The Process - On the funeral

    Recently I came across an old post which I never published, simply forgot about it. It might not be completely accurate, or even up to date. This was written just over a year ago and forgotten about.

    Not long ago I wrote about how the body makes it from the site of death to the hearse for the funeral.  This is my follow up post on what happens once the coffin in loaded into the hearse.  Once again I focus on the coffin and its immediate preparations.  There is a lot of paperwork and other things going on at the same time which I do not cover.  Yet this time I talk more about the staff and how they go about the job.  This is so you can understand the feel of it better.

    Anyway, here's what happens after the coffin is loaded into the hearse.

ESMP open day

    Eastern Suburbs Memorial Park had its open day this weekend.  It was a great day, so much to do and a wonderful atmosphere.  But what made it special was how open and relaxed the staff and company was.

    This was the last public social event for the funeral industry (that I know of).  And it was a great day, a perfect way to end the social calendar for the industry.

The Process - From death to funeral

    This is the process of how a body gets from the place of death to the funeral.  Not many people think about this, and even fewer know about it.  Here it is, step by step in a simple guide from when the person dies to when the coffin is sent on the funeral.

Slow Rise of Obesity - Part one: The transfer

    The funeral industry is a great indicator of society and our daily lives.  Through looking at funerals and death we can examine how we live, how we think, our beliefs, attitudes and more.  Our death and funerals do not simply reflect our lives or society.  Instead the we die is entangled with how we live; how we die is inseparable from how we live just as how we live is inseparable from how we die.

    I intend to explore this idea through first examining obesity in the funeral industry.  By doing this I intend to illustrate how we can look at things like obesity and funerals to look at changes in society and our lifestyles.

    Yet to truly understand this one must understand obesity and funerals.  How an obese body is different from a non-obese body and how an 'obese funeral' is done.  Thus I thought I would write three posts exploring obesity in the funeral industry.  Starting with the transfer, then handling of the body in the mortuary and finishing with the cremation and burial of an obese body.  So here is the first part, the transfer of an obese body.

The Transfer Stretcher

    Lately I have been updating my transfer posts and pages such as this one.  Fixing the formatting, correcting mistakes, adding more information and so on.  In doing so I have realised that there is no post and little information about the transfer stretcher.  This is something that needs fixing as the stretcher is such an important part of the industry.

Between Death & the Funeral: The last trip

    I recently got a question about how bodies are processed in Sydney.  As in what happens to the dead between death and the funeral.  It is a rather interesting question many of us never think of.

    So far I have found nobody has an issue with knowing the details (so long as they are not too graphic) about what happens.  In fact most people are rather interested in it.  However many think of this as a 'taboo' subject.  Well, actually that is not quite true, people think others think death is taboo.  They themselves do not see it as taboo or something to avoid but think most other people do.  As such they avoid this topic to avoid offending or upsetting people.

    We do not avoid this topic because it is taboo.  We avoid it to avoid upsetting others.  And we also know so little about it.  How does your water make it into your tap?  Something most cannot answer, not because it is taboo or upsetting but because they simply do not know.

Body Bags

Fig 1. A body bag on a tray in a mortuary

    When one thinks of body bags one usually thinks of a black plastic bag with a large zipper down the front.  This is however not what I found them to be.

    The body bags in NSW are made of blue tarpaulin, as shown in figure 1.  I remember how surprised I was to find body bags were made of exactly the same stuff as the tarpaulin in my car.  Even down to the colour and feel they are identical.  Occasionally body bags will be made of brown tarpaulin, or a white or brown heavy cloth. This heavy cloth type is rare and more expensive, but some companies prefer it for nursing home or house transfers as it is a lot quieter than the tarpaulin bags.

    The other thing is that body bags do not have handels.  Well there are some with handels but these are rare.  This is because they are "noticeably more expensive" (as someone once told me) and as such groups like hospitals or funeral homes are reluctant to buy them.  The handels are made of seatbelt material and are stitched into the inside of cloth bags.

    Final thing is the zipper.  The zipper is not down the middle or at the front.  Instead it is on the side, slightly above the very edge of the bag.  This makes it much easier to get the bag under a body and then zip it up.  It means you do not have to lift the body into the bag but can simply roll the bag under the body.  This is great for small spaces, heavy bodies or just to save effort.  Plus having the zip on the side means it's less lightly to rip or break under stress.

    With infectious bodies some places use a special yellow body bag.  This bag is basically the same material as the tarpaulin type but a stronger and more leak proof material.  It is a great idea to use this bag as you immediately know by the bright yellow colour that the body is infectious.  However most places do not use these bags for whatever reason.

    Something I find interesting is that on the Australian Museum they have a section on body bags (where I got the picture).  On that page they say that there are special regulations for body bags and that extra precautions are taken for infectious bodies.  But in my experience I have seen bodies transfered while only wrapped in a plastic sheet and/or blanket.  Which apparently meets the legal and health requirements.  And with infectious bodies they are sometimes placed in a yellow bag or in two bags, but this is very rare.

    So that there's some information about the body bag.  It's not a black thing with a large zip on the front like in TV shows and movies.  It's most often a tarpaulin bag with the zip down one side.

~

http://australianmuseum.net.au/image/Body-Bag

Funeral Fun - Whale of a Transfer

    This is not my story, and I was not even in the industry when it happened, someone I use to work with told me this story as a cautionary tale on why to never keep things in pockets higher than your waist.  But it is such an odd and amusing story I thought it worth telling here.

Funeral Fun - Crashing the Home

    Nobody wants to have an accident while doing a transfer,just as when driving a hearse.  It is not a good look for a car to crash and then to find out it had a body onboard.  However this has happened several times in the history of the industry.  However one story that stands out is of a fully loaded transfer van crashing into a home.

    This occurred many years ago at a funeral home which has since been sold off and no longer exists, although many of the employees are still in the industry.  What happened was that the funeral home was on the top of a steep hill.  One day the transfer crew returned and were about to reverse into the mortuary when the driver had an epileptic fit which resulted in him losing control of the van.  The van then rolled down the hill, picking up speed as it went, and crashed into the front room of a house.  Luckily nobody was hurt in the crash, however the van was full at the time.  Yes, it had four bodies on board.  One of the other staff ran to the manager informing him of the accident.  At first the manager did not believe it, hearing that a van had just run into a home with four bodies after the driver had an epileptic fit was a little outlandish to say the least.  Upon realising it had actually happened several staff rushed over with another van and moved the bodies out of the now destroyed van quietly and quickly before the residence or anyone else found out.  The last thing they wanted was to make the news about a van ladened with bodies crashing through a house.

    Overall it was an experience I doubt anyone involved will forget and one even I will remember for some time.  And yet there are many like it and worse, which I will tell at another time.

~~

The Transfer Van: How the dead are transported

The Toyota Hiace

    The transfer van is something that is so important, an essential part of society, and yet almost nobody knows it even exists.  This is not because we do not actively avoid it.  Instead it is just something which nobody is told or thinks about.  Thus I thought it was about time i brought the transfer van out of the dark.

