Body disposal - the greenest options?

I've blogged about body disposal before, including freeze-drying, ossuaries, 'bio-cremation' and 'green' burial. With population increase comes the increasing problem of what to do with corpses, when space is limited. Britain and Japan (for obvious reasons) favour cremation more than most other countries. In an article in The Conversation, Professor Robert Young of the University of Salford writes that about 80% of the British request cremation due to lack of space, but I don't think that this is strictly true. It was the reason that cremation was originally introduced to Great Britain in the late 19th century, when municipal cemeteries were full. There was a lot of resistance to the idea at the time, mainly from the churches, but the Cremation Act was passed in 1902. It's true that it's a popular choice now, but I think that this has less to do with a shortage of burial space than with a general reluctance to stand beside an open grave at a funeral, which some people find repellent. Cremation happens inside a nice warm building where the coffin disappears behind the scenes so you don't have to think too hard about what's happening to it. Silly, but out of sight, out of mind, is a common attitude.

I was interested in one point made by the professor in his article; that the energy used to cremate one person is equal to the energy they use in one month when alive. "In the UK this translates to a yearly energy consumption of a town of 16,000 people."

When I filled in the forms for my body bequest, I requested the burial of my remains when the students have finished with them. I had a choice between burial or cremation. Other options, such as freeze-drying, would be either too complicated or expensive for the medical school, I assume. However, if there's a glut of cadavers when I pop my clogs and they reject my body, my nearest and dearest will have to organise a funeral. Since a funeral pyre in the back garden is probably out of the question, an alternative must be chosen. I trust them to make the best choice, considering cost and climate change. This is one decision I'm happy to avoid.

Funeral flowers

I don't usually have funeral flowers on my windowsill but after a friend's funeral yesterday his family didn't want to take them home on a long car journey and decided that I should have them. My windowsill's the only space big enough.

I was surprised that my friend's daughter had chosen this floral tribute, as my friend had stipulated in his will that he didn't want a lot of money spent on his funeral - just a cardboard coffin and no flowers. These would have cost well over £100. However, he wasn't to know, was he?

Funeral flowers used to serve a practical purpose; their perfume helped to mask the smell of decomposition. Maybe these will help to mask the smell of any dead rodents my cats have hidden around the house.

My friend Meg has found another form of floral tribute, invented by a Japanese ad agency. I like it.

Dying without an appointment

… Not a whit, we defy augury; there’s a special providence in the fall of a sparrow. If it be now, ‘tis not to come; if it be not to come, it will be now; if it be not now, yet it will come: the readiness is all.

William Shakespeare, Hamlet

Doctors do their best, mostly, but they can't always live up to other people's expectations. If you're really ill, you might ask how long you've got, but I don't think I'd bother, nor would I encourage my nearest and dearest to ask, unless my death was imminent and they needed to go and top up a parking meter or visit the loo.

I forget who it was, but I did hear a story about a woman who was given months to live and was still alive twenty years later. Doesn't happen often, but it happens. Another story, told to me by his widow, was about a man who died within days of being taken ill. He'd had an undiagnosed cancer. It wasn't so much the suddenness of it that upset her, as having to have a post mortem. As a Jew whose relatives had been subjected to medical experimentation in a Nazi concentration camp, she hated the thought of him being sliced open.

Trouble is, medicine isn't an exact science and you can't always predict how our bodies will behave. A consultant neurologist explains why doctors get prognoses wrong:

Every patient is different, every disorder is different, every disorder within a disorder is different. People are unpredictable, their illness even more so. But there exist other subtleties that are harder to admit to.

If you develop a life-threatening illness, you might write a bucket list, give away all your belongings, or even plan to go to Dignitas. The latter involves assuming that you'll deteriorate fairly quickly, but there's no way of knowing that. If you didn't commit suicide, you might experience remission and be around for years.

Then there's all the rubbish about bravely "fighting" an illness, usually cancer, or the other euphemism - losing a "battle". It's all such twaddle.

Thinking about the causes of death of the people whose funerals I've conducted, a significant proportion have had illnesses that lasted months or years, yet enjoyed life in spite of it. Some have been very old, and were just worn out and glad to go. Some have just gone - whoosh! - struck down by a heart attack, cerebral haemorrhage (like my mum), or a lorry. There's no point speculating about how you'll die. Concentrate on living, and don't expect your doctor to give you an appointment for anything other than a consultation.

