Sorting the Bones
Cory asks, “How are morticians utilized in natural disaster death tolls?”
In 2001, I was nearing the end of my undergrad degree. That fall semester, I was taking Physical Anthropology. The instructor, Dr. Harrell Gill-King, was one of my favorite professors, and the class came with a bonus bone lab.
On Tuesday, September 11, I woke up early when my father called telling me to turn on the news. That afternoon, not knowing what else to do, I went to class, along with half of my other confused, shell-shocked classmates. Our TA arrived to send us all home: Dr. Gill-King had already flown to New York to help identify remains.
Dr. Gill-King has been, among other things, the director of the University of North Texas’s Institute of Forensic Anthropology, and specializes in the identification of human remains. It was no surprise to hear that he would help with a disaster like 9/11. It wasn’t until I started mortuary school that I learned about DMORT.
Disaster Mortuary Operational Response Teams (DMORT) assist in large-scale disasters when local resources are overwhelmed. Members include coroners, medical examiners, morticians, forensic specialists, dental assistants, autopsy technicians, and many other specialists with training to handle and identify human remains. The teams are organized under the U.S. Department of Health and Human Services National Disaster Medical System. The United States is divided into ten regions, each with a regional director. While in service, members operate under local authorities, and their respective professional licenses are recognized by all states, no matter how that state’s reciprocal licensing would normally work. Teams are supplied by the DHHS’s Disaster Portable Morgue Units.
DMORTs have been used to identify victims of transportation disasters such as plane crashes, and more recently have been deployed for mass casualty events such as 9/11, Hurricane Katrina, and the COVID-19 pandemic. DMORT has more applicants than opportunities—which is fortunate—but I’ve submitted my name to both of the regions in which I’ve worked.
Morticians don’t need to be official members of DMORT to assist in disasters, though. The embalmer who trained me volunteered all over Texas and beyond when COVID hit. Her stories put our local death toll in perspective. Austin had refrigerated trucks; Los Angeles had warehouses. I’m perfectly happy to not work seventy-hour weeks again, but in the event of a disaster that calls for more last responders on deck, I’ll likely volunteer.
Cory also asks: “What’s the protocol if a mortician notices something that looks like forensic evidence of foul play after the body has already been cleared by a coroner?”
Let me start this by saying that, while many of the morticians with whom I’ve worked are true crime enthusiasts, and a few may think they’re forensic experts, we are not, in fact, forensic experts. I’ve heard of cases where murders came to light because of a mortician’s instinct, but this is a rare exception.
According to the laws governing funeral directors and embalmers for the state of Virginia (because I happen to be studying for the state exam right now): “A person licensed for the practice of funeral service shall not (i) remove or embalm a body when he has information indicating the death was such that an investigation by the Office of the Chief Medical Examiner is required…or (ii) cremate or bury at sea a body until he has obtained permission of the Office of the Chief Medical Examiner.”
Simple enough, right? But how does a mortician get that information?
Speaking generally from my experience in two states, a funeral home doesn’t take custody of a body which hasn’t been released through the proper channels, which means we have a certifying physician on record to sign the death certificate. Without that certifying physician, we don’t take the corpse off your hands. Or floor. If the deceased was in hospice care or being treated by a doctor for a known illness, that doctor will normally sign the DC. If the person wasn’t under the care of a physician, or they die unexpectedly, the ME’s office may be involved. That’s why, when one comes home to find a relative expired in an awkward place (and they are almost always awkward), one must call the police. Most of the time, police and paramedics will decide that a death looks natural enough and the ME will release the decedent to the funeral home. I have more than once had to explain this to a family, and sometimes had to play phone tag with the ME’s office in the middle of the night to get that release, when the police have left the scene precipitously.
If the death seems unusual, violent, or otherwise suspicious, the ME may take custody of the body first to conduct an autopsy. This may also happen after a hospital death, if the person died within twenty-four hours of being admitted to the ER.
Caveat the first: Medical examiners are not available everywhere. An ME is always a medical doctor. Some towns, counties, states, etc. have a coroner instead. A coroner is an elected (or sometimes appointed) position and the person in that position may or may not have a medical background.
Caveat the second: Not all medical examiners are utilized equally. In Austin, my funeral home received many cases from our county ME’s office, and almost all of them had been autopsied. Another county adjacent to us was notorious for not wanting to pay for autopsies. Suicides especially seemed to receive a shrug and a “history of mental illness.” I once picked up a fifteen-year-old from their back yard after they hung themselves. The local police called the funeral home without a second thought. Based on my coworkers’ stories, I was lucky that the EMTs even cut the poor child down.
Families may pay for a private autopsy if one is not ordered, and some do. In those cases, we usually had a third-party transport service pick the deceased up from our cooler and take them elsewhere for the examination, to be returned later for services. Because I work for a large, bureaucratic underworld, no one gets embalmed without formal authorization upon which many eyes have fallen, so for someone to be embalmed against the family’s express wishes is rare and…unfortunate.
I’ve heard of cases—and witnessed one—where a decedent was already embalmed when the family ordered an autopsy. I don’t know what sort of insights pathologists glean in such an instance, given the invasive nature of the modern embalming process—I would very much like to learn more.
If a mortician were to call the authorities after a decedent was formally released into their care, I’m not sure what would happen. I guarantee eyes would roll. But that doesn’t mean it doesn’t happen, nor that it shouldn’t happen. Given the state of the legal system in the United States, expecting justice for the dead seems even more bitterly laughable than justice for the living. But we should expect it, and work toward a world in which we can expect both.
Cory can’t carry the weight of the entire living population forever. If you have questions, please submit them through our portal, or ask @stillsostrange on Twitter.