The Doctors’ Riot

The practice of medicine is considered an honorable profession. This was not always the case. One of the first major civil disturbances in post-Revolutionary America was precipitated by popular anger directed at the discipline. The so-called Doctors’ Riot began on 16 April 1788 and killed as many as two dozen people.

Oddly, the incident is almost entirely forgotten today.

In the late 18th century, the state of New York had a single formal medical school (Columbia). But if one wanted to practice as a doctor, another avenue was to attend lectures at local hospitals and enroll in sketchy private schools of anatomy, hoping to learn enough to muddle through patient care.

Anatomical dissection was a major facet of early medical education, though many saw the practice as sacrilegious. In early 1788, New York City newspapers ran several sensational stories about medical students stealing corpses from local cemeteries (usually potters’ fields and the so-called Negro Burial Ground). While some of the reports were rumor and hearsay, there was definitely a kernel of truth to the allegations.

In February of that year, a group of the city’s free and enslaved blacks submitted a petition to the Common Council complaining of “young gentlemen in this city who call themselves students of the physic… [who] under cover of the night, in the most wanton sallies of excess… dig up bodies of our deceased friends and relatives, carrying them away without respect for age or sex.”

Astoundingly, the group didn’t ask for a cessation to the practice, only that it be “conducted with the decency and propriety which the solemnity of such occasion requires” !!

The tepid petition was ignored; it seems that stealing poor black bodies was no big deal. But on 21 February 1788, the Advertiser reported that the body of a young white woman had been stolen from Trinity Churchyard.

THAT was a different story.

A group of angry (white) locals went to Trinity and exhumed several graves upon hearing this news. They found at least one of the coffins empty. Enraged, they descended on New York Hospital, which was known to host private anatomy lectures and demonstrations.

An officer in the local militia wrote what happened next:

“The cry of barbarity… was soon spread, [those] young sons of Galen [a poetic allusion to a physician in Ancient Greece] fleeing in every direction. One took refuge in a chimney. The hospital apartments were ransacked. In the anatomy room were found three fresh bodies – one boiling in a kettle, and two others cut up with certain parts… hanging in a most brutal position. The circumstances, together with the wanton and apparent inhuman complexion of the room, exasperated the mob beyond all bounds, [resulting in] the total destruction of every anatom[ic specimen] in the hospital.”

Although most of the doctors and medical students fled when the shovel-wielding rabble appeared, a handful remained to guard the valuable collection of anatomical and pathological displays, many imported. Their efforts were in vain, and the specimens were dragged out in the street and set ablaze.

A mob then went around town looking for other (entirely uninvolved) doctors and medical students. They descended on Columbia, where they searched the anatomical theatre, museum, chapel, library, and even student’s bedrooms for signs of dissection. Finding no bodies (students had removed them when forewarned), the men searched several other doctors’ homes, and then marched down Broadway to the jail. By later that day, thousands of angry men were demanding that the doctors hiding inside the jail be brought outside.

The militia was called to restore order. Bricks and stones were thrown. Shots were fired. People fell dead.

In the aftermath, vigilante groups set up night watches at cemeteries. And worried prominent physicians in town took out ads saying that they were uninvolved and had never robbed bodies in the city – ‘in the city’ being an important distinction, since the potters’ fields and Negro Burial Ground were outside the city limits.

A grand jury never returned any indictments, but the reputation of the medical profession in New York was sullied for decades.

In the year after the Doctors Riot, the New York legislature passed “An Act to Prevent the Odious Practice of Digging Up and Removing for the Purpose of Dissection, Dead Bodies Interred in Cemeteries or Burial Places.” And although the number of crimes eligible for post mortem dissection was increased in that same statute, there were still major shortages of specimens. It wasn’t until the early 20th century that grave robbing ceased altogether.

But the riot did produce another long-term effect. It led to one of the earliest medical licensing systems in the country, by the terms of which would-be doctors had to apprentice with established and respectable physicians or else attend at least two years of formal medical school in addition to passing a rigorous state exam. This signaled the death-knell for the private and unregulated fly-by-night anatomy schools that were once so common throughout the colonies.

