The Chick and the Dead

by Carla Valentine

  * * *

  Skip forward a few years and here I am in the film studio, advising John that some of the containers they have in the fake mortuary aren’t perfect but they will probably do. However, I do draw the line at one thing: this wonderful prosthetic corpse they’ve had made to resemble the actress Olwen, who plays the deceased main character, has something wrong with its forehead. Questioning this while bending down and looking closer, I learn that the production team assumed that brains are removed at autopsy by lopping off the top of cadavers’ heads in one fell swoop – skin, skull and all. Picture, if you will, the scene from the film Hannibal in which Anthony Hopkins eats the brain out of the live, but drugged, Ray Liotta, and it looks a bit like a flat pink cactus in a plant pot. That’s what the crew envisaged as part of the autopsy.

  I stand up in disbelief and explain to John that there’s a vast difference between their idea and what we actually do during the procedure. The imagery they clearly have in their heads is one of a kitsch Frankenstein’s monster with his horizontal forehead slash and exaggerated stitches. Do the general public really assume that when we carry out an autopsy we access the brain via the deceased’s forehead then roughly stitch it back together with thick black string? Do they think that sometimes, if the mood takes us, we throw in a couple of neck bolts too?

  It makes me worry about the reputation morticians and anatomists have in general – as if members of the public never really got past the idea that we all look and act like a mad scientist’s assistant named Igor, hell-bent on mutilating corpses and storing bits of them in jars for no reason other than to create a cupboard full of pathology-themed lava lamps. Films like Re-animator and Young Frankenstein give the tongue-in-cheek impression that dissection and organ retention are done for nefarious and selfish purposes such as trying to discover the secret of everlasting life or create the perfect woman, and not for the greater good.

  Does it matter? Well, one would hope that when laymen read crime procedural novels or watch forensic-based TV shows they could separate reality from media fantasy and understand that sometimes clichés are perpetuated by writers or producers because they lend a certain dramatic or sexy element to an otherwise mundane scene. Obvious examples are the attractive women of CSI attending crime scenes with their perfectly styled hair waving in the breeze created by the fan placed at the edge of the set – and don’t get me started on their low-cut tops and high-heeled shoes. Everyone knows that in real life CSIs (crime scene investigators) and SOCOs (scene of crime officers) have to wear white Tyvek suits and masks to prevent their own DNA being transferred to the crime scene, don’t they? Unfortunately, not everyone does, and when there are production companies working to create drama these seemingly harmless additions and artistic licences carelessly perpetuate the macabre or simply lax reputation of mortuaries and their staff.

  Around ten years ago, when I was a trainee at the Municipal Mortuary, the team was approached by a production company to be filmed for a TV series called The Death Detective. It was to feature a wonderful pathologist I worked with at the time called Dr Dick Shepherd.* We were happy and honoured to be filmed because the topic of autopsy was to be tackled scientifically, but only as long as the families of the autopsy cases, as well as the local Coroner, also gave consent. Surprisingly, everyone who was asked agreed and the documentary went ahead. The one thing my manager Andrew stipulated was a chance to see the final edit of the TV series before it went on air. It turned out that was a necessary and useful request. In the programme, during post-mortem room footage of one of us removing the top of the skull of the deceased to access the brain, images of our pristine mortuary floor were removed from the VT and instead a scene of blood splashing on some random tiles was spliced in. We all looked at each other in shock. Apparently, my fastidious efforts with the Bioguard detergent were not quite right for this production and only a blood bath would do for their visuals. However, apart from that one issue, which was corrected, the documentary did come out very well.

  I’d been surprised at how many families had granted permission for filming. We’d thought it would be a battle, but next of kin were clearly curious to see what on earth goes on behind those closed mortuary doors. Some also rationalised that if their loved one’s pathological findings were described to a viewer who was perhaps experiencing similar symptoms it could even encourage them to visit a doctor: televising autopsies could literally save lives.

