Dealing with the dead. Part 1.

I have seen dead people before. I’m from that layer of working class that keeps dead relatives in the front room overnight before a funeral.

 This post is the first of two and you might want to read them in succession. Both of Part 1 and Part 2 talk about death and dying and touch on my experiences of both. Please engage in self-care as you read these articles.

October 1973

‘Nurse Walters, will you help me lay out Frances, please?’

I am on my first ward placement — general surgery.  The Staff Nurse is pushing a trolley laden with linen and a wash bowl with one hand and dragging a wheeled linen skip with the other. Laying out — it is under ‘L’ in my handbook of procedures to practice and get signed off before I finish the placement; officially it is called ‘Last Offices’.  This is a learning opportunity.

Frances is in a side ward, a single room with a high ceiling and one long, vertical window.  It is echoey and cool. It has an unoccupied feeling.  She had surgery two weeks ago which turned out to be ‘open and close’, a euphemism for inoperable cancer.  Nothing to be done.  She is (was?) an old woman in her eighties, unmarried, no relatives.  I helped care for her on each of my shifts so far and she had been interested in me and how I was getting on.  She was bright and funny and had made me feel confident that I was doing okay when I helped her wash or changed her bed.  After surgery she had deteriorated very quickly.  Now I am about to do something else for her, the last thing; lay out her body, ready for transfer to the mortuary.  

 I am neither afraid nor apprehensive, just a little curious about the procedure which I haven’t observed before.  I have seen dead people before.  I’m from that layer of working class that keeps dead relatives in the front room overnight before a funeral.  With the lid off.  Relatives come and ‘visit’ for a last look at the dear departed.  This, with Frances, is nothing like that. 

I fill the wash bowl with warm water.  Following the Staff Nurse’s lead, I fold back the bedclothes and help to remove Frances’s nightdress.  It is soft cotton with sprigs of flowers — daisies and tiny pink buds tied together with a floating ribbon, pretty and youthful.  I fold it neatly.  There is a gauze dressing pad on her wrinkled abdomen.  I know that underneath it is a row of ugly, deep-tension sutures holding her incised abdomen together.  We place towels over her emaciated body and the Staff Nurse takes a flannel and soap from the locker beside the bed.  It is Bronnley Lemon soap, in the shape of the fruit and it scents the room with the light, fresh smell of lemons.  She very gently washes Frances’s face and neck.  I follow with the towel, drying her skin.  Together we wash and dry this frail body, gently turning her to wash her back, lifting her arms and legs carefully.   Her limbs are loose, still flexible, and surprisingly heavy, they would slip out of my grasp if I didn’t really concentrate. The stiffening of rigor mortis doesn’t start until about 2 hours after death — I know this, it has been covered in our lectures.  All the time the Staff Nurse talks softly:

      ‘I’m going to wash your face now, Frances… There now, let’s just lift up this leg... Over you go, we’re doing your back…’

Occasionally she looks over at me and smiles, raising a questioning eyebrow:

      ‘Are you OK?  Are you managing alright?’

      ‘Yes, yes, I’m fine.  I’m glad to be doing it.’

We change the gauze dressing, fastening down a fresh one with tape. 

      ‘Is there a comb or brush in the locker?’

I find a brush and gingerly brush Frances’s white hair, fine and straight, smoothing it off her forehead in the way she used to do herself.

      ‘There you go, Frances,’ I murmur. ‘Very presentable.’ 

I am speaking to a dead person, but all my self-consciousness is dispelled by the Staff Nurse’s example. 

We ‘dress’ her in a shroud, tucking her hands just under her thighs, and the Staff Nurse ties a neat label with name and other details to Frances’s big toe.  We share a grimace at this necessary indignity.  Then we carefully pull the under sheet from the mattress at the head and fold it down to cover Frances’s face.  We do the same at her feet.  Each side is pulled up firmly and wrapped over her tiny body so that she is swaddled tightly in it – a winding sheet.  We pin it securely with two large safety pins. We cover her whole body with another sheet, left loose.

We stand back.

‘Okay’ says the Staff Nurse. ‘I think we’re finished here, Nurse Walters.  Well done.’ 

We clear all the bedlinen and towels away into the linen skip, pile the pillows on the trolley, empty the wash bowl, check around, making sure everything is tidy.  The room smells of lemons and emptiness.

      ‘There’s one more thing...’

The Staff Nurse turns to the window and pushes the sash up about two inches.  Cold air filters in.  She looks at me and smiles:

      ‘Just enough to let her soul out.’