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[Copyright 2013 @ The Alienist’s Compendium]

Nellie Bly

[Today’s post is sponsored by my good friends, Monika Vainoriene MD, and Enrikas Vainorius, MD, of Morrisville, NC. We were talking about this very subject recently, and now here is a bit more detail…]

Though likely apocryphal, there’s a story told by psychiatrists over drinks at happy hour that goes something like this: years ago, an employee of a mental asylum in Johannesburg, South Africa, was transporting twenty patients in a bus from one psychiatric facility to another. He stopped (on company time) for a few drinks while en route, and when he got back to the bus, all of the patients had eloped. Fearing for his job and not wanting to admit to his incompetence, the driver proceeded to a nearby bus stop in town and offered everyone waiting there a free ride. He then delivered these unsuspecting passengers to the second asylum, telling the receiving staff that the ‘patients’ were very excitable and prone to bizarre delusions of abduction. The deception wasn’t discovered for almost a week.

It’s long been a joke amongst psychiatrists that if a healthy person were ever committed to a psychiatric facility, they might have a difficult time getting out, since those predictable statements that they’d make – “I’m not crazy!” – are the same utterances that the truly disturbed would say.

Well, we know of at least one situation where this did, in fact, happen.

Elizabeth Jane Cochran was born in 1864 near Pittsburgh PA. She was one of fifteen children, and was always known as the rebellious one. This made her stand out during an age in which women were meant to be seen and not heard.

Her father died when she was 6 years old, and the family was thrown into poverty. By the age of 14, Elizabeth was having to work outside the home to help support the family. She held brief gigs as a schoolteacher and a maid in a boardinghouse, but nothing seemed too permanent.

Around this time, she read an op-ed piece in the Pittsburgh daily newspaper by one Erasmus Wilson, then a well-known journalist. He wrote that working women were “an abomination,” and should be home, pregnant and tending to their husbands. This annoyed Elizabeth, who knew that many working women – she and her mother amongst them – had no such option. So Elizabeth replied to Wilson with a strongly worded letter about the offensive article. The newspaper loved her chutzpah, and subsequently hired her as a writer and giving her the pen name Nellie Bly.

Elizabeth/ Nellie started writing about the plight facing working women, but the newspaper decided she should be writing about fashion and home economics. Nellie wasn’t interested in that, so she quit and headed to New York. Luckily, her reputation by then proceeded her, and it wasn’t long before she was hired by the New York World. They had a plan for Nellie. On 22 September 1887, Nellie was approached by her new editor to write an article about the state’s notorious Blackwell Island Insane Asylum. They wanted to know what went on behind the barred doors, and Nellie agreed to find out. The editor offered no solid plan to get her out of the institution once her observations were completed, but promised her it would be achieved somehow. Her instructions were simple: “Write up things as you find them, good or bad; give praise and blame as you think best, and tell the truth all the time.”

But first, Nellie had to get herself committed, which meant she had to feign insanity convincingly. She decided to pose as a poor girl looking for work at the city’s Temporary Home for Females, under the name Nellie Brown. There, she started displaying ‘insane’ behaviour. She said she was afraid of the other women, spoke vaguely, and spent that first night staring blankly at a wall rather than sleeping. She reported having nightmares of attacking people with a knife.

The plan worked. The ass’t matron called the police and Nellie was hauled away. The next morning, a Judge Duffy ordered a mental examination, and the court’s alienist declared her insane. A second specialist concurred, adding, “[the patient is] positively demented. I consider it a hopeless case. She needs to be put where someone will take care of her.”

Nellie’s first observation: it’s not very difficult to fake mental illness and get admitted to an asylum.

Once at the asylum, Nellie met a number of other women who didn’t seem to have anything wrong with them either. She watched as those women were brought before doctors for follow-up examinations. One woman only had a fever as far as Nellie could tell. Another was German, and as no one at the asylum spoke her language, the staff thought the woman must be crazy. When it was Nellie’s turn, she decided to drop the charade and act/ talk as she did in everyday life; however, the doctor ignored her comments and kept flirting with the nurse instead. Nellie noted that, “the more sanely I talked and acted, the crazier I was thought to be.”

