Poking, Prodding and Slicing: Anatomy as We Know It

1                       Poking,  Prodding,  and  Slicing:  Anatomy  as  We  Know  It           STS.003  The  Rise  of  Modern  Science                       2     Beginning  as  early  as  the  ancients,  humans  have  held  an  active  interest  in  the   structure  and  function  of  the  human  body.  This  interest  has  developed  over  time   into  a  scientific  discipline  called  anatomy  today.    Throughout  history,  the  methods  of   gaining  anatomical  knowledge  have  varied  widely,  including  everything  from   observation,  to  experimentation,  to  dissection  and  vivisection1.  Anatomists  have   poked,  prodded,  and  sliced  the  human  body  in  attempts  to  understand  its  mysteries   –  no  small  task,  to  be  certain.  By  tracing  the  progression  of  anatomical   understanding  back  in  time,  we  can  understand  how  we  got  to  the  knowledge  we   have  today.       The  issue  of  how  to  acquire  knowledge  of  the  body  is  a  longstanding  one.   Depending  on  the  society  and  its  religious  and  ethical  views  as  a  whole,  certain   restrictions  on  the  use  of  bodies,  whether  dead  or  alive,  as  objects  of   experimentation  limited  the  ability  of  scientists  to  understand  them2.  For  the   Greeks,  anatomical  understanding  came  from  the  butchering  of  animals  and   treatment  of  wounds.  In  their  culture,  it  was  completely  taboo  to  dissect  a  human   body3.  Not  surprisingly,  this  was  also  the  case  in  many  other  cultures.  In  fact,   through  the  ancient  history  of  anatomy,  only  once  was  the  dissection  of  humans   acceptable,  a  period  of  100  years  in  Alexandria.  During  this  time,  not  only  was   dissection  acceptable,  but  vivisection  as  well4.                                                                                                                     1  Roy  Porter,  “The  body,”  in  Roy  Porter,  Blood  and  Guts:  A  Short  History  (New  York:   Norton,  2003),  53-­‐74.   Porter, “The body,”, 53-74.   3  Professor  David  Jones,  course  lecture  in  STS.003,  MIT,  25  October  2010.   4  Professor  David  Jones,  course  lecture  in  STS.003,  MIT,  25  October  2010.   2  Roy       3     After  the  brief  period  of  acceptability  in  Alexandria,  human  dissection  did  not   come  to  play  again  until  the  Italian  Renaissance.  This  isn’t  to  say  that  knowledge  of   anatomy  ceased  to  progress  during  this  time,  though.  Galen,  a  Roman  physician,  did   much  to  progress  the  field  of  anatomy  through  his  work  as  a  physician  and  surgeon   as  well  as  his  interest  in  public  animal  dissections5.       The  early  dissections  in  the  Renaissance  era  were  very  private  and  informal,   often  occurring  in  parlors  with  a  small  gathering  of  observers6.  Later,  Vesalius   broadly  publicized  dissection,  bringing  it  under  scrutiny  of  both  those  interested  in   medicine  and  those  common  folk  simply  fascinated  by  the  dissection  itself7.     According  to  Vesalius,  pictures  or  other  representations  of  the  body  are  insufficient   in  educating  one  about  anatomy  -­‐  dissection  is  necessary  in  order  to  gain  a  complete   understanding  of  the  human  body8.   Anatomy  entering  the  early  modern  era  changed  yet  again.  Dissections   became  more  heavily  regulated  and  cadavers  more  difficult  to  come  by.  This,  along   with  changes  in  societal  views  as  a  whole,  led  to  the  retreat  of  anatomy  from  public                                                                                                                   5  Professor  David  Jones,  course  lecture  in  STS.003,  MIT,  25  October  2010.   6  Katharine  Park,  “The  criminal  and  the  saintly  body:  Autopsy  and  dissection  in   Renaissance  Italy,”  in  The  Renaissance:  Italy  and  Abroad,  Rewriting  Histories,  ed.  J.  J.   Martin  (New  York:  Routledge,  2002),  224-­‐252.   7  A.  Vesalius,  “Title  Page  to  the  First  Edition  of  ‘De  Humani  Corporis  Fabrica’”  in   Vesalius:  The  Illustrations  from  His  Works  (New  York:  The  World  Publishing   Company,  1950),  43-­‐45.  Katharine  Park,  “The  criminal  and  the  saintly  body:  Autopsy   and  dissection  in  Renaissance  Italy,”  in  The  Renaissance:  Italy  and  Abroad,  Rewriting   Histories,  ed.  J.  J.  Martin  (New  York:  Routledge,  2002),  224-­‐252.   8  A.  Vesalius,  “Preface  to  On  the  Fabric  of  the  Human  Body”  [1543],  in  Charles  D.   O’Malley,  Andreas  Vesalius  of  Brussels,  1514-­‐64  (Berkeley:  University  of   California  Press,  1964),  321-­‐322.     