Down Among the Dead Men (5 page)

Once undressed, he did not present a pretty picture; both sides of his body were hanging down off the table, he was going a very dark, slimy green, and various blisters had started to appear
over his body as his skin began to break down. Graham was doing the evisceration on this body and, although understandably not cheerful, was professional and resigned about it. What with Mr P being
so slimy, he explained that he needed to be extra careful of slipping with the knife and taking off one of his own fingers with it. He said that the hardest job with cutting open an obese person is
the layer upon layer of fat you have to get through. Once that is done, taking out the organs is a doddle as they aren’t usually so much bigger than those of an average person. He was huffing
and puffing, trying to get the fat to stay back while at the same time trying to reach the organs, which even he – and he is not short – could only do on tiptoes. All the tools he was
using had sheen to them now from the layers of greasy fat that clung to them. Clive made various comment about how he possibly needed to tie some rope around Graham’s ankles in case he fell
in.

And never believe an obese person who tells you they are big-boned; inside Mr P was a small man trying not to suffocate. As it happened, Dr Burberry discovered that Mr P had a deep vein
thrombosis in his leg, which can break off and lead to pulmonary embolism in the lungs. He said that he probably got it because he hardly ever moved.

After this, Graham reconstructed the body, which on an obese body usually proves very difficult as the skin will tear when the needle goes through because of the sheer weight you are trying to
stitch back together; even if that doesn’t happen, you have to hope and pray that the two sides of the incision down the body are lined up. Graham explained that when he started out, quite
often he ended up with one nipple two inches higher than the other! But he now had a nifty way of dealing with the reconstruction of a larger body. He would draw three lines across the body,
horizontally, then stitch these back together first, so everything was lined up again. Job done.

That still wasn’t the end of it, though. Clive said that the problem now was that Mr P was a health hazard. His body cavity had been opened and contaminated with gut contents; we had no
body bag big enough to put him in and we could not refrigerate him as he was too wide. Clive was worried about the health of those of us working in the mortuary. Although with any body there is a
danger of disease and therefore a daily risk to the staff, with an average-sized body, they can be handled safely by being sealed in a body bag and put back into refrigeration. Mr P was lying
uncovered, oozing body fluid which was dripping and trickling onto the floor. Clive rang Neville at once to confirm that we could release the body back to the funeral directors as Ed had given them
a cause of death and our job was done. Initially the funeral directors were not keen on coming and collecting Mr P; they don’t want decomposing bodies around the place any more than we
do.

What the hell were we going to do with him? He could not stay on the table over the weekend forming a puddle on the floor. Clive muttered about the possibility of the mortuary being closed down
and all this hitting the local press. He thought about contacting the Infection Control Department, but wasn’t sure how to go about it. He took this problem to Ed who, thank goodness, got to
work it. Within the hour everything was settled; although there had at one point been talk of hiring – at a cost of several thousand pounds – a refrigerated lorry just for Mr P, the
funeral directors were persuaded to co-operate and come and collect him that day.

Barry Patterson at last left the building just before it was time to lock up for the evening, in a coffin that looked like a wardrobe, and carried by eight undertakers. Another week gone and
definitely time for the pub again. I rang Maddie at once.

I had first met Maddie a couple of days into working in the mortuary. She had started at about the same time as me, taking on a job upstairs in the histology lab as a Medical
Laboratory Assistant, or MLA; these are the people who do the less specialized tasks in the pathology laboratory. It was part of her job to bring down to the mortuary the products of conception
– foetal tissue – for ‘sensitive’ disposal. We clicked instantly and soon became close friends.