Nellie determined quickly that the food was horrible and sleeping arrangements were chilly and uncomfortable. Asylum life, Nellie soon found, was unsuitable for anyone. She was forced to endure ice-cold baths, freezing nights, both verbal and physical abuse at the hands of the nurses, isolation, and the fear of fire (doors were individually locked from the outside, and windows were barred, so if a fire broke out, it was likely that a majority of the patients would die.) “What, excepting torture, would produce insanity quicker than this treatment? Take a perfectly sane and healthy woman, shut her up and make her sit from 6 a.m. to 8 p.m. on straight-back benches, do not allow her to talk or move during these hours, give her no reading and let her know nothing of the world or its doings, give her bad food and harsh treatment, and see how long it will take to make her insane. Two months [of that] would make her a mental and physical wreck.”

Towards the end of her stay, Nellie pressed the doctors for answers. How could they determine whether or not the women were insane if they didn’t listen to them? She insisted on a full examination to determine her sanity, but the doctors only brushed her aside, thinking she was raving. She wrote that “the insane asylum on Blackwell’s Island is a human rat-trap. It is easy to get in, but once there it is impossible to leave.”

Luckily for the intrepid reporter, her editor made good on his promise to get her out. After ten days in the asylum, she was freed and on her way back to the newspaper’s offices (details of her release remain sketchy). The first installment of Nellie’s report on the conditions in the asylum was published a few days later; the entire expose ran over 17 issues (and was later compiled into a book, Ten Days In A Mad House). Readers were horrified, and Nellie Bly was made a celebrity of sorts, praised for her bravery during her time in the asylum.

an illustration from Nellie Bly's book

an illustration from Nellie Bly’s book

Predictably, the medical staff offered many excuses for the allegations in Nellie’s articles. But the public was outraged. Nellie’s writings produced many changes and better treatment for those institutionalized, including more funding for the Department of Public Charities and Corrections. One involuntary patient later wrote, “ever since [Nellie left], everything is different. The nurses are very kind and we are given plenty to wear. The doctors come to see us often and the food is greatly improved.”

Interestingly, her asylum stint wasn’t the last of Nellie’s adventures. She later traveled solo around the world in 72 days, a much bigger deal for a woman in the late 19th century than it would be today, trying to ‘beat’ other reporters and the 80-day mark set by the Jules Verne novel of the same name. Not only did she succeed in her global circumnavigation, but she actually was able to meet Verne in Paris while passing through town!

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[Copyright 2013 @ The Alienist’s Compendium]

Major Gen’l Daniel Sickles

Over his professional life, Daniel Sickles (1819-1914) was both a House Representative and Senator, the U.S. ambassador to Spain, and a controversial general in the Union Army during the Civil War. Less known is how Sickles shot to death the district attorney of Washington DC, one Phillip Barton Key (son of Francis Scott Key of ‘Star Spangled Banner’ fame)… and got away with it based on a novel legal defense.

Sickles married his wife, Teresa, in 1852 when he was 33 and she was just 21. He proceeded to have numerous extramarital affairs, but became incensed when rumor reached him that his neglected spouse had herself taken the younger Key as a lover. He confronted her and forced her to write a confession:

“I have been in a house on Fifteenth Street [in D.C.], with Mr. Key. How many times I don’t know. I believe the house belongs to a colored man. The house is unoccupied. I commenced going there the latter part of January. I have been alone with Mr. Key. We usually stayed an hour or more. There was a bed on the second story. I did what is usual for a wicked woman to do… an intimacy of an improper kind.” She acquiesced to her incensed husband’s demands to cease such behavior.

But on 27 February 1859, Sickles learned of Key’s attempts to contact his wife yet again. He accosted the would-be Romeo in Lafayette Park, just across from the White House. Twelve witnesses later reported that Sickles yelled at Key, “you scoundrel… you have dishonored my home, and you must die!” A pistol was flashed. The first shot fired by Sickles missed, and Key threw an object at his attacker (later determined to be a pair of opera glasses that Key used to see if Mrs Sickles had left him a signal). The fight became hand-to-hand, but Sickles pulled out a second pistol and this time hit Key in the thigh. Sickles pulled a third gun and fatally shot Key in the chest for good measure.

"take that!"

“take that!”

Sickles then went to see Jeremiah Black, the U.S. Attorney General, at his home, where he surrendered himself to the law.

Sickle’s stay in jail pre-trial was rather unusual. He had many visitors from the upper strata of D.C. society, all of whom he was allowed to entertain in the warden’s private quarters. The accused murderer even rec’d a handwritten note, albeit not a visit, from President James Buchanan.

