Hektoen International

A Journal of Medical Humanities

Risus sardonicus

Arunachalam Kumar
Mangalore, India

Relatives and neighbors mourn the death of a loved one at a funeral in Mumbai, India.

There is a pithy adage that goes around in medical circles, “Those who can – DO, those who can’t – TEACH.” Comments like this notwithstanding, some still commit their professional lives to medical teaching as an attractive and rewarding career option. But, who of rational mind, one may ask, would choose anatomy as a specialty and voluntarily submit to a lifetime working in a sanitized formaldehyde-infused dissection hall, delving into dehydrated human flesh and tissue? Many actually do. The anatomist is probably the most despised member of any university’s medical faculty. He is a ringmaster: he terrorizes nascent medicos, schooling them into organized thinking and methodology in action. It’s a hated subject with abhorrent teachers. Alas, the anatomist’s lot is pathetic.

But is it all that odious? Not always. Once in a while, dramatic and memorable events cross his path, though they may be few and far between. An anatomist’s diary can make for fascinating reading.

The other night my telephone jangled me awake: eleven o’clock. On the line was a heartbroken wailing voice, which inter alia, wanted me to make arrangements for embalming and preserving his just deceased mother’s body. We anatomists are trained in these macabre arts, you know, and our set-up does offer mortuary facilities as a public service. Stifling yawns, I went to the college building in inky darkness and pouring rain. Sudden deaths in the family require funerals to be held up till the dear-departed’s kith and kin (in this case, daughters from Mumbai and Dubai) zero in from the nether corners of the country or beyond.

A private ambulance was waiting at the mortuary annex; a few shell-shocked relatives helped the frail body out. Laid out on a cold steel table, the dead matriarch seemed serene and at peace. I set up the formalin infusion apparatus, mixing some glycerin in the fixative; then, bidding all but one attendant to leave the chamber, I partially exposed the roof of the femoral triangle, incised deftly through the fascia and sheath and hooked out the artery. I pushed the wide-bored needle into the vessel and let the fixative perfuse through the lifeless circulatory system. In an hour, the body would be turgid and hard, every cell and tissue preserved for good, if need be.

I sat down, waiting. Idleness soon had me looking at the limp body. It was bedecked in the finest silk and brocade. On the wrinkled neck lay the most massive gold chain I had ever seen. From the wrists, dangling inertly, were a dozen or more gem-studded bangles. From the ear lobes, elongated with age, swung two huge diamond encrusted pieces of art. Hmm… a rich dowager! Rich heirs too!

My watch chimed time, and I checked out the body: Fully fixed. My companion signaled his grieving relatives, who were in the adjacent corridor, to come in for one last loving look at the former matriarch of the family. A few eyes dabbed, a few sniffles and sighs stifled, a few cheeks wiped. Then I wheeled the stretcher into the walk-in freezer, turned down the thermostat, clicked the double doors shut and sealed the cabin. The funeral was to be held the following day, at ten in the morning. I had to be back here to release the body by eight, I was reminded.

Back in bed, I ruminated over life and death, morbid thoughts of how in one moment one is alive and kicking, and then in another, dead and gone. From a loved mum to a limp mummy, all in a trice (pardon the inappropriate pun—we anatomists are not humorless, you see). Suddenly, the damn telephone is yelling again: It’s 3 A.M. God! What a night! On the line was yet another female voice, near hysterical and sobbing. Between sighs, she pleaded for just one single private moment with her mother. Tomorrow would be swarming with people; tears had to be stilled and emotions kept in check: “But now, I can, no I must, hold her palms and tell her how much I loved her, just hold my dearest mum’s hand. God bless her, for one last time, to tell her how much she meant to me.”

Now, now, lady, I interrupted, bodies once fixated and sealed in the deep freeze cannot be exposed midway to changes in temperature. Fluctuations in environment could mess up the embalming process. “Please. Puhleese … just one minute will do, doctor,” the distressed voice trailed off into a paroxysm of sobs. Anatomists may be heartless (to pre-clinical students), but not motherless. And the omnipresent streak of the Oedipal complex still runs through all Indian men. So off I went into the inky darkness, through pouring rain, to let one damsel in despair have her one moment of privacy.

