DIGNITY IN DEATH
Inside a mortuary
Saying goodbye to people who walk out of a mortuary can get quite awkward. ‘‘We often say ‘see you later’, then have to say ‘no, no, not like that’,’’ charge mortuary technician Pat Mahoney says.
But it never gets that awkward with patients. After all, they are not caring about much at that point.
They are dead, of course. Mahoney, who has more than 20 years’ experience, and his colleagues are the final people in Palmerston North Hospital who will deal with them before they leave.
Finding Mahoney’s office is difficult. There are no signs to the mortuary in the public part of the hospital, with directions only appearing once you make your way well down the flights of stairs.
It is obvious why they make it hard to find. There is a chiller not far from the entrance with a morbidly blunt label on the lid – ‘‘limb freezer’’.
There is also a patient – if you can call them that – lying on a trolley, silhouetted by a heavy maroon blanket.
Five tall fridges line a wall. Give them clear doors and a lick of paint and they would easily double as a petrol station drinks display.
But the solid steel doors are there for good reason. Each, chilled to 4 degrees Celsius, can hold three bodies.
They can slide in and out on metal trays, just like on television shows. No tags on the toes, though, with bracelets around the ankle preferred.
Mahoney says you will only end up in the fridge if your death is suspicious, you die in hospital and need to be held before the funeral director shows up, or if a doctor will not sign a ‘‘cause of death’’ form.
Not everyone who comes through the door is given an autopsy, but Mahoney and his colleagues still perform between 325 and 350 a year.
People who have died suspicious deaths will be locked in a fridge, and must usually have two identifying tags – a date of birth and name, for example – before the coroner will give an autopsy the green light.
A police officer will unlock the fridge if it is a suspected homicide, but in all cases the bodies are placed on a trolley and wheeled to the room where the work begins.
The person goes on to steel slats raised above a large sink-like table.
If the police are there, they will take a multitude of photos and forensic scientists will collect evidence, such as fingernail scrapings.
Clothes are then removed, and the patient may be taken for X-rays or CT scans before the autopsy begins.
Mahoney says it all depends on how the person died. If they were shot, it helps to find bullets. If it was a self-inflicted death, it may give clues as to how it happened.
‘‘That all works towards the story of how that person died.’’
Then it is time for the autopsy proper to begin. Mahoney starts with the head, cutting a wedge-like shape in the back to access the skull and brain.
A ‘‘Y’’ shape is cut in the chest running from the two shoulders, linking in the middle of the chest, running down to the pelvic bone. Organs are removed and taken to a different part of the room for the pathologist to collect samples.
This is also when urine, blood and eye fluid samples are taken.
All the organs are put back inside the person afterwards, who is then sewn up, before going back in the fridge.
Special care is taken if the body is going to be in public for a prolonged period of time before burial, such as at a tangi, to ensure no leakage, Mahoney says.
The process can take as little as an hour if the case is not complicated. Aeroplane crash victims, some of the most complicated autopsies to perform, can go all day.
While it is physical work having to move bodies, and various tools and knives are used, stories of mortuary technicians hacking away with no care are false, Mahoney says.
‘‘We really care for the people because they cannot speak for themselves, so we have to speak for them.’’
Simone Hall, who started working as a mortuary technician at 20 years old, says autopsies on crime shows are far too clean.
‘‘It is a person, people. It’s going to be messy.
‘‘But it is not a slasher film.’’ It is more like surgery, with blood bound to get around. But, Hall says, she does not have to worry about a heart monitor, so hoses and hospital-grade disinfectant is the way to keep things clean.
Hall says surgeons will often head to the mortuary to watch an autopsy on a deceased patient, and are often amazed at what is found.
But pathologist Dr Cynric Temple-camp, whose 2017 book The Cause of Death contains some especially graphic descriptions of autopsies, notes mortuary workers have an advantage over surgeons.
‘‘Surgeons have to work through very small holes. We are not confined by that.’’
But caring for the dead is complex. The fridges are monitored around the clock to ensure stable temperatures.
‘‘Some think ‘they are dead, what does it matter?’
‘‘I don’t think people realise just how intensive a job it is to keep a lot of bodies in good shape.
‘‘One of the features of a civilised society is showing you care for the dead.
‘‘When they die, people want to know why. These are important things we ask. That’s why we take this very seriously, finding the cause of death.’’
Too warm and people will decompose. He has never had it get too cold.
‘‘I think they would just freeze solid, like an ice block.’’
Temple-camp says New Zealand’s management of the dead is well ahead of other countries, partly due to the culture of sitting with the deceased.
‘‘In Africa [where Temple-camp is from], no-one viewed a body or sat with one. It was removed immediately and you never saw it again.’’
Mahoney says they allow family members into the mortuary to sit with a deceased relative.
‘‘It is a hospital right through to the end of life. It is a caring facility.
‘‘We have to look after the dead, but also the families. It is like being an interim funeral director.’’
Having to deal with emotional family members, on top of their own emotions around death, can be tough, Mahoney says.
‘‘You go home exhausted from the physical and mental work, but it’s life.
‘‘Death is part of life.’’
‘‘We really care for the people because they cannot speak for themselves, so we have to speak for them.’’
Pat Mahoney