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I am a huge fan of Radiolab, and happened to hear their story of the Resusci Anne, or CPR Annie, recently. I thought Pallimed Arts readers would enjoy this as it fits well into our field.

Most of us at some time have at least seen CPR Annie, others of us have actually pounded on her chest, and preformed mouth to mouth as we went through the CPR steps.  The same face has been used since the beginning of CPR training in the 1960s and Annie remains the most popular CPR manikin face.

This face is not just a plastic computer generated face either. There is a unique history to Resusci Anne.  The designer of Annie is Asmund Laerdal, a Norwegian toy maker.  Laedral agreed to participate in this new training idea when friend Dr. Peter Safar, the father of CPR, asked. Laedral, however, needed inspiration and so while visiting his parents he noticed an attractive mask of a woman's face on their wall and knew immediately this would be his model. The face he saw was actually a death mask, known as "L'Inconnue de la Seine"

If you need a refresher on Death Masks, Amber talked about it in a post a while ago. They are plaster casts made of someone's face, soon after death, used as a memento.

"L'Inconnue de la Seine" actually means the 'unknown woman of the Seine'.  The story goes that this beautiful woman was pulled out of the river Seine in Paris in the 1880's.  Her beauty struck the workers at the morgue, so a death mask was created. The reason for her death was guessed to be suicide and from there her legend grew. In time reproductions were created and people captivated by her unknown identity and beauty began to display the mask in their homes as art.  

Her identity to this day is unknown, but this has not stopped her allure. She was a bit of a sensation, especially in the 1920's and 30's, and well known writers such as Richard le Gallienne, Jules Supervielle, Claire Goll  and Anias Nin mentioned L'Inconnue in their works.  

The Radiolab episode commented on the irony of this whole story. The unknown beautiful lady who drowned, is now symbolically resuscitated in CPR classes around the world, over and over again.

I found a deeper irony in my research. Both Peter Safar and Asmund Laerdal had children who required resuscitation. Asmund's son nearly drowned in 1954 at the age of 2, and his Asmund, despite not knowing CPR, was able to revive him. Dr. Safar had a daughter with severe asthma, who had a tragic asthma attack in 1966. Dr. Safar was able to resuscitate her with CPR, however she had anoxic trauma and died several days later.

I would highly recommend a listen to Radiolab's piece, as they interview Laerdal's son and do a superb job telling this story.   Most of all, the next time you do CPR training, remember the story of the "L'Inconnue de la Seine" as you do your, "Annie, Annie, are you okay?"

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The Lien Foundation has done it again.  They're making us smile by doing unconventional projects that incorporate ideas about dying into the arts.  Like their project "Happy Coffin" done as apart of the overall Life Before Death campaign, the Last Outfit project attempts to reduce the stigma that surrounds death and dying.

This photographic project was instigated by the The Straits Times, a leading Singapore newspaper, who partnered with the philanthropic Lien Foundation. Eight professional photographers captured 23 subjects in their outfit of choice for burial.

Most burial outfits are favorite clothing picked out by a patient just prior to death, or very often picked by family members. The idea traditionally is not about creativity, but respectful formal wear.

The thought from the Last Outfit project was, what if this were changed? What if our final outfit was a statement about who we are? This personal flare is quite obvious in the photographs taken.  Lee Poh Wah, CEO of the Lien Foundation says, "Each exit outfit is one that best expresses the subjects' unique life. Their outfits and candid attitude have given us a fresh and fun perspective on how to deal with death. If there's something like funeral fashion,they are setting a trend by wearing their souls on their sleeves"

One of the subjects actually was on hospice for this project. Madam Foo Piao Lin had cancer and took her role more seriously. She chose an expensive cheongsam, which she had never owned, for her final outfit. She has since passed, byt her wish was fulfilled as she was buried in her cheongsam. She is pictured in the middle photograph in the series at the bottom.

The photographs are definitely conversation starters. I wonder, though, if faced with death like Madam Foo, if indeed these same outfits would be chosen.

What do you think? To those involved in hospice, how often is the last outfit actually brought up or discussed? Do you like the idea of creativity in a burial outfit or is it too much?

To scroll through the 23 images and read short bio's of the participants visit The Last Outfit web page.

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According to the National Funeral Directors Association, the cremation rate in the United States in 2009 was 36.86%, that's up from 25.04% in 1999.  The NFDA also predicts that the cremation rate will be just shy of 59% in 2025! With the rising trend in cremations, it's about time we did a post on urns.  We already know that we can be creative, as explored in our post on custom coffins, so it should be no surprise that custom urns also exist.