Maddie had come to Gloucestershire from Wales with no ties and, since Luke is not the controlling type, we were able to go for a drink after work whenever we felt like it in order to catch up;
in this way our friendship grew. That night, I was overwhelmed by what I had seen over the past week or so with Mr Patterson and bent Maddie’s ear about it for the first part of the evening.
We had gone to the closest pub to the hospital, but as the evening moved on, it started to become full of underage squealing teenagers so we headed to a place we had discovered in town called The
Firestone, an old bar with a modern relaxed feel. They had got it right with this bar when they redesigned it – neutral colours with dark furniture; not huge leather sofas that you just
wanted to curl up and sleep on, but sensible drinking furniture, and nothing too soft or too high. We managed to get what was becoming our regular table by the window so we could watch the sights
walking by and comment on the usual collection of fashion disasters. Maddie and I were smartly dressed in work clothes so we felt entitled to criticize. We stayed until throwing out time, and then
took a taxi back to mine to annoy the neighbours with some loud music and more drinking.

EIGHT

Clive felt that first thing the next Monday morning I should start to eviscerate. I had been handling the organs while doing the weights for the pathologists, so I knew what
sort of textures and smells to expect. This was going to be very different though, and I was nervous.

I stood there that Monday morning, in my scrubs, almost shaking. In front of me lay a little old lady, totally unclothed, waiting for me to start the process that would reveal to her family why
she actually died. This was the first time that I had worked with Clive in the post-mortem room. Being the senior technician, Clive was responsible for training the new technicians in their
evisceration technique, but he had little time for everyday post-mortems due to being tied up in the office with paperwork; that was what Graham and I were employed to do. He went through some
basic anatomy which went over my head; all I could think about was how the hell I was ever going to do this. I had seen Graham do it plenty of times, but he was a dab hand; this was about to be
very real for me. I was going to open up someone’s mother, grandmother, sister, aunt. And then, was I going to be able to get out the organs intact, or was I going to slice and dice them all
into an unrecognizable mess so the pathologist would not be able to work with them?

None of this seemed to matter to Clive, as he encouraged me to place the PM40 onto the body. As I did this, Clive said I had to push down harder on the knife; I needed to cut the skin, not
scratch it. As I put pressure on the blade, I could feel it bump across the bone in the middle of the ribs which, I was to learn, is called the sternum. As I reached the bottom of this, Clive
suddenly informed me that I now had to take the pressure off the knife. Without even thinking, I pulled the knife up and away from the body. I was a bit shocked by the quick instruction from Clive
and felt I had made a horrible mistake. He went on to say that I had to be careful at the lower end of the sternum as the stomach and intestines lie just under, and it is quite easy to put the
blade through them, thereby causing a spillage of contents which not only would be messy and unpleasant, but also might be required for testing by the pathologist. Clive went on to explain in great
detail about the mess and smell this causes, and I got the feeling he was more bothered about that aspect than losing the stomach contents for the pathologist.

I eventually managed to expose the ribs and the intestines, and then folded back the skin to either side of the body, as he told me to do. This was to take a while and Clive got a bit agitated;
he eventually lost patience with me. He had shown me at what point you need to cut the intestine, to be able to unravel it, but I only managed a few inches before, in a hurried manner and while
trying hard not to show his impatience, he took the knife and finished the rest of the evisceration himself. At least, though, as he eviscerated, he talked me through everything he was doing, and
got me to do the ‘easy’ bits, like loosen the lungs from the back of the thoracic cavity, which meant basically just lifting them up. The speed and slickness with which he released the
tongue from the bottom of the mouth were unbelievable. Clive never made a mark on the neck and, once he had packed the inside of the throat with cotton wool, you would never have known any
different.

Clive went on to tell me about a family that he once had to show the stitching to on a deceased’s head, as they did not believe that he had had a post-mortem. ‘The secret is to cut
low around the back of the head, Michelle; that way, when they are laid out on the pillow, the stitching is concealed underneath the head, and with the knots behind the ears, see?’ I was not
about to tell him that Graham had already told me this, and just nodded. ‘Then, Bob’s your uncle; nobody but us need know the difference.’ He finished this sentence off with a
wink.

He then said, ‘I think you should have a go at reconstruction.’ With that, Clive handed me a large shiny silver needle that was curved at the end. This was threaded with what looked
liked carpet twine and, as it turned out, it was. ‘Start from the pelvis up, over and under, over and under,’ he said, leaving me a little foxed. To Clive it was second nature; to me it
was piercing someone’s skin and sewing them up with carpet twine.