4     eye  into  the  professional’s  office9.  Dissection  of  the  human  body  became  a  privilege   that  only  medical  students  got  to  experience.  For  most,  this  is  how  anatomy  is   viewed  –  something  that  one  only  gets  limited  access  to,  through  diagrams,  models   and  charts.  The  general  public  seems  to  have  accepted  this  as  a  norm  –  until  now.   In  recent  years,  German  scientist  Gunther  von  Hagens  has  introduced  a   means  of  study  into  the  discipline  of  anatomy  that  could  potentially  change  the   field’s  accessibility.    With  this  development,  von  Hagens  hopes  to  broaden  the   knowledge  of  anatomy  from  only  the  exclusive  circle  of  medical  schools  and  doctors   offices  and  into  the  hands  of  the  public10.  His  technology,  called  plastination,   involves  replacing  the  fluids  in  the  body  with  plastics  such  as  silicone  rubber,  epoxy   resin,  and  polyester  resin11.    The  results  of  this  technique  are  dry,  odorless,  virtually   un-­‐aging,  and  incredibly  accurate  specimens  that  can  be  used  or  displayed  for  years   on  end.  The  flexibility  of  the  plastination  process  allows  specimens  to  be  arranged,   dissected,  and  exposed  for  a  variety  of  studies  or,  in  von  Hagens’  case,  displays.   Von  Hagens  has  taken  his  technology  of  plastination  and  created  an  entirely   new  concept;  a  concept  he  has  called  “Body  Worlds”.  Body  Worlds  is  a  traveling   exhibit  of  plastinated  specimens  and  gestalt  plastinates  (whole  body  specimens   positioned  in  life  like  poses)  intended  to  educate  the  public  on  the  inner  workings  of   the  human  body.    Von  Hagens  says  of  his  exhibit  that  it  is  an  “aesthetic  and                                                                                                                   9  Douglas  Allchin,  “"Hands-­‐off"  Dissection?  What  do  we  seek  in  alternatives  to   examining  real  organisms?,”  The  American  Biology  Teacher  67:6  (2005):  369-­‐  374.   10  Lawrence  Burns,  “Gunther  von  Hagens’  BODY  WORLDS:  Selling  beautiful   education”  The  American  Journal  of  Bioethics  7:4  (2007):  12–23.   11  G.  von  Hagens,  “Plastinated  Specimens  and  Plastination”  in  Body  Worlds:  The   Anatomical  Exhibition  of  Real  Human  Bodies,  ed.  Gunther  von  Hagens  and  Angelina   Whalley,  trans.  Francis  Kelly  (Heidelberg:  Institut  für  Plastination,  2004),  20-­‐37.     5     instructive  presentation  of  the  body’s  interior”12.  In  his  opinion,  the  exhibitions  give   way  to  self-­‐awareness  even  more  so  than  diagrams,  drawings  or  models  could  have.   They  give  way  to  greater  understanding  and  appreciation  of  the  body,  as  well  as   close  the  gap  between  corpses  on  a  dissecting  table  and  “living”  or  observational   anatomy13.    The  exhibit  has  met  a  fascinated  group  of  viewers  from  a  wide  range  of   background,  allowing  it  to  gain  wild  popularity.   While  all  this  may  be  acceptable,  there  are  many  controversies  surrounding   the  Body  Worlds  exhibit  –  and  rightly  so.  Exhibitions  of  this  type  have  the  potential   to  revolutionize  the  way  society  views  anatomy  and  therefore  all  of  the   consequences  must  be  carefully  considered.  Among  the  controversies,  some  of  the   most  pressing  and  most  vital  include  the  legal  and  ethical  concerns  revolving   around  the  acquisition,  treatment  and  respect  for  the  bodies  used;  the  concern  that   the  entertainment  value  of  the  exhibit  overshadows  its  purpose  as  something   instructional;  and  the  careful  balance  revolving  around  the  necessity  of  dissection   and  how  such  procedures  should  be  rightfully  handled.  While  each  of  these  concerns   hold  validity  and  importance,  none  are  vital  enough  to  warrant  the  removal  of  such   exhibitions  from  society.  The  education  and  insight  received  from  the  Body  Worlds   exhibit  and  others  like  it  far  exceeds  the  concerns  surrounding  it.  To  prove  this,  one   must  not  only  look  at  both  the  arguments  and  von  Hagens’  responses,  but  also  the   historical  background  of  the  anatomy  itself.   In  order  for  dissections  to  occur,  corpses  must  be  acquired.  Since  the   Renaissance,  methods  of  acquisition  have  included  donation,  trading,  theft,  grave                                                                                                                   12  Von  Hagens,  “Plastinated  Specimens  and  Plastination”,  31-­‐32.   