The urn itself is simply a vessel or vase without handles. The urn was used in ancient Greek and Roman times for oils, as well as cremation ashes.

Today after cremation, the options are quite diverse on what is done with the ashes. Many people scatter ashes, so have no need for an urn.  Other people use the urn for the ashes and have the entire thing buried in a cemetery plot or placed above ground in the cemetery columbarium (a specific place within a mausoleum for urns). Just like eco-friendly coffins, they also make bio-degradable urns. Another choice is to bring the urn with the ashes home, keeping the departed's remains with you at all times.

When an urn is used, there really is no industry standard. The typical size for an individual may be to hold 170-350 cubic inches, whereas the popular couple urns hold 400-500 cubic inches of ashes. Materials used range from paper, glass and wood, all the way to metals, ceramics and marble.  And if you thought shape mattered, this too is up for negotiation. Urns can look traditional and vase like, or look like an item. I even saw examples for photo frame urns and music box urns.

Looking around online I found several types of urn dealers.  First there is the mega market dealers.  These urns offered on these sites can be very unique, like these cowboy boot urns, and it's true that these mega market dealers have a lot of inventory, but you can also find these same urns on multiple sites. Therefore, the uniqueness is more in design and not truly a one of a kind urn. The urn's from these large scale dealer's are some of the most economical.


Next are the hand made artisan urns. These urns are made individually by artists. Sybil Sage, for instance does mosaic urns, embedded with personal items such as business cards and photos.

Portrait urns like the kind done by artist Ruby Lindell, are hand painted ceramic urns such this example on the right.

Then, of course, there are the eco-friendly urns. Traditionally eco-friendly urns are made of paper. Though I did find sand  urns meant to place in water.  There is also company known as the "Great Burial Reef" which designs an urn made of natural concrete. The idea is that the urn can be placed on the ocean floor and can foster marine life for future generations.

Unlike coffins, urn's offer an extremely wide variety of creative options, allowing a very personalized urn if desired. What I find interesting is that some of the urns look so much like traditional home decor, that the memorial could easily blend in, completely disguised to house guests.

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We've discussed some of the more unique ways people are being buried these days, like custom coffins or eco-friendly burials.  I am waiting for the recumbent effigy to regain popularity as well.

An effigy is traditionally known as a representation of a person, and as a form of funerary art, first began appearing in the 7th century BC. It was the Etruscan Civilization of northern Italy that really excelled in portraying humans and this art evolved from just a representation of a human head, to entire figures placed on the lid of the sarcophagus.  This picture on the right is taken from the Louvre. It is entitled "Sarcophagus of the Spouses" from 520-510 BC. The detail of clothing and jewelry from a time thousands of years ago is astounding, but so too is the contemporary way this person was honored in death.

This art form re-emerged in the 12th century, and by the 14th century the effigies began to include hands clasped together in prayer. I find this fact interesting, considering that it was in 1415 that the Ars Moriendi text appeared as a directive from the church on how to die well, focusing on prayer for traits of faith, hope, patience, humility and generosity.

A slight variation on the recumbent effigy was seen in the later Middle Ages, depicting the effigy in the form of a decomposing corpse.  Often called "transi" or "corpse tombs", the purpose was to remind the living that the "good" life was indeed temporary.  These funerary monuments often were in double-decker style, with the proper effigy on top, in robes and crowns, and the rotting corpse statue below.  This picture from Fyfield in Berkshire is from Sir John Golafre who died in 1442.

As the centuries progressed more effigies were done in life like poses, often the deceased depicted reading a book, at a banquet and often depicted in younger days.  This example on the right,contained in Paris at the Louvre, is a classic example of this, as the woman appears quite comfortable reading her book with her dog near by.  Notice though, the "Transi" here, with the naked decaying relief showing an older woman below the effigy.

The most recent recumbent effigies I found were of Herbert Kitchner (1850-1916), pictured to the left, which is housed at St. Paul's Cathedral in London and that of Sun Yat-sen (1866-1925) in Nanjing, China.

So, has this funerary art form that has existed for thousands of years finally died off?  Or should we consider the embalming and preservation of such icons as Mao Tse Tung and Vladimir Lenin as modern day variations?  Perhaps even postmortem photography could be considered a branch? Or what of the technique of  plastination... there are plenty of rumors swirling about Zsa Zsa Gabor and Michael Jackson's bodies being plastinated.  If so, this permanent effigy just may be the 21st century's answer to recumbent effigies.

