Stefan Timmermans
Topic: Unclaimed Dead Bodies
Bio: Medical sociologist at UCLA
Readings: The Unclaimed: Abandonment and Hope in the City of Angels is here
If you’d like to share your thoughts on this episode, consider sending a message to @larrybernstein on Substack.
Transcript:
Larry Bernstein:
Welcome to What Happens Next. My name is Larry Bernstein. What Happens Next is a podcast which covers economics, politics, and education.
Today’s topic is Unclaimed Dead Bodies.
Our speaker is Stefan Timmermans who is a medical sociologist at UCLA and the author of a new book entitled The Unclaimed: Abandonment and Hope in the City of Angels.
We will discuss the shocking number of dead Americans who go unclaimed at the city morgue, and what this says about our society and the implications of deciding to live alone away from family. Buckle up. Stefan, please begin with your six minutes of opening remarks.
Stefan Timmermans:
My co-author Pamela Prickett and I wrote a book about people who end up unclaimed. These are people who when they died, their family was either unable or unwilling to bury them. The book explains how you end up at this point in your life where no one seems to care what happens to your body. We look at government agencies that step in when the family zooms out. I look at volunteers who come together to bury strangers.
Why is this topic important and timely now? It is because there is a shift in who is going unclaimed. More people are going unclaimed than ever before in the United States. The best estimates are that there is about 150,000 every year in the United States. Going unclaimed used to be an anomaly, one of the worst fates imagined. Even the poorest try to avoid ending up in an unmarked grave.
People with homes, families. and jobs may end up unclaimed. We talk in the book about a man who died with over a million dollars in his bank account, but his brother did not want to have anything to do with his funeral and left him to the county. Those at risk for going unclaimed dwell among us.
What's driving this phenomenon? In the book, we argue that the unclaimed reflect a deep sense of social isolation caused by eroding family ties. When government officials step in and they find an abandoned body, they call up the next of kin. The person, the government bureaucrat will ask, are you willing to make funeral arrangements? And this is the splitting point. If the person says yes, then they're claimed. But if they say no, they refuse to make funeral arrangements, then the person is unclaimed. And what we find is that in many of these situations, the person being asked to take on this responsibility of organizing a funeral has been estranged from the decedent.
The rise in unclaimed reflects what the current US Surgeon General Vivek Murthy called our epidemic of loneliness and isolation. American households have changed drastically in recent decades. More of us are living alone, more of us are divorced, never married, or childless, and nearly one in four, are estranged from close kin. We can no longer assume that there will be someone to bury us when we die.
What should we do about this? We argue in The Unclaimed that we should build community on two fronts. First, we need to fight social isolation. And specifically for the unclaimed, the law should recognize the deep, meaningful family relationships that do not fit in these boxes of the legal next of kin.
We need to mend our tattered safety net. People should not end up destitute and alone simply because they experience a bout of hardship. We should privilege social relationships. Our book is a wake-up call. Who's going to be there for you when you die? And if the question is uncertain, you need to take stock of your life and decide where to invest.
There is a special opportunity to form communities around the unclaimed by organizing funerals. What is special and meaningful about this is these are strangers burying strangers.
In the book we talk about veterans who come together every Wednesday morning at the Riverside National Cemetery to bury unclaimed veterans. Their families abandoned them and these veterans’ volunteers’ step in where the family stepped out. And for them, it rectifies some of the political abandonment that these veterans have undergone and restores their humanity.
Larry Bernstein:
I want to start by referencing a work of another sociologist Eric Klinenberg who spoke at my book club years ago about his book Going Solo. Eric argued that many Americans are choosing a solo life without a partner or children. He argues that it is a perfectly acceptable choice.
And there's pros and cons. One of the pros is you do not have to take care of children. You do not have to be responsible for others. You can have a hedonistic lifestyle. You can follow your own desires and pleasures. But one of the negative consequences is that you may die alone. And now you are pointing to the consequence and saying that is awful but that is the life you chose.
Stefan Timmermans:
I'm very happy that you started off by reminding us of the work of Eric Klinenberg because Eric is one of the very few people who has looked at the unclaimed before us. Indeed, he put it in a much broader argument of the advantages and disadvantages of deliberately going alone. This is the situation where the way that the legal system looks for a particular next of kin is going to exacerbate the dying alone part and going unclaimed. Because the government officials, when they are trying to find out the legal next of kin, they have a schema with 26 boxes of different kinds of family relationships in front of them. And when they hit the first box that is the person they must notify. They do not look any further. What they do not take into consideration is the quality of the relationships that people have. And what we see is people going solo does not mean that they do not have a community. They are still embedded in communities, but these communities are not legally recognized. It does not have to be that way. If instead the way the system was set up, it would recognize the quality of the relationship rather than a particular legal tie.
