# Written In Bone by Sue Black >[!Abstract] Description > Our bones are the silent witnesses to the lives we lead. Our stories are marbled into their marrow. Drawing upon her years of research and a wealth of remarkable experience, the world-renowned forensic anthropologist Professor Dame Sue Black takes us on a journey of revelation. From skull to feet, via the face, spine, chest, arms, hands, pelvis and legs, she shows that each part of us has a tale to tell. What we eat, where we go, everything we do leaves a trace, a message that waits patiently for months, years, sometimes centuries, until a forensic anthropologist is called upon to decipher it. Some of this information is easily understood, some holds its secrets tight and needs scientific cajoling to be released. But by carefully piecing together the evidence, the facts of a life can be rebuilt. Limb by limb, case by case - some criminal, some historical, some unaccountably bizarre - Sue Black reconstructs with intimate sensitivity and compassion the hidden stories in what we leave behind. %% ### [[The Very Ordinariness of My Remains Will Make Me an Excellent Silent Teacher]] >“I have said before that when I die I would like my body to be dissected in the anatomy department in Dundee university. I want to be embalmed using the Thiel method my department there pioneered in the UK. The very ordinariness of my remains will make me an excellent silent teacher. ^hlzdu > >I would prefer my students to be scientists, please, rather than medics or dentists. Science students learn about anatomy in much more detail, because their curriculum devotes more time to the subject.  > >When they have finished with me, I would like all my bones to be brought together and boiled down to get rid of all the fat inside, and then to be rearticulated as a teaching skeleton so that I can hang in the dissecting room I helped to design and continue to teach for the rest of my death. > >I see it as such a waste to go up in smoke or to be buried uselessly in the soil. And what could be more fitting, for an anatomist and forensic anthropologist, than to want to be an articulated skeleton when she grows up? “ ### [[harris lines - a case study]] > “Growing bones have little caps on their ends and when the caps seal, growth stops. Any event that hampers that process means that bone doesn’t get laid down normally. Instead it is added in lines or bands of increased density parallel to the growth cap. This ‘stutter’, which is visible on an X-ray, tells us that something has temporarily affected the growth of the long bones, although it doesn’t tell us what it was. It may be something as simple as a childhood infection like chickenpox or measles or even a period of malnutrition. ^-r4ir > > These marks, known as Harris lines, can be seen most easily on the distal radius or distal tibia, but they may be found on many other bones within the skeleton where there is a high volume of cancellous bone. Once the incident is over, normal growth resumes and over time the body will reabsorb these white parallel lines as if they never existed. > > I was in a mortuary one day, looking at a mix of bones that had been brought in for investigation. It was fairly obvious that they were all animal and, having confirmed that, I prepared to make a swift exit from the room, where another postmortem was underway. The body being examined was that of a young boy of no more than ten or eleven years old, who, the pathologist confided, had almost certainly hanged himself. > > Suicide in children as young as this is, fortunately, extremely rare and his family and friends were apparently finding it incredibly difficult to come to terms with this explanation as there had been no sign of any illness or anxieties that might have been troubling him. > > He seemed normal, he seemed happy and he’d had his whole life in front of him. The police said he was from a ‘good’ family and that there was no evidence of any form of abuse, psychological, physical or sexual. > > The pathologist popped an X-ray of the boy’s upper limb bones up on the screen and then an image of his lower limbs. He was looking for fractures, current or healed, to see whether there might be any history of physical abuse. > > I remember saying, uninvited, ‘That’s interesting,’ as I noticed three or four very clear Harris lines at the lower ends of both the radius and the tibia. The spaces between these lines, which showed that normal growth had resumed for a while before being interrupted again, suggested that some kind of disturbance may have been repeated at intervals. > > The pathologist asked what I thought these might mean. I could not help, except to say that perhaps something like recurring illness might be a possible answer. > > I never imagined for a moment how the case would unfold, and indeed I would never have known, had it not been for the pathologist recounting the story to me afterwards in a bar at a conference. The police talked to the family and their GP and established that the child had suffered from no obvious or recorded repeated episodes of ill health or anxiety. He had taken his own life just before his mum and dad were due to go on holiday and questions were asked about whether this might be relevant. > > His parents explained that, because they ran a seaside hotel, they were often not able to get a break during the school holidays so, every year for the past five years, they’d got away for a few days on their own in term time while Grandad, Dad’s father, came to stay to look after their son. > > That was when the child’s father broke down and revealed that his own father had abused him as a child. He had believed all this was in the past, but he now feared that history had repeated itself and that perhaps Grandad had been abusing his grandson. The grandfather was interviewed by the police and, after indecent images of child sexual abuse were found at his home, he eventually admitted that this was indeed what had occurred. > > The lines we could see on the X-rays may have been the boy’s body responding every year to the fear and the stress of anticipating his grandfather’s visit and what he would have to endure in his parents’ absence. > > On the last occasion, perhaps he had been so distraught that he had taken his own life at the end of a piece of rope rather than face the trauma again or share his dark secret with anyone. > > The little boy’s dreadful story was discovered too late to help him and only unravelled at all thanks to the testimony of some little white lines on the X-rays of some long bones. If I had been involved in the case, could I have said in evidence that the stress of abuse had caused the Harris lines? No, I could not. But their presence had been enough to lead the police down a particular route of inquiry that had resulted in an explanation, a confession, a conviction and the destruction of a family. > > At times the truth is very painful and its impact devastatingly wide. The passage of time and age give us the perspective to reflect more dispassionately on our own lives and on how, in our childhood, we might have laid down our own