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I was sitting at a stop light recently, nonchalantly glancing to my right when I noticed a sign for a cemetery reading "Resurrection Cemetery".   This struck me as odd. Do only people who believe they will be resurrected get buried here? Do people ever get offended by the name? This led to all sorts of questions about the names allotted to cemeteries.

First, it greatly depends on who owns the cemetery.  Cemeteries can be owned by cities/ townships, churches, or private owners such as a funeral home.  As you may guess, if a cemetery is associated with a church, it most likely will have the name of the church in it.

There is a web site I found that has culled through names and has them listed as most common to least common. For instance, according to The Political Graveyard, the most common name of a cemetery is actually Presbyterian with 175 located mostly east of the Mississippi River.  The second most common is Episcopal (140) and third is Evergreen (111).

It appears that the two main categories of names are either of religious origin; denomination, saint, or biblical theme such as hope, grace, etc. or landscape origin such as Woodlawn, Oakwood, etc.  There are certainly also many cemeteries named for people or towns, such as Washington and Lincoln.

Then there are the names that make us chuckle, like Prospect Hill, which leads one to ask, prospect of what? Or Hollywood Forever Cemetery, which still has some plots for those of us who want to rest with some of the who's who of Hollywood's yesteryear.


If the cemetery name is unique enough, it could even become a national attraction, like the Merry Cemetery in  Sapanta, Romania. As its name implies the tombstones are colorful and whimsical, with poems used as epitaphs.


Although not so much unusual by name, the location of this cemetery is what caught my eye.  The Neptune Memorial Reef located off the coast of Key Biscayne in Miami, Florida is what the name implies, a cemetery under the water.  Loved ones' cremated remains are mixed with cement and attached to the man-made reef with a name plate for future divers to visit.

With the 115,000 cemeteries that exist in the United States, I am sure there are other obscure and unusually named cemeteries.  However, the name is likely not to be under consideration when buying a plot. According to an AARP survey 53% of purchasers picked a cemetery based on family reasons, history or heritage and another 24% chose based on location. It seems the name, be that Assumption, or Mound or Odd Fellow didn't play a part.

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Humans have been placing their deceased loved ones in coffins for centuries.  The word "coffin" is ultimately derived from the Greek word ko-pi-na ,(basket) which as a word appeared in manuscripts as far back as 1300 B.C.!

In the US, the design has stayed relatively the same over the years, except for that brief time in the 1800's that people were afraid of being buried alive and a crop of "safety coffins" popped up.

The same is not true in Ghana, Africa, where for the last 60 years the Ga tribe in the coastal region of Ghana have celebrated an individual's life by designing custom coffins.

When I say custom coffin I do not mean painting a traditional coffin in personalized colors or designs as the company Colorful Coffins in the UK, or Happy Coffins in Singapore does.  Although these coffins are beautiful and individualized, they still hold to the traditional Coffin form.

In Ghana, however, "custom" implies bold and different, as a handful of wood workers have created a unique craft, actually molding the wood into individual objects that represent the deceased's life.  This can range from a soda bottle, seashell, fish, or shoe to represent an item the person sold for a living. Or the coffin may be a symbol of something loved, like a cigarette, Mercedes, airplane or ice cream bar.

The colorful coffins take weeks to months to prepare and can cost a year's salary for a Ghana resident. If the deceased hadn't planned ahead enough for the coffin to be ready- the body sometimes must be refrigerated the length of time it takes to finish.  Other delays can come with family disputes on what item should actually represent the deceased.

They say that more and more foreigners are purchasing these type of coffins, thought whether the purchase is purely for art or if this trend is beginning to catch on for actual burial practices is unknown. In case you are interested eShopAfrica actually offers the Ga coffins for purchase on-line and shipped to your door. (You may also enjoy seeing other ideas)

So, what do you think?  Does the idea of personalizing your coffin as the other two companies listed above do, appeal to you?  Do you think the idea of a over-sized wooden object as a coffin will catch on in the US?

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A death mask is a cast made of a persons face hours after death, a process that goes back to ancient times and was common until the mid 20th century. These are usually done in plaster or wax. The casts are then used as mementos of the dead or to create portraits. (J Edgar Hoover kept a death mask of John Dillinger in his office as a souvenir of his war on crime.) The History Channel made a documentary on the topic, entitled Death Masks.

