A Mortician Talks Openly About Death, And Wants You To, Too

Transcript

TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross.

As a licensed mortician, my guest Caitlin Doughty is trying to reform how we handle the death of loved ones and prepare for our own. She's the founder of The Order of the Good Death, a group of funeral industry professionals, academics and artists that focuses on rituals we perform for our dead and how we dispose of dead bodies and it showcases people at the forefront of change in the funeral industry. Doughty also has her own Web series called "Ask a Mortician" in which she answers questions on a wide range of subjects, including home death, pet death, necrophilia and what happens to breast implants and titanium hip replacements after a body is cremated.

She started her career working as a crematory operator for a family-owned mortuary. She'll soon be starting her own funeral service in LA. She has a new memoir called "Smoke Gets In Your Eyes: And Other Lessons From The Crematory."

Caitlin Doughty, welcome to FRESH AIR. So before we talk about death and working at a mortuary, I want to talk about how we're going to talk about death (laughter).

CAITLIN DOUGHTY: OK.

GROSS: So you've been exposed to some beautiful and some gruesome things in your work. You've handled a lot of corpses, some in better shape than others. I know some people who are listening will be upset if we talk graphically. What is your philosophy about how to speak about the physical remains of the dead and what is done to them in the process before burial or cremation, without seeming disrespectful of the dead and the dead's living loved ones?

DOUGHTY: My philosophy is honesty. I think that we've been so hidden from death in this culture for such a long time that it's very refreshing and liberating to talk about death in an open, honest manner. And I don't use vivid details to try and get a rise out of anyone, that's not the intention. But I don't think that there's anything wrong with open discussion because frankly, there's a lot of facts, in quotation marks, now in our society and in the way we discuss things. And so removing the quotation marks and having it being facts in the tangible, in the concrete - even if it's about something kind of disgusting and kind of visceral and kind of threatening, like death, I still believe it's the best policy.

GROSS: So your first job in the death business - if I may call it that - was in a mortuary actually cremating the corpses. What was your image of cremation before you actually worked in a crematory?

DOUGHTY: I think it was probably more romantic than it actually ended up being. I thought of the idea of - I mean I knew they were machines, but I still had this connotation of the open-air pyre and leading the body to it and placing it on the pyre and everybody's weeping and it's beautiful. But the reality that I found is that modern crematories are really industrial environments. And you - the body goes into large industrial machines and often times, I was the only one there. And it's hot and it's dirty and you get covered in dust as you're working and it was much less...

GROSS: By dust, you mean the ashes of the corpse?

DOUGHTY: ...I mean the ashes of the corpse, yes. Jumping right into the honest talk. Yeah, it's the ashes of the corpse, which are actually inorganic bone fragments, which means that they are the organic material that is the body. Which is - your organs, your flesh, the clothes that you're wearing all burn up and - what's left is inorganic bone and that's what we actually know of as ashes. And there's so much of it that it can - when you're taking it out of the machine - get on you and get into strange little places that you didn't even know you had to get dust on your body.

GROSS: So it wasn't the romantic image that you have of the body being transformed into ash?

DOUGHTY: No, it wasn't - I mean, the idea is that the body is purified by fire and that is true, but the actual working environment was not very romantic, no.

GROSS: What is the temperature of the oven?

DOUGHTY: It depends. It usually - in California, it has to be over 1,500 degrees Fahrenheit. So that would be - when it got over that temperature that's when I would load in the body, but it can get up to 1,800 degrees.

GROSS: So you mentioned that the ashes - the dust - would sometimes - would often get on you. Being covered with the dust of human remains, what's the emotional impact of that? Dealing with that, you know, day in and day out over the course of time that you were working there?

DOUGHTY: It's interesting that it kind of - you get used to it in a way. And I don't mean that you get callous, but you do - it becomes just a reality of your workplace because if you really took it in, in the sense of thinking, ah this is the dust of a man who is no longer here, we are all mortal. You know, if you did that every morning with your cup of coffee while you were cremating your first body, you wouldn't be able to do the work. You really have to look past that and sort of just see it as an occupational hazard.

And that doesn't mean that working with the bodies and working with the family loses its impact over time, but it just means that you can't take in the full existential despair of it every time, or you just wouldn't be able to come to work every day.

GROSS: So one of the things you do is recommend better practices. You know, what you'd consider better practices and more organic practices when it comes to the process surrounding, you know, dealing with the corpse and you know, burying or cremating.

So when it comes to cremation, what would you like to see changed?

