Smoke Gets in Your Eyes and Other Lessons from the Crematory

WESTWIND’S TWO CREMATION MACHINES could handle six bodies (three in each retort) on a typical 8:30–5:00 day—thirty souls a week during busy periods. Each removal took at least forty-five minutes, far longer if the deceased was across the bridge in San Francisco. By all rights Chris and I should have been out fetching bodies constantly. Chris was out constantly, but often just to avoid Mike by volunteering to run petty errands like picking up death certificates and going to the post office. I mostly stayed at Westwind and focused on cremation, since the majority of body pickups didn’t require a number two. Most deaths no longer happen at home.

Dying in the sanitary environment of a hospital is a relatively new concept. In the late nineteenth century, dying at a hospital was reserved for indigents, the people who had nothing and no one. Given the choice, a person wanted to die at home in their bed, surrounded by friends and family. As late as the beginning of the twentieth century, more than 85 percent of Americans still died at home.

The 1930s brought what is known as the “medicalization” of death. The rise of the hospital removed from view all the gruesome sights, smells, and sounds of death. Whereas before a religious leader might preside over a dying person and guide the family in grief, now it was doctors who attended to a patient’s final moments. Medicine addressed life-and-death issues, not appeals to heaven. The dying process became hygienic and heavily regulated in the hospital. Medical professionals deemed unfit for public consumption what death historian Philippe Ariès called the “nauseating spectacle” of mortality. It became taboo to “come into a room that smells of urine, sweat, and gangrene, and where the sheets are soiled.” The hospital was a place where the dying could undergo the indignities of death without offending the sensibilities of the living.

In my high school, my classmates and I had been told in no uncertain terms that we would not get into college and thus would never get a job and thus would end up unsuccessful and alone if we didn’t serve a certain amount of summer volunteer hours. So the summer between my sophomore and junior years, I signed up to volunteer at Queen’s Medical Center, a hospital in downtown Honolulu. They confirmed I was not a drug user and had decent grades, and gave me a hideous bright-yellow polo shirt and a name tag and told me to report to the volunteer office.

The volunteer department allowed you to select two areas of the hospital to rotate between from week to week. I had no interest in popular choices like the gift shop or the maternity ward. “Get Well Soon” balloons and crying babies seemed like a cloying, sappy way to spend the summer. My first choice was working the front desk at the intensive care unit, imagining a glamorous-nurse-wiping-fevered-brows scenario out of World War II.

The ICU was not the thrill ride I had expected. Turns out, they never called the high school student in from the reception desk to assist the doctors in lifesaving procedures. Instead, the job entailed hours of watching incredibly worried families wander in and out of the waiting room to use the restroom and retrieve cups of coffee.

I had more success with my second choice, the distribution department. Working for the distribution department meant passing out mail and memos to different wings of the hospital or wheeling old women out to the front curb after they were discharged. But it also meant transferring dead bodies from wherever they had expired to the morgue in the basement. I coveted that task. The people who worked full-time in the department may not have understood my enthusiasm, but when there was a “code black” called for a corpse transfer, they would generously wait for me to arrive.

In retrospect, it seems odd that the hospital administration would say, “Sure thing, fifteen-year-old volunteer, you’re on corpse-transfer duty.” I can’t imagine this was something they normally assigned to young volunteers. In fact, I recall a fair amount of initial reluctance on their part—overcome by my successful begging.

Kaipo, my direct supervisor, a young local Hawaiian man, would look at the board and declare in his thick pidgin accent, “Eh, Caitlin, you like come get Mr. Yamasake from Pauahi Wing?” Oh yes, I most certainly did want to get Mr. Yamasake.

Kaipo and I arrived in Mr. Yamasake’s room to find him curled up in the fetal position on his immaculate white hospital bed. He looked like a museum mummy, with taut skin like brown leather. He was less than ninety pounds, desiccated by disease and old age. Either one of us could have lifted him onto the stretcher with one hand.