Down Among the Dead Men.

by Mich.e.l.le Williams.

PROLOGUE.

Never in a million years did I think I would end up in a job like this. Although I had worked in the NHS for over a decade, it had been as a carer for people with learning disabilities, a very different life. For the last few months I had been feeling bored and had come to realize that I was never going to make a career out of it. The NHS is a good organization to work for, though; I did not want to leave the pension scheme that I had been paying into for so long and that was mounting up nicely by the year. While I was scanning the intranet pages at work one day, a job caught my eye. It was intriguing and I had to reread it again and again. The vacancy was for a trainee MTO Medical Technical Officer at a local Gloucestershire hospital, and I thought that the t.i.tle alone sounded interesting. It involved working in the hospital mortuary. It did not go into too much detail but the word 'cadaver' was used a lot. Despite having no experience of working with dead people and no real thought about how I would cope, I decided that I had nothing to lose and would give it a go and apply. I like things that are different, not run of the mill, and this job certainly seemed to fit that bill.

A few weeks pa.s.sed and I pressed on with my job, putting the MTO (incidentally, MTOs are now called Anatomical Pathology Technicians, or APTs) post to the back of my mind, all the while thinking I'd have no chance because I had no experience whatsoever. I was educated above the standard required, but I've always thought that knowledge is nothing over experience. To my surprise, though, I eventually received an invitation to attend one of the mortuaries in Gloucestershire for an informal interview. I figured this would be for a look around while it was quiet to see how I felt in a mortuary environment, but how wrong I was.

On arriving at the pathology department at the hospital, I was asked to take a seat in the reception waiting area as several candidates were attending and we would all be shown around together: this job was obviously more popular than I had thought. On entering the waiting area, I saw a woman dressed from head to toe in black gothic clothing with very long curly straw-like ginger hair, who was one of the other applicants. She greeted me cautiously; I smiled faintly at her and decided to sit on the other side of the room. She asked me if I was here for the MTO post and I replied, 'Yes,' wondering what her next question would be. And then she asked me if I had had any breakfast. I thought this was a very bizarre question to ask someone you did not know, but what the invitation letter had failed to tell me was that I was about to witness a real post-mortem on a dead person, there and then. As the other candidates arrived, it turned out that around half of us had not been told what we were in for. Two people decided to walk out on the spot, and I have to admit I thought twice, but curiosity got the better of me.

Within ten minutes we were in the mortuary and being welcomed, given over-gowns, over-shoes, disposable hats and masks and asked if anyone knew, or was related to, a Mr Bentley of Pear Tree Close, Gloucestershire. Strange question, I thought, but it turned out that the post-mortem we were about to witness was on Mr Bentley and it would be neither appropriate nor pleasant to see someone you know being cut from clavicle to pubis for your first experience of dissection. We were handed over to the senior technician, Clive Wilson. All I could see were his eyes under his protective clothing, but they sparkled and looked welcoming. He talked us through the whole post-mortem, stopping often to ask how everyone was doing and advising us, 'There are no heroes in the mortuary. If anyone feels they cannot cope, then they must leave.' Anyway, to my surprise I found it all absolutely fascinating and spoke to Clive as if we were old friends, and although Clive had clearly been doing it for years, I thought it didn't actually look that difficult a job.

Meanwhile, I was also aware of what was going on around us. Apart from the other candidates for the job, some of whom had obviously just wanted to see a post-mortem and nothing else, the atmosphere in the post-mortem room was relaxed: two juniors and one senior MTO were busy removing the organs from other bodies (a process which I later learned was called 'eviscerating') and chatting away with the pathologist about daily topics, while weighing body organs and cleaning floors and surfaces around the room, keeping it as clean as possible. I decided then and there that this was definitely the career for me; I wanted to do what they were doing.

