There is public horror at the stories of children's heads in jars, of shelves of babies' body parts. And all over the country, doctors stare at their newspapers and TV screens, bemused and unable to comprehend what all the fuss is about. The hospitals talk about "outdated bad practice in one or two pockets", which is intended to convey the impression that it used to happen and perhaps still does in some isolated areas, but of course, it isn't the norm.
The truth is that snipping out bits and pieces at postmortems has always been standard practice, one that is so entrenched that no one sees anything wrong with it. The reason relatives have never been told is that what they don't know won't hurt them.
This excuse is part of what the medical profession likes to see as its paternal role - thought for others. Those of us who have seen the profession at close quarters have always known that this is a lie, a cover-up for sheer arrogance andinsensitivity. Doctors remain unable to tell the difference between empathy and sympathy yet still try to convince us that they are kindly, golden-hearted, caring Dr Camerons.
I was once a cardiac technician; all you needed to come within my remit was a pulse or the absence of one. I worked in heart surgery, heart disease, resuscitation, and research in various hospitals here and abroad, rising to chief tech before I changed careers. So I know that patients belong to the medical profession from the moment doctors lay stethoscopes on them. We're not talking about the removal and retention of organs from a few babies and children, or a few hundred even; we are talking about patients of all ages and sizes. That is what that desperate smokescreen is intended to cover, that the situation is across the board, adults as well as children.
Organs are retained for a variety of reasons. For instance, there is great rivalry between medics and surgeons, and if something goes wrong in a case they share, one lot will try to blame the other. I often collected someone's heart from pathology and took it back to my medic colleagues for examination, in the hope that a badly sutured plastic valve could be identified, or maybe a leaking vein or artery, so that the pointed finger could be diverted back to the surgeons. No one ever thought to ask the relatives; medicine just doesn't work like that, and anyway, what they don't know won't hurt them.
And medical research needs supplies of organs, and there are papers to be written to enhance and further medical careers. There is always someone looking for some little piece and another someone perfectly willing to supply it - and who will ever know?
Sometimes pathology technicians have been known to make extra money selling items to drug companies who do their own research, and however hotly denied this may be, it is true all the same. After all, the patient no longer needs it, so where's the harm? I have yet to meet anyone who was asked to donate a piece of a loved one, let alone their unborn or stillborn child. Most women would not react well to a request that their lost baby should be kept in a glass jar for the foreseeable future, or dissected, with bits sent to various interested parties so that they can submit a paper to one of the journals or get more letters after their names. So no one asks.
I lost five babies and, knowing what I knew, the first thing on my mind each time was what would be done with them; however incomplete they were, they were still human, still my children. It's a sad indictment of the medical profession that what became of my child was uppermost in my mind each time, when I should have been coming to terms with my loss. Other women in similar situations were spared that knowledge. Until now, of course; all over the country women today must be wondering if their lost baby is part of that collection at Alder Hey, and how can they ever be sure?
Most of these cases are outside the retention of organs for teaching purposes, to be kept in medical museums, where there might be some justification; though even when I was in medicine I used to look at those preserved oddities and grotesques, but human beings for all that, and feel guilty to be staring at them, the babies with two heads, and other little bodies at different stages of normal development floating in jars for ever. I often wondered if their mothers were aware that their children were here on our dusty shelves and I had an almost irresistible urge to cover them up to stop idle eyes gazing at them. Indeed, I once shared an office with a brain in a jar that had been used as a paperweight for so long that it wasn't questioned. I used to look at it occasionally and wonder if this was the use the owner had envisaged for it, even if he or she had given written consent, which I doubted.
When my mother died some years ago an over-zealous official decided that she should have a postmortem and I vainly tried to stop it happening. Before it went ahead, I vowed dreadful vengeance if any part of her should be removed. Of course, as those conducting the postmortem knew perfectly well, unless I'd been standing beside them throughout I could and would never be certain. Somewhere in the dark recesses of my mind it still bothers me occasionally, though that won't change whatever did happen. But she was my mother, she deserved respect in death, just like all those other mothers I know didn't get it, and the same applies to the babies I lost.
You try not to think that they too might be on shelves somewhere or used for some experiment, but the thought is there, because I saw it happening to other babies, and now that even those emotional creatures outside know too it has all turned into a nightmare for the medical profession, though some of us see it as chickens rightly coming home to roost.
'All that's there is the shell - nothing more'
When I worked in a mortuary as a transporter and cleaner nearly 30 years ago bodies used to be stuffed with rolled-up copies of the local newspaper when the autopsies were finished and the next stop was the undertaker.
And I did not - and still do not - see anything wrong with that.
It was the end of a precise process which may seem appalling to those who have never thought about it before but which I came to realise was absolutely necessary. All the internal organs were taken out and looked at; some were kept and some were thrown away into black plastic bags which one of us then took to the incinerator. I remember once an amputated foot looking rather odd, sticking up as if someone was stuffed whole in the bag. And I remember too what looked like a fully formed baby making that functional final journey.
The noise of an electric saw (or the smell of formaldehyde, for that matter) still takes me back to that autopsy room where the saw was used to cut the skull so that the brain could be taken out. And then paper would go into the head and the skin would be flipped back and sometimes you had to hit the forehead to get the skull into line so that the body would not look like Frankenstein's monster. And sometimes when an intestine had been rolled into a concentric circle on a plate we would put one end into the bin and watch it unwind, until the final plop.
Then we would comb the hair, put a white shroud over the body and wheel it into a room off the chapel. And relatives would come and you could hear them crying for their dead loved ones. And we knew that all that was there was the shell - nothing more.
It taught me, as an 18-year-old, was that once you are dead that's it with the body you have been carrying around all your life. If there is a spirit then it took a hike straight away.
That is why I find the reaction to this week's Alder Hey story mawkish. I appreciate that people are upset that they never knew what was happening to their children's bodies. If they had read the above they probably would not want to know anyway. At Alder Hey theorgans are kept in tubs in a room, which some seem to think an outrage. But how else should they be kept? It seems that we care more about the dead than the living - or certainly the elderly. How can we talk about "dignity in death" when we allow our elderly to die in conditions stripped of dignity?
And is it any better to bury the remains of a human being, to let it rot in the earth, than to have it used to try to help someone else's life?
Pathologists are not murderers, although it seems some have not been playing by the rules. Society can't have it both ways and say we want to find a cure for a plethora of diseases but then get squeamish when we know what is involved. Pathologists use dead people's organs for research. The process involves some butchery. But it is worth it.
And don't forget to carry a donor card.
Useful links
Alder Hey hospital
Report of Chief Medical Officer's group on learning from adverse events in the NHS
Commons debate on organ removal, December 1999
General Medical Council advice on seeking patient consent
The Paediatric Pathology Society
