ASK THE DEATH LADY: Learning About Death And Grief
by Franne Whitney Nelson, EdT., CSDS

COLUMN 7

Q. I dealt with the fatal burn case of a five year old girl and refused to let the parents see her badly burned body because I didn't think that sight should be their last memory of their daughter. A few weeks later they lodged a complaint against me. Why would they do that when I had only their best interests at heart?
Police Sergeant, New York
A. I have no doubt you had their best interests at heart. I also know this is probably the most common mistake made by well-intended law enforcement officers, Physicians, nurses, clergy, funeral directors, medical examiners and victim advocates.
    The single, most therapeutic event of all our death rituals is viewing the body - no matter the condition. However, in order to assure that the sight of a severely traumatized body will not be a family's last visual memory of their dead loved one, I have devised a five component procedure called Death Memory Rectification (DMR)
™.
    If the procedure is correctly followed, and all five elements are present, DMR will occur. The family will have seen the proof of the death, yet, eventually, the memory of their person will revert back to the way they looked before they died.
    If not done correctly, DMR will not occur and the family will have Eidetic Memories. These are memories that are unbidden, unwelcome and intrusive, and they evoke emotions similar to those felt when the actual trauma occurred, which would be the first viewing of the severely damaged body of someone they love.
    Please click here to read about an actual case of Franne's that applies to this topic.



Q. What can I do if I'm in a room with a patient who's in a coma and someone enters and says things that I feel are inappropriate?

Hospital Social Worker, Nevada
A. I would take the person aside and tell them that hearing is the final sense a person loses. I would then tell them to assume they can be heard by the comatose patient and to speak accordingly.

DEATH FACTS & FANCY
  George Washington's last words,         which were spoken to his secretary,     Tobias Lear, were: "I am just going.     Have me decently buried and do not     let my body be put into the vault in       less than three days after I am dead.     Do you understand? Tis well.".

Q. Why would a four year old who has not experienced the death of a loved one be obsessed with talking about death and dying?
Grade School Counselor, Montana
A. Death and dying is all around us, even if it doesn't happen to someone close to us.
   In the world of a child, death is a manifest in dying flowers, falling leaves, roadkill, cartoons, pets, in movies, the death of playmates' family members, etc.
   This can threaten a child's sense of security and needs to be addressed. I recommend trying to find out specifically what the child is concerned about and allay those fears.


Q. It's hard for me because sometimes I get very emotional when dealing with families. What can I do about this?
EMT, South Dakota
A. As long as you are able to carry out your professional responsibilities, try to accept that 
you have a caring heart and you haven't been hardened by constant exposure to death and grieving families.
   If, however, it interferes with your ability to do your job, or diminishes enjoyment in carrying out your everyday activities, it might be that you are suffering from Death Saturation.
   If that's the case, it might be beneficial to take a break from dealing with death.

Q. How do I answer when a grieving person says "I'll never recover from this"?
Monument Dealer, Connecticut
A. I would first agree with them, saying that, in a way, they actually won't ever get over it, because their life is forever changed.
   I would also tell them that I don't use the word "recover" because, after all, one doesn't have a virus of love that we get over when someone we love died and we don't love them anymore. However, I do use the words accommodation and resolution.
   Accommodation is comparable to having our legs become paralyzed and learning to live without them, but always missing them, as with loved ones who have died. As for reaching grief resolution, I characterize that as getting to the point where we have more peace and less pain.



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CASE STUDIES - Column 7


Death Memory Rectification: One spring morning, I got a callout to go to the scene of a rural house fire to assist the son and daughter-in-law of the woman who lived in the house and who died in the fire.

I spent hours on-scene with son Fran and his wife. When the fire was totally out, Fran's mother was put in a body bag, removed from the house and placed on the lawn, awaiting the arrival of the funeral director for transport to the medical examiner's office for autopsy.

One of my primary responsibilities as a Sudden Death Trauma Specialist is to view bodies in order to answer families' questions about the condition of the body or to prepare them to view their loved one if they ask to do so. I walked over to the body bag, a state trooper unzipped it, pulled the sides open and I looked at Fran's mother's body. She had been very badly burned.

