# Stiff by Mary Roach >[!Abstract] Description > An oddly compelling, often hilarious exploration of the strange lives of our bodies postmortem.  > > For two thousand years, cadavers (some willingly, some unwittingly) have been involved in science's boldest strides and weirdest undertakings. They've tested France's first guillotines, ridden the NASA Space Shuttle, been crucified in a Parisian laboratory to test the authenticity of the Shroud of Turin, and helped solve the mystery of TWA Flight 800. For every new surgical procedure, from heart transplants to gender reassignment surgery, cadavers have been there alongside surgeons, making history in their quiet way. > > In this fascinating, ennobling account, Mary Roach visits the good deeds of cadavers over the centuries from the anatomy labs and human-sourced pharmacies of medieval and nineteenth-century Europe to a human decay research facility in Tennessee, to a plastic surgery practice lab, to a Scandinavian funeral directors' conference on human composting. In her droll, inimitable voice, Roach tells the engrossing story of our bodies when we are no longer with them. > %% ## Introduction **01/11/2022, 10:23** > Why lie around on your back when you can do something interesting and new, something useful? For every surgical procedure developed, from heart transplants to gender reassignment surgery, cadavers have been there alongside the surgeons, making history in their own quiet, sundered way. For two thousand years, cadavers—some willingly, some unwittingly—have been involved in science's boldest strides and weirdest undertakings. Cadavers were around to help test France's first guillotine, the "humane" alternative to hanging. They were there at the labs of Lenin's embalmers, helping test the latest techniques. They've been there (on paper) at Congressional hearings, helping make the case for mandatory seat belts. They've ridden the Space Shuttle (okay, pieces of them), helped a graduate student in Tennessee debunk spontaneous human combustion, been crucified in a Parisian laboratory to test the authenticity of the Shroud of Turin. [Link](yomu://content/annotation/B44D5557-4398-4FDC-86EF-AF9509F748F1) **01/11/2022, 10:23** > To me, ending up an exhibit in the Mütter Museum or a skeleton in a medical school classroom is like donating money for a park bench after you're gone: a nice thing to do, a little hit of immortality [Link](yomu://content/annotation/79284262-7D27-4175-9A8D-F8C94A819221) ## A Head Is A Terrible Thing To Waste **01/11/2022, 10:24** > What I do is, I think of them as wax." Theresa is practicing a time-honored coping method: objectification. For those who must deal with human corpses regularly, it is easier (and, I suppose, more accurate) to think of them as objects, not people. For most physicians, objectification is mastered their first year of medical school, in the gross anatomy lab, or "gross lab," as it is casually and somewhat aptly known. To [Link](yomu://content/annotation/707459C7-427B-489D-864A-F5BCB57A0B5E) **01/11/2022, 10:24** > Marilena replies that she doesn't have a problem with heads. "For me, hands are hard." She looks up from what she's doing. "Because you're holding this disconnected hand, and it's holding you back." Cadavers occasionally effect a sort of accidental humanness that catches the medical professional off guard. [Link](yomu://content/annotation/E58F1F11-D98D-4555-B9F3-2FF39698632F) ## Life After Death **01/11/2022, 10:26** > Embalming fluid companies used to encourage experimentation by sponsoring best-preserved-body contests. The hope was that some undertaker, by craft or serendipity, would figure out the perfect balance of preservatives and hydrators, enabling his trade to preserve a body for years without mummifying it. Contestants were invited to submit photographs of decedents who had held up particularly well, along with a write-up of their formulas and methods. The winning entries and photos would be published in mortuary trade journals, on the pre-Jessica Mitford assumption that no one outside the business ever cracked an issue of Casket and Sunnyside. [Link](yomu://content/annotation/780696F6-D690-43DC-88EC-4674D7FB165C) **01/11/2022, 10:26** > The point is that no matter what you choose to do with your body when you die, it won't, ultimately, be very appealing. If you are inclined to donate yourself to science, you should not let images of dissection or dismemberment put you off. They are no more or less gruesome, in my opinion, than ordinary decay or the sewing shut of your jaws via your nostrils for a funeral viewing. Even cremation, when you get right down to it—as W.E.D. Evans, former Senior Lecturer in Morbid Anatomy at the University of London, did in his 1963 book The Chemistry of Death—isn't a pretty event: [Link](yomu://content/annotation/95A2710D-4EF6-4DC8-A1E7-B940CB812D70) ## Beyond The Black Box **01/11/2022, 10:27** > For Shanahan, the hardest thing about Flight 800 was that most of the bodies were relatively whole. "Intactness bothers me much more than the lack of it," he says. The sorts of things most of us can't imagine seeing or coping with—severed hands, legs, scraps of flesh—Shanahan is more comfortable with. "That way, it's just tissue. You can put yourself in that frame of mind and get on with your job." It's gory, but not sad. Gore you get used to. Shattered lives you don't. Shanahan does what the pathologists do. "They focus on the parts, not the person. During the autopsy, they'll be describing the eyes, then the mouth. You don't stand back and say, 'This is a person who is the father of four.' It's the only way you can emotionally survive." [Link](yomu://content/annotation/90884789-94BA-4D10-BDEC-3172F399664F) **01/11/2022, 