At trial, although he confessed to the murder, Sickles’ legal team came up with a novel defense – that of temporary insanity triggered by the ongoing infidelity (note: one defense attorney was none other than Edwin Stanton, soon to be Lincoln’s Secretary of War – eat your heart out, O.J.!) The newspapers of the day jumped on the bandwagon, heralding Sickles for protecting the virtue of the women of Washington from the ravages of the lusty Key and others like him – never mind that Mrs Sickles was fully complicit. And although legally inadmissible, Sickles leaked his wife’s earlier forced confession to the press to further sway the court of public opinion.

“You are here to fix the price of the marriage bed!”, roared another defense attorney, John Graham, in a speech so packed with quotations from Othello, Judaic history and Roman law that it lasted two days and later appeared as a book.

The jury bought it hook-line-and-sinker. Sickles was acquitted. And as his affliction was ‘temporary’ insanity, by then resolved, he didn’t even have to spend any time in an asylum. His was the first such use of this novel defense in American jurisprudence. He basically got away with murder.

Sickles and his wife remained estranged for the rest of her short life. She died of TB in 1861 at the age of 31.

Sickles attempted to rehabilitate himself by enlisting in the Union Army at the outbreak of the Civil War. He commanded a corps at Gettysburg, lost a leg to an artillery shell, and was awarded the Medal of Honor. Still, he was accused of insubordination and disobeying orders during that pivotal battle. He spent the rest of his life trying to put a positive spin on his decisions while under fire, and his prickly relationships with commanding officers.

But he always made time for the ladies. Serving with an American diplomatic legation in London in the 1870s, he introduced his date, a high-priced prostitute, to Queen Victoria. He is also said to have had an affair with deposed Queen Isabella II of Spain while on mission in Madrid.

He died at 94 in New York City and, controversies aside, was buried in Arlington National Cemetery with full honors. His battle-severed leg resides to this day in the National Museum of Health and Medicine in Washington, D.C.

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[Copyright 2013 @ The Alienist’s Compendium]

Death Takes A Holiday (XIV)

to wit, a middle-aged peripatetic shrink undertakes the Great American Cross-Country Road Trip with help from little leaguers, German bikers, the King of Rock ‘n Roll, porn stars and an abandoned brothel, a flock of domesticated ducks, the Department of Homeland Security and the West Memphis police, a decommissioned atomic warhead, some dodgy motels… and a strange rider in the back of a 2013 Ford Fusion.

Heading out of Dallas, Mr Knobby and I were facing a long drive to our next stop on the cross-country itinerary. We knew that we must spend another night on the road, since we’d be arriving at our planned destination well after dark.

You’d think that, after my experience with the Adobe Inn/ Cotton Eyed Joe’s of Clint TX, I would avoid run-down dumps like the plague.

You’d be wrong.

The Bonester was covered in the back seat as I pulled into West Memphis AR after midnight. I was so exhausted that I didn’t feel I could operate the car safely any longer. Fleabag or not, we had to find a place to stop… and in this particular town, sleeping by the side of the road was definitely NOT an option.

In add’n to its urban decay, West Memphis doesn’t have very good road signs. The billboards along the interstate instructed us to exit, but once we did so, I couldn’t locate the strip of motels that were visible from the highway. Frustrated, I was driving up and down deserted avenues looking for the service road access, and not finding it. Recent construction, detours, and orange cones rendered my GPS confused and worthless. And there were no gas stations or fast food joints that appeared safe enough at which to stop to ask for directions.

As I drove down one empty street, I saw what looked like the service road access. There were no cars around. I made a quick u-turn.

The siren and red lights came out of nowhere.

!#$!!@$#!!

I pulled over into the parking lot of a burned-out storefront. The officer approached.

“License, please.”

I keep my license in my wallet next to my Dept of Public Safety badge, and it’s impossible that he didn’t see it. His demeanor became friendlier. He looked young and was probably new on the force. He asked me where I lived and to where I was headed so late at night. He seemed bored. Forgetting my apparent traffic offense, we began to chat as public safety colleagues.

“Yeah, I hate working the night shift. This is a rough town. You see some really bad stuff. Gunshots and knife fights all the time. Drugs. Robberies. Assaults. And you pull people over in cars and never know what you’ll find. Just the other day, I stopped a guy and he had a stiff in the back!”

