the business of death

I know the entrance to the crematorium. I’ve been here before, a couple of years ago. Then, we’d turned into the top of the drive just as two men in black suits and sunglasses, smoking cigarettes, were walking out. It was a hot summer’s day and the ambulance window was down. As we slowed to make the turn, one of the men took the fag out of his mouth and shouted: You’re too late mate.

I got the joke. But even though it must have looked incongruous to see a big yellow truck pitching up to a crematorium, in fact it hardly needs saying that there are no places beyond our reach. In my short time as an EMT I’ve turned up at schools, hospitals, factories, homes, gardens, holes in the ground, holes in buildings, cars, boats, trains, railway tracks, woods, swimming pools and the sea. Anywhere that people go, an ambulance may follow.

This time, though, there are no smart jokes, just a gardener, waving frantically over by the Garden of Remembrance.

As I drive over I suddenly catch a glimpse through the arched gate just behind him: another gardener, kneeling beside a sprawled figure, pressing up and down on her chest.

I leave the engine running as we throw open the doors and drag out all the bags we’ll need. Over to the scene, and we find an elderly woman lying at the foot of some concrete steps. I take over chest compressions whilst Rae cuts through the woman’s top and slaps the pads on. There is vomit over the woman’s face, and blood from a grievous wound at the back of her head which fans out in thick, geometric lines along the joints in the pavement. Asystole. Rae tries to intubate, but the woman has aspirated so much it proves difficult to visualise the cords; the suction unit keeps getting clogged with chunks of food; we get little or no chest rise; her pupils are fixed and dilated, her skin the colour of pumice stone. The second crew turn up and between us we try every drug and procedure we can think of, but at the end of half an hour or more the woman is as flat and dead as before.

Police have turned up. They help liaise with the relatives, the crematorium management, gathering information and controlling access to the scene.

We call the resus, and drape a clean white blanket over the woman. We start to tidy up. The police call for the coroner to attend, so we stay to finish the paperwork and liaise with them. Also, it helps that our ambulance is parked in front of the garden entrance; there’s another funeral gathering out in the car park, and the truck is acting as a screen.

Rae and I go with the police to where the woman’s relatives are waiting by a car. Most of them have gone now, leaving just the immediate family. We tell them that she has died, and how sorry we are. We tell them what we found, what we tried to do, what we failed to do. They cry, and tell us some things of their own. Then we leave them with the police and go back to the scene.

That’s when I see two men, dressed in black, peering round the corner of the crematorium building. I’m not surprised; it’s unusual to see an ambulance and police car there, and they want to know what’s going on. When they catch my eye they nod and wave a little shamefacedly, as if they were embarrassed I’d caught them rubber-necking, and quickly duck back. But I don’t blame them. Out in the street it might be different, but this is a crematorium, a place dedicated to death, the business of it. And now with us, with me here in my uniform by this big yellow truck, the police car, the body on the ground, it’s like a piece of scenery has fallen down and revealed the staff who work the ropes.

I’d be curious.

All the same, I’m glad when the Coroner arrives, so we can finish tidying up.