A few days later, to my surprise, I was called back for the formal interview and waffled my way through it. I was quite honest when explaining why I wanted the job, as I had no other reason. I replied that I really did not know, but that it just felt right and that the urge to be part of the mortuary team and be able to do such an exclusive, fascinating job was very strong. It paid off, and that afternoon the phone call came through offering me the post; I didn't really believe it; not until written confirmation arrived a day later.

What I didn't realize then, was that I was about to start one of the most amazing jobs you can do.

ONE.

My first day as a mortuary technician began on a bright, clear but cold morning in early March. Thirty years of age, until now with no clear idea of what I wanted to do with my life, I had fallen into working with people who were no longer breathing. I was to start work at the other of the two mortuaries in Gloucestershire, the one that I had never before even known existed; because of this, I spent ages just trying to find out where I was supposed to report for work, because hospitals tend not to advertise where mortuaries and body stores are, for obvious reasons (and other reasons that are perhaps not so obvious until you become familiar with life in the mortuary).

I walked around the hospital at least twice looking for it. I eventually went into A&E reception and introduced myself to the receptionist, who looked at me blankly when I asked for directions. After shuffling off, he returned and said someone would be over to collect me. Now I felt that I'd made completely the wrong move. What had I done? I had never felt so unwanted or out of place. I stood around like a spare part for ten minutes, looking at the people waiting to be seen in A&E, until the double doors to the waiting room opened and in walked a silver-haired man in his fifties dressed in a long white lab coat. Heading straight for me, he announced my name, shook my hand firmly and said, 'Welcome to the hospital.' I recognized his eyes and realized this was the same man Clive who had demonstrated the post-mortem a couple of weeks ago at my first interview. It was a relief to see a familiar face.

Greetings over, he led me in the direction of the mortuary. He asked how I was feeling, to which the answer was that I wasn't sure. Nervous, nauseous, frightened and a whole other bunch of emotions that I suppose everyone experiences on their first day at a new job. But this isn't your normal nine-to-five job, is it? I did wonder why they had offered me the post in the first place. I had found the post-mortem fascinating, but never before that had I seen a dead person, let alone spent all day with one. I still didn't really know what made me apply for the job and could only suppose that I had felt I could do it.

While I was walking with Clive over to the mortuary (which to my surprise was actually very close you could see it from A&E if you knew where it was), I wondered what the department would look like. I had seen the post-mortem in the mortuary in the sister hospital, which was only around seven-years-old. Big, light and with lots of room, the whole place was shiny stainless steel and smelt of a strong disinfectant. I wondered if this mortuary would be the same, or if it would be like the mortuaries you see on old horror films, water dripping down the walls, rats scampering in the gutters and a hunchbacked man hovering in the corner holding an eleven-inch blade.

Clive led me to a pair of large red double doors under a corrugated blue steel canopy, which hides the main entrance to the mortuary so that the patients and public don't see bodies being loaded into hea.r.s.es. He told me that it was on the ground floor of the pathology block, at the far end from reception. It was quite understated and not at all obviously a place where you would come across corpses, but easy enough to find. With a single key, Clive opened one of the doors.

As I entered the roomy vestibule, the smell that hit me was a mix of cleaning fluid, musty clothes and an odour I had never smelt before, which I could not even begin to describe but which for some reason reminded me of how my little brother used to smell when he came home from junior school, a sort of stale canteenish smell.

Clive led me into a small office that housed two desks. Sitting at the smaller of these was another silver-haired man, with rosy cheeks and gla.s.ses. Clive introduced Graham to me. Graham stood up and he, too, firmly shook my hand. 'h.e.l.lo, lovey,' was his greeting, and he had a strong Gloucestershire accent which suited his appearance to a T. I vaguely recognized him and it turned out that I, too, struck a chord with him. We chatted and eventually concluded that he must know my father; Dad, being an ex-publican, has met a lot of people in Gloucestershire and, growing up in a pub, I, too, came across many faces.

