Health Check: 'Opening a 9ft fridge, he shows me three of his charges, each carefully shrouded in a white sheet'

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Indy Lifestyle Online

There is an unmarked door in the basement of St Thomas's hospital where ordinary visitors never go. Made of good solid wood, it looks as if it might provide access to a generator or a boiler. The only clue that something more lies behind it is an intercom switch on the wall.

Inside is a windowless, low-ceilinged room with squashy sofas, soft lighting and prints of rural scenes. It is also noticeably cooler. This is the ante-room to the mortuary, a place two thirds of us will pass through on our way to the grave, but almost none will visit while alive.

Exactly what goes on here has attracted increasing interest since the organ- retention scandal came to light at Alder Hey Hospital in 1999. Professor Dick van Velzen's grisly collection of hearts, brains and other bits of human anatomy, taken from dead children without the consent of their parents, sparked a bout of collective grieving, the fallout from which is still being felt four years later.

Last week, MPs started work on the Human Tissue Bill which seeks to enshrine in law basic principles, such as that proper respect should be shown to the dead and proper attention given to the feelings of the living by regulating the removal and storage of organs and tissue.

Much that is proposed in the bill is already common practice. The handling of the dead has undergone a sea change since the Alder Hey scandal. Particular care is now taken at St Thomas's.

James Lowell, who runs the mortuary, is young (26), bright, and an enthusiast for his calling. Opening a 9ft fridge, he shows me three of his charges, each carefully shrouded in a white sheet.

"We don't tend to touch the patients unless we have to - or there is a postmortem. I always call them patients. We are the last people in the hospital to look after them. We are not just people who walk around the mortuary getting bodies out for the pathologists. We care for them."

There is something touching about having people in their twenties, in the first flush of adulthood, untouched by cynicism, processing the dead.

One of the fridges is wider than the others, reflecting the growing number of obese patients. Another is reserved for babies and foetuses. "Parents told us they preferred it if babies were kept together with other babies, so we have tried to do that," Lowell says.

Wearing a surgical gown, Lowell has a piercing through one eyebrow, and a tattoo on one arm. His mother was in palliative care, he says, so he never felt any queasiness about death. When a job came up, he applied, got it and did three years training in biology, surgery and counselling. He spends a lot of time on the phone, talking to the bereaved.

His job involves opening the cadavers due for postmortems and stitching them up again afterwards. He will argue with pathologists about their evisceration techniques because his priority is to protect the appearance of the corpse, while theirs is to gain maximum access.

He is especially proud of his reconstructive skills. Each night he draws up the next day's list for postmortems, leaving to the pathologists the painstaking work of slicing, testing and examining the organs and tissues.

"If a patient has been in the intensive-care unit [with wires and tubes attached] they will often look better after the postmortem," he says proudly. He is, in effect, a surgeon to the dead.

Consent must be obtained for hospital postmortems - though it is not required for those ordered by the coroner, where there is doubt about the cause of death - and the forms must record the family's detailed wishes over what may, and may not, be removed or retained. Exactly how detailed this consent should be is likely to be a key battleground in the debate on the Bill.

Pathologists fear their work may be unreasonably curtailed by the new air of political correctness blowing through mortuaries - and that the understanding of disease will be hindered as a result. But there is little doubt that the dead are better treated than they were in the days of Professor van Velzen.

When I or my loved ones pass this way I cannot think of anyone I would rather have shrouding, washing and stitching than the enthusiastic Lowell and his bunch of youthful assistants.

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