DOUGHTY: If I could see anything change, it would be the level of involvement of the family in the death rituals because when I was working at the crematory, the most shocking thing to me wasn't so much the decomposing bodies or the strange bodies that I saw. It really was that I was alone there and I was sending all of these people off to their - to their final you know, disposition in the crematory machine and there was no one there. And it didn't feel right because I didn't know these people. And it was an honor and I took it very seriously. But, the times when families did come - and that's called a witness cremation, which is something you can ask for at your local crematory or your funeral home - when there was a witness cremation and the family was there and they sat with the body and they took the time and they pushed the button to send the body into the flames, it was an incredibly powerful experience because they took responsibility for that body. And they took responsibility for that death and for that loss to the community. And that to me is the thing that we've lost and that's - it's most crucial that we get back.

GROSS: You know, I didn't even know that that was an option.

DOUGHTY: A lot of people don't. And it's not - when I say that, it's not intended to be blame-y, like, oh you just abandoned this body, because when I talk to people about this a shocking number don't realize that they have all the power in the world with the dead body. The corpse is actually considered quasi-property, which means the family or the person who is in charge of the dead body, the closest to next of kin, essentially owns that dead body. It doesn't have to go immediately to a funeral home. It doesn't have to go out of their hands. They have an incredible amount of power to take the time and decide what they want to do with that dead body.

GROSS: So just one more thing about the idea of the witness cremation - I would guess that most crematories are not really designed to have the family and friends gathering around the oven. And it might be such - a kind of unpleasant environment for an emotional send-off like that since it's not designed for that.

DOUGHTY: Some crematories are better than others. I think it's good for us to be moving towards crematories that are absolutely designed for that, that have big, beautiful skylights and ability to play music. You know, who wouldn't want to be sent off with chanting in the background or Wagner playing or something that meant a lot to the deceased person? And candles and flowers, and all of these things that - yes, the crematory machine is a big industrial machine, but ways to not cover it up but to make the family just generally comfortable in the environment while still feeling like they're very present for this somewhat difficult but necessary thing.

GROSS: If you're just joining us, my guest is Caitlin Doughty. She's a licensed mortician and author of the new book "Smoke Gets In Your Eyes: And Other Lessons From The Crematory." She's also the founder of the website Order of the Good Death in which she does her Web series, "Ask a Mortician" and she is the co-founder of the Death Salon. As you can see, she's really immersed - not only in contemporary death practices, but in like, the history of how people have dealt with corpses. Let's take a short break and then we will talk some more. This is FRESH AIR.

(MUSIC)

GROSS: This is FRESH AIR. And if you're just joining us, my guest is Caitlin Doughty. And she's a licensed mortician, has written a new book, "Smoke Gets In Your Eyes: And Other Lessons From The Crematory." And she is also very interested in the history of how different cultures and religions over the centuries have dealt with corpses. So she's very deeply immersed in all things death. We were just talking about cremation. I want to talk with you about the obvious alternative, which is burial. What direct work have you done with practices related to burial?

DOUGHTY: Since I live in Southern California and was in Northern California before, California is primarily and increasingly a cremation state. So I've done more cremation than anything else. But I did go to school to be an embalmer in something called mortuary school, which is a real thing. And you learned to be an embalmer. And embalming is the practice that the American funeral industry was essentially built on. And it's preservation - short-term preservation - of the body for a viewing. And then the body goes in the casket, and the idea would be that you were buried after you are embalmed. But my personal opinion is that we should be moving towards not embalming unless it's absolutely necessary - because it is a - it is a chemical process, and it can be an expensive process for the family - and return more to just the body as it naturally is and letting it be buried without a big vault and without a big casket and without embalming, just straight into the ground in a shroud or decomposable casket and be allowed to go back into the earth.

GROSS: So there's a movement now to just put the body straight in the ground and to bypass the coffin and certainly the embalming.

DOUGHTY: Yeah, there absolutely is. There's a movement not only to do that, but to also take care of the body yourself, in the home - so in a way, bypassing the funeral director and the mortuary entirely.

GROSS: And you're an advocate of that.

DOUGHTY: I am. I am a mortician who tells you that you don't necessarily need a mortician.

GROSS: So it, on the one hand, sounds kind of simple. Like, take care of the corpse at home. But one, I don't know what that entails. And two, it does sound almost like a frightening responsibility because how many of us have actually handled corpses and prepared them for burial? I mean, what are you taking on if you take that on?

