All the Living and the Dead: A Personal Investigation into the Death Trade 
by Hayley Campbell.
Raven, 268 pp., £18.99, March, 978 1 5266 0139 1
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This is​ what happens when you die. Electricity stops flowing through your neural circuitry and consciousness shuts down as though a switch has been flicked. Blood keeps moving for a while, ebbing without the heart’s propulsion before succumbing to gravity and pooling in the lower back where it congeals. Starved of oxygen, cells are dismantled by enzymes with nothing else to do now life is at an end. Three or four hours later the cooling body enters rigor mortis. Muscles lock and eyelids stiffen, followed shortly by the face and neck. Another few hours and all softness and suppleness has vanished – but within a day or so everything relaxes in the same order it seized up. Not that it’s an entirely dignified restoration. Lips shrivel, the nose twists and cheeks migrate to the ears. Eyeballs deflate and sink into the skull. It’s not all bad news, though, because the tension, worry and pain of existence will have drained from your face. You look serene, unbothered, content. You’re off the hook.

During this process, there’s a good chance you won’t be alone, or not for long. Quite a few people will participate in the removal, inspection and disposal of your corpse. Their work is discreet and business-like. By and large, they’re anonymous. Most people in the developed West hide from the reality of death, and those who don’t, those who make a living from it, are hidden from us. Hayley Campbell wants us to peer into this strange world, not least because it’s where we’re all heading – 55 million of us annually, more than six thousand every hour. Startling and affecting, her candid, compassionate investigation is based on interviews with those who work with dead bodies. We can spare ourselves by closing the book – but we shouldn’t, because Campbell is scared too and has cared enough to do the work in the sincere belief that it will do us good. Nor has she brought us here only to meet the corpse-handlers: we are here to see corpses, the past beloved, who, for all our fond feeling, might as well be monsters.

We know death is there – over the horizon, round the corner, tugging at our sleeve – but, as La Rochefoucauld observed, we cannot stare directly at it, and when we finally do it’s only because we can’t help it. Until then we contrive to disguise dying with art and literature, spirituality and religion. Death is personified as an adversary, as in The Seventh Seal, sometimes faced down by love, as in Romans 6:9 where death ‘hath no more dominion’, a tyrant deposed by Christ. Dylan Thomas made a poem from this bit of scripture, joined to the hope that ‘Though lovers be lost love shall not’ – a secular prayer also given expression in Larkin’s ‘An Arundel Tomb’. Among extinction’s consolations, the fiction of the afterlife reigns supreme. The dead bask or lurk beyond the veil, or they haunt us as ghosts and revenants, behaving in the only way we can reasonably imagine: as though they were still alive.

In previous ages, death was not taboo. The memento mori of funerary sculpture – skulls, scythes, rapidly draining hourglasses – exhorted the living to live well. The medieval trope of the danse macabre did a similar job, showing kings and bishops being dragged off with peasants and paupers; the aesthetic of ‘death be not proud’ came later. After 1700 an iconography inherited from the days of plague was superseded by romantic angels and weeping willows, broken columns and ivied urns. We’ve not really moved on.

Campbell’s conversations, in back rooms and offices, diners and cafés, as well as in areas for the storage, preparation and dissection of bodies, reveal how little time (or room) the death trade has for euphemistic symbols or rituals. She sallies forth like a foreign correspondent, touring Britain by train and roughing it on trips to the US. You get lost in the travelogue only to find yourself contemplating the dualism of mind and matter, the mysteries of consciousness (and its termination), the illusion of selfhood and the glum fact that minus the spark of life we’re just meat. It’s perplexing – but also sobering and, viewed through Campbell’s sympathetic lens, uplifting.

Her episodes tend towards the clinical or the macabre, though the distinction blurs as we grow more familiar with the dead. Her desire to ‘shrink the size of death to … something I could handle’ takes a literal turn when a mortician in Lambeth asks her to hold the fridge-cold hands of a forty-something man called Adam, so that his T-shirt can be removed and given to his family. She looks at, rather than into, ‘his half-open sunken eyes that clung to the corners like oysters in their shells’. Sallow skin is speckled with brighter signs of decomposition: ‘the sight of microbial life taking over a human one is almost luminous.’