“You don’t say?!”

[just minutes before, the officer’s hand had been resting on the back seat window of the driver’s side, not a yardstick from my own stiff’s blanketed bony head]

Sensing my fatigue, the officer told me how to get to the nearest row of highway motels. We parted with a smile – not even a traffic warning – and I followed his directions, soon coming upon an Econolodge ‘vacancy’ sign. There were signs of life in the office despite the late hour. The night clerk buzzed me in, and a very loud chime announced my entrance.

This place lacked bulletproof glass. The door leading to the front desk wasn’t braced with a heavy chair. And there were no bailbondsmen’s cards on the counter (though there was a sign inviting guests to partake of “free alcohol at the manager’s reception each Friday evening.”)

Not free beer or wine. Not champagne, mind you. For the discriminating Arkansan palate, it’s generic alcohol that’s offered.

Vast distances notwithstanding, this Econolodge did nevertheless share some ambience with the Adobe Inn more than 1000 miles to the west.

Abandoned dumpsters out back? Check.

Scattered rattletrap cars all parked ‘facing out’? Check.

Spartan décor that was mid-century Salvation Army at best? Check.

The olfactory pervasion of stale cigarettes? Check

The nagging sensation that Boney was not the first dead body to spend the night there? Check.

An added bonus was the liberal use of concertina wire topping the back parking lot’s fence, which abutted a deserted, trash strewn, and graffiti-bedecked public housing complex. Nice.

Too tired to care, I backed in – like the few other hardy souls braving the place that night – and carried Santa Muerte into our ground floor room. Being the travel pro that I had become, I braced the door with a chair. I then collapsed on the bed and fell fast asleep.

Were there flashing lights or sirens in the parking lot that night, I wasn’t cognizant of them.

I awoke the next morning, still alive and feeling better. Packing my friend in the car once more, we headed off, sorry to have missed the manager’s reception, but brimming with enthusiasm.

Today we would reach Mecca.

[to be continued…]

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[Copyright 2013 @ The Alienist’s Compendium]

Judge Grandison Harris (And His Other Career)

Commencing before the Civil War and lasting until WWI, the imposing brick manse on Telfair Street in Augusta served, no longer as a home, but as the main academic building of the Medical College of Georgia.

The antebellum faculty purchased a slave in Charleston in 1852. He was a large muscular Gullah youth named Grandison Harris, and he was destined to work at the medical school. His official job title was “porter and janitor,” but in reality, his presence was for wholly illegal purposes: to steal corpses from nearby graveyards to feed the demand for anatomic specimens for the medical students.

At that time, nearby Cedar Grove cemetery was the preferred site from which to pilfer the dead, as it was only a degree above a potters’ field, catering to the poor and minority of the area.

Harris was fully literate, a rarity for slaves at that time; this was a necessary skill, however, given his job duties. He needed to monitor newspapers closely to see who had died and where they were going to be buried.

The modus was always the same: enter the cemetery late at night, excavate at the head of the fresh grave, smash the lid of the coffin, and pull out the corpse. Then Harris would toss the body in a burlap sack and haul it back to the school, where it would be immersed in a vat of whiskey awaiting the anatomist’s knife.

It is said that students initially liked Harris, and not only because he was doing their dirty work. He became a de facto teaching assistant who helped during dissections, and the students felt more comfortable with him than with the stern professors. However, the South was still the South. When the Civil War ended, the newly freed Harris – remember, he was fully literate, and was said to be a sharp dresser – served briefly as a judge in the state government then under military Reconstruction. Once federal occupation ended, though, and with the rise of Jim Crow, Harris left the court and returned to the anatomy lab, where many students saw him as a carpetbagger who had shown disloyalty to the South. For a long while, the students derisively addressed him as “Judge,” and many gave him the cold shoulder.

The faculty of MCG, 1877. That's Harris in the doorway

The faculty of MCG, 1877. That’s Harris in the doorway

Still, Harris continued to rob graves, and post-war, he was even occasionally funded by the school to purchase unclaimed bodies from jails and asylums. Having started in servitude and then having evolved into an actual employee, by 1905, after more than 50 years of work, Harris retired and was granted a pension from the medical college. And three years after that, he returned to give a final lecture, said by those in attendance to have touched upon the finer points of grave robbing.