    One of the things that surprises people about the transfer van is that it is literally a van and nothing special.  People often believe the body is transported in a special vehicle designed for the job, much like a hearse if not a hearse.  When I tell them that it is a van, often a Toyota Hiace, they are surprised but not shocked.  Nobody has ever expressed displeasure with the thought of their loved one, or themselves, being transfered in a van.  It is just something they never thought about rather than something they disliked.

    I should not that there are actual state and national laws on what vehicles can transport a body.  Because I do now fully know these laws or regulations I will not go into them in detail.  But basically the vehicle has to have an airtight seal between the driver and the body.  The compartment the body is held in must also have decent ventilation to the outside.  Thus one cannot just transport a body in the back of any car.

    Now for the transfer vehicle itself.  The most common is the Toyota Hiace (pictured right and below) as it is cheap, practical and so reliable.  The Hiace is used by 'Statewide' and 'Mortuary Services Support' (dedicated transfer companies) and many funeral homes.  It is just such a reliable van, I remember how we would run our Hiace up and down freeways for days on end and it never missed a beat.  Plus it is actually quite cheap (to run and buy) which makes it quite a good option from a financial point of view for the company.  All of this is exactly what one wants in the transfer car, last thing anyone wants is to be broken down with a body on board.  The next most common would be a basic Mercedes Van, this is used primarily be InvoCare transfer crews.  It is more expensive to buy than the Hiace, but InvoCare is not just rich, they are also happy and willing to spend money if it is justified.  The Mercedes is a much nicer van inside and outside with better airconditioning and more legroom for the drivers.  However there are other much less common transfer vehicles, I remember an interstate transfer company arrived with a really odd custom built car.  It was like a ute which's tray was a large single and sealed box.  This thing was apparently from the 1980s and on its second engine, which had done over 5 million kilometres.

    Because the Toyota Hiace is the most common transfer vehicle I will primarily look at this as the example of the transfer van.  In the back of the Hiace is an automatic 'lift' (pictured below) which can be raised or lowered.  This makes it possible for the van to hold four bodies at once and because the lift can be lowered it makes 'loading up' the body much easier.  One can simply lower the lift to waist hight rather than have to lift the body to head hight.  Inside the Hiace there is the divider, this divider is not only the airtight seal but also practical because it has so many shelves.  Here is where we keep the body bags, slide sheets, gloves, hand sanitisers, street map and so on.

    One massive drawback to the Hiace is that it is rather top heavy once the lift is installed.  A transfer van, exactly the same as the one featured in this post, actually flipped on its side in Melbourne only a couple of years ago.  When driving it you could really feel this top heaviness.  It was obviously impossible to take any corner too fast or the van would fall over.

Inside the cabin of the Hiace.

Inside the back of the Hiace with the lift raised.

Inside the back of the Hiace with the lift lowered.

The switch to raise and lower the lift.

Stretchers sitting inside the van.

The clamp used to keep the stretchers in place.

Our transfer van, back in the garage after a long day.

The transfer stretchers.
The leg-less one is lying upside down and on top of the one with legs

Inside the transfer van with no stretchers.

    This is what we will all ride in one day, a white van.  It is literally the second last thing most people will be driven in after they die (the last being the hearse).

~~

Transferring Medical Waste - What Becomes of the Cadaver

    Not long ago I wrote a post on the shortage organ donations, donations to medical research and the severe lack of space for forensic cases in Sydney.  To summarise we really lack bodies for research and the major of those who do donate themselves to research are people who worked in the field.  Anatomists, neuroscientists medical illuminati members and so on.  The general public (the majority of users of the research) are not the ones who donate.  Talking to people I find most do not like the idea of 'being hacked appart' or 'carved up'.  They think of it as grose, dirty and destruction of the body which is a part of themselves.  So it is like making themselves dirty or destroying themselves.

    I disagree with this for various reasons, one of which is that it is pointless, and that we want to benefit from research by receiving treatments, surgeries and so on while not wanting to donate to support the research.  The surgeon trained on cadavers to learn how to operate, the anatomist studied cadavers to develop better understandings of the body.  So every time we receive medical treatment we are all benefiting from the research done on cadavers.  Yet we find it difficult or unbecoming to donate to this research.

    Putting my personal ideas aside I thought it might not hurt to explain how cadavers are treated and removed after use.  It is actually one of the more disliked transfers to funeral staff.  They consider it grose, inhumane and just unpleasant work.  Basically a transfer van will arrive at the hospital where the cadavers are.  However the cadavers are no longer 'single bodies'.  They are usually several yellow biowaste bags filled with "a thick soup of bit".  It is not uncommon for a couple of bodies to be mixed together.  A single bag may contain one persons spine and their livers, then another persons hand or brain and so on.  Just whatever fills the bags most effectively is in the bags.

    The biowaste bags are put straight into special coffin.  What makes these coffins special is the placement of the handels, only two in total, one one the head and one on the foot.  This way the coffin can be carried sideways rather than the usual 'foot first'.  As such it can be loaded straight onto the rollers at the crematorium, no turning needed, and they saved on four handels (which are not cheap).

    These special coffins are all cremated with the biowaste bags inside.  How the ash is disposed of I do not know.  But I do know the gardeners consider it to be good fertiliser for the plants.  Next time you are at a crematorium and see the lovely gardens you now know one of their secrets.

    By now you may consider the process as a whole to be rather inhumane.  The cadavers are literally turned into medical waste and disposed of as such.  The only difference being they use a crematorium instead of a waste incinerator.  But really, it is the same thing.  Having seen this process most funeral directors would not donate their bodies to research.  They see how the cadavers are treated as waste and consider it to be grose and inhumane.  Yet despite knowing and seeing this most who work regularly with cadavers (those in the medical teaching/researching fields) end up donating their bodies to research.  They see the negatives of it, but also see the benefits, all the people helped, and consider it quite worth it.

    This difference is interesting and strange.  That those who work primarily with cadavers are likely to donate, while those who primarily work with the end result of the cadavers are less likely to donate.  Perhaps the fact that the researchers get to see the benefits of the research has an influence.  After all, the funeral staff only see yellow biowaste bags being dragged off to a crematorium.

~~

Ignoring the Dead & the Consequences

    One of the biggest issues with the funeral industry is a lack of thought or discussion about it.  Not because it is a taboo or inappropriate subject, but for other reasons such as a lack of information and an odd idea that others find it upsetting or taboo.  This lack of discussion leds to serious issues and deregulation.

    Many argue that it is a 'hidden industry' and that most people do not want to know about it.  Either that it is taboo, upsetting or just something to keep quiet.  However I disagree with this entirely.  People are almost always quite happy to talk about it, and actually really interested in the industry.  This is why it started 'The Other Side of Funerals', to feed people the information they crave.

