Beware the Bone Thieves
The first day I set foot in the embalming lab as a wee mortuary student was a profound experience for me. It was the first time I had been in the room with death, face to face and flesh to flesh. In that moment, any doubts I may have had were quelled: I was in the right place.
The next time I went to the lab to observe, I experienced an equally profound moment of “What the @*$% is that?” I was looking at something out of Silent Hill, or a Clive Barker story. The corpse on the table was splayed open, hollowed out, arms and limbs peeled back like rind to expose muscle and fat, but not bone. I was looking at a meat suit, a flesh husk.
What I was looking at, in more technical terms, was an autopsy and bone harvest.
I’ve spoken of autopsies before, and those are fairly common knowledge, at least in principle. Before I became a mortician, the only idea of medical donation I had was organ transplant, usually through highly dramatized, race-against-the-clock television plots. I had no clue about tissue harvest.
This, dear reader, is where I must offer a sincere disclaimer. I fully support all medical procedures used to save and improve lives. I want people with treatable problems to receive that treatment! And really, if that treatment involves recycling tissue from dead people—that’s pretty freakin’ metal. However, on the mortuary side, tissue harvest complicates matters, and we necromancers frequently say unkind things about the process, and swear a lot in its aftermath. Please understand that we’re only venting, and we begrudge the living none of their secondhand skin or bones.
What is tissue harvest? To quote from the website of United Tissue Resources, an organization we work with frequently: “Hospitals are required by federal law to report deaths to donation organizations. When this happens, agencies like United Tissue Resources will contact the hospital to evaluate the patient for donor eligibility. Referrals may also originate from a medical examiner’s office, justice of the peace, or hospice care…The UTR Staff operates on 24 hours a day to provide families with the option of the donation and facilitate the gift.”
That didn’t answer the question, did it? What is…the gift? Further reading elucidates the types of donation UTR collects.
- Heart valves
- Long bones
- Saphenous veins (found in the leg)
- Skin grafts
- Tendon and ligament grafts
- Nerve grafts
There are other possibilities. We also liaise with the Texas Organ Sharing Association and the eye bank, which handles corneal harvesting.
Note the phrase “provide families with the option.” I don’t know the intricacies of the process on the other side in regards to registered donors vs. viable candidates whose families consent. All I know is that in my particular corner of the underworld, we guard our corpses carefully, and require a lot of paperwork.
Sometimes, in the case of hospital deaths, the harvest can take place at the facility, before the funeral home ever gets involved. This is ideal. If we pick up a viable candidate before the donation service can finalize all the details, though, then we can expect to field a flurry of phone calls. The process is time-sensitive, decay being what it is, and it’s important to keep track of refrigeration times. We also require a paper trail and multiple parties to provide consent before we release anyone for harvest. As with all corporate paperwork, I’m certain that this is because once upon a time something happened.
Once our ritual challenges have been met, we allow the donation service their prize. Someone picks up the decedent, takes them away, and they return to us missing something. Bone, skin, and corneal donation are what I see most often.
Corneas are by far the easiest to deal with. We simply have to dry the eye with cauterants or absorbent powders, use eye caps (imagine a spiky contact lens) to restore the proper shape, and make sure that the lids are sealed.
Skin harvest is perhaps the greatest nuisance for an embalmer, because that skin is often harvested from the person’s back. It’s a large expanse, after all, and less likely to be damaged during surgery or autopsy. The skin is removed in a neat rectangle from the top of the shoulder to the base of the spine. The muscle below is laid bare in a fascinating display of anatomy. When we receive the decedent after the harvest, an absorbent pad has been stitched over the excision site.
Why is this so bad, you may wonder? First of all, they need enough skin to make harvest worthwhile. A ninety-pound person is unlikely to qualify, as opposed to a beefy two-hundred-fifty-pound guy. So after we’ve embalmed them, we have to roll the person onto their stomach to deal with that absorbent pad, which is now soaked with blood and embalming fluid. This is a two-person job, if we’re lucky. (I flipped someone by myself once, and quite frankly I should not have done so. Anubis smiled on me that day; I’m not going to press my luck.)
Once the decedent is—ever so carefully—on their stomach, we get to remove the old pad, apply more cauterant and powder, and stitch a new one back on. Who would have thought necromancy would require so much needlework?*
And then there are bones. Bone harvest is one of the few things in my line of work that gives me the heebie-jeebies. I should be grateful! I had to have a bone graft with dental surgery several years ago. My jaw may contain a dead man’s femur. But I’m afraid I won’t be able to pay that particular gift forward. I’m not especially fussy about what happens to my earthly remains after I die, but in one regard I am resolute: you may not take my bones while they’re still wearing my skin.
UTR’s site mentions use for the long bones of the leg and the crest of the hip, but I can assure you that the humerus is fair game, too. When a bone donor comes to us, they have been opened from hip to ankle, and sometimes shoulder to elbow. The flesh is sometimes packed with desiccant crystals—the kind that come in new shoes and pill bottles, carefully labeled DO NOT EAT. The bone itself has been replaced by a wooden dowel, perhaps to preserve the dignity of what would otherwise be a comically floppy corpse.
After the removal of bones, and possibly veins as well, arterial injection will no longer distribute fluid to the legs. The embalmer will have to hypodermically inject whatever’s left below the hips and pack the rest with paraformaldehyde before—you guessed it—stitching the limb back up. After all that, the dead person will be dressed in a plastic onesie (thoughtfully provided free of charge by the donation service) to contain the myriad potential leaks.
It’s a testament to the cosmetic art of embalming that people missing bones, organs, skin, and eyes can be displayed in an open casket with no one the wiser. Except the embalmer’s aching hands, that is.
Death is an endless source of things you never even thought to ask about. But if you have thought of a question, please send it our way!
*I’ve read at least two fantasy novels in which a dragon’s wing was repaired by patching the wound with leather—when I get sucked through that portal into a magical world, I’m ready.
Amanda Downum is the author of The Necromancer Chronicles, Dreams of Shreds & Tatters, and the World Fantasy Award-nominated collection Still So Strange. Not content with armchair necromancy, she is also a licensed mortician. She lives in Austin, TX with an invisible cat. You can summon her at a crossroads at midnight on the night of a new moon, or find her on Twitter as @stillsostrange.