13  Von  Hagens,  “Plastinated  Specimens  and  Plastination”,  32-­‐33.     6     robbery,  and  purchase  or  acquisition  of  unclaimed  corpses  and  executed  criminals14.   Some  of  these  methods  were  legal,  while  others  were  certainly  not.  Policies   regarding  corpses  varied  dramatically  from  country  to  country,  based  on  the  beliefs   of  individual  societies15.       Von  Hagens  began  his  own  highly  contested  body  donor  program  in  order  to   supply  bodies  for  both  his  research  and  his  exhibits.  This  program  currently  has   over  5600  donors  on  file,  and  has  obtained  over  250  individual  bodies.  Part  of  the   policy  of  the  donation  program  is  absolute  anonymity.  Von  Hagens  has  implemented   this  in  order  to  respect  the  individuals  whose  bodies  have  been  donated.    The   identity  of  a  specimen  cannot  be  traced16.  Within  these  measures  lies  a  source  of   controversy  –  if  the  identity  of  the  specimens  cannot  be  traced,  then  what  proves   that  the  bodies  were  obtained  legitimately?  Von  Hagens  has  had  to  defend  himself   on  multiple  accounts,  using  paper  work  and  his  own  word  to  back  himself  up17.     Hand  in  hand  with  the  necessity  for  proper  acquisition  of  bodies  lies  the   desire  for  respectful  treatment.  Von  Hagens  and  the  Body  Worlds  exhibit  have  been   accused  of  disrespecting  the  donors  through  the  display  of  their  bodies18.  Von   Hagens  counters  this  by  reminding  accusers  that  the  donors  signed  up  to  be                                                                                                                   14  G.  V.  Hagens,  “No  Skeletons  in  the  Closet  –  Facts,  Background  and  Conclusions:  A   response  to  the  alleged  corpse  scandals  in  Novosibirsk,  Russia,  and   Bishkek,Kyrgizstan,  associated  with  the  Body  Worlds  exhibition.”  Public  statement,   distributed  online  17  November  2003,  [http://www.bodyworlds.com],  1.   15  G.V.  Hagens,  “No  Skeletons  in  the  Closet”,  2.   16  G.V.  Hagens,  “No  Skeletons  in  the  Closet”,  2-­‐3.   17  G.V.  Hagens,  “No  Skeletons  in  the  Closet”,  5.   18  Anita  L.  Allan,  “No  dignity  in  Body  Worlds:  A  silent  minority  speaks”  The  American   Journal  of  Bioethics  7:4  (2007):  24-­‐25.       7     plastinated  in  this  such  way19.  Von  Hagens  furthers  his  argument  by  very  carefully   distinguishing  between  plastinates  and  corpses.  He  suggests  that  plastinates,   because  of  their  permanent  and  unchanging  nature,  are  no  longer  objects  of  grief   and  therefore  are  exempt  from  standards  placed  on  corpses.  While  they  still  should   be  treated  with  respect,  they  are  no  longer  subject  to  burial  and  shouldn’t  be  objects   of  mourning20.  Von  Hagens  defends  himself  by  showing  that  the  treatment  of  the   bodies  is  respectful  and  allows  them  to  retain  anatomical  identity  and  a  certain   amount  of  dignity21.     After  visiting  the  exhibit,  skeptics  have  expressed  concern  that  while  von   Hagens  has  an  honorable  goal  of  educating  the  public,  he  has  allowed  the   entertaining  aspect  of  the  exhibit  overpower  its  usefulness  as  an  educational  tool22.   They  base  this  argument  on  the  grounds  that  von  Hagens’  Gestalt  plasinates  seem   more  like  works  of  art  then  tools  of  science,  with  their  creative  and  lifelike  poses,   descriptive  titles,  and  even  von  Hagens’  signature  displayed  nearby.  Their  argument   is  furthered  by  recognizing  the  money,  marketing,  and  advertising  going  into  the   exhibition.  Others  take  the  opposing  viewpoint.  They  say  that  the  artistic  elements   to  the  exhibit  merely  enhance  the  educative  qualities  by  helping  to  draw  observers   in  and  to  remove  the  qualms  they  may  have  regarding  the  plastinates23.     Furthermore,  von  Hagens  suggests  that  the  opinion  that  the  exhibits  are  art  is                                                                                                                   19  G.  von  Hagens,  “On  Gruesome  Corpses,  Gestalt  Plastinates  and  Mandatory   Interment”  in  Body  Worlds:  The  Anatomical  Exhibition  of  Real  Human  Bodies,  ed.   Gunther  von  Hagens  and  Angelina  Whalley,  trans.  Francis  Kelly  (Heidelberg:  Institut   für  Plastination,  2004),  260-­‐282.   20  G.  von  Hagens,  “On  Gruesome  Corpses,”  260-­‐282.   21  Von  Hagens,  “Plastinated  Specimens  and  Plastination”,  30-­‐33.   