Larry Bernstein:
This reminds me of HIPAA. The state will say someone has to must decide like your kid or spouse. But it does not have to be. You could choose someone else.
Stefan Timmermans:
Going solo comes with a certain set of responsibilities. And we have a very lengthy history of encouraging people to put down a next of kin decision maker for a health care proxy. What we find out is that many people still don't do this.
How you die alone, whether you want to be in pain or not, whether you want to be resuscitated, whether you want to be on a ventilator, those are quite concrete decisions. The next step, like what happens to your body after you die, people are even less motivated to make decisions about it even though they can.
You can prepay a funeral, but it is exceedingly rare. We could rely on individuals to avoid going unclaimed by tasking them with making personal decisions, but the reality is that that just has an exceptionally low ceiling.
In medical decision making about whether to extubate. Somebody is at the end of their life, they are on their deathbed, and they call a family meeting and they are trying to come to a decision about the limit of medical interventions, which basically means usually advanced resuscitative efforts.
What is interesting even though there might be a person designated on the form, the medical staff is going to look for family consensus. In the case of disposition of the body, there is much less flexibility. But in healthcare research on end-of-life care, it is much more communal. It is much more of a consensus building process.
Larry Bernstein:
Why do you think hospitals are seeking a consensus? Are they worried that a fight's going to break out between the two of them, one to resuscitate, one not to, and then they will not know what to do?
Stefan Timmermans:
What's triggering is that it is an active step in many cases. Like you're turning off the ventilator. It's not just letting something happen. It's a pretty radical move of initiating the death process. And the stakes are high if you have a relative who is adamantly against it.
And hospitals have bioethicists support teams to bring the family together that keeps in mind what would be in the best interest of the patient on the deathbed. But the legal implications are high here because you are taking steps to allow a person to die by either withdrawing or stopping care altogether.
Larry Bernstein:
I did a book club with Judge Richard Posner for Law and Literature. And what Judge Posner said was that what literature allows us to examine different legal questions that we would not get in real life. Judge Posner could only give standing to those individuals with a real problem. And what literature does is it lets us evaluate a hypothetical problem. And sociologists like Erving Goffman like to sprinkle their works with literary examples. Stefan in your book, you referred to The Great Gatsby.
Here is what happens. The narrator Nick Carraway goes to visit Jay Gatsby's business partner, a Jewish guy by the name of Wolfsheim. And Nick Carraway says to him, I'd like you to go to Gatsby's funeral. He says he does not want to go. I was best of friends. I loved Gatsby. Well, why won't you go? And here is what he says. “Let us learn to show our friendship for a man when he is alive and not after he is dead. After that, my own rule is to let everything else alone.” Is Wolfsheim right?
Stefan Timmermans:
Wolfsheim is historically wrong. We have tried this throughout history since the Greek times to treat dead bodies as waste, as mere matter that we just can dispose of. It has never worked. At every point we have ritualized the disposition process. So even the situation where some people leave bodies open for vultures; it is very deeply ritualized. There are tons of different steps that need to be taken. What sets us apart as humans is that we bury our dead. And wherever you look, you find evidence that in the few instances where people are violating the death post-mortem, it is deliberate. It's done because it adds insult to injury. It's a post-mortem punishment. It is violating people who have been violated in life into the death process.
It is a little self-serving to say that you only care about people while they were alive, while the entire history of humanity shows that we care a lot about how people die. We have fought wars about wrong burials. I feel that is a difficult position to support historically. All the evidence points in a different direction.
One of the people who have made that very forcefully is UC Berkeley Professor Tom Laqueur who wrote The Work of the Dead where he explained that what he calls Diogenes' challenge. Diogenes was a very contrarian Greek philosopher who said after he died, he wanted to have his body thrown over the wall of the city and being eaten by animals.
When his disciples protested and said, “no, that's not what we do around here.” He said, “why don't you give me a stick to chase away the animals?” And again, they said, “if you're dead, how would you be able to chase away the animals?” And he said, “what does it matter?”
