This is what it says on the back of Sandra Pankhurst’s business card:

Excellence is no Accident
Hoarding and Pet Hoarding Clean Up * Squalor/Trashed

Properties * Preparing the Home for
Home Help Agencies to Attend * Odor Control *
Homicide, Suicide and Death Scenes *
Deceased Estates * Mold, Flood and Fire
Remediation * Methamphetamine Lab Clean Up *
Industrial Accidents * Cell Cleaning

I first saw Sandra at a conference for forensic support services. A gaggle of public servants, lawyers and academics had just emerged from a session to descend on urns of crappy coffee and plates of sweating cheese. I passed a card table in the lobby where brochures were spread out next to a sign inviting you to drop your business card into an ice bucket for a chance to win a bottle of shiraz. Next to the ice bucket – silver, with a stag’s head on either side — a tiny TV played scenes of before-and-after trauma cleaning jobs.

Sitting behind the table a very tall woman, perfectly coiffed and tethered to an oxygen tank, fanned her hand out and invited me to enter my card. Hypnotized by her smile and her large blue eyes and the oxygen mask she wore like jewelry and the images on her TV, I haltingly explained that I didn’t have business cards. I did, however, pick up one of her brochures, which I read compulsively for the remainder of the day.

Sandra is the founder of the Australian cleaning company, Specialized Trauma Cleaning (STC) Services Pty. Ltd. For the past 20 years, her job has led her into dark homes where death, sickness and madness have suddenly abbreviated the lives inside.

Most people will never turn their mind to the notion of trauma cleaning, but once they realize that it exists — that it obviously has to — they will probably be surprised to learn that the police do not do trauma clean-up. Neither do firefighters or ambulances or other emergency services. This is why Sandra’s trauma work is varied and includes crime scenes, floods and fires. Other agencies and private individuals call on her to deal with unattended deaths, suicides or cases of long-term property neglect where homes have, in her words, “fallen into disrepute” due to the occupier’s mental illness, aging or physical disability. Grieving families also hire Sandra to help them sort, disperse and dispose of their loved ones’ belongings.

Her work, in short, is a catalogue of the ways we die physically and emotionally, and the strength and delicacy needed to lift the things we leave behind.

Her advertising materials emphasize compassion, but that goes far deeper than the emotional-intelligence equivalent of her technical skill in neutralizing blood-borne pathogens. Sandra knows her clients as well as they know themselves; she airs out their smells, throws out their weird porn, their photos, their letters, the last traces of their DNA entombed in soaps and toothbrushes. She does not, however, erase these people. She couldn’t. She has experienced their same sorrows.

On my voicemail: “Hi Sarah, it’s Sandra. I believe you contacted me for an interview … I’m just inundated at the moment and I’m on my way to a suicide. So if you could just call me back tomorrow … Bye for now.”

When I returned her call, I learned that Sandra has a warm laugh and that she needed a lung transplant. She told me that she had a couple of hours to meet the following week before seeing her lung specialist. It struck me then that, for Sandra Pankhurst, death and sickness are a part of life. Not in a Buddhist koan sort of way, but in a voicemail and lunch-meeting sort of way. Over the next few years, she would reveal to me how this unrelenting forward orientation, fundamental to her character, had saved her life. Through the early violence of her childhood — she was born male — through her times as a young husband, father, drag queen, gender reassignment patient, sex worker and now, businesswoman.

During my time with Sandra, I met a bookbinder, a sex offender, a puppeteer, a cookbook hoarder, a cat hoarder, a wood hoarder and a silent woman whose home was unfit for her many rabbits and whose skin was so swollen that I thought at any moment it would burst like a water balloon. I saw walls that had turned soft from mold, food that had liquefied, drinks that had solidified, flies raised on human blood, the pink soap of the recently deceased and eighteen-year-old chicken bones lying like runes at the bottom of a pot.

I listened to Sandra telling me about her morning or her afternoon — about waiting for the psych team to collect the man who killed his dog so that she could clean its blood off his floors; about a “love triangle stabbing”; about the man who died in the ceiling of his home while spying on his family; about the dead hermit eaten by his dog; about the 240-liter container of syringes she filled and removed from a drug house; about the man who threw himself on a table saw and the mess he left for his family to find.

She has a drive to execute each job as perfectly as possible, which sets her apart from other industrial cleaners who are happy with doing adequate work and calling it good. But that’s not the whole story. She has been intuitively righting her environment — cleaning it, organizing it, coordinating it, filling in gaps where she can, hiding them where she can’t — since she was a child. It is her way of trying to impose order on her world and it brings her profound satisfaction.