Adam’s laying out is methodical yet respectful, like the work of the embalmers who make bodies on the turn look their best. They are meant to appear as though they’re sleeping – sleep and death being ‘pictures’ of each other, as Lady Macbeth says. Kevin, based in Croydon, removes hospital tags and tubes, fits caps beneath the eyelids, secures the jaw and, if limbs need repositioning, snaps the bonded proteins in the joints. Next, he slides a tube into an incision in the carotid artery and switches on a machine that pumps candy-pink embalming fluid into the body. This takes forty minutes. Then he packs the nose and throat with cotton wool, drains liquid from the chambers of the heart, punctures internal organs to stop them swelling with gas and fills the stomach with a hardening compound. The process is grisly, the results miraculous: the body looks composed, its pallid skin flushed pink.

Embalming has a long history. The Egyptians did it, yet by the late 18th century the skill had been lost. Benjamin Franklin speculated that a body might be preserved in a vat of madeira (then revived after a century to see how America had changed), and in 1805 Nelson returned from Trafalgar pickled in brandy. A few years later, when Jeremy Bentham decided he wanted to sit for ever in a glass case at University College London, the embalmer’s art was still in its infancy, which is why Bentham’s head is made of wax and the real one is still in a jar. Embalming took off in the US during the Civil War because of the vast distances bodies had to travel without refrigeration. The physician who perfected the technique charged a hundred bucks a piece and displayed the corpse of an unidentified soldier in the window of his shop to drum up business.

Embalming is now more popular than ever, especially since, as the vice-president of the British Institute of Embalmers explains, funerals take longer to arrange than they used to, and waning religiosity means that all you have is a body and the lingering sense that the person still exists, rather than a conviction that their soul has relocated to paradise. Some fear that, in the vein of Jessica Mitford’s 1963 exposé The American Way of Death, funeral parlours exploit the bereaved, much as mediums are said to do (though the defence is similar: like counsellors they help people come to terms with loss). A more substantive concern relates to the amount of carcinogenic embalming fluid that ends up in the ground: three million litres a year in the US. As Campbell discovers, the formaldehyde gas that escapes during embalming is horrible. Heavier than air, it sticks to your skin, hair and clothes.

Unless you’re Lenin or Mao or one of the Kims, once the farewells are over it’s time for burial or cremation. At Arnos Vale cemetery in Bristol, Campbell meets gravediggers Mike and Bob, known locally as ‘Burke and Hare’. They use a mini-digger if there’s access; otherwise it’s most of a day toiling with spades. They share tricks of the trade: fine soil for scattering into graves is gathered from molehills, clay being too sticky. Six feet under, they maintain, is too deep for worms. In the UK, cremation is chosen for three-quarters of all funerals; a century ago it was fewer than one in two hundred. Campbell goes to Canford Crematorium in Bristol to explore ‘the industrial end of death’. Coffins are shoved into a brick-lined oven ‘as ravaged as the surface of the moon’ to be blasted into charcoal, while Tony and Dave, nose-blind to the odour of steamed clams, sit around with tea and muffins waiting for the next delivery in the hydraulic lift. Tumours are apparently hardest to burn and glow like gold in the inferno. Outside, as mourners file from the chapel, the filtered smoke is invisible.

Another way to remember the dead is through a death mask. Nick Reynolds, an artist and musician in London, begins by doing the hair, then covers the face in moisturiser before applying blue dental alginate and plaster bandages for rigidity. After twenty minutes, he shakes out the head and lines the mould with polyurethane resin mixed with bronze powder, which sinks to form the surface of the mask. He tells Campbell that ‘for a lot of people, it’s … knowing that they’ve managed to save a part of them that isn’t going to become worm food or ashes.’ There’s also a mystical element: ‘that somehow, during the process, part of the mystery of death seems to slip into the casting, and that’s what gives them that otherworldly feel’. Indirectly, at least, Nick’s work also channels the pain of a difficult childhood, on the run in Mexico then stranded at boarding school. His father was Bruce Reynolds, one of the Great Train Robbers. Nick did his mask, as well as those of Ronnie Biggs and ‘Mad’ Frankie Fraser, whom he cast from life, and who struggled to breathe through the drinking straws up his nose because it ‘had been broken so many times it barely worked’.