So, he wanted to point out their hypocrisy with taking the same position that you just laid out. But the reality was that even when he died, that did not happen. People erected a big marble statue in his honor. And the evidence shows that we are concerned about cemeteries, funerals, burying people properly and in a dignified manner.
Larry Bernstein:
In the Jewish tradition, cremation is not an option. Yet, many of my closest relatives have chosen cremation. It seems that norms of behavior are changing about burials. And maybe when you say that people aren't taking the time to think through these issues, sometimes it may express a revealed preference that they don't care. If they did care, it would take an hour's worth of effort to fill out the relevant documents and give it to the appropriate authorities. But they choose not to. And that revealed preference is, I do not care.
Stefan Timmermans:
The evidence does not really support the “I don't care” part of the narrative. The evidence supports that we care. Around 2021, we had a tipping point in how Americans disposed of their loved ones. For the first time, more cremations occurred than burials.
And that trend has continued and had been going on for a long time. That does not reflect a retrenchment of disposition. But it reflects it is more cost effective. The average cremation could be between $500 and $1000. The average funeral in the United States is about $8,000. And for most people, this is an unexpected expense. And if the household income is around $70,000, and you add $8,000 as an unexpected expense, people are going to look for cheaper solutions. But then we also see much more of a memorialization.
The two big changes in the way that we bury our dead these days is the move towards cremation, even among people from religions where that might have been before frowned upon or even forbidden.
And then the stronger personalization of the funeral or the burial part. We see more of an emphasis on a celebration of life in a way that honors the life rather than just focusing on the people left behind. And the message being sent is that by honoring a well-lived life, we are also providing some comfort to those left behind at the same time.
Larry Bernstein:
My dad went into hospice in December of 2020 in the middle of COVID.
I asked my dad if he wanted to do a celebration of life, basically his funeral while still alive. And he said, let's do it. We got 150 people on a Zoom call where he said goodbye and people told stories. It's odd to be at a funeral where the guy's still living. But it is much happier. It's not morose. And it was to celebrate life and choose an ending that he felt comfortable with and wanted to do.
Stefan Timmermans:
This is absolutely beautiful. It warms my heart. I mean that seriously. That's exactly what I'm hoping we get to this point that we are celebrating these lives and that we are taking the time to bring people together. That is exactly what it's all about.
Larry Bernstein:
If podcast listeners want to see and hear my dad’s celebration of life, click here. My Aunt Sharon did a beautiful job editing it and made it available to everyone.
Is the funeral for the dead or for the living?
Stefan Timmermans:
It is for the living. And that is why the unclaimed are important too, because these people are invisible during their life, and we can make them visible at the moment of death. We do not want to wait till they are dead to make them visible, but there is something we can still do if we organize a ceremony for them.
From a government perspective, it is a burden to dispose of these unclaimed bodies. And the simplest thing to do is to spread the ashes in the sea, throw them in a tomb. Funeral directors, medical examiner's coroners, they have boxes and boxes of remains in their facilities. Once you turn that into a ceremony, you bring people together, it just changes the entire experience. And to bring people together, to mourn strangers, it is extraordinarily powerful.
Larry Bernstein:
In the Clint Eastwood movie The Good the Bad and the Ugly, there is a plot twist that the stolen gold is buried in the grave of an unknown soldier. And in the film scene, they get to the location and there are thousands of such graves. What was the attitude for burying unknown persons in wartime?
Stefan Timmermans:
Wartime, disasters, epidemic, pandemics, those are times when it is understandable that a proper funeral is going to be a lower priority. However, people still care a lot. There was an activism during the civil war and historian Drew Faust who used to be President of Harvard talked about how the civil war changed our perception of death and dying and held the government accountable to reuniting dead bodies with their families.
We have an entire system of identification; people are wearing dog tags. It all came out of the fear that a body would be left behind and nobody would know who it is that we could not identify them.
There's enormous effort even in war to try to retrieve human remains. For decades, the US government has sent missions to Vietnam, doing archaeological and historical research to retrieve the last human remains being buried there. This cost millions of dollars. It underscores how much we do care about this once the circumstances allow for it.
Larry Bernstein:
Your co-author for this work is Pamela Prickett. What did Pamela bring to the project that complemented your skills to make Unclaimed a better book?
