REMAINS OF THE AUTHOR

Will She or Won’t She?

It has long been a tradition among anatomy professors to donate their bodies to medical science. Hugh Patterson, the UCSF professor whose lab I visited, looks at it this way: “I’ve enjoyed teaching anatomy, and look, I get to do it after I die.” He told me he felt like he was cheating death.

According to Patterson, the venerable anatomy teachers of Renaissance Padua and Bologna, as death sidled near, would choose their best student and ask him to prepare their skull as an anatomical exhibit. (Should you one day visit Padua, you can see some of these skulls, at the university medical school.)

I don’t teach anatomy, but I understand the impulse. Some months back, I gave thought to becoming a skeleton in a medical school classroom.

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?

Of course, the mystery could as easily be engendered by a more routine donation of my remains. 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.

I actually went so far as to contact a facility at the University of New Mexico’s Maxwell Museum of Anthropology that accepts bodies specifically to harvest the bones. I told the woman who runs it about my book and said that I wanted to come see how skeletons are made. In the Bradbury story, the protagonist ends up having his bones pulled out through his mouth, by an alien disguised as a beautiful woman. Though he was reduced to a jellyfish heap on his living‑room floor, his body remained intact. No blood was spilled.

This was, of course, not the case at the Maxwell lab. I was told I would have the choice of observing one of two steps: a “cut‑down” or a “pour‑off.” The cut‑down was more or less what it sounded like. They got the bones out the only way–barring retractable and highly specialized alien mouthparts–one can: by cutting away the flesh and muscle that surrounds them. Residual meat and sinew is dissolved by boiling the bones in a solution for a few weeks, periodically pouring off the broth and replacing the solution. I pictured the young men of Padua tending to their beloved professors’ heads as they simmered and bobbed. I pictured the actors in a Shakespearean theater troupe I read about last year, confronted by a dead cast member’s last request that his skull be used as Yorick. People really need to think these requests through.

About a month later, I got another e‑mail from the university. They were writing to tell me they had switched to an insect‑based process, wherein fly larvae and carnivorous beetles perform their own scaled‑down, drawn‑out version of the cut‑down.

I did not sign on to become a skeleton. For one thing, I don’t live in New Mexico and they won’t come pick you up. Also, it turns out that the university doesn’t make skeletons, only bones. The bones are left unarticulated and added to the university’s osteological collection.[44]

No one in this country, I learned, is making skeletons for medical schools.

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.

For similarly dumb and narcissistic reasons, I also once considered spending eternity at the Harvard Brain Bank. I wrote about it in my Salon.com column, which was disappointing for the Brain Bank’s director, who assumed I would be writing a serious article about the facility’s serious and very worthwhile research pursuits. Here is an abridged version of the column:

There are many good reasons to become a brain donor.

One of the best is to advance the study of mental dysfunction. Researchers cannot study animal brains to learn about mental illness because animals don’t get mentally ill. While some animals–cats, for example, and dogs small enough to fit into bicycle baskets–seem to incorporate mental illness as a natural personality feature, animals are not known to have diagnosable brain disorders like Alzheimer’s and schizophrenia. So researchers need to study brains of mentally ill humans and, as controls, brains of normal humans like you and me (okay, you).

My reasons for becoming a donor aren’t very good at all. My reasons boil down to a Harvard Brain Bank donor wallet card, which enables me to say “I’m going to Harvard” and not be lying. You do not need brains to go to the Harvard Brain Bank, only a brain.

One fine fall day, I decided to visit my final resting place. The Brain Bank is part of Harvard’s McClean Hospital, which sits on a rolling estate of handsome brick buildings just outside Boston. I was directed to the third floor of the Mailman Research Building. The woman pronounced it “Melmon,” so as to avoid having to answer stupid questions about what kind of research is being done on mailmen.

If you are considering becoming a brain donor, the best thing for you to do is stay away from the Brain Bank. Within ten minutes of arriving, I was watching a twenty‑four‑year‑old technician slice a sixty‑seven‑year‑old brain. The brain had been flash‑frozen and did not slice cleanly. It sliced as does a Butterfinger, with little shards crumbling off. The shards quickly thawed and looked less Butterfingerlike. The technician wiped them up with a paper towel. “There goes third grade.” He has gotten in trouble for saying things like this. I read a newspaper story in which the reporter asked him if he planned to donate his brain and he replied, “No way! I’m going out with whatever I came in with!” Now when you ask him, he says quietly, “I’m only twenty‑four, I really don’t know.”

