Pat Sullivan / AP

Sarah Krebs is used to corpses going missing. As a detective who works in the missing-persons unit in Detroit, she has solved dozens of cases by matching up disappeared people to unidentified bodies left in state custody. But for older cases in which the county was supposed to have buried the body, Krebs says it’s common for her to order an exhumation from the local cemetery and discover that the body she’s looking for is not there.

Anywhere from a few days to a few years later, those bones might turn up in a separate burial plot, or in a box on a medical examiner’s shelf, or in a law-enforcement evidence room, or in a county employee’s house. “I have multiple, multiple cases where we thought the body was buried and we found a couple days later that someone had it at home,” Krebs says.

The reason for this morbid confusion is that the United States is enduring a cadaver pileup. Medical examiners around the country are being overrun with bodies that no one comes to pick up, a trend that many coroners attribute to the nation’s opioid epidemic. Drug-overdose deaths increased by 10 percent from 2016 to 2017, largely driven by fentanyls and similar drugs, according to the Centers for Disease and Control and Prevention. Now medical examiners in cities such as Detroit process dozens of new remains each day. And as Krebs has encountered, some of those bodies can slip under the radar.

The bodies that remain accounted for, meanwhile, float in and out of state custody. No one is quite sure what to do with them. The United States has no uniform system for managing the unclaimed. There is no federal law outlining what steps to take, and many states do not have clear procedures, leaving individual medical examiners to make decisions about how to best deal with the bodies. As a result, examiners without money to simply bury or cremate the remains are resorting to inventive—and strange—solutions.

Among the unclaimed bodies processed in the United States, some are the unidentified remains from missing-persons cases like the ones Krebs works on, but the majority belong to people who were estranged from their family while they were alive, according to Kenna Quinet, an associate professor at Indiana University—Purdue University Indianapolis who co-wrote one of the only academic articles on unclaimed bodies. In most of these cases, the identity of the victim is known, but coroners or funeral directors can’t contact the next of kin, or the next of kin was reached and either doesn’t want the body or can’t afford to bury it. The unclaimed population skews poor and homeless.

Policy makers have rarely backed programs that would set clear terms for the management of the unclaimed, which has left coroners to cycle through a grab bag of disposition methods once a body enters their custody. Coroners often opt to cremate unclaimed remains to save money—burials cost at least twice as much—but some states don’t allow coroners to request a cremation for fear that it could infringe on the deceased’s religious values. In smaller counties that have fewer unclaimed bodies, bodies are kept in coolers; those that are cremated are left in boxes or in a coroner’s closet.

Los Angeles County has one of the more organized systems. There, unclaimed bodies are cremated if no one comes to retrieve them within a month of death, after which the cremains are kept in the county coroner’s office for another three years, according to the Los Angeles Times. If by that point no family has reached out, the cremains are buried alongside more than a thousand others in an annual interfaith funeral.

But because of a lack of funding, counties cannot always afford to pay funeral directors to cremate or bury unclaimed bodies. Only 14 states devote money to funeral costs for unclaimed bodies, and it rarely covers the actual volume of bodies that coroners and funeral directors face. West Virginia, which has the highest rate of opioid deaths in the United States, has run out of funds two years in a row, the state’s Funeral Directors Association told me. And while some counties and towns provide funds in addition to the state’s contribution, many don’t.

That has left cash-poor cities like Detroit to scatter remains in haphazard ways. Shortly after the financial crisis, according to Krebs, the county medical examiner stashed unclaimed bodies in a refrigerated semitrailer in a back parking lot, a last resort usually reserved for disasters like Hurricane Maria. Two funeral homes the City contracted with are currently under investigation after some bodies were found unburied. When unclaimed bodies are in fact buried, Krebs says, the process is cheap and unglamorous: In some cases, cemetery workers have “dug a trench and lined up body bags.”

Other cities have similarly drawn ire over their burial of the unclaimed. In 2015, Washington, D.C., discovered that, in some cases, the funeral home that the City paid to bury its unclaimed bodies had simply dumped the remains in unmarked graves beside trash cans. (The funeral home claimed that it followed the terms of its contract.)

Placing even more strain on medical examiners is the fact that a centuries-old method for clearing out unclaimed bodies—donating them to medical schools—is often no longer viable. Many states have long relied on donations, a tradition that surfaced in the 19th century following a series of riots against the then-common practice of robbing graves to supply bodies for anatomy research. The resulting Anatomy Acts, which passed in many U.S. states in 1831 and 1832, allowed medical schools to dissect “unclaimed bodies.” But as the historian Michael Sappol has written, many of these bodies were simply people who couldn’t afford burials. New York banned unclaimed-body donations in 2016 after an outcry, and even in states where handing over unclaimed bodies is legal, many medical schools now refuse to take them.

All this means that solutions for managing the dead are getting weirder and more controversial—though not necessarily worse. While Tennessee gives some unclaimed cadavers to “body farms” where researchers study decomposition, New York has buried more than 1 million unclaimed bodies on its inaccessible Hart Island, a 100-acre strip of land north of Manhattan. States such as North Carolina cremate unclaimed remains and scatter them at sea. Dallas, which is also overrun with unclaimed bodies, briefly debated liquefying remains through an environmentally friendly process known as alkaline hydrolysis. That initiative failed after lawmakers expressed revulsion for the technique, which reduces human bodies to a brownish liquid and a set of bones.

In the meantime, some people are attempting to limit the number of bodies that go unclaimed in the first place. NamUs, a federal missing-persons database that has recently expanded to include unclaimed bodies, for instance, is attempting to make it easier for medical examiners to match unclaimed remains to missing persons. According to NamUs’s communication and case-management director, J. Todd Matthews, unclaimed bodies are often reported missing in a state other than where they actually died, but medical examiners don’t have direct access to the National Crime Information Center’s missing-person database. NamUs hopes its own database can provide an alternative search tool when medical examiners wind up with bodies whose family they can’t locate.

Still, many medical examiners don’t know NamUs exists, according to Matthews. Until any sort of procedure is standardized, unclaimed bodies in cities that see a high number of dead will continue to float from office to office, home to home, refrigerated truck to refrigerated truck. When Krebs needs to test the DNA of an unclaimed body for a missing-persons case, she will have to keep racing from building to building in search of the transient dead. And she won’t be surprised to find the bones she has been looking for in a glass display at a local university. She’s solved cold cases that way.

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