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Why I’m Donating My Body to Science

“A donated organ can save a life, but a body provides the foundation to save many more.”

In 2009, my mom and I went to see Body Worlds, a traveling exhibit of dissected human bodies preserved through plastination. I had seen it before, but it’s always better to experience these things with another person. I wanted her to see why I was in such awe of the human body. I left the museum that day having made three decisions: my mom is a good sport, $30 for a organ donor t-shirt was totally worth it, and I am donating my body.

Up until that day, I hadn’t given much thought to what would happen to my body after I died. Do I want to be buried? Cremated? Shot into space? To be honest, none of that crossed my mind. I was 25 and invincible. But after walking through the Body Worlds exhibit for the second time, I knew that a coffin six feet under ground wasn’t for me. My atoms crave fame. (Not really. They crave caffeine.)

Body Worlds

Before leaving the exhibit, I used one of the computers there to sign up as a donator. Instead of donating my money, however, I opted to donate my body. It was almost too easy, and part of me believed that I had just sent one of those “wish you were here” museum postcards to a family member. But weeks later I received confirmation in the mail—I even got a fancy ID card to carry with me so people know what to do with my body when I die.

Side note: To be fair, it wasn’t just Body Worlds that had led me down this path. By this point in my life, I had attended several cadaver labs and read “Stiff” by Mary Roach. This book opened my eyes to not only the need for cadavers, but the very important purpose they serve in a number of research capacities. It’s a fascinating book, and she’s a brilliant author. I recommend reading it.

Nearly 10 years later, I haven’t changed my mind. My body will be donated when I die. What has changed is who I am donating it to. While the Body Worlds exhibit is enlightening, there isn’t much need for bodies to be plastinated and put on display. While it serves an educational purpose, it’s self-serving. What is needed, however, are bodies for medical students, anthropologists, ballistics experts, and first-responders.

Giant Heart

In 2016, National Geographic reported that the demand for cadavers is up, but the supply is down. The Anatomical Gift Association of Illinois reported that annual donations fell from 760 in 1984 to 520 in 2015. This was disheartening to read because body donation is such a wonderful gift. There are more than 20,000 enrolled first-year medical students, and for them, anatomy class is a rite of passage. With about six students assigned to one body, it really limits the amount of hands-on learning future doctors have.

According to NatGeo, in 2008, Colorado and Wyoming were 20 bodies short of the 158 cadavers requested by the states’ medical schools. And with physician assistant and nurse practitioner programs now utilizing cadavers, in addition to vocations outside of medical school, the supply is even more strained.

“There are more than 120 million registered organ donors in the United States, and an average of 79 people receive transplants each day, according to the U.S. Department of Health and Human Services. The federal government does not monitor whole body donations in the United States, but researchers estimate each year fewer than 20,000 Americans donate their bodies to medical research and training.”

This doesn’t sit right with me. I have gained so much knowledge from the generosity of body donors, and I’m not even in medical school. I don’t know what happens when we die, but I can’t imagine that I’d rest easily knowing that I opted to keep my body in a box instead of helping future medical professionals better understand anatomy, physiology, and pathology.

Now I’m not here to tell you what to do with your body. It’s yours. But I do hope that maybe I can answer some questions for you in the event that you’re considering body donation.

What is body donation?

Simply put, body donation is the donation of a whole body after death for education and research. Donated bodies are primarily used for medical education and research, but cadavers have helped industries outside of medicine, including NASA and car manufacturers.

What will happen to my body?

That all depends on where you donate your body. In medical settings, donated bodies are mostly used for gross anatomy and surgical anatomy. In 2015, Vice published an in-depth article about what happens to your body after it’s been donated. I recommend checking it out. But to be blunt, you will be dissected. Remember that fetal pig in high school biology? More than likely, though, you’ll be treated with much more respect than that pig.

Your body will be embalmed, which means your blood and other bodily fluids are replaced with chemical preservers. This makes it so your body will last instead of decompose. Side note: read my previous post all about decomposition.

In my personal experience with cadavers, I’ve worked with whole bodies and well as parts, such as arms and legs. I have seen skulls cut open to reveal the hollow space where the brain once sat. I have also seen heads split in half down the middle to reveal the inner workings of the nasal and pharyngeal areas. I have been the person doing the dissecting, and I’ve also been the person who observes the body post-dissection. It all depends on the class you’re taking and career path you’re heading down.

If you’re looking for a moving first-hand account of a cadaver lab, I recommend reading “Body of Work” by Christine Montross.

How can I donate my body?