Grandison Harris died in 1911, in his 70s, and was buried at Cedar Grove, the very site he robbed so many times. Unfortunately, the Savannah River flooded in 1929 and all of the cemetery’s burial records were destroyed. Thus, Harris now lies in an unmarked grave, as do all of his former ‘subjects.’

Well, not all of them. In 1989, renovations on the old medical school building uncovered dozens of partial and complete human skeletons in the dirt basement, along with rusty and broken parts from 19th century dissection tools. The police and the county coroner were called, but after examining the find, it became apparent that this was not a modern crime scene, nor one that the district attorney cared to prosecute… given that all of the principals were themselves by then deceased.

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[Copyright 2013 @ The Alienist’s Compendium]

A Visit To The Crematorium

In medical training, one studies everything that happens from conception to demise. But oddly, the minute somebody expires, it all becomes very mysterious.

One can argue that a doctor’s role is over once the patient is dead, and I suppose there is some truth to that. Still, I’ve always been fascinated by the American ‘death industry,’ in no small part because it functions as the deus ex machina of healthcare: the orderlies silently whisk the body away to the hospital basement, and the next anyone hears, the funeral service is taking place.

I’ve been around a lot of dead bodies over the years, so seeing someone stretched out in the morgue wasn’t my goal. What I really wanted to see was a cremation.

So I called up an acquaintance who owns and operates his family’s funeral home and crematorium in a rural part of the state.

“Mind if I come and watch?”

“Not at all.”

Down I went one day. Knowing that my co-workers would think I had lost my marbles, I merely said that I had an appointment and would be taking off the rest of the afternoon.

I met my acquaintance in his lobby and he gave me a quick tour of the building. A body had just been delivered from another funeral home (one without its own crematorium) and he escorted me back to the refrigerator where it had been placed. That body was naked, stiff, wrapped in plastic, and inside a cardboard box… just like the frozen salmon fillets at Sam’s Club.

The act of burning a body to ashes is not rocket science. But four aspects of my visit stand out even months later.

First, morticians rarely let their ovens cool all the way down unless maintenance needs to take place. It takes too much energy to cool and then reheat repeatedly (much as is the case with the HVAC in your home). Thus, a functioning crematory oven cools a bit, maybe to ‘only’ 450’F, and then the switch of contents takes place. An instrument with a very long handle is used to scoop out still-hot ash and then push the next body inside. Even standing way back from the partially opened door, the blast of heat is impressive, and one starts to sweat almost immediately. And because no one, obviously, goes inside the oven to scrub it between cremations, it is inevitable that there is co-mingling of ashes. This is something that is not advertised to families, I suspect, but it’s obvious to even the untrained eye.

Second, once a body is inside the oven and the door is closed, the heat is turned way up, but periodically the door must still be partially opened so that the long-handled tool can be inserted to ‘turn’ the remains (much as you might do with logs in your fireplace at home). Bones – even those that have been blasted with intense heat – still can retain their shape; when the door was opened during my visit, even after a seemingly long time in the heat, I could still recognize a few bones in silhouette. But like the ashes at the bottom of your charcoal grill on the porch, once the long handled-tool touched them, the bones quickly disintegrated into a pile of pulverized calcified ash.

Third, when the ashes are swept out of the oven at the end of the process, they contain larger chunks of bone that haven’t powderized yet. The mortician takes what looks like a mortar-and-pestle and crunches the cremains to give the ash a more uniform finely granular appearance. And then he runs a magnet through the ash to pull out small bits of metal, such as screws from artificial joints or gaskets from artificial heart valves. These pieces of metal are unceremoniously tossed into a bucket on the floor for recycling.

Finally, some sort of filter is attached to the exhaust system that vents from the oven to the outside. This prevents black smoke from billowing out the chimney on the roof; instead, the hot gases that issue forth are clear and colorless, and not seen by anyone in the surrounding community. The only way that one might know that a cremation is taking place is noticing the slight background distortions caused by heat rising out of the chimney. And I suppose this makes sense – the vision of a crematorium with black smoke belching forth has a slightly Nazi-esque ambience to it, and is almost certainly not good for business.

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[Copyright 2013 @ The Alienist’s Compendium]