Illustration © M Nelson 2000

The Shrewsbury babies' missing ashes

A pencil drawing of stillborn twins

Shropshire Co-operative Funeralcare and Emstrey Crematorium don't seem to have sorted out their customer care. There are some very upset bereaved parents demanding to know why they weren't given their babies' ashes after cremation.

The review into Emstrey Crematorium in Shrewsbury began after the BBC found the ashes of only one baby out of 30 had been given to families since 2004.

When someone is cremated, what remains (usually called cremains) isn't ashes but pulverised bone. Everything else is vaporised in the intense heat of the furnace. The bones are raked out and put into a machine that grinds them up after any spare parts, such as metal screws and plates, are sorted out. The cremains can then be scattered or buried, or (in some cases) kept on your mantelpiece.

Small babies, whose bones haven't fully developed, don't leave anything to be pulverised after cremation. If there is anything left, it's dust. It's not an easy thing to explain to parents mourning the loss of a baby, even if most people weren't so squeamish, so maybe it's not always done well, if at all.

Sadly, the distress that a bereaved parent will naturally feel can become focussed on the lack of a grave or any tangible evidence that their baby existed. One mother is quoted as saying,

"It's just I have got nothing. I need to go where he is because my life isn't complete until I know where he is."

When I miscarried at 18 weeks, a long time ago, I briefly fretted that my baby's tiny body had been pickled in a jar. I was told that wasn't true, and that he'd been "respectfully" disposed of. What almost certainly happened was that the body had gone into the hospital incinerator. A funeral director I know told me that they are sometimes contacted by bereaved parents decades after they lost their baby, asking where he or she is buried. It's only fairly recently that babies have been given individual graves, so it's not possible to tell them.

The Shrewsbury parents seem to have good reason to complain that they weren't properly informed, but what they need now isn't a box of ashes, which is impossible, but help to come to terms with what's happened.

The drawing (above) was my gift to the young parents of stillborn twins. It was copied from a photograph that was unsuitable for framing. I hope that the Shrewsbury parents have photographs, if nothing else.

Click here to read what SANDS (Stillbirth & neonatal death charity) says about cremation.

Update: 5/6/2015

The story rumbles on in today's Guardian. Parents accuse the crematorium staff of not telling the truth. It sounds more like a breakdown in communication and old cremators.

... by 2009 ... furnaces at Emstrey were decrepit. “The computer control system was archaic,” Jenkins said. “The system ran on obsolete floppy discs and staff had to recycle old computers to keep the system running.”

The report noted the cremators had no infant setting and staff did not realise they could override presets. Lower temperatures would have made it more likely that some infant remains could have been recovered. But Jenkins said environmental regulations may have banned that and other practises, such as cremating young children, at the start or end of the day.

What's meant by "some infant remains"? Burnt tissue? Is that really what you'd want to keep? I wonder if the parents have really considered what this means. Burning a cremator at a lower temperature has been described as "gentle" cremation, a euphemism meant to make the process sound pleasant.

In my experience, funeral directors and crematorium staff aren't unaffected by a baby's funeral. They are keenly aware of the parents' feelings, especially as most will have children themselves.

It seems to me that the buck stops with the funeral directors' funeral arrangers, who are responsible for making all the arrangements. They should know what is or isn't possible, and advise the families accordingly.

The moral is, if you want remains after the disposal of a small infant, don't cremate them, bury them.

Shropshire Council commissioned a report into what had happened. Click here to read it.

A similar babies' ashes story has been told in Scotland - click here to read about it.

If you don't think about it, maybe it'll never happen?

So death, the most terrifying of ills, is nothing to us, since so long as we exist, death is not with us; but when death comes, then we do not exist. It does not then concern either the living or the dead, since for the former it is not, and the latter are no more.              ― Epicurus

The Guardian reports on a poll by the Dying Matters Collective,

In a life of inevitabilities it is the most obviously inescapable fate of all, yet remarkably few Britons have discussed their death and its aftermath, according to a survey, with little more than a third having made a will.

