Writer Mary Roach has traveled the world in search of strange and interesting things to write about, and now she explores a topic we often cover with a mental sheet: the experiences of dead bodies. In this book review of Stiff: The Curious Lives of Human Cadavers, you’ll learn about the all-important contributions cadavers have made to the fields of medicine, vehicle safety, and forensics, among others, as well as some of the more absurd situations they have ended up in.
A look at the unsung (and unliving) heroes of science and medicine.
READ THIS BOOK REVIEW IF YOU:
- Want to donate your body to science
- Are interested in the study of anatomy
- Like strange and slightly macabre stories
Introduction
The most important thing to remember about cadavers is that although they look like people, they aren’t. They are what’s left behind when the people pass away. And while dying involves many difficult emotions — love, anger, grief, fear — being dead is a completely different stage in the body’s existence.
Many people like the idea of their body serving a useful purpose after they die, and author Mary Roach sees no disrespect in describing those purposes. Cadavers have taught us anatomy, enabled the success of heart transplants, and helped design safer automobiles. Cadavers can be run over, shot, and operated on without suffering, making them incredibly useful to a society that needs to test surgical procedures and new technology in an ethical way.
A Head Is a Terrible Thing to Waste
In an anatomy lab at a university medical center, severed heads are laid out in aluminum pans on soothing lavender tablecloths. They’re being operated on by plastic surgeons practicing for face-lifts and reconstructive surgeries. Faces and hands can be the hardest cadaver body parts to work with, emotionally, because they’re the parts of a person we see and interact with the most when the person is alive. But at the same time, the surgeons are thrilled to have a chance to practice on a face that won’t scrutinize itself in the mirror later on.
The standard procedure in hospitals for training new surgeons is to have them watch actual surgeries in the operating room, and assist with more and more complicated operations. But many patients these days resist the idea of a less-thanex-pert hand working with their insides, and training is becoming trickier. Medical schools are turning to cadavers for help.
We’ve come a long way from the “operating theaters” of the 19th century and previous, where the surgery was primarily for the benefit of the audience; whether the patient survived was somewhat incidental. Only the poor and desperate offered themselves up to the unanesthetized horrors of the operating theater.
Crimes of Anatomy
The field of anatomy has a long history of taking advantage of the poor and otherwise disadvantaged. Until fairly recently, donating one’s body to science was not a common practice. In Britain, before 1836, it was illegal to dissect any human body except those of executed murderers. Dissection was in fact believed to be a punishment worse than death, because it decreased one’s chances of getting into heaven. As interest in the study of medicine increased in the 1700s and 1800s and the number of medical schools grew, dead bodies became a precious commodity.
Anatomists fell back on some unsavory methods for getting bodies to practice on: raiding graveyards. In 1828 in England, one gang of “resurrectionists” dug up 312 bodies. One pair of notorious criminals even started murdering people and selling their bodies. The leader of the team was eventually hanged and then sent to be dissected himself.
Unlike their historical counterparts, modern cadavers are treated respectfully and even given memorial services with moving tributes. In the last 50 years, donating one’s body has become more and more common, due perhaps in equal part to altruism and the high cost of funerals. But dissection may no longer be necessary for anatomy students; in 1993 a 3D digital model was created from almost 2,000 photographs of a dissected corpse. And as the field of medicine grows, medical students no longer have time to spend hours learning hands-on what they could more easily see onscreen.
Life After Death
Dissection, stomach-turning as it may be for some, is arguably not the grossest thing that could happen to a body after death. During the normal process of decay, liquids loosen the skin, gases cause bloating, the brain dribbles out the ears, and eventually hard-working bacteria liquify all the body’s tissues, leaving the skeleton in a puddle. If the body is exposed to the world, flies and their larvae and meateating beetles help the process along.
The stages of decay have been comprehensively studied by scientists in the service of forensics, to give police investigators accurate information about how long a murder victim or mysterious corpse has been dead. Temperature can be used for the first few hours — a dead body cools by about 1.5 degrees Fahrenheit each hour until it hits the ambient temperature. Afterward, more-sophisticated analysis is called for, one that measures the levels of certain time-sensitive decay chemicals. Research labs study how the process of decay changes if the body is buried versus left in the open, or shut in a car trunk versus bundled into a bag.
A different kind of dead-body professional tries to keep the body from decaying. Embalmers pump preserving fluids through the body’s circulatory system and clean up any leaks from the inside as they ready a body for funeral viewing. Embalming hit the bigtime in our society just a century and a half ago, during the Civil War, to enable dead soldiers to be sent home to their families in recognizable form. Even embalming, though, only delays the inevitable.
