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Todd Miller slowly positions the head of the body between plastic blocks as Curtis Foley makes a 2-inch incision on the neck near the collar bone. Miller then digs beneath the skin, grasps the carotid artery and jugular vein and pulls them toward the surface, tying them together to ensure easy access for later. Foley makes a tiny cut for a tube to enter each vessel.

Meanwhile, Miller closes the corpse's eyes. He uses plastic eye caps lined with a texture similar to Velcro to affix the eyeball to the lid. This prevents the eyes from sinking into the skull and keeps the eyelids from dehydrating.

Miller washes the body several times with heavy-duty disinfectant soap and water and massages the body to loosen the muscles, reversing the effects of rigor mortis.

He runs his hands along the arteries, preparing them to be emptied of blood.

In the world of morticians, this process is called "setting the features." Once embalming fluid is added, the body will stiffen into position — the position it'll stay in until it's buried.

This body, like most of those that are embalmed, is destined for a plush casket, a fancy outfit and plenty of makeup and refinement, all before being placed in the ground and topped off with an elegant headstone.

It's here, lying on a shiny metal table under the care of morticians like Foley and Miller, that most of us will eventually wind up. Roughly 2.5 million Americans die each year, and about 2 million of them will be embalmed, according to the National Funeral Directors Association. Though overwhelmingly popular in U.S. funerals, embalming is performed on only a fraction of the world's newly dead.

Although conventional embalming and burying the dead remains the most popular choice in this country, recent years have shown a shift toward different methods to dispose of America's dead. Today, the bodies of about one-third of Americans are cremated after death, perhaps the most significant change in consumer preference.

Though no concrete numbers exist, industry experts estimate that 10,000 bodies are donated to science each year. Movements toward green burials and home funerals and burials are emerging, creating a simpler and significantly cheaper transition from life. In some cases, these emerging practices reject America's idea of a conventional funeral.

For those dealing with loss, navigating the world of death care can be a daunting and expensive task. Critics say many people avoid planning for death until it happens, leading to uninformed consumers and a system susceptible to abuse.

It's a problem many have faced. For one KU professor, the experience of arranging funerals for her father and two grandparents during her time of grief left her feeling so unprepared and frustrated that she devoted much of her research and writing to the topic. She now teaches a course on death and dying to help students prepare for and understand death.

In the embalming room at Rumsey-Yost Funeral Home, 601 Indiana St., Miller and Foley are covered head to toe in protective gear. They each wear thick, blue rubber gloves, non-absorbent gowns and plastic protective masks.

Bodies often leak. Vomit and bile are prone to purging through the mouth. Without muscles tightly holding everything in place, feces can spill onto the table.

The embalming room, behind a heavy metal door in the basement, looks more like an operating room for the living than a place to care for the dead. Each of the two adjustable tables is lined with a guttering system, positioned near cabinets and shelves that store sterile-looking utensils, creams and chemicals.

Foley, with four years under his belt as a licensed funeral director and embalmer, has this process down to a fine art. Miller is still a student, and he's working to get his state license. But first, he must complete a mandatory apprenticeship. He's not allowed to embalm a body himself, but he assists wherever possible. In three years working at Rumsey-Yost, Miller has watched and participated in this process at least 100 times.

With the corpse washed, the muscles loosened and the hair freshly rinsed with Head and Shoulders shampoo, the two begin the embalming process.

Foley attaches plastic tubes to the incisions on the carotid and jugular. The tubes lead to the embalming machine, which holds several gallons of embalming fluid. The mixture is made of formaldehyde and contains perfumes and dyes. Without blood in the body, the skin will be pale white.

The machine will pump for about 90 minutes, acting almost like a heart for the deceased's circulatory system. One tube pushes the potion into the body, where it streams through every artery, vessel, vein and capillary. The other tube drains the blood, which is dumped into the sewer system like dirty bath water.

After the blood is replaced by preservative, the artery and vein are tied off, and Foley stitches the incisions closed. The wounds will later be masked by makeup and cream, leaving no evidence of the operation they've performed.

Miller then grabs a trocar, a metal tool used to poke a hole near the navel. The trocar is attached to a suction tube, which draws the remaining fluid out of the cavities. It punctures each organ, releasing its contents such as gas, bile and bodily fluids.

No one wants a solemn funeral service interrupted by the gurgling sounds of settling gas in Grandma's tummy.

The tool then injects more embalming fluid through the puncture site, preserving the body's innards. The puncture wound is sealed, and the body is given time to rest.

Embalming bodies this way didn't become popular until well into the 20th century.

Before that, the funeral and burial took place at home or church. Embalming started during the Civil War as a means of preserving and shipping the bodies of fallen Union soldiers back to their Northern homes.

Although embalming made sense to allow for time to transport bodies before the development of refrigeration and high-speed travel, now environmentalists and industry watchdogs are questioning the practicality, the high costs and the environmental effects of the tradition.

When a lengthy journey of a decomposing corpse ceased to be a problem, undertakers touted embalming as a safeguard for public health. Not many diseases can survive in a body steeped in formaldehyde.

But scientists have since discovered that, except in the rarest cases, a dead body poses little risk to the health of the living. The Centers for Disease Control and Prevention now maintains that embalming serves no benefit to public health.

But now it's thought that embalming is detrimental to public health. In 2009, research from the National Cancer Institute linked embalming fluid's active ingredient, formaldehyde, which is classified as a known carcinogen by the International Agency for Research on Cancer, to myeloid leukemia. The study proved what many had suspected for years: Funeral directors who embalm over an extended period of time have an increased risk of contracting cancer.

Embalming also poses a problem for environmentalists, who can only guess what long-term effects toxic formaldehyde has on the Earth.

Funeral directors now pay close attention to the health debate, if only because evidence suggests their work environment may be accelerating their own need for a funeral.

After release of the National Cancer Institute's findings, the National Funeral Directors Association updated its list of Formaldehyde Best Management Practices, which suggests increasing ventilation, limiting exposure to formaldehyde and using a less concentrated mixture of embalming fluid.

Still, no federal regulations or industry-wide changes have been implemented since the research was published.

"If there was a serious risk with embalming, the government wouldn't allow it," said Pam Scott, executive director of the Kansas Funeral Directors Association.

The Environmental Protection Agency has yet to take a stance on embalming, but it does note that formaldehyde can cause cancer "within the respiratory or GI tract after inhalation or oral exposure."

It's estimated that Americans annually bury more than 827,000 gallons of embalming fluid — enough to overflow an Olympic size swimming pool — across America's 22,500 cemeteries, along with nearly 93,000 tons of steel, copper and bronze and 30 million board feet of hardwoods from caskets.

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