Archive for April, 2007

“Bringing Out the Dead” (Originally Posted 2/11/2005)

Friday, April 13th, 2007

I don’t know if the average person ever thinks about the issue of removing a body from a scene. Most everyone has seen a body rolled away on the news or on a crime drama by people specially “trained” to perform that task. Needless to say, there is no actual formal training. Each removal is potentially its own little training session. Training sessions are distinguished from routine removals as they are typically punctuated by variations of the phrases “That worked well” or “Don’t ever try that again.”

A best-case scenario for body removal is a 100 pound little old lady that died in bed during the night on the first floor of her house. First, she’s easy to lift. In fact, it may be possible to collapse the gurney to the same level as the bed and just slide her over wrapped in a sheet. Second, she’s already laid out flat. No need to struggle with breaking the rigor mortis in order to buckle her to the gurney. Next, she died in the night. She hasn’t been dead that long, so there may not be any foul odor until her body is moved. And lastly, she’s on the first floor, so no more than one or two steps to go up.

Now for a worst case scenario—a 350 pound man that died in bed two weeks ago on the third floor of his apartment building. Obviously the increased weight changes everything and it’s only complicated by the fact that he’s been dead for some time. It is now necessary that he be placed in a body bag in order to contain the decomposition “juices” that have accumulated just under the surface of the skin. The rigor mortis has already gone away or “passed,” but his girth still makes it difficult to zip up the body bag and to strap him to the gurney.

The only redeeming element of this scenario is that the man is in bed and not directly on the floor or (God forbid) in the bathtub. As it stands, I would lay the open body bag on the floor next to the bed. Then I would throw a bed sheet over the body to catch any decomposition juices expelled from areas of concentration ruptured during the initial move. Next, I would grab the body through the sheet, pull it from the edge of the bed, and let gravity do the rest. It’s at this point that the decomposition juice is actually helpful. It makes for a slippery surface on which it is much easier to slide a body.

Once he’s in the bag, there is still the issue of getting him to ground level. He’s already met the “250 Pound Rule” which states that “Anyone who dies in an apartment building above the first floor is guaranteed to weigh at least 250 pounds.” Hundreds of apartment buildings in this city and they seem to have all been constructed before the days of handicap accessibility.

Without an elevator, gravity is called upon once again. I am a firm believer in letting the floor do the majority of the work, so there is a lot of sliding involved—especially when it comes to stairs. Holding on tightly to the bag, I slowly allow it to slide down each flight of stairs to the ground floor. The drawback of this process in conjunction with the lack of rigor mortis results in the body slumping down into one end of the bag like an orange in a sock.

I’ve lost count of how many times I wished I had “body handlers” at my disposal like the ones that are often shown on television and in movies. Hollywood body handlers are typically two respectable looking actors with no lines that are shown moving the body from the scene on a gurney. Their manner of dress makes them look a lot like paramedics but without the sense of urgency burdening those with life-saving responsibilities.

In the real world—or at least my corner of it—the body handlers are myself, the mortician transporting the body, and anyone else willing to help. Needless to say, volunteers are usually hard to come by.

After reading the above, Douglas commented:

“You mention using the floor to do most of your work. And specifically describe a trip down the stairs. Is there not much concern that a bouncy trip down the stairs would produce new damage or obscure existing wounds making pronouncement that much more difficult?”

To which I responded:

As I reread my post, I can see where my description sounds like a scene from “Weekend at Bernie’s” with a body sliding uncontrollably down the stairs like a runaway toboggan. It’s more of a controlled slide as we ease the bag down with the help of gravity. It still requires some straining, but considerably less than carrying it the whole way down.

As such, there is minimal impact to the body. I have seen a head strike a concrete surface as a gurney fell over. There was a slight mark to the scalp but no underlying fracture present at autopsy and there was no swelling because there was no blood pumping.

About the only trauma that might occur would be an abrasion to the body from rubbing against the inside of the bag. In this case there would be very little “reaction” in the skin tissue–that is to say the abraded area of the skin would have a parchment-like appearance as opposed to the typical appearance of aggravated tissue that has started to heal itself.

As for obscuring the wounds, they should have already been documented before removing the body.

Couches are easier to move down stairs. They may be bulkier, but they are much more rigid and the weight is even distributed. Even a body in full rigor will sag in the middle making the body seem much heavier. I wouldn’t be surprised if an undertaker was the first person to coin the phrase “dead weight.”

Hope that answers your question…

A Douglas

“Autopsy Technician / Pathology Assistant Employment”

Tuesday, April 10th, 2007

Found your site today as I tried to pursue information on ‘Forensic Autopsy Technician’ involving education required and position availability. I’ve been an RN for 30 years and this aspect of medicine has always intriqued me. Early in my VA career, they would call me down to autopsies to observe, because they knew I was so interested. I’m seriously considering this career detour. I haven’t found any concrete guidelines for educational guidelines in my research. Any advice? Thank you!

Maureen Santamaria

Maureen

I’ve gotten this question quite a lot over the last year, so I’ll respond to your comment in post form in case my answer is helpful to anyone else out there.

I’d start by calling your local Medical Examiner/Coroner office to find out if they hire their Autopsy Technicians/Pathology Assistants directly or if you have to go through a state or county agency. If they do there own hiring, pay them a visit to deliver a resume or fill out an application. This gives them a chance to see that you are professional and genuinely interested and aren’t someone just looking to meet their weekly unemployment application quota. It may make the difference between your application ending up on someone’s desk rather than the “to be shredded” bin.

There really isn’t any formal training available so it isn’t required in most cases. Reason being, even someone with minimal formal medical training can make equal or greater money doing something far less repulsive. If you start off with a salary in the low 20’s (even less in some parts of the country), you’re making the industry average. High school degrees or equivalents seem to be the norm because the pay is so unattractive. The only real financial benefit comes with the associated benefits and job security—total population and subsequent deaths only increase each year.

Most of the training for eviscerating bodies comes after you’ve already gotten the job. It helps to have some past experience in working on or around dead bodies or some exposure to some pretty nasty sights and smells. I guess that’s why individuals with previous employment in funeral services or as medical orderlies seem to succeed where others might quit before becoming “acclimated” to the tasks the job demands.

The moral of the story is if you’re looking for a job that:

–requires direct physical contact with some of the more questionable members of society as well as the potentially life threatening infectious diseases their tissue and fluids may contain…

–requires you to see and do things that common sense dictates you not share with the general public for fear of being regarded as an insensitive monster…

–causes many people to quit the minute they are faced with making their first cut on a decomposed body…

–provides a unique learning experience on a daily basis and allows you to feel as though you are contributing to an investigative process that is bigger than any single person or agency, then this is the job for you.

Good luck to you.

A Douglas