While more than 30% of people think about their death at least once a week, nearly three-quarters believe their fellow Britons are uncomfortable discussing dying and bereavement...

You can contribute your thoughts on the matter, if you've had any, by answering some questions via Guardian Witness. Yes, I have made a will, and yes, I have made plans for my death, though not for my funeral, as that'll be up to those who survive me. I've always thought it odd to plan your own funeral. After all, I won't be there.

I've blogged about making a will. Everyone should, especially if you have a family.

Update, 30/5/2015

Just learned a new expression - TMT, or Terror Management Theory.

In social psychology, terror management theory (TMT) proposes a basic psychological conflict that results from having a desire to live but realizing that death is inevitable. This conflict produces terror, and is believed to be unique to human beings.

It's mentioned in an article by Oliver Burkeman in The Guardian and it reminded me of a quote from The Oxford Book of Death:

The human race is the only one that knows it must die, and it knows this only through its experience. A child brought up alone and transported to a desert island would have no more idea of death than a cat or a plant.                                      ― Voltaire

Beware rubbish celebrants

I did a crematorium funeral today and got into conversation with one of the staff, someone I've known for years. Heard some horror stories about incompetent celebrants, some trained by organisations, some not trained at all. Any old Tom, Dick or Harriet can set him or herself up as a celebrant; there are no rules. Typical case is someone who's recently retired and thinks it'll be a good way to earn some extra money. One women, who hasn't had any training and doesn't seem to know what she's doing, is "a nightmare," said my friend. She hasn't a clue about time limits or sorting out the music. She'll tell them she's going to do one thing, then do something completely different during the ceremony. Why any funeral director would book her is a mystery. Another, who had been trained but clearly hadn't been advised about presentation, has turned up at funerals looking like she's been dragged through a hedge backwards, stinking like an ash tray. I've also heard recently about a celebrant in the next county who failed to turn up for funerals not once, but twice.

I was told, as I suspected, that the training organisations aren't too bothered about how many people they train to work in an area, and ours is over-supplied with Civil Celebrants. They're probably unwilling to turn people away and lose the income from their fees, currently £2,220, including VAT, with Civil Ceremonies, or £1,920 with the BHA. When someone's forked out about £2,000 there's possibly a reluctance to fail them - does anyone get a refund if they don't pass? - and some might feel that, having paid all that money, they're entitled to a reasonable amount of work to recoup their expenses. According to one or two people who've paid a lot of money for training, the quality's been disappointing. One applied to train with our team, having felt ill-prepared by what she'd been given elsewhere.

When I started work as a celebrant, there were no fees (and hardly any celebrants). We've never charged anyone for training within our group, though we're very fussy about accepting trainees. Over the years, an increasing proportion of our work has been repeat business (families we've worked for before), people who've attended one of our ceremonies, or word of mouth recommendations. Years ago, I met someone at a meeting in London, a highly-regarded man who'd been involved with the British Humanist Association since its inception, and told him about how we did things in Suffolk. No fees, but we expect potential trainees to get to know us, and vice versa, and to have all the necessary skills and qualities. It's like an apprenticeship, there's no time limit, and they learn by shadowing experienced celebrants and taking advice from all of us. After they go solo, they can rely on the rest of us for support. "That's the humanist way," said the venerable gentleman, and he was right.

Hearing my crematorium friend's stories made me realise why the staff always seem pleased to see me; at least they know what to expect. I thanked my driver for coming to collect me and he said, "Any time." Being car-free isn't necessarily a disadvantage if you're any good, it seems.

Sadly, no one of any real promise has come forward for training with us for some time. Two of us are over seventy, with health problems, and the other has family and work commitments that prevent her from doing many ceremonies, so how much longer we'll be able to carry on, I can't say. There'll be no shortage of celebrants to take funerals in Suffolk when we stop. Some are very good, some are OK, and some are horrid. You only have one opportunity to get a funeral right, so choose carefully. If you were buying a car, you'd shop around, wouldn't you? A funeral is much more important.