I was offered a chair and a hot drink. Graham bent down from his chair to flick on the kettle, which was on the floor by his desk, and grabbed three cups off a bookshelf behind his head. A carton of milk was fetched from outside the double doors. Clive told me cheerfully that, until a few years ago, they would keep the milk in the bottom of the same fridge that held the bodies, but health and safety had put a stop to this. I decided then and there that I would stick with black coffee.

The office I was sitting in had seen better days. Standard hospital cream and blue paint was peeling off the walls, and the damp was rising at the bottom around the electrical socket. The furniture was dated, as if it had been dumped in the mortuary, out of the way of the main hospital which was being modernized all the time. The desks had no varnish left on them and the vinyl covering on each of the chairs was slightly torn. While Graham was in charge of making the beverages, Clive began to tell me about my predecessor who had fallen into dispute with the senior technician at the sister hospital and decided to leave. He did not go on to say what the dispute was, and I could see he wanted me to ask but I wasn't going to, not on my first day. Lots of small talk followed and I wondered if this was it for mortuary life. Did we sit all day waiting for something to happen? Did sirens ring when someone died in the hospital? Did the police barge in through a secret door with a disfigured body when somebody got hit by a bus? I found the courage to ask Clive about this and he laughed. Not in a nasty way, but in an 'Oh bless' way.

Clive had been doing this job for twenty-six years. He had begun his career in theatre as a scrub a.s.sistant, and knew the importance of infection control throughout the hospital, mortuary included. From the way he spoke, he took no prisoners when it came to the cleanliness of the mortuary. It soon became clear, too, that you name a mode of death and Clive had seen it; nothing could shock him any more.

So, there I was, my first day, ready and eager for action, but all I had been offered was coffee because things had gone quiet, and there were to be no post-mortems that day. Clive knew how precious days like this were. Because there was no post-mortem work, only a few bodies in the body store and all the paperwork was up to date, Clive had a chance to relax and de-stress. You would not realize how busy the dead can make you, and at that moment I certainly had no idea.

We all spent the whole day chatting while Clive taught me the correct method for releasing bodies as well as other important procedures. I was introduced to a lot of people, including porters, undertakers and the lab manager, and given a tour of the huge hospital that was now my new workplace. I arrived home to my two dogs, Harvey and Oscar, mentally exhausted without knowing why, but excited at what tomorrow might bring. I rang my Gramp that evening to tell him about my day. I had kept him up to date on all the events and he was as excited as me about my new job. It was important for me that he knew about my life. I knew a lot about his, and he worshipped me as the only granddaughter in a male-dominated family, so it was only right he knew. And, of course, he was interested.

TWO.

When I had first applied for the job as a medical technical officer in the mortuary, I did not immediately tell my parents, my brother Michael or my Gramp. Although we all have a very close relationship, some things are best not said until they are certain. But, me being me, I could not contain myself when the letter came through to say I had been shortlisted for an interview following the post-mortem demonstration. Mum and Dad knew that I was unhappy with my job in learning disabilities, but would never have encouraged me to leave one job until I'd found another, as I had responsibilities, and I was not sure what their reaction would be to this one. I had grown up in a family that has a strong sense of responsibility, and Mum and Dad had always worked hard. Of course they knew I had an interest in true crime my bookcase when I lived at home was full of books about people who had committed murders but I knew enough to realize that this job was not going to involve a lot of murders. I guessed that very little of it would involve any of the fascinating crime stuff that is portrayed on TV, and I was later to find out I was right.

When the request to attend for an interview arrived, I didn't say a word to any of my colleagues at my then workplace, but was bursting to tell someone, so after my early shift I returned home at about two thirty, put the two dogs on the lead and we set off on the two and a half mile walk to my parents'. Mum as usual made a huge fuss of Harvey and Oscar, as Dad shouted, 'Aye up, look out, the boys are back,' and as soon as they heard his voice they smothered him.

'All right, love?' Dad has asked me this question for as long as I can remember.

