The Undertaker's Racket

Jessica Mitford's curiosity about undertakers was "whetted by the funeral trade magazines which opened up for me the bizarre world of the 'average' American funeral, far more curious than the death customs of ancient days or remote tribes. Further investigation convinced me that the fall implications of the funeral industry are undreamt of by the average American, even in his nightmares." Her book, The American Way of Death, will be published this summer by Simon & Schuster.
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Some rather solid-sounding sounding justifications for the procedure have been advanced, above and beyond the fact that embalming is good business for the undertaker because it helps him to sell more expensive caskets.

The two most common grounds chosen by the undertaking trade for defense of embalming embrace two objectives near and dear to the hearts of Americans: hygiene and mental health. The theory that embalming is an essential hygienic measure has long been put forward by the funeral industry. A much newer concept, that embalming and restoring the deceased are necessary for the mental well-being of the survivors, is just now being developed by industry leaders. The observer who looks closely will discover a myth in the making here. "Grief Therapy" is the official name bestowed by the undertakers on this new aspect of their work.

Still, the primary purpose of embalming, all funeral men will tell you, is a sanitary one, the disinfecting of the body so that it is no longer a health menace. Several writers for the trade, soaring to wonderful heights of fantasy; have gone so far as to attribute the falling death rate in this century to the practice of embalming (which, if true, would seem a little shortsighted on the part of the practitioners): "It is a significant fact that when embalming was in its infancy, the death rate was 21 to every 1,000 persons per year, and today it has been reduced to 10 to every 1,000 per year." The writer magnanimously bestows "a great deal of credit" for this on the medical profession, adding that funeral directors are responsible for "about 50 percent of this wonderful work of sanitation which has so materially lowered the death rate."

When embalmers get together to talk among themselves, they are more realistic about the wonderful work of sanitation. In a panel discussion reported in the National Funeral Service Journal of April, 1959, Dr. I. M. Feinberg, an instructor at the Worsham College of Mortuary Science, said: 'Sanitation is probably the farthest thing from the mind of the modern embalmer….We must realize that the motives for embalming at the present time are economic and sentimental, with a slight religious overtone."

Whether or not the undertakers themselves actually believe that embalming fulfills an important health function (and there is evidence that most of them really do believe it), they have been extraordinarily successful in convincing the public that it does. Outside of medical circles, people who are otherwise reasonably knowledgeable and sophisticated take for granted not only that embalming is done for reasons of sanitation but that it is required by law.

In an effort to sift fact from fiction and to get an objective opinion on the matter, I sought out Dr. Jesse Carr, chief of pathology at the San Francisco General Hospital and professor of pathology at the University of California Medical School, I wanted to know specifically how, and to what extent, and under what circumstances an unembalmed cadaver poses a health threat to the living.

To my question, "Arc undertakers, in their capacity of embalmers guardians of the public health?", Dr. Carr's answer was short and to the point: "They are not guardians of anything except their pocketbooks. Public-health virtues of embalming? You can write it off as inapplicable to our present-day conditions." Discussing possible injury to health caused by the presence of a dead body, Dr. Carr explained that in cases of communicable disease a dead body is considerably less of a hazard than a live one. "There are several advantages to being dead," he said cheerfully. "You don't excrete, inhale, exhale, or perspire." The body of a person who has died of a noncommunicable illness, such as heart disease or cancer, presents no hazard whatsoever, he explained. In the case of death from typhoid, cholera, plague, or other enteric infections, epidemics have been caused in the past by spread of infection by rodents and seepage from graves into the city water supply. The old-time cemeteries and churchyards were particularly dangerous breeding grounds for these scourges. The solution, however, lies in city planning, engineering, and sanitation, rather than in embalming, for the organisms which cause disease live in the organs, the blood, and the bowel, and cannot all be killed by the embalming process. Thus was toppled, for me at least, the last stronghold of the embalmers; for until then I had confidently believed that their work had value in the rare cases where death is caused by such diseases.

A body will keep, under normal conditions, for twenty-four hours unless it has been opened. Floaters, explained Dr. Cart' in his commonsense way, are another matter; the hospital staff used to burn gunpowder in the morgue when floaters were brought in, to mask the smell, but now they put them in the deepfreeze, and after about four hours the odor stops (because the outside of the body is frozen) and the autopsy can be performed. "A good undertaker would do his cosmetology and then freeze," said Dr. Carr thoughtfully. "Freezing is modern and sensible."

Anxious that we should not drift back to the subject of the floaters, I asked about the efficacy of embalming as a means of preservation. Even if it is very well done, he said, few cadavers embalmed for the funeral (as distinct from those embalmed for research purposes) are actually preserved. "An exhumed embalmed body is a repugnant, moldy, foul-looking object," said Dr. Carr emphatically. "It's not the image of one who has been loved. You might use the quotation, 'John Brown's Body Lies A-Mouldering in the Grave'; that really sums it up.''

The caskets, he said, even the solid mahogany ones that cost thousands of dollars, just disintegrate. He spoke of a case where a man was exhumed two and a half months after burial: "The casket fell apart and the body was covered with mold, long whiskers of penicillin -he looked ghastly. I'd rather be nice and rotten than covered with those whiskers of mold, although the penicillin is a pretty good preservative. Better, in fact, than embalming fluid."

Will an embalmed corpse fare better in a sealed metal casket? Far from it. 'If you seal up a casket so it is more or less airtight, you seal in the anaerobic bacteria- the kind that thrive in an airless atmosphere, you see. These are the putrefactive bacteria, and the results of their growth are pretty horrible." He proceeded to describe them rather vividly, and added, "You're a lot better off to be buried in an aerobic atmosphere; otherwise the putrefactive bacteria take over. In fact, you're really better off with a shroud and no casket at all."

Like many another pathologist, Dr. Carr has had his run-ins with funeral directors who urge their clients to refuse to consent to postmortem medical examinations. The funeral men hate autopsies; for one thing, it does make embalming more difficult, and also they find it harder to sell the family an expensive casket if the decedent has been autopsied. Dr. Carr said, "It's generally the badly trained or avaricious undertaker who is resistant to the autopsy procedure. They all tip the hospital morgue men who help them, but the resistant ones are obstructive, unskilled, and can be nasty to the point of viciousness. They lie to the family, citing all sorts of horrible things that can happen to the deceased, and while they're usually very soft-spoken with the family, they are inordinately profane with hospital superintendents and pathologists."

In a symposium in Mortuary Management of November, 1959, on funeral directors' attitudes toward autopsies, some of this hostility to doctors erupts into print. One undertaker writes, "The trouble with doctors is that they think they are little tin Gods, and anything they want, we should bow to, without question. My feeling is that the business of the Funeral director is to serve the family in the best way he knows how, and if the funeral director knows that an autopsy is going to work a hardship, and result in a body that would be difficult to show, or that couldn't be shown at all, then I think the funeral director has not only the right, but the duty, to advise the family against permitting an autopsy." Another, defending the pathologists ("After all, the medical profession as a whole is reasonably intelligent"), describes himself as a "renegade embalmer where the matter of autopsies is concerned." He points to medical discoveries which have resulted from postmortem examination; but he evidently feels he is in a minority, for he says: "Most funeral directors are still 'horse and buggy undertakers' in their thinking and it shows up glaringly in their moronic attitude towards autopsies."

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