I just found my new signature embalming move, and I’m not talking about those routine six-point injections like when I worked for SCI.

Suspend the body! I’ve never seen anyone do this, but this might still be one of those obvious moves that everyone has been doing for years and I just learned about. If the body is suspended and you can access every angle, while remaining in a comfortable position yourself, you can more easily spot, treat and clean conditions you would otherwise miss. You can suture spinal autopsies and bullet holes. You can dress and wrap a leg and be able to get under and around it from the hip down. It’s also easier to clean the table.

It’s one of those things that I decided to start doing on everyone after a few annoying mistakes. I got called by a funeral home about a body I had embalmed, a gunshot case. They just wanted me to touch up some cosmetics before the second viewing. There was also a bit of an odor, they said, “…but it might not be a big deal because it’s not that bad and she’s being buried in two days.”

A lot can go wrong in 48 hours, especially in a facility without refrigeration on a hot day. And if a funeral director with 35+ years in the business can smell something, most likely the funeral guests can too. I said I’d come by in the morning just to make sure all was well; that the odor may be coming from a punctured plastic viscera bag and I could cut open some sutures, aspirate any fluids, treat everything with more cavity fluid, and fix everything back up with her still in the casket.

But I could immediately see the clothing was wet, and we had to act quickly because the parents were coming for the viewing in two hours. The other director began removing the clothing and hand-washing it in a bucket while I tried to find which of my sutures had leaked. The Y incision and head sutures were intact and dry. Had she simply bled out an ear and all over her dress?

I hooked canvas straps under the body and attached it to the lift in the ceiling and hoisted her out of the casket, because I knew the casket lining had to be wet if the dress was. When I had the body up in the air, I noticed a steady drip falling on the casket lining, a mixture of blood and water and embalming fluid. It wasn’t from her ear. It was from her upper back. On the day I embalmed her, for some reason it didn’t occur to me that a person shot in the chest may also have a wound in her back. It was a small-caliber handgun and the tiny wound, from a bird’s-eye view of the open thoracic cavity, was indistinguishable from her body tissues. I only saw it when I was able to look at her back externally.

This funeral home didn’t have laundry facilities, so the other director was drying the dress, stockings and undergarments with a hair dryer as I worked on the bullet wound, and treated a lot of unnoticed skin slip as well. It was quick, just a lot of sewing and wrapping and taping. The casket lining was trashed but luckily it was a rental casket, so we put in a new lining. The clothing got dry (enough) in time and she was re dressed, re casketed, and fixed up again for her viewing, which I am told went well. And no one ever knew just how closely we came to everything being ruined. The director kept saying “Thank God you were available!” Yeah…to fix my own mistake! I’m definitely glad we fixed everything – and this is why if I embalm someone I will remain available to them until final disposition – but this all could have been avoided if I had taken the time to thoroughly examine all surfaces of the body.

How often have you noticed an odor or leakage a day or so after embalming and it’s coming from a bedsore or skin slip on the back? How many times have you been surprised by an incision in the spine when you go to dress someone? The back is a very large expanse of skin; lots of room for things to go wrong. I imagine taller people don’t have to resort to suspension to examine the whole body, and if I’m working on someone close to my size, I can usually see enough of them just by rotating the upper body at the shoulder.

But it’s one of those steps that I have to take with everyone because of the one or two times I didn’t do it for someone else, and everything was ruined or nearly ruined. Just like using plastic pants on bodies under the clothes. I didn’t always do it on everyone, because those garments have to be obtained from the funeral supply stores so that’s just one more thing the funeral home has to buy and stock and remember to order. But of course, at one service, I decided not to use the pants because I had re-aspirated the body twice and she was in good condition. She was wearing a really nice dress and I wanted it to lie flat, so I just dressed her in the undergarments and nylons provided and sent her off. And then, at some point during the service, after the two re-aspirations and the closure of the abdominal puncture, a small amount of fluid leaked out her stomach anyway, through the underwear and nylons and dress lining and intricate beaded dress and THEN, the offending fluid somehow CONTINUED its course upward and even began to show through the end of a white scarf that was draped over the middle of the dress. On the one day I skipped the plastics. So now everyone gets plastic pants, even if they are severely dehydrated and embalmed hard enough to stand in a corner [like I want to be done].

In the past few days, I’ve put a few cases on the body lift after I was done, and there’s always something worth treating, like a blister or some area of poor distribution. The only downside to doing this routinely is the canvas straps can cause the skin to tear if the person is already in bad shape, but this would only be a problem in cases who are so heavy that I can’t move the upper body at all. Some funeral homes also have hard plastic straps that can easily be sprayed with disinfectant and then just slid under the body.

It’s discouraging sometimes. I start making rookie mistakes, like breaking veins or leaving people with razor burn, and I think maybe I should go to one of those embalming conventions now that they might be starting up in person again. I’ve never been to one, because good luck ever getting a bunch of embalmers together; we’re always on call or working or sleeping. And even more discouraging is when you truly do everything right and even take extra precautions – like re-aspirating twice the morning of the service – and everything is all screwed up anyway. We are dealing with human tissues and usually operate blind, cutting into the body without knowing what’s under the surface. Sometimes, we will be surprised. I still don’t understand how that fluid leak happened. Maybe someone secretly pushed on her stomach.

So don’t ignore a weird odor! It’s probably something urgent that will result in the service being ruined and no one ever forgetting about it. You can try baking soda, cat litter and heavy perfumes but above all, take the body out of the casket and physically look at them, and actually treat any post-embalming conditions that are probably the cause of the odor in the first place. Don’t just throw some plastic over everything and hope no one complains.