|Oct/Nov 2003 Book Reviews|
W. W. Norton & Co. (2003) 303 pages
Apparently, "Where will I go when I die?" is a question that agitates a lot of people, and a considerable literature has grown up that attempts to explore it.
Well, we have an answer, at least for some people. They may be going to medical school. This new book by Mary Roach, whose lively columns on science and medicine have appeared in Salon.com for several years, outlines the curriculum followed by those friends of the first year medical student, the cadavers who are the first patients of all doctors-in-training.
These combination patients and teachers are more versatile than most of us imagine. I have a mental picture of the medical freshmen earnestly dissecting and labeling the parts of someone who is lying on a table, much like a patient in an operating room. Ms. Roach lets us know that there are other kinds of anatomy lessons. Here is the opening of her book:
"The human head is of the same approximate size and weight as a roaster chicken. I have never before had occasion to make the comparison, for never before today have I seen a head in a roasting pan. But here are forty of them, one per pan, resting face-up on what looks to be a small pet-food bowl."
The heads, she goes on to tell us, are the study materials for a plastic surgery refresher course. Each of the heads will be given a facelift by a pair of surgeons who are taking a continuing-education class under the tutelage of some famous face fixers.
If the detail of heads in roasting pans—they are the disposable aluminum kind you buy every year to cook your Thanksgiving turkey in—bothers you, perhaps you will not care to continue with the book, or even with this review. But if your curiosity is stronger than your impulse to run away shuddering, then Ms. Roach has many a meaty morsel for you to feast on.
It's important to understand that in death as in life, not everyone makes it into medical school. But your remains may find a career in law enforcement instead. Perhaps you are one of the millions who watch the Crime Scene Investigation (CSI) TV programs, and you have wondered how the clever cops can tell so much about the time of a victim's death just by looking at his body (in the usual car trunk, shallow grave, or assortment of small badly wrapped, oddly stained bundles in the mail room). Well, Mary Roach knows, and she will tell you. You may not be so keen on those TV programs after you read her account, but you will agree that the crime scene folks earn their money the hard way.
She takes us to a bucolic scene near Knoxville, Tennessee, on the campus of the University of Tennessee Medical Center: "...a lovely, forested grove with squirrels leaping in the branches and birds calling and patches of green grass where people lie on their backs in the sun, or sometimes the shade, depending on where the researchers put them."
Yep, they're dead. They are donated cadavers, and they are the subjects of an ongoing study of how corpses decay. From this study comes the data that allows the cops to make a good guess at the time of death of the victims of crime or mishap. The bodies in the grove are long past their shelf life, and the smell is memorable, to put it mildly. Mary, ever the intrepid reporter, walks among them with a researcher named Arpad Vass. Professor Vass is obviously a hard man to upset, but he reveals that once he did come close to returning his lunch while working among his little flock of decomposing subjects. "One day last summer... I inhaled a fly. I could feel it buzzing down my throat."
Like any good descriptive writer, Ms. Roach gives us images of familiar things to help us visualize this new scene. After you read this chapter, the words "rice" and "chicken soup" will have new resonances. You have been warned.
After that harrowing visit, Ms. Roach points out that not many dead people wind up in the duck pond or the unclaimed luggage room or are found by people walking their dogs. They go straight to the undertaker's shop, where they are embalmed. Naturally (as in "he looks so natural"), she tells us what happens to the departed when they get there, how students learn to make the dead presentable, and how long the mortician's works of art may be expected to last (Answer: long enough to get through the funeral and a little to spare, but don't expect to keep Uncle Elmo on display like Lenin). This chapter, by the way, introduces us to some very nice mortuary-science students. We may not want to follow them in their career paths, but it is a good deed to humanize and demystify these decent, humane people, and I am glad Ms. Roach has done so.
But enough of this. We don't want the everyday life of the ordinary family corpse. If we are going to spend our money on a book about the doings of dead folks, we want action! Ms. Roach supplies it. Crash test dummies? Those are for sissies. Real researchers strap corpses in crashing cars to see if the air bags work. And the people who investigate airliner disasters need to know whether the carnage came from "ordinary" impact or from a bomb blast. Want the details? Chapter 4, "Dead Man Driving," and Chapter 5, "Beyond the Black Box." Speed! Thrills! Extremely Sudden Stops!
Patriotism is possible beyond the grave, too. How do you think the military knows whether a new bullet does enough damage to an enemy soldier to make it worthwhile issuing it to our own troops? You guessed it. Researchers have been blazing away at dead bodies and noting the results at least since 1800, and one assumes that the thirst for this information goes on today. Hey, they call those ROTC courses "military science," don't they? See Chapter 6, "The Corpse Who Joined the Army." You might not re-enlist, but you will realize that your own time in the service could have been worse. Much worse.
