Say It Ain't So, Bjorn LThe rotten world of professional tennis,by Michael Mewshaw.

Rest in PiecesLots of folks want your ood~

(after you're done with it).

The High Art of Movie CreditsFinding the drama in the tiny type.

Can Sociobiology Be Saved?The latest thinking about genes and culture.

Two cures for the economy: "Public policy" versus

r·-~--····- " u -, .~,~, I"The Sensational

.JD?$Q,l.i\ No.J.!)NIN~t~r Jonathan Penner.

. S4*90 "o~ N01~NrNN3a

30 L?A~~ f1~H '£LOqOOON N81 r~£O~L

70

place the time-honored, undirected,and relatively ineffectual indoctri-nation system that has always beenpracticed by families, schools, peergroups, governments, and the media?

In reality, any Edenic (Lumsdenand Wilson) or Gothic (Marxist)scenarios pitting the forces of dark-ness and light against each other arescience fiction of the dreariest kind.Even if rigorous sociobiologists canestablish indisputable connectionsbetween our genetic and culturalheritages (which we earnestly hopethey will labor to do, for the sake ofknowledge and intellectual free-dom), how much power will theyhave? Wasn't Swift, in his A ModestProposal, working almost as effec-tively as any sociobiologist couldon our genetically programmed, cul-turally reinforced sense of right,wrong, and disgust? Propaganda hasalways played more or less effective-lyon just those deeply ingrainedfeelings of group superiority, dis-trust of strangers, and terror of theunknown that sociobiology posits.

Sociobiology is rapidly unravelingmany of the mysteries of animal so-cieties. In doing so, it will give usinvaluable insights into' why we hu-mans organize ourselves as we do,act as we do, perhaps even thinkas we do. To the extent that thissort of armchair speculation, bol-stered by anthropological anecdoteand mathematical calculation ofprobabilities, can encourage newways of looking at our own evolu-tion and the genetic constraints onour behavior, Lumsden and Wilsonhave done a service in making theirtheories accessible to the thinkingpublic in Promethean Fire.

But in prop'osing any sort of eugen-ic fallout from sociobiology, they areopening themselves to the same hys-terical criticism from Marxists, cre-ationists, and other anthropocentricsthat almost overwhelmed Wilson'soriginal formulation of his bravenew synthesis. It is a sad truth thatuntil scientists are able to presenttheir ideas clearly to well-educatedand receptive minds, valuable the-ories like sociobiology will inevi-tably fall prey to our disproportion-ate fears and feed our unrealistichopes. •

HARPER'S/ JUNE 1983

Rest jn Piecesby David OwenLife was a feast. Now, how to dispose of the leftovers?

Y WIFE recently told meshe intends to donateher body to science. 1found the proposition

ghoulish, even though it would re-lieve me (I intend to survive her) ofthe expense of disposal. 1 said that1 was determined to have a moretraditional send-off: a waterproof,silk-lined, air-conditioned casketpriced in the sports car range, sev-eral acres of freshly cut flowers, aprocession of aggrieved schoolchil-dren winding slowly through somepublic square, a tape-recorded com-pilation of my final reflections, and,local ordinances permitting, an eter-nal flame. But after a bit of re- "search, 1 have come around to herpoint of view.

Two powerful human emotions-c-the fear of death and the love ofbargains-inexorably conflict in anyserious consideration of what to dowith an expired loved one, all themore so if the loved one is oneself.Most people secretly believe that

thinking about death is the singlesurest method of shortening life ex-pectancy.

On the other hand, the appealof the bargain intensifies when athird (though essentially unheard-of) emotion-the desire to do goodfor its own sake-is injected intothe discussion. If, after one is en-tirely through with it, one's bodycan be put to some humane or sci-entific use, enabling life to be pre-served or knowledge to be advanced,can one in good conscience refuse?And yet, the mortal coil recoils.

o freezing in the winter. 'No scorching in the sum-mer." Such are the ad-vantages of booking space

in an aboveground burial condo-minium, according to a flyer I re-ceived not long ago. Printed acrossthe bottom of the page was this dis-claimer: "We sincerely regret if thisletter should reach any home where

there is illness or sorrow, as thiscertainly was not intended." In oth-er words, if this information has ar-rived at one of the rare moments inyour life when it would actually beof immediate use, please ignore it.