  It’s exciting for anyone to be on TV, but for me, as a trainee APT, doing the job I’d always wanted to do and being able to show it my family and friends, it was as thrilling as hell. I remember inviting everyone round to my flat and making popcorn when the first episode was due to be aired. We all crowded around the screen, most people sitting on the floor and me squeezed between two more on the sofa. Everyone munched in near silence after the opening credits had rolled. There was a voiceover introduction and the first few clips, then suddenly me, tiny and blonde with a huge pair of silver rib shears, cracking my way through a man’s rib cage, the tough bones making the most awful noises in the echoey post-mortem suite.

  Nine astonished faces turned to me in silence in that living room, popcorn-filled hands paused halfway to open mouths.

  ‘What?’ I exclaimed as I looked from one set of wide eyes to another.

  It seems my friends didn’t quite understand the exact nature of my work. I suppose many of them never really wanted to think about it. That is, until they saw the brute force required and became aware that I really did have to get in there and get my hands (and arms and elbows) dirty. One of them said, ‘I thought you just did paperwork or something!’ and another, ‘I thought you put make-up on them!’ – fairly common misconceptions. With this documentary there were certainly no more unanswered questions: nothing was left to the imagination.

  Correcting these mistakes matters to me because we pathology staff do our best to maintain an air of dignity during what could be considered quite an invasive and undignified procedure. The post-mortem room is as respectful and clean as most operating theatres and we want families to know that, not to watch TV and have all their greatest fears and ghoulish imaginings about autopsies and death realised.

  So I’m being incredibly picky on the set of this film, refusing to let the team portray APTs as forehead-chopping miscreants. It turns out the production team would need to replace the prosthetic’s entire head at a cost of hundreds of pounds if they’re to show the brain removal the correct way, but I won’t budge! I’ve developed a wonderful rapport with the special effects girls, one of whom actually used to be a SOCO before moving into SFX make-up in hospital dramas such as Holby City. She completely understands the dangers of misrepresentation in the media so we spend a lot of time chatting about TV shows such as Silent Witness and Waking the Dead. It’s nice to have someone on set to discuss such a familiar topic with. She’s of the opinion that if the current film producers were so keen on doing it right they should have asked for the guidance of someone like me long before they started creating the prosthetics and decorating the mortuary set. I have to agree with her. Getting the right information before any action is the best strategy, which is why we read through the 97A form carefully before we begin an autopsy and ensure we’re fully prepared.

  * * *

  Exactly like the SOCO-turned-SFX girl, I too have had a career change by the time I’m on set. Although I carried out autopsies for years, eventually qualifying as a Senior in the field, I began to realise I was doing more paperwork and less hands-on pathology. That’s why I’m now the technical curator of a pathology museum, and instead of opening the recently deceased and removing their pathologies for the doctors to examine, I maintain and utilise five thousand preserved examples of pathologies that have already been removed over the last two hundred and fifty years and kept for posterity in beautiful containers or ‘pots’. I use these unusual objects from the human body to teach students and engage the public with the topics of medical history, the autopsy proces
s and more. The irony is that being an APT is a very demanding job, so much so that when I did it I didn’t have the time to talk about it. Now that my schedule is marginally less hectic (read that as ‘bloody’) I’m able to think back on and revisit all those years of training to help advise students and the public on the career via TV, theatre, writing and, of course, the current film.

  * * *

  A few days later I return to the set and, while the team are busy being briefed near the audio-visual equipment in what they call their ‘video village’, I hang back at the breakfast table to grab my coffee and brioche, avoiding any flaky pastry items of course. It’s a routine to which I’m getting fairly addicted by this point. ‘Chocolate chips? In the morning? Don’t mind if I do!’ I think as I reach out to the buffet. It feels very transgressive because I normally have a green smoothie for breakfast – a smoothie which also resembles some kind of post-mortem emanation, but I think that’s enough food comparisons for one chapter.

  Once I’ve stuffed the brioche in my mouth and devoured it as though my life depended on it, I decide to sneak on set and take a look around the mortuary. I enter undetected and there she is, lying on the PM table, the lovely prosthetic corpse of the star of the film. Coffee in hand, I bend over to inspect her forehead and note that the visible slash – where her head was supposed to split apart – has gone. It’s good that they sorted it over the last few days, I think. I take a look again. She’so realistic, even the eyelashes! And the little hairs on the arm! I idly wonder how much she must have cost while I give her upper arm a squeeze.