Dead Man Driving
In a Michigan university lab, researchers prop up a cadaver in a seat, mimicking the position of a car driver. Then they fire a piston that slams into the body’s shoulder. Later an autopsy will assess the damage, and the information will help design safer cars.
Cadavers have a long history in helping out with automobile safety; they’re the only way to assess the impact of a crash on a human body without causing anyone any pain. Crash test dummies can be used to measure the force of an impact, but that information is only useful if you know the damage threshold for an actual body.
Impact research on cadavers has shaped dashboards and steering wheels and has influenced the design of seatbelts and windshields. One article estimates that this research has saved more than a quarter million lives in the last 30 years.
Current research focuses on side-impact crashes — which are now much more dangerous than head-on collisions, since there’s only a couple of inches of car door to absorb the impact — and impact studies of the body’s extremities. Thanks to modern car technology, people are surviving previously fatal levels of car crash, but with severe damage to their knees or ankles.
The current cadaver-testing situation, however, is unable to generate answers to one of the most important issues in automobile safety: the effect of impacts on children’s bodies. No one wants to ask grieving parents for their child’s body, so animals like baboons are used instead, but the results are not really accurate, and animal rights advocates are not happy.
Beyond the Black Box
When a plane crashes leaving no survivors, investigators can discover the reason for the crash from the flight recorder — often called the “black box” — or from the wrecked pieces of the plane itself. When a plane goes down into the ocean, however, the black box may be lost along with most of the wreckage. When this happens, as with TWA Flight 800 that came apart above the Atlantic in July 1966, the only evidence is what floats — most usefully, the bodies of the passengers and crew.
The bodies are examined by an injury analyst, whose job it is to solve the mystery of the crash based on the condition of the corpses. The injury analyst brought in for the Flight 800 case was able to rule out a bomb because most of the bodies were intact and displayed no noticeable patterns of shrapnel such as a bomb would inflict. The bodies had chemical burns on their backs, from jet fuel in the water, but not on their fronts, contradicting speculation that a missile had been involved.
Further examination of the bodies suggested that there had been a fire in the cabin, but that the passengers had been thrown clear fairly quickly. Many of their injuries — broken ribs, punctured lungs, and torn aortas — were consistent with the damage that occurs from extreme impact with water.
Based on this analysis, authorities guessed that a fuel tank in one of the wings had exploded, and this theory was later confirmed with recovered fragments of the plane.
One of the first injury analyses, of a British airliner that went down in 1954, noted that half the passengers were clothed, while half were mostly naked. A team of investigators dropped dummies into the sea to confirm their theory: that passengers in the front of the plane were thrown free and had their clothes blown off by the impact with the water, while the passengers in the rear were still in the plane when it crashed into the sea.
The Cadaver Who Joined the Army
Around the turn of the 20th century, the US tested the effects of bullets by firing them at dead bodies. In part their goal was to study the bullet holes to improve medical treatment for wounded soldiers. But they were also interested in what is called “stopping power.” Already-dead bodies turned out not to be very useful for measuring the stopping power of a bullet, however, and later tests were conducted on cows.
It turns out, though, that a bullet’s power to knock someone down may depend on the victim’s awareness of the bullet’s power. Deer often run for 40 or 50 yards after being shot in the heart; a human can collapse just from hearing a gunshot.
A competing theory holds that a bullet can cause a “neural overload,” causing the body to collapse. The theory suggests that the neural overload is trigger by the moment of impact, when a cavity briefly opens around the bullet. Modern testing facilities use clear gelatin-based substance to simulate human tissue.
Most ballistics-testing labs avoid working with cadavers out of concern for the public response. Whether they’re testing a bullet’s efficacy in stopping someone or testing an armored vest’s ability to stop the bullet, they don’t want to be shooting at an actual body. One lab did use cadavers to test the ability of a variety of footwear to protect their wearers against landmines. However, cadavers are usually old enough that the results of a test may not hold for a younger body.
Holy Cadaver
In 1931, a priest attended a medical conference in France, looking for medical assistance in determining the authenticity of the Shroud of Turin, which was said to be Jesus’ burial shroud. A doctor named Pierre Barbet took on the assignment with enthusiasm, and he developed a variety of theories that showed that yes, the red smears on the shroud matched the likely position of a body on a cross. To prove his points, he tacked up a corpse on a cross. But then he started wondering if the nails might have been put through Jesus’s wrists rather than his hands. While experimenting with this theory, he nailed up a total of 13 amputated arms.