10:28** > Shanahan also looked at thermal burns, the kind caused by fire. Here there was a pattern. By looking at the orientation of the burns—most were on the front of the body—he was able to trace the path of a fire that had swept through the cabin. Next he looked at data on how badly these passengers' seats had been burned. That their chairs were far more severely burned than they themselves were told him that people had been thrown from their seats and clear of the plane within seconds after the fire broke out. Authorities had begun to suspect that a wing fuel tank had exploded. The blast was far enough away from passengers that they had remained intact, but serious enough to damage the body of the plane to the point that it broke apart and the passengers were thrown clear. [Link](yomu://content/annotation/E8D43203-CFB6-4D7E-93B0-316026DEFE5F) **01/11/2022, 10:28** > I ask Shanahan why the bodies would be thrown from the plane if they were wearing seat belts. Once a plane starts breaking up, he replies, enormous forces come into play. Unlike the split-second forces of a bomb, they won't typically rip a body apart, but they are powerful enough to wrench passengers from their seats. "This is a plane that's traveling at three hundred miles per hour," Shanahan says. "When it breaks up, it loses its aerodynamic capability. The engines are still providing thrust, but now the plane's not stable. It's going to be going through horrible gyrations. Fractures propagate and within five or six seconds this plane's in chunks. My theory is that the plane was breaking up pretty rapidly, and seatbacks were collapsing and people were slipping out of their restraint systems." [Link](yomu://content/annotation/10F0DCC3-B72E-46B3-AB35-67E8FF3EFC62) **01/11/2022, 10:28** > The Flight 800 injuries fit Dennis's theory: People tended to have the sort of massive internal trauma that one typically sees from what they call in Shanahan's world "extreme water impact." A falling human stops short when it hits the surface of the water, but its organs keep traveling for a fraction of a second longer, until they hit the wall of the body cavity, which by that point has started to rebound. The aorta often ruptures because part of it is fixed to the body cavity—and thus stops at the same time—while the other part, the part closest to the heart, hangs free and stops slightly later; the two parts wind up traveling in opposite directions and the resultant shear forces cause the vessel to snap. Seventy-three percent of Flight 800's passengers had serious aortic tears. [Link](yomu://content/annotation/3C2AC8B0-4E1B-4580-B32E-939CEE67E124) **01/11/2022, 10:28** > The other thing that reliably happens when a body hits water after a long fall is that the ribs break. This fact has been documented by former Civil Aeromedical Institute researchers Richard Snyder and Clyde Snow. In 1968, Snyder looked at autopsy reports from 169 people who had jumped off the Golden Gate Bridge. Eighty-five percent had broken ribs, whereas only 15 percent emerged with fractured vertebrae and only a third with arm or leg fractures. Broken ribs are minor in and of themselves, but during high-velocity impacts they become sharp, jagged weapons that pierce and slice what lies within them: heart, lungs, aorta. In 76 percent of the cases Snyder and Snow looked at, the ribs had punctured the lungs. [Link](yomu://content/annotation/7A1261D6-E26E-4BC6-844C-6C789A665B46) **01/11/2022, 10:28** > If a brutal impact against the water's surface was what killed most passengers, does that mean they were alive and aware of their circumstances during the three-minute drop to the sea? Alive, perhaps. "If you define alive as heart pumping and them breathing," says Shanahan, "there might have been a significant number." Aware? Dennis doesn't think so. "I think it's very remote. The seats and the passengers are being tossed around. You'd just get overwhelmed." Shanahan has made a point of asking the hundreds of plane and car crash survivors he interviews what they felt and observed during their accident. "I've come to the general conclusion that they don't have a whole lot of awareness that they've been severely traumatized. I find them very detached. They're aware of a lot of things going on, but they give you this kind of ethereal response—'I knew what was going on, but I didn't really know what was going on. I didn't particularly feel like I was a part of it, but on the other hand I knew I was a part of it.' " [Link](yomu://content/annotation/B405B375-B7E9-494A-88E7-8F70E79D4DB4) **01/11/2022, 10:28** > In "Human Survivability of Extreme Impacts in Free-Fall," he reports the case of a man who fell seven miles from an airplane and survived, albeit for only half a day. And this poor sap didn't have the relative luxury of a water landing. He hit ground. (From that height, in fact, there is little difference.) [Link](yomu://content/annotation/E65085C8-C219-4DD1-B827-44E16DCE8B7C) **01/11/2022, 10:28** > Generally speaking, people falling from planes have booked their final flight. According to Snyder's paper, the maximum speed at which a human being has a respectable shot at surviving a feet-first—that's the safest position—fall into water is about 70 mph. Given that the terminal velocity of a falling body is 120 mph, and that it takes only five hundred feet to reach that speed, you are probably not going to fall five miles from an exploding plane and live to be interviewed by Dennis Shanahan. [Link](yomu://content/annotation/07661306-F2C6-428E-82D6-1C4E0764970E) ## The Cadaver Who Joined The Army ### [[we may be able to construct an entire functioning nonhuman human from pieces of other species]] > Pigs don't get