DOUGHTY: It's - it might be a frightening responsibility. But it's also a really incredible responsibility because first of all, we've been led to believe that dead bodies are dangerous in some way, which - for the most part, they're absolutely not, especially a body that would die at home is going to be a very safe corpse. The bacteria that cause decomposition are not the bacteria that cause disease. You're not going to catch a disease from a dead body that you're taking care of. And there are two reasons that I think taking care of a dead body yourself are so powerful. The first reason is that this is somebody that you loved. And over a period of a day or two days or however long you keep them in your home, you get to see them change in little, subtle ways. You can see almost the life leave them. You can feel the body growing colder. You can see that this person that was a part of your community and a part of your life is not going to be there anymore. And you can take the time to address any feelings that that might bring up. And then, the second thing is that if you don't really see any dead bodies, it's hard to know for sure that you're going to die. And when you have the opportunity to be there with a dead body and really look it in the face and stare your own mortality in the face, it's a real clear message that you too are going to die. And that message is missing from a lot of our culture right now. And I would argue that this is one of the best ways to get that back.

GROSS: I'm thinking, as you're speaking, about whether I'd want to see those changes in the body that you're talking about, whether I'd want to see the life slowly leave and the body transform and grow cold, whether I'd want that to be my last memories of somebody who I loved.

DOUGHTY: Well, I would argue that it's more threatening...

GROSS: And you know how sometimes memories like that overpower other memories? And you fear, like, this is what I'm going to be left with? This is going to be, like, the default image I have in my mind 'cause it's the last image.

DOUGHTY: People who have what's called home wakes or home funerals almost universally really have a glowingly positive experience because any - any hesitation with seeing the body really is overcome as it happens, especially if you're washing the body, if you're washing the hair, if you're dressing the body. It's incredibly empowering, and you feel like you are doing the absolute best thing you can for that body. And you feel involved, and you feel like you are - you are giving something back to this person that you loved. And you're able to say your goodbyes in this meaningful way. So very, very infrequently - in fact, never, for me, have I ever heard someone say, I sat with a body for two days and gosh, I wish I hadn't done that. Now I only see these terrible, terrible flashes of their dead body. The times that I do hear that are when somebody only sees them at the hospital and then leaves or only sees a body heavily embalmed with makeup and only is in there for five minutes and keeps that memory in their head. People who really spend the time with the body over a longer period of time really rarely have that experience.

GROSS: And how long is it OK to keep a body at home before you're going to start to see things that you wish you hadn't?

DOUGHTY: Well, that depends on - first of all, it depends on where you live. And is it the dead of winter? Is it really humid? But the best thing you can do is put the body on some dry ice because refrigeration and lower temperatures really, really, really slow down the rate of decomposition. So if you have that body on some dry ice, that can really keep it fine for, you know, 36 hours, 48 hours, you know, up to three days, four days. Usually, families choose one to two days to have the body at home. But if you want it much longer, there are ways to do that.

GROSS: You went to mortuary school and studied embalming. And you left that program not wanting to embalm. What happened at the school that changed your mind about embalming?

DOUGHTY: Well, I think I did know before I went to school that I - that I didn't necessarily agree with it. And I think things that happened at school just confirmed that for me. It's a very - it's a very invasive process. And a lot of people don't realize that. It involves removing the blood from the circulatory system through a vein and then putting chemicals, including formaldehyde, to replace the blood. And then it also involves penetrating the internal organs and putting chemicals there as well. And for me, it doesn't seem necessary. If you're shipping a body to Germany or something, you probably want to embalm it, or if there's some reason that you need to preserve it for a long period of time at the coroner's or medical examiner's office or for a medical school study, perhaps. But other than that, if you're just going to have it at a wake and then bury it, it doesn't really make sense to have this environmentally unfriendly and invasive procedure done.

GROSS: And the corpses that you practiced on in school were the corpses of indigent and homeless people.

DOUGHTY: Yes, people who had died without families to take care of them in Los Angeles County would be used as embalming lab practice for us.

GROSS: What was that like for you as the student?

DOUGHTY: It didn't sit particularly well with me. I understand why they did it because if you believe very strongly that we need a corps of trained embalmers out there in the world, then you believe that we need to have these bodies in order to make them the best embalmers that they can be. But if you're - if you're someone with my viewpoint, which is that maybe we don't need as many embalmers as we have, it seems, you know, like we were talking about earlier, being able to imagine the death that you want; I'm pretty sure that this is not the death that these people would have wanted.