Mum came out with her usual, 'Have you eaten? I'm just cooking our tea if you want to stay,' which was followed by, 'Have you got enough money?' and finished with, 'Is Luke looking after you?' Luke being my boyfriend. She then put the kettle on.

Dad went into his usual routine: 'You remembered where we lived then?' which is what I get when I have spent more than three days without being in touch. So, after all the usual chat about work and life and stuff, I decided I would tell them that I had applied for the technician's job.

Mum's reaction was, surprisingly, delight. 'What? Working with dead people?' She lowered her voice. 'If I was your age again, I would do that.'

Dad had a different response. 'Comes from your mother's side of the family, that sort of interest.' As soon as he said this I thought, The Addams Family The Addams Family, as Adams was Mum's maiden name; that, and the fact that in my last year at school my nickname was Morticia because of my long dark hair and pale complexion, meant it all seemed quite fitting. I told Mum and Dad that nothing was certain yet.

When it came to it, Mum took the day off and went with me to the interview, bringing with her Dad's good luck wishes. I think she was probably more excited than I was. She waited in the cafe down the road from the hospital while I sat through the second interview, which involved a lot of questions about my personality and, as I said before, why I wanted the job, and how I would deal with situations that I have never been in, to most of which I replied that I would refer to a more experienced member of staff. The twenty minutes seemed to last for ever. At the end I was told I would be contacted that afternoon. I rejoined Mum, who didn't say much apart from asking me how I felt and did I need a proper drink to settle myself, but when the phone call came through offering me the job and I accepted, she hugged me to the point where I nearly became unconscious. I rang Dad to tell him the news, and he replied, 'Well done, love.'

I then rang my brother, whose reply was typical. 'What do you want to do that for?'

Luke was pleased as he knew how much I wanted the job, and suggested we celebrate that evening. Last, but by no means least, was Gramp. He was not a hundred per cent sure as to what I was talking about, so we visited him later that day and explained all. And, while I'm sure he still did not fully understand, he was very proud that I was going to be working at the main hospital.

THREE.

I arrived ten minutes early on my second morning at the mortuary (now that I knew vaguely where it was) and was greeted warmly by Clive who had already been in for forty minutes and had the kettle on. He liked to get in early as he always preferred to be one step ahead of the game. Graham arrived five minutes later and went straight into the body store to register the bodies that had been brought in overnight. I followed him through, as I was intrigued as to what this involved and eager to learn more of the routines of the MTO life.

The body store leads directly from the entrance vestibule. It is a large room containing a huge fridge which can house twenty-eight bodies and is fronted by seven tall doors. Opposite these are some cupboards, with a bench top, as well as a sink and waste bins. Every time the porters bring a body into the mortuary, they fill in a sheet that lives on the bench top; it details who the deceased is, where they have come from and which fridge they have been put into, plus a few other facts for continuity. Graham consulted this, and then went to one of the seven fridge doors; when he opened it, I saw that behind it were four metal trays, one above the other, each supporting a full body bag.

He manoeuvred a hydraulic trolley on wheels in front of this, and then proceeded to raise it by pumping a lever energetically at the far end. When it was level with the third tray up, he dragged this out and I saw that it rolled along metal runners. On the outside of the white body bag was a clear plastic pocket containing the person's details on a small beige-coloured cardboard label.

Graham removed the tag, opened the bag and checked it against similar tags that were tied around the dead person's wrist and big toe. He did this in a matter-of-fact manner, as if he had done it a thousand times before. Graham is a man of average height, with a pure white head of hair and the cheeks you get from spending a long time out of doors. Very friendly, he is full of stories about everything which he tells in a deep, cosy voice bathed in a broad Gloucestershire accent; I felt very comfortable in his company from the word go. He has no airs or graces and talks a lot about how things have changed.