That the funeral business is filledwith smoothies, crooks, and canmen has been well known since atleast 1963, when Jessica Mitfordpublished her classic expose, TheAmerican Way of Death. Mitford'sbook is required reading for allmortals. Fit-A-Fut and Ko-Zee, sherevealed, were the trade names oftwo styles of "burial footwear," thelatter model described by its manu-facturer as having "soft, cushionedsales and warm, luxurious slippercomfort, but true shoe smartness."The same company also sold specialpostmortem "pantees" and "ves-tees," enabling funeral directors togouge a few extra dollars out of anyfamily that could be dissuaded fromburying a loved one in her own un-derwear.

Twenty years later, the death in-dustry is unchanged in almost ev-ery particular except cost. Mitfordfound that the average funeral bill,according to industry figures, was$708. When I visited a local mor-tuary to price a simple burial fora fictitious ailing aunt, the directorrattled off a list of probable chargesthat added up to more than $5,000,flowers and cemetery plot extra. Hisestimate included $110 for haulingher body two blocks to his estab-lishment and $80 for carrying itback out to the curb. Pallbearing isa union job in New York City; fam-ily members can't lay a hand on acoffin without getting a waiver fromthe local. ("If they drop the casket,pal," a Teamsters spokesman toldme, "you're gonna be in trouble.")Hairdresser, $35. Allowing "Aunt-ie" (as he once referred to her) torepose in his "chapel" for one day-something he told me was man-datory, despite the fact that I saidI didn't 'want a memorial serviceand that no relatives would bedropping by-would be $400.

The largest single charge we dis-cussed was for the casket. He usedthe word "minimum" as an adjec-tive to des.cribe virtually any model

I expressed an interest in that costless than $1,500. The single woodencoffin in his showroom was "very"minimum ($1,100). The whole ge-nius of the funeral business is inmaking you believe you're buying arefrigerator or a sofa or even a carinstead of a box that will be low-ered into the ground and coveredwith dirt. Since there are no realcriteria, other than price, for pre-ferring one such box to another,you end up doing things like stick-ing your hands inside a few modelsand choosing the one with the firm-est bedsprings. "Women seem tolike the color coordination," myCharon said in reference to a 20-gauge steel model (I think it wascalled the Brittany) with a baby-blue interior. Since the women hewas talking about are dead, thatword "seem" is positively eerie.

Cremation is becoming a fairlypopular choice among people whothink of themselves as smart shop-pers. The funeral industry has re-sponded to this trend by subtlydiscouraging its customers fromconsidering cremation and by mak-ing sure that cremation is verynearly as expensive as burial in abox. A pamphlet called "Consid-erations Concerning Cremation,"published by the National FuneralDirectors Association, Inc., and dis-tributed by morticians, pretends tobe evenhanded but is actually in-tended to horrify its readers. "Oper-ating at an extremely high tempera-ture [a cremation oven] reduces thebody to a few pounds of bone frag-ments and ashes in less than twohours. . . . Most of the crematedremains are then placed in an urnor canister and carefully identified."This last sentence is the funeral di-rector's equivalent of "Most new-born babies are then sent homewith their proper mothers." Earthburial, in contrast, is "a gradual pro-cess of reduction to basic elements."

If the funeral business dislikescremation, it positively abhors thedonation of bodies to medicalschools, because in such cases theopportunities for profiteering aredramatically reduced-though not,to be sure, eliminated. There is vir-tually nothing you can do, short of

71

being disintegrated by Martians inthe middle of the ocean, to keep afuneral director from claiming apiece of the action when you die.Once again, a pamphlet tells thestory: " ... essential to avoid thepossibility of disappointment . . .more bodies available than themaximum required . . . rejection ispermitted by state law ... you canexpect your funeral director to beof assistance .... "

One almost wishes one could dietomorrow, the sooner to savor thepleasure of taking one's businesselsewhere.

RNEST W. APRIL, associateprofessor of anatomy at Co-lumbia University's Collegeof Physicians & Surgeons,

is the man in charge of superin-tending Columbia's supply of cadav-ers. Dr. April shares his office withRufus, a huge red dog who wan-dered into his yard one day anddoesn't like to be left alone. Alsoin Dr. April's office are some skulls,an old-fashioned radio, a humanskeleton, a spine, a paperback bookwith a picture of a skull on it, somemore skulls, a few microscopes,some big bones on a shelf, and asmall plastic bone on the floor (forRufus) ..