Some tests have suggested that the “blood” on the shroud is actually paint. A recent study tied live volunteers to a wooden cross with leather straps and disproved several of Barbet’s ideas. The authenticity of the shroud remains in question.
How to Know If You’re Dead
Ancient Egyptians believed that the spirit resided in the heart, and when they mummified a corpse, they removed all the other organs but left the heart. Babylonians, on the other hand, believed the soul made its home in the liver. Classical Greek thought divided the soul between the heart and the brain.
For centuries, death was measured as the moment the heart stops. But modern legal and medical definitions draw the line between life and death in the brain. When the brain dies, the body can no longer survive on its own.
If you connect the body to an artificial respirator, however, the heart will go on beating after the brain is dead, and the other organs also will survive for several days. These beating-heart cadavers are the donors for the modern miracle of organ transplants. They’re wheeled into the operating room with their blood still flowing, their skin warm, and their torso opened up. The organs are surgically removed and sent to save the lives of people with living brains but malfunctioning hearts, livers, or kidneys.
The waiting list for donated organs is tens of thousands long, but families often blanch at the idea of sending their loved one away with heart still beating. The idea of the heart as the core of our being still pervades our culture and consciousness. The recipients of heart transplants often describe powerful feelings of otherness, of feelings or memories that aren’t theirs. But according to one transplant surgeon, those memories never correspond with the actual identity of the donor.
Just a Head
The guillotine was invented in France as a more humane alternative to hanging. But critics protested that death by the falling blade was not actually instantaneous, that the severed heads could be seen to grimace and move in the basket. Nineteenth-century French scientists undertook a number of unsuccessful experiments to revive decapitated heads by injecting blood into the arteries.
Around the turn of the 20th century, one physician attending a execution in Paris observed that when he called the name of the man who had just been guillotined, the head in the basket opened its eyes and focused on his face. A few years later, organ-transplant pioneers Charles Guthrie and Alexis Carrel began to experiment with splicing extra heads onto dogs.
It is now known that the brain remains conscious for 10 or 12 seconds once its blood supply has been cut off, and final death doesn’t occur until six to 10 minutes have passed. The first head-attaching surgeries lasted too long, and the head retained only basic reflexive movements. Experiments in the Soviet Union in the 1950s, however, yielded two-headed dogs apparently with full brain function, although none of them lived longer than a month.
In 1971, American neurosurgeon Robert White successfully transplanted a head from one rhesus monkey to another. The monkeys didn’t live very long, but White says there’s no reason human heads couldn’t be transplanted as well. He thinks of it as a total body transplant. There have been actual people interested in the idea, but no one wants to go first.
Eat Me
Humans have a long history of using bits of other people’s bodies to enhance their own health. From tubs of blood (bathed in, to cure leprosy) to human flesh preserved for 100 years in honey (eaten, to heal wounds or broken bones), bits of the human body have been prescribed to cure practically every ailment.
Nor are these the least appealing treatments in a list that includes a phosphorescent extract of fecal matter and strips of dried human skin. Medicines made from mummies were so popular in the 1700s that apothecaries were making their own mummies by wrapping bodies in bandages and pitch, and drying them in ovens.
Nowadays, of course, life-saving medicines like insulin and other hormonal treatments are extracted from the bodies of animals, or synthetically made. Modern medicines differ from the nostrums of history not as much in concept as in effectiveness.
In some parts of the world, the human body is still considered to have powerful healing properties. Hospitals in China, for example, sell supplements made from aborted fetuses. If this sounds barbaric to you, consider that several Western pregnancy websites recommend eating the placenta to prevent postpartum depression. These websites offer recipes that incorporate placenta into pizza, lasagna and cocktails.
Is there a difference between eating nutritious pieces of plants and eating nutritious pieces of humans? Between accepting a heart transplant and accepting a piece of roasted heart?
Out of the Fire, Into the Compost Bin
A traditional Christian burial, with a casket and a cemetery plot and all those flowers, costs a lot. A variety of alternatives has been suggested over the years, but the only one that reached the mainstream was incineration. Cremation has become more and more common since 1963, the year that both the Catholic ban on burning bodies was lifted and Jessica Mitford’s exposé of the funeral business, The American Way of Death, was published.