shot at because our culture reviles them as filthy and disgusting. Pigs get shot at because their organs are a lot like ours. The heart of the pig is a particularly close match. Goats were another favorite, because their lungs are like ours. I was told this by Commander Marlene DeMaio, who studies body armor at the Armed Forces Institute of Pathology (AFIP). Talking to DeMaio, I got the impression that it would be possible to construct an entire functioning nonhuman human from pieces of other species. "The human knee most resembles the brown bear's," she said at one point, following up with a surprising or not so surprising statement: "The human brain most resembles that of Jersey cows at about six months." [1] I learned elsewhere that emu hips are dead ringers for human hips, a situation that has worked out better for humans than for emus, who, over at Iowa State University, have been lamed in a manner that mimics osteonecrosis and then shuttled in and out of CT scanners by researchers seeking to understand the disease ^m2evc [Link](yomu://content/annotation/774292B5-A3C1-42A2-985F-45C3C12480AD) ## How To Know If You're Dead **11/11/2022, 06:44** > H is unique in that she is both a dead person and a patient on the way to surgery. She is what's known as a "beating-heart cadaver," alive and well everywhere but her brain. Up until artificial respiration was developed, there was no such entity; without a functioning brain, a body will not breathe on its own. But hook it up to a respirator and its heart will beat, and the rest of its organs will, for a matter of days, continue to thrive. [Link](yomu://content/annotation/FEFC8B34-425C-48D5-9084-CBFE05FA701A) **11/11/2022, 06:44** > Since brain death is the legal definition of death in this country, H the person is certifiably dead. But H the organs and tissues is very much alive. These two seemingly contradictory facts afford her an opportunity most corpses do not have: that of extending the lives of two or three dying strangers. Over the next four hours, H will surrender her liver, kidneys, and heart. One at a time, surgeons will come and go, taking an organ and returning in haste to their stricken patients. Until recently, the process was known among transplant professionals as an "organ harvest," which had a joyous, celebratory ring to it, perhaps a little too joyous, as it has been of late replaced by the more businesslike "organ recovery." [Link](yomu://content/annotation/4C1744B2-338C-42F8-AD5A-C1DC3190930D) **11/11/2022, 06:46** > The contradictions and counterintuitions of the beating-heart cadaver can exact an emotional toll on the intensive care unit (ICU) staff, who must, in the days preceding the harvest, not only think of patients like H as living beings, but treat and care for them that way as well. The cadaver must be monitored around the clock and "life-saving" interventions undertaken on its behalf. Since the brain can no longer regulate blood pressure or the levels of hormones and their release into the bloodstream, these things must be done by ICU staff, in order to keep the organs from degrading. Observed a group of Case Western Reserve University School of Medicine physicians in a New England Journal of Medicine article entitled "Psychosocial and Ethical Implications of Organ Retrieval": [Link](yomu://content/annotation/DD399113-3FF9-4EB6-A60D-1FC551D0C2AC) **11/11/2022, 06:46** > "Intensive care unit personnel may feel confused about having to perform cardiopulmonary resuscitation on a patient who has been declared dead, whereas a 'do not resuscitate' order has been written for a living patient in the next bed." [Link](yomu://content/annotation/AFA40BD2-0E53-447C-9EF2-B078E8392C13) **11/11/2022, 06:47** > Before brain activity could be measured, the stopping of the heart had long been considered the defining moment. [Link](yomu://content/annotation/7A560434-DE21-48CD-B73D-08F5347A67AA) **11/11/2022, 06:48** > The stethoscope wasn't invented until the mid-1800s, and the early models amounted to little more than a sort of medical ear trumpet. [Link](yomu://content/annotation/C33C6385-13C4-4CCF-85C8-30300D5ACD40) **11/11/2022, 06:49** > To allay patients' considerable fears of live burial, as well as their own insecurities, eighteenth- and nineteenth-century physicians devised a diverting roster of methods for verifying death. [Link](yomu://content/annotation/2A00E541-D262-4B38-84D8-7D40DC11CCCB) **11/11/2022, 06:49** > The soles of the feet were sliced with razors, and needles jammed beneath toenails. Ears were assaulted with bugle fanfares and "hideous Shrieks and excessive Noises." [Link](yomu://content/annotation/20D5E4DD-E36E-4A89-B984-47F3C5B5F7E2) **11/11/2022, 06:50** > A French physician invented a set of nipple pincers specifically for the purpose of reanimation. Another invented a bagpipelike contraption for administering tobacco enemas, [Link](yomu://content/annotation/2C35CB8B-BF1A-4F48-916C-90782386C92D) **11/11/2022, 06:50** > The seventeenth-century anatomist Jacob Winslow entreated his colleagues to pour boiling Spanish wax on patients' foreheads and warm urine into their mouths. One Swedish tract on the matter suggested that a crawling insect be put into the corpse's ear. For simplicity and originality, though, nothing quite matches the thrusting of "a sharp pencil" up the presumed cadaver's nose. [Link](yomu://content/annotation/BAE8A58E-D7D6-419E-8621-6FD58C25D865) **11/11/2022, 06:50** > French physician Jean Baptiste Vincent Laborde wrote at great length of his technique of rhythmic tongue-pulling, which was to be carried out for no less than three hours following the suspected death. [Link](yomu://content/annotation/FD1D8607-5731-45D6-A9D5-6910F47D4716) **11/11/2022, 