  She sits up.

  She howls so loudly and unexpectedly that I throw my coffee so far upwards it hits the makeshift ceiling. I scream three, maybe four times in a row before we both burst out laughing at my utter idiocy and at the terrified pale faces of the crew who have run on to the set in abject horror at the sounds we made.

  Of course it’s not the prosthetic, it’s Olwen, who is a method actress lying on the stainless-steel PM table trying to get in the right frame of mind to – well, be a good corpse, I suppose. That is, until I wandered in, bleary-eyed and curious, and decided to fondle her. I’ve never laughed so hard in my life. The crew and I are in tears, ribs practically splitting.

  ‘Well, what a pathology expert I am,’ I think, unable to tell a live body from a fake dead one. ‘Who can’t tell fantasy from reality now?’

  * * *

  One thing I like about the film’s two main stars – both veteran Hollywood actors – is that they keep saying they’re very pleased to have me there, although there is a bit of confusion about exactly who or what I am.

  ‘It’s so great to have a pathologist here!’ said Emile Hirsch on my first day, shaking my hand enthusiastically.

  ‘Thanks,’ I’d mumbled shyly, ‘but I’m not a pathologist, I’m a pathology technician.’

  ‘What’s the difference?’ he’d asked, confused, at the same time as John said, ‘But I thought you were a pathology technologist.’

  ‘The pathologist is a qualified medical doctor who uses his knowledge to diagnose cause of death by dissecting the organs and examining the body,’ I explained to them both. ‘I offer technical support for the procedure, but I’m qualified in a different way. I carry out all the physical aspects, like removing organs and specimens, but I also help the pathologist with the diagnosis and run the mortuary.’ Then I turned to John specifically. ‘There are so many different words for our job but the professionally used acronym is APT. The “technician” part was changed to “technologist” a while back but it never sat well with me because the dictionary definition of “technician” makes much more sense in this context than “technologist” does.’

  ‘Ah, I see,’ they both said, with a smile.

  I wasn’t sure they did see. ‘Look, if “technician” was good enough for R. A. Burnett, MBChB, FRCP, FRIPH, FRCPath, who literally wrote the book on the subject, then it’s good enough for me!’

  I laughed, realising that if a person has never seen The Red Book, which is basically the APT’s training bible, then that joke isn’t funny.

  ‘Just call me a mortician,’ I relented, embarrassed, ‘for ease.’

  I use the word mortician all the time though I know some other APTs don’t really like it.* I use it for several reasons. Firstly, nobody knows what an APT is. If I’m asked what I do and I say I’m an APT it just stops the conversation dead (pun not intended) for all the wrong reasons, or alternatively far too many questions follow: questions about what it stands for, how you spell it, am I a doctor etc. Secondly, the official phrase ‘anatomical pathology technologist’ is incredibly clunky – my tongue wraps around it like a thrashing eel. I think ‘mortuary technician’ is neater and self-explanatory, but I like to imagine the words ‘mortuary’ and ‘technician’ as two separate, cumbersome handfuls of snow which I can squeeze into one compact snowball of a word: ‘mort-ician’. Everyone knows what ‘mortician’ means. Then, like a snowball, it can be metaphorically thrown into the face of the enquiring person in a cold, descriptive burst which surprises them and makes them shake their head in disbelief.

  But finally, I’m not only an APT: my career with the dead has spanned embalming, medical dissection and prosection, excavation and examination of bones as well as conserving historical human remains. As an individual I am a mortician.

  ‘Really? A mortician? You don’t look like one!’ is the usual response. And I quite like that; I like being something totally different from what my exterior implies. But more than that, I’ve worked with the dead all my adult life and it is important to me to get that passion across. It’s become part of my identity. As the poet-undertaker Thomas Lynch described it, I am one of the ‘people whose being had begun to meld with their doing’. Me the person and Me the caretaker of the dead are two entities that have become indivisible.

