Please be aware that while I will speak lightly on technical elements, I want to discuss the thoughts and mental process you may find yourself experiencing when undertaking a case requiring facial restoration.
We’ve all been here: You receive a decedent, peel back the sheet and assess. While typical embalming challenges such as jaundice or edema can be difficult, taking on a restoration that is the result of trauma is a whole other mindset.
You ask yourself if it’s possible to change what you see in a way that makes a difference, if you are capable. The first hurdle is often yourself. Self- doubt can be as compelling as self-confidence, and this is where you choose which to embrace. If you chose self-confidence (aka the “I have nothing to lose so why not try” path), then please continue. If you are unsure and need a moment, you can catch up – no worries.
Once you decide to perform a reconstruction, you commit to a process. Unlike some cases where you can walk in, embalm, and then leave the prep room feeling like there was a clear finish line, this will be different. You will be forming a plan (where to start, what you’ll need, your approach and order), and this takes time. It also requires creativity. You may find yourself holding a wooden coffee stir stick that in your mind’s eye becomes a tool for straightening a nostril. You may examine a plastic zip tie to implement as a means of connection. I recently found myself wandering the aisles of a hardware store for a particularly challenging case, considering options for creating structural stability. I had an idea of what I needed to do, but by taking my time and having an open mind I was able to craft a solution.
When these occasions arise, be careful with what you choose to use. The material must be able to withstand the potential exposure to your embalming chemicals, manipulation, etc. Also, consider how that material’s use could be perceived. For example, plastic sheeting is preferred over trash bags. Many of us are of the generation that saw empty embalming fluid bottles taped together and used as positioning blocks, but we should be more thoughtful. We have new mortuary products that take away the need to be MacGyver when you have a complex case (or at least less like him). It’s a new day, and these should be considered first.
You will likely look at photos to help guide your work. This is another area where times have changed. Many moons ago I would have requested a photo from a family, and they could often present one that portrayed the person honestly. While this is still a possibility, technology and filters have redefined normal in a lot of images. I, myself once took a picture of my grandmother using a photo filter that made her have a full beard and mustache. While she admittedly had a chin hair or two, she obviously didn’t look like that. Skin tones and symmetry can be altered, as well as expectations. It is very important to be clear when asking for a photo- recent, unfiltered. Sure, you can look for the individual on social media, but I recommend you proceed with caution, or utilize that option as a last resort. Filters reign supreme there. Additionally, distancing yourself from the personal details surrounding that life can help you remain focused on the technical work you are performing. There are times when we must be clinical in our approach, and I have found this is one of those times.
When you have the photo, that voice you heard earlier might pipe up again- “I can’t make him/her look like this. What was I thinking? I don’t have the skills for this.” The reality is you may not be able to make them look like that. Your goal is to get as close as you can. If you fixate on perfection, you will inevitably feel defeated no matter how good your work. In my experience, self-doubt will sabotage you if you allow it to. Try referring to industry materials and sources if you have questions or want another opinion. This is where having a trusted squad of professionals you can reach out to is invaluable. Social media groups can be helpful but are uncertain based on the attitudes of members. This is why you need to have a resource you can be comfortable with. Reminder- none of us are born with a trocar in our hands, so we shouldn’t be expected to be geniuses. If you are new to the field, start making friends and widen your net. Your squad can be as large as you feel comfortable with and having a couple of peers you can speak to honestly and who will honor the privacy of your case’s shared details.
While performing the RA tasks, I have found it is helpful to take breaks and walk away at times. Sometimes we become so focused on perfecting something that we gauge the overall success of what we are doing by it. Taking a breather allows your weary eyes and brain to rest, and for you to take things in with a refreshed perspective. Recognize when you are tapped out and need to step away. When you return you may see progress instead of that pesky uneven facial feature, skin tone or texture you are momentarily displeased with.
Finally, and this is specifically for you- Don’t take it personally if the family is not pleased, even after you tried. You can only do your best, and sometimes even when we think they look “good”, we forget a major factor that will differ between us and the family: They are imagining what that person looked like when they saw them alive. We are comparing it to photos and what we saw when we pulled back the sheet and working with what we have in front of us.
I encourage you to be brave, and don’t let that inner voice discourage you. It can contribute to feelings of reassurance or of failure. You get to choose.
