John drowned at the age of 14, but was rescued in time to be taken to the hospital and kept alive on life support. I learned he did not want to be kept alive by artificial means, and I learned this because he told me so.

 
I talk to the dead all the time. I have strict rules about what can be said in their presence. Main rule: never say anything in the presence of a deceased person you would not say in front of their family. But John was the only one who talked back to me.

 
I sometimes have to do things to the dead that would be very painful if they were alive, and I let them know I understand it’s painful and I’m sorry for what has to be done. I’m going to bend your leg over your head. I’m going to straighten out every one of your fingers. I will try not to hurt you. I have accidentally broken their bones before – jawbones, forearms, shoulders.  I am sorry. Back when I used to cry, I’d cry.

 
One of the worst experiences I’ve had on the job is when I accidentally cut the neck of a child who died of blunt force trauma to the throat. Four of us were working on him and we were in a hurry. I was too quick with my scissors and I cut him on the throat. It took me years before I could talk about it. I had hurt him in the place where he received a fatal blow.

 
“Are you ready?” I never proceed with the first cut if they object. “I’m going to have to cut you again.” I explain everything I do to them. Never assume they cannot hear you.

 
I picked John up from the medical examiner and when I unwrapped him, he asked me not to hurt him anymore. All his organ systems had failed, he had undergone an amputation, and he just wanted to leave. He should have died in the water. He had been out having fun, and should have died in a place he enjoyed. Instead he was brought to a place where he fought against life and was not allowed to leave on his own terms.

 
I did what I do and John was feeling better already. Finally he was allowed to be dead, as he had been three months ago before someone intervened and did not allow it to happen. He relaxed and smiled. He thanked me for rescuing him. It was the first time one of the bodies I worked on had ever talked to me. It will probably be the last.

 
I brought John back home to his jubilant mother. She knew he was finally not suffering. The family home was full of his schoolmates and other young friends, who were sobbing because they had confirmation right in front of them that there really was no more hope. His father was silent. His mother was laughing and poking fun at him.

 
But eventually she had to let him go. I had a similar case a few years ago; a kid killed in a motorcycle accident. His mother took three weeks to plan the funeral, during which time she visited her son every day. One day she asked me if she could just leave him with me at the funeral home, and be my friend, and I had to tell her no. It was time to have the funeral. It was time to release him.

 
John’s mother had me bring him to the church, and then she knew it was over. She could not have her son in the house anymore, surrounded by friends who wrote messages on his casket. He was really, fully, dead. The casket would be closed and a traditional religious service conducted. I did snap some photos of the balloon release afterward.

 
Then we rode to the crematory. John’s mother would be loading him into the oven, pressing the button and turning on the blast of flames that would forever take her son away. She already knew he was gone, but this marked the moment she would no longer see his face. Due to his amputation he was much lighter than most kids his age, yet she struggled to push his casket into the oven.

 
That struggle was nothing compared to what I saw on her face when she pushed the button. As soon as she did, the giant metal door would swing shut and the flame would engulf him. There would be no turning back. No last goodbye.

 
She was wild-eyed, sweating, straining, crying, her hair plastered to her face, looking the way she must have looked giving birth to him. In pain she brought her son into the world and in greater pain she would send him away.

 
I have watched men lift hundreds of pounds with their arms, with their legs, on their backs, yelling and falling over and vomiting. That is nothing compared to what I saw on a little woman’s face that day.