Stiff: The Curious Lives of Human Cadavers

Reviewer: Kenneth V. Iserson, MD, MBA

Disclosures

August 26, 2003

Introduction

by Mary Roach
W.W. Norton & Company
Copyright 2003
224 pages
ISBN: 0-393-05093-9
$23.95 hardcover

In the elegant ambiance of a five-star restaurant, I once spent an evening with a group of friends discussing the latest tidbits I had unearthed while researching a book on corpse disposition.[1] Suddenly, everyone at the table realized that a "deathly" still had enveloped this home of haute cuisine. Other diners quickly devoured their meals in silence, averting their eyes from our offending table and rushing out when they had finished. Let this stand as fair warning of the tales you might relate after reading Mary Roach's macabre book Stiff: The Curious Lives of Human Cadavers.

Why do people write about dying, death, and cadavers? Freud might call it an abreaction; that is, a desire to express through language a deep fear of the unknown and unknowable that the person has repressed. Often, these authors (and many readers) conceal their dread behind a veil of humor. Mary Roach, a San Francisco-based writer for such magazines as Discover, Reader's Digest, and Salon.com, fights valiantly to suppress her natural impulses, but her overt fear mingles with morbid fascination and ghoulish humor as she surveys the many ways cadavers serve the living.

In her introduction, Roach asserts: "Death. It doesn't have to be boring" (pp 10-11). Boring, this book isn't. Beginning her morbid adventures in the well-titled chapter, "A Head Is a Terrible Thing to Waste," she wheedles her way into a refresher course for plastic surgeons practicing their face-lift techniques on donated human heads which are lying unceremoniously in roasting pans. "The whole thing has the look of a catered reception," she deadpans (p. 19). Moving on to a medical school's memorial service for anatomical cadavers, she describes medical students' almost reverent attitude toward the bodies they dissected to learn anatomy and for the people who donated them. This is where Roach's nonmedical observer begins to have difficulty relating. Although her descriptions are accurate and even poignant, they lack insight into what students gain from the dissection experience, an experience that separates physicians in so many ways from the lay public.

Roach's humor often deteriorates into cynical comments, with many of her irreverent remarks feeling forced. Sadly, when she lacks interview or experiential material, she often pads her chapters with marginally relevant history, and, occasionally, goes on at length about the use of animals and animal corpses. ("I am easily distracted," she admits at one point [p. 231].) In a chapter devoted to medical cannibalism, for example, she begins her inclusion of dubious information with a dramatic quote of questionable veracity from Diego Rivera, who alleged in his memoir that he had eaten human flesh as a student: "We lived on this cannibal diet for two months and everyone's health improved" (p. 229). She then devotes long passages to urban legends that she eventually disproves, such as the story that funeral directors in Hainan, China, before cremating corpses, carved off pieces to sell for food.

The book's highlights are Roach's naive take on the medical episodes she witnesses and her vivid interviews with diverse experts in corpse use and disposal. Her graphic description of visiting the University of Tennessee's "Body Farm" will leave even those familiar with death and corpses both fascinated and a bit nauseated. Roach's tour guide, a professor of forensic anthropology, describes his research with time-dependent decay chemicals as they stroll around the property inspecting donated corpses in various stages of decomposition. This attention to detail begs the question: just how morbid is Mary Roach? Responding to one of her queries, her guide asked, "You want a vivid description of what's going through my brain as I'm cutting through a liver and all these larvae are spilling all over me and juice pops out of the intestines?" She writes, "I kind of did, but I kept quiet" (p. 63).

Roach's discussion with an aircraft accident investigator, in which he describes how experts determine whether crashes result from bombs, fires, or structural failure, provides a wealth of fascinating information. For example, recovered corpses with chemical burns might indicate that a missile had torn through the cabin, but investigators can use the fact that burns occurred only on the backs of "floaters" to determine that they resulted from burning jet fuel on the water's surface. Learning how these specialists reach their conclusions is much more illuminating than the vague official pronouncements made after major airline crashes. One caveat: don't read this section on an airplane!

Exploring the truly eccentric, Roach's "Holy Cadaver" chapter describes her discussions with a harried New York forensic pathologist who, as a hobby, studies crucifixion theories from a medical point of view -- using a real crucifix and live volunteers (who are tied, not nailed, to the cross). It turns out that his bizarre studies are part of decades of research tied to proving whether the Shroud of Turin is authentic, a controversy not yet put to rest.

Roach applauds those who donate their bodies and body parts to science, writing, "Cadavers are our superheroes . . . This is a book about notable achievements made while dead" (p. 10). Indeed, she does discuss organ donation as the best-known way that the dead aid the living, but she seems amazed and bewildered by the surgery involved in organ retrieval. Surprisingly, she never mentions the tissue donations (cornea, bone, skin, etc.) that help so many. Confirming her lack of knowledge about this vital area of medicine, she writes "brain death is the legal definition of death in this country" (p. 168). (Health professionals better describe this as "death by brain criteria" so that no one thinks that "only the brain is dead." Moreover, it is only one of the definitions of death; cessation of cardiac function, "heart-lung death," remains the way nearly everyone dies.) Confusing readers even more, she segues from this cutting-edge topic into a discussion of the pseudoscience of measuring the soul's weight and religious beliefs about where the soul resides, examples of metaphysics at its worst.

Roach eventually meanders through the possibilities for the final disposition of her body: anatomical cadaver, anthropology bone donor, plastinized museum specimen, or freeze-dried human compost, an interesting new technology being developed in Sweden. Her best idea may be to donate her brain to the Harvard Brain Bank, as it "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" (p. 284). In the end, she says that she will donate her solid organs if she is "brain dead," but fails to offer to donate her tissues if, which is more likely, she is just plain dead. After all her investigations, she still does not seem to understand the differences between organ and tissue donations, a common and often tragic misunderstanding that diminishes the number of potentially willing donors who actually donate their tissues after death.

Despite the flaws of Roach's book Stiff: The Curious Lives of Human Cadavers, the author's conversational style makes this an enjoyable "quick read" that should appeal to a broad audience, especially those who slow down at accidents, thrill to the History Channel's darker stories, and devour the bloody news headlines. No doubt, readers will be unable to resist relating its details to others with a similar bent. Just don't do it within earshot of those enjoying fine dining.

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