***

A few hours’ drive from my home, a woman lives in a house with broken windows and dark words sprayed across its exterior in writing that looks like it came from the hand of a giant. It says I HATE YOU and BRAIN and WELL BEING? and HUMANITY and THE SHAME. The windows facing the street are covered, variously, with blankets, a battered blind held in place by a blue plastic flute and a sheet of cardboard.

Sandra is sitting in an immaculate white SUV with a large white sticker stretched across the back window that says MISSIBITCHI. Wrapping up a phone call, she pops her door open and unfolds her long, slim legs from the car. Sandra is wearing bright pink lipstick, a navy blouse, dark skinny jeans and pristine white ballet flats. Her platinum blonde hair is perfectly blow-dried and it floats slowly around her as she turns in the morning light.

The tenant at this morning’s job is named Kim. Sandra has been briefed that Kim describes herself as a puppeteer, a magician and a pet trainer and that, though she is “a smart woman”, she becomes extremely suspicious of those trying to help. She will talk about her self-diagnosed conditions, which include bipolar disorder and a tumor in her head. Kim is “very angry” because the previous cleaner got rid of her pets, “thirty rats, all dead”. I’m still processing the image of thirty dead rats as we walk towards the house. Sandra starts explaining that the goal is to make Kim sufficiently comfortable with the cleaning process so that the job causes her minimal distress.

Though Kim opens her front door, she remains hidden deep inside while Sandra explains that she is here to help but first needs to have a look around. You could easily mistake Kim for a young boy but she is a mother in her early forties. Her voice is also boyish, piping but gruff, trying to be brave.

Stepping inside, Sandra puts her hand on Kim’s shoulder and says, “I hear that you’re an animal trainer. I need help with a dog. Here, look at this.” She starts swiping through photos on her phone, her long red nail clicking crisply on the screen until she gets to a shot of her Lana, small and white, staring at the camera mid-shiver. Sandra explains to Kim how Lana was probably abused because she cowers at any quick movement, how the dog still refuses to be picked up and runs off, which is real rough because of her lung problem, you see? Kim cracks a half smile and drops suddenly onto all fours, explaining from down there that Sandra simply needs to adopt a “submissive permissive physical language” with the dog.

Sandra nods with vague interest, not conscious of the fact that she has just intuitively executed that same move with Kim, who — even in explaining this — is mirroring it right back at Sandra. “Right. You can help me, I can help you,” Sandra says. “We’ll work together.” She looks at her surrounds, raring to begin.

What Sandra does here is magnificent. Beautiful. One of her talents is that she is superb at instantly conveying a bespoke blend of respect, warmth, humor and interest that establishes a basic human equity and makes her clients comfortable enough to return the favor. This gesture is the opposite of the shaming to which she has been subjected consistently throughout her life, and it is lovely to witness its salutary effect on the whole spectrum of humanity. Of course, Sandra’s skill at making others feel secure also eliminates a whole host of threats to herself and optimizes her ability to move forward with her work and with her life, because Sandra is a virtuoso at survival.

She puts a hand on Kim’s shoulder. I wonder how long it has been since Kim has been touched in this way. “Let’s have a look around, shall we?”

I hang back, sapped for a moment by the smell. Hanging over everything is one of two smells (the other being death) that I will discover and come to know during the time I spend watching Sandra at work: human dirt at close quarters over time. We have no single word for it, this smell. We have no adjective to describe how profoundly repulsive and unsettling it is. It’s not just human effluence or rot, nor is it a simple matter of filth or grime or feculence or unwashedness. It’s not merely nasty or gross or disgusting, or the “FEH!” of my grandmother. It is the smell of defeat, of isolation, of self-hate. Or, more simply, it is the smell of pain.

I hear Kim telling a story like she’s at a bar with friends; Sandra breaks out into long laughter with her. Then they come outside and Kim, frowning, squats and lights a cigarette butt. Sandra treats each client as unique in their circumstance and equal in their dignity. I asked her, once, how she managed to maintain that attitude of compassion and absolute nonjudgment. “I think it’s a drive for me that everyone deserves it because I deserve it as well,” she explained.

***

I pull up in front of a complex of Soviet-style apartments and walk over to the travelling hardware store that is the STC company van, where I am handed a white disposable jumpsuit. Four of Sandra’s cleaners are there: Tania, Cheryl, Lizzie and Dylan, everyone reduced to a small cheery face sticking out of a white disposable hood.

