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Monday, July 25, 2005

Stiff by Mary Roach

Many readers and reviewers, including one of my daughters, have praised Stiff: The Curious Lives of Human Cadavers, by Mary Roach (Norton: New York, 2000). Add me to that list.

Stiff is about dead people, and some of the things we do to them, or used to do to them. Roach is both humorous and respectful, which is a measure of her ability as a writer--to do both is difficult.

There are those who will disagree with me, who feel that to do anything other than bury or cremate the dead is disrespectful. That includes, I suspect, writing about them. Many people will find this book disrespectful. There is nothing amusing about being dead, they will say. Ah, but there is. Being dead is absurd. It's the silliest situation you'll find yourself in. Your limbs are floppy and uncooperative. Your mouth hangs open. Being dead is unsightly and stinky and embarrassing, and there's . . . [nothing] to be done about it. (p. 11)

Roach considers the emotional effects of dealing with cadavers. For example:

The contradictions and counterintuitions of the beating-heart cadaver can exact an emotional toll on the intensive care unit . . . staff, who must, in the days preceding the harvest, not only think of patients like H as living beings, but treat and care for them that way as well. The cadaver must be monitored around the clock and "life-saving" interventions undertaken on its behalf. Since the brain can no longer regulate blood pressure or the levels of hormones and their release into the blood stream, these things must be done by ICU staff, in order to keep the organs from degrading. Observed a group of Case Western Reserve University School of Medicine physicians in a New England Journal of Medicine article . . . : "Intensive care unit personnel may feel confused about having to perform cardiopulmonary resuscitation on a patient who has been declared dead, whereas a 'do not resuscitate' order has been written for a living patient in the next bed." (p. 170)

Roach says little about religion, and seems to put forth no particular religious viewpoint. She is generally respectful, and occasionally humorous, about religion. She does point out that the Catholic church accepts the concept of brain death, and organ transplantation, but holds that death occurs when the soul leaves the body, not when the soul leaves the brain. (p. 216)

The things we do include using cadavers, not only in medical school gross anatomy classes, but in training surgeons, testing footwear for protection against land mines, making cars and planes safer, studying decay patterns for use in solving crimes, donating organs, and many other uses. Roach has investigated thoroughly, consulting experts, observing procedures, and tracking rumors. Her investigations included looking into dissolving bodies, and composting, as alternatives to burial or cremation. Both methods show promise as respectful, inexpensive, and environmentally benign, but culturally, we aren't ready for either on a large scale. Roach didn't write much about cremation or burial, except to note that cremation releases mercury into the air, from dental fillings.

It is hard to think of anyone who wouldn't be interested in this book--all of us, unless Christ returns soon, are going to die.

Roach concludes by indicating that she would like to donate her cadaver for use in training, but that her husband, like too many of the rest of us, is too squeamish to allow this, and he will have to make the final decision, if he outlives her.

The acknowledgements include many living people. They also include the cadavers Roach observed in her research, as they were designated by investigators using them, including H, who donated organs.

I agree with Roach--dead humans should be treated with respect, but this does not prevent us from using them to gain knowledge.


Brandy said...

"Being dead is unsightly and stinky and embarrassing, and there's . . . [nothing] to be done about it." -- I laughed outloud when I read that :)

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