There are several ways to do it. First and foremost, you can opt to be an organ donor. This is much more common than whole body donation. Working at the morgue, I receive a lot of Gift of Hope patients. These are bodies that have already had their corneas, organs, long bones, and even some skin removed.

My next recommendation is to check with your state to see if they have a formal organization. Illinois, where I am located, has the Anatomical Gift Association. It receives, prepares, preservers, and distributes donated human remains to medical education and research institutions across Illinois.

You might also consider research facilities like a “body farm”. The most notable one, at least in my opinion, is located at the University of Tennessee. It was founded in 1981 and has been used to study human decomposition. Similar projects have followed at Western Carolina University, Texas State University, Sam Houston State University, Southern Illinois University, and Colorado Mesa University. All six are, or at least at one point, accepted human donations. If you like podcasts, here’s a great one about body farms from the guys at Stuff You Should Know.

What happens to my body when they’re done?

That’s a great question. In my research, I’ve read that most places hold a type of memorial service or ceremony. Certain institutions will invite family members, while others prefer to limit it to the students and faculty that worked with the cadavers. It’s a great way to show respect and gratitude for the generous gift. Bodies are then cremated, and their remains are returned to their families.

So there you have it. It’s a very quick overview of body donation. If you are considering it, I encourage you to research further. Like me, you might change your mind about where you’d like your body to go or what you’d like it used for. It’s an important decision, and one that shouldn’t be made impulsively. That said, it’s truly a wonderful gift and one that I am extremely proud to give.

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A Composition on Decomposition

I have worked at the morgue for a little over a month and I can say with certainty that the worst part of my job is getting hands-on with head traumas and decomposed bodies.

I will get to head traumas another time. Right now I’d like to focus on decomposition because while disgusting, it’s a truly fascinating process from a physiological standpoint. Before I dive into the specifics, here’s a bit of background in case you’re just tuning in.

At the morgue, it is my job to x-ray every decomposed body that comes in, regardless of how the person died. As I stated in a previous post, I’m responsible for x-raying all gunshot wounds, motor vehicle accidents, and child deaths, without question. I’ll read reports from falls and suicides. Depending on the nature of the event, we may or may not need to x-ray them. Decomposed bodies always get x-rayed without question.

decompLet’s talk a bit about decomposition—yay! I should note that I will be showing some images that might be unsettling or upsetting. View at your own risk.

When you die, your heart stops beating and your body’s cells stop receiving oxygen. Typically brain cells are the first to die, while bone and skin cells can survive for several days. Blood begins to drain from vessels and pools in the lower-lying portion of the body. So if a person dies lying on their left side, that side will appear darker while the right side appears more pale. This is called livor mortis, or lividity.

livor mortis
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Side note: There are several “mortis” stages that a body goes through. The ones not covered in great detail here are pallor mortis, which is a pale or ashy appearance, and algor mortis, which is a change in body temperature. Algor literally translates to coldness.

Roughly three hours after death, rigor mortis sets in. Rigor mortis is simply a stiffening of muscles. In a living body, calcium ions flow into muscle cells and promote attachment between two muscle fibers, actin and myosin. Once attached, this causes the muscle to contract. A muscle remains in this state until ATP arrives to pump the calcium out of the cell. However, in a dead body, no oxygen means no ATP. Skeletal muscles will remain contracted until the muscles start to decompose.

Fun facts about rigor mortis:

  • It’s Latin for “stiffness of death”
  • Facial muscles stiffen before larger muscles
  • It can start anywhere from 10 minutes to several hours following death and can last up to three days (it’s greatly affected by temperature)

As the cells within a body begin to die, there is nothing maintaining their structural integrity, and so their membranes begin to break. As they do, they release enzymes that begin eating the cell from the inside out. This is usually referred to as autolysis, which means self-digestion. While this is happening, microorganisms and bacteria produce very unpleasant odors called putrefaction.

Additionally, the leaked enzymes produce many gases, including hydrogen sulfide, carbon dioxide, and methane. The pressure from these gases cause the body to bloat, which is the second phase of decomposition. The pressure can become so intense that some bodies can actually double in size. Bloat usually occurs around five days after death, according to an article I read.

Bloat
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Fun fact: Tongues and scrotums aren’t immune to bloating. Bloat is most common in the face, abdomen, and in males, the scrotum. One of the only good things about working with decomposed bodies is that we don’t have to open the body bag. However, this can make positioning a body for an x-ray more challenging since landmarks aren’t easily identifiable. One of the ways we “get our bearings” is to feel for facial landmarks. Usually we go for the nose and eyes, but depending on the stage of decay, sometimes the tongue is a dead (heh, pun) giveaway. The tongue expands so much that it protrudes from the mouth acting almost like a handle.