Even when corpses are dismembered and dissected, Campbell’s gaze remains unblinking. The anatomical services department at the Mayo Clinic in Minnesota smells like a school biology lab but has something of the torture chamber about it: the metal snake that chews and sucks tissue; the ‘golf-ball sized cheese grater’ for cleaning sockets. Terry Regnier, the director, joints bodies, following the line of the bone as if carving a chicken. He thaws whatever is needed, and lines up severed heads for students to learn rhinoplasty with. Campbell is told about a marathon face transplant operation for which surgeons did fifty weekends of practice as they waited for a donor. Regnier is matter-of-fact, sorting through a tub of extracted metal knees and hips, mechanical heart valves and a rubber testicle ‘that bounces once as he chucks it back in the box’. But he is respectful. He returned the hundred swapped faces to their owners, and all the cut-up bits are saved in hanging bags until the bodies can be reassembled and cremated.

Similar pains are taken at autopsies. After expertly flaying, slicing and gutting a body, leaving an abdominal cavity reeking of ‘refrigerated meat, human shit and the blended penny tang of blood’, Lara-Rose Iredale of St Thomas’s Hospital puts everything back together with needle and thread, gives the body an antibacterial sponge bath, and washes the hair in Alberto Balsam Sweet Strawberry. The brain stays out. Campbell holds one, marvelling at the cold, dense jelly’s capacity for sentience and cognition, recalling what a neurosurgeon told her: ‘Your senses are spies for your brain. It pieces together what it can from the scant information it is supplied, blurs it with memory and experience and calls it life.’ Iredale is mystified by her own lack of squeamishness. She has nightmares about her corpses coming back to life – but only because of the paperwork it would entail.

The horrific, harrowing deaths Campbell describes are grimly compelling. It is the job of Neal Smither, employed by the Californian company Crime Scene Cleaners Inc., to eradicate signs of death. It could be a homicide or a natural end of life ‘where the body lay quietly decomposing until the neighbours complained, burning an outline into the mattress like a liquid victim of Pompeii’. Smither took his first step into the business aged twelve when he scrubbed the splatter of a suicide from the side of his grandparents’ house. He remembers the lesson: do brains first as they set like marble. Now, Smither removes every bodily trace with bleach, even the sticky footprints of flies on walls and ceilings (amateurs overlook this, just as they don’t realise that blood stains are bigger under the carpet, ‘like an upside-down mushroom’). Smither’s job, as Campbell puts it, is ‘to literally dehumanise the situation in order to make the house sellable for the third cousin going through the drawers in the other room’. He insists that three things are always found at murder scenes: a weapon, an inebriant, and porn or a sex toy. His customers disgust him.

After murder, retribution. Campbell admits that executioners qualify for her inquiry only because they haunt the border of mortality. Historical context is useful. Pre-modern hangmen and headsmen were dishonourable, untouchable, magically polluted. Executions, by contrast, were pious set-pieces performed in open-air theatres sanctified by state power. In the 19th century, public spectacle turned into clinical privacy, and executioners became anonymous, their feelings a matter of personal conscience. Jerry Givens was Virginia’s state executioner for seventeen years, ending more than sixty lives. Despite believing that he shared responsibility with the justice system, and ultimately with God, on the day of an execution he couldn’t speak or look in the mirror. His wife only knew that he worked in a correctional facility. Then, after a spell in prison for money laundering, Givens began having doubts. He started mentoring teenagers, moved by pity for the lives of America’s underclass and the torment of death row. He died from Covid in April 2020, less than a year before Virginia abolished capital punishment.

