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Overview
Carla Valentine works with the dead. After studying forensics, she assisted pathologists with post-mortems for years before becoming the curator of the world’s most famous pathology museum. When it comes to death, she truly is an expert, and in this book she shares that expertise.
Using the most common post-mortem process as the backbone of the narrative, The Chick and the Dead takes the reader through the process of an autopsy while also describing the history and changing cultures of our relationship with the dead. The book is full of vivid insight into what happens to our bodies in the end. Each chapter considers an aspect of an autopsy alongside an aspect of Carla’s own life and work and touches on some of the more controversial aspects of our feelings towards death, including the relationship between sex and death and our attitudes toward human tissue collection.
Starting with the first cut, we move from external examination into the body itself, discovering more about the heart, stomach and brain, and into dismembered and reconstructed bodies, at each stage taking a colorful detour into the question of what these things can teach us about the living. Join Carla on the journey from microscope-requesting nine-year-old to pathology educator and death engager at a Victorian museum (a journey made via around 5,000 autopsies) as she tells the story of exactly what it’s like to live a life immersed in death.
Product Details
| ISBN-13: | 9781250120694 |
|---|---|
| Publisher: | St. Martin's Publishing Group |
| Publication date: | 06/13/2017 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 302 |
| Sales rank: | 251,933 |
| File size: | 1 MB |
About the Author
Read an Excerpt
The Chick And The Dead
Life and Death Behind Mortuary Doors
By Carla Valentine
St. Martin's Press
Copyright © 2017 Carla ValentineAll rights reserved.
ISBN: 978-1-250-12069-4
CHAPTER 1
Information: 'Media Most Foul'
We live in a society in which spurious realities are manufactured by the media. I ask in my writing, 'What is real?'
— Philip K. Dick
I have never been close up to a fake corpse before. I've seen thousands of genuine cadavers in different shapes and sizes, their bouquet of smells and spectrum of colours all competing for my attention. But, in a bizarre inverse to the experience of most of the population, it's the fake corpses I'm unfamiliar with.
The prosthetic dead body now in front of me is quite pleasant despite being very realistic: she's a slender female with ivory skin and a tiny waist which I find myself envying, in the same way a young girl may envy the curves of a Barbie doll. Her long, tousled, chestnut hair is splayed around her head on the post-mortem table like a dirty halo. Her chest has been opened via the usual Y-incision, causing her loose skin to cascade over her breasts like two bloodstained pink and yellow petals, and the pearly white of her intact breastbone is just visible in the gap. She is a fake cadaver at the phase of the autopsy in which she is not quite open but merely on the cusp – just at the point where I'd relinquished my PM40 to Jason during my first case. As a result, she is still easy for me to identify as a young female and therefore identify with: the tangles of her hair immediately make me think of the struggle I have when blow-drying mine, and her fingers, curling gently up from the surface of the metal, have such a realistic human quality I'm glad they're not painted with nail polish as it would only add to the illusion. She looks so real I feel there should be an odour of blood, day-old perfume and sweat about her. There isn't, of course.
'What do you think?' the assistant director, John, asks me.
'She's wonderful,' I reply with awe. 'If only all my cases were this pleasant!'
I'm in a small, freezing-cold film studio in East London. I've been brought in because the picture being made here focuses specifically on an autopsy and the director wants to make sure everything – every instrument, every technique, every sentence – is absolutely perfect.
I have to hand it to them: as far as fake mortuaries go – and I've seen a fair few now – they've done incredibly well. There's only the odd anomaly. For example, in place of rib shears, the specific medical tool which would be used to remove that as-yet-unopened rib cage, there is a pair of heavy-duty bolt cutters from a hardware store. I suppose they do look fairly similar so they'll pass for correct. Instead of post-mortem twine, which should be more like the thick white string used to tie up parcels, there is thin green cotton – cotton which would slice through the delicate skin of a real cadaver and be useless at sewing up any incisions. Also, on a magnetic tool rack above the sink there seems to be a cake slice. I can think of no justification for that ...
