Ben nods. “And the liver, pancreas, kidneys, spleen,” he says, pointing out the other organs of the abdomen in turn, sometimes nudging one aside to expose another behind or beneath it. They are not fixed and hard like the plastic teaching models, but move about easily. I am vaguely reminded of water balloons. There is a lot of other stuff in there, too—threaded blood vessels and nerves and tendons, and lots and lots of intestines, all of it just kind of tipped in, as if this poor, anonymous, former person had had to pack himself in a hurry. It was impossible to visualize how any of this disordered interior could ever have conducted the tasks that would allow the very inert body before us to sit up and think and laugh and live.
“You can’t mistake death,” Ben says to me. “Live people look alive—and even more so on the inside than on the surface. When you open them up in surgery, the organs throb and glisten. They are clearly living things. But in death they lose that.”
Ben is an old friend and a distinguished academic and surgeon. He is clinical associate professor of trauma surgery at the University of Nottingham and a consultant trauma surgeon at Queen’s Medical Centre in the city. There isn’t anything in the human body that doesn’t fascinate him. We rather race around this one as he tries to tell me everything about it that interests him, which is everything.
“Just consider all that the hand and wrist do,” he says. He tugs gently on an exposed tendon in the cadaver’s forearm up near the elbow, and to my surprise the little finger moves. Ben smiles at my startlement and explains that we have so much packed into a small space in the hand that a lot of the work has to be done remotely, like strings on a marionette. “If you make a tight fist, you feel the strain in your forearm. That’s because it’s the arm muscles that are doing most of the work.”
With a blue-gloved hand, he gently swivels the cadaver’s wrist, as if conducting an examination. “The wrist is just a thing of beauty,” he goes on. “Everything has to go through there—muscles, nerves, blood vessels, everything—and yet it has to be completely mobile at the same time. Think of all the things your wrist has to do—take a lid off a jam jar, wave good-bye, turn a key in a lock, change a lightbulb. It’s a magnificent piece of engineering.”
Ben’s field is orthopedics, so he loves bones and tendons and cartilage—the living infrastructure of the body—the way other people love expensive cars or excellent wines. “See that?” he says, tapping a small, smooth very white obtrusion at the base of the thumb, which I take to be a bit of exposed bone. “No, it’s cartilage,” he says. “Cartilage is remarkable, too. It is many times smoother than glass: it has a friction coefficient five times less than ice. Imagine playing ice hockey on a surface so smooth that the skaters went sixteen times as fast. That’s cartilage. But unlike ice, it isn’t brittle. It doesn’t crack under pressure as ice would. And you grow it yourself. It’s a living thing. None of this has been equaled in engineering or science. Most of the best technology that exists on Earth is right here inside us. And everybody takes it almost completely for granted.”
Before we move on, Ben examines the wrist more closely for a moment. “You shouldn’t ever try to kill yourself by cutting your wrists, by the way,” he says. “All of those things going in are wrapped in a protective band called a fascial sheath, which makes it really hard to get to the arteries. Most people who cut their wrists fail to kill themselves, which is no doubt a good thing.” He is briefly thoughtful. “It’s also really hard to kill yourself by jumping from a height,” he adds. “The legs become a kind of crumple zone. You can make a real mess of yourself, but you are very likely to survive. Killing yourself is actually difficult. We are designed not to die.”
This seems a slightly ironic thing to say in a big room full of dead bodies, but I take his point.
* * *
—
Most of the time the dissecting room at Nottingham is filled with medical students, but it is the summer holidays when Ben Ollivere shows me around. Two other people join us from time to time, Siobhan Loughna, a lecturer in anatomy at the university, and Margaret “Margy” Pratten, head of the anatomy teaching section and associate professor of anatomy.
The dissecting room is a large, well-lit room, clinically clean and slightly chilly, with a dozen anatomical workstations ranged around it. A liniment-like smell of embalming fluid hangs in the air. “We have just changed formulations,” Siobhan explains. “It preserves better, but smells a bit more. Embalming fluid is mostly formaldehyde and alcohol.”
Most bodies are cut into pieces—or transected, to use the formal term—so that students can focus on a particular area: a leg or shoulder or neck, say. The unit gets through about fifty bodies a year, Margy tells me. I ask her if it is hard to find volunteers.
“No, quite the opposite,” she replies. “More bodies are donated than we can accept. Some we have to reject—if the person had Creutzfeldt-Jakob disease, for instance, because there would still be a danger of infection, or if they were morbidly obese.” (Very large bodies can be physically challenging to deal with.)
At Nottingham, they have an informal policy that they keep only one-third of a transected body, Margy adds. The retained parts may be kept for years. “The rest is returned to the family so that they can have a funeral service.” Whole bodies are generally kept for no more than three years before being sent off for cremation. Members of the staff and medical students often attend the ceremonies. Margy makes a point of always trying to go.
It seems a little strange to say when talking about bodies that have been carefully quartered, then turned over to students to further incise and probe, but at Nottingham they are fastidious about treating the bodies with respect. Not all institutions are quite so rigorous. Not long after my visit to Nottingham, there was a brief scandal in America after an assistant professor and some graduate students from the University of Connecticut were photographed posing with two severed heads in a selfie taken in a dissecting room in New Haven. By law no photography is allowed in dissecting rooms in Britain. At Nottingham, you cannot bring a phone in.
“These were real people with hopes and dreams and families and all the rest that makes us human, who have given their bodies to help others, and that’s incredibly noble, and we try very hard never to lose sight of that,” Margy told me.
* * *
—
It took a surprisingly long time for medical science to take a very active interest in what fills the space inside us and how it all works. Up to the Renaissance, human dissection was widely forbidden, and even when it became tolerated, not many people had the stomach for it. A few intrepid souls—Leonardo da Vinci most famously—cut people up for the sake of knowledge, but even Leonardo observed in his notes that a decomposing body was pretty disgusting.