"Most medical students look for-ward to receiving their cadaver,"Dr. April told me. "Once they havetheir cadaver they are, from theirpoint of view, in medical school.It's something tangible. There's an-ticipation, trepidation. In the firstlaboratory exercise, the studentsbasically come up and meet the ca-daver, almost as if it were a pa-tient."

As at all medical schools, Colum-bia's cadavers are donated. Pro-spective benefactors eighteen yearsof age and older fill out anatomicalbequeathal forms and return themto the university. Hours, days,weeks, months, or years pass."When the Time Comes," as onebrochure puts it, the donor's survi-vors call the medical school's de-partment of anatomy. "Within thegreater metropolitan area," the bro-chure says, "arrangements for re-

HARPER'S! JUNE 1983

72

moval of the body can be made bythe medical college. Alternatively,the family may engage a local fu-neral director to deliver the unem-balmed body to the medical collegeat the address on the cover." Medi-cal schools almost always require un-embalmed bodies because ordinarycosmetic embalming, the kind soldat funeral homes, turns skin to theconsistency of old shoes and doesn'thold orr deterioration for more thana few days. Medical school embalm-ing, on the other hand, is designed

Do Not Read This!Inscribed on a wall at the Office

of the Chief Medical Examiner ofNew York, better known as themorgue, are the words TACEANTCOLLOQUIA EFFUGIAT RISiJS HIC LOCUSEST URI MORS GAUDET SUCCERERE .VITA. I make this out as, "If you haveany sense at all, you won't go down-stairs and look at the bodies." Butmy Latin is weak and my curiosityis strong and I went down anyway.I peered into an autopsy room througha tiny window in the door and cameto the conclusion that death is acondition suffered by many youngblack men, a few old white men, andno women 'at all. After I had seenmuch more than enough, my guidetook me upstairs to the true object ofmy visit: Room 601, the morguemuseum. In planning the disposal ofyour body, don't overlook this little-known option.

The morgue museum is not one ofNew York's better-known attractions.Indeed, it is usually open only tomedical. students, police academycadets, and other aspirants to profes-sions that require a solid groundingin morbidity. I was just a humbletourist, but they let me in anyway.

The morgue museum is theHelmsley Palace of final resting places,an elite repository of the bizarrewhose requirements for admission arestrict but exactly opposite to thoseof the anatomical donation programs.If you leave a pretty corpse, you don'tstand a chance of ending up here.But if you play your cards right-orWrong, I suppose-some extremelyinteresting part of you could con-ceivably be immortalized in an insti-tution that, though it isn't the Louvre,is at any rate the most creative waste

HARPER'S/ JUNE 1983

for the ages. "We've had some spec-imens that we've kept for over twen-ty years," one professor told me."It's almost like the Egyptians."

Donated cadavers are stored ina refrigerated room until they'reneeded. Columbia has about 200students in each class. The idealstudent-cadaver ratio is four to one(which means "every two people getone of everything there's two of," amedical student explains). Contraryto what the funeral directors imply,Columbia, like many schools, has

of taxpayers' money I've ever en-countered. The museum's collectionis not quite up to date, modern lifebeing what it is, and families beinghesitant to put their loved ones ondisplay. But there is still plenty tolook at, including:

A scorched bathtub in which agreat many people were incineratedby someone; empty cans of inflam-mable liquids: a helpful displayidentifying several hundred charredbone fragments belonging to thevictims.

The blocked esophagus of a youngboy who defeated his brother in acontest to see which of them couldswallow the largest unchewed pieceof meat.

A number of broken safety har-nesses worn by window washers whofell to their deaths.

The fetus of a cyclops with sixfingers on each hand and six toes oneach foot.

Part of the skull of someone whocommitted suicide by stabbing himselfin the head with 'a pair of scissors;the entry wound is clearly visible,along with evidence of several half-hearted attempts; the scissors.

Some tattoos, in a jar.The private portions of sex-crime

victims.A pillow through which bullets

were fired in the murder of someone:A barbell that fell from an eighth-

floor apartment window onto apedestrian's head, killing him.

A photograph of a man who diedafter sitting on a broken drinkingglass; the glass he sat on, still stainedwith blood.