Perhaps these are things that only someone qualified to work in this environment – a pathologist or a pathology technician – would notice in a film. But, boy would they notice. 'What's a friggin' cake slice doing next to the knives and scissors?' I can already hear that audience cry, incredulous. Granted, there are some pathological conditions with confectionery-themed nicknames, such as 'maple-syrup urine disease', 'nutmeg liver' and 'icing-sugar spleen' – an observation that once led me to a pop-up anatomical cake shop called Eat Your Heart Out – but I don't think there's such a thing as 'Victoria sponge pancreas', even if it does sound delicious. Mind you, there are times when the skin of the deceased flakes off like the pastry of a croissant, and there can sometimes be a dark brown, gritty purge fluid we call 'coffee grounds' which escapes from the mouth and nose. Perhaps these, along with 'foamy discharge' and the aforementioned 'nutmeg liver', mean the dead can resemble a Starbucks menu more than a cake stand?
I do my best to explain to John that these errors will be noticeable to certain parts of the audience but he informs me it's too late now to make any changes to the props or the set because the team have already started filming scenes in the fake mortuary. I discover that in showbiz parlance this is 'the shots have already been established'. But there are still some things I can advise on: for example, the exact technique for crunching through the ribs (you really need to put your weight behind the shears and give it some welly) or the type of container that would be used to collect specimens for examination.
* * *
Back in the post-mortem room, after our distraction, I'm just in time to help Jason collect specimens from the anorexic dentist.
'Carla, can you swab the decubitus ulcers, please?' Dr Jameson asks.
I look at him, puzzled.
'The bedsores,' he explains.
I feel like an idiot.
Jason gently tilts the deceased on his side while I take a swab – the correct container for this type of specimen collection – from the stainless-steel cupboard and begin labelling it, hiding my flush of embarrassment behind the cupboard door. The swab's casing is a long, thin plastic tube with a rounded bottom and a blue lid. The rounded end is filled with a nutrient jelly that allows microbiological cultures to be grown and then examined in the lab. When I pull off the lid, the swab comes with it, its end already moist and prepared with the jelly from the bottom of the tube. It looks like an elongated wet cotton bud. I use this to gently swipe at some of the greenish-yellow pus in the purulent bedsores, then place the swab and its contents safely back in the tube.
Dr Jameson writes on his clipboard as he explains, 'I thought perhaps heart failure may have been his cause of death, but now I'm suspecting septicaemia.'
Septicaemia is often called blood-poisoning or sepsis and is caused by an infection entering the bloodstream. It looks as though this man's bedsores have become infected and, left untreated for so long, the microorganisms have poisoned his blood. Jason has already taken some blood samples and now they're also off to the lab for the microbiologists to help in the post-mortem process. We've done our part perfectly, for now.
* * *
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 process 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.
(Continues...)
Excerpted from The Chick And The Dead by Carla Valentine. Copyright © 2017 Carla Valentine. Excerpted by permission of St. Martin's Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Contents
Title Page,Copyright Notice,
Dedication,
Author's Note,
PROLOGUE The First Cut,
ONE Information: 'Media Most Foul',
TWO Preparation: 'Grief Encounters',
THREE Examination: 'Judging a Book by its Cover',
FOUR Difficult and Decomposed Examinations: 'Pulp Fiction',
FIVE Penetration: 'Rose Cottage',
SIX Thoracic Block: 'Home Isn't Where the Heart Is',
SEVEN Abdominal Block: 'Pickled Punks',
EIGHT The Head: 'Losing My Head',
NINE Fragmented Remains: 'Bitsa',
TEN Reconstruction: 'All the King's Men',
ELEVEN Chapel of Rest: 'Sister Act',
EPILOGUE The Angel's Share,
Bibliography,
Acknowledgements,
About the Author,
Copyright,