When Graham opened the large white body bag containing Mr Evans, I was shocked to see what lay before me. Mr Evans was an elderly gentleman, and I expected to see a body that looked as though it was at rest. What I did see was a frail old man with head tilted back, eyes staring wide and mouth gaping open. Graham noticed straight away that I was taken aback. He explained to me about the muscles in the jaw relaxing at death and making the mouth drop open, but not about the eyes and the arched neck. At that point, Clive came into the body store and said that Mr Evans was going for autopsy, so could we take him through to the post-mortem room and put him on the middle table?

The three tables in the PM room each had a delegated technician in order of rank. Clive was on the top table, being the senior technician, and Graham on the middle one, so I figured I would be a.s.signed the third table, lowest in the rank. Clive told us that this had become a Coroner's case and would therefore require an autopsy because the death had happened a week or so after Mr Evans had been admitted to hospital after a fall at home; all deaths that might be the result of an accident come under the jurisdiction of the Coroner and therefore require a post-mortem examination. Apparently, though, such cases as these are usually straightforward. Clive informed us airily that this was probably a pulmonary embolus a blood clot that forms usually in the leg veins and then breaks off to travel to and block the blood supply to the lungs. I looked at him blankly and he walked away chuckling, saying as he went, 'You'll get there.'

This was to be the only PM for the day, so Clive asked me if I would be satisfied just to go and watch Graham take the organs out of the body eviscerate it and then help him clean up afterwards. More than happy, I was shown into a small changing room where I dressed in blue scrubs that were three sizes too big and picked from a large selection of white clogs the pair that was closest to my size. I entered the PM room from the opposite, 'dirty', door in the changing room. Graham was already there and he showed me a small alcove off the main room which housed disposable hats, masks, gloves and goggles.

Not having a clue what glove size I am, I chose the smallest and then struggled with the disposable hat I probably ended up looking like the Pope until Graham pointed me in the direction of the mirror. I found myself looking at someone out of perhaps a science fiction film or a medical soap opera; I felt really weird wearing all this protective gear and, once again, was worrying that I was out of my depth.

Graham had stripped Mr Evans and placed a wooden block under the middle of his back so the torso was raised and the spine slightly curved to expose the neck. Graham checked the identification on Mr Evans against what was written on the postmortem request. Having satisfied himself that this was the right person, he told me that identification of the body is our most important responsibility; every so often the wrong body gets eviscerated, and what follows is a tidal wave of trouble. The next of kin, not surprisingly, tend to become upset when they discover what has happened. From the way he spoke, I guessed that he might have committed this sin in the past, but I did not want to pry further because it was obviously painful; however, it lodged at once in my head as something to avoid and something to be worried about.

Graham had a tray of instruments on the table with him, resting on Mr Evans' legs. From this tray he took a knife; it was about the size of a table knife, but with a disposable blade that looked as though it would cut through steel. Graham placed the tip of this at the top of the torso, in the midline just below the Adam's apple, and ran it down with a single, easy sweep to end just above the pubic hair. Sticking his fingers in a small, deeper incision that he had made in this slit just under the ribcage, he then cut down through a couple of layers of fat and muscle to expose the guts; he extended this down towards the feet so that all the abdominal organs were exposed. This done, he then began to gently retract the skin from the ribs, slicing it off with practised strokes of a knife laid flat to the ribs, so that within a couple of minutes Mr Evans' skin was completely free of the front of his body, hanging away from it. It looked as if you would almost be able to zip him right back up.

He rinsed off his knife, which was apparently called a PM40, and replaced it in his tray. After that, he washed off any blood that was on the table, and was telling me about how some corpses 'bleed' more than others depending on how long they have been dead as he picked up what looked like a pair of small stainless steel garden shears. He opened them up and put the blades around the lowest of Mr Evans' ribs on the right-hand side. He began to cut upwards, severing each rib with a crunch and then moving on up to the next until he reached the top; he did this on both sides, and thereby removed the front of the ribcage, pulling away a big triangle like a prehistoric crab. This exposed the heart, lungs and most of the liver. He placed the 'crab' to one side and moved down the table so that he was over Mr Evans' bowels, which were fully exposed and waiting to be unravelled.