    It was almost surprising the first time I saw the white Toyota van and was told that it was the transfer vehicle.  It was very unexpected to find out that the body is picked up and brought to the funeral home in the back of a Toyota Hiace van.  What was more surprising is how I had never actually thought about this. About how the body is moved about, I knew they would die in hospital then turn up in a coffin at the funeral.  Everything in the middle was an absence, an area I had never avoided because I had never even considered it.  And I think this is the case for most people.  It is not a topic we avoid thinking or talking about, but a topic we never think or talk about.

    When driving families whilst on funerals I never brought up the topic of how the industry worked.  But it was surprising how often and keenly the family asked me about it.  Especially once they realised that I would be open, honest and still quite diplomatic and not graphic about the industry.  One would consider this to be an inappropriate time to discuss these things.  Here they are, in a black car following a hearse containing the body of their loved one.  Yet they always appreciated it, now knowing for sure that their loved one had been treated respectfully and what the basics of the process was.  I never once had a bad reaction from those who asked about the industry.

    A certain mortician at Westmead Hospital once told me about how the hospital had an open day one a year.  And once the heads of the hospital had asked if the mortuary would be appropriate or possible to include in tours.  The mortuary staff agreed, saying they had no issue with showing and explaining to people about the mortuary.  Then the first open day rolled around which would include the mortuary, the staff did not thinking many of the public would be willing or interested.  Yet they had too many people, the day was scheduled to shut at 16:00 and he said they were still letting people inside well after 19:00.  It was a huge success and very popular.  So popular in fact that the hospital then started regular tours, first focusing on bringing people from the military, police, fire brigade and so on, the aim was to let them experience a body and understand the mortuary.  But after a while the mortuary staff put a stop to the tours as they were becoming a 'freak show'.  The hospital even went as far as to invite young boy scouts to see the bodies and mortuary.  So the public is so keen and willing to see a mortuary.

    This defies what I have experienced at most hospitals.  Mortuaries are never labelled on maps or the doors, the only two exceptions I know of being Concorde and Westmead.  Instead the mortuary is down a corridor at the end of a car park and behind doors that look as though they lead to a closet.  Hospitals do their best to hid the fact that they have a mortuary, almost as though admitting its existence would be telling the patients that they will die.  They hide the mortuary as though they are hiding the fact of death within their hospital.  Yet the one time that I know of where they publicised its existence and even held tours it was hugely popular.

    Because we never think of the industry there are a lot of areas and processes which exist, yet are unknown.  They are blankes in how we think.  perhaps the best example in the movement of the body; tehy die in a nursing home and arrive at the funeral already in a coffin.  But how did this happen, how did they make it to the funeral home or into the coffin?  You probably do not know and yet it happens every day.

    There is a lot of misunderstanding about the industry.  Because many do not know much about it they believe the strangest things.  A great one is that gravediggers steal belongings from coffins, a really odd idea.  They barely have time to eat lunch let alone open a whole coffin on the chance that they would get something of value.  Or that undertakers will break a persons legs to fit them in the coffin when breaking legs involves so much work compared to bending them (you bend your legs all the time when you walk or sit, it is not hard), or getting just a bigger coffin.

    But why is it such a hidden and misunderstood industry?  If we are not against talking about it then why do we never actually talk about it?  I have heard many argue that it is a taboo topic, something inappropriate to discuss.  These people then go on to argue how this is changing over time and the industry is now more 'appropriate' to talk about.  While this may have once been true it is no longer the case these days at all.  As I said before, people are really interested in the industry and very rarely take offence to anything said.  There are two reason I believe people do not know about funerals.  The first being that they think others will be offended or find in inappropriate or upsetting.  Discussing how a body is moved and handled could upset someone whose loved one recently died.  And yet this is rarely if ever the case.  People are often more interested as they now have been involved in the process.  Plus they like to know how their loved one was treated.  The second reason is that people have little information about the industry.  How many know someone who works as an undertaker, gravedigger or another similar role?  How many have read a book or seen a movie about the funeral industry and not just one set in the industry?  There is actually rather little information or acknowledgement of the industry.

    So now you might be asking what the result of this lack of knowledge leads to.  Well, it has a direct and serious impact on the industry as a whole.  The first, and most important to many, case is with hospitals.  They hid the morgue for various reasons and this lets the place be mis-managed.  Most hospitals have decent morgues, clean enough and organised well enough.  I have noticed that those with dedicated and full-time staff are by far the best, especially compared to just having casual support staff who take care of the morgue along with many other duties.  Westmead is a good example, with dedicated staff who are responsible for everything they are also proud of everything.  The place is so neat and clean that the blue floors would be more hygienic than your kitchen stove.  With not even a paint chip or scuff mark to be seen then place is actually really nice inside.  At Westmead they also signpost the location of the mortuary, not hiding it from anyone.  However RPA there is no sign to identify it, the mortuary is located in the middle of a service corridor, scuff marks along the walls, rubbish and food processing nearby.  The support staff are always late to arrive, often making funeral staff wait an hour or more, which is then tacked onto the cost of the funeral for the family.  RPA is hated by many in the industry (myself included) and we would never want to have a loved one die in that hospital.  And it use to be worse, much worse.  The old mortuary was even more run-down and mis-managed to the point where they found a dead baby behind a fridge when renovating.  Hiding the mortuary lets problems bread and does not help anyone.

    Another issue from a lack of thought is the deregulation of the industry.  If one wants to become a funeral director all they really need is a briefcase, phone, fax and computer.  Everything else from mortuary to hearse and even staff can be leased out for the day by these "briefcase funeral directors".  The result is that they have little control or influence in the process, allowing for all kinds of misconduct and mistakes.  It was actually rather amusing but when I started in the industry it was discovered that a small catering company who had never organised a funeral got given an important state funeral in Canberra.  Obviously they were the lowest bidder andas such who knows what the funeral was like.  There are no qualifications or credentials needed to join the funeral industry, if you want to join all you should have is a drivers license, and even that is optional.  This deregulation is also having an impact in transfers.  I have heard stories from funeral directors where they have done police transfers, pulling bodies out of cars or taking them from the crime scene to the coroners.  And all they get is a regular suit and a pair of latex gloves.  Appart from the gloves there is little to no protective equipment.  It is not like the movies, or like America, where the coroners has a special and dedicated transfer crew.  Instead in Australia it is just a local funeral home who will take the body from one place to the next.  Yes, just a couple of undertakers working for minimum wage, with no training and no protective equipment are the ones who transfer bodies about.

    Overall the funeral industry is a hidden and unknown one.  But not because it is taboo so much as people do not know about it and some think it will offend people.  This lack of public knowledge lends room for misconduct and deregulation.  No qualifications or training is needed to become a funeral director or transfer bodies from crime scenes or anywhere else.  If the public would look at the industry a little closer regulations which are desperately needed could be introduced.  The public would also find the work and processes to be a lot less upsetting, taboo or grose than thought.

~~

Misconceptions & Questions - Part 2

This is the second post of misconceptions and questions I have found about the funeral industry.