The tech I trained with opened every decomp bag so I could see the process in its various stages. Disgusted, I still looked because my sense of curiosity is a glutton for punishment. Before opening the bag, she would say, “Here, feel this.” Completely at a loss for what body part my hand might be touching, I’d ask her what it was. “That’s his scrotum.” I skeptically pulled my hand away because it felt more like a knee or elbow than soft tissue. But I was proven wrong when she opened the bag. The scrotum had such a buildup of pressure due to the gases within the body that it had no choice but to expand to double its original size.

Although a great way to startle a first-week forensic tech, this can actually be dangerous. The buildup of pressure combined with the loss of integrity of the decomposing skin could cause the body to rupture. So think twice before you go poking around decomposed bodies, okay?

Black
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By this point, the combination of feeding maggots, purged fluids, and cellular breakdown means the body has entered active decay. During this time, liquefaction of tissues becomes more visually apparent and extremely strong odors exist. If you think a fresh dead body smells bad, you’re gravely mistaken. I don’t know how to begin to describe the smell of a decomposing body.

One article attempted to do so, stating:

  • Cadaverine and putrescine smell like rotting flesh
  • Skatole has a strong feces odor
  • Indole has a musty, mothball-like smell
  • Hydrogen sulfide smells like rotten eggs
  • Methanethiol smells like rotting cabbage
  • Dimethyl disulfide and trisfulfide have a foul, garlic-like odor

Another article went the less scientific route, asking 20 people to describe the smell of death. I think this one is the most accurate:

“Rotten eggs, feces, and a used toilet left out for a month x 1,000.”

Working with bodies in active decay is very difficult. The vicious attack on one’s nose is frustrating enough, but the bodies are slippery too. The pressure from the gases forces fluids within the body to escape through open orifices, like the mouth, nose, anus, etc. And since we’re working through the body bag. The material of the bag paired with the slippery goop makes for a very frustrated x-ray tech.

Toward the end of active decay, when all of the body’s soft tissue has decomposed, hair, bones, and cartilage remain. Although decomposition begins almost immediately following death, it can take up to one year for a body to completely decompose to a skeleton. From there, it can take another eight to 12 years to decompose a skeleton. It depends on a variety of factors. Is the body buried in a dirt grave? Was it buried in a coffin? Was it embalmed? If not buried, what’s the temperature and environment like?

After active decay, the body enters something called butyric fermentation. While I’m not certain this is an official stage of decomposition, it’s something that occurs once the body has dried out and butyric acid accumulates. Butyric acid is present in human vomit, so you can imagine how awesome this stage smells. During this “stage,” the skin turns leathery and marks the transition from active decay to dry decay. In dry decay, roughly 50 days to one year after death, the body is almost completely dry and may actually mummify depending on environmental conditions.

At the morgue, I have worked with bodies in every stage of decay. None were pleasant, but I suppose the beginning stage is the easiest. When it comes to working with dead people, I prefer those that are still exhibiting rigor mortis. In a later post, you’ll see how I contradict that statement, but for now I stand by it. Without rigor mortis, bodies move too easily and seem too life-like. It interferes with the mental barrier I’ve constructed so I can do my job without puking and/or crying.

I debated whether or not I would show you this. I was given permission to use x-rays for education purposes at school, so I felt conflicted about posting anything here. I don’t think I’ll make a habit of this, but I really wanted you to see the differences between an x-ray of someone who had just died compared to that of someone who’s actively decaying.

Compare

Normal on the left and decay on the right.

Can you see the difference? Isn’t it interesting?! Because we work through the bags, I’m never quite sure what stage of decomposition the body is in. But the x-rays always show it. Now, an x-ray won’t tell you down to the day of decomposition the body is in, but it can give you a fairly good idea of whether it’s in the beginning stage or active stage. I think it’s fascinating. Hopefully, as I learn more about pathology and identifying different types on x-rays, I’ll be able to notice even the most subtle of decomposition markers. #XrayGoals

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The Autopsy: A Lesson in Distance and Empathy

I have participated in my fair share of cadaver labs. Aside from the smell of formaldehyde, I wasn’t bothered by the experience. I’d often boast that I felt so comfortable inside of a cadaver lab that I could (and did) eat my breakfast in there.

During my first week at the morgue I was allowed to observe a couple of autopsies. By observe, I don’t mean in a comfortable and well-ventilated space outside of the autopsy room. I was in there, next to the pathologist, smelling the stomach contents and hearing the cracking of the ribs. At one point, I was handed a clipboard and asked to record the weight of various organs. How’s that for audience participation?