I had no idea at that time that I would soon get into such a flow, but I actually found it quite easy to reconstruct and my initial fear of piercing a body with a huge needle soon faded. Clive
reminded me to stop three-quarters of the way up, as we still had to replace the organs in the body after they had been examined by the pathologist.

Clive next told me that I needed to stay in the post-mortem room because, having worked with the body, I was now contaminated, and that Dr Burberry would be arriving shortly. He then left and so
I sat in the PM room alone with the little old lady, listening to the radio and awaiting the pathologist. Within ten minutes, the door from the consultants’ changing room opened, and Dr Ed
Burberry entered the PM room. ‘Good morning, Michelle,’ he said with a smile. ‘How are you?’ He must have seen that I was as nervous as hell. I was convinced he was going to
ask me a medical question that I had no idea about, and that I would probably forget everything that Clive had told me I had to tell him about the patient in front of me.

I nodded at him and squeaked rather inanely, ‘Yes, thank you, Dr Burberry.’

I should not have worried about striking up a conversation with Ed. It turned out we got on like a house on fire. We spoke freely about each other’s interests and I began to relax in his
company. He let me in on a few secrets about Clive and Graham, as he had worked alongside them for so long; he knew how they liked to work and what routines they had. He gave me tips on how to stay
ahead of the pathologist during an evisceration and what they expected from their technician while in the PM room.

I finished my first post-mortem session full of knowledge, but the best thing was the feeling that I had done something a step up from cleaning down. I was now, sort of and after a fashion, able
to do what Clive and Graham did, and I could now properly help towards the running of the mortuary. And he might be a consultant pathologist, but I was sure I had found a friend in Ed.

When I got home that evening, the first thing I did, after letting Harvey and Oscar out, was phone my parents to tell them I was a fully fledged mortician. I thought about ringing Gramp, but
after the conversation we had had when I got the job, I thought it would be better to tell him when we visited him at the weekend.

NINE

On Wednesday the following week, Ed Burberry did the post-mortem of Samuel Chandler who had come into the hospital for an elective operation to remove his gall bladder. Before
that he had been reasonably fit; he had had the odd touch of chronic bronchitis in winter, a hernia operation three years earlier, occasional gout and mild hypertension, or raised blood pressure.
He had been married for forty-nine years and was a retired local government officer. It had been a ‘keyhole operation’ and had apparently gone well in that Samuel had made a full
recovery from the anaesthetic and the surgeon, Mr Wilson, was happy that there had been no technical problems. Two days later, though, he had begun to feel unwell and very soon after that he had
become very sick. Mr Wilson went back in and found bile and inflammation all over the abdominal cavity. He had tried to wash this out and then sent Mr Chandler straight to Intensive Therapy, but
the poor man died just twelve hours later.

When Graham and I got Mr Chandler out of the body bag, I was shocked at the state of him. He was bloated with fluid that had leaked out of him so that he looked, as Graham remarked, as if
he’d been dragged from the river. He was covered in a patchy red rash and there was a liverish tinge to his waxy skin. Something else that I was amazed at was the number of places that
intravenous lines had been inserted – one into the crook of each elbow, one into each wrist, one into his left ankle and one (with six tubes spreading out from it) into the right side of his
neck. There was a urinary catheter, a tube down his nose and one poking out of his mouth from his throat. Running down the front of his tummy was a long adhesive dressing with two smaller ones just
under the ribs on the right. He wasn’t smelling too clever, either.

Graham told me to make a note of all the lines and tubes, but not to start the post-mortem yet because he thought Ed would want to see Mr Chandler as he was. I did as I was told, then we went
back into the office for some coffee. Clive had gone to our sister hospital for a meeting, so Graham and I exchanged chat about this and that for half an hour. Ed came in, wished us both good
morning, then went into the dissection room. Almost immediately we heard him cry out, ‘Oh, my God! Not another ITU failure?’