Misconceptions & Questions - Part 1

Misconceptions & Questions - Part 3

Complete List of misconceptions & questions


- Has anyone ever been buried / cremated alive or woken up in a mortuary?
I do not know for sure, but I doubt it. The body is kept in a fridge which is between 3-5C. Too cold for anyone to survive long, especially on a metal or plastic tray and without clothes. So even if someone did go into a mortuary alive (which I doubt would happen) they would never wake up.

- What is rigor mortise and can you get rid of it?
Rigor mortise is basically a stiffening of the limbs.  The joints become difficult to bend, this does not happen with all bodies, in fact it does not even happen in most. The way it is gotten rid of is through a process called "breaking the rigor mortise". Basically you bend the limbs back and forward a few times and the joints will losen up. This 'breaks' the stiffness and the body is back to normal.

- Is everybody embalmed?
No, in fact very few people are embalmed in Australia (unlike America or New Zealand where it is basically mandatory).  Generally it is only done if needed for interstate or international transfers or if the body is going into a vault.  There are several types of embalming ranging from ‘TP’ which is a temporary embalm used for preservation on long distance transfers.  Then there is the ‘full embalm’ which can preserve a body indefinitely.  Used mainly for those wishing to go in a vault or other special circumstances this is the real embalming dating back at least as far as the Egyptians.



- How long does it take to embalm a body?
There are several types of ‘embalming’ from the temporary ones to transfer them interstate or internationally to the full embalm to preserve the body for a long time.  It will usually take about three hours to fully embalm a person.



- Does it smell in the mortuary and / or do you smell after working in there?
Sometimes, it depends. As with cooking, it sometimes smells, other times it does not, it depends on what you are doing. Some bodies smell, either they have "leaked" out an end or they have decomposed or they just smell. Other times it is due to the chemicals used by the embalmer. It is also the chemical smell which can cling to clothing, not the smell of the body.



- How do you keep bodies?
All mortuary fridges are kept between 3 and 5 degrees celsius.  Any colder and they begin to freeze which damages the body and makes it hard to work with.  Any warmer and there will be obvious side effects (like rotting).  I, and others, have noticed that certain fungi will grow on bodies kept in the fridge for long periods.  It is either orange or white and not found anywhere else.  Not even on similar bodies if they are out of the fridge for a long time, nor on the fridge itself.  This fungi is just something that can only grow on a body when it is kept in a fridge.



- Do you 'reconstruct' the body?
Rarely will we do much more than put on clothes and suture the mouth shut or brush their hair. Funeral homes in Australia avoid delving into makeup and other methods to make the body look life like. This is because it is just so difficult to get right. The person may have worn a lot of makeup, or very little, we do not know. And going by a photo is difficult because colours are not always accurate. Hair styling is something they also shy away from. Getting it 'just right' or at least 'good enough' for families is so difficult. Undertakers are not hairdressers, they are not makeup artists, they are just workers ferrying the dead about. I have never seen a funeral home employ a hairdresser or makeup specialist, nor have I even hear of it. 


- Have you seen 'Six Feet Under'?
This is perhaps the most known TV show about a funeral home. And it is a great show, well written, interesting rounded characters, etc. But it is not accurate of an Australian funeral home. For one we do not embalm many bodies (although it is becoming more common), we very rarely put makeup or anything similar on a body (even if it is for viewing) and we always wear gloves when handeling the deceased or even in the mortuary. On the show they have a lot more focus on 'fixing' the appearance of the deceased. Using special tools and chemicals to make them look like they are sleeping. In Australia we tend to just suture the mouth shut, put some eye-caps under the eyelids and nothing much else. ALso on that show they never wear gloves much. Here we must always put on gloves before we even enter the mortuary.
~~

Funeral Terminology

    There is a bit of specific terminology in the funeral industry.  But actually not that much, especially when compared with other areas such as psychology, medicine, etc.


General Terminology:

• DC - Death Certificate, the original is essential with all burials and cremations.  Also used as authority to transfer a body.
• CC - Cremation Certificate, the original is essential with all cremations.
• Intrim - A temporary DC used to transfer a body.  It is not suitable for burial or cremation.
• NDY or Not Dead Yet - Someone who is soon to die and is arranging their funeral.

Transfer Terminology:

• Transfer - The process of moving a dead body prior to any service, such as collecting a body from the hospital to bring to the funeral home.  Or taking the body to the airport to be sent overseas.
• Transfer Vehicle, Ambulance Hearse - Although 'ambulance hearse' is a much older term often considered inappropriate by many, it can still be used.  Either way this is the vehicle used to transfer the body.  It is usually a white Toyota Hiace van.
• Ambulance Stretcher, Collapsible Stretcher - A stretcher used to transfer bodies.  It has collapsable legs, like an ambulance stretcher, which fold down and in with the use of a handel.
• One-Man Stretcher, Carry Stretcher - A stretcher used to transfer bodies.  It has no legs, instead only two wheels on the foot end of the stretcher.  It is much lighter and cheaper than the ambulance stretcher but the lack of legs makes it difficult to carry heavy bodies.
• Slide Sheets - Large slippery sheets made from parachute material.  They are used to slide or carry bodies about, often in small or awkward spaces.  Although these sheets are not cheap they are durable and reusable.
• Pat Slides - A flat, thin board, smaller than the average person.  It is used in hospitals and nursing homes as well to slide a body from the bed to stretcher.  Or to slide a body up or down small heights.
• Evacuation Pod - This is basically like a hammock that is sealed with buckles.  Used to move a body up or down stairs.  One person will hold the long handles at both the foot and head end which makes the weight even and controllable, even down steep stairs or slopes.
• Seat Slide - A cloth basket like carrier with four handles.  It is used to move a body from a seated position (such as on the toilet or in a chair) and onto the stretcher.
• Body Bag - A blue large plastic bag made out of tarpaulin like material used for containing and moving a body.  It has a long zipper from head to toe and can be unzipped so it is completely open.  Although most body bags are simple and have no handels lately there have been more with handels, and more cloth style body bags.
• Valuables - Anything on the body other than clothes.  Such as jewellery, pictures, watches, money, etc.  It does not have to be worth anything.  All valuables should be noted on the transfer sheet and in the mortuary book.
• ID Tag, Wrist Tag - An armband placed around at least one, but sometimes both wrists of the deceased.  There should always be at least one on the body at all times.  The wirst tag is similar to a hospital or club wrist band, plastic and secured with one press button that cannot be undone once fastened.  Some places use different colours to represent different things, such as yellow for valuables to be returned to the family and blue for valuables to stay with the body or red for no valuables.