06:51** > Not all that surprisingly, none of these techniques gained wide acceptance, and most doctors felt that putrefaction was the only reliable way to verify that someone was dead. This meant that corpses had to sit around the house or the doctor's office for two or three days until the telltale signs and smells could be detected, a prospect perhaps even less appealing than giving them enemas. And so it was that special buildings, called waiting mortuaries, were built for the purpose of warehousing the moldering dead. [Link](yomu://content/annotation/DD46A25E-9C7E-412F-9B46-572F95E4A9D8) **11/11/2022, 06:53** > The seat-of-the-soul debate has been ongoing some four thousand years. [Link](yomu://content/annotation/D23832A6-3E62-4AAB-BB13-50F5273D520B) **11/11/2022, 06:53** > It started out not as a heart-versus-brain debate, but as heart-versus-liver. [Link](yomu://content/annotation/EE6A686D-6FA1-4DAA-9F3C-2066B1DD8881) **11/11/2022, 06:54** > The ancient Egyptians were the original heart guys. They believed that the ka resided in the heart. Ka was the essence of the person: spirit, intelligence, feelings and passions, humor, grudges, annoying television theme songs, all the things that make a person a person and not a nematode. The heart was the only organ left inside a mummified corpse, for a man needed his ka in the afterlife. [Link](yomu://content/annotation/96517EC8-77E9-4F39-A243-6081129A589B) **11/11/2022, 06:54** > The Babylonians were the original liver guys, believing the organ to be the source of human emotion and spirit. The Mesopotamians played both sides of the argument, assigning emotion to the liver and intellect to the heart. These guys clearly marched to the beat of a freethinking drummer, for they assigned a further portion of the soul (cunning) to the stomach. [Link](yomu://content/annotation/1FE9BA9E-234C-43D6-BCF8-76F4728AC43A) **11/11/2022, 06:54** > Similar freethinkers throughout history have included Descartes, who wrote that the soul could be found in the walnut-sized pineal gland, and the Alexandrian anatomist Strato, who decided it lived "behind the eyebrows." [Link](yomu://content/annotation/E41B9F2E-4464-4BFE-804B-666FD7B6AC83) **11/11/2022, 06:55** > With the rise of classical Greece, the soul debate evolved into the more familiar heart-versus-brain, the liver having been demoted to an accessory role. [Link](yomu://content/annotation/DF435E78-1AF1-4DAD-9AD1-41F211C999DA) **11/11/2022, 06:58** > There is her heart. I've never seen one beating. I had no idea they moved so much. You put your hand on your heart and you picture something pulsing slightly but basically still, like a hand on a desktop tapping Morse code. This thing is going wild in there. It's a mixing-machine part, a stoat squirming in its burrow, an alien life form that's just won a Pontiac on The Price Is Right. If you were looking for the home of the human body's animating spirit, I could imagine believing it to be here, for the simple reason that it is the human body's most animated organ. [Link](yomu://content/annotation/778B6294-5957-4941-A484-F2FC9B83A1AB) **11/11/2022, 07:00** > Here is the deeply unnerving thing: The heart, cut from the chest, keeps beating on its own. Did Poe know this when he wrote "The Tell-Tale Heart"? So animated are these freestanding hearts that surgeons have been known to drop them. "We wash them off and they do just fine," replied New York heart transplant surgeon Mehmet Oz when I asked him about [Link](yomu://content/annotation/657B72F4-23D2-4668-A8A9-DDA7E607006F) ## Just A Head **11/11/2022, 07:08** > It was 1968 when the Journal of the American Medical Association published a paper by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death advocating that irreversible coma be the new criterion for death, and clearing the ethical footpath for organ transplantation. It wasn't until 1974 that the law began to catch up. What forced the issue was a bizarre murder trial in Oakland, California. [Link](yomu://content/annotation/48F7687D-FBE5-46B6-B43E-AF93200A2327) **11/11/2022, 07:08** > The killer, Andrew Lyons, shot a man in the head in September 1973 and left him brain-dead. When Lyons's attorneys found out that the victim's family had donated his heart for transplantation, they tried to use this in Lyons's defense: If the heart was stil beating at the time of surgery, they maintained, then how could it be that Lyons had killed him the day before? They tried to convince the jury that, technically speaking, Andrew Lyons hadn't murdered the man, the organ recovery surgeon had. According to Stanford University heart transplant pioneer Norman Shumway, who testified in the case, the judge would have none of it. He informed the jury that the accepted criteria for death were those set forth by the Harvard committee, and that that should inform their decision. [Link](yomu://content/annotation/A84A0271-C926-4D4E-B9AB-6EC434FD05B5) **11/11/2022, 07:08** > In the end, Lyons was convicted of murder. Based on the outcome of the case, California passed legislation making brain death the legal definition of death. Other states quickly followed suit. [Link](yomu://content/annotation/85EDB082-5F7D-4499-9EC2-B58DD57D70A4) **13/11/2022, 07:39** > The worry, explained Oz, was that someday someone who wasn't actually brain-dead was going to have his heart cut out. There exist certain rare medical conditions that can look, to the untrained or negligent eye, a lot like brain death, and the legal types didn't trust the medical types to get it right. To a very, very small degree, they had reason to worry. Take, for example, the condition known as "locked-in state." In one form of the disease, the nerves, from eyeballs to toes, suddenly