Dead End

By Mark Wheeler|Thursday, June 01, 1995
RELATED TAGS: HEALTH POLICY, GENETICS
So. You’re dead. Deceased, expired, done for, defunct--no more. What now? you’d ask, if only you could. But you can’t, because of course you’re history--suffering from the ultimate outta here.

Still, there are decisions that must be made regarding your disposal, decisions that you can’t be involved in. Then again, once a decision has been reached, you’ll be about as involved as you can be-- embalmment, followed by a service, perhaps, and burial, or maybe cremation and an urn? But had you bothered to do a little spadework, you’d know there were other options regarding your recent demise.

For example, if you were a male, you might have wanted to borrow a page from the Tana Toradja, who live on the island of Sulawesi in Indonesia. During a mourning period lasting months and sometimes years, the corpse remains in his own home. His wife maintains a constant vigil and provides him with food. Later, when the official death notice is made, the whole community parties hearty, even engaging in sporting events. Still later, the body is finally placed in a coffin and buried, much to the relief, no doubt, of the widow, finally rid of the husband from hell.

You could say I’m bugged by the big D. Death, that is. Chances are you’re bugged by death, too, especially if you’ve attended your Lordy, Lordy, I can’t believe I’m 40 birthday wake. I have, and I’m damned cranky about it. It’s got me thinking about life (short), death (long), and south (due)--the direction in which various anatomic parts like hair, stomach, and neurons are inexorably heading. Indeed, it’s got me thinking like 120- year-old Jeanne Calment, the world’s oldest human, who when asked what kind of future she expected, replied, A very short one.

Death is one reason that lately, when I can’t sleep, I don’t count sheep to get drowsy. I count corpuscles. Not all of them, of course; just my own. Specifically, the 100 billion or so within me that kick the bucket each and every day, having exhausted their 120-day life expectancy.

Sure, there are trillions of them in our bodies, and when they die, hematopoietic cells in our bone marrow produce healthy new ones to replace them. All in all, a nice, evolutionarily refined and tested give- and-take relationship--unless, of course, all my cells decide to kill themselves, which, it appears, the mutinous little SOBs are perfectly capable of. The process is called apoptosis, or PCD (programmed cell death). Whether the cells do or don’t, says Martin Raff of University College, London, seems to depend on the regular receipt of chemical signals from other cells. Turn off the juice and they’re toast.

Technically, this is a good thing. The tail of a tadpole, for instance, drops off when no longer needed, thanks to PCD. During human gestation, the skin between our fingers undergoes apoptosis, so that we aren’t born with hands resembling Ping-Pong paddles. All PCD works the same way: at the appointed hour, enzymes inside each cell’s nucleus begin to break up its DNA. The surface of the cell starts to undulate: first it bulges out, then it collapses in, then out, then in, in a process called blebbing (in gyms it’s a process called aerobics). The whole cell finally disintegrates into pieces to be collected by macrophages, the immune system’s sanitation engineers.

In addition to apoptosis, there’s always the chance that my cells will pick up some aberrant, mutant, I-spit-in-the-face-of-antibiotics bacterium and succumb to necrosis, death caused by injury or disease. Then the little darlings would just swell up and explode, spilling their infected guts everywhere, which would cause an inflammatory reaction that could kill neighboring cells. Apoptosis and necrosis: the Felix Unger and Oscar Madison of the cellular set.

So, with this willingness on the part of my back-stabbing body to bag it at any time, I fret. And don’t tell me I’m alone in my worrying. I can’t have single-handedly put two books on the best-seller lists: How We Die, by surgeon Sherwin Nuland, an elegantly written account of our demise (Death is the surcease that comes when the exhausting battle [against disease] has been fought), and the mega-mega-hit Embraced by the Light, by Betty J. Eadie, from the near-death, Oh, see the beautiful tunnel of light but jump back, Jack school.

Nuland, by the way, manages to burst any mystical bubble a reader might be clinging to by suggesting that all the imagery used to describe near-death experiences is probably nothing more than the result of biochemical spewings of endorphins, seizures in the temporal lobes, or insufficient oxygen to the brain. Thank you, Sher.

I also worry about the possibilities of near death, but not exactly the way it’s described by Betty J. I worry, for instance, about the kind of random mishap that befell Sipho William Mdletshe: in 1993 this 24- year-old South African was declared dead following a traffic accident. Reasonably enough, he was taken to a mortuary and placed in a metal box. The only problem was, Mdletshe wasn’t dead, just unconscious. But there he lay for two long days and two long nights, until he woke up enough to scream for help. The startled--to say the least--mortuary workers set him free.

Happy Mdletshe, no doubt relieved that he had dodged a bullet, so to speak, raced home to tell his fiancée the good news. The result? Rejection. The reason? She thought he’d turned into a zombie.

