All That Remains

Sue Black is a forensic anthropologist and anatomist whose career has been spent identifying the dead and reconstructing the lives inscribed in human remains. In this memoir, which blends popular science, casework, and autobiography, she argues that modern society's estrangement from death, through sinister imagery and euphemistic language, has deepened a collective misunderstanding of what is a natural and necessary part of life. Her own father's death exemplifies her approach: He is not "lost" or "passed." He is buried at Tomnahurich Cemetery in Inverness, and he is dead. The book, she writes, is "as much about life as about death" (10).

Black traces her career to a childhood in the Scottish Highlands, where a strict Presbyterian upbringing instilled a no-nonsense pragmatism. From the age of twelve, she worked at a butcher's shop near Inverness, learning the precision of cutting around bones. At the University of Aberdeen, two uninspiring years gave way to a transformative encounter with human dissection. She and her partner named their cadaver Henry, after Henry Gray, author of Gray's Anatomy. Henry, who had died of a heart attack in his late seventies, became her silent teacher for a full academic year.

Black distinguishes between forensic pathology, which seeks the cause and manner of death, and forensic anthropology, which reconstructs the life lived by reuniting a living identity with what remains of the body. Two cases illustrate the partnership: In one, she reassembles over 40 skull fragments to confirm that a 15-year-old boy was executed by a close-range gunshot. In the other, she reconstructs a skull to identify the hammer used to kill a young man who had confronted vandals.

She explores the biological foundations of identity. Every human begins as two fused cells that multiply into over 50 trillion in adulthood, organized into roughly 250 cell types and 78 organs, yet only five organs are vital to sustained life: the heart, brain, lungs, kidneys, and liver. Four cell types persist for an entire lifetime, including the otic capsule, a tiny bone at the skull's base formed during pregnancy whose chemical composition reflects the mother's diet, carrying a permanent elemental signature. Stable isotope analysis of teeth, bones, and hair can reveal where a person lived, what they ate, and whether they consumed drugs, providing a chemical timeline of a life.

Black outlines seven stages of postmortem change, from pallor mortis (paleness within minutes of death) through rigor mortis (temporary muscle stiffening) to putrefaction and skeletonisation, noting that environmental factors make these stages unreliable for determining time since death. The identification of unknown remains relies on three primary indicators recognized by INTERPOL, the International Criminal Police Organization: DNA, fingerprints, and dental records. When none produces a match, forensic anthropologists construct a biological profile based on sex, age, stature, and ancestry. Black is candid about limitations: Sex cannot be reliably determined from a child's skeleton, and age estimation grows imprecise after 40. In one case, a young man's skeletal remains found hanging in Scottish woodland could not be identified through initial analysis. A facial reconstruction broadcast on the BBC program Crimewatch prompted a call from his mother, whose DNA confirmed the match. He had left home to escape drug debts and died by suicide.

Black's personal encounters with death anchor the narrative. Her first experience viewing a loved one's body came when her father sent her to check on Uncle Willie at a funeral home. Uncle Willie, a jovial master plasterer who had helped raise Black's mother, had died at 83. She describes the disconnect between the laughing man she remembered and the smaller, waxy figure in the coffin. Her grandmother, whom Black calls the most important person in her life, died of lung cancer when Black was 15, her first real experience of loss. Before dying, her grandmother made Black promise to be with her father at his death, insisting that nobody should step through death's door alone.

Her mother's rapid decline from liver failure unfolded over five weekends. On the final visit, Black and her two youngest daughters filled the hospital room with Disney songs and Scottish ditties sung to their comatose grandmother. Her father's dementia progressed over years. On his last day, after months of near-total unresponsiveness, a look of terror crossed his face when Black said she was leaving. She recognized his silent plea and stayed, holding his hand through the night with her daughter Beth until his breathing slowed and stopped, fulfilling the promise she had made decades earlier.

Among the book's most memorable figures is Arthur, an elderly anatomy donor who has planned his own death by suicide and shared a code word with Black that he will leave on her answering machine as a signal. At Black's arrangement, Arthur visited the dissecting room, spoke with students, and examined specimens, an encounter that profoundly affected everyone present. Black describes the moral weight of knowing his plans and presents arguments for and against assisted dying.

Black's deployment to Kosovo in 1999 and 2000 forms the book's most harrowing chapter. She joined the British forensic team investigating war crimes for the International Criminal Tribunal for the former Yugoslavia. At the village of Velika Krusa, she found the remains of over 40 men and boys who had been machine-gunned and set alight by Serbian special police. At another site, children had been forced to run toward their mothers across open grassland while captors shot at them. When a colleague was overwhelmed by the sight of a two-year-old victim, Black broke protocol to comfort him.

The knowledge gained from co-authoring Developmental Juvenile Osteology with anatomist Louise Scheuer proved essential in Kosovo. Black spent 12 hours separating the commingled remains of a family of 11, including eight children killed by a rocket-propelled grenade, assigning fragments to specific individuals by skeletal age and identifying the twins by a Mickey Mouse vest their father confirmed. She also recounts unsolved UK cases: the 1976 disappearance of Renee MacRae and her three-year-old son Andrew from Inverness, and the 1957 disappearance of 11-year-old Moira Anderson from Coatbridge. Despite exhaustive excavations, neither victim was found.

Her chapter on criminal dismemberment classifies five types, with defensive dismemberment, motivated by disposal, accounting for 85 percent of cases. She recounts the 2009 "jigsaw murder," in which a victim was jointed with anatomical precision by a cutter, a gang member apprenticed to dismember bodies. She also describes the 2012 murder of actress Gemma McCluskie by her brother Tony, who dismembered her body and disposed of parts in Regent's Canal. The 2004 Asian tsunami propelled Black into Disaster Victim Identification (DVI). Frustrated by the UK government's response, she wrote to Prime Minister Tony Blair demanding a national capability. By 2006, a national DVI team was established, and Dundee University trained over 550 police officers using bequeathed cadavers in simulated disaster scenarios.

A 2006 child sexual abuse case led Black to revive century-old research by Italian forensic scientist Arrigo Tamassia on vein-pattern identification. Because veins on the back of the hand form before birth and remain unique to each individual, their patterns can identify perpetrators in abuse images. In over 82 percent of accepted cases, defendants changed their plea to guilty, sparing child victims from testifying. She also recounts developing the Thiel cadaveric facility at Dundee, adopting a "soft-fix" embalming method created by Austrian anatomist Walter Thiel that produces flexible, nearly odorless cadavers. A fundraising campaign called "Million for a Morgue," organized with crime writer Val McDermid, raised the funds for the new mortuary, which opened in 2014.

The book closes with Black's reflections on her own mortality. She does not want a prolonged death or dementia; she wants to be fully conscious at the moment of death to experience it as her final adventure. She plans to bequeath her body to a Scottish anatomy department, to be Thiel-embalmed and dissected, with her skeleton stored in Dundee's teaching collection so she can "continue to teach there long after I have stopped functioning" (338).