[this missive first appeared from The Alienist in early 2013]

“Bones are all that survive of the body. They are keys to our collective past and reminders of our own mortality, so it is no mystery that they have a magic aura for artists, for the faithful of many religions, for collectors, for all of us.”
~Barbara Norfleet (1993)

In the winter of 1983 I engaged in that time-honored rite of passage known as the campus visit. In this case it was pursuant to my applications to medical school. Of the schools I had tentatively chosen, all of the curricula were similar, and the work load at each appeared predictably onerous. But one thing that stood out almost immediately was the manner in which the respective schools addressed and dealt with the dead. And I don’t necessarily mean dead patients. I mean dead teaching tools and specimens.

Case in point: at one public university, as part of the prospective students’ tour, we were brought through the anatomy lab. I remember that it was a large antiseptic room with gurneys, tables, and bodies in zipped bags, along with some articulated skeletons on stands next to the walls. I didn’t sense anything lurid about the showing of this area to the applicants; it was just another part of the tour: “on your left, you see some cadavers, and over here on your right….”

However, later at a private university, it was entirely different. The prospectives’ tour stopped outside the doors to the anatomy lab, and the tour guide said, “here is the anatomy lab. I can’t take you inside because it would violate the sanctity of the area. Every day before we begin our dissection, we have a moment of silence and introspection to thank the deceased for their priceless gift to us and our ability to learn from them and assist in the care of those who are still living.”

What a contrast! It’s not that I’m advocating for disrespect, but the second institution struck me as utterly dour. Being accepted at both, I wound up going to the first school, and I didn’t regret the choice. And yes, I did later give my cadaver a name, one rather tongue-in-cheek and in keeping with the usual ‘whistling past the graveyard’ approach to death employed by many in the health professions.

So much for that moment of silence and introspection.

But I’ve pondered at length since then the manner in which we collectively interact with the dead in the 21st century. I’m not a policy-maker, a mortician, a crime scene investigator, or a hospice-worker. But I do think our society’s approach is rather schizophrenic, perhaps reflecting our own conflicted feelings.

Another case in point: later, as a second year medical student, one recurrent exercise in pathology class was known affectionately as the “pot case” or, better, “the man in a can.” Teaching assistants would obtain the leftovers from recent autopsies performed in the medical center and would place the offal in large plastic buckets. Hearts, livers, pertinent bones, brains, kidneys. Any part of a human body was potentially sloshing around inside. After pots were distributed, we would divide into groups and dump out the contents. We’d be told that we had an hour to look through the contents and then to report on our findings. It seemed entirely scientific and not in the least lurid. But while I remember the pathologies encountered in the pots quite well, I have no recollection of ever having pondered the ultimate question: “who WAS this person, and did she ever think that she was going to wind up like this?”

When one looks, human remains are everywhere. There are medical museums – the Armed Forces Institute of Pathology in Washington DC and the Mutter in Philadelphia come to mind – with vast collections of bizarre wet and dry specimens. The Smithsonian has anthropological exhibits of human skulls from around the world, and other academic and research centers possess similar holdings. There are the Capuchin ossuaries in Italy, charnal houses in Egypt, and bone chapels in Portugal that are filled with piles of skulls and stacks of femurs and pelvic bones upon which we gaze. Extant life-sized statuary of saints from the Middle Ages often employ real bones as accessories. And as a lapsed Freemason, I can personally attest that human crania do indeed find their way into lodge ritual more often than not.

So then there is the unavoidable question: how to treat those remains that are not in the ground? It’s not as easy a question as it might at first seem. Many answer by waffling on the age and apparent anonymity of the original owners – specimens from ancient Paleolithic sites rarely stir visceral emotions, whereas that difficult grey zone is encountered, skirting frank grave-robbery, when the remains at issue are nearly identifiable or at least bear an association with someone(s) still living.

For example, at legislative hearings in the 1990s over the fate of the Dickson burial mound in Illinois (active 9thc – 13thc CE), Professor Raymond Fogelson of the University of Chicago spoke for (a distinct minority within) the scientific community when he characterized the curated display of human remains from that site as “obscene pornography.” I prefer to think that another academic who testified, Professor William Sumner, also from the University of Chicago, was closer to accurate when he said that the display “fires the imagination of school children and adults alike…. It inspires a striking recognition of how the past is a continuation with the present and leaves a lasting impression that leads to an enriched intellectual life.”

Besides, it’s not as though such academic collections are spread out to gawkers like a carnival side show. As author Christine Quigley noted in 2001, “the bulk of institutional collections of human remains is rarely visible to the public, despite the fact that displays of [such] are among the most effective tools for luring people into museums.”

And admittedly, not all displays of human remains fall into the academic realm. The successful Bodies tour that has been viewed by hundreds of thousands in cities all across the U.S. is one example of the (some would say crass) commercialization of the dissected dead. There are businesses that specialize in providing “osteological specimens” – certainly a sanitized description – to just about anyone with interest and cash. Prominent auction houses have sold remains when they have historical interest. And human skulls and other bones are freely available online to anyone, no questions asked, as long as the items are listed as “medical teaching tools” to circumvent purported bans on selling body parts on the Internet.

This dichotomy is perhaps easier to understand when viewed through the prism of the early modern age, a time when the scientific method was blossoming alongside P.T. Barnum. Or as Alberti and Hallam presciently noted, “the macabre seeds sewn in the Enlightenment bore their morbid fruit in the Victorian era. Medical collections founded in the late 18th and 19th centuries were at the intersection of a number of cultural and scientific currents: the development of pathology and comparative anatomy as disciplines, the formalization of medical education, European colonial expansion, and the spread of popular shows and exhibitions.”

There is a wonderful book entitled Dissection: Photographs of a Rite of Passage in American Medicine, 1880-1930, by Warner and Edmonson. Based on the vintage collection of the Dittrick Museum of Case Western Reserve University, the book illustrates a surprisingly common form of group photography that became popular around the turn of the 20th century – medical students and house staff posing with skeletons and cadavers. If you search ‘cadaver’ and ‘antique’ and ‘photograph’ on Google Images, you’ll find dozens of these pictures. It seems that just about every American medical school and hospital of the day had students and staff posing openly with the dead.

This ‘art form’ died out after WWII – students would risk expulsion were they to try this today – but even when viewed through the lenses of modern sensibilities, the photos, at least to me, do not seem exploitative or pornographic. Instead the scenes appear innocent, good natured, and in a manner, curious and inquisitive.

But the question remains answered, if at all, unsatisfactorily. It is still unclear what has changed in our collective consciousness of, and appreciation for, the dead. Is it political-correctness run amok? Or something deeper that we are only now coming to understand?

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[Copyright 2013 @ The Alienist’s Compendium]