GROSS: Caitlin Doughty will be back in the second half of the show. Her new memoir is called, "Smoke Gets In Your Eyes: And Other Lessons From The Crematory." I'm Terry Gross, and this is FRESH AIR.

(MUSIC)

GROSS: This is FRESH AIR. I'm Terry Gross back with Caitlin Doughty, a mortician who has written a new memoir called "Smoke Gets In Your Eyes: And Other Lessons From The Crematory." She's trying to reform how we handle the deaths of loved ones and prepare for our own. She's the founder of the group The Order of the Good Death and hosts the web series "Ask A Mortician." She used to work as a crematory operator for a family-owned mortuary.

You actually recently left the mortuary where you were working to start your own business. What's your ambition with the business that you're starting?

DOUGHTY: The ambition is to - it's called Undertaking LA. And the ambition is to educate people on what we've been talking about - on their power and ability to take care of a lot of the things around death themselves and within their own family and using the funeral industry as a tool for the parts that they maybe don't want to do or are perhaps not comfortable with - but knowing all the things that they are legally and physically and emotionally and mentally capable of doing themselves.

GROSS: And so will you be, like, part-undertaker and part-teacher and hand-holder?

DOUGHTY: That's the idea, yes.

GROSS: So at the pretty typical funeral now in the United States, after, you know, your loved one dies and the body is being, you know - the body has been taken to the funeral home, you're supposed to bring clothes to dress the body in - assuming there's going to be any open casket aspect to it, even if it's just opening it briefly for the immediate family. And then you have to decide, what are the appropriate clothes to bring? Should they be formal clothes or casual clothes - their favorite outfit? And that becomes a very kind of meaningful choice even though - you know how difficult that choice is, right? So I just wonder what you think of dressing the body in clothes.

DOUGHTY: I do think that it can be incredibly meaningful. I think that sometimes families make choices - make idealistic choices. They make choices based on the person in their prime, when they were either a lot skinnier or a lot healthier and more robust than the dead body in the funeral home actually is. And that can be problematic because we have to find a way to get them into the clothes. And some funeral homes will just cut the clothes up the back to get the body into it. I've never worked at a funeral home that did that, but it does happen. I don't know. Clothes are an interesting thing. I think there's also a lot of opportunity for the family to be involved there as well - not only in picking the clothes but in dressing the person because it has a very tangible, ritualistic aspect to it.

GROSS: You know, the idea in open casket funerals is usually to make the corpse look as much like the person did when they were living, and that includes, you know, maybe some makeup, you know, just - tell us what it includes actually. You know more than I do.

DOUGHTY: (Laughter) Right. Well, if it's an embalmed corpse, the embalming fluids have usually some kind of pinkish tint in them to try and make the body look a little more - they don't say life-like anymore because they think that's a negative connotation for obvious reasons. They say natural. So they're trying to make the body look more natural, and then they have special mortuary makeups that are used for embalmed skin, which is very, very taught and very tight, much more so than a living skin. It's not very pliable because the proteins are fixed. That's what happens in embalming.

And as to whether or not the presentation of the embalmed corpse is comforting really depends on the viewer. There's a lot of people who come in and say, oh, my God, she looks beautiful. She looks, you know, better than she did when she was alive. And then there's another big portion of people who think, oh, my gosh, why does she look waxen? Why does she look - she never would wear her makeup like that in real life. She never would do that. This is a really uncanny valley, uncomfortable thing. So embalming is really in the presentation of the corpse in that way - of the beautiful corpse is really a polarizing thing.

GROSS: We've talked a little bit about some of the practices you'd like to see changed in the funeral industry. What are some of the practices you'd like to see changed that you haven't already mentioned?

DOUGHTY: I would like to see there be different options for body disposal or disposition, as we call it in the industry. And one thing that is starting to happen is called alkaline hydrolysis. And it started to be used in medical schools like the Mayo Clinic and UCLA to - as a way to dispose of their bodies - medical school bodies. And it's starting to be used in very few states now in funeral homes.

And what it is is dissolving the body in a very hot water and lye - the base chemical lye. And it's billed as an alternative to cremation - cremation by water, as opposed to cremation by flame. And it is more environmentally friendly, and people tended to choose it, they found, because they like the idea of disposal by water as opposed to disposal by flame because they think that cremation is the only option. But there are other ways to have the kind of same effect without actually using flame.

GROSS: Does it take a big, emotional toll out of you to be surrounded by death all the time?