A bra and girdle worn by a trans-vestite suicide at the time of his death.

fewer bodies than it would like andso must assign five students to each.Ratios as high as eight to one arenot unheard of. If the donor con-sents beforehand, a cadaver be-queathed to one institution may betransferred to another with greaterneed. New Jersey, for some reason,attracts almost as many cadavers asit does medical students and occa-sionally ships extras to New York.(That's extra cadavers, not extramedical students.) People who don'tlike the idea of being dissected by

An eight-pound heart that belongedto a man who used to complain ofchest pains.

A scalp.The false eyelashes of a dead

transvestite; the curling iron usedto groom them.

A postcard-sized color photographof a fifty-eight-year-old Filipino manwho had an enormous, deformed,parasitic human fetus growing out ofhis back; he refused an operation toremove it.

Various mummified infants.An incomprehensible b~t apparently

ribald cartoon about the autopsy ofa beautiful young woman.

. The silicone inserts of a dead trans-sexual.

The face of an .air-crash victim,literally blown off in the explosion.

A book belonging to an air-crashvictim, with the victim's nose boneembedded in it.

A piece of skin with shark bites011 it.

A sign (not an exhibit) promotingthe sale of a book called Where DeathDelights ($12.50).

Some charred fingertips.A window gate attached to a

700-voit transformer, used by an apart-ment dweller to protect his domain;the shoe of a burglar who tried toenter the window, was electrocuted,and hung upside down in the building'sair shaft for several hours un til hewas discovered; photographs fromhis autopsy.

A large photograph of a dead manslumped on a bed with a bullet woundin his head. On a windowsill abovethe bed isa sign that says, "STOPWORRYING You'll Never Get Out ofThis World Alive." D. O.

students at all can specify on theirbequeathal forms that their bodiesare to be used only for research.

"If a person donates his remainsfor biomedical education and re-search," Dr. April says, "there's amoral obligation on our part to uti-lize the body on this premises if atall possible, and only for that pur-pose. The only exception is thatwe occasionally do make materialthat has been dissected available toart students because, going back tothe time of Leonardo da Vinci,Raphael, Titian, and Michelangelo,artists have had a real need to knowand understand anatomy." Sub-scribers to public television, amongothers, should find this prospect ir-resistible: a chance to benefit sci-ence and the arts.

When Columbia's anatomycourses end, the cadavers are indi-vidually cremated and buried in acemetery plot the university owns.All of this is done at the univer-sity's expense. (In comparison withfuneral home rates, the cost of pick-ing up, embalming, storing, cremat-ing, and burying each cadaver isestimated by medical school officialsat about $400.) If the family de-sires, the uncremated remains canbe returned at the end of the course,as long as the family asks before-hand and agrees to cover any ex-tra costs.

NEARLYall medical schoolsoperate donation pro-grams much like Colum-bia's. All you have to do

is call up the anatomy departmentat the nearest medical school andask what the procedure is. A groupcalled the Associated MedicalSchools of New York, based atManhattan's Bellevue Hospital,oversees donations to a dozen orso institutions around the state, in-cluding the New York College ofPodiatric Medicine and the NewYork University School of Dentist-ry. You might think that a podi-atry school and a dental schoolcould happily share cadavers, butno school will take less than a wholebody.

I sent away for donation informa-

tion from dozens of medical schoolsand state anatomical boards. Study-ing the resulting avalanche of bro-chures has given me more than aweek of intense reading pleasure,making me feel at times like ayoung girl poring over brides' mag-azines in hopes of discovering theperfect honeymoon. Comparison-shopping for a place to send one'scorpse, like all consumer activities,quickly becomes a joy independentof its actual object. There are manyfactors to consider.

For example, I knew an elderlyman who pledged his body to Har-vard. When he died last year, hiswife contacted a local funeral hometo make the arrangements and wastold that it would cost about $1,000above and beyond the standard feepaid by Harvard. When the widowproperly balked (all they had to dowas drive the corpse fifty miles), themortician supplied an eight-page let-ter justifying his charge. Among oth-er problems, .he wrote, was "thepossibility that a body may be re-jected by the Medical School." Thisconjures up unwanted images of ad-missions committees, and obliquelysuggests that if my friend had aimeda little lower in the first place, theproblem might never have arisen.