CSIs and their bags

I've been fascinated by TV shows about forensic scientists for ages, though the original CSI series on CBS hasn't been nearly so good since the departure of Gil Grissom, played by William Petersen. He specialised in forensic entomology, the use of insect evidence. Insect larvae, for example, may be found on bodies that have been exposed to the open air, and the time of death inferred from their stage of development and the environment they were found in, including the effect of the weather. Some of the offshoot series, including CSI Miami and New York, have verged on the ridiculous. In Miami, a lead character called Horatio seems to spend all his time striking poses with sunglasses on, to lend gravitas, while the New York's laboratory has more CGI than CSI - highly unrealistic. One of the things than all these shows have in common is the murder bag, a CSI's portable laboratory, full of swabs, evidence bags, test tubes, Luminol sprays (to detect blood), and sundry other pieces of equipment.

Most crime shows now seems to feature the hunt for DNA evidence, but it's only fairly recently that this has become common practice. It was a British scientist, Alec Jeffreys, who developed the technique of DNA profiling. It was first used in 1986 to solve two rapes and murders in Leicestershire. I thought it was interesting that a Google search for DNA profiling led to an American site about the technique that refers to America cases, but makes no mention of the British invention. Most people probably imagine that it was an American invention. The story of the Leicestershire cases was recently dramatised by ITV, called 'Code of a Killer'.

As a fan of forensics, I'd be very interested to see an exhibition at the Wellcome Collection - Forensics; The Anatomy of Crime. One of the exhibits is a murder bag from the 1970s. Since then, murder bags have been commercially produced and contain an increasingly sophisticated collection of tools. It's not as easy to get away with murder as it used to be.

Vitamins

An octogenarian (almost nonagenarian) friend who's terminally ill has asked me to buy him some more of the lutein and vitamin supplement tablets we've both been taking for our macular disease. He started taking them, at my suggestion, after spinach began to disagree with him. They won't have any effect before he dies, but I shall buy them anyway. I wish I could buy him something to stop the bed sores from hurting, the crumbling bones from aching, and to hasten his freedom from a body that's gradually rotting away.

Life with and after sorrow

A bereaved mother, who'd lost a small child, once asked me, "How long will this feeling last?" Sorrow has no time limit; it just changes. Sherry Amatenstein explains:

I am a therapist, and when I see the fortitude of my patients in dealing with catastrophic events beyond their control I am reminded anew of what human beings can discover about themselves once they accept that they can't undo a tragedy — but they can relate to it in a new, healthier way. Here are six positive things that can emerge from grief.

It's worth reading more.

Selfish suicides

Much has been written about, and speculated about, the mental state of Andreas Lubitz, the Germanwings co-pilot who deliberately crashed his plane full of passengers. He'd apparently researched suicide methods and had written about his wish to be remembered for the dramatic nature of his death. This reminded me of the words of the American trans-gender teenager Leela Alcorn, who wrote in her blog, "My death needs to mean something." She walked into traffic and was killed by a random motorist. She presumably meant that her death should attract attention to the bullying that she and others like her had suffered, and to a large extent it did, but it was also significant because she didn't appear to have considered its effect on the man who killed her. If he had swerved to avoid her and caused a pile-up, other people may have been killed too. In a previous post about suicides, there's a link to a news report from America in which a would-be suicide drove his car into a school bus; on that occasion, no one was seriously hurt.

The Lubitz story has attracted a lot of attention because he killed 149 people by his action, resulting in irrelevant reports about his pregnant girlfriend and other trivia, as well as calls for more care about the selection of flight crew. In hindsight, it seems absurd that airlines should have introduced reinforced doors to the flight deck that can't be opened from the outside in response to the 9/11 terrorist attack, without considering the potential for just such a tragedy as the Lubitz one, which left the pilot helplessly hacking at an impenetrable door with an axe. The odds against such an event happening again are enormous, and flying is still far safer than travelling by car, but this is little comfort to the thousands with a fear of flying.

The point of this post is that the Lubitz case is especially remarkable because of the scale of the deaths, people he didn't know or care about, but there are many other cases of suicide that put innocent people at risk of death or of trauma that affects their mental health, in some cases even leading to their suicides. As I've written before, suicides are notoriously oblivious to the effect that their death, and the methods that they choose, will have on other people. Taking an overdose of a prescribed drug may seem relatively less likely to cause harm to others, apart from the grief that friends and relatives may suffer, but it's not necessarily that simple. I once did a funeral for a woman who took an overdose of Paracetamol, not realising that it can cause a slow death if not caught in time - the stomach must be pumped quickly. By the time she began to regret her action, a day or two after she'd taken the tablets, and walked into the local A & E, the damage was done. All her family could do was watch her die over the following couple of weeks.