Because sudden, unexpected death provides no transition whatsoever from a live beloved person to a dead beloved person, most victim-survivors have an almost obsessive need for information, which takes the place of transition. This need is a natural, normal and involuntary phenomenon of sudden, unexpected death. Generally, the most compelling and urgent need that families express is to view the body in its natural state, before it has been prepared by a funeral director, when families sometimes feel that their person doesn't "belong" to them anymore. They want to see their person immediately, in order to see the proof of death for themselves. And also to hold them, caress them, kiss them.

In my experience, most well-intended people advise the family against viewing a badly traumatized body, telling the family that this shouldn't be their last memory of their person and that they should remember them the way they were. And they would be wrong. Generally, by giving that uninformed advice, they have unintentionally created a situation that can result in the survivors looking forever to say goodbye.

The single, most therapeutic event of all our death rituals is viewing the body - no matter the condition of the body. Note: This applies to adults only. However, there is a vital caveat to this statement. In order not to cause secondary trauma, I have devised a specific, five-step procedure which must be meticulously followed. Otherwise, viewing a severely damaged body can re-traumatize the survivors and cause eidetic memories, which are visual memories that are intrusive, unwelcome and unbidden and will evoke emotions similar to those they felt when experiencing the actual event.

I have named this process Death Memory Rectification (DMR). If the five components are present and the process is followed correctly, they will have seen the proof before their very eyes, but the sight of their loved one will begin to fade and eventually will revert to the way the person looked before they died. DMR often begins in 48 hours and can take up to two years to complete.

The five critical components to DMR are:

1. It must be a sudden, unexpected death. DMR does not apply to expected death.

2. The viewers must love their person and have a history of memories with them.

3. The person must want to see their dead family member. They should never be forced or coerced into the viewing.

4. They must be incrementally prepared in great detail for what they are going to see (general, specific, graphic).

5. Their reaction should not be curtailed or inhibited, unless it's clear they're going to hurt themselves or someone else.

If the family is on-scene, the viewing takes place at the scene. If not, they usually view their loved one in a hospital emergency department, the funeral home or, less frequently, at the medical examiner's office.

Fran wanted to see his mother.

When I am preparing someone to view the traumatized body of someone they love, I do it incrementally, using what I call the funnel method. I begin with a general description. I told Fran that his mother had been very badly burned. I did not use the word body - to Fran, this was his mother, not a body. He said "I don't care. I want to see her".

I then get more specific. I said "Fran, your mother has been so badly burned, she's not recognizable as a human being. He forcefully said "I still want to see her!"

The last step in the funnel method is to get graphic. I told Fran that the only thing that was left of his mother was her torso, which had split open and he would see her internal organs. He softly said "I just want to see her".

I explained to him that the last sight of his mother would begin to fade and eventually that memory would revert back to the way she looked before she died. You see, I did not know her and I, therefore, have no history of memories with her for my mind to revert to, so I remember the way she looked. But Fran would see the person who read him bedtime stories when he was a child. He would see the one who snuggled him when he was sick. He would look at the person who made his birthday cakes - the dear mother who had adored her little boy - and her big boy.

The firefighters and law enforcement officers had worked on scenes with me long enough to know what was coming, so they respectfully moved away from the body bag so Fran could have privacy. I walked with him over to his mother, re-opened the bag and stood close to him for a few moments as he looked down at his dead mother for the first time. I then stepped away - with a huge lump in my throat - as he knelt down close to her and sobbed - huge, heaving sobs.

I never hurry the family in these circumstances because they often feel a compelling need to stare at their beloved person over and over in order to try to assimilate that they will never again see this person alive. Fran stayed near his mother for about half an hour, then unsteadily got to his feet. I walked over to him and embraced him.

He wanted to stay near his mom, so we walked beside her as she was carried across the lawn and placed in the hearse. Fran leaned down and picked up some apple blossoms that had drifted from the apple tree on the edge of the lawn. He sprinkled them on his mom's body bag, stood there for a few moments, then gently closed the back door of the hearse.

I will never forget the sight of Fran, on that sunny day with a brilliant blue sky, standing in the middle of that dirt road, tears streaming down his face, as he watched his mother being driven away from her home for the last time.




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