and rather swiftly drop out of commission, with the result that the body is completely paralyzed, while the mind remains normal. The patient can hear what's being said but has no way of communicating that he's still in there, and that no, it's definitely not okay to give his organs away for transplant. In severe cases, even the muscles that contract to change the size of the pupils no longer function. This is bad news, for a common test of brain death is to shine a light in the patient's eyes to check for the reflexive contraction of the pupils. Typically, victims of locked-in state recover fully, provided no one has mistakenly wheeled them off to the OR to take out their heart. [Link](yomu://content/annotation/3AF775FD-3B9D-405E-A19B-8639111981D2) **13/11/2022, 07:52** > A male heart, Oz says, is in fact slightly different from a female heart. A heart surgeon can tell one from the other by looking at the ECG, because the intervals are slightly different. When you put a female heart into a man, it will continue to beat like a female heart. And vice versa.) [Link](yomu://content/annotation/D27863B2-4375-4690-943E-DE61188FEAB0) **16/11/2022, 15:03** > H appears no different from the corpses already here. [8] But H is different. She has made three sick people well. She has brought them extra time on earth. To be able, as a dead person, to make a gift of this magnitude is phenomenal. Most people don't manage this sort of thing while they're alive. Cadavers like H are the dead's heros. It is astounding to me, and achingly sad, that with eighty thousand people on the waiting list for donated hearts and livers and kidneys, with sixteen a day dying there on that list, that more than half of the people in the position H's family was in will say no, will choose to burn those organs or let them rot. We abide the surgeon's scalpel to save our own lives, our loved ones' lives, but not to save a stranger's life. H has no heart, but heartless is the last thing you'd call her. [Link](yomu://content/annotation/3399BAEB-E1AB-428D-91D1-01E569F1181D) **13/11/2022, 07:57** > I read on a Web site somewhere that this was the origin of the saying "Saved by the bell." In fact, by one reckoning, not a single corpse of the million-plus sent to waiting mortuaries over a twenty-year period awakened. If the bell alerted the attendant, which it often did, it was due to the corpse's shifting and collapsing as it decomposed. [Link](yomu://content/annotation/31765FAB-31A3-402D-8C12-4DFE74D3BCF2) **13/11/2022, 08:00** > People have trouble believing Thomas Edison to be a loopy individual. I offer as evidence the following passage on human memory, taken from his diaries: "We do not remember. A certain group of our little people do this for us. They live in that part of the brain which has become known as the 'fold of Broca.'…There may be twelve or fifteen shifts that change about and are on duty at different times like men in a factory….Therefore it seems likely that remembering a thing is all a matter of getting in touch with the shift that was on duty when the recording was done." [Link](yomu://content/annotation/97F49D6A-C84C-40BB-B19C-5F8C0BE09DDC) ## Eat Me **07/12/2022, 09:10** > In the grand bazaars of twelfth-century Arabia, it was occasionally possible, if you knew where to look and you had a lot of cash and a tote bag you didn't care about, to procure an item known as mellified man. The verb "to mellify" comes from the Latin for honey, mel. Mellified man was dead human remains steeped in honey. Its other name was "human mummy confection," though this is misleading, for, unlike other honey-steeped Middle Eastern confections, this one did not get served for dessert. One administered it topically and, I am sorry to say, orally as medicine. [Link](yomu://content/annotation/AD177E53-F859-48F7-8449-A6797F7CB1A6) **07/12/2022, 09:11** > In Arabia there are men 70 to 80 years old who are willing to give their bodies to save others. The subject does not eat food, he only bathes and partakes of honey. After a month he only excretes honey (the urine and feces are entirely honey) and death follows. His fellow men place him in a stone coffin full of honey in which he macerates. The date is put upon the coffin giving the year and month. After a hundred years the seals are removed. A confection is formed which is used for the treatment of broken and wounded limbs. A small amount taken internally will immediately cure the complaint. The above recipe appears in the Chinese Materia Medica, a 1597 compendium of medicinal plants and animals compiled by the great naturalist Li Shih-chen. [Link](yomu://content/annotation/ABCE7C58-D7F9-452B-87D9-A73AA006CA38) **07/12/2022, 09:11** > the following were almost certainly used as medicine in sixteenth-century China: human dandruff ("best taken from a fat man"), human knee dirt, human ear wax, human perspiration, old drumskins ("ashed and applied to the penis for difficult urination"), "the juice squeezed out of pig's feces," and "dirt from the proximal end of a donkey's tail." [Link](yomu://content/annotation/E0A5304A-F828-4EF5-A71E-7794BFDD3663) **07/12/2022, 09:13** > Mummy elixir was a rather striking example of the cure being worse than the complaint. Though it was prescribed for conditions ranging from palsy to vertigo, by far its most common use was as a treatment for contusions and preventing coagulation of blood: People were swallowing decayed human cadaver for the treatment of bruises. Seventeenth-century druggist Johann Becher, quoted in Wootton, maintained that it was "very beneficial in flatulency" (which, if he meant as a causative agent, I do not doubt). Other examples of human-sourced pharmaceuticals surely causing more distress