Mental illness drives people inward, preoccupied by their own feelings and fears. I've been criticised for describing some suicides as "selfish", which has been called judgemental, but the dictionary defines selfish as "lacking consideration for other people," which is a statement of fact. What could be more selfish than wishing to be remembered for the manner of your death, rather than how many people you killed in the process? The only answer that I can think of to such a problem is to be alert to the state of mind of those close to you, and seek help if it alarms you. The Lubitzs of this world must be scrutinised even more closely, since they're so dangerous. Better by far that they should be restrained, physically or chemically, than that they should be free to live out their lethal fantasies.

Green burial in America

A body in a shroud ready for burial. Image from the American Green Burial Council.

10 eco-friendly funeral ideas

From the Guardian, some ideas to reduce the environmental impact of your death. Some are just common sense. The link to Bios Urn doesn't work, but Google does:

The Bios Urn is a fully biodegradable urn designed to convert you into a tree after life. Mainly composed by two parts, the urn contains a seed which will grow to remember your loved one. Bios Urn turns death into a transformation and a return to life through nature.

Only problem is that seeds don't always germinate and trees sometimes fail - wonder if there's a warning on the packaging?

Leela Alcorn's killer - what about him?

You might imagine that, of course, losing someone to suicide will deeply affect the people closest to the person who died. I've conducted funerals for people who've taken an overdose or slit their wrists, both deeply shocking for the friend or relative who found them. But sometimes the people most deeply affected are those who killed the suicides, through no fault of their own.

Over the last week or so the story of Leelah Alcorn has been told on social media. A transgender teenager, she committed suicide by stepping into traffic and being hit by a tractor and trailer.

On Sunday, just before 2:30 a.m., Alcorn walked 4 miles from her middle-class Kings Mills neighborhood with its views of Kings Island to Interstate 71. There, she was struck and killed by a tractor-trailer. The highway was closed for more than a hour.

While I have every sympathy with Leela's mother, and with all her friends and relatives, and I share the feeling that it was a tragedy that she chose to die because of her circumstances, I also feel that one other person's trauma has been largely ignored; the driver whose vehicle crushed Leela's body. He will never be able to forget what happened.

Leela is described in a statement from her school as "a sweet, talented, tender-hearted 17-year-old." She wrote in her blog, "My death needs to mean something". She was referring to the prejudice and bullying experienced by people like herself. But this sweet, tender-hearted teen didn't take pills or drown herself; she got someone else to kill her. She didn't think about the effect that might have on him.

Letters to The Age in 2012 reflect the trauma suffered by railway workers whose trains have struck suicides. A front-seat passenger described one fatality,

I will never forget the scream of the driver and the feeling of the train running over the woman's body...

Can you imagine that? Can you imagine the nightmares? The anxiety every time you see someone stepping towards the road out of the corner of your eye? In the UK, train drivers who used to be able to claim compensation from the Criminal Injuries Compensation Fund have lost that right, despite being off work for months or leaving the job altogether, and suffering long-term depression. Nik Douglas, whose train hit a man, described how his life changed in 2012:

For the next six months he was off work with post-traumatic stress. “When I was on my own I’d burst into tears for no reason, I found sleep hard and I’d have flashbacks during the night and day,” he says. “I could be in a room full of people with a really good party atmosphere but feel alone, isolated. That’s one of the biggest things I remember, feeling alone.”

The Samaritans and Network Rail have formed a partnership to try and address the problem, for the benefit of all concerned. Here's their video.

So OK, sympathise with Leela, and others like her, but think of the damage that they've done to other people too. It may have been unintentional, but maybe if more people are aware of the problem it might, just might, prevent copy-cat suicides.

As I wrote in a previous post, suicides are notoriously oblivious to the effect that their actions have on other people.

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Update - BBC Look East news report, 28/1/2015:

Rail minister tells MPs number of rail services affected by suicides in greater anglia area increased from1700 to 8000 in last year
— Andrew Sinclair (@andrewpolitics) January 28, 2015