Funeral & Hearse Terminology:

• Goose Neck - The stopper used in a hearse to keep the coffin in place.  It is slotted into special holes along the middle of the hearse and tightened with a horizontal screw with a rubber stopped on the end.
• Pegs - The small metal 'sticks' used to keep the coffin straight as it is loaded or unloaded from the hearse.  They have rubber on the top to prevent damage to the coffin.
• Ropes - The long flat ropes used to manually lower the coffin at the grave.
• Automatic Lower - A device used at the graveside to lower coffins automatically.  It can only be used on certain lawn graves.  Basically it uses clockwork style gears inside to keep the speed steady and slow.
• Wing Droos, Side Doors - When referring to the hearse this is describing the small doors on either side that open to the space under where the coffin sits.  The space underneath the coffin is completely hollow and designed to store things, these doors give access to that area.
• Coffin Bars - Long bars used to carry a coffin.  At least two are placed under the coffin, one at each end, and one person will carry the bar on either side.  This means at least four people will carry the coffin with both hands, which makes it much easier.
• Catafalgue - A special and specific object at crematoriums.  This is what the coffin is placed on at the crematorium, be it fixed to the front or movable and on wheels.
• Crypt, Vault - A special above ground 'burial' for the deceased.  Usually refers to a small stone building where four to ten coffins can sit on each level.  It sometimes has two levels, one on the surface and one underground.
• Cortege - The process of cars following the hearse.  They should (by law) have their lights on, but not hazard lights or high beams.  The cortege should also have right of way (by law) at roundabouts and other intersections without lights.  It is also highly illegal to cut-off a cortege, but this is difficult to prove or police.
• Police Cortege, Police Honour Guard - A special cortege which has police guiding it or blocking traffic at least part of the way.  Very rare now with few funerals having police escorts unless the deceased had direct ties to the police or was extremely important.  This type of cortege will often speed slightly and run read lights.  They will also follow each other a lot closer in this type of cortege.
• Family Car, Mourning Car - The car provided by the funeral company to transport the family, friends of the deceased or the priest or celebrant.  For example Greek Orthodox funerals must provide a free car for the priest, although they will often charge the family secretly.
• Zink Liner - A special inside lining made of zink.  It is used for international transfers or for coffins going into a vault.  The zink liner prevents fluids and gases getting in or out of the coffin.
• Grave Marker - A simple marker used to indicate where someone was recently buried.  It can be used temporarily or in lieu of a gravestone.  Most often it is a simple white wooden cross.

Mortuary Terminology:

• TP - A temporary, simple embalming of the body.  It is much quicker and easier than a complete embalm.
• Aneurysm Hook - Perhaps one of the most useful and versatile tools in the mortuary.  And it looks and feels great! With a flat hook on one end and a rounded scraper on the other it can be used in endless ways.  Plus the gap in the middle makes it great for tying suture corde to, this means the needle wont go falling off the table.
• Forceps - Scissor like tool that seals, grabs and clamps rather than cuts.
• Trocar - An ancient device used to inject and/or remove fluids from a body.

This is a picture of just about every tool used in embalming or the mortuary in general.  Starting from left to right at the top you can see the trocar, other similar fluid removing/adding tools, forceps and clamps and finally the different gauges of needles used for suturing and other such tasks.  On the second, bottom row we see scalpels, scissors, a few different aneurysm hooks, tweezers and finally different attachments for the trocar.

~~

What is a Funeral Director?

    What a funeral director or undertaker is may appear to be simple or obvious.  But it is surprising how many people get it wrong.  Unless they have been in or heavily around the industry many are quite wrong about = the industry.  What our roles are, our responsibilities, what happens, who runs things and so on.  Thus I have decided to put together a brief post about what a funeral director actually is.  I will cover some other roles in the industry, but the focus is on funeral directors.

    The public perspective is that the undertaker will organise the funeral, bring the coffin to the funeral, then to the grave or crematorium and that is basically it.  This is fairly wrong.  To start a 'funeral director' can mean and involve many different things.  Once a mortician at a major hospital was telling me about the family of a deceased believing funeral directors were a rip off and un-necessary.  As such they wanted to do everything themselves and save the thousands it costs to hire an undertaker.  However he refused to release the body from the hospital as they did not have an appropriate vehicle.  They had bought a station-wagon just for the job.  But you need more than this, there are actual regulations and laws about what a vehicle needs to transfer a body, which a normal car does not meet.  So they had the car modified specially, now it met the qualifications but he still could not release the body as they had incorrect papers.  Then the family had issues with the cemetery.  Finally they got a funeral director after much expense and waisted time.  So obviously there is more to the role than just filling some forms and carrying a coffin.

I will break down the funeral director's role in order of action from beginning to end.

- Arranging the funeral: The arrangers are often experienced funeral directors who will go to the family's house and organise what they want on the funeral.  From the coffin and flowers to printing the orders of service and buying the grave plot or booking the crematorium.  They will book everyone and everything needed and just make sure it is all organised.

- Collecting the body: Firstly the funeral staff have to actually collect the body (through a process called a transfer).  It could involve collecting the body from a hospital, crime scene, home, nursing home or just about anywhere else you can think of.

- Preparing the body: A lot of people have wishes for what they want done to their body when they die.  And many are not willing or able to carry out these wishes on a loved one.  This may involve just dressing the deceased in certain clothing.  Or it could involve embalming the body for long-distance trips or for a crypt.  The body is placed in the coffin in this stage as well.

- Driving: The hearse is long, big and heavy.  It is best thought of as a small low truck or bus.  And somebody has to drive it, after all, not many funerals do not have a hearse.  While the hearse is almost always essential it is often not the only car used on the funeral.  This is what a lot of people do not realise until they are involved in a funeral.  Funeral directors also supply and often drive 'family/mourning cars' for close family and friends to travel in.  It is basically a hire car driver role, not as much of a job as a real HC driver, but still very similar.

- Working the funeral: Although people see funeral directors at the funeral not many people actually look or remember the undertaker.  The funeral staff often have light-hearted chats or jokes with the public, so it is not due to a 'morbid' or 'taboo' reasoning.  Funeral staff will get people to sign the condolence book, carry the coffin, assist with the ceremony (religious or otherwise), direct people to the facilities such as toilets, help less mobile people in/out, direct people to parking if needed and much more.  There is a lot going on behind the scenes on funerals, and the funeral directors do it all.

- Conducting the funeral: This is separate as it is a separate role and even position.  Conductors get paid more and are responsible for everything on the day of the funeral.  The rest of the funeral staff do not see them much, turning to the hearse driver instead.  This is because the conductor will spend more time with the family or celebrant(s) and be unable to organise things out at the front of the funeral.  But everything that happens on a funeral is ultimately the responsibility of the conductor.

- Carrying the coffin at the cemetery/crematorium: Sometimes people will carry on a funeral, however it is not something I would bet on with most funerals.  Instead the funeral directors will carry the coffin about.  However even if the family and/or friends do carry at the first part of the service they are unlikely to do so at the grave side of crematorium.  They realise how heavy the coffin can be.  How those handels, while pretty, are incredibly awkward and painful to hold.  Then they look at the long, uneven and sometimes narrow distance needed to carry along.  And they decline, falling quietly into the crowed.  So yes, the funeral director will often end up carrying at some part of the service.