Stefan Timmermans:
She was the one who approached me and said, do you want to do this? I am fascinated by the hierarchy of mourning. Like some people the entire nation comes together to mourn. Other people we seem to have forgotten before they even take their last breath. I was game for this project.
Pamela is a former journalist and what makes the unclaimed interesting makes them difficult to study because these are people who have been abandoned by their relatives. But to get to their stories, you need to talk to their relatives. Pamela would go house by house talking to the neighbors about a person that died a couple of years ago. And I would be sitting in the car and just sinking deeper and deeper and hoping nobody would answer the phone, but she would just have no qualms dealing with this. I am better with bureaucracies, and she is also an extraordinary, gifted writer. In the writing process. I am good at throwing things on paper and then she's good at cutting unnecessary text. The beautiful writing of the book is largely due to her.
Larry Bernstein:
In preparation for this podcast, I read two of your other books on sociology theory. And the essence of those books is what questions should we ask and who should we interview to learn from? And in this case, the person who normally you would want to interview is dead. What problems do you have when you cannot interview the client?
Stefan Timmermans:
This is indeed something that is critical to doing what Iddo Tavory and I call abductive analysis, where you look for surprises in your research, because the surprises are going to point to something you don't know yet and that you have to grapple with and maybe theorize anew.
What is interesting in terms of The Unclaimed is that they're dead by the time we are arriving on the scene. You cannot go and study a bunch of people in the hope that somebody goes unclaimed. And what is fascinating about this is that the four main characters that we follow in the book, we knew a little bit about them. But then when we started digging into their lives, we found so many fascinating twists and turns over their life course that nobody could have anticipated. These people have fascinating lives, and we are burying 2,000 of them every year in Los Angeles County in one mass grave their ashes co-mingled. And what stories are we burying them? So rather than running away from the fact that you cannot really know something about these people because you cannot ask them yourself, you just need to lean into it and go as deep as you can in there. The real challenge of this project was could we pull this off? Was this even possible? Is it possible to tell these stories? Because besides the amazing work that Eric Klinenberg did, we're one of the very few people who are focused on the unclaimed. And maybe there's a reason for that. I tell my students, if nobody else has studied it, it is either because you are the first genius to come up with a good idea or there's a good reason that nobody else has studied it.
Larry Bernstein:
Let's dig in a little deeper on one of the characters in your book Midge. She has close friends at the church, and they want to take the body, bury it, and be responsible.
Stefan Timmermans:
But they lack standing now that the county finds a related next of kin her rights take priority over this caring and involved church community in Westchester, Los Angeles.
But then when the county comes in and says, we find a legal next of kin the rights of that community are severe. They are not allowed to bury her.
Larry Bernstein:
Let us workshop this. What can they do? They can hold a funeral. They can hold a celebration of life. They can get together as a community and honor Midge. What they've lost control over is the dead body. They cannot bury her, cremate her, do as they wish. The adopted niece has power over the body but cannot control her memory. All limited to is the rights of the body. And to that, I would say, unless you are interested in where that cremation or the body is placed, it's not that significant.
Stefan Timmermans:
You are right in the sense that they did create a celebration of life ceremony in the church that celebrated the role that she had in the community. But then we talked to the people who were the closest to Midge in this church community, and some of them could not get their head around the idea that she had become unclaimed. That her body had been put in a mass grave with everyone else. It still was some judgment on her life, a final official signature that defined her in ways that they felt violated what she meant for them in the community. They were upset about this.
Larry Bernstein:
I enjoy going to museum exhibits. One of my favorites was The Body exhibit, which I saw at the Seaport. A hundred bodies were cut open so we could see muscles, ligaments, eyeballs, the full human body. And in the exhibit these bodies were unclaimed, and a Chinese municipality had sold the bodies to the organizers of this exhibit.
How do you feel about exploiting the use of these unclaimed bodies, albeit for educational purposes?
Stefan Timmermans:
Body Worlds is a tricky outlier in terms of educational purposes because a lot of it is entertainment. And the line between those two is very murky in Body Worlds. But the broader point holds like the unclaimed have been the go-to providers of bodies for medical students to learn autopsy techniques and to mortuary schools to practice embalming. And that is still the case. Even in Los Angeles County, some of the bodies of the unclaimed are siphoned off to a mortuary school and then brought back to be cremated afterwards. And what it signifies to me is the way in which these bodies are bad deaths. Going unclaimed is a bad outcome that you want to try to avoid because if there would be a situation which does happen now with more and more in medical schools where you can get consent for donating your body to science, that would be preferable by making the people who have been abandoned to the default research subjects or objects to practice embalming and autopsy skills.