I saw a jeep parked near the annex and beside it stood, a middle-aged woman, sobbing and shaking. I quickly opened the door, switched on the lights, unsealed the cooler, and wheeled out the dead body. “Ten minutes,” I whispered. Then, in deference to human emotion and its display, I left the room and paced the anteroom corridor. After a quarter of an hour, I gently tapped the kneeling and whimpering woman’s shoulders to signal it was time the body went back into the cooler. I locked up, and, as I was leaving the building, the woman, the Mumbai daughter I presumed, thanked me profusely pressing a five-hundred rupee currency note into my palm. No thanks ma’am, we anatomists may be desperately poor, but are certainly not destitute (not yet, at least).

The next day I was back amidst a horde of relatives, all jostling and elbowing. Some were spraying fresheners, and others were squirting perfumes to smother the acrid smell of formalin that pervaded the room. Flowers and wreaths and a fine-grained metal embossed coffin were all ready. Some lady attendants wanted to change the sari on the body; it was slightly stained from seepage of fluid from last night’s femoral incision. So, all of us trooped out. I lit myself a cigarette, letting a lungful of nicotine surge through my arteries. My job was almost over now. A few forms had to be filled in, a signature or two, and a nominal payment by check. Then, all of a sudden, an ear-piercing scream rent the air, “Oh, my God.” Someone must have swooned, it often happens in these tragic scenarios. I scampered in again, along with a score more.

“Where are the jewels? The rings, the bangles, the gold and diamonds…all gone,” a hysterical relative was yelling. Sure enough, I saw the body was bereft of any ornament. The old lady, so adorned last night, now appeared shorn plain. Sensing trouble, I quickly called aside a serious-looking booted and suited figure, and, in a flurry of words, I informed him of the late-night mourner who wanted a private moment with her mother. “The Mumbai daughter, maybe?” I added, pleading.

“What are you talking about doctor?” the man interrupted me rudely, “The daughter is only due for arrival today from Bombay by the 9 A.M. flight.”

I was stunned. Noticing my absolutely shell-shocked stare, another voice chipped in “Maybe you are right.” Then all, every sari and suit, every perfumed female and pinstriped male of the party, went into a huddle, looking askance every now and then towards me, with suspicious eyes. The upshot of the mini conference was, I soon learnt, in all probability, it was a third daughter of the dear departed, a family black-sheep, who had sneaked in at night and dispossessed her “dearest mother” of every vestige of dignity and decorum. After a confirmation that she had indeed come in a dilapidated jeep, I was, it appeared, pronounced not guilty: an innocent accomplice maybe, but one that had acted in good faith.

Phew! That was a close call indeed. I soon heard, the till-then somber, mourning relatives spew forth four letter words and profanities, cussing the prodigal female, her progeny, both present and future, for bringing shame and scandal. Then all of them swore me into a pact of silence: La Cosa Nostra. The incident was not to be aired in public, ever, to avoid a needless tongue wagging. Boy was I relieved!!

Anyway, the corpse was rewrapped in a new silken sari, and fresh chunks of jewels were mounted. And off the troop went for the last journey. Just as the grieving family was about to transfer the coffin with its contents onto the hearse, I had one fleeting glimpse of the dead woman around whom so much drama had transpired. Strangely her lips appeared to be curled in a sort of grin: Aha!

Now I recollected, risus sardonicus—the smile of death! The wry smirk that sometimes adorns the dead when facial muscles go into a spasmodic postmortem contraction: a mocking grin. What was the old lady smiling about I wondered? At the shams, hams, actors and hypocrites around her? Was she mocking the dramatis personae in her life, some grieving daughters and some thieving ones too?

The events of that dark rainy night taught me valuable lessons. That an anatomist not only teaches the structure of the human body, but also learns the fabric of humanity. The stories the dead relate can be profound and ironic. Ask anybody.

PROF. ARUNACHALAM KUMAR is presently the Dean, Faculty of Medicine of Nitte University’s the K. S. Hegde Medical Academy in Mangalore, India. He has over 30 years teaching experience in Anatomy and has published a number of human interest articles in medical journals, including a few in the British Medical Journal and the Canadian Medical Association Journal (CMAJ) among others. Dr. Kumar, as “ixedoc,” is one of India’s top bloggers. His blogs can be accessed at: http://ixedoc.sulekha.com/blog/posts.htm.

Highlighted in Frontispiece Winter 2010 – Volume 2, Issue 1

Winter 2010



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