologist to do a postmortem and that way find out the reason for the death.

So much to take in. Clive told me that most of our work was for the Coroner because, following the scandals at Bristol and Alder Hey, very few hospital (for educational or research purposes)
post-mortems – which require the consent of the next of kin because the cause of death is already known – were being done. This was because families, given the choice, very rarely want
their loved ones literally internally examined.

Whether a cause of death is unnatural is not always as clear-cut as you may think, either. Obviously, cases of suicide, violence by a third party (which would require a forensic autopsy by the
Home Office Pathologist and not just a Coroner’s autopsy) or accident are unnatural, but so is industrial disease, and so is neglect, whether self-neglect or neglect by someone else.

This leads me on to Amber Court . . .

I had been in my new job less than a week when I met my first body from Amber Court which had come to us for post-mortem. Amber Court is a large residential home on the other
side of Gloucestershire; it has a reputation for being low cost and, in residential care as in most things in life, you get what you pay for. It houses a large number of frail and elderly people,
and is staffed by the least talented members of society. As long as they can walk and breathe, the owners of Amber Court are happy to employ them; they are paid to do a very bad job and, in return,
those in their care are treated with no respect and little, if any, kindness. I imagine a little fat greedy man, sitting in a back office tucked away somewhere, rubbing his hands together at all
the money he is making by providing so-called care.

As this is common knowledge throughout Gloucestershire, almost every death they have in Amber Court gets reported to the Coroner. It is his statutory duty to rule out neglect in cases of
unexpected death, and that, inevitably, means that most deaths at Amber Court end up having a post-mortem.

Clive did a quick evisceration of an elderly, frail, almost gossamer-thin lady – Mrs Ethel Humbler – that took him no time at all, but it turned out to be fascinating. Ed was on PM
duty again, and what he found made everyone stop the banter and friendly insults that were being fired around and led Clive to turn down the volume on the radio. In Mrs Humbler’s throat,
wedged right down in the trachea, was a paper napkin. It was almost spooky when Ed flattened it out, because written in the corner was Mrs Humbler’s own name. It was immediately obvious what
had happened; in their uneducated wisdom, her so-called ‘carers’ had left her, despite the fact that she had full-blown dementia, to help herself to her own lunch. In her own confused
world, Mrs H had obviously felt compelled to consume everything that was laid out in front of her and, with no one around to stop her, she had stuffed the napkin into her mouth. It had become
lodged in her throat leading to what I can only imagine to be a lonely and scary death.

So, Ed had a cause of death for the Coroner but, as Clive said afterwards, that would not be the end of it. For the time being, this would be an accidental death, but there are accidents and
there are ‘accidents’; some are more avoidable than others and it’s the Coroner’s job to sort out the two types. I vowed secretly that I would never allow any of my family
to go into care; I would rather struggle to look after them, no matter how hard that was, than allow this to happen to one of mine. How were Mrs Humbler’s family going to react?

After the PM, Mrs H was reconstructed by Clive to nearly her former glory and ended up actually looking more peaceful than before, then placed in the body store alongside the rest of the poor
souls who reside with us while they await collection by the undertakers.

FIVE

Like most people, I had always assumed that mortuaries dealt only in dead people, but it had become apparent very quickly that there was a large stream of other kinds of thing
coming through. The first time this was brought home to me was quite early on when I answered the bell of the main red doors to find a porter with a large yellow bin that was about a foot deep and
two feet square. He thrust it at me and said, ‘From the delivery suite.’

I took it and asked, ‘What is it?’

He looked at me pityingly. ‘Well, I’m not the bloody stork, and this ain’t no bonny baby.’

With that he was gone.

At this point Clive came into the vestibule and found me looking down at the box. He made a face. ‘Oh dear.’

‘What’s this?’ I asked.

He took the box from me. ‘Products.’

‘Products?’ I echoed. What sort of products did he mean?

‘Products of conception.’ I still did not catch on. He took the box into the body store and put it on a trolley, then turned to face me. ‘Abortions, miscarriages, that kind of
thing,’ he said gently.

The truth hit me and left me feeling sick. ‘They come here?’ I asked incredulously.

‘Where else would they go?’

I’d never really thought about it and, now I did, it made sense. Nervously, I asked, ‘Are there babies in there?’

He smiled. ‘Bless you, Michelle, no. If a baby is stillborn, or dies shortly after birth, then of course it comes down here exactly as an adult does. But with the early miscarriages and
abortions and suchlike, there’s nothing much to see other than tissues.’

I wasn’t sure I liked to think about what he meant by ‘tissues’. ‘What happens to them?’

‘We treat them exactly as we do everyone else. If the parents want them buried, then an undertaker buries them. If they want an undertaker to handle the cremation, then that’s what
happens. Most of the time, though, the parents are happy for us to handle things. We get the chaplain to bless them, and they go directly to a crematorium from here. We make absolutely certain that
they are treated respectfully at all times.’

About a month later, I answered the door exactly as before and once again a porter stood there. This one held a white plastic bucket, sealed with a lid; it was about eighteen inches in diameter
and about three feet tall. He smiled at me and held it out for me to take, as if it was a bunch of flowers and he was proposing. ‘Here you are, love.’

With that he went. I was completely flummoxed. Were these more products of conception? All the others had arrived in the same type of box but, I thought, perhaps they had run out of that sort
and were using anything they could lay their hands on. It was incredibly heavy and, when I shook it gently, there was a sloshing noise. Obviously there was something big inside; for a moment I
panicked and wondered if someone had made a mistake and put a baby in there.

‘Clive?’

Clive came out of his office. When he saw what I was holding, he said, ‘That goes in the bottom fridge on the left.’

‘What is it?’

He smiled. ‘From the size of it, I’d say it’s a leg.’

I nearly dropped it. ‘A leg?’

He nodded. ‘They put the arms in smaller ones.’

Feeling slightly queasy, I did as I was told. I had known that the bottom fridge on the left was used for the products of conception, but hadn’t realized that we put other things in there.
When I had done as I was told, I returned to the office. As Graham was taking the day off to slaughter some wildlife, we were alone. I said, ‘So we get limbs, then?’

‘From theatres. And hands and feet.’ He paused, and added with a twinkle in his eye, ‘But no heads, at least not from theatres.’

Clive told me that most of the bits and bobs that they cut out in theatres go upstairs to the laboratory for the pathologists to look at and write a report on. Some of them, however, don’t
need a pathologist’s opinion; the smaller ones – such as fingers that have been crushed and have to be cut off because they can’t be saved – go straight into clinical waste
in the theatre, but the arms and legs (removed because of poor blood supply or injury) are too big and have to come to us for storage until they are collected for incineration.