The documentary focuses on the death and life masks (made while the person was still alive) of several famous historic figures, Abraham Lincoln, George Washington, Julius Caesar, William Shakespeare, Napoleon, John Dillinger . They then use modern computer scans to create life like images of how the person would look in real life. They go into the process of how the masks are made. A life mask made in Lincoln's time had to set about an hour on the persons face to dry. Not a big deal if you were already dead, but I would imagine a long hour if you were alive. (Below is a death mask of Shakespeare.)

Mostly the documentary focused on what the masks could tell us about the deceased. Was the man shot in Chicago really John Dillinger? Is the dollar bill an accurate portrait of George Washington? It seems that sometimes more than one death mask will surface for a particular person and it is a challenge to find which is the right one. The two life masks of Lincoln, taken 5 years apart (one before he became president and one just weeks before he died) shows a marked decline in his health. The last mask made has actually be confused for a death mask.

The documentary goes into some of the psychology behind the desk masks. "From ancient times, capturing the faces of the dead for all to see was a macabre reminder that we all end up as dust." Death masks were not just meant to be mementos but to serve as a warning to the living. "Death masks in particular are dark. This is not a living person. This is a corpse. In many ways they are a message to the living. They are about your mortality. About this is what you will become. They are designed to frighten in many ways." There are some very frightening death masks shown in the documentary.

The death masks reminded me a lot of the death photography. Both I find interesting but just a bit creepy. I'm not sure I would want either hanging in my living room. (Who wants a reminder of their own mortality hanging above their television?) I think I would much rather of a life mask of a loved one. Remember how they were before death, not after.

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The exact origins of Memorial Day are not exactly agreed upon. Many cities claim to be the founders of this holiday. The tradition, however, dates back to Civil War times. At one time Memorial day was known as Decoration Day, as it was the day families and friends of fallen Civil War soldiers would choose place flowers and "decorate" the graves.

The first official Memorial Day was May 30th 1868, after the day was declared by General John Logan, commander of the Grand Army of the Republic (a veterans' organization). The holiday was adopted by Michigan and New York and then by all the Northern states through the late 1800's. The Southern states had there own days they observed and did not recognize this holiday until after WWI (several Southern states still have a separate Memorial Day type holiday to honor confederate soldiers). Apparently the date, May 30th was chosen as it was not the anniversary of any battle.

At first the holiday was just to honor the Civil War dead. After WWI, Memorial Day changed to honoring all of Americans who died fighting in any war. Now it is often seen as a day to remember all who have died. (I remember going to the cemetery to decorate the graves of family members on Memorial Day when I was young.) In 1967, the name of the holiday was officially changed to "Memorial Day" and in 1971 the National Holiday Act changed the date of the holiday to the last Monday in May, creating a very convenient 3-day weekend. There has been for several years a push to move Memorial Day back to May 30th in order to try to give some meaning back to the day (so it's not just the long weekend when the pools open).

The top photo is from Arlington National Cemetery. Every year around Memorial Day, the 3rd U.S. Infantry Regiment or The Old Guard, in a tradition called "Flags In", places small flags in front of all graves in the cemetery.

The Fredericksburg National Cemetary hosts an annual Luminaria each year for Memorial Day. Approximately 15,300 candles are placed by volunteers on each of the graves (80% of which are unknown soldiers).

I have often wondered about the significance of the red flowers being given out for donations around this time every year. Inspired by the poem, "In Flanders Fields" (poem below) by Canadian WWI veteran and poet John McCrae, the Veterans of Foreign Wars take donations for their "Buddy" Poppy every year around Memorial Day. Theses poppies are assembled by disabled and needy veterans. Since 1922 this program has been raising money for veterans and their families through the poppies.

In Flanders Fields

In Flanders fields, the poppies blow

Between the crosses, row on row,

That mark our place; and in the sky

The larks, still bravely singing, fly

Scarce heard amid the guns below...

We are the Dead. Short days ago

We lived, felt dawn, saw sunset glow,

Loved, and were loved, and now we lie

In Flanders fields...

Take up our quarrel with the foe:

To you from failing hands, we throw

The torch; be yours to hold it high.

If ye break faith with us who die

We shall not sleep, though poppies grow

In Flanders fields...

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Everyone seems focused on "Going Green" these days, and the world of burial practices is no different.

I always just assumed that cremation was an eco-friendly alternative to the traditional embalming and casket burial. I have learned researching this topic that there are actually several more natural alternatives out there.

Let's talk ecology first. There are two aspects to consider in an eco-friendly burial; first the process itself shouldn't harm, pollute or tax earth's resources and second true eco-friendliness would allow the body itself to provide benefit to the earth as it biodegrades.