For all these reasons and more, I plan on being prepared when I croak. That’s why I’ve turned to the definitive book on pushing up daisies, one Death to Dust: What Happens to Dead Bodies? by Kenneth V. Iserson. Indeed, everything you’ve ever wanted to know about cashing in your chips is included in this deadly little 709-page tomb, uh, tome--from A, for autopsy (step 2: A Y-shaped incision that begins at each shoulder or armpit area and runs beneath the breasts to the bottom of the breastbone. The incisions then join and proceed down the middle of the abdomen to the pubis, just above the genitals), to Z, for the aforementioned zombies (from Haiti, where live burials purportedly take place after an injection of tetrodotoxin, a fish poison that induces a deathlike state in which the victim exhibits no outward response to stimulation. If a proper dose is given, the rebounded remains could be dug up and used to, say, scare the bejesus out of poor Sipho William Mdletshe’s fiancée).

Iserson wrote the book to demystify the idea of death and to help, as morticians like to say, those who are left behind. He’s hoping, given that death is a mutilating experience, that more of us will consider donating any or all of our 25 organs and tissues that can be transplanted. Right now, he notes, fewer than 1 percent of those who kick the bucket in the United States each year bother to donate. In 1994, 36,500 people were waiting for organ transplants; 60 percent of them were younger than 45 when they went on the list.

Iserson, a professor of surgery at the University of Arizona and an emergency room physician, has seen his share of people who have met their demise, and it ain’t pretty. Consider his chapter Beauty in Death, which covers what morticians tactfully call restoration and what Iserson points out is the absurdity of trying to make someone look as if he’s alive right after he’s dead. Without going into any gory details (none of that if the body has been decapitated, the restorer trims the skin edges and sews the head back on with dental floss, adding splints to avoid having it sag to one side stuff), procedures that shouldn’t be overlooked include burning off unsightly ear hair with a candle flame; using superglue to hold the hands in place; packing the throat with gauze; and, if the stiff’s a drooler, cutting and tying off the trachea and esophagus when the neck is cut open for embalming. (Sometimes a little dab of superglue is also squirted into the eyes to keep them closed. Iserson points out that a peaceful look is achieved when the upper lids meet the lower lids about two-thirds of the way down the eye. If the lids meet in the middle, the corpse takes on a pained look, and heaven knows you wouldn’t want to have a dead person look pained.)

I’ll gloss over the nasty embalming part. Suffice it to say that with the most common method, roughly four gallons of formaldehyde and methyl alcohol are pumped into the body through an artery in the neck, groin, or upper arm. The chemicals go in, and the blood comes out via a vein that’s been sliced open. To keep things tidy, the embalming table is ringed by a gutter that funnels away the draining blood.

Iserson’s book is also chockablock with history. He writes of the time, for instance, when British sailors turned to makeshift embalming for Lord Nelson, who was fatally wounded during the Battle of Trafalgar. His officers decided to return the famous admiral to England rather than bury his body at sea.

Reportedly, to preserve Lord Nelson’s body, the sailors immersed it in brandy from his ship’s reserves. But you know sailors--not wanting to go without a little snort now and then, they siphoned off the Nelson- flavored brandy with a piece of macaroni. Eventually, they drained the admiral dry. The British navy still uses the term tapping the admiral for getting a drink of rum.

Iserson also presents strong evidence for near-death underpinnings of the cliché luck of the Irish. The year: 1773. The place: the Green Isle itself. The man: one Patrick Redmond, a robber condemned to be hung by the neck until dead. And so he was, for 29 minutes. Presumably the authorities wanted to ensure the goal of any successful hanging-- partial decapitation, and a separation of the spinal cord at the third and fourth cervical vertebrae.

Alas for the authorities, perhaps 30 would have been the magic number. As it was, Redmond’s friends hurried away his body, put tobacco enemas (!) in it, and then (good friends that they were) held lit pipes (!!) to it (good, good friends) while rubbing his limbs. Son of a gun if that feisty Redmond didn’t revive.

I’ve decided to fill out my organ donor card and go the cremation route, cooking my carcass at a temperature of 2,500 degrees. But if you opt for a traditional burial, might I suggest a handy fail-safe gadget so you don’t run into the same problem as poor Sipho William Mdletshe? The Karnicé-Karnicki coffin, named after the Belgian count Karnicé-Karnicki and patented in 1897, is a hermetically sealed coffin with a tube extending to a box on the surface. The tube is attached to a spring-loaded ball sitting on your chest. Should you awake and spring the spring, it will open the box’s lid to let in light and air. It will also send up a flag, ring a bell, and light a lamp in case it’s after dark, all giving new meaning to the phrase Hope springs eternal.

However you dispose of yourself, here’s hoping you’ll heed Iserson’s organ call. For whatever happens to your body post-death, we’re all eventually dust anyway. If you’re an agnostic, presumably you’ve been steeled for this all along. And if you possess a religious bent, take solace in the thought that perhaps, much like donating organs, death is nothing more than God recycling.
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