Next, Graham took a pair of scissors and cut through a piece of gut near the stomach. He tugged at the guts and began to unwind them, cutting as he did so through the fatty membrane that was holding them in place. Within a very few minutes, the bowels were lying in a stainless steel bowl at Mr Evans' feet. While Graham was doing what he had done a hundred times before, I started to notice the smell. I stood thinking of what it reminded me of. Graham told me how he used to work in a slaughterhouse, and then it hit me. The smell was almost the same as in the butcher's. By the time I had gathered my thoughts, Graham had loosened the remaining organs from the back of the opened torso although I missed how he had done it and he now had his PM40 up inside Mr Evans' throat, busily working away under the skin, pushing the blade into the floor of the mouth. After a few moments he had cut through this and around the back of the tongue so that he was able to free the mouth and neck organs. What he did then was like some sort of gory magic trick; he pulled the tongue down through the throat, everything still intact, and then he continued to pull everything away from the spine lungs, heart, liver, stomach, spleen, kidneys . . . It amazed me then and still amazes me now how all the organs are attached to each other.

By doing this, he had released all Mr Evans' organs from his body, and was now holding what he told me was referred to as the 'pluck'. Grasped firmly in Graham's hand were Mr Evans' neck structures, his tongue resting on Graham's hand while suspended below was every other major organ except the gut and the brain. He placed all this in a second stainless steel bowl, and placed both of the bowls on the dissection bench ready for the pathologist. Graham got cleaned up and we both took off our protective equipment, changed into clean scrubs and went back to the office for coffee. Clive had already rung the pathologist, Dr Ed Burberry, who had told him he would be down at ten thirty to start, so we still had an hour before he was due to arrive. Graham and I took our drinks and went and sat under the canopy outside the double doors to the mortuary to have a smoke.

From here, at the back of the pathology building, you can see loads of staff walking about, but they don't really see you. It's as though this place is completely ignored a blind spot or something that they would rather not think existed or maybe people are just not aware of it. We went for a little stroll around the car park. 'So you can get your bearings,' Graham said. We didn't get very far, as Graham knew so many members of staff that he spoke to everyone we met; he had worked at the hospital for years and years, first as a driver before joining the mortuary. He introduced me to everyone, but I knew I would never remember them all, and I thought it would take a few weeks till I got my bearings.

After our break, we returned to the post-mortem room and Graham st.i.tched up the lower half of Mr Evans' torso, leaving the top half open so he could put the organs back when Dr Burberry had finished with them. He removed the wooden block from under Mr Evans and rested his head on it. Taking a scalpel, Graham then cut behind Mr Evans' right ear and ran the blade around the back of his head to end behind the left ear. He informed me that it was important to make this incision on the head as low as possible. The reason for this is that if a family want to view the deceased after a post-mortem, the lower the incision on the head, the less likely it will be seen as it will be nestling on the pillow. Apparently, the technicians have lots of little such ploys to hide things from people. I thought it was good that Graham had thoughts for the family of Mr Evans, although it somehow made it all feel very real.

Graham then began to retract Mr Evans' scalp from his skull. This is not an easy thing to do, because the skull and the scalp do not come apart readily; in fact, Graham got even redder in the face than usual as he folded the scalp back to cover Mr Evans' face. After he had loosened the scalp from behind the ears, he then took a wide wedge of the skull off with an electric rotating saw to expose the brain; this he then removed by sliding his fingers between the brain and the forehead bone, then gently pulling it so that he could put a scalpel under the brain. I asked what he was doing and he explained that he was cutting through a fibrous membrane that held the cerebellum in place, and then severing the cranial nerves and the spinal cord. Having done this, he withdrew the scalpel and pulled out the brain with frightening ease and nonchalance.

