Risky Business: Embalming 101

What is embalming?    Well....
     Embalming is a process of temporary preservation, sanitation, and restoration of body tissues after death. At least, that's the textbook answer. The real answer is that embalming is a delicate mix of art and science--one that can (and will) make or break the funeral business as we know it. There is a lot of mystery behind the process of embalming.... probably for good reason... but, nonetheless, it is part of the distance our culture has created in all matters regarding death and dying.

     Simply put, embalming is the drainage of blood from the body and subsequent injection of preservative chemicals. This is most often done by utilizing the vessels of the extensive, beautifully built-in circulatory system, as well as by supplemental injection of stronger fluids into the viscera (where all the nasty bacteria live). The process is multi-dimensional and entirely dependent on individual circumstances. There are a multitude of chemicals, techniques, products, etc. for almost any situation you could imagine.... because.... the goal is to be able to provide an open-casket for any case that comes through the doors.

Instruments used for Elvis Presley's Autopsy.
Click for image credit.

     Embalming even the most straightforward case does not come without its challenges, and trust me, it's not for the faint of heart (or stomach). I've been on a pretty steep learning curve when it comes to embalming and I'm finding out that it's not so much about knowing how to do everything right... it's about knowing how to fix things when they start to go wrong. Good life lesson there.
     Embalming a body requires all these things; skills, techniques, chemicals, products, but at the end of the day, each body is different and it is a process that is not without its risks. There are risks when it comes to restoring the body to a more natural appearance. There's always a risk the body won't turn out well. There's also a risk the family will simply not like what you've done even if the body does turn out well. There is a risk too of rapid decomposition, even after thorough embalming. There are also behind the scenes risks of the health and safety of we embalmers who deal with the chemicals and the instruments and the dead bodies themselves. Protective measures are taken, universal precautions, we call them... because you never know what you're going to run into when faced with a body--dead or alive. 

     We have plenty of OSHA guidelines and specialized equipment to keep us as safe as possible in most situations. We have lifts, and gloves, and cots, and tables, and tubes, and all kinds of neat things to get the job done. And it's all really easy as long as you can see the potential problems at hand. For example: you get a death call from the hospital. The deceased is about 350 lbs. Take two people. Position the cot so it allows for the body to be moved head first, discuss options for oversized caskets and/or cremation. Etc. 
     But what about the things we can't see? Arteriosclerosis. Bacteria. Blood clots. Infectious diseases. Bloodborne pathogens. All the things your mom told you not to talk to, even if they offered you candy. Yeah. They can interfere with the embalming process and can be just plain dangerous. REALLY dangerous. That's why universal precautions are absolutely necessary. And that's why we use specialized equipment and some really powerful disinfectants. We are not only concerned about having microorganisms transfer from the bodies to us workers, but also from one dead body to other dead bodies. Some of the more commonly thought of dangers include tuberculosis, MRSA, Hepatitis A, B, and C, Clostridium perfringens, and HIV.

HIV attacking a human cell.
Click for image credit.

Draining the blood and then effectively giving the tissues a good dose of formaldehyde takes care of most of the risk, but we still have to be careful. There are everyday occupational hazards like needle sticks, fluid spills, and inhalation dangers that we are always looking out for. It is thought that HIV cannot live outside of the body longer than 4 hours, but other diseases, like hepatitis and those caused by most bacteria can live on surfaces for days. Did you know that TB is the oldest known communicable disease? That is mostly because tuberculosis is readily transmitted through inhalation and because it is more resistant to environmental factors due to its ability to form endospores, or protective capsules, that can allow it to survive for hundreds of years. Muah-ha-ha.
     The point is really to minimize risks in every way possible for all involved: embalmers, the deceased, the family, and the general public. We truly have to treat every case as if it were potentially dangerous because we often don't find out otherwise until after most of our work has been done. There is certainly room for improvement throughout the deathcare industry, especially in regards to updating older funeral homes and having universal requirements for different steps in the embalming process.
     It ultimately comes down to the level of professionalism practiced by individual employees. Education is key. So is having adequate resources. Communication within the firm and with the families is paramount to doing good business, and it is important to be honest about what can and cannot be done in each situation, even if it ruffles some feathers. The good thing is that bad cases are usually few and far between--people can get away with not knowing all that goes on behind the scenes....and whether that is good or bad is up for debate.
    To be continued.....

What's Your "Comfort Level" with Death?

My mother and brother recently came to 'Clinnon' to tend to some business at PC. While they were in town, they stopped by to see me at work. Naturally, I gave them a little tour of the funeral home.

As I led them around, I noticed how consciously aware I was of their reactions to different things I showed them, and that I was especially careful when leading them into a visitation room with an open casket. You see, I know from growing up going to visitations and funerals with my parents that saying that my mom does not particularly 'like' open caskets is an understatement. She tentatively approached the casket, stopping well outside of arm's reach. My brother was not much more adventurous. They asked a few questions and then we carried on with the tour.

The isolated experience with my mom and brother didn't mean much to me at the time. In fact, I sort of forgot about it...... UNTIL......

Somebody died. The family came in the next day to finalize arrangements. We had a brief conversation. I led them down the hallway for an initial viewing of the body, which we had embalmed, dressed, and casketed. I opened the door to the private viewing room and motioned for them to enter the room. All of this was very 'normal' to me. Then, it dawned on me.... Why was I doing it like that? It was like I didn't want to intrude on their personal space with their dead loved one. I was standing back, expecting them to go into the room and do their 'grief thing' while I went back to what I had been doing before they arrived. It slowly occurred to me that they might not actually want to go into the room.... at least not alone. Some of them (probably all of them) might be unsure, confused, or absolutely terrified. I wondered if I was doing them a disservice by hanging back in the doorway, or if I was doing exactly what I should be doing: giving them space.

As funeral professionals, it's sometimes hard to gauge peoples' "comfort level" with death right off the bat; it's something we have to ease into with families. It takes time. It takes conversations, and eye contact, and buzz words, and a little bit of awkwardness, and probably too much 'professional' distance on our part. We don't have a personal history with many of the people we interact with on a daily basis, so unlike the situation with my own family, we have very little to go off of unless the individuals actually tell us how they feel. ....And it's amazing how clammed up and inconsistent people get around death.

What about you? What's your "comfort level?" Open casket or closed? Would you want space? Or more direction? It's all very subjective and dependent on the circumstances.

A talk from a convention I went to earlier this year is echoing in my mind as I write this. The topic was along the lines of how much the field of funeral service has changed in the past few decades and how little actual funeral home design and basic merchandise has changed. One point made was about caskets: At the end of the day, a casket is a casket is a casket. (Unless it's a coffin....but that's another story for another day).

http://www.donnachaidhinternational.com/2012/09/what-is-the-difference-between-a-casket-and-a-coffin/

Caskets in general freak people out. Open caskets, in particular, really freak people out. Add in the fact that there's a dead loved one in the casket, and you've got some serious emotional issues on your hands. Denial is no longer an option. Death is all of a sudden within arm's reach. Grief is raw. People simply don't know how to react. I understand more fully now that I have a responsibility to focus more on ushering people through this process instead of just motioning them forward into it. I trust that this is a quality that will come about in time and with experience and in all the little ways that make this job more than a job but a true vocation.