The autopsy itself didn’t bother me. Honestly, I didn’t expect it to. The thing that didn’t sit right with me was the nonchalant attitudes of the pathologists, residents, and photographers working in the room. This isn’t a bad thing. Not once did I get the impression that these professionals were being disrespectful. Rather, it felt like I was observing a conversation among coworkers around a water cooler—that just happens to be a steel table with a dead body on it. For them, this is just a normal part of their work day. The body on their table is probably the fiftieth, hundredth, or thousandth body they’ve worked on. The shock and novelty has worn off and muscle memory has taken over.

It’s one thing to read about autopsies, but it’s a whole other experience to actually watch one. Where I thought they’d surely struggle, they worked masterfully. Is that a weird thing to say about someone cutting open a human body? I hope it’s not inappropriate, but it reminded me a lot of a chef preparing an elaborate meal. Every cut planned and expertly executed. The process was extremely efficient, no doubt from years of practice. Are you thinking of Hannibal now? Fava beans… Sorry.

I was engrossed. I couldn’t take my eyes off of the resident’s hand. I have spent years studying the human body, so there was something morbidly satisfying about seeing muscles and organs only hours after blood flowed through them. The thing about cadaver labs is that everything is lifeless. That’s not to say things are lively at the morgue, but the bodies are, well, for a lack of a better word, fresh. There’s color, contrast, definition, and volume. In cadavers, bodies have already been embalmed. They’re drained, beige, brown, and flaccid. It’s very easy to forget that there was once a person in there. But at the morgue, there’s no doubt. If not for some discoloration and stiffness, you’d think the person on the table was sleeping. Okay fine. No one sleeps with their chest flailed open, but you know what I mean. Right?

Torn

My experience working at the morgue, so far, has been that of a game of tug-of-war. I am constantly fighting with myself to remain disconnected enough to not let what I see affect me too strongly, but empathetic enough to understand that there once was life here. This is someone’s someone.

What happened during my most recent shift is a perfect example of this. While reading the case reports, as we do at the start of every shift, I saw a self-inflicted injury on the list. Knowing we’d have to x-ray this person, I checked for scene photos. I like to know what I’m getting myself into, especially with suicides. In the picture on the screen, a middle-aged man lay face down, gun nearby. This is going to be messy. And I was right. There were six evidence cards scattered around the body. I was confused at first because the report said self-inflicted. There shouldn’t be six gun casings. There weren’t. The cards were indicating pieces of brain tissue.

When I finally got the body on my table, I reluctantly opened the bag because I knew this would be difficult to see. The man had shot himself in the head with a big enough gun to remove more than half of his brain. As I looked into the bowl that was once his skull, I was angry. How could he do this to his family? Why would he leave this horrific scene for them to come home to? But I didn’t dwell. There’s no room for emotions at the morgue. I quickly switched gears and my curiosity took over. Exactly how much of his brain was missing? Do we have all of the pieces? Where exactly did he put the gun to make this sort of wound? Is it possible for him to have an open casket at the wake? A tug of his neck here, a push of his body there, and just like that, the x-rays were done. I zipped him back up and wheeled him out to the cooler, saying nothing other than “I’m sorry” because I got his cart stuck between the wall and the freezer door.

Side note: I’m convinced that every body I x-ray is accompanied by their spirit and it’s watching me perform their exams. In the event that it’s true, I don’t want any angry spirits coming home with me because I couldn’t control the cart properly. So I apologize in hopes of appeasing an invisible entity that likely doesn’t exist. “Hey Jenn, tell us how you cope with working at the morgue because surely you’ve got to be a sane person to do that.” Sigh. But of ALL the places to be haunted, I mean, come on. I’m not crazy in thinking that we’re not alone in the cooler.

I digress.

The true test came when I had to x-ray not one, but two babies, neither of which were older than a couple of months. As I said in a previous post, when it comes to children, we handle them differently. They’re smaller and easy to carry. Why bring a giant metal cart if we don’t need to? As I unwrapped the body bag folded around this baby, my partner and I were commenting about intake’s folding skills. “This is how you should wrap a baby in a body bag.”

I’m not a mother, so I can’t even begin to fathom what it must be like to lose a child. When I saw this tiny human on my table, something inside of me hurt. I grabbed its tiny hand and squeezed, half-heartedly expecting to feel a squeeze in return. Every move was careful and delicate, despite being told again and again, “They can’t feel it”. With the x-rays done, I wrapped up the baby, folded the body bag around it, and carried it like I would a newborn. I rubbed its back and told it I was sorry that it didn’t have a chance to really live. I gently placed it back on its cart inside of the cooler, and then I left.