DOUGHTY: It does, but I take really good care of myself. I have a therapist. I do yoga. I read a lot. I write a lot - because it can take a lot out of you and especially if you consider the job as more than just a trade. There are some people in the industry who are very good at their jobs, but they very much consider it a trade. They go into work. They make money. They prepare the bodies. And that's what they do.

And I don't see it that way. I see it in the larger, cultural context. And if you're not taking really, really good care of your self - because not only are you dealing with the dead bodies, you're dealing with the incredible sorrow of the families and the fact that they can get very mad at you. They can - they can respect you and like what you do, but they're angry that somebody has died. And they're looking for somebody to take it out on. So you spend a lot of your day as a funeral director eating crow in a way and backpedaling and apologizing for things that aren't necessarily your fault and taking on their sorrow. And you have to take really good care of yourself or you just - the dropout rate in the industry is incredibly high because if you're not doing that, you won't make it.

GROSS: So, you know, you have a very popular website and blog. The website is called The Order of the Good Death, and your web series on there is called "Ask A Mortician," which you have videos asking - you know, answering questions that you've been asked. And you're really into, you know, just, like, looking as a reality and just kind of accepting that this is what death is opposed to, like, trying to hide from it or protect yourself from it.

At the same time, we now have the option - the grotesque option of seeing hideous, ugly, vicious death. And I'm thinking specifically of the beheading videos that ISIS has - you know, has released. And, you know, people have had the option of watching that if they've wanted to. They've been warned by all kinds of people not to watch, but I wonder as somebody who's, you know, trying to get people to, you know, examine what's death really is - what goes through your mind when you hear about these - these - this grotesque theater? And...

DOUGHTY: Yeah.

GROSS: ...Of the desecration of life and death that those of videos signify.

DOUGHTY: Yeah. I'm very comfortable with seeing dead bodies, and I'm very comfortable with death. But there is no way in the world that I would choose to watch one of those videos. And - because there's a huge difference between violence and the psychological terror that they're trying to create with a video like that and a dead body in its natural state.

Death in its natural state can be very beautiful. When you think about a body that's died of natural causes - family taking care of it - all of that is very beautiful. But that in a way almost has nothing to do with death being used as psychological terror.

And one of the ways that they have been able to - anywhere in the world where people are using terror or using means - psychological means - they're taking death, and because we are so uncomfortable with death as it naturally is, hijacking death for that purpose is going to be that much more powerful. And it's going to be that much more difficult to see and that much more damaging to our psyche and to our morale. And I think that anybody doing that knows that. And is - as a culture, if we were more comfortable with death as it naturally is, there wouldn't be this kind of perverse, theater element to videos like that.

GROSS: So one more question for you. In your web series, "Ask A Mortician," people have compared how you look to, you know, the daughter on "The Addams Family" because you have, like, really dark, straight, black hair and those bangs and a slightly Goth look about you. And I'm kind of curious why you're doing that in the sense that, you know, the whole Addams-family look and kind of Goth - like, Goth is a kind of, like, stylish death kind of thing. And the Addams family is a kind of comically ghoulish thing. And so I'm just kind of interested in why you'd want to flirt with the possibility of having those images surrounding what I think you - you practice very soberly which is, you know, dealing with - dealing with death.

DOUGHTY: Right. The honest answer to that is that, for me as somebody who is very passionate about this and is trying to help forward and create a movement around this, I'm also - because I'm younger - I'm also cognizant of what brings people in the door. And if I think that if I was just making videos of myself saying, here's how you wash and prepare a dead body, I don't think those videos would get people to watch them. I think that humor gets people to watch them. I think cultural references gets people to watch them. I think me being friendly and young gets people to watch them. And I'm willing to do what it takes to get people to hear about it - about this and to get people in the door.

GROSS: You also have a natural theatrical flair. (Laughter).

DOUGHTY: I do. I did theater in college. And yes, I do. And I like - I'm passionate about this academically. But I'm also passionate about presenting it in a way that makes people consider it and makes people not so afraid of it. If I'm a friendly face and if I am someone that they think that they could be friends with, that will make them more willing to consider the possibility of facing death.

GROSS: Well, Caitlin Doughty, thank you so much.

DOUGHTY: Thank you.

GROSS: Caitlin Doughty is the author of the new book "Smoke Gets In Your Eyes: And Other Lessons From The Crematory." You can read an excerpt on our website freshair.npr.org. Coming up, rock historian Ed Ward shows us how rock and roll, swing and country came together to form the Bakersfield Sound. This is FRESH AIR. Transcript provided by NPR, Copyright NPR.