    That is about it.  There is more to the role, but nothing important or relevant.  This is basically the job of a funeral director.  Undertakes can however have less roles.  By this I mean they can specialise, such as only doing transfers, or only doing mortuary work, or only driving the hearse.

    There are many odd misconceptions surrounding the role of a funeral director.  The most common is confusing funeral directors with grave diggers or crematorium staff.  I was once told by a very strange man who I was driving on a funeral that he had a lot of ties with funeral directors.  As a doctor he had met a lot, which is usually untrue, we do not meet many of the 'competition' in the health service unless it is in a mortuary.  He also said that although this was the first funeral he had been to he talked with many funeral directors over the years.  And that he knew we buried the bodies after the service at the grave so he would have time for a fe coffees while I buried his brother.  I pictured myself, in my three piece suit, with a shovel in the middle of a grave.  No matter how much I informed him otherwise he was convinced I would be the one to burry his brother.  This is so wrong, the grave diggers burry the coffin.  And they are qualified tradesmen/gardeners.  You will see them at the cemetery with their workers fluro shirts or driving trucks.  They have nothing to do with the body and we have nothing to do with it after the service.

~~

The Slow Rise of Obesity

    Obesity and heavy bodies are becoming an increasing problem for the funeral industry.  Yes, on one hand it means a shorter life spane which is good for the industry.  But more importantly it is causing big issues and costing the whole industry a lot of time and money.  So here is a look at some changes being introduced to handle heavy bodies and why.

    Australia now has a higher number of obese people than America.  And there is countless evidence to show how Australians are getting heavier.  Indeed there is no doubt that the average weight is changing.  So the funeral industry, just like many other industries, will have to keep up with this change.

    Any body over 70kg is tricky to work with.  At 90kg they become difficult and require special attention.  The first issue we have with a heavy body is with the transfer. The transfer crew consists of two people.  Only two people and little special equipment.  This makes moving 90kg+ of dead weight very difficult.  And as I outline in the house transfers post most homes were not designed to move a body through.  Hence the saying "I hope they die on the ground floor".  So some of the first changes seen in the funeral industry are procedural changes dealing with transferring heavy bodies.  They are designing special courses solely dedicated to teaching staff how to safely move a heavy body.  These courses are targeted at western Sydney, such as Liverpool, Penrith, Eastern Creek, Paramatta, etc.  Obviously this is because there is a higher rate of obese people people in Western Sydney.  And truth be told all except for one of the heavy or obese bodies I have transfered were either from the coroners or from Westmead Hospital.

    I remember assisting the embalmer with a big guy from the Pacific Islands.  The skin on his skull was over an inch thick, and it should only be a few millimetres at most.  Usually the embalmer can work alone and have a body fully embalmed in about three hours.  However it took three of us about two days just to embalm him.  Then five of us another day to dress and coffin him.

    Special body bags and coffins for heavy or large bodies have always existed.  But their rate of use is increasing.  Now body bags with handles are becoming more common and are almost a regular site for many transfer crews.  One coffin manufacturer told me how he is making proportionately more oversize (OS) coffins than he did a few years ago.  He is also looking at different, more secure ways to attach the handles to coffins.

    Most normal OS coffins will fit in a hearse and most other spaces without too much trouble.  It might be a bit tight, but it can get about.  However the custom larger OS coffins are another story, some will not even fit in the hearse.  A transfer van is the only option for transporting a large OS coffin.  And nobody could carry it by handles, so no handles are attached (which also saves space).  They carry it on three to four long bars they place underneath the coffin.  This means there is always three to four people on each side, making it easier to carry.  However this coffin is too large for most cemeteries and crematoriums.  We struggle to fit something like that through a large door, having to go through the service garage door.

    Most of these large coffins do not fit in many regular crematoriums, either through the doors or in the 'burner' itself.  Just last year crematorium set about installing a spacial new 'burner' to cremate larger bodies.  It will have a bigger door and more space inside because they had a couple of bodies that would not fit in the crematorium.  They had to get the funeral director to re-coffin the body into a smaller custom made coffin with thin walls.  Squishing up the body to do so.  A regular 'burner' costs over $250,000 just to buy, let alone install.  So a special larger one will cost a lot more.  Yet it is obviously worth it and they will be one of the only crematoriums to have the larger accommodation.  The average burning time is about 3 hours for most bodies.  However they have had a couple in recent time who took 24-36 hours.  This is a big difference from most people.

    Recently the coroners at Glebe installed a special lifting machine over the lift we use to load bodies in and out of the coroners.  This lifting device is designed to move a body between the coroners trolleys and the transfer stretcher.  It is not just bolted onto the roof but has its own special frame built into the roof and has a weight rating of up to 400kg.  This would have easily cost tens of thousands to buy and install.  And the coroners had their last budget heavily slashed so much they had to reduce staff in some areas.  But again, just like the special cremator it is worth it.

    There were rumours that the cemeteries were considering increasing the size of grave plots.  You can buy larger plots, or double sized plots.  But the rumour was that they were looking at increasing the average size of plots.  And cemeteries are very space conscious.  They covert space and hold on to it with devotion, always desiring and devouring more.  After all, once a space is taken it will be decades before it may become open again.  Waverly for example is mostly closed, to buy a plot there would cost at least $70,000 for just one, if it is even available.  And selling space is worth a lot, they even take out or shrink roads to make space for more grave plots.  Others constantly try to expand into neighbouring national parks or empty land.  For the cemeteries to increase plot size would be to lose land, which is a massive issue for the cemetery.

    Overall many new procedures, technologies and attitudes are being developed to deal with the increasing number of obese people in Australia.  All at great cost, time and effort.  But in the end many organisations see it as worth it.

~~

My First Transfer

   In about my second week at the funeral home they sent me on my first transfer.  It was over at St Vincents Public Hospital.  I still remember it; the anticipation, the nervousness, the excitement.  I had no idea what to expect.  While they had explained ‘transfers’ to me a couple of times I had never actually seen one let alone been on one.  And here I was, going to collect my first body from a hospital.  Transfers are a two person operation, in this case the guy who went with me was a veteran of the industry.  ‘Garry’ has been doing transfers and working funerals for longer than I have been alive.  And it shows as he is quite good at it.  In fact he is very good at just about everything he does and he would later become my favourite hearse driver.

   At this time we still had the Ford Falcon station-wagon.  This held only two stretchers at a time but was a little more palatable than the van.  So we would use it for quick or nursing home transfers.  Garry and I hoped in the wagon, he drove while i held the paperwork.  They explained that I would have to check everything, but I knew he would be looking over my shoulder to make sure I got it right.  Which actually made me feel better that there would be less chance of a mistake, but also worse as I had someone watching my every move.