A Brain Bank spokesman showed me around. Down the hall from the dissection room was the computer room. The spokesman referred to this as “the brains of the operation,” which in any other operation would have been fine, but in this case was a tad confusing. At the end of the hall were the real brains. It wasn’t quite what I imagined. I had pictured whole intact brains floating in glass jars. But the brains are cut in half, one side being sliced and frozen, the other side sliced and stored in formaldehyde inside Rubbermaid and Freezette food savers. Somehow, I’d expected more of Harvard. If not glass, at least Tupperware. I wondered what the dorms look like these days.

…The spokesman assured me that no one would even be able to tell that my brain was missing. He assured me in a way that assured me and at the same time didn’t bring me a lot closer to being a committed brain donor. “First,” he began, “they cut the skin like this and pull it up over the face.” Here he made a motion as though taking off a Halloween mask. “They use a saw to cut the top of the skull off, the brain is removed, and the skull is put back and screwed in place. Put the skin flap back, and comb the hair back over.” He used the peppy how‑to language of an infomercial host, making brain harvesting sound like something that takes just minutes and wipes clean with a damp cloth….

Yet again, I backed off from my plan. Not so much because of the harvesting process–as you may have gleaned, I’m not a squeamish individual–but because of my mistaken expectations. I wanted to be a brain in a jar, at Harvard. I wanted to look atmospheric and fascinating on a shelf. I didn’t want to spend the hereafter as cut‑up pieces in a storeroom refrigerator.

There is but one way to be an organ on a shelf, and that is to be plastinated. Plastination is the process of taking organic tissue–a rosebud, say, or a human head–and replacing the water in it with a liquid silicone polymer, turning the organism into a permanently preserved version of itself. Plastination was developed by German anatomist Gunther von Hagens. Like most plastinators, von Hagens makes educational models for anatomy programs. He is best known, however, for his controversial plastinated whole‑body art exhibit, “Körperwelten”–or, in England, “Bodyworlds”–which has toured Europe for the past five years, raising eyebrows and tidy sums of cash (attendance to date is over eight million). The skinless bodies are posed as living people in action: swimming, riding (plastinated horse included), playing chess. One figure’s skin flies out behind it like a cape. Von Hagens cites as inspiration the works of Renaissance anatomists such as Andreas Vesalius, whose De Humani Corporis Fabrica featured bodies drawn in active human poses, rather than lying flat or standing arms to the side, à la the typical medical illustration. A skeleton waves hello; a “muscle man” gazes at the view from a hilltop of the town below.

“Körperwelten” raises the ire of church fathers and conservatives wherever it opens, mainly on the grounds of violated dignity. Von Hagens counters that the bodies in the show were donated by their owners specifically for this purpose. (He leaves a stack of donor forms at the exit of the exhibit. According to a 2001 London Observer article, the donor list is up to 3,700.)

Most of von Hagens’s bodies are plastinated in China, in an operation called Plastination City. He is said to employ two hundred Chinese in what sounds to me like a sort of cadaver sweat shop. This is not all that surprising, as his technique is extremely labor‑intensive and time‑consuming–it takes over a year to plastinate one individual. (The U.S. version of the technique, modified by Dow Corning after von Hagens’s patent expired, takes one tenth the time.) I contacted von Hagens’s office in Germany to see if I could visit Plastination City and see what kind of shenanigans are in store for a donor body, but von Hagens was on the road and did not return my e‑mails in time.

Instead of China, I traveled to the University of Michigan Medical School, where anatomy professor Roy Glover and plastination chemicals manufacturer Dan Corcoran, who worked with Dow Corning to update the technique, have been plastinating whole dead bodies for a museum project of their own, called “Exhibit Human: The Wonders Within”–slated to open in San Francisco in mid‑2003. Theirs is strictly educational: twelve plastinated (Corcoran prefers the term “polymer‑preserved”) bodies, each displaying a different system–nervous, digestive, reproductive, etc. (At press date, no U.S. museum had signed up to exhibit “Körperwelten.”)

Glover offered to show me how plastination works. We met in his office.

Glover has a long face that made me think of Leo G. Carroll. (I had recently seen Tarantula , wherein Carroll plays a scientist who figures out how to make huge, scary versions of harmless animals, e.g. “Guinea pigs the size of police dogs!”) You could tell Glover was a nice guy because a To Do list on a white board on his office wall said: “Maria Lopez, brain for daughter– science fair.” I decided that this was what I wanted to do with my remains. Travel around to classrooms and science fairs, astounding children and inspiring careers in science. Glover took me across the hall, to a storeroom with a wall of shelves crowded with plastinated human pieces and parts. There was a brain sliced like a loaf of bread and a head split in two so that you could see the labyrinths of the sinuses and the deep, secret source of the tongue. You could pick the organs up and marvel at them, for they were completely dry and had no smell. Yet still, they were clearly real and not plastic. For the many disciplines (dentistry, nursing, speech pathology) that study anatomy but have no time for dissection, models like these are a godsend.

