May 2008

The Nation Reviewed

Organic matter

By Robyn Davidson
Illustration by Jeff Fisher.

One of the great things about getting older is that all the anxieties you once had about death and decline (and some of us have had them daily since we first grasped the fact of mortality) are anxieties no longer. You are liberated from them because they have become real. Friends fall off perches not singly, here and there, but in batches, like autumnal fruits. (That metaphor was mixed, but another thing about getting older is that things in the brain do get mixed, like putting your glasses in the fridge and the milk on top of the book pile.) You begin to give thought to where you want to be buried/burnt, what music should be played at the wake/vigil/funeral and what you hope people will say in the hesped/eulogy. You glance in the mirror and wonder who the old bag is wearing your clothes.

It's all quite comic, and not particularly unpleasant. If you start from the premise that life is absurd - fascinating, worth being around for, but absurd - then decline and death are even more so.

In our culture, to be getting older, particularly if you are female, is to be gradually erased. Until, when you're truly decrepit, the only people who notice that you exist are those few of your era left sharing the scrap heap. (‘Scrap heap' is a cliché which I will justify shortly, when I come to the paragraphs on organ donation.)

Death is unfashionable here, and therefore it's in poor taste to remind people of it by shrinking, wizening, losing your faculties or sprouting rogue hairs on your chin. It's rather like extramarital sex was in the '50s: a lot of it happened, and people pretended it didn't. We are so steeped in the message that a positive attitude can overcome any obstacle, it's as if old age and its logical conclusion are indicators of moral weakness. I can imagine a day when the acknowledgement of, coming-to-terms-with, musings about death will be regarded rather as smoking is at present. Poems and novels about the Big D will be permanently out of print. Deathless prose will take on a whole new meaning. Health and Safety will have a field day.

Where I've just come from, India, specifically the Himalayas, death is about as common as life. Not fifty-fifty, because although many people visibly die there, even more get born. Still, death is big. Generally, as Indians get older, they become more, not less, important. All the wisdom stored up in them! Little old ladies with cataracts and trembly hands are led around by great-grandchildren who seem genuinely to adore them, to want to be with them, to speak highly and affectionately and reverently of them.

Before I went to that country, in my late twenties, I had seen only one cadaver. He (it?) was an old tramp ‘asleep' in the back of an abandoned car in the inner-Sydney suburb of Ultimo, back when Ultimo was a slum. He looked sick and his mouth was ajar, so I opened the door and asked if I could help him. He didn't answer and I figured out why within a fragment of a second. There's not a huge difference between a living body and a dead one. But there is a difference.

And for all the deaths around which my life's trajectory has bent - my five most important people - I have neither been to a funeral, nor seen the face of a dead beloved. I suspect that this is not uncommon in the West.

Along the path up to my house in the Himalayas, there is a small cement platform where the bodies of poor people are burnt. It's beside a little stream in the forest. Relatives cut wood for the pyre, after thorough and public grieving. Anyone who's interested can watch the body burn. The idea is that the ashes will enter the stream and eventually make their way down to the Ganges, because the poor can't afford to take the body to the Ganges themselves. It's a marvellous idea: the river taking the spirit out to the ocean, so that it rejoins, symbolically, the unity of creation.

Sometimes a body isn't fully consumed by the flames. A couple of years ago, a clot of shiny black hair and scalp remained on a rock in the path for months. You stepped over it, just as if it were a bit of goat. Then the monsoons came and sent it on its way.

Which brings me to the morgue, and second-hand body parts. The organ-transplant industry has given life to thousands of desperate people, but like most industries it is fuelled less by altruism than by profits. It is not common knowledge that a good healthy corpse can raise about a million dollars on the international scrap market. You think that the skin you leave behind is sure to go to some poor burns victim? More likely it will be bought, for a hefty sum, by a large cosmetics company.

The most laissez-faire commercial harvesting goes on in America. The harvesters wear rubber gloves and aprons, like meat workers. A fresh cadaver's scalp is cut, then pulled over the face. The skull is sawn off, leaving a notch at the back, so that when it's replaced for the funeral it doesn't slip off at an awkward moment. Sometimes bones, eyes and inner ears are taken, making it impossible to display the face anyway. Skin is peeled from the body; fascia and veins are withdrawn; cartilage, ligaments and tendons are removed. Bones are taken for recycling, or tossed, with other bits and pieces, into machines that can cleanse them of various diseases and render them medically or cosmetically useful products.

After all this, open-casket funerals can be a bit of a problem. A bucket with a lid might be a better option. Morticians do their best to make the cadaver appear to be peacefully sleeping. They fill gaps, pump gel, remould, reshape, insert pipes for bones, then put what's left of the bodies in odour-proof bags with holes for faces and hands. Their skills are expensive. Neither the transplant industry nor governments recognise the extra cost of funerals for relatives of organ donors.

If the cadaver is a ‘beating heart' cadaver, that is, if the person being harvested for fresh organs has suffered brain death but still has a viable, breathing, blood-pumping body, it will be wheeled from the ward to an operating theatre (after a short farewell from the grieving family), still on its life-support system, where a team of specialists will hack, saw and no doubt chat away, and drop the good organs into eskies, leaving the awful mess to be cleaned up by junior medical staff. Too bad if the Buddhists are right, and consciousness takes days to dissipate.

There have long been people who were permanently unconscious (remember, not so long ago, Terri Schiavo?), but it wasn't until the organ-transplant industry got going, about 40 years ago, that a new diagnostic criterion based on brain function became important for the certification of death. The Harvard medical committee that came up with the definition listed two reasons for its necessity. The first was the burden of futile treatment. The second was the facilitation of organ donation. It wasn't possible to kill people in order to take their organs, so a new way had to be found to declare them dead. These days, a lot of doctors are questioning the criterion. The brain-dead may be permanently comatose, but is that the same as being dead?

Death is a complex process. It has transitional states that lie, you could say, somewhere between being alive and being dead. Exactly where to place the line is a cultural decision. For Buddhists, that line is pushed way out towards body necrosis. For utilitarian materialists like most of us, dignity for the dying comes second to the needs of the clearly living.

I am materialist enough to continue to be an organ donor; suspicious enough to wish profit-making companies out of the business. And primitive enough to want my dying body to be treated with basic respect. And then burnt on a cement plinth in a forest in the Himalayas.

Robyn Davidson
Robyn Davidson is a non-fiction writer. She is the author of the award-winning books Tracks and Desert Places, and the editor of The Best Australian Essays 2009 and The Picador Book of Journeys.

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