Dr Burberry arrived shortly after this. Graham had been telling me that Dr Burberry is the lead pathologist for the department, so he takes the rap for the whole of the department when things go wrong, and has the responsibility for the mortuary. Graham was proud of the fact that he felt he had a normal relationship with Dr Burberry; as he put it, 'One that two human beings should have. We can talk openly, but we both know where the levels of respect lie.' I was intrigued to see what Dr Burberry was going to be like; Clive had spoken highly of him too.

Dr Ed Burberry gave off the aura of a very important person. Of average height and stature, he was in his mid-forties and very well spoken. I could see instantly why he was in charge. He wasn't what I was expecting at all, because he looked relatively normal and not at all the snooty professorial type. He greeted us both with, 'Good morning,' and once again, I felt out of my depth, as if maybe I should be cleaning the toilets or something. How was I ever going to be able to hold a conversation with somebody so highly qualified? I suddenly found myself staring at Graham and wondering how this was going to progress. Never had I imagined being in a situation like this. Me, a normal female (except that, OK, I was one with an interest that a lot of people might find odd), Graham, an ex-slaughterman with no desire to better himself, just wanting to do his job and go home; and Dr Burberry, a highly educated consultant, who was about to perform a detailed dissection of Mr Evans' internal organs, and who would then be able to determine what killed him.

In the event, though, what happened I would never have believed, and you had to be there to see it. Graham and Dr Burberry chatted like old friends, which I suppose they probably were, as they had worked together for a long time. They spoke about cricket, television, the weather and what they had planned for the evening. In the background, Dr Burberry insisted that we have Radio 2 on as loud as possible. As he examined Mr Evans' organs, he placed them in a plastic tray and Graham weighed them individually, making a record of each weight. While they were doing this, they talked so normally it was obvious that they were immune to what they were doing. I stood in the background, watching in awe. It all felt comfortable and my thoughts of being out of place were starting to fade.

Dr Burberry had finished his examination within thirty minutes and then left the post-mortem room. Graham returned all the organs to Mr Evans' body and finished st.i.tching him up. I was asked to wash down the work bench that Dr Burberry had been using and disinfect it, which I did with pleasure. I actually felt useful at last.

FOUR.

One of the things I had to learn about quickly was the Coroner's system. The Coroner is effectively a judge usually a lawyer, although there are some medically qualified Coroners who has legal jurisdiction over a corpse if no natural cause of death can be given by a suitably qualified doctor. If the medical cause of death is unknown or if there is reason to believe that it may be due to unnatural causes, then the case has to be reported to the Coroner. He then has absolute control over that body no one, not even the next of kin, can stop him asking a pathologist to do a postmortem and that way find out the reason for the death.

So much to take in. Clive told me that most of our work was for the Coroner because, following the scandals at Bristol and Alder Hey, very few hospital (for educational or research purposes) post-mortems which require the consent of the next of kin because the cause of death is already known were being done. This was because families, given the choice, very rarely want their loved ones literally internally examined.

Whether a cause of death is unnatural is not always as clear-cut as you may think, either. Obviously, cases of suicide, violence by a third party (which would require a forensic autopsy by the Home Office Pathologist and not just a Coroner's autopsy) or accident are unnatural, but so is industrial disease, and so is neglect, whether self-neglect or neglect by someone else.

This leads me on to Amber Court . . .

I had been in my new job less than a week when I met my first body from Amber Court which had come to us for post-mortem. Amber Court is a large residential home on the other side of Gloucestershire; it has a reputation for being low cost and, in residential care as in most things in life, you get what you pay for. It houses a large number of frail and elderly people, and is staffed by the least talented members of society. As long as they can walk and breathe, the owners of Amber Court are happy to employ them; they are paid to do a very bad job and, in return, those in their care are treated with no respect and little, if any, kindness. I imagine a little fat greedy man, sitting in a back office tucked away somewhere, rubbing his hands together at all the money he is making by providing so-called care.

