Free to Read: “A Necessary Service”
After trying to sell “A Necessary Service” for over a year, it’s finally time to admit that its forever home is my blog. I hope you enjoy it. -Thomas
A Necessary Service
Ensuring Personal Safety When Handling Hemolapsic Human Remains
-A San Francisco Department of Public Health Publication
Hemolapsia presents several safety challenges for first responders, none so more than collecting a deceased individual’s remains. The primary focus of this guide is to ensure that remains avoid all contact with UV radiation, which can cause an unpredictable and violent photochemical reaction.
The old-timer, John, bore keloids that crisscrossed his hands and forearms. The rookie didn’t.
It was just before dawn, and the rookie was adding a final coat of polish to the white van, once an ambulance.
John ran his finger over the county seal on the hood. It was clean. “That’ll do. Put everything away and get in the passenger seat.”
“But we haven’t even…” The rookie stopped himself. John knew better.
The two men drank coffee in the van’s cabin. As the sun rose outside, John pushed a button to open the garage door. The first call came in less than five minutes later.
If the death of a hemolapsic individual should occur in a home or another enclosed structure, a standard human remains pouch (HRP) offers excellent protection for first responders. However, if the death should occur outdoors or where sunlight is present…
“Get out the tent,” John ordered as he parked just behind the police line. Stepping out of the van, they breathed in air heavy with the smell of burnt flesh. A police officer directed them to a nearby alley.
…a secondary reaction can occur if moving the remains allows UV radiation to penetrate areas of unburned or underlying skin. While wearing a face shield and fire-retardant clothing, first responders should use an approved shelter to cover the remains.
The charred body was a vision of Pompeii – a gray figure curled into a fetal position. The clothes had burned away, leaving few clues about the person’s station or life. All that was recognizable were the white fangs.
Without speaking, John and the rookie erected the thick rubber tent around the body. Inside, it would have been pitch black if not for their headlamps. The work went quickly.
After putting the remains into an HRP, ensure that they are transferred to an appropriate vehicle as soon as possible.
The body in the van, the rookie returned to the tent with a portable shop vac. “You want to get every bit,” John had told him during training. “Even a piece the size of a pencil eraser can blow off a kid’s hand.”
Their job complete, the men took the tent apart. It was now the rookie’s turn to drive.
“Suicide?” The rookie asked as he merged into traffic.
“Who knows,” John said. “There were a lot more when I started. There’d be whole groups at Ocean Beach that would ignite together at sun up.”
“I remember the ash falling from the sky. It was like what happens after one of those forest fires up north.”
John nodded in agreement.
The county vehicle involved in remains retrieval must report directly to an authorized crematorium. During this time, the vehicle’s transponder should stay on to report its location to law enforcement and public health officials.
“You gotta be kidding me.” John and the rookie heard the exasperated voice the moment they stepped out of the van.
“What is it now, Abe?” John asked as the intake agent stepped out of the unloading dock’s office. An orderly followed a few steps behind.
“I told your people that the furnace blew its thermocouples the other day. We’re shut down.”
John rubbed his temple. “Regulation twelve-sixty states that…”
Abe held up a hand. “Stop, just stop. Fine. I guess we have some space left in the cooler. Jimmy, you know what to do.”
The orderly nodded, and with the rookie’s help, loaded the body bag on to a nearby gurney.
Abe sighed as he watched Jimmy and the body disappear down a long hallway. “Any name?”
“No,” John said while filling out the delivery form. “The Fourth Precinct is performing the investigation. They should be in touch.”
Abe handed John a paper receipt. “Sure they will.”
Note: Deaths that occur at a licensed blood maintenance clinic require extra security. First responders must wait for police presence before entering.
“You guys are late,” John said to the two police officers who had just pulled up outside the blood clinic. “We’ve been here thirty minutes.”
“Just get to work,” the senior officer said as he and his partner flanked the entrance.
John and the rookie stepped inside the blood clinic. “I’m sorry we took so long,” John said to the two women, both employees. Nearby, a broken computer monitor and shattered picture frames lay scattered on the floor near the reception desk. In the middle of the room was the body that up until two hours ago had been a young man. Black blood stained his mouth, neck, and shirt.
“It’s fine,” the taller of the two women said. “I’m the doctor here. This is my receptionist.”
“Hello,” she said. Her irises were dark red – a telltale symptom.
The rookie looked between the hemolapsic woman and the dead man. “Did he attack you?”
John was about to speak before the receptionist responded. “He was desperate and couldn’t tell. I usually wear contacts to hide…” She motioned to her eyes while simultaneously trying to hide them. “This. My blood, we’re poison to one another, you know? I’m okay now. Really.”
Even with the body gone, the carpet was still stained beyond repair.
“Be safe getting home,” John said, offering a rare smile to the women as he and the rookie departed.
#
It was late afternoon when they arrived back at the Department of Public Health’s underground parking garage. “You shouldn’t talk to them,” John told the rookie while turning off the engine.
“Why?”
Finally, no matter the cause of death, it is worth reiterating that state and federal law define hemolapsic remains as hazardous medical waste. Traditional burial is strictly forbidden.
“Because one day you or your great-grandkid will have to take her body to the fire. That’s just how it is, how it has to be.”
Hose it all down and head home. We have another long day tomorrow.”
“Yes, sir.”
After watching John head into the office to file paperwork, the rookie unraveled a hose hanging from the wall. Pointing the nozzle at the van, however, he paused before going to his kit for a few clean rags. He wetted one before wiping down the steel and chrome with slow, deliberate strokes.
“The Lord is my shepherd; I shall not want…”
The thin layer of ash that had collected throughout the day came off easily.
“…The rod and thy staff they comfort me…”
He paused briefly to wet another rag.
“…and I will dwell in the house of the Lord forever.”
The van clean, the rookie carefully packed away the now soiled rags. He knew of a small plot of land where he could bury them in private.
“Amen.”