than they relieved include strips of cadaver skin tied around the calves to prevent cramping, "old liquified placenta" to "quieten a patient whose hair stands up without cause" (I'm quoting Li Shih-chen on this one and the next),"clear liquid feces" for worms ("the smell will induce insects to crawl out of any of the body orifices and relieve irritation"), fresh blood injected into the face for eczema (popular in France at the time Thompson was writing), gallstone for hiccoughs, tartar of human teeth for wasp bite, tincture of human navel for sore throat, and the spittle of a woman applied to the eyes for ophthalmia. (The ancient Romans, Jews, and Chinese were all saliva enthusiasts, though as far as I can tell you couldn't use your own. Treatments would specify the type of spittle required: woman spittle, newborn man-child spittle, even Imperial Saliva, Roman emperors apparently contributing to a community spittoon for the welfare of the people. Most physicians delivered the substance by eyedropper, or prescribed it as a sort of tincture, although in Li Shih-chen's day, for cases of "nightmare due to attack by devils," the unfortunate sufferer was treated by "quietly spitting into the face.") [Link](yomu://content/annotation/C3245A8F-D0CB-485E-A252-B5F607EC8430) **07/12/2022, 09:14** > According to the Chinese Materia Medica, diabetics were to be treated with "a cupful of urine from a public latrine." (Anticipating resistance, the text instructs that the heinous drink be "given secretly") Another example comes from Nicholas Lemery, chemist and member of the Royal Academy of Sciences, who wrote that anthrax and plague could be treated with human excrement. Lemery did not take credit for the discovery, citing instead, in his A Course of Chymistry, a German named Homberg who in 1710 delivered before the Royal Academy a talk on the method of extracting "an admirable phosphorus from a man's excrements, which he found out after much application and pains"; Lemery reported the method in his book ("Take four ounces of humane Excrement newly made, of ordinary consistency…"). Homberg's fecal phosphorus was said to actually glow, an ocular demonstration of which I would give my eyeteeth (useful for the treatment for malaria, breast abscess, and eruptive smallpox) to see. [Link](yomu://content/annotation/616BB354-A641-4E3A-8C5E-0FB195AE4AAA) ## Remains Of The Author **30/12/2022, 20:23** > Years ago I read a Ray Bradbury story about a man who becomes obsessed with his skeleton. He has come to think of it as a sentient, sinister entity that lives inside him, biding its time until he dies and the bones slowly prevail. I began thinking about my skeleton, this solid, beautiful thing inside me that I would never see. I didn't see it becoming my usurper, but more my stand-in, my means to earthly immortality. I've enjoyed hanging around in rooms doing nothing much, and look, I get to do it after I die. Plus, on the off chance that an afterlife exists, and that it includes the option of home planet visitations, I'd be able to pop by the med school and finally see what my bones looked like. I liked the idea that when I was gone, my skeleton would live on in some sunny, boisterous anatomy classroom. I wanted to be a mystery in some future medical student's head: Who was this woman? What did she do? How did she come to be here? [Link](yomu://content/annotation/5B0E2295-3DB3-44AA-A96E-4A6D98A67F8E) **30/12/2022, 20:24** > Upward of 80 percent of the bodies left to science are used for anatomy lab dissections. Most assuredly, a lab cadaver occupies the thoughts and dreams of its dissectors. The problem, for me, is that while a skeleton is ageless and aesthetically pleasing, an eighty-year-old corpse is withered and dead. The thought of young people gazing in horror and repulsion at my sagging flesh and atrophied limbs does not hold strong appeal. I'm forty-three, and already they're doing it. A skeleton seemed the less humiliating course. [Link](yomu://content/annotation/14F2A7BA-1027-491A-8F8E-D9E5F73CE59F) **30/12/2022, 20:25** > The vast majority of the world's medical school skeletons have, over the years, been imported from Calcutta. No longer. According to a June 15,1986, Chicago Tribune story, India banned the export of bones in 1985, after reports surfaced of children being kidnapped and murdered for their bones and skulls. According to one story, which I desperately hope is exaggerated, fifteen hundred children per month were being killed in the state of Bihar, their bones then sent to Calcutta for processing and export. Since the ban, the supply of human bones has dwindled to almost nothing. Some come out of Asia, where, it is rumored, they are dug up from Chinese cemeteries and stolen from Cambodia's killing fields. They are old, mossy, and generally of poor quality, and for the most part, detailed plastic skeletons have taken their place. So much for my future as a skeleton. [Link](yomu://content/annotation/62076242-2A94-4354-9698-0AC84FCFE757) **30/12/2022, 20:26** > Here's the other thing I think about. It makes little sense to try to control what happens to your remains when you are no longer around to reap the joys or benefits of that control. People who make elaborate requests concerning disposition of their bodies are probably people who have trouble with the concept of not existing [Link](yomu://content/annotation/126D11D0-C576-4FFD-891E-437F176D9E32) **30/12/2022, 20:27** > Mourning and moving on are hard enough. Why add to the burden? If someone wants to arrange a balloon launch of the deceased's ashes into inner space, that's fine. But if it is burdensome or troubling for any reason, then perhaps they shouldn't have to. McCabe's policy is to honor