Medical schools do reserve theright not to honor pledges. Allschools turn down bodies that havebeen severely burned, for obviousreasons. Other requirements vary.Pennsylvania rejects bodies that are"recently operated on, autopsied, de-composed, obese, emaciated, ampu-tated, infectious, mutilated or other-wise unfit." Contagious diseases areparticularly worrisome; anatomistskeep a careful watch for Jakob-Creutzfeldt disease, a slow-actingvirus that kills not only the occa-sional medical student but also can-nibals who dine on the brains oftheir victims. All schools, as far asI can tell, accept bodies from whichthe eyes and thin strips of skin havebeen removed for transplantation.Removal of major organs, however,is almost always unacceptable, whichmeans that organ donors (see be-low) generally can't also be cadaverdonors. The state of Pennsylvaniais more lenient in this regard. Most

73

other schools want their cadaversintact, although the University ofKansas will accept bodies fromwhich no more than "one extremityhas been amputated."

Stanford's brochure is full of highsentence and King Jamesian reso-nances, the sort of prose selectivecolleges use to dishearten the hoipolloi. One section lists five groundsfor rejection, each beginning withthe phrase "The Division of Hu-man Anatomy will not accept ... "One thing the Division of HumanAnatomy. will not stand for is "thebody of a person who died duringmajor surgery," which sounds likethe medical equivalent of refusingto cross a picket line. The sectionconcludes, "In summary, the Divi-sion of Human Anatomy reservesthe right to refuse any body whichis, in the opinion of the Division,unfit for its use."

C'HANCES are, you have along and healthy life tolive. But a lot of otherpeople don't. ... " This

strangely comforting thought comesfrom a pamphlet called "The Giftof Life," published by a Clevelandoutfit called Organ Recovery, Inc.Since there's usually no way to tellwhether your organs or your wholebody will be more useful until Whenthe Time Comes, the wisest courseis to promise everything to every-one and leave it to the experts tosort things out later.

Organ donation has been givena lot of publicity in recent years.Drivers' licenses in most states nowhave tiny organ-pledge forms on theback. These forms don't have muchlegal meaning. At New York's Co-lumbia Presbyterian Hospital, forinstance, no one will remove an or-gan (or cart away a cadaver to amedical school) unless the next ofkin give their consent. You coulddie with an organ-donor card inevery pocket, and another onepasted on your forehead, and stillno one would touch you if yourcurrent or separated but not di-vorced spouse, son or daughtertwenty-one years of age or older,parent, brother or sister twenty-

HARPER'S/ JUNE 1983

74

one years of age or older, or guar-dian, in that order, said no. PrinceCharles carries a donor card; butif he dropped dead (God save theKing) at Presbyterian, someonewould have to get permission fromLady Di before removing anything.If you want to be an organ donor,carrying a card is much less impor-tant than making sure your relativesknow your wishes.

No matter how thorough you areabout clearing the way, however,the chances are slim that your heart,liver, kidneys, or lungs will ever betransplanted into somebody else.Only about one percent of all thepeople who die are potential kidneydonors, for instance, and kidneysare actually removed from onlyone in five of these. The reason isthat a suitable organ donor is thatrarest of individuals, a person inmarvelous health who is also, some-how, dead. Major organs for trans-plantation have to be removed whilethe donors' hearts are still beating,which means that all major-organdonors are brain-dead hospital pa-tients on artificial respiration. Theideal donor is a young man who hasplayed a game of basketball, run afew miles, and then had a safedropped on his head.

John M. Kiernan, organ recoverycoordinator at Columbia Presbyteri-an, explains that Karen Ann Quinlanis not a potential organ donor, be-cause she is not dead. She is breath-ing by herself and there is activityin her brain. Every organ donormust be pronounced utterly andirretrievably deceased by two sep-arate physicians who will not beinvolved in the ultimate transplan-tation. They are not goners; theyare gone. This requirement is meantto reassure people who fear thatsigning organ-donor cards is therough equivalent of putting out Ma-fia contracts on their own lives. Iused to share these fears; now theystrike me as silly.

The bookshelves in Kiernan's of-fice hold volumes with titles likeBrain Death: A New Concept orNew Criteria? Nearby are a few testtubes filled with darkish blood. Be-hind his door is a big blue-and-white picnic cooler that he uses to

HARPER'S/ JUNE 1983

carry transplantable organs fromdonors to recipients. Big blue-and-white picnic coolers seem to be theindustry standard for moving or-gans, whether across town or acrossthe country. In a cover story onliver transplants last year, Life mag-azine published a picture of a manhoisting a cooler called a PlaymatePlus into the back of a station wag-on. The cooler contained a liverpacked in ice.

