It’s happened to me twice now, discovering that someone close does not want a funeral but wants their body used for medical experimentation.
Some time after my father died the university that had received him held a service of thanksgiving for the families of donors. This was a very suitable occasion prefaced with some remarks by a speaker from the university about donors who considered their body totally theirs to donate without reference to their next of kin.
This really got to the heart of the matter. When I first discovered that my father had left his body to science was when my cousin and his wife, ransacking what had just become my mother’s house, for the will, while she was in hospital, discovered the will and I read it. This is not really a piece of news you need to digest with onlookers keen to see what they are going to get. On the other hand this is something that needs to be discovered quickly. Death is not an event, it is a process triggered by the stopping of the heart and circulation. For some time some automatic systems carry on; hair and fingernails can continue to grow while there is cellular nourishment available. Other systems decay or change state very rapidly, blood congeals, some areas collapse, gas builds up. All sorts of changes can take place in a dead body which can be varied for many reasons. To be useable for research purposes the body needs to be as fresh as possible. For example, if you are training surgeons it’s no use them having a go at dissecting a vein or inserting a stent in a body that has turned to mush. I’d like the surgeon who inserts a stent into my artery to have practised on one as like my living blood vessel as possible. I’d like medical students to be able to recognise something as near to a healthy heart as possible so they can spot what is unhealthy about my heart. Equally if I am undergoing a disease process, I’d like the example they are working from to be as fresh as possible, I’d like the person scanning me to have seen the real thing in a body as soon as possible after death, so they can spot the difference and see how far along the path I’ve gone. You can learn from textbooks, you can learn from videos, these days you can probably learn from virtual reality, but I’d like the doctors who treat my body to have learned from real bodies as often as possible.
This is what body donation is about, all over the world. Doctors are no different from any other worker, they get better by practise.
So, here’s a question. Who are funerals for?
No marks if you answered ‘the deceased’. There is no doubt that it may give you comfort when you contemplate your mortality to picture a very lot of people, preferably hundreds, gathered round having a jolly good sob at the horrible thought that the world will have to struggle on as best it can without you. We all like to think we make a difference. But really the people to whom we most make a difference are the old N&D. Even if it’s just that they no longer have to fetch your slippers and resist the urge to beat you up with them, it’s going to affect them most. Who knows, they may have been rehearsing your eulogy along the lines of ‘He was a git but he was my git’ for years and have honed it to perfection, twelve minutes including the extract from your favourite, very meaningful, pop song.
So the very first thing to do, if you are contemplating donating any or all of your body to medical science after your death is talk to your relatives, not least because they will be the people who have to make it happen. You have to actually address the real practicalities, you cannot just airily write as my father did, ‘I leave my body to medical science if possible’ in your will and hope it happens. If you do so it will turn the days after your death into some kind of terrible breakneck race against time and, in my case, against the threats of relatives and some incredibly bad behaviour. At the very least people will be surprised, at worst they will be shocked and behave accordingly. It’s a good idea to leave your body: if you’re young and healthy, organs can be used to help others live, if you’re old and healthy you can be used to help to train doctors to help others to live, if you are diseased your disease can be studied to help others live. Facing the truth that the world will go on without you and making plans to help others with the body you have stopped using is a wonderful way of making sense of the horrible fact that we are all mortal. But first, please talk to your relatives, you may be surprised to find they are nearly as attached to your body as you are.
If your relatives are either OK with it or can be talked round to your point of view you then you need to get online and find out how to do it where you are, and then share the information with the N&D. The difference between the aftermath of the death of my father, where the body donation came as a complete surprise and the death of my mother, where I had everything set up and could set events in train with three phone calls, was incredible. The first contributed considerably to the grief and shock, the second contributed considerably to the feeling of a dignified process, well carried out. The first time, I did not know who to contact and had to discover everything on the go with a sick, bereaved and confused mother to support at the same time with relatives hanging on my heels at every step. The second time I had already spoken to nearly everyone involved, the coroners were a surprise but helpful and professional and because all agencies had had pre-notification, everybody quickly found the file and they all talked to each other. It was easy for me because I had made it easy long ago.
Just because you have decided to put your whole self in doesn’t mean it will happen. Parts of you may not be acceptable for reasons of health hazards, if you have died of something infectious from tissue sample for example. You may die in a location which means that you cannot be got to the receiving place in time before you degrade. This time will vary depending on your geographical location. If you will go dying somewhere hot and remote, you are probably stuffed, as it were. If you die before a lengthy public holiday when the receiving location is shut and all the medical students are nursing a hangover you are probably stuffed as well.
So you can’t just go arranging to be donated and think that’s it. You will need to make plan B for when circumstances prevent the donation, too. In the worst case scenario you may be landed with the same misfortune that befell my mother, the brain was acceptable but the rest was not, so I had to arrange a donation and a cremation. However because I had spoken to the funeral director years before to investigate the situation, he was professional, helpful and already cognisant of all possibilities. He said that it was a pity that most people only talked to funeral arrangers when they had a body to hand, so to speak. It isn’t just those adverts on the television about paying for your funeral on the instalment plan who can help. Your local funeral director would probably like the money a bit at a time as not at all, too and it might be cheaper without a finance company involved who have to pay for television adverts.
If you are able to make an entire body donation it may cost you nothing, with transport and storage costs paid for by the receiving agency, though you cannot discover after your relative has croaked that there is little in the kitty and suddenly decide to donate them to save on the outgoings. In fact you cannot decide to donate someone else at all. Even if they are really annoying. No, not even that annoying.
The cost of funerals varies but will always be more than you think, wherever you are. You do not have to have the standard item. Funerals are for the living (did you get that question right, earlier on?) as a way of drawing a line under the past and obtaining that nice modern thing, closure. They are not for the dead person. The dead person is, well, you know, dead. Whoever was there has gone. If you are not sure about this, there are websites which document near-death experiences. These contain the testimony of people who have clinically died and then due to the advance of medical science, been brought back to life again. They include people who died on operating tables, in accidents and so on. In every case they were revived and able to say what happened next. I have read many such evidential reports and not one single one says they were trapped in their body after death. Every single one says they left their body immediately after death. Find them with a search engine and read them yourself. After death what is left behind is just a body, nothing else. The person you loved is gone. What is left is a body, nothing more.
So what are you going to do with yours? Are you going to be the corneas of a child and a nice ceremony for the rest and your relatives? Are you going to be training for young doctors who will remember dissecting your artery and know just how hard they can push to get the stent in place that will keep a heart going? Or are you going to be the glass coffin, the black horses with the ostrich feather headdresses, the lengthy eulogy you’ve written yourself, the brass band and the slap-up meal at a five star hotel for the grieving relatives tastefully attired in a selection of the latest hats, in black, with veils and lovely black fishnet tights ( for the one who once starred at the back in the TV soap crowd scene.)?
The choice is yours if you make it in time. It’s almost certainly the last choice you will have, so you might as well get what you want and then tell people so they know that’s what you want and can help you to make it happen. With a bit of forward planning you can do something wonderful every day of your life, even the last one.
Nothing in his life became him like the leaving of it. Malcolm’s speech in Shakespeare’s Scottish play.