Dying art

As a famed anatomical collection goes on public view, Wendy Moore finds that taboos about the dissection of dead bodies trouble us as much as they did in the 18th century.
  
  


The first thing I notice as I wait nervously in the corridor is a sign that reads: "If you have borrowed a skull please return it to the office." It is then I realise that I am about to cross a line into a world in which normal conventions of society no longer apply.

It is a moment I have been putting off for some time. Soon after I began researching my biography of John Hunter, the pioneering 18th-century surgeon and anatomist, I realised that I had to see a human dissection for myself if I was to appreciate properly his work and domain.

The anatomists at Guy's, King's and St Thomas' School of Biomedical Sciences, in London, who had kindly answered my many peculiar queries about the workings of the human body, were enthusiastic. Since public access to dissecting rooms is heavily restricted under the Anatomy Act 1984, they arranged formal approval for my visit. It was an enthusiasm I found hard to share. I had seen a dead body only once before, and while that had been traumatising enough, it was at least intact.

In the aftermath of the scandal over organs being retained without permission at Liverpool's Alder Hey hospital, and elsewhere, there is no doubt that the enduring social taboo surrounding death - and dead bodies in particular - is as deep rooted as ever. Some critics have even drawn parallels between the "theft" of body parts for medical research and the body-snatching practices ubiquitous in Hunter's day.

While Hunter did his utmost to promote acceptance of consented postmortems, he was willing to obtain his research material by underhand means when necessary. But the horror of being dissected after death and having organs removed for scientists' enlightenment appears as strong today as it was in the 18th century.

Symptomatic of this enduring climate - but also in a positive shift away from traditional "cramming" tuition, as well as for financial reasons - most medical schools have steadily withdrawn hands-on anatomy in recent years, resorting instead to prepared specimens and technical aids. Dissection, it seems, is a dying art.

The newly-founded Peninsula Medical School, based at the Universities of Exeter and Plymouth, has dispensed with cadavers completely. Its tutors believe artificial models, computer-generated imaging and live volunteers are at least as useful as practical anatomy. "A preserved dead body is unlike a living one," argues John McLachlan, professor of medical education. He questions the view that working on corpses provides a "rite of passage" for future doctors, and believes it might even desensitise them to real patients.

While teachers at Guy's also use artificial models to explain anatomy, they insist there is no substitute for hands-on practical dissection in teaching the three-dimensional structure of the human form. Alistair Hunter, senior lecturer and academic manager of the Guy's dissecting rooms (and no relation to John Hunter), believes it also helps students acquire the "clinical detachment" they need to perform invasive interventions in future practice.

Facing my own rite of passage, I thought I would last about 10 minutes before making my excuses and leaving. In the event, I stayed for two hours and came away feeling privileged to have witnessed such a dignified, respectful and absorbing spectacle.

At first, as the students cluster around the bodies - eight or so to each table - I hang back. But slowly I begin to understand what has motivated anatomists, from John Hunter to the present day, to spend their waking hours in the company of the dead. It was Hunter's delight in nature's design that inspired his mission to make surgery safe and effective.

About 800 bodies are donated each year to medical schools as a result of prior consent by donors. After a marked decline following the Alder Hey revelations in 1999, numbers began to rise, but have slumped again in the last 12 months, falling far short of anatomy departments' needs.

Whereas, 50 years ago, people witnessed loved ones dying and families grieved over dead bodies at home, medical and social improvements mean we now rarely witness death or the dead. This has created an unhealthy divide between what doctors and the rest of us see and know. We are obsessed by health and pour millions into treatment, yet most people have no notion of the complex geography of the organs, muscles and circulatory system they abuse until they fail them.

Partly, this is the fault of a paternalistic medical profession, which has assumed the role of dealing with death and dead bodies on our behalf.

But Jeremy Metters, HM Inspector of Anatomy, who oversees body donation, agrees that the taboo on discussing what happens after death is not necessarily healthy. He says: "As there are fewer deaths in people's homes, death has become largely medicalised."

Medical historian Ruth Richardson, who referred to the "fearful symmetry" between events at Alder Hey and the bodysnatching practices of the past in her book, Death, Dissection and the Destitute, believes greater openness is certainly in the public interest. "It is quite peculiar that we know more about the surface of Mars than we do about where our spleens are," she says. She believes that, while most people are horrified at the idea of medical students dissecting dead bodies, when they undergo surgery they want a surgeon who has practised on a cadaver, not a computer. Anatomy should be properly taught in schools, she argues, and is in favour of the establishment of a museum of the human body.

Today sees the official opening of such a musuem at the Royal College of Surgeons, where John Hunter's collection of more than 3,500 anatomical specimens, paintings and drawings this week goes on public display.

The crowds that flocked to Professor Gunter von Hagens's recent Body Works exhibition, where "plastinated" corpses revealed their inner parts, and the audience for his television dissections, broadcast live, indicate widespread fascination with anatomy.

Alistair Hunter would go even further. Last year, for the first time, Guy's opened its dissecting room to the public, hosting an art exhibition on the body. He sees no reason why classes in dissection should not be made open to public view. "There is nothing we are hiding," he says. "Dissection is a wonderful thing to be able to offer. I am sure people would be fascinated."

· Wendy Moore is the author of The Knife Man: the Extraordinary Life and Times of John Hunter, Father of Modern Surgery, published by Bantam Press, price £18.99. The Hunterian Museum is at the Royal College of Surgeons, 35-43 Lincoln's Inn Fields, London WC2.It is open to the public, free of charge, from Feb12.

 

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