Campbell’s​ most memorable encounter is with Mark Oliver, the vice president of Kenyon, a UK-based company you’ve never heard of but will have heard in action. Kenyon is a white-label management firm that takes on the branding and voice of organisations when they are forced to deal with disasters. Oliver, a former detective, gained experience registering bodies in Kosovo and in South-East Asia after the 2004 tsunami. Kenyon employs a lot of ex-police, but also forensic scientists, bomb disposal experts, psychologists, funeral directors and aviation specialists – two thousand people in all. They handle the PR, set up crisis lines, edit websites and arrange travel for relatives. Hotel mealtimes are staggered to keep the bereaved and holidaymakers apart; if the disaster was a fire, there will be no barbecues; Japanese families can expect chrysanthemums rather than disrespectful roses. When Campbell met Oliver, Kenyon was still sorting and cleaning 750,000 personal items removed from Grenfell Tower.

Throughout the book Campbell is itching to understand the people who do these jobs. Oliver, like most people she meets, has a clear answer: his vocation is to help the living and give dignity to the dead. According to Anthony Mattick, a retired policeman in South Wales, ‘there’s no greater privilege in life than being allowed to investigate the death of another human being.’ The funeral director Poppy Mardall agrees. She worked for Sotheby’s until her parents were both diagnosed with cancer and she was bombarded by clichés and platitudes. Bemused to have to ‘face the idea of death – in her family, in herself – without ever knowing what it looked like’, she turned her search for meaning into a career. Death’s conventions can be challenged, after all. Dennis Kowalski of the Cryonics Institute in Detroit, not a city awash with hope, is a utopian who would rather be the experiment than the control. He has faith that death will one day be redefined for him and the two thousand other members of the institute, all of them destined to be kept in suspended animation until a happier day.

Campbell is also curious about the psychological impact of death-work – but this doesn’t get her far. Relaxing in a downtown seafood joint, the executioner Jerry Givens is candid with his back story but less forthcoming about his inner life, all the while making short work of the lobster he has just casually sentenced to death. Thomas Hardy felt ashamed after watching the hanging of Martha Brown at Dorchester in 1856, expiated perhaps through his creation of that ‘pure woman’ Tess Durbeyfield (though Tess, too, is hanged). But Givens, like the others Campbell meets, is less overtly emotional. Terry Regnier of the Mayo Clinic chuckles at her most searching questions and is unfussed about handling people whose faces have been gnawed off by their pets.

The other person of interest in the story is Campbell herself. At the beginning she has never seen a dead body (I still haven’t, aged 55) but has been fascinated by death for as long as she can remember. Her father is the artist Eddie Campbell. When she was seven, he brought home a kidney to draw from (he was working with Alan Moore on their graphic novel about Jack the Ripper, From Hell), so she drew her own version and a picture of a murdered woman to shock the teachers at her Catholic school. Her friend Harriet drowned trying to save her dog from a creek, and at the funeral was hidden in a screwed-down white coffin. ‘Every magician,’ Campbell says, ‘knows that sticking a closed box in the middle of a group of people is a recipe for sustained suspense.’

Her composure breaks only once: at the sight of a two-week-old baby in a mortuary, ‘the small bouncing pebble that got me right between the eyes’. For months afterwards, babies invaded her dreams. The bodies of children represent the limit of what several interviewees can bear. Regnier struggled when he had to saw a friend’s head off, but otherwise the only troubling prospect would be the corpse of a child. Clare Beesley, a bereavement midwife in Birmingham, ‘almost a cartoon of a caring nurse’, is a font of consolation to grieving mothers; she drives home from work in silence, slowly decompressing, tears welling. When Nick Reynolds agreed to make a cast of a dead girl’s feet it broke his heart. Even offhand Neal Smither, who forgets clean-up jobs as soon as he leaves them, was disturbed by the bloody footprints of a toddler whose parents had been murdered.

Overall, though, Campbell’s immersion in death is free of trauma, more like an irreversible transition to a state of maturity, from innocence to experience, like losing your virginity. She admits she was naive, and that getting close to human remains is almost indescribably transformative. Her senses are sharpened; she is appreciative and humbled. And she is convinced that, as Poppy Mardall advises, your first corpse shouldn’t be someone you love: no one needs to handle the shock of death and the shock of grief at the same time. Life would be better lived if we knew death better.

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