  I had already met the older of the two actors, Brian Cox, as he had previously been to the Pathology Museum where I work to record part of a documentary he was presenting. That particular segment was all about the dangers of alcohol on the liver and I’d had to bring a variety of livers to the table and present them for the crew’s approval. It was a bit like being a London market trader, setting down my wares and trying to convince them of their quality so I didn’t have to keep hauling livers all over the place from three different floors:

  ‘Nah, this is a lahvly liver, mate, exactly wotcha lookin’ for.’

  ‘Nah, sir, ya don’t want that one up there – I’ll do y’a deal on this one!’

  He and Emile, who is playing the part of Brian’s son, both seem jovial enough at first, and the crew keep reminding me I’m a necessary part of the team: ‘Brian and Emile are so pleased you’re here to help them out.’ That is until week four of the shoot when they are getting tired and acting like the typical divas you imagine from the tabloids. Emile is growing more and more irascible and Brian seems to have lost interest and comes back on set after the lunchtime break looking anything but enthusiastic. The crew asks me to work some more days but, apart from the fact I really don’t want to be anywhere for twelve hours a day, let alone a freezing-cold warehouse studio, I just can’t spare the time away from my day job. On my final day I ask the art director if the actors’ behaviour is typical of a film because I don’t really have a clue and she says, ‘No, it’s just been a very “trying” project.’

  I witness this first hand when, on my last day, I offer some advice to Emile and he shouts at me, ‘Nobody will know and nobody cares.’

  ‘Oh, well, I’m glad I’ve been spending twelve hours a day here to advise you on correct procedure, then,’ I think as I quietly walk away.

  I wonder again whether this is reflective of the attitude of others: that somehow what we do in mortuaries is considered so weird or unimportant that nobody cares anyway and no one wants to know. There’s a definite divide between people who enjoy this type of work or want to know all about it, and people who think it’s totally bizarre. I
can’t count the number of times someone in the crew whispered to me, ‘A film set – it’s exciting, isn’t it?’ and I had to whisper back, ‘No, it’s a bit boring. To me this would be more exciting if it were a real mortuary and a real autopsy.’ I chose to work with the dead because I find it interesting and incredibly rewarding. Hanging around on productions, for me at least, is not really how I’d prefer to spend every day.

  * * *

  Conversely, in the post-mortem room, the action never stops. Even though the pathologist has left there is still work to be done. Jason has taken on the cleaning so that I can focus on reconstructing the anorexic dentist. I sew all his incisions together, I wash him, I comb his unkempt hair, I place dressings on his bedsores and I even trim his overgrown fingernails. He actually looks better now than when he first came in. He’s perfectly viewable for any family or friends … but no one has come forward to ask to view him. It’s not a wasted effort, though; I did this for him, not necessarily for anyone else. That’s why it’s rewarding – he looks at peace now. I gently graze his forehead with my hand to make sure his eyes are properly closed, then zip up the body bag and place him back in his section of the fridge.

  * * *

  Many people do think working with the dead is interesting and want to know more so I give a lot of interviews. The problem with giving interviews is that even with the best intentions, writers can alter what you’ve said for dramatic effect, or not do their research correctly. It’s not because they’re being malicious – death inhabits a very confusing and sensitive world.

  Take the dead body, for example. I can euphemistically call the deceased someone’s ‘loved one’ or a ‘decedent’. In certain contexts, for example when we study taphonomy (the science of decaying organisms) or discuss organ and body donation and dissection, we refer to the dead as ‘cadavers’. The word ‘patient’ just wouldn’t make sense. Yet when I worked in a hospital mortuary they were all called ‘patients’ because they came to us from the hospital and the autopsy is the last part of their medical journey, so they’re still technically under patient care. However, those who work in Coronial mortuaries, like I did at first, don’t use the term ‘patient’ and are more likely to say ‘case’. They all mean the same thing but they have their own individual nuances which don’t quite make sense in all contexts, and a journalist, for example, may not understand that. That is why I try my best to give thorough interviews when anyone is kind enough to ask me to, but it can’t be helped if my use of the word ‘patient’ gets changed to ‘corpse’ in the final edit because of the perceived confusion it may cause for the reader.