22  Lawrence  Burns,  “Selling  Beautiful  Education”,  14.   23  Lawrence  Burns,  “Selling  Beautiful  Education”,  15-­‐17.     8     merely  that    -­‐  an  opinion.  The  artistic  qualities  are  in  the  eye  of  the  beholder  and  von   Hagens’  main  focus  is  on  the  education24.    In  some  respect,  as  before  mentioned,  the   ability  of  the  exhibit  to  educate  would  disintegrate  if  aesthetics  were  not  placed  into   consideration25.  In  addition  to  these  claims,  it  is  also  important  to  note  that  anatomy   is  often  very  closely  tied  to  art  –  Vesalius  with  his  anatomical  drawings,   Michelangelo  with  his  anatomically  demonstrative  sculptures,  and  modern  uses  of   diagrams,  charts,  drawings,  and  models.   Traditionally,  part  of  every  medical  students’  education  includes  work  on  a   human  cadaver.  This  critical  part  of  the  education  is  deemed  necessary  because  it   gives  the  student  hands  on  work  with  a  body  –  something  very  different  than   models  or  even  virtual  representations.  There  has  been  a  longstanding  struggle  to   balance  respect  for  life  with  the  necessity  to  dissect.  In  an  attempt  to  mediate  this   situation,  scientists  have  developed  alternate  tools  such  as  virtual  dissections.  The   problem  with  these  alternatives  is  first,  that  they  do  not  fully  show  the  complexity  of   the  body  and  second,  that  they  still  promote  the  destructive  part  of  dissecting,   namely  the  piece-­‐by-­‐piece  removal  and  discard  of  organs26.  Von  Hagens’   plastination  exhibits  more  successfully  tackle  this  struggle  for  balance  by   maintaining  respect  for  the  body,  lessening  destructive  procedures,  and  fully   showing  the  complexity  of  the  body  to  viewers.    The  practicality  of  using  plastinates   as  a  tool  for  educating  medical  students  lies  in  the  longevity  of  the  specimens,  the                                                                                                                   24  Von  Hagens,  “On  Gruesome  Corpses”,  260-­‐262.   25  Von  Hagens,  “On  Gruesome  Corpses”,  261.   26  Douglas  Allchin,  “Hands-­‐off  Dissections?”  369-­‐370.       9     ability  for  specimens  to  be  manipulated  into  poses  that  wouldn’t  be  possible  with   traditional  cadavers,  and  that  there  is  no  loss  in  authenticity  or  detail  27.   Although  controversies  surrounding  the  Body  Worlds  exhibit  do  express   valid  concerns,  they  are  easily  broken  down  both  by  further  understanding  the   exhibit  and  by  realizing  the  benefits  of  the  exhibit  far  outweigh  any  consequences.   Through  this  exhibit  and  others  like  it,  knowledge  of  anatomy  can  be  brought  out  of   the  doctor’s  offices  and  medical  schools  and  shared  with  the  general  public.  Such  an   increase  in  awareness  of  oneself  has  very  positive  consequences.  For  example,   visitors  to  the  Body  Worlds  exhibit  have  expressed  that  they  have  felt  motivated  or   encouraged  by  the  exhibition  to  take  better  care  of  their  bodies  and  have  gained  a   greater  understanding  and  appreciation  for  the  human  body28.  Furthermore,  it  is   interesting  to  speculate  as  to  the  long  term  effects  of  exhibits  such  as  these  on   society  and  the  discipline  of  anatomy  as  a  whole.  Will  anatomical  displays  become   commonplace  in  museums  or  other  venues?  Will  the  general  public  be  highly   educated  as  to  the  structure  of  their  bodies?  What  about  the  views  of  society   towards  dissection  and  anatomical  research?  It  is  very  possible  that  as  exhibits  such   as  these  become  more  acceptable,  the  study  of  anatomy  will  be  democratized,   changing  into  something  entirely  different  than  what  we  have  today.                                                                                                                         27  Von  Hagens,  “Plastinated  Specimens  and  Plastination”,  20.   28  Penny  Herscovitch,  “Rest  in  plastic:  Review  of  ‘Body  Worlds,  The  Anatomical   Exhibition  of  Real  Human  Bodies’  by  Gunther  von  Hagens,”  Science  299  (Feb.  7,   2003):  828-­‐829.     10     Bibliography     Douglas  Allchin,  “"Hands-­‐off"  Dissection?  What  do  we  seek  in  alternatives  to   examining  real  organisms?,”  The  American  Biology  Teacher  67:6  (2005):  369-­‐   374.   Lawrence  Burns,  “Gunther  von  Hagens’  BODY  WORLDS:  Selling  beautiful  education”   The 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