Sunday, September 27, 2015

Book Review: Stiff by Mary Roach

While browsing the community public library aisles came across this book called Stiff: The Curious Lives of Human Cadavers. I had heard about it ~10 years back and so it piqued my curiosity. It easily turned out to be the most morbid book I have ever read! The author Mary Roach being a journalist, book had an easy to read feel to it. It is not hard to comprehend but packs quite a few interesting facts/angles in its 300 pages. 

She starts off the first chapter with an onsite reporting of a CME (Continuing Medical Education) type seminar where plastic surgeons practice their face lifting skills on cadavers. This makes perfect sense since physicians that are training to be surgeons in their residency often learn the trade on the job by assisting board certified surgeons operating on real patients that doesn't leave much room for error. They initially start off with closing sutures and move up stage by stage to doing the surgery themselves under more experienced surgeon's supervision. You can immediately see the value in getting trained on cadavers where you can make all the mistakes you want to acquire the knowledge/skills you need. But the morbidity streak starts on the first chapter itself as she gets into the details of how the training is provided not on full cadavers but just using human heads that have been separated from their bodies and the details of the separation process. Still a gentle start. Next chapter dives into body snatching and other tales from the dawn of human dissection. Since dissection wasn't an allowed practice by the church and there were weird promulgated laws that defined the confines of where/when such research can take place, there were a lot of black market trading/work that went on. Body snatching from graves was a very profitable business for grave diggers themselves in those days!

Next four chapters were the most educational as they dive into so many types of research that won't be possible but for the help provided by cadavers. As the author writes in the acknowledgements section, researchers working on cadavers don't want to be on the spotlight since their work is often and very easily misunderstood and their research funding is invariably very vulnerable to negative publicity it tends to attract. But we need to salute the kind of work that gets done in these areas in one of a kind places. Take the vaguely named Anthropological Research Facility that is part of the University of Tennessee Medical Center outside Knoxville. I heard about this facility on the radio just couple of months back. They study the decaying process of cadavers under varying conditions and publish detailed reports. These conditions include dry, wet, humid, buried, underwater, shallow/deep graves, car trunks, inside concrete, mud, plastic wraps and every other scenarios criminals all over the world might have thought of! Without these studies forensic analysis of murder victims can never be as accurate as it is these days to help nab the culprits. An ORNL (Oak Ridge National Lab) team is working with them to develop an electronic nose that can smell the body and tell you when the person died. Findings like barring extreme temperatures, corpses lose 1.5 degree Fahrenheit per hour until they reach the temperature of the air around them, if the unique volatile fatty acids/compounds of human decay are not found in the soil, the body had been moved and so forth can not be added to our forensic science knowledge base without this work. 

Next chapter talks about cadavers being used in automobile crash tests to first assess what level of force inflicts which type of injury on human beings. While we never hear about this research on the media or car advertisements, the crash test dummies that are often shown in safety test videos come later. Those dummies measure how much force was in play in various crash conditions to be compared to what a human being can withstand based on previously completed cadaver tests! Following chapter talks about what data you can gather from dead bodies found in plane crashes. If a bomb had been exploded from a plane toilet, you'd see burn marks on the fronts of the people sitting right behind the toilet. On the otherhand, if you see burn marks on the back of floating bodies in the sea, it might be from burning fuel that caused the mark after death as dead victims will usually be lying face down on water. 

There is a chapter on tests done to assess the impact of bullets/bombs on victims. This is again very sensitive as relatives like to hear that their dead relative's body was used for organ donation rather than being used for shooting practice. So, even though gathered information could be quite useful, wherever possible researchers use gelatin like substitutes that is also easy for studying exit wounds as the artificial substance is clear (i.e. no need to do surgery to understand what happend inside) and can be reused. One chapter that touches upon embalming was also detailed enough to give a good view of the process the schools put their students through to prepare them for this trade.

Subsequent chapters, while providing the needed comprehensive completeness of the subject, go into weird and gruesome areas of animal research, cannibalism and the so called religious research related to crucifixion. If you read the book and happened to be queasy, you can skip chapters 7 to 10 to save yourself some trouble. Last chapter gets back into alternatives for burial/cremation discussing water reduction and composting of human bodies that are more eco friendly! If you have seen the Body Works exhibit that is making the rounds around the world, the plastination treatment used to produce those exhibits are also covered. If case if you are interested this YouTube video has a quick primer. :-)

Perhaps since the material might be off putting to lot of readers, the author intentionally finds/maintains a sense of humor throughout the book. Though it wasn't disrespectful in anyway, it still felt a bit a odd. But one can understand it from a defense mechanism point of view for the treatment of this subject. 

One heck of an unusual, peculiar, unorthodox book!
It reinforced my conviction that when I die, donating all my useful organs and allowing my body to be used for medical research is the right thing to do.  I already have it recorded in my Last Will and Testament. Do you? 
-sundar.

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