Do you see what happened with those two stories? With the gentleman who had killed himself, I acknowledged him. I referred to him as a “him”. In fact, in the x-ray room, I even called him by name. I almost always do, which really throws off the pathologists because they refer to everyone by medical ID number. But with him, I kept my distance emotionally and didn’t let myself get sucked into his story. However, with the child, I used terms like “baby” and “it,” yet I most definitely got emotionally involved. It’s a constant tug-of-war between distance and empathy. It’s interesting to see how this disconnect manifests itself. The heart and mind have very subtle ways of protecting themselves.

I have gotten way off track. I guess what I am trying to say is that while observing the autopsy, I also got to observe a brilliantly choreographed dance by the pathologists. There didn’t appear to be a jerky struggle between emotions, but rather a fluid waltz from cut to cut. Again, there’s no doubt in my mind that this is from years of experience. That said, they’re not impenetrable. They know that better than anyone.

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I created a new Instagram account: @afistfulofneurons. I get that not everyone who follows @bottlethecrazy wants to hear about my early mornings at the morgue or adventures at surgical science museums. My new account is private, but please follow along if you’re so inclined.

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Down Among the Dead Men

My interest in the medical field began in high school. Junior year to be exact. My anatomy class took a field trip to a chiropractic college to see a cadaver dissection. While we couldn’t get hands-on, I immediately took an interest in the topic of body donation and working in the medical field. (Side note: I have been meaning to write a post about my decision to donate my body. Hold me accountable.) It wasn’t until nearly six years after that class that I really began taking steps to make a career in health care a reality.

Long story short, in 2015 I enrolled in a 20-month radiography program—which is the reason why this blog has been quiet for so long. I graduated this past May and immediately began working. I purposely sought out part-time and temporary positions for a few reasons. One, because as a new grad, I had realistic expectations about my hireability (Is that a word?). Two, because I was interested in many modalities/settings and didn’t want to spend all of my time in just one. And finally, I hadn’t found the job yet.

But in July, I found it. The local morgue was looking for a part-time x-ray tech. I’m not talking hospital morgue. I mean the morgue that serves the second largest county (in terms of population) in the U.S. It was the least-desirable shift, but I had to apply. For years I had researched careers in forensic and pathology fields. I strongly considered going to medical school to become a medical examiner. I even toyed with the idea of mortuary school. I worked for an autopsy company and read dozens of books by pathologists, pathology assistants, crematorium and funeral directors, and so on. I had to get this job.

The tricky part was figuring out how to show my enthusiasm without coming across as creepy. I mean, I’d be working with dead bodies. No one should be that excited. But I really wanted this. I wanted it because I had to know if I was cut out to work in this field. I went in to interview, and at the end of it they asked if I wanted a tour. A tour of the morgue? Um, yes please. Unfortunately the autopsies had ended for the day, but I still got to see the rooms and the giant refrigerator where all the bodies are stored. I stood there asking question after question, trying to contain my excitement and solidify the fact that I’m most definitely a normal person with a very healthy curiosity.

Morgue
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It turns out my questions didn’t scare them away because a few weeks later I was offered the job. It took weeks of background checks, medical screenings, and paperwork before I received my start date. In that time, my emotions ranged from excited to terrified to overjoyed to nervous to perplexed. I was happy that I had the job, but I was nervous that I wouldn’t be able to stomach it. Sure, I’ve worked with cadavers before and that never bothered me, but this is different. These people, some of whom have suffered horrific and tragic fates, are not embalmed. Not only that, but I’d work with bodies before they’re cleaned, before bullets have been removed, bodies that are in pieces or decomposing. What do bullet holes look like? What does a decomposing body smell like? Will I throw up? How will I emotionally handle murder and child abuse cases?

Panic set in. My anxiety took over and I began imagining every terrible scenario I could think of. Maybe I’d get locked in the body cooler. Or perhaps a body bag would start moving. I’d bump into the pathologist and mess up their autopsy. I’d vomit on the x-ray control board. Would I start questioning my own existence? If I see tragedy first-hand, would it weigh heavily on my soul? I thought I was ready, but the fear of the unknown had taken hold and there was no rationalizing it. I needed to get through my first day. I needed to smell the smells and see the sights. I wanted to see the worst of the worst so I’d know if this was something I could handle.

Ask and you shall receive. I’ll cover what my first week at the morgue looked like in my next post. Right now, I really need a shower because my hair smells like dead people.

**Unless specified (and granted permission) none of the pictures included in these posts are from my workplace. They’re found via Creative Commons.**