   He made sure to explain the process to me as we drove out.  How he would be looking over what I did, for my sake as much as anything else.  That discretion and appropriate behaviour was always crucial.   He told me the sort of things to look for on a DC or CC and how imporant they are.  Then he told me about a couple of stories from his transfer days.  The usual things about how hospitals work, nothing special.


   We arrived at the hospital and headed in to reception together.  He introduced me to the receptionist, a nice older lady behind the large desk.  She handed me the appropriate papers and then we headed off to the mortuary.  He drove up what looked like a park, ignoring and passing several ‘No Entry’ signs as he did so.  I assumed this was alright, but was still surprised.


   Upon arriving at the mortuary he started to reverse up into the garage.  This is when I first noticed that due to the capsule to contain and hide the stretchers the back window was completely blacked out.  The only way to see behind was through the wing mirrors.  And yet the middle rear-view mirror remained attached to the windscreen.  Noticing me see the mirror he commented that it was being kept there as they intended to sell the car later and removing it would count as an after market modification.  Which could reduce its value.  It was funny how we could be talking about the resale value of a car while picking up a body from the hospital.


   Even though the rear vision was limited to two wing-mirrors he reversed it in without issue.  Obviously he had done this many times before.  Now we were inside he showed me the stretcher.  Something I had never seen in action before.  It was relatively simple once you got the idea.  He demonstrated how to grab the stretcher and squeeze a little handle on the right as you pulled it out.  This made the legs fold down.  Then he put it back in, squeezing the same handle just as the first legs of the stretcher kissed the back of the car.  He gave me a go at it, although I had trouble at first by the second or third time it was easy.


   This was all done while the mortician got the body out.  This mortician is a very nice guy, easy to get along with and very professional.  So he had no issue with us having a little practice in the garage.  Actually he was taking great amusement and interest in the whole spectacle.  Garry and the mortician obviously knew each other exchanging pleasantries and asking how each others kids were; after all they had been working together for decades.  As we entered the mortuary Garry grabbed some gloves out of a box on the wall, as he did so he informed me that all hospitals would have gloves.  But not nursing homes or the coroners.


   The mortuary was connected directly to the small garage by a roller door.  It had a white roof with creme walls and a floor to match.  The fluro lights gave it a cold and very bright atmosphere.  An old computer sat quietly on one side by a large square cut into the floor.  I would later learn that this square was actually a weighing machine and was in just about every hospital.  On the other side of the room proudly stood a row of stainless steel draws.  They glistened under the fluro lighting.  In the middle of the room was a trolley with a long blue lumpy bad on it.  Inside the bag was the body.


   The mortician and Garry then showed me how to check the body for valuables and put on the wrist tag.  Garry then signed the mortuary book, showing me how to do so as he did it.  Next we all stood opposite the our stretcher and grabbed the body bag together.  Then we pulled him across onto our stretcher.  Our stretcher come with two seat-belts, one set at the foot end and one set at the head end.  We buckled then tightened these to prevent the body moving about on the stretcher.


   Finally we were ready to load the stretcher into our wagon.  Loading the stretcher was more difficult with weight on it.  Although it was not perfect I got it in.  We said our goodbyes to the mortician and moved off.


   Back at the base we revered up to the mortuary and unloaded the stretcher.  Then we transferred the body to one of our trays.  Garry and I then filled out our whiteboard and mortuary book together before I took the paperwork into the office as he put the wagon away.

~~

Relocation Transfers

This is the ‘leftover’ method of transfer.  Basically it is anything that does not fit into one of the other three categories.  A good example would be ‘police transfer’, something I have never done.  A police transfer is when the body is taken out of a crime scene, such as a in a suicide, murder or accident.  Because I have never done one I cannot speak to them much, other than the stories I have heard.  But one thing that surprised me, and surprises many others, is that there is no government or special organisation to do this job.  Just funeral homes basically.  And they get no special training or equipment other than.  They have ordinary latex gloves and sometimes shower-caps on their shoes.  Other than that they are ordinary people with no qualifications who are paid minimal wage and wear a business suit.

Glebe Coroners:

The corners is a mixed bag at the best of times.  One simple mix up on your paperwork, a queue, or any other unpredictable delay and you can be held up for as little as 10minutes or as log as an hour.  They are heavily underfunded and mostly understaffed and over worked (this is where all coronial and most forensic cases go) so do not blame the staff.  They are actually very good, always being nice and efficient every time I have been there.  The coroners is also very particular about paperwork, so make sure you have everything and that it is correct.

1. Enter via Arundel st, Forest Ledge.
2. The entrance is through the glass doors on the brown building with the four red pillars.  Park by the row of small trees right outside the building.  Although it says no parking this is actually special parking just for police and mortuary vehicles.  So do not worry.
3. Go in the double glass doors and up to the counter behind the glass.  This is where you will give them all the papers and see how long it will take.  But this is not where you get anything.
4. Once they have everything they need go back to the car and drive into the large garage door between the red pillars.  It is just on the left after the row of small trees.  Often they will open it as you approach, but if they do not buzz the intercom to enter.
5. The mortuary dock will be on the left.  Reverse up to it and get as close to the lift as you safely can.  Load the stretcher onto the lift and raise it up as high as you can.
6. Leave the stretcher on the lift and wait by the glass doors to be let in.
7. Go into the actual mortuary, it will smell funny, due to the cleaners they use, hence the nick-name ‘the fish markets’.
8. The body should be waiting you you as you enter.  They will then ask you to read the number on the red writ tag on the body.
9. Check for valuables and if infections!!  Place your writ tag on the body.
10. Now fill in their mortuary book, it is different to most and will need you to input the next of kin name, your name, your company, date, time and initial a declaration.  All of this is on the one page.  If unsure ask them, they are nice and know what they are doing.
11. This is where they will give you all your paperwork, the DC, CC and so on.  Make sure you do not leave without it.
12. Wheel the body on its trolley out into the car park, load them up onto your stretcher which should still be on the lift.
13. Lower the lift as far as it goes and put the stretcher into your car.
14. Drive out, you may have to use the button on the right by the door to open it.

~~

Transfers; Moving the dead

A Toyota transfer van.

    Not many people know of the 'transfer'.  What it is or even the fact that it happens.  When one sees a while van outside a hospital they would assume it was a courier.  However this is not always the case, it might just well be a transfer crew.

    At this point you might be asking what a transfer is.  Simply put it is the process of moving a body from one place to another.  When someone dies in a hospital, their home or somewhere else they need to get to the funeral home.  This is what a transfer is.


Who 'Transfers' a Body?
    Generally funeral company employees such as undertakers will do the transfer.  There are also transfer companies who do not do funerals or anything other than transferring bodies about.  These companies generally deal with the more difficult transfers such as interstate or after hours.  No qualifications or training is needed to do a transfer.  The transfer crews are just regular people on minimum wage and have no equipment other than a pair of gloves.  This is the same with police transfers, there is no government group who transfer bodies.  In other words a couple of undertakers will move the body from the crime scene to the coroners.