the wishes of the family over the wishes of the dead. Willed body program coordinators feel similarly. "I've had kids object to their dad's wishes [to donate]," says Ronn Wade, director of the Anatomical Services Division of the University of Maryland School of Medicine. "I tell them, 'Do what's best for you. You're the one who has to live with it.'" [Link](yomu://content/annotation/44AEBD6B-3CC1-43E4-BCFC-5D546CE05911) **30/12/2022, 20:27** > I saw this happen between my father and mother. My father, who rejected organized religion early in his life, asked my mother to have him cremated in a plain pine box and to hold no memorial service. My mother, against her Catholic inclinations, honored his wishes. She later regretted it. People she barely knew confronted her about their disappointment over there having been no memorial service. (My father had been a beloved character around town.) My mother felt shamed and slandered. The urn was a further source of discomfort, partly because the Catholic Church insists on burial of remains, even cremated ones, and partly because she didn't like having it around the house. Pop sat in a closet for a year or two until one day, with no word to my brother or me, she brought him down to the Rand Funeral Home, pushed aside her guilt, and had the urn buried in a cemetery plot beside the one she'd reserved for herself. Initially, I had sided with my father and was indignant over her disrespect of his stated request. When I realized how distressing his last wishes had been for her, I changed my mind. [Link](yomu://content/annotation/F1E5F2FB-C849-4705-BB54-26D2F6FF8B37) ### None > Why lie around on your back when you can do something interesting and new, something useful? ### None > For every surgical procedure developed, from heart transplants to gender reassignment surgery, cadavers have been there alongside the surgeons, making history in their own quiet, sundered way. For two thousand years, cadavers—some willingly, some unwittingly—have been involved in science's boldest strides and weirdest undertakings. Cadavers were around to help test France's first guillotine, the "humane" alternative to hanging. They were there at the labs of Lenin's embalmers, helping test the latest techniques. They've been there (on paper) at Congressional hearings, helping make the case for mandatory seat belts. They've ridden the Space Shuttle (okay, pieces of them), helped a graduate student in Tennessee debunk spontaneous human combustion, been crucified in a Parisian laboratory to test the authenticity of the Shroud of Turin. ### None > To me, ending up an exhibit in the Mütter Museum or a skeleton in a medical school classroom is like donating money for a park bench after you're gone: a nice thing to do, a little hit of immortality. ### None > Theresa is practicing a time-honored coping method: objectification. For those who must deal with human corpses regularly, it is easier (and, I suppose, more accurate) to think of them as objects, not people. For most physicians, objectification is mastered their first year of medical school, in the gross anatomy lab, or "gross lab," as it is casually and somewhat aptly known. ### None > Marilena replies that she doesn't have a problem with heads. "For me, hands are hard." She looks up from what she's doing. "Because you're holding this disconnected hand, and it's holding you back." Cadavers occasionally effect a sort of accidental humanness that catches the medical professional off guard. ### None > Embalming fluid companies used to encourage experimentation by sponsoring best-preserved-body contests. The hope was that some undertaker, by craft or serendipity, would figure out the perfect balance of preservatives and hydrators, enabling his trade to preserve a body for years without mummifying it. Contestants were invited to submit photographs of decedents who had held up particularly well, along with a write-up of their formulas and methods. The winning entries and photos would be published in mortuary trade journals, on the pre-Jessica Mitford assumption that no one outside the business ever cracked an issue of Casket and Sunnyside. ### None > The point is that no matter what you choose to do with your body when you die, it won't, ultimately, be very appealing. If you are inclined to donate yourself to science, you should not let images of dissection or dismemberment put you off. They are no more or less gruesome, in my opinion, than ordinary decay or the sewing shut of your jaws via your nostrils for a funeral viewing. Even cremation, when you get right down to it—as W.E.D. Evans, former Senior Lecturer in Morbid Anatomy at the University of London, did in his 1963 book The Chemistry of Death—isn't a pretty event ### None > For Shanahan, the hardest thing about Flight 800 was that most of the bodies were relatively whole. "Intactness bothers me much more than the lack of it," he says. The sorts of things most of us can't imagine seeing or coping with—severed hands, legs, scraps of flesh—Shanahan is more comfortable with. "That way, it's just tissue. You can put yourself in that frame of mind and get on with your job." It's gory, but not sad. Gore you get used to. Shattered lives you don't. Shanahan does what the pathologists do. "They focus on the parts, not the person. During the autopsy, they'll be describing the eyes, then the mouth. You don't stand back and say, 'This is a person who is the father of four.' It's the only way you can emotionally survive." ### None > I ask Shanahan why the bodies would be thrown from the plane if they were wearing seat belts. Once a plane starts breaking up, he replies, enormous forces come into play. Unlike the split-second forces of a bomb, they