Religion has always been involved with the afterlife, but I had always assumed that the main concern was for the immortal part, if any, not so much the earthly remains. Shows what I knew. Mary Roach has set me straight. She details the researches of a French priest and a French surgeon who, in 1931, became obsessed with the details of crucifixion. The priest was a devotee of the famous (and controversial) Shroud of Turin, a piece of cloth that many believe is the burial cloth of Jesus Christ (others say it's a fake).
The surgeon, a Dr. Pierre Barbet, actually crucified cadavers in order to see whether the trauma matched the wounds apparently outlined on the shroud. Possibly because he already believed they would, they did. Surprise! But now comes one Frederick Zugibe, a medical examiner in Rockland County, New York, who has conducted a series of strange experiments that seem to refute Dr. Barbet's work. Zugibe has used live volunteers, who are crucified for varying periods of time (no nails; they are tied to their crosses). He has also subjected various corpses to exams that he says duplicate Barbet's tests. He comes away skeptical, and presents his findings at "Shroudie conferences" around the world, where one imagines he is about as popular as Judas. Ms. Roach has little sympathy for the work of either of these gentlemen, which she calls religious propaganda. Her heroes among the dead are the ones whose hearts are still beating--the newly deceased whose systems are kept functioning as they await their last willed action: donating their still-useful organs to living patients.
This, to me, is the most important chapter in the book. This judgement, of course, reflects my belief that organ donation is a thrilling opportunity to do something unambiguously good. This practice is still fairly rare, in spite of the moving success stories that everyone has heard, in spite of the massive advertising support for organ donation. Families are still very reluctant to allow their dead loved ones to be mined for spare parts, even when the dying patient has asked that it be done. When push comes to shove, a lot of families, already half undone by grief, cannot bring themselves to allow what they see as an unseemly assault on the dead.
Ms. Roach is not unsympathetic, but she clearly wishes that more families eased their bereavement by giving their lost members a literal new life, or lives, as the saviors of the lives of people who need a new kidney, heart, liver, or other innard. As is her strategy throughout the book, she walks us through the routine of organ harvest, emphasizing that the donor is really dead (a persistent worry of the survivors), and that the donor is treated as a patient, not a parts bin. At risk of an atrocious pun—ah, what the hell, Roach puns all the time—it's a heartening process.
Since some people can't get over the fear that an organ might be harvested from someone who still has his own agenda for it, Ms. Roach goes into some detail about how to know if you're dead. It's easy if your caretakers (caregivers? Is there a difference? Hmmm) have an electroencephalograph and know how to use it. But before we had a way to measure brain function, people got understandably concerned about such things. Edgar Allen Poe wrote a story called "The Premature Burial" that gave me a severe case of the creeps when I was a kid, and I wasn't alone. Apparently a lot of people feared being buried alive, and doctors disagreed on just how to tell that someone freshly dead was really dead. Ms. Roach details some of the tests that medicos applied in the 18th and 19th Centuries. These included slicing the soles of the feet with razors, sticking needles under fingernails, making intolerable noises, and poking a variety of terrible things-red-hot pokers, for instance, or a machine that gave tobacco enemas-up various orifices of the presumed decedent. The modern reader may shudder, but by golly, these methods would soon sort out the malingerers. If you didn't jump when these tests were performed, you were a goner for sure.
There have been some ingenious inventions to deal with this ultimate just-in-case. Ms. Roach tells us of "waiting mortuaries" in 19th-Century Germany, where corpses were left to demonstrate that they were well and truly dead by beginning to smell bad. (Hate your job? Think of the attendants in these places. The customers don't even tip.) In some of them, the corpses had strings attached to fingers at one end and bells at the other. Presumably any movement would summon a rescuer.
[As an aside, I recall that Mark Twain visited one of these institutions; and I have seen reproductions of advertisements for patented coffins with a port for a bell cord. But I don't remember reading that anyone was ever revived because of these measures.]
More interestingly, Ms. Roach gives us some stories of the people who received the hearts of the dead. In some cases, they felt more than mere gratitude toward the donor. They became uncannily like the donor. "My out-and-out favorite," she writes, "was the woman who got a prostitute's heart and suddenly began renting X-rated movies, demanding sex with her husband every night, and performing strip teases for him." More tamely, but still very remarkably, several patients claimed to know a great deal about their donors. Alas, most of the stories did not check out. Still, the "new" hearts carried a lot of baggage with them. One recipient started saying "we" instead of "I," so strong was the feeling that the donor was alive within him.
Oh, there's more, much more, including creative new alternatives to both burial and cremation. Avid gardeners will no doubt opt for composting, now being pioneered in Sweden.
And where will the author go when she dies? She'd like to donate her body to a medical school, she says, but her husband is squeamish about it and hopes she won't. But should she outlive him, she may get admitted to medical school after all. If so, one hopes the students who learn anatomy from her have the same cheerful, sensible, humane, and humorous view of the whole thing that she does.