Other, less popular proposals for skipping the lavish burial and putting people to use after they die have included making leather out of human skin, burning human fat in lamps, and chopping up and drying bodies to use a fertilizer.
The lack of dignity in these processes was probably their deathknell, but the idea of making compost from human remains is still around. A Swedish company called Promessa is promoting a process it calls an “ecological funeral,” which involves freezing a body, shattering it, and freeze-drying it. The result material is rich in nutrients and perfect for planting a memorial tree or shrub in. (The ash that results from cremation, on the other hand, has very little value as plant food.)
Promessa’s motivation is mainly environmental. Cremation is an energy-intensive process, and concerns have also been raised about the vaporized mercury from tooth fillings. Promessa’s founders want to provide people with the opportunity to truly give themselves back to earth.
Remains of the Author
It’s no longer possible to become the classic brain on display in a jar or a morbidly elegant skeleton in a classroom. At the Harvard Brain Bank, for example, brains are sliced and frozen in plastic tubs, and bone-research facilities keep their bones unconnected to each other.
The University of Michigan Medical School does have a plastination lab, where bodies are permanently preserved through a process that replaces water with a silicone polymer. Traveling museum exhibits have been made from plastinated bodies.
If you donate your body to science, you don’t have a say in whether you end up in an anatomy class or in the driver’s seat of a simulated car crash. But should you even get to decide whether to donate your body in the first place? Your family members are the ones dealing with the whole situation, and if it would add to their distress to think anatomy students are poking around in your insides, do you have the right to force that choice on them?
Roach has decided that she’ll let her family make the choice after she’s gone, with one stipulation: If her organs are in good shape, someone else should have them. If she’s the donor for a heart transplant, we can only hope that memory transfer truly is a myth, and that the recipient won’t wake up with unexpected memories of a lot of cadavers.
About the author
Mary Roach’s articles have been published in Wired, National Geographic, and The New York Times Magazine. Her bestselling books include Bonk: The Curious Coupling of Science and Sex and Grunt: The Curious Science of Humans at War. She lives in San Francisco and enjoys late-night TV shows about parasitic worms and other unpleasant creatures.
Mary Roach is the author of five best-selling works of nonfiction, including Grunt, Stiff, and, most recently, Fuzz. Her writing has appeared in National Geographic and the New York Times Magazine, among other publications. She lives in Oakland, California.
Genres
Biology, Medicine, Forensic Medicine, Sociology of Death, Anatomy, Science, Humor, Medical, History, Adult
Table of Contents
Introduction 9
1 A Head is a Terrible Thing to Waste 19
Practicing surgery on the dead
2 Crimes of Anatomy 37
Body snatching and other sordid tales from the dawn of human dissection
3 Life After Death 61
On human decay and what can be done about it
4 Dead Man Driving 87
Human crash test dummies and the ghastly, necessary science of impact tolerance
5 Beyond the Black Box 113
When the bodies of the passengers must tell the story of a crash
6 The Cadaver Who Joined the Army 131
The sticky ethics of bullets and bombs
7 Holy Cadaver 157
The crucifixion experiments
8 How to Know If You’re Dead 167
Beating-heart cadavers, live burial, and the scientific search for the soul
9 Just a Head 199
Decapitation, reanimation, and the human head transplant
10 Eat Me 221
Medicinal cannibalism and the case of the human dumplings
11 Out of the Fire, into the Compost Bin 251
And other new ways to end up
12 Remains of the Author 281
Will she or won’t she?
Epilogue 293
Acknowledgments 301
Bibliography 303
Overview
Beloved, best-selling science writer Mary Roach’s “acutely entertaining, morbidly fascinating” (Susan Adams, Forbes) classic, now with a new epilogue.
For two thousand years, cadavers – some willingly, some unwittingly – have been involved in science’s boldest strides and weirdest undertakings. They’ve tested France’s first guillotines, ridden the NASA Space Shuttle, been crucified in a Parisian laboratory to test the authenticity of the Shroud of Turin, and helped solve the mystery of TWA Flight 800. For every new surgical procedure, from heart transplants to gender confirmation surgery, cadavers have helped make history in their quiet way. “Delightful—though never disrespectful” (Les Simpson, Time Out New York), Stiff investigates the strange lives of our bodies postmortem and answers the question: What should we do after we die?