Glover took me down the hall to the plastination lab, which was chilly and cluttered with heavy, strange‑looking tanks. He began explaining the process. “First the body is washed.” This is done much as it was when the body was alive: in a tub. “This is a body,” said Glover, quite unnecessarily, regarding a figure on its back in the tub.

The man had been in his sixties. He had a mustache and a tattoo, both of which would survive the plastination process. The head was submerged, giving the corpse a disconcerting murder‑victim sort of look. Also, the front chest wall had been separated from the rest of the torso and lay off to the side of the body. It looked like a Roman gladiator’s chest plate, or maybe I just found it helpful to think of it that way. Glover said that he and Corcoran planned to reattach it with a hinge on one side, so that it would swing open “like a refrigerator door” to reveal the organs within. (Months later, I saw photos of the exhibit pieces. Disappointingly, someone must have nixed the refrigerator door idea.)

The second body lay in a stainless‑steel tank of acetone, which filled the lab with a powerful smell of nail polish remover each time Dr. Glover lifted the lid. The acetone drives water from the body’s tissue, readying it for impregnation with the silicone polymer. I tried to picture this dead man propped on a stand in a science museum. “Will he be wearing anything, or will his penis just be hanging out?” I asked tactlessly.

“He’s going to have it hanging out,” replied Glover. I got the feeling he’d been asked this question before. “I mean, this is a perfectly normal part of a person’s anatomy. Why should we attempt to hide what’s normal?”

From the acetone bath, the cadavers are transferred to the whole‑body plastination chamber, a cylindrical stainless‑steel tank filled with liquid polymer. A vacuum attached to the tank lowers the internal pressure, turning the acetone to a gas and drawing it from the body. “When the acetone comes out of the specimen, it creates space, and into that space is pulled the polymer,” said Glover. He handed me a flashlight so I could see the view through a porthole on the top of the chamber, which happened to look down onto a perfectly normal part of a person’s anatomy.

It looked peaceful in there. Like a guinea pig the size of a police dog, the concept of being plastinated is more unsettling than the reality. You just lie there, soaking and plastinating. Eventually, someone lifts you out and poses you, much as one poses a Gumby. A catalyst is then rubbed into your skin, and a two‑day hardening process begins, working its way through your tissues, preserving you for all eternity in your freshly dead state. I asked Dean Mueller, a southeastern Michigan funeral director whose company, Eternal Preservation, offers mortuary plastination for about $50,000, how long he thought a plastinated specimen would last.

He said at least ten thousand years, which is about as eternal as anyone in their right, or even their wrong, mind could care about. Mueller has high hopes that the process will catch on among heads of state (think what plastination could have done for Lenin) and rich eccentrics, and I imagine that it might.

I would happily donate my organs as teaching tools, but unless I move to Michigan or some other state with a plastination lab, I can’t. I could ask my loved ones to ship me to Michigan, but that would be silly. Besides, you can’t specify what happens to you when you donate your remains to science, only what doesn’t happen. The dead people whose parts Glover and Corcoran have plastinated over the years checked a box on their University of Michigan donor form indicating that they did not object to “permanent preservation,” but they didn’t request it specifically.

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. Leaving a note requesting that your family and friends travel to the Ganges or ship your body to a plastination lab in Michigan is a way of exerting influence after you’re gone–of still being there, in a sense. I imagine it is a symptom of the fear, the dread, of being gone, of the refusal to accept that you no longer control, or even participate in, anything that happens on earth. I spoke about this with funeral director Kevin McCabe, who believes that decisions concerning the disposition of a body should be made by the survivors, not the dead. “It’s none of their business what happens to them when they die,” he said to me. While I wouldn’t go that far, I do understand what he was getting at: that the survivors shouldn’t have to do something they’re uncomfortable with or ethically opposed to.

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.’”

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.

If I donated my body to science, my husband, Ed, would have to picture me on a lab table and, worse, picture all the things that might be done to me there. Many people would be fine with this. But Ed is squeamish about bodies, living or dead. This is a man who refuses to wear contacts because he’d have to touch his eyes. I have to limit my visits to the Surgery Channel for evenings when he’s out of town. When I told him I was thinking about joining the Harvard Brain Bank a couple years back, he started shaking his head: “Ix‑nay on the ainbank‑bray.”

Whatever Ed wants to do with me is what will be done with me. (The exception being organ donation. If I wind up brain‑dead with usable parts, someone’s going to use them, squeamishness be damned.) If Ed goes first, only then do I fill out the willed body form.

And if do, I will include a biographical note in my file for the students who dissect me (you can do this), so they can look down at my dilapidated hull and say, “Hey, check this. I got that woman who wrote a book about cadavers.” And if there’s any way I can arrange it, I’ll make the thing wink.