If your major organs don't makeit (because, say, you've lived along time and faded away slowly inthe comfort of your own bed),there's still hope for lesser service.Almost anyone can give skin, eyes,bone, often without hurting one'schances of getting into medicalschool. Small strips of skin (whoseremoval does not disfigure a cadav-er) arc used to make dressings forburn victims. These dressings helpkeep many people alive who mightdie without them. Several parts ofthe eye can be transplanted. Thereare perhaps 50,000 people nowblind who would be able to see ifenough of us followed the exampleof Henry Fonda and Arthur God-frey and donated our corneas. Bonetransplants eliminate the need foramputation in many cancer cases.The National Temporal Bone BanksProgram of the Deafness ResearchFoundation collects tiny inner-earbones and uses them in medicalresearch.

None of these programs will saveyou burial costs the way donatingyour whole body will. Nor can youreceive money for giving all or partof yourself away. Paying for bodiesis widely held to be unseemly andis, in fact, against the law. On theother hand, physicians do not to myknowledge refuse payment for per-forming transplant operations. May-be the law ought to be rewritten toinclude a little sweetener for thepeople who make the operationspossible. On still another hand, thelast thing Washington needs rightnow is a lobby for dead people, whoonly vote in Texas and Chicago asit is.

To find out more about theseprograms you can either ask yourdoctor or write to an organization

called The Living Bank, P.O. Box6725, Houston, Texas 77265. TheLiving Bank is a clearinghouse fororgan and whole-body donation, co-ordinating anatomical gifts all overthe country.

MAKING intelligent con-sumer choices usuallyentails trying out themerchandise. In this

case, a test drive is out of the ques-tion. But since I had never so muchas clapped eyes on an actual deadperson before, I asked Columbia'sErnest April if he would give me atour of his anatomy classroom. Heagreed somewhat reluctantly, thenled me down precisely the sort ofstairway you would expect to be leddown on your way to a room fullof bodies. The classroom, by con-trast, was cool and airy and had ahigh-priced view of the HudsonRiver. Blue walls, green floor,bright lights, a big blackboard, alighted panel for displaying X rays,videotape monitors hanging fromthe ceiling, lots of enormous sinksfor washing up.

Also, of course, the bodies. Thereseemed to be about thirty of them,each one lying on a metal table andcovered with a bright yellow plas-tic sheet. The only noticeable odorin the room was the odor of newplastic, familiar to anyone who hassmelled a beach ball. Since thecourse was drawing to an end, theshapes beneath the sheets were dis-concertingly smaller than expected:as dissection progresses, studentstag the parts they're finished withand store them elsewhere. To dem-onstrate, Dr. April pulled backthe yellow sheet on the table near-est us, causing a momentary cessa-tion of my heartbeat and revealingthe top of a skull, a set of dentures,a long striated purplish thing, someother things, I'm not sure what else.But no arm, the object of his search.Far across the room, a few studentswere huddled over a dark form thatsuggested nothing so much as theweek after Thanksgiving. My ini-tial queasiness subsided and, witha sort of overcompensating enthu-siasm, I asked if I could bound

across the room for a closer look.Dr. April gently persuaded me tostay put. "This is late in the course,"he said softly. "It's not particularlypleasant."

Unpleasant, yes; but is it disgust-ing or unbearable? Many people saythey can't stand the thought of be-ing dissected; much better, they say,to be fussed over by a funeral direc-tor and eased into a concrete vault,there to slumber intact until awak-ened by choirs of angels. But deathis death, and every body, whetherlying on a dissection table, bakingin a crematorium, or "reposing" ina $10,000 casket, undergoes a trans-formation that doesn't lend itself tohappy contemplation. In terms ofsheer physical preservation, a medi-cal school cadaver is vastly moreenduring than the recipient of eventhe costliest ministrations of a fu-neral director. No casket ever pre-vented anyone from following theroad that Robert Graves describedin Goodbye to All That: "Thecolour of the faces changed fromwhite to yellow-grey, to red, to pur-ple, to green, to black, to slimy."The transformation takes hours,days.