As this is common knowledge throughout Gloucestershire, almost every death they have in Amber Court gets reported to the Coroner. It is his statutory duty to rule out neglect in cases of unexpected death, and that, inevitably, means that most deaths at Amber Court end up having a post-mortem.

Clive did a quick evisceration of an elderly, frail, almost gossamer-thin lady Mrs Ethel Humbler that took him no time at all, but it turned out to be fascinating. Ed was on PM duty again, and what he found made everyone stop the banter and friendly insults that were being fired around and led Clive to turn down the volume on the radio. In Mrs Humbler's throat, wedged right down in the trachea, was a paper napkin. It was almost spooky when Ed flattened it out, because written in the corner was Mrs Humbler's own name. It was immediately obvious what had happened; in their uneducated wisdom, her so-called 'carers' had left her, despite the fact that she had full-blown dementia, to help herself to her own lunch. In her own confused world, Mrs H had obviously felt compelled to consume everything that was laid out in front of her and, with no one around to stop her, she had stuffed the napkin into her mouth. It had become lodged in her throat leading to what I can only imagine to be a lonely and scary death.

So, Ed had a cause of death for the Coroner but, as Clive said afterwards, that would not be the end of it. For the time being, this would be an accidental death, but there are accidents and there are 'accidents'; some are more avoidable than others and it's the Coroner's job to sort out the two types. I vowed secretly that I would never allow any of my family to go into care; I would rather struggle to look after them, no matter how hard that was, than allow this to happen to one of mine. How were Mrs Humbler's family going to react?

After the PM, Mrs H was reconstructed by Clive to nearly her former glory and ended up actually looking more peaceful than before, then placed in the body store alongside the rest of the poor souls who reside with us while they await collection by the undertakers.

FIVE.

Like most people, I had always a.s.sumed that mortuaries dealt only in dead people, but it had become apparent very quickly that there was a large stream of other kinds of thing coming through. The first time this was brought home to me was quite early on when I answered the bell of the main red doors to find a porter with a large yellow bin that was about a foot deep and two feet square. He thrust it at me and said, 'From the delivery suite.'

I took it and asked, 'What is it?'

He looked at me pityingly. 'Well, I'm not the b.l.o.o.d.y stork, and this ain't no bonny baby.'

With that he was gone.

At this point Clive came into the vestibule and found me looking down at the box. He made a face. 'Oh dear.'

'What's this?' I asked.

He took the box from me. 'Products.'

'Products?' I echoed. What sort of products did he mean?

'Products of conception.' I still did not catch on. He took the box into the body store and put it on a trolley, then turned to face me. 'Abortions, miscarriages, that kind of thing,' he said gently.

The truth hit me and left me feeling sick. 'They come here?' I asked incredulously.

'Where else would they go?'

I'd never really thought about it and, now I did, it made sense. Nervously, I asked, 'Are there babies in there?'

He smiled. 'Bless you, Mich.e.l.le, no. If a baby is stillborn, or dies shortly after birth, then of course it comes down here exactly as an adult does. But with the early miscarriages and abortions and suchlike, there's nothing much to see other than tissues.'

I wasn't sure I liked to think about what he meant by 'tissues'. 'What happens to them?'

'We treat them exactly as we do everyone else. If the parents want them buried, then an undertaker buries them. If they want an undertaker to handle the cremation, then that's what happens. Most of the time, though, the parents are happy for us to handle things. We get the chaplain to bless them, and they go directly to a crematorium from here. We make absolutely certain that they are treated respectfully at all times.'

About a month later, I answered the door exactly as before and once again a porter stood there. This one held a white plastic bucket, sealed with a lid; it was about eighteen inches in diameter and about three feet tall. He smiled at me and held it out for me to take, as if it was a bunch of flowers and he was proposing. 'Here you are, love.'