All That Remains: A Renowned Forensic Scientist on Death, Mortality, and Solving Crimes

by Sue Black

She is not afraid to sit and hold a patient’s hand in their final moments, offering comfort and reassurance untainted by falsehoods.

Research using electroencephalograms (EEG) suggests that of all our senses, hearing is the last to go when we are unconscious or dying. This is why palliative care professionals are very cautious about what is said in the vicinity of a patient and why families are encouraged to talk to those who appear comatose.

Even though recalling her death is still sad and painful, the memory of that bizarre last day still makes the girls laugh. We went through our repertoire of hits from Disney films, a range of Christmas songs (despite it being the height of summer), all my mother’s favourites and one or two old-fashioned Scottish ditties. Every time a nurse or doctor came into the room they smiled and shook their heads at the sight of the three of us lolling around belting out songs in inglorious disharmony.

the room filled with love, laughter, light and warmth as well as caterwauling.

I know that not everybody agrees with that philosophy, but it was important to me that my children were there, not only to say a proper goodbye to their grandmother but also so that, when it is their turn to attend to me and their father, they will know that it is OK to laugh and be silly and that we would rather have laughter and song than heartbreak and tears.

While I will always feel that I should have been with her at the end, I fear that if we had stayed she would have continued to cling on to life for us. I had to let her go, and it seemed to me that it was only by departing that I could do so.

Whatever plans or promises we make, illness and death have a habit of shifting the goalposts.

But was it difficult for him or just difficult for the rest of us? How much greater is the burden of grief for those who have to watch Alzheimer’s rob someone of their memories, and most of their very identity, than it is for those who have them stolen?

It was obvious that it was not safe for him to continue living on his own. The strong, stubborn man of my youth would have to be taken into care.

yet this undemonstrative man would sit with her and talk at her for hours at a time,

‘How do we know she doesn’t hear us?’ he said. ‘How do we know that she isn’t just locked inside her head and simply can’t communicate? How do we know she isn’t lonely and scared?’

I would sit with him in the sunshine and hold his hand – a tactile demonstration of affection I could never have contemplated as a child.

because his face would light up when we came into the room.

Yet how the man he had been would have detested his dependency on others,

In the last year of his life he forgot how to walk and then how to speak. And then, slowly, he started to shut down.

It seemed that, to all intents and purposes, he had simply decided to switch himself off.

An unmistakable look of terror crossed his face and flashed out from those expressive, black eyes. I was stunned. My father had been virtually non-communicative for months.

he had found the strength to send out an SOS in the only way he could. He knew what was coming and he did not want to be alone.

I don’t think my father was afraid to die, just anxious about dying alone.

– a gradual giving out of power.

The huge physical and spiritual presence that had been a cornerstone of my life had slipped away from this world in what seemed like the flick of a light switch.

I felt no attachment to this shell, because it was not him. My father was not his body, he was something very much more than that.

These ceremonies are very important, not only in enabling families and communities to commemorate the lives of the deceased and bid them a public farewell, but also in bringing some solace to the bereaved by giving them a framework within which to ritualise their grief, whether that involves expressing it or masking it.

So with time it may become more distant, more compartmentalised and therefore easier to manage, but it does not go away.

All we can hope for is that the periods of paralysing, overwhelming grief become less frequent.

I love a good graveyard, too. They are wonderfully peaceful and welcoming places, especially those in town centres, where their prime position reflects their importance to the community in times gone by.

If I regret the disappearance of some of our longstanding conventions, I would acknowledge that in many respects the freedom we now have to mark a death by choreographing a farewell that more specifically reflects the identity, personality and beliefs of the departed is a positive development.

Yet however desperate I was to do him proud, I couldn’t escape the feeling that it was ridiculous to be still thinking about his preferences when he was the one person not going to be there that day to care one way or another.

I moved forward, threw up my hands and shouted for everyone to stop – yes, in the middle of the service. I told them how my father felt about playing the organ when people didn’t sing from their hearts, and asked if they could please give it some welly, just for him.

But I do like an occasion to be memorable.

Even our cleaners, after the initial shock, got used to him being there and became rather fond of him. They would say good morning to him when they came in the front door and give his brass plaque a bit of a dust down. They were quite sorry when he eventually left. People don’t have to be alive to make their presence felt.

So she found my father’s death difficult not only because she adored him, but because she was terrified by the thought of whose turn it might be next.

visceral need for a specific place they can visit, or picture in their mind’s eye, where the mortal remains of their loved one reside. For some this will be a grave; for others a wider landscape where cremated ashes have been scattered, generally a location that meant something to the deceased in life.

by the number of imaginative things you can now do with somebody’s ashes. They can be fired into space or deposited in water to create a marine reef; you can have them incorporated into glass and made into jewellery, paperweights or vases.

A body bequeathed to science can be retained by law for three years – a long time for a family to wait for the ashes of their loved one to be returned to them. But in the case of these donors, we hope the certainty that the firm wish of the deceased is being fulfilled brings some comfort.

The bequeathers sign the forms in front of a witness

send one back to the anatomy department and lodge the other with their will at their solicitor’s office.

This can be a challenging time for families. They might not understand or agree with the decision of the person they love and often feel confused by the inherent lengthy postponement of the usual funeral ceremonies.

since we have no desire to cause additional pain to relatives, at times strong family objections may overrule the wishes of the deceased.

which is why we advise all our donors to speak openly and honestly with their families about their decision.

We now have several generations of Dundee families who have ‘gone to the university’. Their names are recorded in our Book of Remembrance. This is not just a memorial to the bequeathers but a daily reminder to our students of how fortunate they are to benefit from the gift of so many people who have asked only one thing in return: that they learn.

He tells me he has purchased equipment from the internet that will allow him to go peacefully, will not cause any disruption to his body and will leave him fully in control of his actions and his decision until the very last moment.

These are not thought processes that many of us follow in such detail through to the conclusion

Suicide tourism is an expensive business and the decision to embark on it is often made earlier than is necessary because of fears that delaying too long may result in the person becoming too ill to undertake the journey. In making sure this doesn’t happen, they may well be depriving themselves and their families of a few more precious moments and experiences together before reaching the point where no quality of life at all is possible.

The difference between the two practices lies in the degree of involvement of a second party. If a patient asks a physician to end his life, perhaps with a lethal injection, and the physician complies, this is defined as voluntary euthanasia. If the physician prescribes lethal drugs for the patient to self-administer, it is assisted suicide.

In America, assisted suicide is legal only for those diagnosed as both terminally ill and mentally competent who die in Oregon, Montana, Washington, Vermont or California. Oregon was the first US state to legalise assisted dying with its Death with Dignity Act of 1994. Medication can be prescribed by a physician and self-administered only after two doctors have confirmed that the patient is likely to have less than six months to live.

Perhaps simply knowing that the drug is there if they want it is enough to reassure the terminally ill that control of their own life and death resides in their own hands.

perhaps understandably fearing that it would have a detrimental effect on society’s trust in doctors. Yet in a recent European survey, the country with the highest level of trust in doctors was the Netherlands, where assisted death is legal. It seems that being given a choice may increase trust rather than diminish it.

It is not illegal for them to end their lives, but to comply with the law it must be done without assistance, which means that often the only options at their disposal are traumatic or violent.

It is probably no coincidence that those countries and states where assisted dying is legal usually have a higher investment in palliative care and are generally more open about death and end-of-life options.