Except for Sandra. Sandra is wearing an ironed, slim-line purple parka with jeans and spotless white canvas sneakers. She leads us through the security gates to an apartment where a young woman died of a heroin overdose and lay undiscovered for two and a half weeks in the summer heat. Sandra will collect the deceased’s personal items for the family, appraise what needs to be done to rent the apartment again, and supervise the cleaning.

One of the cleaners unlocks the door. Sandra has a quick look inside. “Ugh. Stinks,” she says. “Right. Masks on, breathe through your mouth!” Cheryl takes out a small jar of Tiger Balm and rubs some under her nose before slipping on her mask. Sandra remains unmasked. “Been doing it for so long, I don’t bother … grin and bear it!” she sings.

She will sometimes take precautions against the environmental threats she encounters (sick clients, black mold spores, biological pathogens) by wearing a mask or gloves. But these are usually quickly cast off because they impede her ability to work efficiently, and because she does not want to alienate her already distressed clients. But she does this at her own risk.

It is not her most visible trait – you would miss it altogether if you did not know her well, if she had not let you in sufficiently to welcome your calls with a sweetly rasping, “Good morning my little dove” – but that is what makes it her strongest: a bodily fortitude so incredible that it cannot be ascribed to mere biology. In addition to severe pulmonary disease, Sandra has cirrhosis of the liver. The causes of her conditions are various and complex. The chemicals she used in the early years of her cleaning business may have played a role; so, too, her decades of double-dosing female hormones. Then there are viruses and biology and a factor euphemistically known as “lifestyle”; like many trans people, she once self-medicated heavily with alcohol and drugs.

When I asked Sandra’s doctor what the average patient with her comorbid conditions would be doing each day, he replied that they would be at home, resting. I mentioned how much she takes on and her seemingly infinite energy, and he responded drolly but with clear admiration: “She should just be tired all the time. I can’t imagine what she would have been like without this.” He stopped to ponder the counterfactual scenario for a moment before shaking his head. “It’s just incredible.”

“Breathe through your mouth! Concentrate on it!” Sandra commands as she turns the doorknob and leads the charge straight ahead into the dim apartment.

The first thing I notice is the flies. Their papery corpses are crisp underfoot. The TV has been left on and is playing cartoons. A breeze blows in through an open sliding door and over the sofa, which has been stripped of its cover but not the person-shaped rust-red stain spread across the seat nearest the window. The stain is shocking and frightening — but not as frightening as the tableau of a life suddenly interrupted.

Everyone has gathered around a few framed photos of the deceased woman with friends or family. “What a waste, hey,” someone says, peering into it. The cleaners are quiet and efficient; quick and respectful. They remind me of nurses.

I force myself to look around slowly. I see two scattered bed pillows covered with the same red-brown stain as the one on the couch. Drying blood. I see a viscous smear of human shit on the floor under the couch. I see a big bottle of Diet Pepsi, still full, and a pack of cigarettes on the coffee table, also full. The apartment is simultaneously so full and so empty; absence is a presence like dark matter and black holes.

Sandra places a birthday card with a sassy cat on it into a trash bag full of personal items and then instructs Dylan to look carefully through all the books to see if there are any photos between the pages. The family wants anything that’s personalized. It’s important.

The four small rooms are an encyclopedia of striving and struggle. The basket of clean laundry. The elliptical machine painted thick with dust. The kitchen drawer of grocery bags at the ready for reuse. The Narcotics Anonymous handbook and Secrets of Attraction. The clean syringes. The smell of death, unnoticed for two and a half weeks at the height of summer, which is seeping through my mask and into my mouth.

While Sandra shows Dylan how to double-bag the personal items so they don’t smell, how to wrap tape around the top in a way that is easy for the family to open, I stare across into the windows of the identical apartments surrounding us.

This is how it ends, sometimes, with strangers in gloves looking at your blood and your too-many bottles of shampoo and your now-ironic Make Positive Changes postcard of Krishna and the last TV channel you flipped to on the night you died and the way the sun hits the tree outside your bedroom window that you used to wake up looking at. This is how it ends if you are unlucky, but lucky enough to have someone like Sandra remember to go through your books for pieces of you to save before strangers move their furniture into the spots where yours used to stand.

From The Trauma Cleaner: One Woman's Extraordinary Life in the Business of Death, Decay, and Disaster by Sarah Krasnostein. Copyright © 2017 by the author and reprinted by permission of St. Martin’s Press. You can follow Sarah on Twitter at @delasarah.