Types of Transfers:
    There are four main types of transfers; house transfers, nursing home transfers, hospital transfers and relocation transfers.  You can click on the links to get more details, but here is a short summary:

    House transfer - the act of removing a body from a home or private residence to take to a funeral place.  This is the most intimate and personal form of transfer, and has the most chance for the family to be present.  It is also the most unpredictable transfer.

    Nursing home transfer - the act of removing a body from a nursing home to take to a funeral place.  This is a fairly intimate and delicate transfer.  There will be other residents, relatives and patients who know why the transfer crew are there and will not like it.  The family, or other residents might be there watching.

    Hospital transfers - the act of removing a body from a hospital to take to a funeral place.  This is not really an intimate form of transfer.  It is in fact one of the easier, simpler and predictable.

    Relocation transfer - the act of collecting a body from the coroners to take to a funeral place or the act of collecting a body to take to the coroners, hospital or somewhere else.  It can involve police jobs (such as murders, suicides, accidents, etc) and other random work.  This is a highly unpredictable form of transfer.

Inside a transfer van.

The Transfer Vehicle:  
    A transfer vehicle is just a while van.  Some places use a station-wagon at nursing homes or houses to be more "discreet".  Yet in almost all cases a Toyota Hiace is used to transfer the dead.  A few funeral companies such as InvoCare use white Mercedes vans, but the vast majority use a Toyota Hiace.  The transfer can can hold four bodies at a single time thanks to a shelf in the middle.  This shelf uses a hydraulic system so it can be raised and lowered to make getting bodies in and out easier.

    Not just any car can be used to transfer a body.  I do not know the specifics but in NSW a transfer vehicle must have a a airtight compartment for the body, sealed and separated from the driver.  This compartment must also vent to the outside of the car.  However not all transfer vehicles meet either of these requirements.  But either way one cannot just collect a body from a hospital in a regular car.  Although some have tried.

    For more information and photos of a transfer van go to this post.


Stretchers:

Two stretchers on top of each other.
The 'carry' stretcher is on top of the ambulance stretcher.

    There are two main types of stretchers.  The cheaper and simpler type is the "two man" or "carry" stretcher.  This stretcher has two wheels at the foot end and no wheels at the head end.  The other thing is that the wheels on this stretcher are fixed and cannot be raised or lowered.  Which means the stretcher has to be carried about.  This means the carry stretcher is quite light and piratical in areas where a lot of carrying is needed.

    The other type of stretcher is the "ambulance" or "collapsable" stretcher.  This stretcher has four wheels on the end of legs.  So the legs, and the whole stretcher, can be raised and lowered.  A benefit is that the stretcher can be raised to bed hight and that the stretcher does not need to be carried.  The down side is that this stretcher is quite expensive and heavy.

    The ambulance stretcher was my favourite, loading it up into the back of the transfer van had such a satisfying click and clank.


Foot First:
    A body always travels foot first when going anywhere.  This means the zipper on the stretcher and body bag must be at the head end.  It also means the body should go into a vehicle, be it a transfer van or hearse, foot first.  So that as the car drives the body travels foot first.  The other thing is that a body should be wheeled or carried on the stretcher foot first.

    This actually has a rather practical reason.  Bodies are liable to 'purge' which is not nice.  Purging is basically when a body 'leaks' fluids out of the mouth or nose.  To prevent this one must always keep the head higher than the torso.  So when carrying a body down stairs take it foot first.


Identity & Name Tags:
    This is perhaps the most important aspect of the transfer.  Making sure you have the correct body.  It is obviously very important as collecting or identifying the wrong body could have serious consequences.  So the correct name tage has to be on the correct body.

    The first thing you should do is check to make sure you have the right body.  In a hospital look for ID tags on their wrists, all patients wear them.  Nursing homes do not generally have a good ID system, so you will have to rely on the nurses.  Generally the best you can do outside a hospital or the coroners is hope and go by what others say.

    Next you will need to place your own ID tag on the body.  Contrary to popular belief the funeral industry does not use toe tags.  I explain the reasons why we use wrist tags and why toe tags are never used in this post here.


Paperwork:
    The appropriate paperwork is essential.  You cannot and must not ever move a body without a DC (death certificate) or an interim.  An interim is a temporary document to say the person is dead, it allows one to transfer a body and to start the paperwork for a funeral.  However a DC will be needed for a burial or cremation and to actually go through with the funeral.

Things to ask about the paperwork:
- Is it the original?
- Is it filled out correctly?
- Does it have the name of the deceased (the exact and correct name)?
- Does it have a date of death?
- Has it been signed?

    There are more specifics, such as a DC must also list cause of death and duration for the cause.  However these other specifics vary and are too numerous to list here.

    The other thing to not with paperwork is if the body is going to be cremated a CC (cremation certificate) will be needed.  You will not need a CC to transfer or bury the body but it is a must for cremations.  The price differs with each state, in NSW it is $88 but it is only $65 in QLD (as far as I am told).  The other thing is a CC will cost $88 to get from the hospital which has to be paid for by check.  So make sure if the body is due for a cremation that you wither have a check to get the CC or payment has been arranged.  And do not forget to actually collect the CC!!

    With the DC and CC check to see if the body has a pacemaker.  If there is a pacemaker or other "battery" device inside the body then it must be removed before cremation.  They explore in the crematorium and can do serious damage.

    At the end of the day actively check all paperwork.  There are little issues to look for, like question10 on a CC is often missed by doctors because it is in small writing and right where the paper is usually folded.  So the fold hides the question, and it is an important question.


Valuables:
    All items need to be catalogued and recorded, to do so they are grouped under 'valuables'.  Valuables are the items on or with the body other than clothing.  Anything and everything on the body is considered a valuable.  These items might not actually have any real 'value' but they are all treated as precious.  I remember one valuable was just a piece of string, but it was important to the deceased and the family.  So we treated it as though it carefully.

    Not everything is a valuable.  Clothing, while recorded and catalogued, are not counted as valuables and have their own section.  Things in the room with the decease are also not valuables unless told otherwise.  Basically valuables are only what is on the body and going with the body.

    Always count and record valuables!  But do not be too specific.  For example with a diamond gold ring one would write "yellow coloured metal ring with white stone".  It is unknown for sure if the ring is gold and the stone is a diamond, so just describe it visually and simplistically.  Too much detail might be incorrect or confusing.


Pay & Experience:
    I get asked this a lot.  Many people assume that those who transfer bodies get paid a fortune.  That it is a job so few want to do that it must pay well.  Or they assume there is lots of training and equipment needed.  Truth is that it is a minimum wage job with no safety equipment other than a pair of regular gloves.  The only thing needed to transfer a body is a drivers license.


Links and Further Information:

- To learn about what becomes of medical waste and the cadaver go here.

- To read about wrist tags and why toe tags are not used go here.

- For pictures and a description of a transfer van go here.

- For information and descriptions about body bags go here.

- To read a funny and rather unusual story about a transfer go here.

- For funeral industry terminology go here.

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