Guest-blogger Zivarna Murphy offers a glimpse into the process of memorialising those who have gifted their bodies to medical research.
When thinking about the changing face of memorialisation in Britain and the increasing emphasis on the individual as the Remember Me Project puts forward, I can’t help but question this when it comes to memorialising donated bodies. I have spent the last two years exploring body donation for medical science with a focus on identifying good practice in the interactions between Medical School Anatomy Unit staff (AUS) and families. I’ve had an access-all-areas pass which has allowed me to understand what happens after a body is donated. I think that their memorialisation is not only changing but hidden as many people do not know what happens after a body is donated yet the practice has been happening for years. There is also a collective nature to the memorialisation that happens with body donors in addition to the individual memorialisation. I’ll first outline the process of body donation today and then describe the memorialisation of the donated body.
Body donation today
Yes anatomical dissection does have a shady past of prisoners, punishment and public display but today, in the UK, people can choose to donate their bodies after death for anatomical examination, education, training, and research. When somebody has decided to donate their body they can enter their postcode on the HTA website (https://www.hta.gov.uk/donating-your-body) to find their local medical school. They will then be able to speak to a member of staff who will send a donation information pack and consent form. Hopefully at this early stage the person will discuss their wishes with their loved ones. It is crucial to have their support as someone will need to witness the consent form and inform the medical school at the time of death to make the donation happen.
When a person passes away a call is made to the medical school, usually by a loved one or the individual that has cared for the person at the end of their life. At this point the medical school makes the decision whether the body can be accepted. Many people do not realise that bodies may not be able to be accepted for various reasons such as the medical condition of the individual, or logistical reasons. If the body is unable to be accepted to the initial medical school then another medical school may be able to accept.
The body is kept for around two years, however may be kept for a longer or shorter period of time depending on the medical school, the donor’s wishes and those of their family. During this time the donation is used to its maximum potential, facilitating education, training and research. After this period a committal service is held, which is the equivalent of a funeral, and the donor’s remains are cremated and in some cases buried. At some medical schools the families are invited to this service. The AUS may also attend if the family is happy for them to do so. The ashes are then collected or delivered to the donor’s family if they have asked for the ashes to be returned. When ashes are not collected they are, in the case of most medical schools, scattered or buried at a university owned plot at a crematorium. At the end of the process some medical schools hold a Service of Thanksgiving which gives thanks to the donors and their families.
These processes differ between medical schools and many donors’ families express that they didn’t realise that all this stuff went on. To be honest, neither did I. Most often families express that they didn’t realise they’d have this support from the AUS. They didn’t know that a beautiful ‘proper’ coffin and floral tribute would be provided at the committal service which happens even if no-one attends. Memorialising donated bodies and giving the families an opportunity to memorialise is extremely important to AUS and they put so much effort into facilitating this.
Memorialising donated bodies
So it’s clear that the ‘normal’ post-death process is disrupted for people who donate their bodies. One man said: “Whilst donating a body for medical research, is a wonderful gift, one is left with a strange, almost empty feeling, with no body to bury or cremate.” The funeral is delayed although the family may decide to have a service without the body at the time of death. For some, like the spouse below, this delay influences the bereavement process;
“[…] her husband said he’s been waiting for that day [of the committal service] the whole time and hadn’t been able to move on […]”
Many families decide to attend the medical school Service of Thanksgiving if this is available, as not all schools hold them. In most cases it is an opportunity for the staff and students to meet the families of those who have donated their bodies. Bolt (2012), in her study of memorialising donated bodies in the Netherlands (the only study of this kind), found that AUS had a key part to play in reciprocating the donor’s ‘gift’ of body donation. The committal services and the thanksgiving services are an opportunity for the staff to ‘give back’ and give thanks to the donor’s family;
“I speak to the relatives and shake hands with them and have a bit of a chat and thank them for what their loved one has done for, for the, you know, for the university, for the medical school.”
Often the families find this an important time to reflect on the donation. I spoke to a lovely lady at one thanksgiving service who was the Granddaughter of a body donor. She explained that she hadn’t come to terms with her Granny donating her body until attending the service and understanding what an amazing thing she had done. She found solace in understanding how many medical students and trainee surgeons had benefitted from her generosity. After another thanksgiving service on lady commented that the service “touched my heart, but more importantly healed my heart.” So this is clearly a very important event that helps to make up for the disruption caused by body donation.
This is a collective service which memorialises the donors as a group of people. Families in this situation come together. One person said “I attended on my own, to commemorate my mother’s bequeathals, but soon made several new friends. The atmosphere was extremely friendly, as we all had the one thing in common.” It really does bring people together. I had the most amazing conversations with complete strangers and saw that the commonality of having a loved one who donated their body brought people together.
In addition to the Services of Thanksgiving families often have conversations with the AUS as a way of Continuing Bonds (Klass et al., 1996) with their deceased loved ones;
“We have a gentleman that phones up every six months or so to say is his wife still doing a good job for us (laughs) we assure him that she is […]”
In this case the gentleman retains a connection with his wife by checking in on her. The bond to a deceased loved one may change over time and take on new forms but the bereaved individual still holds on while letting go; an irreconcilable tension. Some families also write letters or send items such as cuddly toys;
“[…] they do quite often have things that stay with them and then go out in the coffin when they’re going for the funeral.”
This contact with the AUS can be seen as a way of Continuing Bonds with their loved one. People also visit the physical memorials that are provided by some medical schools, for example, memorial benches, plaques, books of remembrance, and dedicated plots at cemeteries and natural burial grounds. The image below shows the Hull York Medical School (HYMS) memorial bench after the Service of Thanksgiving 2017. White carnations that were given by the AUS as a token of thanks to the families and friends were left on the bench, which may be a way of memorialising their loved ones. The plaques on the bench read ‘Forever remembered by tomorrow’s doctors’ with the dates of those who have donated.
There are a wide range of ways that donated bodies are memorialised by their families and friends, the AUS, and students. This memorialisation changes and evolves over time which is notable with the ever developing post-donation processes. However, it may be that memorialising donated bodies is not changing but hidden as it is clear that many people, myself included, do not know about the post-donation processes and the work AUS do with the families of donors. I’m sure some of you reading this have learnt something new about what happens within body donation. In absence of a normal post-death process a new one has been put in place and this is not a recent tradition as some medical schools have held thanksgiving services for many years, which is a key way of memorialising the donated body. The AUS go out of their way to make sure the experience of body donation is positive for the donors and their families. I really can’t express what a privilege it has been to spend time with the wonderful staff that work in UK anatomy units and the opportunity to access-all-areas and understand the post-donation processes. I didn’t know this all went on and I encourage you all to find out more – the HTA website (mentioned earlier) is a good place to start or there are some great television programmes, for example ‘Body Donors’ on Channel 5.
Bolt, S. (2012) Dead bodies matter: gift giving and the unveiling of body donor monuments in the Netherlands. Medical Anthropology Quarterly, 26(4): 613-634. DOI: 10.1111/maq.12010
Klass, D., Silverman, P. R. and Nickman, S. L. (eds.) (1996) Continuing bonds: new understandings of grief. London: Routledge.
Zivarna Murphy is a postgraduate research student within the Supportive Care, Early Diagnosis and Advanced Disease (SEDA) research group at the Hull York Medical School. She is currently exploring body donation for medical science with a focus on identifying good practice in the interactions between Medical School Anatomy Unit staff and families. She has research interests within public engagement with human remains, death and the dead, and body donation for medical science.