The touted benefits for cremation are that it takes up less land and eliminates the need for embalming. The entire purpose of embalming is to retard decomposition and prohibits the body's breakdown. Of note, according to Wikipedia, each year in the US we bury 827,060 gallons of embalming fluid!

The downsides for cremation are that the actual process of burning releases pollutants into the atmosphere, including mercury from fillings, and that it uses a tremendous amount of energy.

So the alternatives? There is a growing movement for true natural burials. Unlike traditional burials, the body is not embalmed, biodegradable caskets are used and the depth of burial is much more shallow. Biodegradable caskets can be anything from recycled paper, like the picture up top, to woven products like sea grass, willow or bamboo. Scattered in the US are cemeteries specializing in natural burial grounds. Often in these cemeteries there is the option for planting trees over the graveside and headstones are engraved natural stone that lies flush to the ground.

A similar process to cremation, without the same high energy use is Resomation. This developing format uses water and potassium hydroxide at high temperatures to dissolve the body. The end result is a white colored dust returned to the family and a green/brown liquid rich with peptides and amino acids that can be recycled into nature.

There is yet another possibility on the horizon for the eco-friendly patron called Promession. With this process the body is frozen in liquid nitrogen, shattered with vibrations, and freeze dried to remove water. Next a magnetic field is introduced to remove anything metal. The remains are placed in a corn starch coffin and buried. The body is essentially compost in 6-12 months, much quicker than the natural burial process. Also, unlike cremation, in which only inert materials remain, promession allows for organic material that provides nutrients for living things.

My hunch is that these next decades will bring even more options for the eco-friendly consumer. For more exploration related to this topic check out this 11 min video on natural burial by Mark Harris, and this interesting article on NPR "To Casket or Not to Casket"

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Researching for a former post on euphemisms and misnomers relating to death slang piqued my interest in the fear of being buried alive.

It seems that in the Victorian era, this fear was wide spread. Edgar Allen Poe wrote a story entitled "The Premature Burial", 1st published in Dollar Newspaper in 1844. It was a first hand account of a man with an intense fear of being buried alive, who actually has this happen. His story tells tales of people who've been buried alive. However unlikely these stories were in truth, the fear was very real...and perhaps for Edgar Allen Poe himself.

Besides literature themes abounding with this fear during the mid to late 1800's, the patent offices showed a spike of "Safety Coffins" during this time. They are all fairly similar, providing some way to either signal or escape the coffin. There's an article here listing all the patent descriptions with illustrations linked.

One of my favorites is this device by John Kirchbaum, from 1882. There is a bar actually placed in the corpse's hands when they are buried- so that if they awake they can turn the bar which turns a pointer in a glass box at the surface. I can just picture the grave yard attendant walking the rows looking to see if these pointers were now pointing to different numbers. The patent states that the device is used for “persons buried under doubt of being in a trance.”

There were editorials written in this time discussing the topic as well. In an 1893 issue of Science a man writes a personal account of an accidental burial entitled "Buried Alive: One's Sensations and Thoughts". Although not someone who was pronounced dead, but accidentally fell into a grave, readers would surely have walked away with this frightening experience on their mind.

In 1998 JAMA reprinted an editorial from 1898 that spoke about premature burial. The point of the editorial was to debunk the myths, helping us believe that the fear was public enough to lead a medical journal to address the issue. Part of the reassurance was that the average coffin had so little oxygen, that asphyxia would precede any return to consciousness. How comforting.

In case you thought this issue was long gone, consider an article published in the Journal of Palliative Medicine in 2006 entitled "Buried Alive; an Unusual Problem at the End of Life". In this case report the medical team dealt with a woman who was so frightened by the thought of being prematurely buried, that she requested immediate amputation of her hands at death, to ensure a "true" death. Read the article to find out the solution to this demand by family here.

While some fears of being buried alive may still exist, the height of social anxiety in this matter seemed to fade in the early 1900's as the practice of embalming became more widespread and technology began to provide methods marking the cessation of life.

References:
Moorehead, WK "Buried Alive, -One's sensations and thoughts" Science Feb.3, 1893. Vol. 21:522 (p61)
The Journal of the American Medical Association (1898;30:273-274, reprinted JAMA 1998;279(3):182) http://www.personalmd.com/news/a1998012212.shtml
Polizzotto, MN et al "Buried Alive: an Unusual Problem at the End of Life" Journal of Palliative Care. Summer(2006). Vol 22:2(p117)