The Mortuary Visit

Pay day! My first wage packet. Makes it seem all worthwhile somehow. Not the sentiment I was expecting of myself though. My rose tinted specs on feeling great satisfaction from patient care grew wings and flew away a few weeks ago. I should be able to save money for the first time ever due to the sheer reality of not having time to shop. I think a far chunk is going to be spent on pedicures. I’ve already had two.

At last I find the free parking spaces on the side roads around the hospital. After spending two days in the on site multi storey at £12 a day, I needed to find alternatives. The broken glass along frequent stretches of road from previously assaulted cars is somewhat discerning though. They say its just a matter of time before a member of staff is mugged or worse.

I arrive on the ward and notice that Mr Brown is not there. He died during the night. I didn’t realise he was so close to the end yesterday. He was becoming increasingly confused. He associated me with needles and every time I walked by he held his arms close to his body. His kidneys as well as his liver were failing, but I didn’t realise he was dying. I have never come across someone dying before. It just didn’t feature as part of medical school.

I am asked to write my first death certificate. The family are coming by in half an hour to pick it up. It feels somewhat unfitting to be doing it in biro. It should be in black ink. I am after all declaring the death of a man. I make a mistake and start a fresh one, trying to use my best hand writing. I fight against my normal junior doctors ‘no time’ scrawl. He is to be cremated, which requires me to fill another certificate. It was never my forte. The main points to remember here are to use block capitals, check the patient doesn’t have a pace maker as that would cause the furnace to explode and then pop down to the mortuary to see the body. For this final duty we are paid the ‘crem fee.’ I don’t know how much but I am told a cheque will arrive in the post. There is a vast amount of paper work in this job, which is probably why I am struggling.

That’s a job on my list today-’go to mortuary to see Mr Brown.’ The mortuary in Glasgow Royal Infirmary is again my first. I had imagined them as being clinical, white and silver. This one however is not. I press the bell at the locked door and stand there as people inside ignore me. I literally make eye contact with them as they walk past with that awkward ‘pretend you are not there’ look. A nurse in scrubs arrives and lets me in. Maybe only nurses are authorised to open the door. She’s young and cheerful. She somehow knows that I’m a mortuary virgin. Must be my wide eyes and nervous laughter. To get to the bodies, we need to get to the basement. Its like something out of a murder series, complete with an old lift that creaks and shakes as it descends. The doors to the lifts are wooden screens that need to be pulled across. The nurse explains that during the winter the lift and the lower floor flood. The staff wear wellies. Not sure if she is having me on. Suppose I’ll find out soon enough.

I had looked after this man in life. Only the day before I almost knocked myself out with surprise when I got blood gases off him. This involves using a special syringe and needle, and aiming for the radial artery on the wrist. If your in, you are rewarded with a red flash back of blood, which fills up the syringe under the pressure of the blood without any further effort. It’s a sore procedure and there have been many times when I have had to continue stabbing at the wrist trying to get that bit of blood. Its awful for the patient and its awful for me to continue to inflict pain, due to my inexperience of locating the correct area. Its an important test to establish the blood content of oxygen and carbon dioxide. Like all things in medicine there are normal parameters to work with and if the results are outside those we need to know why and try to fix it. All parts of the jigsaw puzzle I still am learning to put together.

We get to the place where the bodies are kept. This bit looks familiar. It could be a scene from Silent Witness. That smell must be formaldehyde. I try using shallow breaths through my mouth. One side of the room is filled with floor to ceiling draws that pull out to reveal corpses wrapped in white sheets. I subconsciously begin to back away until I can go no further when my back reaches the far wall. The nurse smiles and suggests I come closer to be able to see Mr Brown. She unzips the bag. What am I supposed to say? I try not to stare at him with morbid curiosity. My one task firmly fixed in my head is to check for the presence of a pacemaker. I purposefully look in the left chest area. No sign of scars, so no pacemaker. He can be cremated without fear of an explosion. It helps to make me feel my presence there justified even though it’s a legal requirement of writing the ‘crem forms’.

He is leaking brown fluid hence the use of the giant white plastic bag. He had been really puffy from excess fluid in the last few days from liver failure. That was the booze doing its work. It is now seeping out. I had known him as a jaundiced patient, yellow. Now he is grey. I am happy to leave that space and enter the land of the living. I can’t help but take a deep breath of fresh air and feel the urge to shower.

This account was published in The Glasgow Herald.