Morticians sew corpses' lips to-gether, bringing the needle outthrough a nostril. Lips are pinned togums. Eyes are covered with plas-tic patches, then cemented shut.Orifices are plugged. To preventloved ones from belching, howling,or worse as the accumulating gasesof deterioration escape through anyand all available exits, funeral homeemployees press hard on the ab-domen immediately before and af-ter family "viewings." Makeup isslathered on. Abdomens are drained.Leaks are patched. Unsightly lumpsand bulges are trimmed away.

The trouble with death is that allthe alternatives are bleak. It isn'treally dissection that appalls; it'smortality: It may be gross to be dis-sected, but it's no less gross to beburned or buried. There just isn'tanything you can do to make beingdead seem pleasant and appealing.And barring some great medicalbreakthrough involving interferon,every single one of us is going todie. We should all swallow hard

and face the facts and do what'sbest for the people who will followus.

Which is why you would thinkthat doctors, who spend their entirelives swallowing hard and facingfacts, would be the eagerest ana-tomical donors of all. But they arenot. Of all the people I interviewedfor this article-including severalheads of anatomical donation pro-grams, a number of medical stu-dents, physicians, even the chiefmedical examiner of New York-only one of them, Ernest W. April,had pledged any part of his bodyto scientific study or transplanta-tion. And April is a Ph.D., not anM.D. "I don't know of any medicalstudent who is going to give his :body," a medical student told me.

Do DOCTORS know some-thing? Does it, maybe,hurt? Of course not. Everyprofession lives in secret

horror of its own methods. Most re-porters I know can't stand the ideaof being interviewed. But societywould crumble if we weren't occa-sionally better than those who be-lieve themselves to be our betters.

Morbid humor at their expenseis one thing future cadavers worryabout. Medical schools are aware ofthis and take great pains to keepjokes to a minimum. Still, a certainamount of horsing around is inevi-table. Michael Meyers, the man whoplayed Ali McGraw's brother inGoodbye, Columbus and went onto become a physician, describedsome dissection hijinks in a bookcalled Goodbye Columbus, HelloMedicine. "By the second week ofgross anatomy," Meyers wrote, "itwas interesting to notice whichmembers of the class really rolledup their sleeves and dug in (no punintended-although one group ofstudents did nickname their cadav-er 'Ernest,' so they could alwayssay that they were 'digging in Er-nest') ... " and so on and so on.This is a level of comedy that I donot, to be perfectly frank, find in-timidating. And a cadaver donorwho wanted to have the last laughcould arrange to have an obscene

75

or hilarious message ("SocializedMedicine"?) tattooed across hischest. Beat them to the punchline.Humorous tattoos don't seem to begrounds for rejection, even at Stan-ford.

As for dissection itself, it's aboutwhat you would expect. "You workthrough the text," says a youngwoman just beginning her residency,"and by Halloween you've gottento the hands. Well, we had a girl inour group who wanted to be a sur-geon, and she did the most amazingthing. She dissected off the skin inone piece. It was like a glove. Itwas beautiful. And then there wasmine. It looked like someone hadbeen cracking walnuts. Little flecks,you know? And then this graduatestudent comes up and says, 'Haveyou found the recurrent branch ofthe medial nerve?' And I start look-ing through my pile ... "

A first dissection, like a sexualinitiation, is likely to be a botchedjob: long on theory and good in-tentions, short on practical know-how. Results improve with practice,but early impressions linger. Nowonder medical students don't likethe idea of being dissected. Formany of them, anatomy class istheir first real experience of death.Maybe it's a good thing if physiciansdevelop, right from the beginning,an overpowering abhorrence of ca-davers. We are all better served ifour physicians devote their energiesto keeping us from turning into thethings they hated to dissect in med-ical school. Anatomy classes, in asense, trick grade-grubbing pre-meds into developing somethinglike a reverence for human life.

Donating one's body is an act ofcourage, but it's not a martyrdom.Medical students may not imme-diately comprehend the magnitudeof the gift, but so what? I confess Isort of like the idea of one dayinhabiting the nightmares of someas yet (I hope) unborn medical stu-dent. And if my contribution meansthat my neighborhood morticianwill go to bed hungry, shuffling offto his drafty garret in the Fit-A-Futcoffin shoes I decided not to buy,then so much the better. Dying wellis the best revenge. •

HARPER'S! JUNE 1983