traumatic memories in our bones. Biological healing and remodelling may remove the physical evidence, but the mental scars are much harder to erase.” ### [[less than 40% of people have a fabella]] ### [[the fabella is more common in elderly men]] > “It is estimated to be present in fewer than 40 per cent of people and is more common in elderly men than in any other group. So when we come upon a fabella, it is worth finding out whether antemortem X-rays are available for comparison, as its presence may have some relevance in helping to identify the deceased. “ [[Sue Black]] ^734f41 --- ### [[lithopaedion]] > “A lithopaedion, Greek for ‘stone baby’, can form either from a primary abdominal pregnancy or from a secondary abdominal implantation following an ectopic pregnancy. The egg is usually fertilized high up in the fallopian tube, but if this occurs as it crosses the gap between the ovary and the tube, it can sometimes be deflected into the abdominal cavity. > > In an ectopic pregnancy, the fertilized egg does not get as far as the uterus and instead implants in the fallopian tube. Should the tube rupture, the embryo can migrate into the abdominal cavity. Alternatively, if the egg is fertilized before it enters the fallopian tube, it may fail to cross the gap between the surface of the ovary and the fimbriae of the tube and embed directly in the abdominal cavity. > > The embryo is a genuine parasite, and provided it can implant successfully on to an abdominal surface, it can survive and develop outside the uterus, sometimes for as long as twelve to fourteen weeks. This is the stage when a fetus normally shifts its pole for placental implantation, and if a placenta cannot get hold of a sufficient blood supply, a function for which the uterus is specifically designed, the abdominal pregnancy will usually fail and the fetus will die. However, lithopaedions have survived beyond this age. > > The oldest we know of lived for thirty weeks. Since the fetus cannot be expelled naturally – it has no way out – and may in some instances be too large to be absorbed by the mother’s body, it begins to calcify. It is likely that the conversion into bone is an autoimmune response to protect the mother from infection in the event that the fetus starts to decompose. And so it is slowly turned into a stone baby. > > The medical literature recounts fewer than 300 authenticated cases of lithopaedia and in most the mother was unaware that the stone baby even existed until it was discovered during a pelvic examination, often for something unconnected. > > Women have gone on to give birth to other live children without knowing they had a secret passenger on board. A stone baby can weigh as much as four pounds, yet in some instances, a lithopaedion has remained in the body undetected for forty years or more.” ^fcbuk ### None > Collagen, a protein, takes its name from the Greek word for ‘glue’, and it literally holds the mineral parts of bone together to provide us with a complex amalgam that maximizes both strength and flexibility. ### None > Situations like this are horribly stressful because we have to lay bare our thought processes in front of the officers in the room. What you think the bone may be when you start your deliberations is often not what you decide it is most likely to be at the end. Having to arrive at your conclusions out loud, via all the inevitable dead ends and red herrings, makes you worry what the police must think of you and your expertise. ### None > In this regard we do have something in common with Sherlock Holmes. We all follow the maxim: ‘When you have eliminated the impossible, whatever remains, however improbable, must be the truth.’ ### None > evidence to suggest that if your mastoid processes point downwards, your earlobe will not be well defined (known as an ‘attached’ earlobe). If the mastoid processes point forwards, you will probably have a well-defined, ‘free’ lobe to your ear. ### None > Sometimes, in the sutures between the different bones of the vault, accessory bones called Wormian bones may be found, which are a marker for some conditions, such as Down’s syndrome and rickets. ### None > It helps being an anatomist: you can legitimately use terminology that is normal in our line of work but quite discomfiting for others. In both meetings, when it became clear that a question was being asked of me simply because I was the only woman in the room, I inquired, very politely, whether they were interested in my response or simply in the presence of my uterus. ### None > Most of us can remember about 20 per cent of the people we meet, but these ‘super-recognizers’ can recall in the region of 80 per cent. Such an innate skill is, not surprisingly, in high demand in the intelligence and security world and also in the commercial market for private clients ranging from casinos to football clubs. ### None > The classification of super-recognizers emerged from an entirely different field of research: a clinical psychology experiment which was studying the opposite end of the spectrum: prosopagnosia. This is a clinical condition, sometimes described as face blindness, where people have extreme difficulty identifying faces ### None > Shoulder blades are where your wings were when you were an angel’ > David Almond > WRITER ### None > There is another sesamoid bone that might be found in the knee joint: the fabella (‘little bean’), which can form in the tendon of the lateral head of the gastrocnemius muscle at the top of the calf. It is estimated to be present in fewer than 40 per cent of people and is more common in elderly men than in any other group. So when we come upon a fabella, it is worth finding out whether antemortem X-rays are available for comparison, as its presence may have some relevance in helping to identify the deceased. The function of the fabella is not well understood. ### None > There has been a suggestion that it is an evolutionary feature which has re-emerged, perhaps due to a combination of genetic and environmental factors. That theory seems more than a little far-fetched to me, but then, I am not a geneticist. ### None > I have said before that when I die I would like my body to be dissected in the anatomy department in Dundee university. I want to be embalmed using the Thiel method my department there pioneered in the UK. The very ordinariness of my remains will make me an excellent silent teacher. I would prefer my students to be scientists, please, rather than medics or dentists. Science students learn about anatomy in much more detail, because their curriculum devotes more time to the subject. When they have finished with me, I would like all my bones to be brought together and boiled down to get rid of all the fat inside, and then to be rearticulated as a teaching skeleton so that I can hang in the dissecting room I helped to design and continue to teach for the rest of my death. > I see it as such a waste to go up in smoke or to be buried uselessly in the soil. And what could be more fitting, for an anatomist and forensic anthropologist, than to want to be an articulated skeleton when she grows up?