Stiff is an oddly compelling, often hilarious exploration of the strange lives of our bodies postmortem. For two thousand years, cadavers―some willingly, some unwittingly―have been involved in science’s boldest strides and weirdest undertakings. In this fascinating account, Mary Roach visits the good deeds of cadavers over the centuries and tells the engrossing story of our bodies when we are no longer with them.
Review/Endorsements/Praise/Award
“One of the funniest and most unusual books of the year….Gross, educational, and unexpectedly sidesplitting.”―Entertainment Weekly
“This quirky, funny read offers perspective and insight about life, death and the medical profession…. You can close this book with an appreciation of the miracle that the human body really is.” ― Tara Parker-Pope, Wall Street Journal
“A laugh-out-loud funny book… one of those wonderful books that offers up enlightenment in the guise of entertainment.” ― Michael Little, Washington City Paper
“As weird as the book gets, Roach manages to convey a sense of respect and appreciation for her subjects.” ― Roy Rivenburg, Los Angeles Times
“Roach is authoritative, endlessly curious and drolly funny. Her research is scrupulous and winningly presented.” ― Adam Woog, Seattle Times
“Mary Roach is one of an endangered species: a science writer with a sense of humor. She is able to make macabre funny without looting death of its dignity.” ― Brian Richard Boylan, Denver Post
“Roach writes in an insouciant style and displays her métier in tangents about bizarre incidents in pathological history. Death may have the last laugh, but, in the meantime, Roach finds merriment in the macabre.” ― Gilbert Taylor, Booklist
“Acutely entertaining, morbidly fascinating.” ― Susan Adams, Forbes
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Read an Excerpt/PDF Preview
From the chapter “A Head is a Terrible Thing to Waste,” about plastic-surgery instruction on cadavers:
The human head is of the same approximate size and weight as a roaster chicken. I have never before had the occasion to make the comparison, for never before today have I seen a head in a roasting pan. But here are forty of them, one per pan, resting face-up on what looks to be a small pet-food bowl. The heads are for plastic surgeons, two per head, to practice on…. “Isolate the brow as a skin island.” The [instructor] speaks slowly, in a flat tone. I’m sure the idea is to sound neither excited and delighted at the prospect of isolating skin islands, nor overly dismayed. The net effect is that he sounds chemically sedated, which seems to me like a good idea.
From the chapter “Life After Death,” about forensics and embalming:
Out behind the University of Tennessee Medical center is a lovely, forested grove with squirrels leaping in the branches of hickory trees and birds calling and patches of green grass where people lie on their backs in the sun, or sometimes in the shade, depending on where the researchers put them.
This pleasant Knoxville hillside is a field research facility, the only one in the world dedicated to the study of human decay. The people lying in the sun are dead…
An eye cap is a simple ten-cent piece of plastic. It is slightly larger than a contact lens, less flexible, and considerably less comfortable. The plastic is repeatedly lanced through, so that small, sharp spurs stick up from its surface. The spurs work on the same principle as those steel spikes that threaten Severe Tire Damage on behalf of rental car companies: The eyelid will come down over an eye cap, but, once closed, will not easily open back up. Eye caps were invented by a mortician to help dead people keep their eyes shut. There have been times this morning when I wished that someone had outfitted me with a pair of eye caps. I’ve been standing around, eyelids up, in the basement embalming room of the San Francisco College of Mortuary Science.
From the chapter “Dead Man Driving,” about human crash-test dummies:
By and large, the dead aren’t very talented. They can’t play water polo, or lace up their boots, or maximize market share. They can’t tell a joke, and they can’t dance for beans. There is one thing dead people excel at. They’re very good at handling pain. For instance, UM 006. UM 006 is a cadaver who recently journeyed across Detroit from the University of Michigan to the bioengineering lab at Wayne State University. His job, which he will undertake at approximately 7 p.m. tonight, is to be hit in the shoulder with a linear impactor.
From the chapter “How to Know If You’re Dead,” about beating-heart cadavers and the scientific search for the soul:
A patient on the way to surgery travels at twice the speed of a patient on the way to the morgue. Gurneys that ferry the living through hospital corridors move forward in an aura of purpose and push, flanked by caregivers with long strides and set faces, steadying IVs, pumping ambu bags, barreling into double doors. A gurney with a cadaver commands no urgency. It is wheeled by a single person, calmly and with little notice, like a shopping cart.
For this reason, I thought I would be able to tell when the dead woman was wheeled past…
H. is unique in that she is both a dead person and a patient on the way to surgery. She is what’s known as a “beating-heart cadaver,” alive and well everywhere but her brain.