We used to use bodies from people convicted to death. Whenever somebody died by a hanging or by a firing squad, their bodies would be sent to the medical schools. And this extra punishment that extended from life into the post-mortem afterlife. And we are doing this for unclaimed bodies, it is significant.
Larry Bernstein:
Back to an example you made in your opening remarks, Tom was the individual who died very wealthy. He had a son who he disinherited. And he had a brother who he had a close relationship and would speak to weekly. He had an estate of $1.3 million. In his will, he said, I'm going to give the $1.3 million to my brother, yet the brother decides not to give him a funeral. And you, Stefan, said, I just cannot believe this guy.
Stefan Timmermans:
Yeah, exactly. What really happened is that the government will take money out of his estate and give him a private funeral. He does not end up in the pauper's grave. But the private funeral is the saddest affair you can imagine. We attended some of these funerals. The only people present is the funeral director and a hired priest.
We timed it. It took seven minutes to bury one of those people. And one of those funerals was right next to one of the highways in the cemetery, one of those highways that are crisscrossing Los Angeles. And there was a homeless camp like seven feet away from this gravestone. It is a sad ending.
There is just this element of greed where people's antennas go up with the prospect of inheriting an estate, but then they don't want to do even the minimum effort to organize a burial or a funeral or to memorialize these decedents and that contrast between the eagerness to get the death certificate and to get to the money versus the reluctance with the funeral is very striking.
Larry Bernstein:
There are bureaucrats who have a job to find the next of kin and it's like a maze and they're good at it.
Stefan Timmermans:
Very good.
Larry Bernstein:
They found that child, the needle in the haystack. They get on the phone, and they say, “I'm so sorry to inform you, but your kin have passed. Would you like to take over with the funeral arrangements? And the guy says no.
Stefan Timmermans:
Exactly. Imagine how crushing this is. You've been a detective, you've been sleuthing in genealogy databases, you have gone into government databases that are compiled by private companies and you have turned over and it's a little bit of a competition because there's several agencies doing this and so you're trying to be the first one to get to this next of kin and then they basically say, no, I don't care.
And they find out about money. You are looking at the zip codes where their houses are of these next of kin. And you see they are in the wealthy neighborhoods. And then they decline to take care of their loved one. And they are focused on getting that death certificate so they can get to the inheritance. It can be soul crushing.
The government's business model is they allow the relatives to waver for only a couple of months and then the body will be cremated because cremations are much easier to store. And then the government gives these relatives in Los Angeles County three years to retrieve the ashes but most of them will not.
Larry Bernstein:
I end each podcast with a note of optimism. What are you optimistic about as it relates to unclaimed bodies?
Stefan Timmermans:
What I’m optimistic about unclaimed bodies is that we care about them that they tug at our heartstrings and that they signify abandonment. They send you the message that nobody cares whether you died or not. And that is a deep existential question that each one of us must grapple with. But they also bring people together to bury strangers. And this idea of strangers burying strangers is a beacon of hope in a polarized world.
Larry Bernstein:
Thanks to Stefan for joining us today.
If you missed our last two podcasts, they were with Anne Curzan who is the Dean of Literature, Science and Arts at the University of Michigan and the author of Says Who? A Kinder, Funner Usage Guide for Everyone Who Cares About Words.
This was a two-part series on English grammar. We discussed the ongoing changes in proper usage of words, the growing importance of Microsoft Word’s Grammar Checker, how to effectively use dictionaries, the impact of non-native speakers on English, the changing pronunciation of words, teaching grammar to kids, and the introduction of new words to the English language.
I would now like to make a plug for next week’s podcast with Chris Arnade. Chris worked with me at Salomon Brothers in the 1990s. He now walks the world with his camera sending dispatches from different cities around the world. I intend to discuss some of the walks described in Chris’s Substack Archive including Seoul, Hanoi, Amman, Tokyo and Dakar.
You can find our previous episodes and transcripts on our website whathappensnextin6minutes.com. Please subscribe to our weekly emails and follow us on Apple Podcasts or Spotify.
Thank you for joining us today, good-bye.
Check out our previous episode, The Continuing Evolution of English, here.
Unclaimed Dead Bodies