won't typically rip a body apart, but they are powerful enough to wrench passengers from their seats. "This is a plane that's traveling at three hundred miles per hour," Shanahan says. "When it breaks up, it loses its aerodynamic capability. The engines are still providing thrust, but now the plane's not stable. It's going to be going through horrible gyrations. Fractures propagate and within five or six seconds this plane's in chunks. My theory is that the plane was breaking up pretty rapidly, and seatbacks were collapsing and people were slipping out of their restraint systems." ### None > Shanahan also looked at thermal burns, the kind caused by fire. Here there was a pattern. By looking at the orientation of the burns—most were on the front of the body—he was able to trace the path of a fire that had swept through the cabin. Next he looked at data on how badly these passengers' seats had been burned. That their chairs were far more severely burned than they themselves were told him that people had been thrown from their seats and clear of the plane within seconds after the fire broke out. Authorities had begun to suspect that a wing fuel tank had exploded. The blast was far enough away from passengers that they had remained intact, but serious enough to damage the body of the plane to the point that it broke apart and the passengers were thrown clear ### None > The Flight 800 injuries fit Dennis's theory: People tended to have the sort of massive internal trauma that one typically sees from what they call in Shanahan's world "extreme water impact." A falling human stops short when it hits the surface of the water, but its organs keep traveling for a fraction of a second longer, until they hit the wall of the body cavity, which by that point has started to rebound. The aorta often ruptures because part of it is fixed to the body cavity—and thus stops at the same time—while the other part, the part closest to the heart, hangs free and stops slightly later; the two parts wind up traveling in opposite directions and the resultant shear forces cause the vessel to snap. Seventy-three percent of Flight 800's passengers had serious aortic tears. ### None > The other thing that reliably happens when a body hits water after a long fall is that the ribs break. This fact has been documented by former Civil Aeromedical Institute researchers Richard Snyder and Clyde Snow. In 1968, Snyder looked at autopsy reports from 169 people who had jumped off the Golden Gate Bridge. Eighty-five percent had broken ribs, whereas only 15 percent emerged with fractured vertebrae and only a third with arm or leg fractures. Broken ribs are minor in and of themselves, but during high-velocity impacts they become sharp, jagged weapons that pierce and slice what lies within them: heart, lungs, aorta. In 76 percent of the cases Snyder and Snow looked at, the ribs had punctured the lungs. ### None > If a brutal impact against the water's surface was what killed most passengers, does that mean they were alive and aware of their circumstances during the three-minute drop to the sea? Alive, perhaps. "If you define alive as heart pumping and them breathing," says Shanahan, "there might have been a significant number." Aware? Dennis doesn't think so. "I think it's very remote. The seats and the passengers are being tossed around. You'd just get overwhelmed." Shanahan has made a point of asking the hundreds of plane and car crash survivors he interviews what they felt and observed during their accident. "I've come to the general conclusion that they don't have a whole lot of awareness that they've been severely traumatized. I find them very detached. They're aware of a lot of things going on, but they give you this kind of ethereal response—'I knew what was going on, but I didn't really know what was going on. I didn't particularly feel like I was a part of it, but on the other hand I knew I was a part of it.' " ### None > Generally speaking, people falling from planes have booked their final flight. According to Snyder's paper, the maximum speed at which a human being has a respectable shot at surviving a feet-first—that's the safest position—fall into water is about 70 mph. Given that the terminal velocity of a falling body is 120 mph, and that it takes only five hundred feet to reach that speed, you are probably not going to fall five miles from an exploding plane and live to be interviewed by Dennis Shanahan. ### None > In "Human Survivability of Extreme Impacts in Free-Fall," he reports the case of a man who fell seven miles from an airplane and survived, albeit for only half a day. And this poor sap didn't have the relative luxury of a water landing. He hit ground. (From that height, in fact, there is little difference. ### None > Pigs get shot at because their organs are a lot like ours. The heart of the pig is a particularly close match. Goats were another favorite, because their lungs are like ours. I was told this by Commander Marlene DeMaio, who studies body armor at the Armed Forces Institute of Pathology (AFIP). Talking to DeMaio, I got the impression that it would be possible to construct an entire functioning nonhuman human from pieces of other species. "The human knee most resembles the brown bear's," she said at one point, following up with a surprising or not so surprising statement: "The human brain most resembles that of Jersey cows at about six months." [1] I learned elsewhere that emu hips are dead ringers for human hips, a situation that has worked out better for humans than for emus, who, over at Iowa State University, have been lamed in a manner that mimics osteonecrosis and then shuttled in and out of CT scanners by researchers seeking to understand the disease.